Ivers, Rebecca; Clapham, Kathleen; Senserrick, Teresa; Lyford, Marilyn; Stevenson, Mark
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. Addressing the complex range of injury problems in disadvantaged Indigenous communities requires considerable work in building or enhancing existing capacity of communities to address local safety issues. 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.
Pollard, Christina M; Nyaradi, Anett; Lester, Matthew; Sauer, Kay
Food insecurity in remote Western Australian (WA) Indigenous communities. This study explored remote community store managers' views on issues related to improving food security in order to inform health policy. A census of all remote WA Indigenous community store managers was conducted in 2010. Telephone interviews sought managers' perceptions of community food insecurity, problems with their store, and potential policy options for improving the supply, accessibility, affordability and consumption of nutritious foods. Descriptive analyses were conducted using SPSS for Windows version 17.0. Managers stated that freight costs and irregular deliveries contributed to high prices and a limited range of foods. Poor store infrastructure, compromised cold chain logistics, and commonly occurring power outages affected food quality. Half of the managers said there was hunger in their community because people did not have enough money to buy food. The role of nutritionists beyond a clinical and educational role was not understood. Food security interventions in remote communities need to take into consideration issues such as freight costs, transport and low demand for nutritious foods. Store managers provide important local knowledge regarding the development and implementation of food security interventions. SO WHAT? Agencies acting to address the issue of food insecurity in remote WA Indigenous communities should heed the advice of community store managers that high food prices, poor quality and limited availability are mainly due to transport inefficiencies and freight costs. Improving healthy food affordability in communities where high unemployment and low household income abound is fundamental to improving food security, yet presents a significant challenge.
Vaughan, Jill; Wigglesworth, Gillian; Loakes, Deborah; Disbray, Samantha; Moses, Karin
This paper reports on a study in two remote multilingual Indigenous Australian communities: Yakanarra in the Kimberley region of Western Australia and Tennant Creek in the Barkly region of the Northern Territory. In both communities, processes of language shift are underway from a traditional language (Walmajarri and Warumungu, respectively) to a local creole variety (Fitzroy Valley Kriol and Wumpurrarni English, respectively). The study focuses on language input from primary caregivers to a group of preschool children, and on the children's productive language. The study further highlights child-caregiver interactions as a site of importance in understanding the broader processes of language shift. We use longitudinal data from two time-points, approximately 2 years apart, to explore changes in adult input over time and developmental patterns in the children's speech. At both time points, the local creole varieties are the preferred codes of communication for the dyads in this study, although there is some use of the traditional language in both communities. Results show that for measures of turn length (MLT), there are notable differences between the two communities for both the focus children and their caregivers. In Tennant Creek, children and caregivers use longer turns at Time 2, while in Yakanarra the picture is more variable. The two communities also show differing trends in terms of conversational load (MLT ratio). For measures of morphosyntactic complexity (MLU), children and caregivers in Tennant Creek use more complex utterances at Time 2, while caregivers in Yakanarra show less complexity in their language at that time point. The study's findings contribute to providing a more detailed picture of the multilingual practices at Yakanarra and Tennant Creek, with implications for understanding broader processes of language shift. They also elucidate how children's language and linguistic input varies diachronically across time. As such, we contribute to
Full Text Available This paper reports on a study in two remote multilingual Indigenous Australian communities: Yakanarra in the Kimberley region of Western Australia and Tennant Creek in the Barkly region of the Northern Territory. In both communities, processes of language shift are underway from a traditional language (Walmajarri and Warumungu respectively to a local creole variety (Fitzroy Valley Kriol and Wumpurrarni English respectively. The study focuses on language input from primary caregivers to a group of preschool children, and on the children’s productive language. The study further highlights child-caregiver interactions as a site of importance in understanding the broader processes of language shift. We use longitudinal data from two time-points, approximately two years apart, to explore changes in adult input over time and developmental patterns in the children’s speech.At both time points, the local creole varieties are the preferred codes of communication for the dyads in this study, although there is some use of the traditional language in both communities. Results show that for measures of turn length (MLT, there are notable differences between the two communities for both the focus children and their caregivers. In Tennant Creek, children and caregivers use longer turns at Time 2, while in Yakanarra the picture is more variable. The two communities also show differing trends in terms of conversational load (MLT ratio. For measures of morphosyntactic complexity (MLU, children and caregivers in Tennant Creek use more complex utterances at Time 2, while caregivers in Yakanarra show less complexity in their language at that time point. The study’s findings contribute to providing a more detailed picture of the multilingual practices at Yakanarra and Tennant Creek, with implications for understanding broader processes of language shift. They also elucidate how children’s language and linguistic input varies diachronically across time. As
The concept of collective trauma has predominantly been applied in the context of natural and human disasters. This paper seeks to explore whether collective trauma offers a respectful way in which to explore and respond to mental health and wellbeing issues for Aboriginal families and communities. A review of the international literature was undertaken in order to determine the elements of collective and mass trauma studies which may have relevance for Indigenous communities in Australia. Findings support the proposition that the patterns of human responses to disasters, particularly in protracted traumas such as war-zones, shows strong parallels to the contemporary patterns of experience and responses articulated by Aboriginal people affected by colonization and its sequelae in Australia. Adopting evidence-informed principles of family and community healing developed internationally in disaster situations may provide helpful ways of conceptualizing and responding in a coordinated way to mental health and wellbeing issues for Indigenous people within Australia.
Smout, Felicity A; Skerratt, Lee F; Butler, James R A; Johnson, Christopher N; Congdon, Bradley C; Thompson, R C Andrew
Ancylostoma ceylanicum is the common hookworm of domestic dogs and cats throughout Asia, and is an emerging but little understood public health risk in tropical northern Australia. We investigated the prevalence of A. ceylanicum in soil and free-ranging domestic dogs at six rainforest locations in Far North Queensland that are Indigenous Australian communities and popular tourist attractions within the Wet Tropics World Heritage Area. By combining PCR-based techniques with traditional methods of hookworm species identification, we found the prevalence of hookworm in Indigenous community dogs was high (96.3% and 91.9% from necropsy and faecal samples, respectively). The majority of these infections were A. caninum. We also observed, for the first time, the presence of A. ceylanicum infection in domestic dogs (21.7%) and soil (55.6%) in an Indigenous community. A. ceylanicum was present in soil samples from two out of the three popular tourist locations sampled. Our results contribute to the understanding of dogs as a public health risk to Indigenous communities and tourists in the Wet Tropics. Dog health needs to be more fully addressed as part of the Australian Government's commitments to "closing the gap" in chronic disease between Indigenous and other Australians, and encouraging tourism in similar locations.
Felicity A. Smout
Full Text Available Ancylostoma ceylanicum is the common hookworm of domestic dogs and cats throughout Asia, and is an emerging but little understood public health risk in tropical northern Australia. We investigated the prevalence of A. ceylanicum in soil and free-ranging domestic dogs at six rainforest locations in Far North Queensland that are Indigenous Australian communities and popular tourist attractions within the Wet Tropics World Heritage Area. By combining PCR-based techniques with traditional methods of hookworm species identification, we found the prevalence of hookworm in Indigenous community dogs was high (96.3% and 91.9% from necropsy and faecal samples, respectively. The majority of these infections were A. caninum. We also observed, for the first time, the presence of A. ceylanicum infection in domestic dogs (21.7% and soil (55.6% in an Indigenous community. A. ceylanicum was present in soil samples from two out of the three popular tourist locations sampled. Our results contribute to the understanding of dogs as a public health risk to Indigenous communities and tourists in the Wet Tropics. Dog health needs to be more fully addressed as part of the Australian Government's commitments to “closing the gap” in chronic disease between Indigenous and other Australians, and encouraging tourism in similar locations.
Fogarty, Marisa; Coalter, Nicola; Gordon, Ashley; Breen, Helen
Gambling impacts affect Australian Indigenous families and communities in diverse and complex ways. Indigenous people throughout Australia engage in a broad range of regulated and unregulated gambling activities. Challenges in this area include the complexities that come with delivering services and programmes between the most remote regions, to highly populated towns and cities of Australia. There is little knowledge transfer between states and territories in Australia and no conceptual understanding or analysis of what constitutes 'best practice' in gambling service delivery for Indigenous people, families and communities. This article reviews health promotion approaches used in Australia, with a particular focus on Indigenous and gambling-based initiatives. Contributing to this review is an examination of health promotion strategies used in Indigenous gambling service delivery in the Northern Territory, New South Wales and Western Australia, demonstrating diversity and innovation in approaches. The article concludes by emphasizing the potential value of adopting health promotion strategies to underpin programme and service delivery for addressing gambling problems in Australian Indigenous communities. However, success is contingent on robust, evidence-based programme design, implementation and evaluation that adhere to health promotion principles. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: email@example.com.
Constable, S E; Dixon, R M; Dixon, R J; Toribio, J-A
Dog health in rural and remote Australian Indigenous communities is below urban averages in numerous respects. Many Indigenous communities have called for knowledge sharing in this area. However, dog health education programs are in their infancy, and lack data on effective practices. Without this core knowledge, health promotion efforts cannot progress effectively. This paper discusses a strategy that draws from successful approaches in human health and indigenous education, such as dadirri, and culturally respectful community engagement and development. Negotiating an appropriate education program is explored in its practical application through four case studies. Though each case was unique, the comparison of the four illustrated the importance of listening (community consultation), developing and maintaining relationships, community involvement and employment. The most successful case studies were those that could fully implement all four areas. Outcomes included improved local dog health capacity, local employment and engagement with the program and significantly improved dog health.
Full Text Available Closing the health gap between Indigenous and non-Indigenous Australians relies, in part, on addressing the poor levels of nutrition in remote Indigenous communities (RIC. This article identifies and maps key influencers of food choice at the point-of-purchase (POP in Australian RIC and identifies gaps in our knowledge. It is based on a narrative review of the literature pertaining to food in RIC from a range of disciplinary perspectives including nutrition, ethnography, public health, anthropology, and remote health to map POP drivers of food choice. In particular, the role of habit is identified as a key factor that has previously not been discussed in the literature. The conceptual framework can be used as a basis for future POP research in RIC and provides guidance for social marketers, public health, nutrition, and policy workers operating in this field.
Nasir, Bushra; Kisely, Steve; Hides, Leanne; Ranmuthugala, Geetha; Brennan-Olsen, Sharon; Nicholson, Geoffrey C; Gill, Neeraj S; Hayman, Noel; Kondalsamy-Chennakesavan, Srinivas; Toombs, Maree
Little is known of the appropriateness of existing gatekeeper suicide prevention programs for Indigenous communities. Despite the high rates of Indigenous suicide in Australia, especially among Indigenous youth, it is unclear how effective existing suicide prevention programs are in providing appropriate management of Indigenous people at risk of suicide. In-depth, semi-structured interviews and focus groups were conducted with Indigenous communities in rural and regional areas of Southern Queensland. Thematic analysis was performed on the gathered information. Existing programs were time-intensive and included content irrelevant to Indigenous people. There was inconsistency in the content and delivery of gatekeeper training. Programs were also not sustainable for rural and regional Indigenous communities. Appropriate programs should be practical, relevant, and sustainable across all Indigenous communities, with a focus on the social, emotional, cultural and spiritual underpinnings of community wellbeing. Programs need to be developed in thorough consultation with Indigenous communities. Indigenous-led suicide intervention training programs are needed to mitigate the increasing rates of suicide experienced by Indigenous peoples living in rural and remote locations.
Full Text Available Increasing attention to formal recognition of indigenous and community conserved areas (ICCAs as part of national and/or global protected area systems is generating novel encounters between the customary institutions through which indigenous peoples and local communities manage these traditional estates and the bureaucratic institutions of protected area management planning. Although management plans are widely considered to be important to effective management of protected areas, little guidance has been available about how their form and content can effectively reflect the distinctive socio-cultural and political characteristics of ICCAs. This gap has been particularly apparent in Australia where a trend to rapidly increased formal engagement of indigenous people in environmental management resulted, by 2012, in 50 indigenous groups voluntarily declaring their intent to manage all or part of their estates for conservation in perpetuity, as an indigenous protected area (IPA. Development and adoption of a management plan is central to the process through which the Australian Government recognizes these voluntary declarations and invests resources in IPA management. We identified four types of innovations, apparent in some recent IPA plans, which reflect the distinctive socio-cultural and political characteristics of ICCAs and support indigenous people as the primary decision makers and drivers of knowledge integration in IPAs. These are (1 a focus on customary institutions in governance; (2 strategic planning approaches that respond to interlinkages of stewardship between people, place, plants, and animals; (3 planning frameworks that bridge scales by considering values and issues across the whole of an indigenous people's territory; and (4 varied communication modes appropriate to varied audiences, including an emphasis on visual and spatial modes. Further research is warranted into how governance and management of IPAs, and the plans that
Stewart, J.; Anda, M.; Harper, R.J.
A decision-making model was constructed to assist remote Australian Indigenous communities select appropriate climate change mitigation programs. The Resilient Community and Livelihood Asset Integration Model (ReCLAIM) comprises six steps that focus on community assets and aspirations. The second of these steps is to determine the baseline carbon profiles of communities based on six sources of carbon emissions: materials, construction processes, stationary energy, transport, water systems and waste. The methodology employed an annualised lifecycle analysis of housing materials and construction, and an annual inventory of other emission sources. Profiles were calculated for two remote communities and compared to the Australian average and also average electricity consumption by remote communities in the Northern Territory. The results, expressed in tonnes of carbon dioxide equivalent (tCO_2-e), showed that average household carbon profiles of the two communities (6.3 and 4.1 tCO_2-e/capita/yr) were generally lower than the Australian average (7.3 tCO_2-e/capita/yr). The stationary energy results revealed that infrastructure and building design could raise fuel consumption and costs, and therefore carbon emissions, despite modest lifestyles. The carbon emission categories differed between the two communities highlighting the need for an individualised approach to understanding the drivers of carbon emissions and mitigation responses. - Highlights: •We model carbon profiles of two remote Aboriginal communities. •Community carbon profiles were lower than the Australian average. •We compare stationary energy with a 72-community sample average. •Low-carbon communities are possible with renewable energy systems. •Building design and energy source can impact significantly on emissions.
Hing, Nerilee; Breen, Helen; Gordon, Ashley; Russell, Alex
The gambling activities of minority groups such as Indigenous peoples are usually culturally complex and poorly understood. To redress the scarcity of information and contribute to a better understanding of gambling by Indigenous people, this paper presents quantitative evidence gathered at three Australian Indigenous festivals, online and in several Indigenous communities. With support from Indigenous communities, the study collected and analyzed surveys from 1,259 self-selected Indigenous adults. Approximately 33 % of respondents gambled on card games while 80 % gambled on commercial gambling forms in the previous year. Gambling participation and involvement are high, particularly on electronic gaming machines (EGMs), the favorite and most regular form of gambling. Men are significantly more likely to participate in gambling and to gamble more frequently on EGMs, horse/dog races, sports betting and instant scratch tickets. This elevated participation and frequency of gambling on continuous forms would appear to heighten gambling risks for Indigenous men. This is particularly the case for younger Indigenous men, who are more likely than their older counterparts to gamble on EGMs, table games and poker. While distinct differences between the gambling behaviors of our Indigenous sample and non-Indigenous Australians are apparent, Australian Indigenous behavior appears similar to that of some Indigenous and First Nations populations in other countries. Although this study represents the largest survey of Indigenous Australian gambling ever conducted in New South Wales and Queensland, further research is needed to extend our knowledge of Indigenous gambling and to limit the risks from gambling for Indigenous peoples.
Cooper, Patrick; Kohler, Mark; Blunden, Sarah
Disruptions to sleep in childhood are associated with poor behaviour and deficits in academic performance and executive function. Although academic performance of indigenous children from remote communities in Australia is documented as well below that of non-indigenous children, the extent of sleep disruption and its contribution to academic performance among this population has not been assessed. This pilot study aimed to objectively assess the sleep of remote indigenous children and the association between sleep disruption and both academic performance and executive function. Twenty-one children from a remote Australian indigenous community aged 6-13 years wore actigraphy for two consecutive nights, reported subjective sleepiness, and were objectively assessed for academic performance (Wechsler Individual Achievement Test, 2nd Edition) and executive function (NEuroloPSYcological Assessment-II). Results show marked reduction in sleep time, sleep fragmentation, academic performance and auditory attention compared with non-indigenous norms. Sleep duration was not associated with performance, possibly because of reduced sleep and performance observed across the entire group. Sleep fragmentation was associated with reduced reading and numerical skills (P sleep of indigenous children in remote communities is an important area of future inquiry, and our initial findings of poor sleep and an association between sleep disruption and academic performance may have important implications for intervention strategies aimed at 'closing the gap'. Further studies should assess a broader range of demographic, social and economic factors to better understand the associations reported here and guide future intervention. © 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians).
Full Text Available Indigenous Australians experience a high prevalence of sexual assault, yet a regional sexual assault service found few Indigenous Australians accessed their services. This prompted exploration of how its services might be improved. A resultant systematic search of the literature is reported in this article. Seven electronic databases and seven websites were systematically searched for peer reviewed and gray literature documenting responses to the sexual assault of Indigenous Australians. These publications were then classified by response type and study type. Twenty-three publications met the inclusion criteria. They included studies of legal justice, media, and community-based and mainstream service responses for Indigenous survivors and perpetrators. We located program descriptions, measurement, and descriptive research, but no intervention studies. There is currently insufficient evidence to confidently prescribe what works to effectively respond to Indigenous Australian sexual assault. The study revealed an urgent need for researchers, Indigenous communities, and services to work together to develop the evidence base.
Brimblecombe, Julie; van den Boogaard, Christel; Wood, Beverley; Liberato, Selma C; Brown, Jacqui; Barnes, Adam; Rogers, Alison; Coveney, John; Ritchie, Jan; Bailie, Ross
Few frameworks exist to assist food system planning, especially for Indigenous Australian remote communities. We developed a Good Food Planning Tool to support stakeholders to collectively plan and take action for local food system improvement. Development occurred over a four-year period through an evolving four phase participatory process that included literature review, several meetings with representatives of various organisations and communities and application of the Tool with multi-sector groups in each of four Indigenous Australian remote communities. A diverse range of 148 stakeholders, 78 of whom were Indigenous, had input to its development. Five food system domains: (i) Leadership and partnerships; (ii) Traditional food and local food production; (iii) Food businesses; (iv) Buildings, public places and transport; (v) Community and services and 28 activity areas form the framework of the Tool. The Good Food Planning Tool provides a useful framework to facilitate collective appraisal of the food system and to identify opportunities for food system improvement in Indigenous Australian remote communities, with potential for adaptation for wider application. Copyright © 2015 Elsevier Ltd. All rights reserved.
Crowe, Ruth; Stanley, Rebecca; Probst, Yasmine; McMahon, Anne
1) To explore the links between Indigenous Australian children's perspectives on culture, and healthy lifestyle behaviours. 2) To provide insight into how to approach the development of a health intervention targeting lifestyle behaviours in Australian Indigenous children. Seven semi-structured focus groups sessions were conducted with Australian Indigenous children aged 5-12 years living on the South Coast of New South Wales. Audio-recordings were transcribed and thematic analyses were conducted and related to principles of grounded theory. Participants had connections to aspects of Australian Indigenous culture that were embedded in their everyday lives. Healthy lifestyle behaviours (such as healthy eating and physical activity) were found to be interconnected with Australian Indigenous culture and positive emotional wellbeing was identified as an important outcome of connecting Australian Indigenous children to cultural practices. Understanding the importance of culture and its role in healthy lifestyles is critical in the development of health interventions for Indigenous populations. Health interventions embedded with Australian Indigenous culture may have potential to improve physical and emotional health within Australian Indigenous communities. However, it is unlikely that a 'one size fits all' approach to health interventions can be taken. © 2017 The Authors.
Snijder, Mieke; Shakeshaft, Anthony; Wagemakers, Annemarie; Stephens, Anne; Calabria, Bianca
Background: Community development is a health promotion approach identified as having great potential to improve Indigenous health, because of its potential for extensive community participation. There has been no systematic examination of the extent of community participation in community
d'Abbs, Peter; Shaw, Gillian; Field, Emma
Since 2005, the Australian Government has subsidized the production and distribution of Low Aromatic Fuel (LAF) as a deterrent against petrol (gasoline) sniffing in remote Indigenous communities. LAF is used in place of unleaded petrol as a fuel for vehicles and other engines. This paper reports findings from an independent evaluation of the LAF rollout. Forty one Indigenous communities were surveyed between 2010 and 2014, with each community being visited twice at a two yearly interval. Quantitative data on prevalence of petrol sniffing were collected, as well as qualitative data on the acceptability of LAF, evidence of substitution for inhaled petrol with other drugs, and programs such as recreational, training and employment opportunities. Prevalence rates of sniffing per 1000 population for each survey year and community were calculated by dividing the total number of sniffers by the population aged 5-39 years and multiplying by 1000. Between 2011-12 and 2013-14, the total estimated number of people sniffing petrol declined from 289 to 204, a fall of 29.4%. At both times, the median petrol sniffing prevalence rate was lower in communities with LAF than in communities without LAF. In 17 of the 41 communities, comparable data were available over a longer period, commencing in 2005-06. Fifteen of these communities stocked LAF over the entire period. In these communities, the median rate of petrol sniffing declined by 96%, from 141.6 per 1000 population in 2005-06 to 5.5 in 2013-14 (p < 0.05). LAF was widely accepted, although acceptance was often qualified by a belief that LAF harmed engines. Anecdotal reports suggest that the fall in petrol sniffing may have been offset by increased use of cannabis and other drugs, but the relationship is not one of simple cause-and-effect, with evidence that an increase in cannabis use in communities commenced before the LAF rollout began. Provision of services in communities has improved in recent years, but many programs
Full Text Available Tobacco smoking is a major health issue for Indigenous Australians, however there are few interventions with demonstrated efficacy in this population. The Transtheoretical Model may provide a useful framework for describing smoking behaviour and assessing readiness to quit, with the aim of developing better interventions. Interviews were conducted with 593 Indigenous Australians in eight rural and remote communities in north Queensland, to examine stages of change and smoking behaviour. Among current smokers, 39.6% and 43.4% were in Precontemplation and Contemplation stages respectively. A further 13.9% were making preparations to quit (Preparation whilst only 3.2% said they were actively trying to quit (Action. When analysed by stage of change, the pattern of smoking-related behaviours conformed to the results of past research using the model. Importantly however, distribution of individuals across the stages opposes those observed in investigations of smoking behaviour in non-Indigenous Australian populations. The Transtheoretical Model can be used to meaningfully classify Indigenous smokers in remote north Queensland according to stages along the behaviour change continuum. Importantly, in this large sample across eight communities, most Indigenous smokers were not making preparations to change their smoking behaviour. This suggests that interventions should focus on promoting movement toward the Preparation and Action stages of change.
Robertson Jan A
Full Text Available Abstract Background In Australia generally, smoking prevalence more than halved after 1980 and recently commenced to decline among Australia's disadvantaged Indigenous peoples. However, in some remote Indigenous Australian communities in the Northern Territory (NT, extremely high rates of up to 83% have not changed over the past 25 years. The World Health Organisation has called for public health and political leadership to address a global tobacco epidemic. For Indigenous Australians, unprecedented policies aim to overcome disadvantage and close the 'health gap' with reducing tobacco use the top priority. This study identifies challenges and opportunities to implementing these important new tobacco initiatives in remote Indigenous communities. Methods: With little empirical evidence available, we interviewed 82 key stakeholders across the NT representing operational- and management-level service providers, local Indigenous and non-Indigenous participants to identify challenges and opportunities for translating new policies into successful tobacco interventions. Data were analysed using qualitative approaches to identify emergent themes. Results The 20 emergent themes were classified using counts of occasions each theme occurred in the transcribed data as challenge or opportunity. The 'smoke-free policies' theme occurred most frequently as opportunity but infrequently as challenge while 'health workforce capacity' occurred most frequently as challenge but less frequently as opportunity, suggesting that policy implementation is constrained by lack of a skilled workforce. 'Smoking cessation support' occurred frequently as opportunity but also frequently as challenge suggesting that support for individuals requires additional input and attention. Conclusions These results from interviews with local and operational-level participants indicate that current tobacco policies in Australia targeting Indigenous smoking are sound and comprehensive
Constable, Sophie; Dixon, Roselyn; Dixon, Robert
As part of strategies to improve dog and community health in rural and remote Indigenous communities, this study investigated preferences and impacts of dog health education programs. Semistructured interviews with 63 residents from five communities explored learning preferences. Though each community differed, on average yarning was preferred by…
Hudson, Emily G; Brookes, Victoria J; Dürr, Salome; Ward, Michael P
Although Australia is canine rabies free, the Northern Peninsula Area (NPA), Queensland and other northern Australian communities are at risk of an incursion due to proximity to rabies infected islands of Indonesia and existing disease spread pathways. Northern Australia also has large populations of free-roaming domestic dogs, presenting a risk of rabies establishment and maintenance should an incursion occur. Agent-based rabies spread models are being used to predict potential outbreak size and identify effective control strategies to aid incursion preparedness. A key component of these models is knowledge of dog roaming patterns to inform contact rates. However, a comprehensive understanding of how dogs utilise their environment and the heterogeneity of their movements to estimate contact rates is lacking. Using a novel simulation approach - and GPS data collected from 21 free-roaming domestic dogs in the NPA in 2014 and 2016 - we characterised the roaming patterns within this dog population. Multiple subsets from each individual dog's GPS dataset were selected representing different monitoring durations and a utilisation distribution (UD) and derived core (50%) and extended (95%) home ranges (HR) were estimated for each duration. Three roaming patterns were identified, based on changes in mean HR over increased monitoring durations, supported by assessment of maps of daily UDs of each dog. Stay-at-home dogs consolidated their HR around their owner's residence, resulting in a decrease in mean HR (both core and extended) as monitoring duration increased (median peak core and extended HR 0.336 and 3.696ha, respectively). Roamer dogs consolidated their core HR but their extended HR increased with longer monitoring durations, suggesting that their roaming patterns based on place of residence were more variable (median peak core and extended HR 0.391 and 6.049ha, respectively). Explorer dogs demonstrated large variability in their roaming patterns, with both core and
Ann E. Fleming
Full Text Available There is significant evidence that culture-aligned economies are more effective in engaging remote-living Indigenous Australians in work long-term. Despite this evidence, governments remain resistant to investing substantially in these economies, with the result that low employment rates persist. This article argues that governmental systems of organisation are not designed to support non-mainstream economies and this position is unlikely to change. Similarly, the commercial sector lacks confidence that investing in culture-aligned economies will generate financial returns. This article presents a localised, pragmatic approach to Indigenous business support that works within existing systems of government, business and culture. Most unsuccessful programs fail to recognise the full suite of critical factors for sustained market engagement by both business and Indigenous people. This article reports on work to bring all critical factors together into a business support framework to inform the design and implementation of an aquaculture development program in a remote Indigenous Australian community.
Sushames, Ashleigh; Engelberg, Terry; Gebel, Klaus
Aboriginal and Torres Strait Islander people have higher rates of chronic disease and a lower life expectancy than non-Indigenous Australians. In non-urban areas these health disparities are even larger. The aim of this qualitative study was to explore perceived barriers and enablers to attending an eight-week physical activity program in a rural and regional setting which aimed to improve health outcomes, but had a low attendance rate. Thirty-four Indigenous Australians participated in the intervention from the rural (n = 12) and the regional (n = 22) community. Qualitative semi-structured individual interviews were conducted at the follow-up health assessments with 12 participants. A thematic network analysis was undertaken to examine the barriers and enablers to participation in the program. Overall, there were positive attitudes to, and high levels of motivation towards, the physical activity program. Enablers to participation were the inclusion of family members, no financial cost and a good relationship with the principal investigator, which was strengthened by the community-based participatory approach to the program design. Barriers to program attendance were mostly beyond the control of the individuals, such as 'sorry business', needing to travel away from the community and lack of community infrastructure. More consideration is needed prior to implementation of programs to understand how community-specific barriers and enablers will affect attendance to the program. ACTRN12616000497404 . Registered 18 April 2016.
Emily G Hudson
Full Text Available Australia is underprepared for a rabies incursion due to a lack of information about how a rabies outbreak would spread within the susceptible canine populations and which control strategies would be best to control it. The aim of this study was to collect information to parameterize a recently developed dog rabies spread model as well as use this information to gauge how the community would accept potential control strategies. Such information-together with model outputs-would be used to inform decision makers on the best control strategies and improve Australia's preparedness against a canine rabies incursion. The parameters this study focussed on were detection time, vaccination rates and dog-culling and dog movement restriction compliance. A cross-sectional survey of 31 dog-owners, using a questionnaire, was undertaken in the five communities of the Northern Peninsular Area (NPA in northern Australia regarding community dog movements, veterinary visits, reporting systems, perceptions of sick dogs and potential human behaviours during hypothetical rabies outbreaks. It highlighted the significant shortfalls in veterinary care that would need to be vastly improved during an outbreak, who educational programs should be targeted towards and which dog movements should be restricted. The results indicate that men were significantly more likely than women to allow their dogs to roam and to move their dogs. The current low vaccination rate of 12% highlighted the limited veterinary services that would need to be substantially increased to achieve effective rabies control. Participation in mass vaccination was accepted by 100% of the respondents. There was lower acceptance for other possible rabies control strategies with 10-20% of the respondents stating a resistance to both a mass culling program and a ban on dog movements. Consequently, movement bans and mass dog culling would have limited effectiveness as a control strategy in the NPA community
This article focuses on the impact of colonisation and its associated impact on Indigenous teaching and learning. Western European institutions have dominated Indigenous ways of knowing and in Australia this has led to barriers which restrict the participation of Aboriginal people in education systems. Globally Indigenous people are attempting to bring into the introduced educational systems culturally appropriate teaching and learning practices so that a more holistic approach to education can become the norm rather than the exception. The relationship between Indigenous knowledge and western European concepts of knowledge and knowing need to placed in a framework of mutual interaction so that not only do Indigenous people benefit, but so do non-Indigenous educators and students.
Brimblecombe, J; Bailie, R; van den Boogaard, C; Wood, B; Liberato, S C; Ferguson, M; Coveney, J; Jaenke, R; Ritchie, J
Food insecurity underlies and compounds many of the development issues faced by remote Indigenous communities in Australia. Multi-sector approaches offer promise to improve food security. We assessed the feasibility of a novel multi-sector approach to enhance community food security in remote Indigenous Australia. A longitudinal comparative multi-site case study, the Good Food Systems Good Food for All Project, was conducted (2009-2013) with four Aboriginal communities. Continuous improvement meetings were held in each community. Data from project documents and store sales were used to assess feasibility according to engagement, uptake and sustainability of action, and impact on community diet, as well as identifying conditions facilitating or hindering these. Engagement was established where: the community perceived a need for the approach; where trust was developed between the community and facilitators; where there was community stability; and where flexibility was applied in the timing of meetings. The approach enabled stakeholders in each community to collectively appraise the community food system and plan action. Actions that could be directly implemented within available resources resulted from developing collaborative capacity. Actions requiring advocacy, multi-sectoral involvement, commitment or further resources were less frequently used. Positive shifts in community diet were associated with key areas where actions were implemented. A multi-sector participatory approach seeking continuous improvement engaged committed Aboriginal and non-Aboriginal stakeholders and was shown to have potential to shift community diet. Provision of clear mechanisms to link this approach with higher level policy and decision-making structures, clarity of roles and responsibilities, and processes to prioritise and communicate actions across sectors should further strengthen capacity for food security improvement. Integrating this approach enabling local decision-making into
McMahon, Emma; Clarke, Rozlynne; Jaenke, Rachael; Brimblecombe, Julie
Food reformulation is an important strategy to reduce the excess salt intake observed in remote Indigenous Australia. We aimed to examine whether 12.5% and 25% salt reduction in bread is detectable, and, if so, whether acceptability is changed, in a sample of adults living in a remote Indigenous community in the Northern Territory of Australia. Convenience samples were recruited for testing of reduced-salt (300 and 350 mg Na/100 g) versus Standard (~400 mg Na/100 g) white and wholemeal breads (n = 62 for white; n = 72 for wholemeal). Triangle testing was used to examine whether participants could detect a difference between the breads. Liking of each bread was also measured; standard consumer acceptability questionnaires were modified to maximise cultural appropriateness and understanding. Participants were unable to detect a difference between Standard and reduced-salt breads (all p values > 0.05 when analysed using binomial probability). Further, as expected, liking of the breads was not changed with salt reduction (all p values > 0.05 when analysed using ANOVA). Reducing salt in products commonly purchased in remote Indigenous communities has potential as an equitable, cost-effective and sustainable strategy to reduce population salt intake and reduce risk of chronic disease, without the barriers associated with strategies that require individual behaviour change. PMID:26999196
Full Text Available This article comments on Indigenous Australian art from an intercultural perspective. The painting Bush Tomato Dreaming (1998, by the Anmatyerre artist Lucy Ngwarai Kunoth serves as model case for my argument that art expresses existential social knowledge. In consequence, I will argue that social theory and art theory together provide tools for intercultural understanding and competence.
Arnold, Luke W; Hoy, Wendy E; Wang, Zhiqiang
Indigenous Australians are significantly burdened by chronic kidney disease (CKD). Elevated levels of C-reactive protein (CRP) have been associated with diabetes and cardiovascular incidence in previous studies. Elevated CRP has been associated with albuminuria and reduced eGFR in cross-sectional studies. This study investigated the long-term predictive association between CRP measured at a baseline exam and the incidence of a CKD-related hospitalization. Health screening examinations were conducted in individuals of a remote indigenous Australian community between 1992 and 1998. The risk of subsequent CKD hospitalisations, documented through Northern Territory hospital records up to 2010, was estimated with Cox proportional hazard models in people aged over 18 years at the baseline screen and who had albumin-creatinine ratios (ACRs) less than 34g/mol. 546 participants were eligible for our study. Individuals in the highest CRP tertile at baseline had increased levels of traditional cardiovascular risk factors. They also had almost 4 times the risk of a CKD-related hospitalisation compared with participants in the lowest CRP tertile (HR=3.91, 95%CI 1.01-15.20, P=0.049) after adjustment for potential confounding factors. Participants with CRP concentrations greater than 3mg/L had almost 3 times the risk of CKD hospitalisations than those ≤3mg/L (HR=2.84, 95%CI 1.00-8.00, P=0.049). Furthermore, risk of CKD hospitalisations increased 34% per doubling of baseline CRP (HR=1.34, 95%CI 1.04-1.74, P=0.024). In individuals in this remote indigenous community without overt albuminuria at baseline the risk for incident CKD related hospitalisations was predicted by elevated C-reactive protein levels almost a decade earlier. Further research is needed to understand the roles that CRP and systemic inflammation play in CKD risk. © 2016 Asian Pacific Society of Nephrology.
Kate A. Berry
Full Text Available This paper examines the significance of knowledge and values for water quality and its governance. Modernist approaches to the governance of water quality in rivers and lakes need to be reconceptualised and overhauled. The problems include: perceiving water only as a physical and chemical liquid, defining quality in narrow terms, rendering water knowledge as invisible, boiling down water values to uses of presumed economic importance and limiting how and by whom objectives are set or actions taken. In addressing the need to reframe water quality governance, and as a counter to the objectification of water quality, we propose a framework that explicitly recognises the significance of knowledge and values relating to water. While our framework could apply to other contexts under the influence of modernist water-management regimes, here we pay particular attention to the relevance of the water knowledge, values and governance of water quality by Indigenous people. In the second half of the paper we address issues related to Indigenous water-quality governance in two countries, Brazil and Australia, showing some of the ways in which, despite enormous obstacles, Indigenous communities re-work governance structures through their engagements with water quality and pay attention to water knowledge and values.
Melissa J. Stoneham
Full Text Available It is acknowledged that health outcomes for Australian Indigenous peoples are lower than those of non-Indigenous Australians. Research suggests negative media in relation to Indigenous Australians perpetuates racist stereotypes among the wider population and impacts on the health of Indigenous Australians. This study examined the media portrayal of Indigenous Australian public health issues in selected media over a twelve month period and found that, overwhelmingly, the articles were negative in their portrayal of Indigenous health. A total of 74 percent of the coverage of Australian Indigenous related articles were negative, 15 percent were positive, and 11 percent were neutral. The most common negative subject descriptors related to alcohol, child abuse, petrol sniffing, violence, suicide, deaths in custody, and crime.
This paper discusses the individual, family, household and area level characteristics associated with preschool attendance for Indigenous and non-Indigenous Australians (aged three to five years who are not at school). Controlling for these factors explains all of the difference between Indigenous and non-Indigenous attendance rates for…
Full Text Available For many non-Indigenous Australians the only time they have any engagement with Indigenous peoples, history or issues is through watching sport on television or being at a football match at the MCG. This general myopia and indifference by settler Australians with Indigenous Australians manifests itself in many ways but perhaps most obscenely in the simple fact that Indigenous Australians die nearly 20 years younger than the rest of Australias citizens. Many non-Indigenous Australians do not know this. Sport in many ways has offered Indigenous Australians a platform from which to begin the slow, hard process for social justice and equity to be actualised. This paper will discuss the participation of Indigenous Australians in sport and show how sport has enabled Indigenous Australians to create a space so that they can speak out against the injustices they have experienced and to further improve on relations going into the future. The central contention is that through sport all Australians can begin a process of engaging with Indigenous history as a means to improve race relations between the two groups.
Thurber, Katherine A; Banks, Emily; Banwell, Cathy
Indigenous Australians experience profound levels of disadvantage in health, living standards, life expectancy, education and employment, particularly in comparison with non-Indigenous Australians. Very little information is available about the healthy development of Australian Indigenous children; the Longitudinal Study of Indigenous Children (LSIC) is designed to fill this knowledge gap.This dataset provides an opportunity to follow the development of up to 1759 Indigenous children. LSIC conducts annual face-to-face interviews with children (aged 0.5-2 and 3.5-5 years at baseline in 2008) and their caregivers. This represents between 5% and 10% of the total population of Indigenous children in these age groups, including families of varied socioeconomic and cultural backgrounds. Study topics include: the physical, social and emotional well-being of children and their caregivers; language; culture; parenting; and early childhood education.LSIC is a shared resource, formed in partnership with communities; its data are readily accessible through the Australian Government Department of Social Services (see http://dss.gov.au/lsic for data and access arrangements). As one of very few longitudinal studies of Indigenous children, and the only national one, LSIC will enable an understanding of Indigenous children from a wide range of environments and cultures. Findings from LSIC form part of a growing infrastructure from which to understand Indigenous child health. © The Author 2014. Published by Oxford University Press on behalf of the International Epidemiological Association.
Dolan, Kate; Rodas, Ana; Bode, Adam
The purpose of this paper is to compare the use of drugs and alcohol by Indigenous and non-Indigenous prisoners and examine relevant treatment in Australian prisons. Prison authorities were surveyed about alcohol and drug use by prisoners prior to and during imprisonment and drug and alcohol treatment programs in prison. The literature was review for information on alcohol and drug use and treatment in Australian prisons. In 2009, over 80 percent of Indigenous and non-Indigenous inmates smoked. Prior to imprisonment, many Indigenous and non-Indigenous inmates drank alcohol at risky levels (65 vs 47 percent) and used illicit drugs (over 70 percent for both groups). Reports of using heroin (15 vs 21 percent), ATS (21 vs 33 percent), cannabis (59 vs 50 percent) and injecting (61 vs 53 percent) were similarly high for both groups. Prison-based programs included detoxification, Opioid Substitution Treatment, counselling and drug free units, but access was limited especially among Indigenous prisoners. Drug and alcohol use was a significant issue in Australian prisons. Prisoners were over five times more likely than the general population to have a substance use disorder. Imprisonment provides an important opportunity for rehabilitation for offenders. This opportunity is especially relevant to Indigenous prisoners who were more likely to use health services when in prison than in the community and given their vast over representations in prison populations. Given the effectiveness of treatment in reducing re-offending rates, it is important to expand drug treatment and especially culturally appropriate treatment programs for Indigenous inmates. Very little is known about Indigenous specific drug and alcohol programs in Australian prisons.
Woods John A
Full Text Available Abstract Background Cardiovascular diseases contribute substantially to the poor health and reduced life expectancy of Indigenous Australians. Heart failure is a common, disabling, progressive and costly complication of these disorders. The epidemiology of heart failure and the adequacy of relevant health service provision in Indigenous Australians are not well delineated. Methods A systematic search of the electronic databases PubMed, Embase, Web of Science, Cinahl Plus, Informit and Google Scholar was undertaken in April 2012 for peer-reviewed journal articles relevant to the topic of heart failure in Indigenous Australians. Additionally, a website search was done to identify other pertinent publications, particularly government reports. Results There was a paucity of relevant peer-reviewed research, and government reports dominated the results. Ten journal articles, 1 published conference abstract and 10 reports were eligible for inclusion. Indigenous Australians reportedly have higher morbidity and mortality from heart failure than their non-Indigenous counterparts (age-standardised prevalence ratio 1.7; age-standardised hospital separation ratio ≥3; crude per capita hospital expenditure ratio 1.58; age-adjusted mortality ratio >2. Despite the evident disproportionate burden of heart failure in Indigenous Australians, the accuracy of estimation from administrative data is limited by poor indigenous identification, inadequate case ascertainment and exclusion of younger subjects from mortality statistics. A recent journal article specifically documented a high prevalence of heart failure in Central Australian Aboriginal adults (5.3%, noting frequent undiagnosed disease. One study examined barriers to health service provision for Indigenous Australians in the context of heart failure. Conclusions Despite the shortcomings of available published data, it is clear that Indigenous Australians have an excess burden of heart failure. Emerging data
Full Text Available It has previously been shown that being of aboriginal descent is a risk factor for hamstring injuries in Australian football. The aim of this study was to review the Australian Football League (AFL injury database to determine whether there were any injuries where indigenous players had different relative risks to non-indigenous players. Analysis was conducted using data from the AFL injury database, which included data from 4,492 players over 21 years (1992–2012, covering 162,683 player-matches at AFL level, 91,098 matches at lower levels and 328,181 weeks (possible matches of exposure. Compared to non-indigenous players, indigenous players had a significantly higher risk of hamstring injuries (RR 1.52, 95% CI 1.32–1.73 and calf strains (RR 1.30, 95% CI 1.00–1.69. Conversely, indigenous players had a significantly lower risk of lumbar/thoracic spine injuries (RR 0.61, 95% CI 0.41–0.91, groin strains/osteitis pubis (RR 0.75, 95% CI 0.58–0.96 and Achilles tendon injuries (RR 0.32, 95% CI 0.12–0.86. The results for the above injuries were also significant in terms of games missed. There was no difference between overall risk of injury (RR 1.03, 95% CI 0.96–1.10 or missed games (RR 1.00, 95% CI 0.97–1.04. This suggests that indigenous AFL players have the same overall number of injuries and missed games, but a slightly different injury profile.
Jervis-Bardy, J; Carney, A S; Duguid, R; Leach, A J
To review research addressing the polymicrobial aetiology of otitis media in Indigenous Australian children in order to identify research gaps and inform best practice in effective prevention strategies and therapeutic interventions. Literature review. Studies of aspirated middle-ear fluid represented a minor component of the literature reviewed. Most studies relied upon specimens from middle-ear discharge or the nasopharynx. Culture-based middle-ear discharge studies have found that non-typeable Haemophilus influenzae and Streptococcus pneumoniae predominate, with Moraxella catarrhalis, Staphylococcus aureus and Streptococcus pyogenes isolated in a lower proportion of samples. Alloiococcus otitidis was detected in a number of studies; however, its role in otitis media pathogenesis remains controversial. Nasopharyngeal colonisation is a risk factor for otitis media in Indigenous infants, and bacterial load of otopathogens in the nasopharynx can predict the ear state of Indigenous children. Most studies have used culture-based methods and specimens from middle-ear discharge or the nasopharynx. Findings from these studies are consistent with international literature, but reliance on culture may incorrectly characterise the microbiology of this condition. Advances in genomic technologies are now providing microbiologists with the ability to analyse the entire mixed bacterial communities ('microbiomes') of samples obtained from Indigenous children with otitis media.
Blake, Tamara L; Chang, Anne B; Petsky, Helen L; Rodwell, Leanne T; Brown, Michael G; Hill, Debra C; Thompson, Bruce; McElrea, Margaret S
To evaluate published spirometry data for Australian Aboriginal and Torres Strait Islander (Indigenous) peoples to determine (i) whether their ethnicity influenced spirometry results; and (ii) if any reliable spirometry reference values exist for Indigenous Australians. Systematic review of published and grey literature. PubMed and Cochrane Library databases, references of included articles and appropriate grey literature. Last searches were conducted in April 2016. We included any study that performed spirometry on healthy Indigenous Australians and compared their results with those from people of European ancestry. Two authors independently screened titles and abstracts and then reviewed potentially relevant full-text articles for possible inclusion. We used PRISMA systematic review reporting methods to collate data. Of a possible 125 studies, 18 full-text articles were reviewed, but only nine fulfilled the inclusion criteria. None specified Torres Strait Islander inclusion. All studies reported lower spirometry values (as much as 30% lower) for Aboriginal people compared with non-Indigenous people. Five studies developed spirometry reference values for Indigenous Australians; however, none adhered to all participant inclusion and exclusion criteria outlined by the American Thoracic Society and European Respiratory Society. Hence, reported results and subsequent reference values may not be a true representation of spirometry values in healthy Indigenous people. The lower spirometry values reported for Indigenous Australians may be due to study limitations. Furthermore, there are currently no reliable spirometry reference values for Indigenous Australians that adhere to current guidelines. Developing a set of Indigenous Australian reference values will improve the accuracy of test interpretation and aid in the diagnosis of respiratory disease in this population.
Genevieve C. Lai
Full Text Available Indigenous Australians are under-represented in the health workforce. The shortfall in the Indigenous health workforce compounds the health disparities experienced by Indigenous Australians and places pressure on Indigenous health professionals. This systematic review aims to identify enablers and barriers to the retention of Indigenous Australians within the health workforce and to describe strategies to assist with development and retention of Indigenous health professionals after qualification. Four electronic databases were systematically searched in August 2017. Supplementary searches of relevant websites were also undertaken. Articles were screened for inclusion using pre-defined criteria and assessed for quality using the Mixed Methods Assessment Tool. Fifteen articles met the criteria for inclusion. Important factors affecting the retention of Indigenous health professionals included work environment, heavy workloads, poorly documented/understood roles and responsibilities, low salary and a perception of salary disparity, and the influence of community as both a strong personal motivator and source of stress when work/life boundaries could not be maintained. Evidence suggests that retention of Indigenous health professionals will be improved through building supportive and culturally safe workplaces; clearly documenting and communicating roles, scope of practice and responsibilities; and ensuring that employees are appropriately supported and remunerated. The absence of intervention studies highlights the need for deliberative interventions that rigorously evaluate all aspects of implementation of relevant workforce, health service policy, and practice change.
Thomas Merlin C
Full Text Available Abstract Background Indigenous Australians have high rates of diabetes and its complications. This study examines ethnic differences in the management of patients with type 2 diabetes in Australian primary care. Methods Diabetes management and outcomes in Indigenous patients enrolled in the NEFRON study (n = 144 was systematically compared with that in non-Indigenous patients presenting consecutively to the same practitioner (n = 449, and the NEFRON cohort as a whole (n = 3893. Results Indigenous Australians with diabetes had high rates of micro- and macrovascular disease. 60% of Indigenous patients had an abnormal albumin to creatinine ratio compared to 33% of non-Indigenous patients (p 1c ≥ 8.0%, observed in 55% of all Indigenous patients, despite the similar frequency use of oral antidiabetic agents and insulin. Smoking was also more common in Indigenous patients (38%vs 10%, p Conclusion Although seeing the same doctors and receiving the same medications, glycaemic and smoking cessation targets remain unfulfilled in Indigenous patients. This cross-sectional study confirms Aboriginal ethnicity as a powerful risk factor for microvascular and macrovascular disease, which practitioners should use to identify candidates for intensive multifactorial intervention.
Conclusion: A multi-sector participatory approach seeking continuous improvement engaged committed Aboriginal and non-Aboriginal stakeholders and was shown to have potential to shift community diet. Provision of clear mechanisms to link this approach with higher level policy and decision-making structures, clarity of roles and responsibilities, and processes to prioritise and communicate actions across sectors should further strengthen capacity for food security improvement. Integrating this approach enabling local decision-making into community governance structures with adequate resourcing is an imperative.
Stewart, Harold S.; Bowden, Jacqueline A.; Bayly, Megan C.; Sharplin, Greg R.; Durkin, Sarah J.; Miller, Caroline L.; Givans, Sharon E.; Warne, Charles D.; Wakefield, Melanie A.
Aboriginal and Torres Strait Islander Australians (Indigenous Australians) have more than twice the smoking prevalence of non-Indigenous Australians. Anti-smoking campaigns have demonstrated success in the general population but little is known about their impact among Indigenous people. A total of 143 Indigenous and a comparison group of 156…
Ricciardelli Lina A
Full Text Available Abstract Background Overall the physical health of Indigenous men is among the worst in Australia. Research has indicated that modifiable lifestyle factors, such as poor nutrition and physical inactivity, appear to contribute strongly to these poor health conditions. To effectively develop and implement strategies to improve the health of Australia's Indigenous peoples, a greater understanding is needed of how Indigenous men perceive health, and how they view and care for their bodies. Further, a more systematic understanding of how sociocultural factors affect their health attitudes and behaviours is needed. This article presents the study protocol of a community-based investigation into the factors surrounding the health and body image of Indigenous Australian men. Methods and design The study will be conducted in a collaborative manner with Indigenous Australian men using a participatory action research framework. Men will be recruited from three locations around Australia (metropolitan, regional, and rural and interviewed to understand their experiences and perspectives on a number of issues related to health and health behaviour. The information that is collected will be analysed using modified grounded theory and thematic analysis. The results will then be used to develop and implement community events in each location to provide feedback on the findings to the community, promote health enhancing strategies, and determine future action and collaboration. Discussion This study will explore both risk and protective factors that affect the health of Indigenous Australian men. This knowledge will be disseminated to the wider Indigenous community and can be used to inform future health promotion strategies. The expected outcome of this study is therefore an increased understanding of health and health change in Indigenous Australian men, the development of strategies that promote healthy eating and positive patterns of physical activity and, in
Alcohol management plans in Aboriginal and Torres Strait Islander (Indigenous Australian communities in Queensland: community residents have experienced favourable impacts but also suffered unfavourable ones
Alan R. Clough
Full Text Available Abstract Background In Australia, ‘Alcohol Management Plans’ (AMPs provide the policy infrastructure for State and Commonwealth Governments to address problematic alcohol use among Aboriginal and Torres Strait Islanders. We report community residents’ experiences of AMPs in 10 of Queensland’s 15 remote Indigenous communities. Methods This cross-sectional study used a two-stage sampling strategy: N = 1211; 588 (48% males, 623 (52% females aged ≥18 years in 10 communities. Seven propositions about ‘favourable’ impacts and seven about ‘unfavourable’ impacts were developed from semi-structured interviews. For each proposition, one-sample tests of proportions examined participant agreement and multivariable binary logistic regressions assessed influences of gender, age (18–24, 25–44, 45–64, ≥65 years, residence (≥6 years, current drinking and Indigenous status. Confirmatory factor analyses estimated scale reliability (ρ, item loadings and covariances. Results Slim majorities agreed that: AMPs reduced violence (53%, p = 0.024; community a better place to live (54%, 0.012; and children were safer (56%, p < 0.001. More agreed that: school attendance improved (66%, p < 0.001; and awareness of alcohol’s harms increased (71%, p < 0.001. Participants were equivocal about improved personal safety (53%, p = 0.097 and reduced violence against women (49%, p = 0.362. The seven ‘favourable’ items reliably summarized participants’ experiences of reduced violence and improved community amenity (ρ = 0.90. Stronger agreement was found for six ‘unfavourable’ items: alcohol availability not reduced (58%, p < 0.001; drinking not reduced (56%, p < 0.001; cannabis use increased (69%, p < 0.001; more binge drinking (73%, p < 0.001; discrimination experienced (77%, p < 0.001; increased fines, convictions and criminal records for breaching restrictions (90%, p < 0
Full Text Available One of the most common Aboriginalist representations of Indigenous Australian people is, as Indigenous female performer Lou Bennett points out, ‘basically a man, out in the desert, black skin, flat nose with a lap-lap on, standing on one leg, resting against a spear’. Her comment raises many issues. In what ways are discourses of Aboriginalism gendered? How does Aboriginalism affect performance and specifically Aboriginal women performers? In exploring these questions, I examine Aboriginalist representations of Aboriginal women performers by white male scholars and the role of women anthropologists in the production of Aboriginalist discourse about Aboriginal women. Drawing on interviews with Indigenous women performers and musical examples of their songs, I explore the impact of Aboriginalism on non-Indigenous expectations of Indigenous Australian women performing in contemporary music contexts, the strategies performers use to work within and against these constructions and my own relationship to Aboriginalism.
Full Text Available One of the most common Aboriginalist representations of Indigenous Australian people is, as Indigenous female performer Lou Bennett points out, ‘basically a man, out in the desert, black skin, flat nose with a lap-lap on, standing on one leg, resting against a spear’. Her comment raises many issues. In what ways are discourses of Aboriginalism gendered? How does Aboriginalism affect performance and specifically Aboriginal women performers? In exploring these questions, I examine Aboriginalist representations of Aboriginal women performers by white male scholars and the role of women anthropologists in the production of Aboriginalist discourse about Aboriginal women. Drawing on interviews with Indigenous women performers and musical examples of their songs, I explore the impact of Aboriginalism on non-Indigenous expectations of Indigenous Australian women performing in contemporary music contexts, the strategies performers use to work within and against these constructions and my own relationship to Aboriginalism.
Pringle, Kirsty G; de Meaultsart, Celine Corbisier; Sykes, Shane D; Weatherall, Loretta J; Keogh, Lyniece; Clausen, Don C; Dekker, Gus A; Smith, Roger; Roberts, Claire T; Rae, Kym M; Lumbers, Eugenie R
The intrarenal renin-angiotensin system (iRAS) is implicated in the pathogenesis of hypertension, chronic kidney disease and diabetic nephropathy. Urinary angiotensinogen (uAGT) levels reflect the activity of the iRAS and are altered in women with preeclampsia. Since Indigenous Australians suffer high rates and early onset of renal disease, we hypothesised that Indigenous Australian pregnant women, like non-Indigenous women with pregnancy complications, would have altered uAGT levels. The excretion of RAS proteins was measured in non-Indigenous and Indigenous Australian women with uncomplicated or complicated pregnancies (preeclampsia, diabetes/gestational diabetes, proteinuria/albuminuria, hypertension, small/large for gestational age, preterm birth), and in non-pregnant non-Indigenous women. Non-Indigenous pregnant women with uncomplicated pregnancies, had higher uAGT/creatinine levels than non-Indigenous non-pregnant women (P pregnant women with pregnancy complications, uAGT/creatinine was suppressed in the third trimester (P pregnant women with uncomplicated pregnancies, there was no change in uAGT/creatinine with gestational age and uAGT/creatinine was lower in the 2nd and 3rd trimesters than in non-Indigenous pregnant women with uncomplicated pregnancies (P pregnant women may reflect subclinical renal dysfunction which limits the ability of the kidney to maintain sodium balance and could indicate an increased risk of pregnancy complications and/or future renal disease. Copyright © 2018. Published by Elsevier B.V.
This article examines a controversial initiative in Indigenous education: the establishment of the Cape York Aboriginal Australian Academy (CYAAA). The article provides a brief description of the Academy's three campuses and their communities and considers: the circumstances of its creation, including the role of Noel Pearson and Cape York…
Brad M. Farrant
Full Text Available The current study sought to increase our understanding of the factors involved in the early vocabulary development of Australian Indigenous children. Data from the Longitudinal Study of Indigenous Children were available for 573 Indigenous children (291 boys who spoke English (M=37.0 months, SD=5.4 months, at wave 3. Data were also available for 86 children (51 boys who spoke an Indigenous language (M=37.1 months, SD=6.0 months, at wave 3. As hypothesised, higher levels of parent-child book reading and having more children’s books in the home were associated with better English vocabulary development. Oral storytelling in Indigenous language was a significant predictor of the size of children’s Indigenous vocabulary.
Balaratnasingam, Sivasankaran; Janca, Aleksandar
To examine the validity of concept and diagnosis of personality disorder in transcultural settings using Indigenous Australian people as an example. There are significant deficits in comparative research on personality disorders across cultures. There is also a dearth of information regarding Indigenous Australians, and cultural applicability and clinical utility of the diagnosis of personality disorder in this group. The concept of culture is generally ignored when making a diagnosis of personality disorder. A valid diagnosis should incorporate what would be considered understandable and adaptive behavior in a person's culture. In Indigenous Australian culture, making diagnosis of a personality disorder is complicated by historical trauma from colonization, disruption of kinship networks, and ongoing effects of poverty and social marginalization.
Hollow, Robert; Harvey-Smith, Lisa; Brooks, Kate; Boddington, Leonie
The Murchison region of Western Australia is the site of the Murchison Radio-astronomy Observatory (MRO) that includes the Australian SKA Pathfinder (ASKAP) and the Murchison Widefield Array (MWA) and soon the SKA. This is also traditional land of the Wajarri Yamatji people. As part of its development in the region CSIRO has extensive engagement with the Wajarri Yamatji people. This includes educational, cultural, training and commercial opportunities. We outline the Indigenous Land Use Agreement (ILUA) between the Wajarri Yamatji and CSIRO, focusing on the educational and training aspects. Starting with "Wildflowers in the Sky" program in 2006 we have made extensive tours to all schools in the region providing teacher training and student engagement. More recently we have implemented a program where CSIRO Astronomy and Space Science staff visit the Pia Wadjarri Remote Community School, the closest school to the MRO, to mentor students. Students and staff from the school visit the MRO annually to explore the ASKAP telescope and see what is involved in its operation. An educational resource about ASKAP and astronomy that also incorporates traditional sky stories and local ecology is being trialled and developed. A cadetship and trainee program supporting Indigenous students has been implemented with the goal of providing employment opportunities and work skills in a diverse range of areas.
Condon John R
Full Text Available Abstract Background Indigenous women in Australia have a disproportionate burden of cervical cancer despite a national cervical screening program. Prior to introduction of a national human papilloma virus (HPV vaccination program, we determined HPV genotype prevalence by Indigenous status and residence in remote areas. Methods We recruited women aged 17 to 40 years presenting to community-based primary health services for routine Pap screening across Australia. A liquid-based cytology (LBC cervical specimen was tested for HPV DNA using the AMPLICOR HPV-DNA test and a PGMY09/11-based HPV consensus PCR; positive specimens were typed by reverse hybridization. We calculated age-adjusted prevalence by weighting to relevant population data, and determined predictors of HPV-DNA positivity by age, Indigenous status and area of residence using logistic regression. Results Of 2152 women (655 Indigenous, prevalence of the high-risk HPV genotypes was similar for Indigenous and non-Indigenous women (HPV 16 was 9.4% and 10.5%, respectively; HPV 18 was 4.1% and 3.8%, respectively, and did not differ by age group. In younger age groups, the prevalence of other genotypes also did not differ, but in those aged 31 to 40 years, HPV prevalence was higher for Indigenous women (35% versus 22.5%; P Conclusion Although we found no difference in the prevalence of HPV16/18 among Australian women by Indigenous status or, for Indigenous women, residence in remote regions, differences were found in the prevalence of risk factors and some other HPV genotypes. This reinforces the importance of cervical screening as a complement to vaccination for all women, and the value of baseline data on HPV genotype prevalence by Indigenous status and residence for the monitoring of vaccine impact.
Durey, Angela; Thompson, Sandra C
Indigenous peoples have worse health than non-Indigenous, are over-represented amongst the poor and disadvantaged, have lower life expectancies, and success in improving disparities is limited. To address this, research usually focuses on disadvantaged and marginalised groups, offering only partial understanding of influences underpinning slow progress. Critical analysis is also required of those with the power to perpetuate or improve health inequities. In this paper, using Australia as a case example, we explore the effects of 'White', Anglo-Australian cultural dominance in health service delivery to Indigenous Australians. We address the issue using race as an organising principle, underpinned by relations of power. Interviews with non-Indigenous medical practitioners in Western Australia with extensive experience in Indigenous health encouraged reflection and articulation of their insights into factors promoting or impeding quality health care to Indigenous Australians. Interviews were audio-taped and transcribed. An inductive, exploratory analysis identified key themes that were reviewed and interrogated in light of existing literature on health care to Indigenous people, race and disadvantage. The researchers' past experience, knowledge and understanding of health care and Indigenous health assisted with data interpretation. Informal discussions were also held with colleagues working professionally in Indigenous policy, practice and community settings. Racism emerged as a key issue, leading us to more deeply interrogate the role 'Whiteness' plays in Indigenous health care. While Whiteness can refer to skin colour, it also represents a racialized social structure where Indigenous knowledge, beliefs and values are subjugated to the dominant western biomedical model in policy and practice. Racism towards Indigenous patients in health services was institutional and interpersonal. Internalised racism was manifest when Indigenous patients incorporated racist
Full Text Available Abstract Background Indigenous peoples have worse health than non-Indigenous, are over-represented amongst the poor and disadvantaged, have lower life expectancies, and success in improving disparities is limited. To address this, research usually focuses on disadvantaged and marginalised groups, offering only partial understanding of influences underpinning slow progress. Critical analysis is also required of those with the power to perpetuate or improve health inequities. In this paper, using Australia as a case example, we explore the effects of ‘White’, Anglo-Australian cultural dominance in health service delivery to Indigenous Australians. We address the issue using race as an organising principle, underpinned by relations of power. Methods Interviews with non-Indigenous medical practitioners in Western Australia with extensive experience in Indigenous health encouraged reflection and articulation of their insights into factors promoting or impeding quality health care to Indigenous Australians. Interviews were audio-taped and transcribed. An inductive, exploratory analysis identified key themes that were reviewed and interrogated in light of existing literature on health care to Indigenous people, race and disadvantage. The researchers’ past experience, knowledge and understanding of health care and Indigenous health assisted with data interpretation. Informal discussions were also held with colleagues working professionally in Indigenous policy, practice and community settings. Results Racism emerged as a key issue, leading us to more deeply interrogate the role ‘Whiteness’ plays in Indigenous health care. While Whiteness can refer to skin colour, it also represents a racialized social structure where Indigenous knowledge, beliefs and values are subjugated to the dominant western biomedical model in policy and practice. Racism towards Indigenous patients in health services was institutional and interpersonal. Internalised
Jervis-Bardy, Jake; Sanchez, L; Carney, A S
Otitis media represents a major health concern in Australian Indigenous children ('Indigenous children'), which has persisted, despite public health measures, for over 30 years. Global searches were performed to retrieve peer-reviewed and 'grey' literature investigating the epidemiology of and risk factors for otitis media in Indigenous children, published between 1985 and 2012. In Indigenous children, the prevalence of otitis media subtypes is 7.1-12.8 per cent for acute otitis media, 10.5-30.3 per cent for active chronic otitis media and 31-50 per cent for tympanic membrane perforation. The initial onset of otitis media in Indigenous children occurs earlier and persists for longer after the first year of life, compared with non-Indigenous children. Indigenous children are colonised by otopathogens more frequently, at younger ages and with a higher bacterial load. Poor community and domestic infrastructure, overcrowding and exposure to tobacco smoke increase the risk of otitis media in Indigenous children; however, the availability of swimming pools plays no role in the prevention or management of otitis media. Despite awareness of the epidemiological burden of otitis media and its risk factors in Indigenous children, studies undertaken since 1985 demonstrate that otitis media remains a significant public health concern in this population.
Living in a compassionate community is not a new practice in First Nations communities; they have always recognized dying as a social experience. First Nations hold extensive traditional knowledge and have community-based practices to support the personal, familial, and community experiences surrounding end-of-life. However, western health systems were imposed and typically did not support these social and cultural practices at end of life. In fact, the different expectations of western medicine and the community related to end of life care has created stress and misunderstanding for both. One solution is for First Nations communities to develop palliative care programs so that people can receive care at home amongst their family, community and culture. Our research project "Improving End-of-Life Care in First Nations Communities" (EOLFN) was funded by the Canadian Institutes of Health Research [2010-2015] and was conducted in partnership with four First Nations communities in Canada (see www.eolfn.lakeheadu.ca). Results included a community capacity development approach to support Indigenous models of care at end-of-life. The workshop will describe the community capacity development process used to develop palliative care programs in First Nations communities. It will highlight the foundation to this approach, namely, grounding the program in community values and principles, rooted in individual, family, community and culture. Two First Nations communities will share stories about their experiences developing their own palliative care programs, which celebrated cultural capacity in their communities while enhancing medical palliative care services in a way that respected and integrated with their community cultural practices. This workshop shares the experiences of two First Nations communities who developed palliative care programs by building upon community culture, values and principles. The underlying model guiding development is shared.
Harrold, Timothy C; Randall, Deborah A; Falster, Michael O; Lujic, Sanja; Jorm, Louisa R
To quantify the independent roles of geography and Indigenous status in explaining disparities in Potentially Preventable Hospital (PPH) admissions between Indigenous and non-Indigenous Australians. Analysis of linked hospital admission data for New South Wales (NSW), Australia, for the period July 1 2003 to June 30 2008. Age-standardised admission rates, and rate ratios adjusted for age, sex and Statistical Local Area (SLA) of residence using multilevel models. PPH diagnoses accounted for 987,604 admissions in NSW over the study period, of which 3.7% were for Indigenous people. The age-standardised PPH admission rate was 76.5 and 27.3 per 1,000 for Indigenous and non-Indigenous people respectively. PPH admission rates in Indigenous people were 2.16 times higher than in non-Indigenous people of the same age group and sex who lived in the same SLA. The largest disparities in PPH admission rates were seen for diabetes complications, chronic obstructive pulmonary disease and rheumatic heart disease. Both rates of PPH admission in Indigenous people, and the disparity in rates between Indigenous than non-Indigenous people, varied significantly by SLA, with greater disparities seen in regional and remote areas than in major cities. Higher rates of PPH admission among Indigenous people are not simply a function of their greater likelihood of living in rural and remote areas. The very considerable geographic variation in the disparity in rates of PPH admission between Indigenous and non-Indigenous people indicates that there is potential to reduce unwarranted variation by characterising outlying areas which contribute the most to this disparity.
Tam, Laura; Garvey, Gail; Meiklejohn, Judith; Martin, Jennifer; Adams, Jon; Walpole, Euan; Fay, Michael; Valery, Patricia
Amongst Indigenous Australians, “cancer” has negative connotations that detrimentally impact upon access to cancer care services. Barriers to accessing cancer services amongst Indigenous Australians are widely reported. In contrast, factors that facilitate this cohort to successfully navigate cancer care services (“enablers”) are scarcely reported in the literature. Through qualitative interviews, this article examines factors that assist Indigenous Australians to have positive cancer experiences. Semi-structured interviews were conducted with twelve adult Indigenous oncology patients recruited from a tertiary hospital in Queensland, Australia during 2012–2014. Data generated from the interviews were independently reviewed by two researchers via inductive thematic analytical processes. Discussions followed by consensus on the major categories allowed conclusions to be drawn on potential enablers. Two major categories of enablers were identified by the researchers: resilience and communication. Individual’s intrinsic strength, their coping strategies, and receipt of support improved participant’s resilience and consequently supported a positive experience. Communication methods and an effective patient-provider relationship facilitated positive experiences for participants. Despite potential barriers to access of care for Indigenous cancer patients, participants in the study demonstrated that it was still possible to focus on the positive aspects of their cancer experiences. Many participants explained how cancer changed their outlook on life, often for the better, with many feeling empowered as they progressed through their cancer diagnosis and treatment processes. PMID:29342934
du Plessis, Santie
The study objectives were to develop, trial and evaluate a cross-cultural adaptation of the Adaptive Behavior Assessment System-Second Edition Teacher Form (ABAS-II TF) ages 5-21 for use with Indigenous Australian students ages 5-14. This study introduced a multiphase mixed-method design with semi-structured and informal interviews, school…
Wilson, Katie; Wilks, Judith
The growth of Aboriginal and Torres Strait Islander participation in Australian higher education from 1959 to the present is notable statistically, but below population parity. Distinct patterns in government policy-making and programme development, inconsistent funding and political influences, together with Indigenous representation during the…
Gilroy, John; Dew, Angela; Lincoln, Michelle; Hines, Monique
To identify approaches for developing workforce capacity to deliver the National Disability Insurance Scheme (NDIS) to Indigenous people with disability in Australian rural and remote communities. A narrative review of peer-reviewed and gray literature was undertaken. Searches of electronic databases and websites of key government and non-government organizations were used to supplement the authors' knowledge of literature that (a) focused on Indigenous peoples in Australia or other countries; (b) referred to people with disability; (c) considered rural/remote settings; (d) recommended workforce strategies; and (e) was published in English between 2004 and 2014. Recommended workforce strategies in each publication were summarized in a narrative synthesis. Six peer-reviewed articles and 12 gray publications met inclusion criteria. Three broad categories of workforce strategies were identified: (a) community-based rehabilitation (CBR) and community-centered approaches; (b) cultural training for all workers; and (c) development of an Indigenous disability workforce. An Indigenous disability workforce strategy based on community-centered principles and incorporating cultural training and Indigenous disability workforce development may help to ensure that Indigenous people with a disability in rural and remote communities benefit from current disability sector reforms. Indigenous workforce development requires strategies to attract and retain Aboriginal workers. Implications for Rehabilitation Indigenous people with disability living in rural and remote areas experience significant access and equity barriers to culturally appropriate supports and services that enable them to live independent, socially inclusive lives. A workforce strategy based on community-centered principles has potential for ensuring that the disability services sector meets the rehabilitation needs of Aboriginal people with disability living in rural and remote areas. Cultural training and
John Robert Evans
Full Text Available The argument that participation in sport among disadvantaged populations can produce positive outcomes in wide range of areas has been a consistent theme in academic literature. It is argued that sport participation can promote women’s empowerment, sexuality, lifestyle, peacemaking, youth development, poverty reduction and conflict resolution. Similarly, in Australia, participation in sport among Indigenous Australians has been proffered as a ‘panacea’ for many Indigenous problems; from promoting better health and education outcomes, to encouraging community building, good citizenship and entrepreneurship. Parallel to this has been a focus on documenting and analysing sport participation among Indigenous Australians in elite sport which often concludes that Indigenous Australians have an innate and ‘natural ability’ in sports. These two assumptions, first, that sport participation can help realise a wide range of positive social outcomes; and second, that Indigenous Australians are natural athletes, have driven significant public investment in numerous sport focused programs. This paper questions these assumptions and outlines some of the challenges inherent with an emphasis on sport as a solution to Indigenous disadvantage. We highlight how participation in sport has often been tied to ambitious, ill-defined and, in terms of evaluation, often elusive social outcome goals. Second, we also argue that there is limited research to indicate that participation in either elite or grassroots level sport has led to any discernible social progress in addressing inequality. We contrast historical Indigenous participation in a range of sporting codes to demonstrate the influence of factors beyond the ‘natural ability’ and ‘born to play’ propositions. Finally, we outline six ‘perils’ associated with viewing sport as a panacea; including how privileging sport can not only perpetuate disadvantage by reinforcing stereotypes and also
Full Text Available Abstract Background This project is a community-level study of equity of access to eye health services for Indigenous Australians. Methods The project used data on eye health services from multiple sources including Medicare Australia, inpatient and outpatient data and the National Indigenous Eye Health Survey. The analysis focused on the extent to which access to eye health services varied at an area level according to the proportion of the population that was Indigenous (very low = 0-1.0%, low = 1.1-3.0%, low medium = 3.1-6.0%, high medium = 6.1-10.0%, high = 10.1-20.0%, very high = 20 + %. The analysis of health service utilisation also took into account age, remoteness and the Socioeconomic Indices for Areas (SEIFA. Results The rate of eye exams provided in areas with very high Indigenous populations was two-thirds of the rate of eye exams for areas with very low indigenous populations. The cataract surgery rates in areas with high medium to very high Indigenous populations were less than half that reference areas. In over a third of communities with very high Indigenous populations the cataract surgery rate fell below the World Health Organization (WHO guidelines compared to a cataract surgery rate of 3% in areas with very low Indigenous populations. Conclusions There remain serious disparities in access to eye health service in areas with high Indigenous populations. Addressing disparities requires a co-ordinated approach to improving Indigenous people’s access to eye health services. More extensive take-up of existing Medicare provisions is an important step in this process. Along with improving access to health services, community education concerning the importance of eye health and the effectiveness of treatment might reduce reluctance to seek help.
Evans, John Robert; Wilson, Rachel; Coleman, Clare; Man, Wing Young Nicola; Olds, Tim
Sport and physical activity (PA) hold particular significance in Australian Indigenous communities, and have the potential to address many of the health and education challenges faced by Indigenous communities. Optimal levels of PA are an important foundation in efforts to build healthy communities and reduce social disadvantage experienced to date. Yet little evidence relating to the current levels of PA within these communities, or the relationship between PA and outcomes, has been available. Drawing on national survey data from the Australian Bureau of Statistics, we examine levels of PA in the Australian Aboriginal and Torres Strait Islander Health Survey 2012-13. These data describe PA levels among Indigenous Australians, aged 5-17 years, in remote and non-remote communities. We also examine the relationship between PA and participation in education and self-reported health among 15-17 year olds. Overall, participation rates appear to be high, with 64-84% of youth reporting at least 60 min of PA on the previous day. A gender gap was also evident, with lower levels of activity among girls. PA decreased with age, particularly at or around the age of puberty. There were no significant associations between PA and either self-reported health or engagement in study. There was a relationship between high PA and low area-level socio-economic status in remote areas, but no association in non-remote areas. The differences between remote and non-remote areas highlight the importance of disaggregated analysis of Indigenous populations and are consistent with qualitative studies identifying locally contextualised factors influential in promoting PA. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.
Reducing disparities in education outcomes between Indigenous and non-Indigenous Australians is one of the main ways in which the relative disadvantage Indigenous Australians face will be overcome. Relative and absolute participation rates in all forms of education have improved, however they are still unacceptably low. Those Indigenous…
McPhail-Bell, Karen; Appo, Nathan; Haymes, Alana; Bond, Chelsea; Brough, Mark; Fredericks, Bronwyn
The potential for health promotion through social networking sites (SNSs) is widely recognized. However, while health promotion prides itself in focusing on the social determinants of health, its partiality for persuading individuals to comply with health behaviours dominates the way health promotion utilizes SNSs. This paper contributes to an understanding of collaborative ways SNSs can work for health promotion agendas of self-determination and empowerment in an Indigenous Australia context. An ethnographic study was undertaken with Deadly Choices, an Indigenous-led health promotion initiative. The study involved participant observation of interactions on Deadly Choices SNSs between Deadly Choices and its online community members. Deadly Choices provides an example of SNSs providing a powerful tool to create a safe, inclusive and positive space for Indigenous people and communities to profile their healthy choices, according to Indigenous notions of health and identity. The study found five principles that underpin Deadly Choices' use of SNSs for health promotion. These are: create a dialogue; build community online and offline; incentivise healthy online engagement; celebrate Indigenous identity and culture; and prioritize partnerships. Deadly Choices SNSs empowers Indigenous people and communities to be health promoters themselves, which represents a power shift from health promotion practitioner to Indigenous people and communities and more broadly, an enactment of Indigenous self-determination on SNSs. Mainstream health promotion can learn from Indigenous health promotion practice regarding the use of SNSs for health promotion agendas. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Dudley, Mary Jo
Describes the effects on indigenous communities of Bolivia's recent Popular Participation Laws, which relocated political and financial decision making to the municipal level; community efforts toward cultural maintenance and nonformal agricultural education; the activism of indigenous university students; and the dual discrimination suffered by…
Interventions to encourage smoke-free homes in remote indigenous Australian communities: a study protocol to evaluate the effects of a community-inspired awareness-raising and motivational enhancement strategy
Clough, Alan R; Grant, Kristy; Robertson, Jan; Wrigley, Matthew; Nichols, Nina; Fitzgibbon, Tracey
Introduction Rates of secondhand smoke exposure are currently significantly higher among remote indigenous communities in the top end of Australia. By implementing a ‘smoke-free home’ rule, secondhand smoke exposure can be reduced. Smoke-free homes encourage quit attempts and improve the health of children. The prevalence of indigenous smoking rates in remote, discrete communities in Australia is elevated compared with their non-indigenous counterparts. The primary aim of this project is to examine the feasibility of conducting a health-driven intervention to encourage community members to make their homes a smoke-free zone. Methods and analysis This study uses mixed-methods exploratory evaluation design to obtain data from key informants and community householders to assess their willingness to implement a ‘smoke-free’ rule in their homes. Initial focus groups will provide guidance on intervention content and deliver evaluation procedures and community requirements. A rapid survey will be conducted to ascertain interest from community members in having the project team visit to discuss study objectives further and to have a particle meter (with consent) placed in the house. Focus groups recordings will be transcribed and analysed thematically. Rapid surveys will be analysed using frequency distributions and tabulations of responses. Ethics and dissemination The National Health and Medical Research Council guidelines on ethical research approaches to indigenous studies will be adhered to. The James Cook University Human Research Ethics Committee has provided ethics approval. PMID:29500205
Lavoie, Josée G; Dwyer, Judith
Objective Over past decades, Australian and Canadian Indigenous primary healthcare policies have focused on supporting community controlled Indigenous health organisations. After more than 20 years of sustained effort, over 89% of eligible communities in Canada are currently engaged in the planning, management and provision of community controlled health services. In Australia, policy commitment to community control has also been in place for more than 25 years, but implementation has been complicated by unrealistic timelines, underdeveloped change management processes, inflexible funding agreements and distrust. This paper discusses the lessons from the Canadian experience to inform the continuing efforts to achieve the implementation of community control in Australia. Methods We reviewed Canadian policy and evaluation grey literature documents, and assessed lessons and recommendations for relevance to the Australian context. Results Our analysis yielded three broad lessons. First, implementing community control takes time. It took Canada 20 years to achieve 89% implementation. To succeed, Australia will need to make a firm long term commitment to this objective. Second, implementing community control is complex. Communities require adequate resources to support change management. And third, accountability frameworks must be tailored to the Indigenous primary health care context to be meaningful. Conclusions We conclude that although the Canadian experience is based on a different context, the processes and tools created to implement community control in Canada can help inform the Australian context. What is known about the topic? Although Australia has promoted Indigenous control over primary healthcare (PHC) services, implementation remains incomplete. Enduring barriers to the transfer of PHC services to community control have not been addressed in the largely sporadic attention to this challenge to date, despite significant recent efforts in some jurisdictions
Study Protocol: establishing good relationships between patients and health care providers while providing cardiac care. Exploring how patient-clinician engagement contributes to health disparities between indigenous and non-indigenous Australians in South Australia
Roe Yvette L
Full Text Available Abstract Background Studies that compare Indigenous Australian and non-Indigenous patients who experience a cardiac event or chest pain are inconclusive about the reasons for the differences in-hospital and survival rates. The advances in diagnostic accuracy, medication and specialised workforce has contributed to a lower case fatality and lengthen survival rates however this is not evident in the Indigenous Australian population. A possible driver contributing to this disparity may be the impact of patient-clinician interface during key interactions during the health care process. Methods/Design This study will apply an Indigenous framework to describe the interaction between Indigenous patients and clinicians during the continuum of cardiac health care, i.e. from acute admission, secondary and rehabilitative care. Adopting an Indigenous framework is more aligned with Indigenous realities, knowledge, intellects, histories and experiences. A triple layered designed focus group will be employed to discuss patient-clinician engagement. Focus groups will be arranged by geographic clusters i.e. metropolitan and a regional centre. Patient informants will be identified by Indigenous status (i.e. Indigenous and non-Indigenous and the focus groups will be convened separately. The health care provider focus groups will be convened on an organisational basis i.e. state health providers and Aboriginal Community Controlled Health Services. Yarning will be used as a research method to facilitate discussion. Yarning is in congruence with the oral traditions that are still a reality in day-to-day Indigenous lives. Discussion This study is nestled in a larger research program that explores the drivers to the disparity of care and health outcomes for Indigenous and non-Indigenous Australians who experience an acute cardiac admission. A focus on health status, risk factors and clinical interventions may camouflage critical issues within a patient
Pandya, R. E.; Bennett, B.
Historically, the goal of broadening participation in the geosciences has been expressed and approached from the viewpoint of the majority-dominated geoscience community. The need for more students who are American Indian, Native Hawaiian, or Alaska Native is expressed in terms of the need to diversify the research community, and strategies to engage more students are often posed around the question “what can we do to get more indigenous students interested in coming to our institutions to do geosciences?” This approach can lead to neglecting indigenous ways of knowing, inadvertently prioritizes western values over traditional ones, and doesn’t necessarily honor tribal community’s desire to hold on to their talented youth. Further, while this approach has resulted in some modest success, the overall participation in geoscience by students from indigenous backgrounds remains low. Many successful programs, however, have tried an alternate approach; they begin by approaching the geosciences from the viewpoint of indigenous communities. The questions they ask center around how geosciences can advance the priorities of indigenous communities, and their approaches focus on building capacity for the geosciences within indigenous communities. Most importantly, perhaps, these efforts originate in Tribal communities themselves, and invite the geoscience research community to partner in projects that are rooted in indigenous culture and values. Finally, these programs recognize that scientific expertise is only one among many skills indigenous peoples employ in their relation with their homelands. Climate change, like all things related to the landscape, is intimately connected to the core of indigenous cultures. Thus, emerging concerns about climate change provide a venue for developing new, indigenous-centered, approaches to the persistent problem of broadening participation in the geoscience. This presentation will highlight three indigenous-led efforts in to
Lyons, Jasmine G; O'Dea, Kerin; Walker, Karen Z
Low plasma high-density lipoprotein cholesterol (HDL-C) levels are a strong, independent, but poorly understood risk factor for cardiovascular disease (CVD). Although this atherogenic lipid abnormality has been widely reported in Australia's Indigenous peoples, Aboriginal and Torres Strait Islanders, the evidence has not come under systematic review. This review therefore examines published data for Indigenous Australians reporting 1) mean HDL-C levels for both sexes and 2) factors associated with low HDL-C. PubMed, Medline and Informit ATSI Health databases were systematically searched between 1950 and 2012 for studies on Indigenous Australians reporting mean HDL-C levels in both sexes. Retrieved studies were evaluated by standard criteria. Low HDL-C was defined as: Indigenous populations living in rural and remote communities. Inverse associations between HDL-C and central obesity, diabetes prevalence and inflammatory markers suggest a particularly adverse CVD risk factor profile. An absence of sex dichotomy in HDL-C levels warrants further investigation.
Blunden, Sarah; Magee, Chris; Attard, Kelly; Clarkson, Larissa; Caputi, Peter; Skinner, Timothy
Sleep duration and sleep schedule variability have been related to negative health and well-being outcomes in children, but little is known about Australian Indigenous children. Data for children aged 7-9 years came from the Australian Longitudinal Study of Indigenous Children and the National Assessment Program-Literacy and Numeracy (NAPLAN). Latent class analysis determined sleep classes taking into account sleep duration, bedtimes, waketimes, and variability in bedtimes from weekdays to weekends. Regression models tested whether the sleep classes were cross-sectionally associated with grade 3 NAPLAN scores. Latent change score modeling then examined whether the sleep classes predicted changes in NAPLAN performance from grades 3 to 5. Five sleep schedule classes were identified: normative sleep, early risers, long sleep, variable sleep, and short sleep. Overall, long sleepers performed best, with those with reduced sleep (short sleepers and early risers) performing the worse on grammar, numeracy, and writing performance. Latent change score results also showed that long sleepers performed best in spelling and writing and short sleepers and typical sleepers performed the worst over time. In this sample of Australian Indigenous children, short sleep was associated with poorer school performance compared with long sleep, with this performance worsening over time for some performance indicators. Other sleep schedules (eg, early wake times and variable sleep) also had some relationships with school performance. As sleep scheduling is modifiable, this offers opportunity for improvement in sleep and thus performance outcomes for these and potentially all children. Copyright © 2018 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.
Reifels, Lennart; Nicholas, Angela; Fletcher, Justine; Bassilios, Bridget; King, Kylie; Ewen, Shaun; Pirkis, Jane
Improving access to culturally appropriate mental healthcare has been recognised as a key strategy to address the often greater burden of mental health issues experienced by Indigenous populations. We present data from the evaluation of a national attempt at improving access to culturally appropriate mental healthcare for Indigenous Australians through a mainstream primary mental healthcare program, the Access to Allied Psychological Services program, whilst specifically focusing on the implementation strategies and perspectives of service providers. We conducted semi-structured interviews with 31 service providers (primary care agency staff, referrers, and mental health professionals) that were analysed thematically and descriptively. Agency-level implementation strategies to enhance service access and cultural appropriateness included: the conduct of local service needs assessments; Indigenous stakeholder consultation and partnership development; establishment of clinical governance frameworks; workforce recruitment, clinical/cultural training and supervision; stakeholder and referrer education; and service co-location at Indigenous health organisations. Dedicated provider-level strategies to ensure the cultural appropriateness of services were primarily aimed at the context and process of delivery (involving, flexible referral pathways, suitable locations, adaptation of client engagement and service feedback processes) and, to a lesser extent, the nature and content of interventions (provision of culturally adapted therapy). This study offers insights into key factors underpinning the successful national service implementation approach. Study findings highlight that concerted national attempts to enhance mainstream primary mental healthcare for Indigenous people are critically dependent on effective local agency- and provider-level strategies to optimise the integration, adaptation and broader utility of these services within local Indigenous community and
Full Text Available Abstract Background Indigenous Australians are known to be at greater risk of morbidity and mortality from mental health related conditions, but most available data relate to the use of mental health services, and little is known about other aspects of social and emotional wellbeing. Using the first available nationally representative data, we examined the prevalence and patterning of psychological distress among Indigenous Australian adults and compared these with corresponding data from the non-Indigenous population. Methods The analysis used weighted data on psychological distress, as measured by a modified Kessler Psychological Distress score (K5, and a range of socio-demographic measures for 5,417 Indigenous and 15,432 non-Indigenous adults aged 18-64 years from two nationally representative surveys. Very high psychological distress (VHPD was defined as a K5 score ≥ 15 (possible range = 5-25. Results Indigenous adults were about three times more likely than non-Indigenous adults to be classified with VHPD: 14.5% (95% confidence interval (CI 12.9-16.0% versus 5.5% (95% CI 5.0-5.9%. After adjusting for age, most socio-demographic variables were significantly associated with VHPD in both populations, although the relative odds were generally larger among non-Indigenous people. Indigenous people in remote areas had a lower prevalence of VHPD than their non-remote counterparts, and only marital status, main language, and food insecurity were significantly associated with VHPD in remote areas. Conclusions Higher absolute levels of VHPD combined with smaller socio-demographic gradients in the Indigenous population suggest the importance of risk factors such as interpersonal racism, marginalization and dispossession, chronic stress and exposure to violence that are experienced by Indigenous Australians with common and/or cross-cutting effects across the socioeconomic spectrum. The lower prevalence of VHPD and lack of association with many socio
The number of Indigenous Australians completing doctoral qualifications is disparately below their non-Indigenous contemporaries. Whilst there has been a steady increase in Indigenous completions in recent years, significant work remains to redress the imbalance. Supervision has been identified as a primary influencer of the likely success of…
McCabe, Marita P.; Ricciardelli, Lina; Mellor, David; Ball, Kylie
There has been no previous investigation of body image concerns and body change strategies among indigenous Australians. This study was designed to investigate the level of body satisfaction, body change strategies, and perceived media messages about body change strategies among 50 indigenous (25 males, 25 females) and 50 non-indigenous (25 males,…
Breen, Helen M.
The purpose of this paper was to examine risk and protective factors associated with the consequences of card gambling and commercial gambling for Indigenous Australians in north Queensland. With Indigenous Elders' approval and using qualitative methodology, semi-structured interviews were conducted with 60 Indigenous and 48 non-Indigenous…
Ng, Soo Khai; Kahawita, Shyalle; Andrew, Nicholas Howard; Henderson, Tim; Craig, Jamie Evan; Landers, John
It is well established from different population-based studies that visual impairment is associated with increased mortality rate. However, to our knowledge, the association of visual impairment with increased mortality rate has not been reported among indigenous Australian individuals. To assess the association between visual impairment and 10-year mortality risk among the remote indigenous Australian population. Prospective cohort study recruiting indigenous Australian individuals from 30 remote communities located within the central Australian statistical local area over a 36-month period between July 2005 and June 2008. The data were analyzed in January 2017. Visual acuity, slitlamp biomicroscopy, and fundus examination were performed on all patients at recruitment. Visual impairment was defined as a visual acuity of less than 6/12 in the better eye. Mortality rate and mortality cause were obtained at 10 years, and statistical analyses were performed. Hazard ratios for 10-year mortality with 95% confidence intervals are presented. One thousand three hundred forty-seven patients were recruited from a total target population number of 2014. The mean (SD) age was 56 (11) years, and 62% were women. The total all-cause mortality was found to be 29.3% at 10 years. This varied from 21.1% among those without visual impairment to 48.5% among those with visual impairment. After adjustment for age, sex, and the presence of diabetes and hypertension, those with visual impairment were 40% more likely to die (hazard ratio, 1.40; 95% CI, 1.16-1.70; P = .001) during the 10-year follow-up period compared with those with normal vision. Bilateral visual impairment among remote indigenous Australian individuals was associated with 40% higher 10-year mortality risk compared with those who were not visually impaired. Resource allocation toward improving visual acuity may therefore aid in closing the gap in mortality outcomes between indigenous and nonindigenous Australian
Thomas David P
Full Text Available Abstract Background In Australia, national smoking prevalence has successfully fallen below 20%, but remains about 50% amongst Indigenous Australians. Australian Indigenous tobacco control is framed by the idea that nothing has worked and a sense of either despondency or the difficulty of the challenge. Methods This paper examines the trends in smoking prevalence of Australian Indigenous men and women aged 18 and over in three large national cross-sectional surveys in 1994, 2002 and 2004. Results From 1994 to 2004, Indigenous smoking prevalence fell by 5.5% and 3.5% in non-remote and remote men, and by 1.9% in non-remote women. In contrast, Indigenous smoking prevalence rose by 5.7% in remote women from 1994 to 2002, before falling by 0.8% between 2002 and 2004. Male and female Indigenous smoking prevalences in non-remote Australia fell in parallel with those in the total Australian population. The different Indigenous smoking prevalence trends in remote and non-remote Australia can be plausibly explained by the typical characteristics of national tobacco epidemic curves, with remote Indigenous Australia just at an earlier point in the epidemic. Conclusion Reducing Indigenous smoking need not be considered exceptionally difficult. Inequities in the distribution of smoking related-deaths and illness may be reduced by increasing the exposure and access of Indigenous Australians, and other disadvantaged groups with high smoking prevalence, to proven tobacco control strategies.
Kinchin, Irina; Jacups, Susan; Tsey, Komla; Lines, Katrina
Empowerment programs have been shown to contribute to increased empowerment of individuals and build capacity within the community or workplace. To-date, the impact of empowerment programs has yet to be quantified in the published literature in this field. This study assessed the Indigenous-developed Family Wellbeing (FWB) program as an empowerment intervention for a child safety workforce in remote Indigenous communities by measuring effect sizes. The study also assessed the value of measurement tools for future impact evaluations. A three-day FWB workshop designed to promote empowerment and workplace engagement among child protection staff was held across five remote north Queensland Indigenous communities. The FWB assessment tool comprised a set of validated surveys including the Growth and Empowerment Measure (GEM), Australian Unity Wellbeing Index, Kessler psychological distress scale (K10) and Workforce engagement survey. The assessment was conducted pre-intervention and three months post-intervention. The analysis of pre-and post-surveys revealed that the GEM appeared to be the most tangible measure for detecting positive changes in communication, conflict resolution, decision making and life skill development. The GEM indicated a 17 % positive change compared to 9 % for the Australian Unity Wellbeing Index, 5 % for the workforce engagement survey and less than 1 % for K10. This study extended qualitative research and identified the best measurement tool for detecting the outcomes of empowerment programs. The GEM was found the most sensitive and the most tangible measure that captures improvements in communication, conflict resolution, decision making and life skill development. The GEM and Australian Unity Wellbeing Index could be recommended as routine measures for empowerment programs assessment among similar remote area workforce.
Heather A. Knauer
Full Text Available Parenting may be influenced by ethnicity; marginalization; education; and poverty. A critical but unexamined question is how these factors may interact to compromise or support parenting practices in ethnic minority communities. This analysis examined associations between mothers’ stimulating parenting practices and a range of child-level (age; sex; and cognitive and socio-emotional development; household-level (indigenous ethnicity; poverty; and parental education; and community-level (economic marginalization and majority indigenous population variables among 1893 children ages 4–18 months in poor; rural communities in Mexico. We also explored modifiers of associations between living in an indigenous community and parenting. Key findings were that stimulating parenting was negatively associated with living in an indigenous community or family self-identification as indigenous (β = −4.25; SE (Standard Error = 0.98; β = −1.58; SE = 0.83 respectively. However; living in an indigenous community was associated with significantly more stimulating parenting among indigenous families than living in a non-indigenous community (β = 2.96; SE = 1.25. Maternal education was positively associated with stimulating parenting only in indigenous communities; and household crowding was negatively associated with stimulating parenting only in non-indigenous communities. Mothers’ parenting practices were not associated with child sex; father’s residential status; education; or community marginalization. Our findings demonstrate that despite greater community marginalization; living in an indigenous community is protective for stimulating parenting practices of indigenous mothers.
Clarke, Kendall; Denton, Marijke
Supporting children in their early development and learning has long-term benefits for both them and the broader community. Yet in Australia we still have significant examples of inequality of opportunity (Allan, 2010) and other structural barriers to family wellbeing, particularly in Indigenous and rural and remote communities (Bourke, Humphreys,…
Percival, Nikki A; McCalman, Janya; Armit, Christine; O'Donoghue, Lynette; Bainbridge, Roxanne; Rowley, Kevin; Doyle, Joyce; Tsey, Komla
In Australia, significant resources have been invested in producing health promotion best practice guidelines, frameworks and tools (herein referred to as health promotion tools) as a strategy to improve Indigenous health promotion programmes. Yet, there has been very little rigorous implementation research about whether or how health promotion tools are implemented. This paper theorizes the complex processes of health promotion tool implementation in Indigenous comprehensive primary healthcare services. Data were derived from published and grey literature about the development and the implementation of four Indigenous health promotion tools. Tools were theoretically sampled to account for the key implementation types described in the literature. Data were analysed using the grounded-theory methods of coding and constant comparison with construct a theoretical implementation model. An Indigenous Health Promotion Tool Implementation Model was developed. Implementation is a social process, whereby researchers, practitioners and community members collectively interacted in creating culturally responsive health promotion to the common purpose of facilitating empowerment. The implementation of health promotion tools was influenced by the presence of change agents; a commitment to reciprocity and organizational governance and resourcing. The Indigenous Health Promotion Tool Implementation Model assists in explaining how health promotion tools are implemented and the conditions that influence these actions. Rather than simply developing more health promotion tools, our study suggests that continuous investment in developing conditions that support empowering implementation processes are required to maximize the beneficial impacts and effectiveness of health promotion tools. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: email@example.com
Parker, Elizabeth; Meiklejohn, Beryl; Patterson, Carla; Edwards, Ken; Preece, Cilia; Shuter, Patricia; Gould, Trish
Indigenous Australians have higher morbidity and mortality rates than non-Indigenous Australians. Until recently, few health promotion interventions have had more than limited success in Indigenous populations. This community-based health promotion initiative introduced traditional Indigenous games into schools and community groups in Cherbourg and Stradbroke Island (Queensland, Australia). A joint community forum managed the project, and the Indigenous community-based project officers co-ordinated training in traditional games and undertook community asset audits and evaluations. The games have been included in the activities of a range of community organisations in Cherbourg and Stradbroke Island. Several other organisations and communities in Australia have included them in their projects. A games video and manual were produced to facilitate the initiative's transferability and sustainability. Conventional approaches to health promotion generally focus on individual risk factors and often ignore a more holistic perspective. This project adopted a culturally appropriate, holistic approach, embracing a paradigm that concentrated on the communities' cultural assets and contributed to sustainable and transferable outcomes. There is a need for appropriate evaluation tools for time-limited community engagement projects.
Full Text Available Over the last few years, I have attended several political meetings concerned with the refugee crisis, multiculturalism or Indigenous rights in Australia, meetings at which liberal democratic–minded ‘left-wing’ people came together to discuss, or agitate for change in, governmental policies. At these meetings, I always found it difficult to accept the slogans on their placards and in their speeches: ‘Shame Australia! Reconciliation for a united Australia’, ‘Wake up Australia! We welcome refugees!’ or ‘True Australians are tolerant! Let’s celebrate multicultural Australia!’ My uncomfortable feeling came not only from the fact that I was left out because of my Japanese nationality but also because I had never seen or heard words like ‘shame Japan’, ‘wake up Japan’ or ‘true Japanese are ...’ at Japanese ‘left-wing’ political gatherings. In Japan, these are words used only by right-wing nationalists. Indeed it is difficult to even imagine liberal-left intellectuals in postwar Japan calling for a ‘true Japanese’ political response (as if such a response was positive, such is the extent to which the idea of ‘good nationalism’ is now regarded as an oxymoron. This is my starting point for an essay in which I want to be attentive to the different roles played by national(ism in the Japanese and Australian political environments.
Full Text Available International literature clearly demonstrates the potential for gender-based inequalities to constrain development processes. In the United Nations Development Programme Gender-related Development Index, Australia ranks in the top five across 177 countries, suggesting that the loss of human development due to gender inequality is minor. However, such analysis has not been systematically applied to the Indigenous Australian population, at least in a quantitative sense. Using the 2006 Australian Census, this paper provides an analysis across three dimensions of socioeconomic disparity: Indigeneity, gender, and geography. This paper also explores the development of a similar gender-related index as a tool to enable a relative ranking of the performance of Indigenous males and females at the regional level across a set of socioeconomic outcomes.The initial findings suggest that although there is a substantial development gap between Indigenous and non-Indigenous Australians, the development loss from gender-related inequality for Indigenous Australians is relatively small. Higher life expectancy and education attainment for Indigenous females balances out their slightly lower earnings to a large extent. At the regional level, Indigenous females tend to fare better than Indigenous males for the set of indicators chosen; and, this is particularly true in capital cities.
Ellender, Isabel; Drysdale, Marlene; Chesters, Janice; Faulkner, Susan; Kelly, Heather; Turnbull, Leanne
This paper investigates reasons Indigenous Australian medical students gave for leaving their courses prior to graduation. Indigenous students who had withdrawn or deferred from their medical courses were asked about the barriers and disincentives that had dissuaded them from graduating. Although the response rate to the questionnaire was very…
Australian children's literature has traditionally provided a space for colonial Australia to perpetuate ideas about segregation, assimilation, and reconciliation. Children's literature offers a complex medium for readers, Indigenous and non-Indigenous, to question and challenge prevalent attitudes, in particular, the notion of…
Hart, Victor; Whatman, Susan; McLaughlin, Juliana; Sharma-Brymer, Vinathe
This paper argues from the standpoint that embedding Indigenous knowledge and perspectives in Australian curricula occurs within a space of tension, "the cultural interface", in negotiation and contestation with other dominant knowledge systems. In this interface, Indigenous knowledge is in a state of constancy and flux, invisible and…
Claire E. Brolan
Full Text Available Abstract: This article reviews the health and wellbeing of Aboriginal and Torres Strait Islander Australians with intellectual disability in the Australian prison system through a human rights lens. There is an information gap on this group of Australian prisoners in the health and disability literature and the multi-disciplinary criminal law and human rights law literature. This article will consider the context of Indigenous imprisonment in Australia and examine the status of prisoner health in that country, as well as the status of the health and wellbeing of prisoners with intellectual disability. It will then specifically explore the health, wellbeing and impact of imprisonment on Indigenous Australians with intellectual disability, and highlight how intersectional rights deficits (including health and human rights deficits causally impact the ability of Indigenous Australians with intellectual disability to access due process, equal recognition and justice in the criminal justice and prison system. A central barrier to improving intersectional and discriminatory landscapes relating to health, human rights and justice for Indigenous Australian inmates with intellectual disability, and prisoners with intellectual disability more broadly in the Australian context, is the lack of sufficient governance and accountability mechanisms (including Indigenous-led mechanisms to enforce the operationalisation of consistent, transparent, culturally responsive, rights-based remedies.
Full Text Available Abstract Background In common with Indigenous populations elsewhere, Indigenous Australians have higher incidence of end-stage kidney disease (ESKD, but lower transplantation rates than their non-Indigenous counterparts. Understanding how the demands of dialysis impact on, and are impacted by, the lives of Indigenous patients may provide important insight into treatment pathways and decision-making. Methods We conducted semi-structured interviews in 2005–06 with 146 Indigenous and 95 non-Indigenous patients from nine hospital renal wards and 17 associated dialysis centres, which together treat the majority of Indigenous Australian ESKD patients. Results Factors influencing treatment experience included: the impacts of late diagnosis; family separations associated with relocating for treatment; the physical and psychosocial demands of hemodialysis; and ineffective communication between health care providers and patients. Although not unique to them, Indigenous patients were more likely to experience the combined effect of all factors. Conclusions Social/situational circumstances profoundly affect Indigenous Australian dialysis patients’ ability to fully engage with treatment. This may ultimately affect their likelihood of receiving optimal treatment, including transplantation. Areas for improvement include: earlier diagnosis; improved linkages between specialist renal services and primary care in regional settings; more effective communication and patient education; and more systematic, transparent approaches to patient “compliance” in transplant and home dialysis guidelines.
Liu, Ebony; Ng, Soo K; Kahawita, Shyalle; Andrew, Nicholas H; Henderson, Tim; Craig, Jamie E; Landers, John
No studies to date have explored the association of vision with mortality in Indigenous Australians. We aimed to determine the 10-year all-cause mortality and its associations among Indigenous Australians living in Central Australia. Prospective observational cohort study. A total of 1257 (93.0%) of 1347 patients from The Central Australian Ocular Health Study, over the age of 40 years, were available for follow-up during a 10-year period. All-cause mortality and its associations with visual acuity, age and gender were analysed. All-cause mortality. All-cause mortality was 29.3% at the end of 10 years. Mortality increased as age of recruitment increased: 14.2% (40-49 years), 22.6% (50-59 years), 50.3% (60 years or older) (χ = 59.15; P < 0.00001). Gender was not associated with mortality as an unadjusted variable, but after adjustment with age and visual acuity, women were 17.0% less likely to die (t = 2.09; P = 0.037). Reduced visual acuity was associated with increased mortality rate (5% increased mortality per one line of reduced visual acuity; t = 4.74; P < 0.0001) after adjustment for age, sex, diabetes and hypertension. The 10-year all-cause mortality rate of Indigenous Australians over the age of 40 years and living in remote communities of Central Australia was 29.3%. This is more than double that of the Australian population as a whole. Mortality was significantly associated with visual acuity at recruitment. Further work designed to better understand this association is warranted and may help to reduce this disparity in the future. © 2016 Royal Australian and New Zealand College of Ophthalmologists.
Full Text Available BACKGROUND: Genetic research has potential benefits for improving health, such as identifying molecular characteristics of a disease, understanding disease prevalence and treatment, and developing treatments tailored to patients based on individual genetic characteristics of their disease. Indigenous people are often targeted for genetic research because genes are easier to study in communities that practice endogamy. Therefore, populations perceived to be more homogenous, such as Indigenous peoples, are ideal for genetic studies. While Indigenous communities remain the focal point of many genomic studies, some result in harm and unethical practice. Unfortunately, the harms of poorly formulated and unethical research involving Indigenous people have created barriers to participation that prevent critical and lifesaving research. These harms have led a number of Indigenous communities to develop guidelines for engaging with researchers to assist in safely bridging the gap between genetic research and Indigenous peoples.SPECIFIC AIMS: The specific aims of this study were: (1 to conduct an international review and comparison of Indigenous research guidelines that highlight topics regarding genetics and use of biological samples and identify commonalities and differences among ethical principles of concern to Indigenous peoples; and (2 develop policy recommendations for Indigenous populations interested in creating formal policies around the use of genetic information and protection of biological samples using data from specific aim 1.METHODS: A comparative analysis was performed to identify best research practices and recommendations for Indigenous groups from four countries: Canada, New Zealand, Australia, and the United States. The analysis examined commonalities in political relationships, which support self-determination among these Indigenous communities to control their data. Current international Indigenous guidelines were analyzed to review
An evaluation of the telehealth facilitation of diabetes and cardiovascular care in remote Australian Indigenous communities: - protocol for the telehealth eye and associated medical services network [TEAMSnet] project, a pre-post study design.
Brazionis, Laima; Jenkins, Alicia; Keech, Anthony; Ryan, Chris; Bursell, Sven-Erik
Despite substantial investment in detection, early intervention and evidence-based treatments, current management strategies for diabetes-associated retinopathy and cardiovascular disease are largely based on real-time and face-to-face approaches. There are limited data re telehealth facilitation in type 2 diabetes management. Therefore, we aim to investigate efficacy of telehealth facilitation of diabetes and cardiovascular disease care in high-risk vulnerable Aboriginal and Torres Strait Islanders in remote/very remote Australia. Using a pre-post intervention design, 600 Indigenous Australians with type 2 diabetes will be recruited from three primary-care health-services in the Northern Territory. Diabetes status will be based on clinical records. There will be four technological interventions: 1. Baseline retinal imaging [as a real-time patient education/engagement tool and telehealth screening strategy]. 2. A lifestyle survey tool administered at ≈ 6-months. 3. At ≈ 6- and 18-months, an electronic cardiovascular disease and diabetes decision-support tool based on current guidelines in the Standard Treatment Manual of the Central Australian Rural Practitioner's Association to generate clinical recommendations. 4. Mobile tablet technology developed to enhance participant engagement in self-management. Data will include: Pre-intervention clinical and encounter-history data, baseline retinopathy status, decision-support and survey data/opportunistic mobile tablet encounter data. The primary outcome is increased participant adherence to clinical appointments, a marker of engagement and self-management. A cost-benefit analysis will be performed. Remoteness is a major barrier to provision and uptake of best-practice chronic disease management. Telehealth, beyond videoconferencing of consultations, could facilitate evidence-based management of diabetes and cardiovascular disease in Indigenous Australians and serve as a model for other conditions. Australia
The title of the paper requires some brief reflection on the main topics implied. It is appropriate to start off with a definition of Indigenous Knowledge Systems (IKS) as well as a statement regarding the constitutional status of a community. Thereafter I will expand on the merits of IKS towards community development as well as ...
Kandasamy, Y; Smith, R; Wright, I M R; Lumbers, E R
Rates of chronic kidney disease (CKD) among Indigenous groups in Australia exceed non-Indigenous rates eight-fold. Using kidney volume as a surrogate for nephron number, we carried out a study to determine if Indigenous neonates have a smaller kidney volume (and thus a reduced nephron number) from birth compared with non-Indigenous neonates. We recruited term and preterm neonates (Indigenous) and 39 term (13 Indigenous) neonates. TKV of Indigenous neonates was significantly lower at 32 weeks [12.0 (2.0) v. 15.4 (5.1) ml; P=0.03] and 38 weeks CA [18.6 (4.0) v. 22.6 (5.9) ml; P=0.04] respectively. Term Indigenous neonates also had smaller kidney volumes compared with non-Indigenous neonates. Despite a smaller kidney volume (and reduced nephron number), Indigenous neonates did not have a significantly lower eGFR. Indigenous neonates achieve similar eGFRs to Non-Indigenous neonates, presumably through a higher single nephron filtration rate. This places Indigenous neonates at a greater risk of long-term kidney damage later in life.
Diehl, Eliana Elisabeth; Langdon, Esther Jean; Dias-Scopel, Raquel Paiva
Indigenous community health workers are part of a strategy developed by Brazil in the last two decades to promote a special healthcare model for indigenous peoples. Their role is designed to deal with various aspects of the special health policy, including the link between the heath team and the community and mediation between scientific and indigenous medical knowledge. Despite a significant increase in the number of indigenous community health workers in recent years, an evaluation of their responsibilities and contributions to the success of special care had not been conducted previously. This article, based on a literature review and original research by the authors, analyzes the role of the indigenous community health workers vis-à-vis their training and participation in health teams in different contexts in Brazil. Considering the importance assigned to the role of indigenous community health workers, this analysis reveals various ambiguities and contradictions that hinder both their performance and their potential contribution to the special health services.
Full Text Available The formal reconciliation process in Australia was conducted between 1991 and 2000 and aimed to reconcile Indigenous and non-Indigenous peoples by 2001. In this paper, I detail the failure of both this reconciliation process and governments, in particular the Howard Government, to recognise Indigenous rights, such as sovereignty, a treaty, self-determination and land rights.
Vujcich, Daniel; Rayner, Mike; Allender, Steven; Fitzpatrick, Ray
The Indigenous Tobacco Control Initiative and Tackling Indigenous Smoking Measure were both announced by the Australian Government at a time when its rhetoric around the importance of evidence-based policy making was strong. This article will (1) examine how the Rudd Government used evidence in Indigenous tobacco control policy making and (2) explore the facilitators of and barriers to the use of evidence. Data were collected through (1) a review of primary documents largely obtained under the Freedom of Information Act 1982 (Commonwealth of Australia) and (2) interviews with senior politicians, senior bureaucrats, government advisors, Indigenous health advocates, and academics. Through the Freedom of Information Act process, 24 previously undisclosed government documents relevant to the making of Indigenous tobacco control policies were identified. Interviewees ( n = 31, response rate 62%) were identified through both purposive and snowball recruitment strategies. The Framework Analysis method was used to analyze documentary and interview data. Government policy design was heavily influenced by the recommendations presented in government authored/commissioned literature reviews. Resulting policies were led by equivocal evidence for improved tobacco control outcomes among Indigenous Australians. Many of the cited studies had methodological limitations. In the absence of high-quality evidence, some policy makers supported policy recommendations that were perceived to be popular among the Indigenous community. Other policy makers recognized that there were barriers to accumulating rigorous, generalizable evidence; in the absence of such evidence, the policy makers considered that the "need for action" could be combined with the "need for research" by introducing innovative strategies and evaluating them. Despite the absence of high-quality evidence, the formulation and adoption of Indigenous tobacco policy was neither irrational nor reckless. The decision to
Full Text Available BACKGROUND: The Indigenous Tobacco Control Initiative and Tackling Indigenous Smoking Measure were both announced by the Australian Government at a time when its rhetoric around the importance of evidence-based policy making was strong. This article will (1 examine how the Rudd Government used evidence in Indigenous tobacco control policy making and (2 explore the facilitators of and barriers to the use of evidence. METHODS: Data were collected through: (1 a review of primary documents largely obtained under the Freedom of Information Act 1982 (Commonwealth of Australia and (2 interviews with senior politicians, senior bureaucrats, government advisors, Indigenous health advocates and academics. Through the Freedom of Information Act process, 24 previously undisclosed government documents relevant to the making of Indigenous tobacco control policies were identified. Interviewees (n=31, response rate 62% were identified through both purposive and snowball recruitment strategies. The Framework Analysis method was used to analyse documentary and interview data.RESULTS: Government policy design was heavily influenced by recommendations presented in government authored/commissioned literature reviews. Resulting policies were led by equivocal evidence for improved tobacco control outcomes among Indigenous Australians. Many of the cited studies had methodological limitations. In the absence of high quality evidence, some policy makers supported policy recommendations that were perceived to be popular among the Indigenous community. Other policy makers recognised that there were barriers to accumulating rigorous, generalizable evidence; in the absence of such evidence, the policy makers considered that the ‘need for action’ could be combined with the ‘need for research’ by introducing innovative strategies and evaluating them.DISCUSSION: Despite the absence of high quality evidence, the formulation and adoption of Indigenous Tobacco policy was
Rogerson, Bernadette; Copeland, Jan; Buttner, Petra; Bohanna, India; Cadet-James, Yvonne; Sarnyai, Zoltan; Clough, Alan R
Cannabis use and dependence is a serious health and criminal justice issue among incarcerated populations internationally. Upon abrupt, enforced cessation of cannabis, prisoners may suffer irritability and anger that can lead to threatening behaviour, intimidation, violence, sleep disturbances and self-harm. Cannabis withdrawal syndrome, proposed for inclusion in the Diagnostic and Statistical Manual of Mental Disorders in 2013, has not been examined in Indigenous populations. Owing to the exceptionally high rates of cannabis use in the community, high proportions of Australian Indigenous prisoners may suffer from withdrawal upon entry to custody. 60 male and 60 female Indigenous prisoners (18-40 years) at a high risk of cannabis dependence will be recruited upon entry to custody. A pictorial representation of the standard Cannabis Withdrawal Scale will be tested for reliability and validity. Cortisol markers will be measured in saliva, as the indicators of onset and severity of cannabis withdrawal and psychological distress. The characteristics will be described as percentages and mean or median values with 95% CI. Receiver operator curve analysis will determine an ideal cut-off of the Cannabis Withdrawal Scale and generalised estimating equations modelling will test changes over time. The acceptability and efficacy of proposed resources will be assessed qualitatively using thematic analysis. A valid and reliable measure of cannabis withdrawal for use with Indigenous populations, the onset and time course of withdrawal symptoms in this population and the development of culturally acceptable resources and interventions to identify and manage cannabis withdrawal. The project has been approved by the James Cook University Human Research Ethics Committee (approval number H4651).The results will be reported via peer reviewed publications, conference, seminar presentations and on-line media for national and international dissemination.
Full Text Available Significant natural resource management investment is flowing to bioculturally diverse areas occupied by indigenous and other socioeconomically and politically marginalized groups. Such investment focuses on environmental benefit but may also generate ancillary economic, social, and other cobenefits. Increased investor interest in such cobenefits is driving the emerging research literature on cobenefit identification, categorization, and assessment. For local people undertaking community-based natural resource management, this emerging cobenefit discourse creates opportunities for more holistic program assessments that better reflect local perspectives, but it also contains risks of increased reporting burdens and institutional capture. Here, we synthesize and critically review the cobenefit literature arising from Australian indigenous cultural and natural resource management programs, a context in which there is a strong investor interest in cobenefits, particularly from government. We identify a wide suite of cobenefits in the existing literature and highlight previously unrecognized conceptual gaps and elisions in cobenefit categorization, including inconsistencies in category definition, the underanalysis of key categories, and a lack of systematic attention to beneficiaries as well as benefits. We propose a clarified and expanded conceptual framework to identify consistently the full suite of benefits, thereby enabling further assessment, valuation, and development of incentive mechanisms, standards, and guidelines. Our analysis has implications for community-based natural resource management assessment in a wide range of international contexts.
Rountree, Jennifer; Smith, Addie
Mainstream child and family well-being indicators frequently are based on measuring health, economic, and social deficits, and do not reflect Indigenous holistic and strength-based definitions of health and well-being. The present article is a review of literature that features Indigenous communities' self-identified strength-based indicators of child and family well-being. The literature search included Indigenous communities from across the world, incorporating findings from American Indians and Alaska Natives, First Nations, Native Hawaiians, Māori, Aboriginal Australians, and Sámi communities. Sorting the identified indicators into the quadrants of the Relational Worldview, an Indigenous framework for well-being based on medicine wheel teachings that views health and well-being as a balance among physical, mental, contextual, and spiritual factors, the authors discuss the findings.
Full Text Available Abstract Background Indigenous Australians are significantly less likely to participate in colorectal cancer (CRC screening compared to non-Indigenous people. This study aimed to identify important factors influencing the decision to undertake screening using Faecal Occult Blood Testing (FOBT among Indigenous Australians. Very little evidence exists to guide interventions and programmatic approaches for facilitating screening uptake in this population in order to reduce the disparity in colorectal cancer outcomes. Methods Interviewer-administered surveys were carried out with a convenience sample (n = 93 of Indigenous Western Australians between November 2009-March 2010 to assess knowledge, awareness, attitudes and behavioural intent in regard to CRC and CRC screening. Results Awareness and knowledge of CRC and screening were low, although both were significantly associated with exposure to media advertising (p = 0.008; p Conclusions Improving CRC related knowledge and confidence to carry out the FOBT self-screening test through education and greater promotion of screening has the potential to enhance Indigenous participation in CRC screening. These findings should guide the development of interventions to encourage screening uptake and reduce bowel cancer related deaths among Indigenous Australians.
Full Text Available Abstract Background Asthma is more common among Indigenous than non-Indigenous Australian adults, but little is known about socioeconomic patterning of asthma within the Indigenous population, or whether it is similar to the non-Indigenous population. Methods I analysed weighted data on self-reported current diagnosed asthma and a range of socio-economic and demographic measures for 5,417 Indigenous and 15,432 non-Indigenous adults aged 18-64 years from two nationally representative surveys conducted in parallel by the Australian Bureau of Statistics in 2004-05. Results Current asthma prevalence was higher for Indigenous than non-Indigenous people in every age group. After adjusting for age and sex, main language and place of residence were significantly associated with asthma prevalence in both populations. Traditional SES variables such as education, income and employment status were significantly associated with asthma in the non-Indigenous but not the Indigenous population. For example, age-and sex-adjusted relative odds of asthma among those who did not complete Year 10 (versus those who did was 1.2 (95% confidence interval (CI 1.0-1.5 in the non-Indigenous population versus 1.0 (95% CI 0.8-1.3 in the Indigenous population. Conclusions The socioeconomic patterning of asthma among Indigenous Australians is much less pronounced than for other chronic diseases such as diabetes and kidney disease, and contrasts with asthma patterns in the non-Indigenous population. This may be due in part to the episodic nature of asthma, and the well-known challenges in diagnosing it, especially among people with limited health literacy and/or limited access to health care, both of which are more likely in the Indigenous population. It may also reflect the importance of exposures occurring across the socioeconomic spectrum among Indigenous Australians, such as racism, and discrimination, marginalization and dispossession, chronic stress and exposure to
Vino, Thiripura; Singh, Gurmeet R; Davison, Belinda; Campbell, Patricia T; Lydeamore, Michael J; Robinson, Andrew; McVernon, Jodie; Tong, Steven Y C; Geard, Nicholas
Households are an important location for the transmission of communicable diseases. Social contact between household members is typically more frequent, of greater intensity, and is more likely to involve people of different age groups than contact occurring in the general community. Understanding household structure in different populations is therefore fundamental to explaining patterns of disease transmission in these populations. Indigenous populations in Australia tend to live in larger households than non-Indigenous populations, but limited data are available on the structure of these households, and how they differ between remote and urban communities. We have developed a novel approach to the collection of household structure data, suitable for use in a variety of contexts, which provides a detailed view of age, gender, and room occupancy patterns in remote and urban Australian Indigenous households. Here we report analysis of data collected using this tool, which quantifies the extent of crowding in Indigenous households, particularly in remote areas. We use these data to generate matrices of age-specific contact rates, as used by mathematical models of infectious disease transmission. To demonstrate the impact of household structure, we use a mathematical model to simulate an influenza-like illness in different populations. Our simulations suggest that outbreaks in remote populations are likely to spread more rapidly and to a greater extent than outbreaks in non-Indigenous populations.
Full Text Available Households are an important location for the transmission of communicable diseases. Social contact between household members is typically more frequent, of greater intensity, and is more likely to involve people of different age groups than contact occurring in the general community. Understanding household structure in different populations is therefore fundamental to explaining patterns of disease transmission in these populations. Indigenous populations in Australia tend to live in larger households than non-Indigenous populations, but limited data are available on the structure of these households, and how they differ between remote and urban communities. We have developed a novel approach to the collection of household structure data, suitable for use in a variety of contexts, which provides a detailed view of age, gender, and room occupancy patterns in remote and urban Australian Indigenous households. Here we report analysis of data collected using this tool, which quantifies the extent of crowding in Indigenous households, particularly in remote areas. We use these data to generate matrices of age-specific contact rates, as used by mathematical models of infectious disease transmission. To demonstrate the impact of household structure, we use a mathematical model to simulate an influenza-like illness in different populations. Our simulations suggest that outbreaks in remote populations are likely to spread more rapidly and to a greater extent than outbreaks in non-Indigenous populations.
Tighe, Joseph; Shand, Fiona; Ridani, Rebecca; Mackinnon, Andrew; De La Mata, Nicole; Christensen, Helen
Rates of youth suicide in Australian Indigenous communities are 4 times the national youth average and demand innovative interventions. Historical and persistent disadvantage is coupled with multiple barriers to help seeking. Mobile phone applications offer the opportunity to deliver therapeutic interventions directly to individuals in remote communities. The pilot study aimed to evaluate the effectiveness of a self-help mobile app (ibobbly) targeting suicidal ideation, depression, psychological distress and impulsivity among Indigenous youth in remote Australia. Remote and very remote communities in the Kimberley region of North Western Australia. Indigenous Australians aged 18-35 years. 61 participants were recruited and randomised to receive either an app (ibobbly) which delivered acceptance-based therapy over 6 weeks or were waitlisted for 6 weeks and then received the app for the following 6 weeks. The primary outcome was the Depressive Symptom Inventory-Suicidality Subscale (DSI-SS) to identify the frequency and intensity of suicidal ideation in the previous weeks. Secondary outcomes were the Patient Health Questionnaire 9 (PHQ-9), The Kessler Psychological Distress Scale (K10) and the Barratt Impulsivity Scale (BIS-11). Although preintervention and postintervention changes on the (DSI-SS) were significant in the ibobbly arm (t=2.40; df=58.1; p=0.0195), these differences were not significant compared with the waitlist arm (t=1.05; df=57.8; p=0.2962). However, participants in the ibobbly group showed substantial and statistically significant reductions in PHQ-9 and K10 scores compared with waitlist. No differences were observed in impulsivity. Waitlist participants improved after 6 weeks of app use. Apps for suicide prevention reduce distress and depression but do not show significant reductions on suicide ideation or impulsivity. A feasible and acceptable means of lowering symptoms for mental health disorders in remote communities is via
Ewen, Shaun C
This paper investigates the relationship between the unacceptably poor levels of Indigenous health in Australia, the very low levels of representation (As at 2009, approximately 140 Indigenous medical graduates Australia wide) of Indigenous people within the medical field, and the potential for parrhesia (translated as "fearless speech") to challenge the medical hegemony, and as a tool of self-care for Indigenous medical students. This paper outlines the elements that make up parrhesia, the current state of Australian Indigenous (ill) health and Indigenous participation in the Australian health workforce, with some international comparison. Using Huckaby's (Educ Phil Theor 40: 770-788, 2008) conceptualization of specific parrhesiastic scholars, the paper introduces the idea of an Indigenous parrhesiastes. The paper then discusses, and endeavors to briefly address three questions that Foucault articulated in his series of lectures on parrhesia in 1983: "How can we recognize someone as a parrhesiastes? What is the importance of having a parrhesiastes in the city? What is the training of a good parrhesiastes?" (Foucault, http://foucault.info/documents/parrhesia/, 1985). In conclusion, this paper shows that Indigenous parrhesiastes could make a strong and positive contribution to medicine and medical education.
Emma V. Taylor
Full Text Available Indigenous Australians continue to experience significantly poorer outcomes from cancer than non-Indigenous Australians. Despite the importance of culturally appropriate cancer services in improving outcomes, there is a lack of awareness of current programs and initiatives that are aimed at meeting the needs of Indigenous patients. Telephone interviews were used to identify and describe the Indigenous-specific programs and initiatives that are implemented in a subset of the services that participated in a larger national online survey of cancer treatment services. Fourteen services located across Australia participated in the interviews. Participants identified a number of factors that were seen as critical to delivering culturally appropriate treatment and support, including having a trained workforce with effective cross-cultural communication skills, providing best practice care, and improving the knowledge, attitudes, and understanding of cancer by Indigenous people. However, over a third of participants were not sure how their service compared with others, indicating that they were not aware of how other services are doing in this field. There are currently many Indigenous-specific programs and initiatives that are aimed at providing culturally appropriate treatment and supporting Indigenous people affected by cancer across Australia. However, details of these initiatives are not widely known and barriers to information sharing exist. Further research in this area is needed to evaluate programs and initiatives and showcase the effective approaches to Indigenous cancer care.
Davies, Jane; Bukulatjpi, Sarah; Sharma, Suresh; Caldwell, Luci; Johnston, Vanessa; Davis, Joshua Saul
Hepatitis B is endemic in Indigenous communities in Northern Australia; however, there is a lack of culturally appropriate educational tools. Health care workers and educators in this setting have voiced a desire for visual, interactive tools in local languages. Mobile phones are increasingly used and available in remote Indigenous communities. In this context, we identified the need for a tablet-based health education app about hepatitis B, developed in partnership with an Australian remote Indigenous community. To develop a culturally appropriate bilingual app about hepatitis B for Indigenous Australians in Arnhem Land using a participatory action research (PAR) framework. This project was a partnership between the Menzies School of Health Research, Miwatj Aboriginal Health Corporation, Royal Darwin Hospital Liver Clinic, and Dreamedia Darwin. We have previously published a qualitative study that identified major knowledge gaps about hepatitis B in this community, and suggested that a tablet-based app would be an appropriate and popular tool to improve this knowledge. The process of developing the app was based on PAR principles, particularly ongoing consultation, evaluation, and discussion with the community throughout each iterative cycle. Stages included development of the storyboard, the translation process (forward translation and backtranslation), prelaunch community review, launch and initial community evaluation, and finally, wider launch and evaluation at a viral hepatitis conference. We produced an app called "Hep B Story" for use with iPad, iPhone, Android tablets, and mobile phones or personal computers. The app is culturally appropriate, audiovisual, interactive, and users can choose either English or Yolŋu Matha (the most common language in East Arnhem Land) as their preferred language. The initial evaluation demonstrated a statistically significant improvement in Hep B-related knowledge for 2 of 3 questions (P=.01 and .02, respectively) and
Tucker, Richard; Choy, Darryl Low; Heyes, Scott; Revell, Grant; Jones, David
This paper reviews the current status and focus of Australian Architecture programs with respect to Indigenous Knowledge and the extent to which these tertiary programs currently address reconciliation and respect to Indigenous Australians in relation to their professional institutions and accreditation policies. The paper draws upon the findings…
McWhirter, Rebekah E; Mununggirritj, Djapirri; Marika, Dipililnga; Dickinson, Joanne L; Condon, John R
Indigenous populations, in common with all populations, stand to benefit from the potential of genetic research to lead to improvements in diagnostic and therapeutic tools for a wide range of complex diseases. However, many Indigenous communities, especially ones that are isolated, are not included in genetic research efforts. This situation is largely a consequence of the challenges of ethically conducting genetic research in Indigenous communities and compounded by Indigenous peoples' negative past experiences with genetic issues. To examine ways of addressing these challenges, we review one investigation of a cancer cluster in remote Aboriginal communities in Arnhem Land, Australia. Our experiences demonstrate that genetic research can be both ethically and successfully conducted with Indigenous communities by respecting the authority of the community, involving community members, and including regular community review throughout the research process. Copyright © 2012 Elsevier Ltd. All rights reserved.
Gould, Gillian S; Bovill, Michelle; Clarke, Marilyn J; Gruppetta, Maree; Cadet-James, Yvonne; Bonevski, Billie
One in two Indigenous Australian pregnant women smoke, yet little is known about their trajectory of smoking. This study aimed to explore Aboriginal women's narratives from starting smoking through to pregnancy. A female Aboriginal Researcher conducted individual face-to-face interviews with 20 Aboriginal women from New South Wales, Australia. Recruitment, through Aboriginal services and community networks, continued until saturation was reached. Audio-recorded transcripts were independently open coded by two researchers, inductively analysed and reported using a three-dimensional structure of looking backwards, forwards, inwards, outwards and a sense of place, to elucidate the chronology of events, life stages, characters, environments, and turning points of the stories. A chronology emerged from smoking initiation in childhood, coming of age, becoming pregnant, through to attempts at quitting, and relapse post-partum. Several new themes emerged: the role mothers play in women's smoking and quitting; the contribution of nausea to spontaneous quitting; depression as a barrier to quitting; and the hopes of women for their own and their children's future. The epiphany of pregnancy was a key turning point for many - including the interplay of successive pregnancies; and the intensity of expressed regret. Aboriginal women report multiple influences in the progression of early smoking to pregnancy and beyond. Potential opportunities to intervene include: a) childhood, coming of age, pregnancy, post-natal, in-between births; b) key influencers; c) environments, and d) targeting concurrent substance use. Morning sickness appears to be a natural deterrent to continued smoking. Depression, and its relationship to smoking and quitting in Australian Indigenous pregnant women, requires further research. Copyright © 2017. Published by Elsevier Ltd.
Macniven, Rona; Plater, Suzanne; Canuto, Karla; Dickson, Michelle; Gwynn, Josephine; Bauman, Adrian; Richards, Justin
Physical inactivity is a key health risk among Aboriginal and Torres Strait Islander (Indigenous) Australians. We examined perceptions of the Indigenous Marathon Program (IMP) in a remote Torres Strait island community. Semi-structured interviews with community and program stakeholders (n = 18; 14 Indigenous) examined barriers and enablers to running and the influence of the IMP on the community. A questionnaire asked 104 running event participants (n = 42 Indigenous) about their physical activity behaviours, running motivation and perceptions of program impact. Qualitative data were analysed using thematic content analysis, and quantitative data were analysed using descriptive statistics. Interviews revealed six main themes: community readiness, changing social norms to adopt healthy lifestyles, importance of social support, program appeal to hard-to-reach population groups, program sustainability and initiation of broader healthy lifestyle ripple effects beyond running. Barriers to running in the community were personal (cultural attitudes; shyness) and environmental (infrastructure; weather; dogs). Enablers reflected potential strategies to overcome described barriers. Indigenous questionnaire respondents were more likely to report being inspired to run by IMP runners than non-Indigenous respondents. Positive "ripple" effects of the IMP on running and broader health were described to have occurred through local role modelling of healthy lifestyles by IMP runners that reduced levels of "shame" and embarrassment, a common barrier to physical activity among Indigenous Australians. A high initial level of community readiness for behaviour change was also reported. SO WHAT?: Strategies to overcome this "shame" factor and community readiness measurement should be incorporated into the design of future Indigenous physical activity programs. © 2018 Australian Health Promotion Association.
Christopher J. Diehm
Full Text Available Introduction: Indigenous Australians experience higher rates of renal disease and hypertension than non-Indigenous Australians. Low birth weight is recognized as a contributing factor in chronic disease and has been shown to increase the risk of renal failure in adulthood. A smaller kidney volume with fewer nephrons places an individual at risk of hypertension and renal failure. Indigenous Australians have fewer nephrons than non-Indigenous Australians. In this study, intrauterine fetal and kidney growth were evaluated in 174 Indigenous Australian babies throughout gestation in order to record and evaluate fetal growth and kidney size, within a population that is at high risk for chronic illness.Methods: Pregnant women that identified as Indigenous, or non-Indigenous women that were pregnant with a partner who identified as an Indigenous Australian were eligible to participate. Maternal history, smoking status, blood and urine samples and fetal ultrasounds were collected throughout pregnancy. Fetal kidney measurements were collected using ultrasound. Statistical analysis was performed using the Stata 14.1 software package.Results: 15.2% of babies were born prematurely. 44% of the mothers reported smoking in pregnancy. The median birth weight of this cohort was 3,240 g. Male fetuses had higher kidney to body weight ratios than female fetuses (P = 0.02. The birth weights of term neonates whose mothers smoked during pregnancy were lower (327 g, P < 0.001 than the birth weights of term babies from non-smoking mothers. The kidney volumes of babies whose mothers smoked were also smaller (P = 0.02, but were in proportion to body weight.Conclusion: In this cohort of Indigenous women smoking was associated with both increased number of preterm births and with a reduction in birth weights, even of term infants. Since kidney volume is a surrogate measure of nephron number and nephrogenesis is complete at birth, babies whose mothers smoked during pregnancy
This paper therefore attempts to examine gender issues in five indigenous communities in Port Harcourt. The communities are: Abuloma, Oroazi, Rumuadaolu, Elekahia and Ogbuna-abali. The key questions explored in the study are: how are urban indigenous women been marginalized in the process of urban growth and ...
Tondini, Federico; Jiranek, Vladimir; Grbin, Paul R; Onetto, Cristobal A
Here, we report the first sequenced genome of an indigenous Australian wine isolate of Torulaspora delbrueckii using the Oxford Nanopore MinION and Illumina HiSeq sequencing platforms. The genome size is 9.4 Mb and contains 4,831 genes. Copyright © 2018 Tondini et al.
Carter, Jennifer; Hollinsworth, David; Raciti, Maria; Gilbey, Kathryn
Place is a concept used to explore how people ascribe meaning to their physical and social surrounds, and their emotional affects. Exploring the university as a place can highlight social relations affecting Australian Indigenous students' sense of belonging and identity. We asked what university factors contribute to the development of a positive…
Since colonisation, the marginalisation of Indigenous Australians has adversely affected their language, culture and health. Mainstream society has failed to address social differences and establish culturally-appropriate health programmes for these groups. This paper extracts important humanistic themes within the context of health from four Indigenous Australian plays written during a period of social unrest in response to past oppression: (1) The dreamers, by Jack David; (2) Murras, by Eva Johnson; (3) Coordah, by Richard Walley; and (4) The keepers, by Bob Maza. These plays will be analysed to (a) illuminate human suffering from an indigenous perspective, based upon social and cultural planes of analysis; (b) understand the socio-cultural basis of poor health; and (c) instruct healthcare professionals that health is a social construct that can be interpreted as the product of select plays that are not solely based upon an illness narrative.
Hay Phillipa J
Full Text Available Abstract Background Obesity and related cardiovascular and metabolic conditions are well recognized problems for Australian Aboriginal and Torres Strait Islander peoples. However, there is a dearth of research on relevant eating disorders (EDs such as binge eating disorder in these groups. Methods Data were obtained from interviews of 3047 (in 2005 and 3034 (in 2008 adults who were participants in a randomly selected South Australian household survey of individuals' age > 15 years. The interviewed comprised a general health survey in which ED questions were embedded. Data were weighted according to national census results and comprised key features of ED symptoms. Results In 2005 there were 94 (85 weighted First Australian respondents, and in 2008 65 (70 weighted. Controlling for secular differences, in 2005 rates of objective binge eating and levels of weight and shape influence on self-evaluation were significantly higher in indigenous compared to non-indigenous participants, but no significant differences were found in ED features in 2008. Conclusions Whilst results on small numbers must be interpreted with caution, the main finding was consistent over the two samples. For First Australians ED symptoms are at least as frequent as for non-indigenous Australians.
Mah, Beth; Weatherall, Loretta; Burrows, Julie; Blackwell, Caroline C; Gwynn, Josephine; Wadhwa, Pathik; Lumbers, Eugenie R; Smith, Roger; Rae, Kym M
Pregnancy can be a stressful time for many women. There is ample evidence of numerous physical and mental health inequities for Indigenous Australians. For those Indigenous women who are pregnant, it is established that there is a higher incidence of poor physical perinatal outcomes when compared with non-Indigenous Australians. However, little evidence exists that examines stressful events and post-traumatic stress disorder (PTSD) symptoms in pregnant women who are members of this community. To quantify the rates of stressful events and PTSD symptoms in pregnant Indigenous women. One hundred and fifty rural and remote Indigenous women were invited to complete a survey during each trimester of their pregnancy. The survey measures were the stressful life events and the Impact of Events Scale. Extremely high rates of PTSD symptoms were reported by participants. Approximately 40% of this group exhibited PTSD symptoms during their pregnancy with mean score 33.38 (SD = 14.37) significantly higher than a study of European victims of crisis, including terrorism attacks (20.6, SD = 18.5). The extreme levels of PTSD symptoms found in the women participating in this study are likely to result in negative implications for both mother and infant. An urgent response must be mounted at government, health, community development and research levels to address these findings. Immediate attention needs to focus on the development of interventions to address the high levels of PTSD symptoms that pregnant Australian Indigenous women experience. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
Medlin, Linda G; Chang, Anne B; Fong, Kwun; Jackson, Rebecca; Bishop, Penny; Dent, Annette; Hill, Deb C; Vincent, Stephen; O'Grady, Kerry-Ann F
Respiratory diseases are a leading cause of morbidity and mortality in Indigenous Australians. However, there are limited approaches to specialist respiratory care in rural and remote communities that are culturally appropriate. A specialist Indigenous Respiratory Outreach Care (IROC) program, developed to address this gap, is described. The aim of the present study was to implement, pilot and evaluate multidisciplinary specialist respiratory outreach medical teams in rural and remote Indigenous communities in Queensland, Australia. Sites were identified based on a perception of unmet need, burden of respiratory disease and/or capacity to use the clinical service and capacity building for support offered. IROC commenced in March 2011 and, to date, has been implemented in 13 communities servicing a population of approximately 43000 Indigenous people. Clinical service delivery has been possible through community engagement and capacity building initiatives directed by community protocols. IROC is a culturally sensitive and sustainable model for adult and paediatric specialist outreach respiratory services that may be transferrable to Indigenous communities across Queensland and Australia.
Full Text Available While some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centres. Our study objectives were to: (a describe the scope and quality of health promotion activities; (b describe the status of health centre system support for health promotion activities; and (c introduce a CQI intervention and examine the impact on health promotion activities and health centres systems over two years. Baseline assessments showed sub-optimal health centre systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health centre systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence based health promotion by engaging front line health practitioners in decision making processes about the design/redesign of health centre systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff and members of the local community to address organisational and policy level barriers.
Percival, Nikki; O'Donoghue, Lynette; Lin, Vivian; Tsey, Komla; Bailie, Ross Stewart
Although some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI) projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centers. Our study objectives were to (a) describe the scope and quality of health promotion activities, (b) describe the status of health center system support for health promotion activities, and (c) introduce a CQI intervention and examine the impact on health promotion activities and health centers systems over 2 years. Baseline assessments showed suboptimal health center systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health center systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence-based health promotion by engaging front line health practitioners in decision-making processes about the design/redesign of health center systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff, and members of the local community to address organizational and policy level barriers.
Percival, Nikki; O’Donoghue, Lynette; Lin, Vivian; Tsey, Komla; Bailie, Ross Stewart
Although some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI) projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centers. Our study objectives were to (a) describe the scope and quality of health promotion activities, (b) describe the status of health center system support for health promotion activities, and (c) introduce a CQI intervention and examine the impact on health promotion activities and health centers systems over 2 years. Baseline assessments showed suboptimal health center systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health center systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence-based health promotion by engaging front line health practitioners in decision-making processes about the design/redesign of health center systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff, and members of the local community to address organizational and policy level barriers. PMID:27066470
Chamberlain, Catherine R; Oldenburg, Brian; Wilson, Alyce N; Eades, Sandra J; O'Dea, Kerin; Oats, Jeremy J N; Wolfe, Rory
Gestational diabetes is associated with a high risk of type 2 diabetes. However, progression rates among Indigenous women in Australia who experience high prevalence of gestational diabetes are unknown. This retrospective cohort study includes all births to women at a regional hospital in Far North Queensland, Australia, coded as having 'gestational diabetes' from 1 January 2004 to 31 December 2010 (1098 births) and receiving laboratory postpartum screening from 1 January 2004 to 31 December 2011 (n = 483 births). Women who did not receive postpartum screening were excluded from the denominator. Data were linked between hospital electronic records, routinely collected birth data and laboratories, with sample validation by reviews of medical records. Analysis was conducted using Cox-proportional regression models. Indigenous women had a greater than fourfold risk of developing type 2 diabetes within 8 years of having gestational diabetes, compared with non-Indigenous women (hazards ratio 4.55, 95% confidence interval 2.63-7.88, p Australian women have a greater than fourfold risk of developing type 2 diabetes after gestational diabetes. Strategies are urgently needed to reduce rates of type 2 diabetes by supporting a healthy weight and breastfeeding and to improve postpartum screening among Indigenous women with gestational diabetes. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
Katzenellenbogen Judith M
Full Text Available Abstract Background Despite a lower incidence of bowel cancer overall, Indigenous Australians are more likely to be diagnosed at an advanced stage when prognosis is poor. Bowel cancer screening is an effective means of reducing incidence and mortality from bowel cancer through early identification and prompt treatment. In 2006, Australia began rolling out a population-based National Bowel Cancer Screening Program (NBCSP using the Faecal Occult Blood Test. Initial evaluation of the program revealed substantial disparities in bowel cancer screening uptake with Indigenous Australians significantly less likely to participate in screening than the non-Indigenous population. This paper critically reviews characteristics of the program which may contribute to the discrepancy in screening uptake, and includes an analysis of organisational, structural, and socio-cultural barriers that play a part in the poorer participation of Indigenous and other disadvantaged and minority groups. Methods A search was undertaken of peer-reviewed journal articles, government reports, and other grey literature using electronic databases and citation snowballing. Articles were critically evaluated for relevance to themes that addressed the research questions. Results The NBCSP is not reaching many Indigenous Australians in the target group, with factors contributing to sub-optimal participation including how participants are selected, the way the screening kit is distributed, the nature of the test and comprehensiveness of its contents, cultural perceptions of cancer and prevailing low levels of knowledge and awareness of bowel cancer and the importance of screening. Conclusions Our findings suggest that the population-based approach to implementing bowel cancer screening to the Australian population unintentionally excludes vulnerable minorities, particularly Indigenous and other culturally and linguistically diverse groups. This potentially contributes to exacerbating
Bodkin-Andrews, Gawaian; Carlson, Bronwyn
It may be argued that the emerging discourses focusing on the social, emotional, educational, and economic disadvantages identified for Australia's First Peoples (when compared to their non-Indigenous counterparts) are becoming increasingly dissociated with an understanding of the interplay between historical and current trends in racism.…
Winschiers-Theophilus, Heike; Rodil, Kasper; Zaman, Tariq
In this paper we explore the opportunities of mobile technologies in three of our own development endeavors with rural communities, promoting the preservation of indigenous knowledge. We reflect upon and recognize the fact that the representation of indigenous knowledge will be transformed within...
Dyer, Suzanne Marie; Gomersall, Judith Streak; Smithers, Lisa Gaye; Davy, Carol; Coleman, Dylan T; Street, Jackie Mary
Evidence-based profiling of obesity and overweight in Indigenous Australian children has been poor. This study systematically reviewed evidence of the prevalence and patterns of obesity/overweight, with respect to gender, age, remoteness, and birth weight, in Indigenous Australian children, 0-18 years (PROSPERO CRD42014007626). Study quality and risk of bias were assessed. Twenty-five publications (21 studies) met inclusion criteria, with large variations in prevalence for obesity or overweight (11 to 54%) reported. A high degree of heterogeneity in study design was observed, few studies (6/21) were representative of the target population, and few appropriately recruited Indigenous children (8/21). Variability in study design, conduct, and small sample sizes mean that it is not possible to derive a single estimate for prevalence although two high-quality studies indicate at least one in four Indigenous Australian children are overweight or obese. Four of six studies reporting on gender, found overweight/obesity higher in girls and eight studies reporting on overweight/obesity by age suggest prevalence increases with age with one high quality large national study reporting total overweight/obesity as 22.4% of children aged 2-4 years, 27.5% of those aged 5-9, 38.5% aged 10-14, and 36.3% aged 15-17. Three of four studies, reporting obesity/overweight by region, found lower rates for children living in more remote areas than urban areas.
Zimmet Paul Z
Full Text Available Abstract Background Indigenous Australians have an incidence of end stage kidney disease 8-10 times higher than non-Indigenous Australians. The majority of research studies concerning Indigenous Australians have been performed in rural or remote regions, whilst the majority of Indigenous Australians actually live in urban settings. We studied prevalence and factors associated with markers of kidney disease in an urban Indigenous Australian cohort, and compared results with those for the general Australian population. Methods 860 Indigenous adult participants of the Darwin Region Urban Indigenous Diabetes (DRUID Study were assessed for albuminuria (urine albumin-creatinine ratio≥2.5 mg/mmol males, ≥3.5 mg/mmol females and low eGFR (estimated glomular filtration rate 2. Associations between risk factors and kidney disease markers were explored. Comparison was made with the AusDiab cohort (n = 8,936 aged 25-64 years, representative of the general Australian adult population. Results A high prevalence of albuminuria (14.8% was found in DRUID, whilst prevalence of low eGFR was 2.4%. Older age, higher HbA1c, hypertension, higher C-reactive protein and current smoking were independently associated with albuminuria on multiple regression. Low eGFR was independently associated with older age, hypertension, albuminuria and higher triglycerides. Compared to AusDiab participants, DRUID participants had a 3-fold higher adjusted risk of albuminuria but not of low eGFR. Conclusions Given the significant excess of ESKD observed in Indigenous versus non-Indigenous Australians, these findings could suggest either: albuminuria may be a better prognostic marker of kidney disease than low eGFR; that eGFR equations may be inaccurate in the Indigenous population; a less marked differential between Indigenous and non-Indigenous Australians for ESKD rates in urban compared to remote regions; or that differences in the pathophysiology of chronic kidney disease exist
Bookallil, M; Chalmers, E; Andrew, B
To measure the quality of antenatal care in rural and remote regions of the Northern Territory, using asymptomatic bacteruria as an indicator. Indigenous Australian women and their babies have a greater frequency of adverse outcomes in pregnancy than their non-Indigenous counterparts. It is well established that asymptomatic bacteriuria may have serious outcomes in pregnancy, including an increased risk of pyelonephritis and a strong association with preterm and low birth weight delivery. Ensuring good quality antenatal care can reduce the individual risks of pregnancy for mothers and their babies. In the Northern Territory there are well established guidelines for antenatal care in rural and remote Indigenous communities. These are documented in the Women's Business Manual. Audit and feedback is one method that has been shown to have a small to moderate effect in changing clinician behaviour, in this case improving compliance with guidelines. A retrospective chart audit of antenatal clients was conducted at 10 rural and remote primary health care clinics in the Northern Territory, Australia. The audit reviewed all the available charts (n = 268) of pregnant women, from the participating communities, who gave birth in 2002 or 2003. The diagnosis and management of asymptomatic bacteriuria was chosen as the indicator of quality antenatal care, as it is one of five areas of antenatal care where there is evidence that appropriate management improves outcomes. The quality of care was measured against the local guidelines, the Women's Business Manual. Women frequently had urine tests with where the dipstick showed an abnormal result, with 75% (95% CI [0.70,0.80]) of women having at least one episode of abnormal urinalysis during pregnancy. Six hundred and twenty episodes of abnormal urinalysis in pregnancy were identified. The incidence of bacteriuria at first visit was 16%, (95%-confidence interval = 95% CI [0.10, 0.21]). Compliance with the guidelines was poor. Fifty
Schumacher, Tracy L; Weatherall, Loretta; Keogh, Lyniece; Sutherland, Kathryn; Collins, Clare E; Pringle, Kirsty G; Rae, Kym M
to determine the adequacy of gestational weight gain for a cohort of Indigenous Australian women and investigate whether it is associated with pre-pregnancy body mass index. analysis of observational data collected from a longitudinal cohort study that follows Indigenous Australian women through pregnancy. women recruited through antenatal clinics in regional and remote towns in NSW, Australia to the Gomeroi gaaynggal program. 110 pregnant women who either identified as being an Indigenous Australian or as carrying an Indigenous child. measurements included weight and height, self-reported pre-pregnancy weight and smoking status, parity and health conditions that may contribute to gestational weight gain, such as hypertensive or diabetic disorders. Compared to the 2009 Institute of Medicine recommendations for gestational weight gain and based on prepregnancy body mass index, the rate of adequate gestational weight gain in this cohort was very low (15%). 32% of women had inadequate weight gain and 54% had excessive weight gain. The highest rate of excessive gestational weight gain was found in overweight women (74%), with rates of 48% and 50% found in healthy and obese (all classes) categories, respectively. Parity (coefficient 4.5, p<0.01) and hypertension (coefficient 4.8, p = 0.04) were found to be significantly associated with gestational weight gain in mixed model linear regression. few women gained adequate gestational weight gain in this study. Culturally acceptable ways of addressing this issue are needed for this group of women, as inadequate and excessive rates of gestational weight gain have health implications for women and their offspring. a systematic approach to addressing gestational weight gain within antenatal care is required, including asking about diet and exercise, for all women identifying as Indigenous Australian. Copyright © 2018 Elsevier Ltd. All rights reserved.
Brusse, Carl; Gardner, Karen; McAullay, Daniel; Dowden, Michelle
Health promotion organizations are increasingly embracing social media technologies to engage end users in a more interactive way and to widely disseminate their messages with the aim of improving health outcomes. However, such technologies are still in their early stages of development and, thus, evidence of their efficacy is limited. The study aimed to provide a current overview of the evidence surrounding consumer-use social media and mobile software apps for health promotion interventions, with a particular focus on the Australian context and on health promotion targeted toward an Indigenous audience. Specifically, our research questions were: (1) What is the peer-reviewed evidence of benefit for social media and mobile technologies used in health promotion, intervention, self-management, and health service delivery, with regard to smoking cessation, sexual health, and otitis media? and (2) What social media and mobile software have been used in Indigenous-focused health promotion interventions in Australia with respect to smoking cessation, sexual health, or otitis media, and what is the evidence of their effectiveness and benefit? We conducted a scoping study of peer-reviewed evidence for the effectiveness of social media and mobile technologies in health promotion (globally) with respect to smoking cessation, sexual health, and otitis media. A scoping review was also conducted for Australian uses of social media to reach Indigenous Australians and mobile apps produced by Australian health bodies, again with respect to these three areas. The review identified 17 intervention studies and seven systematic reviews that met inclusion criteria, which showed limited evidence of benefit from these interventions. We also found five Australian projects with significant social media health components targeting the Indigenous Australian population for health promotion purposes, and four mobile software apps that met inclusion criteria. No evidence of benefit was found
Dingwall, Kylie; Cairney, Sheree
The aim of this paper was to investigate the importance and challenges involved in conducting serial cognitive assessments among healthy Indigenous adolescents. Cognitive assessments were conducted at fortnightly intervals for 2 months and again at 6 and 12 months among a group of Indigenous students from a boarding school in the Northern Territory. These students were to be the healthy control group in a long-term study of substance abuse. Recruitment and attrition rates were reviewed and related challenges for assessing participants were identified. From the recruited sample (n=49), 18% reported heavy or frequent use of alcohol, cannabis or petrol. Males were more likely to have used these substances compared to females. Attrition increased as the follow-up interval increased with 49 recruits reducing to 32 in the first 2 months and only 15 and 13 of the initial group remaining for the 6 and 12 month follow-ups respectively. Main challenges included (i) appropriateness of tests and assessment processes, (ii) high rates of substance abuse and other illness in the control group and (iii) high attrition rates. The importance of assessing cognition appropriately is highlighted by a lack of information regarding mental health issues in Indigenous populations.
Ross Stewart Bailie
Full Text Available BackgroundPotentially preventable chronic diseases are the greatest contributor to the health gap between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians. Preventive care is important for earlier detection and control of chronic disease, and a number of recent policy initiatives have aimed to enhance delivery of preventive care. We examined documented delivery of recommended preventive services for Indigenous peoples across Australia, and investigated the influence of health center and client level factors on adherence to best practice guidelines. MethodsClinical audit data from 2012-2014 for 3623 well adult clients (aged 15-54 of 101 health centers from four Australian states and territories were analyzed to determine adherence to delivery of 26 recommended preventive services classified into five different modes of care on the basis of the way in which they are delivered (eg. basic measurement; laboratory tests and imaging; assessment and brief interventions, eye, ear and oral checks; follow-up of abnormal findings. Summary statistics were used to describe the delivery of each service item across jurisdictions. Multilevel regression models were used to quantify the variation in service delivery attributable to health center and client level factors and to identify factors associated with higher quality care.ResultsDelivery of recommended preventive care varied widely between service items, with good delivery of most basic measurements but poor follow-up of abnormal findings. Health center characteristics were associated with most variation. Higher quality care was associated with Northern Territory location, urban services and smaller service population size. Client factors associated with higher quality care included age between 25-34 years, female sex and more regular attendance. ConclusionsWide variation in documented preventive care delivery, poor follow-up of abnormal findings, and system factors that
Clough, Alan R; MacLaren, David J; Robertson, Jan A; Ivers, Rowena G; Conigrave, Katherine M
In remote Indigenous Australian communities measuring individual tobacco use can be confounded by cultural expectations, including sharing. We compared self-reported tobacco consumption with community-level estimates in Arnhem Land (Northern Territory). In a cross-sectional survey in three communities (population 2319 Indigenous residents, aged ≥16 years), 400 Indigenous residents were interviewed (206 men, 194 women). Eight community stores provided information about tobacco sold during the survey. To gauge the impact of 255 non-Indigenous residents on tobacco turnover, 10 were interviewed (five men, five women). Breath carbon monoxide levels confirmed self-reported smoking. Self-reported number of cigarettes smoked per day was compared with daily tobacco consumption per user estimated using amounts of tobacco sold during 12 months before the survey (2007-2008). 'Lighter smokers' (Indigenous study participants, 305 (76%) used tobacco; four chewed tobacco. Of 301 Indigenous smokers, 177 (58%) provided self-reported consumption information; a median of 11-11.5 cigarettes per day in men and 5.5-10 cigarettes per day in women. Men were three times (odds ratio=2.9) more likely to be 'heavier smokers'. Store turnover data indicated that Indigenous tobacco users consumed the equivalent of 9.2-13.1 cigarettes per day; very similar to self-reported levels. Sixty per cent (=6/10) of non-Indigenous residents interviewed were smokers, but with little impact on tobacco turnover overall (2-6%). Smoking levels reported by Indigenous Australians in this study, when sharing tobacco was considered, closely reflected quantities of tobacco sold in community stores. © 2010 Australasian Professional Society on Alcohol and other Drugs.
Cornelis Martin Renes
Full Text Available This paper locates the postcolonial crime novel as a space for disenfranchised groups to write back to the marginalisation inherent in the process of colonisation, and explores the example of Australia. From its inception in the mid-19th century, Australian crime fiction reflected upon the challenging harshness and otherness of the Australian experience for the free and convict settler, expelled from the metropole. It created a series of popular subgenres derived from the convict narrative proper, while more ‘standard’ modes of crime fiction, popularised in and through British and American crime fiction, were late to develop. Whereas Australian crime fiction has given expression to the white experience of the continent in manifold ways, up until recently it made no room for Indigenous voices – with the exception of the classic Inspector Napoleon Bonaparte series written by the prolific Arthur Upfield in the first half of the 20th century. For the longest time, this absence reflected the dispossession, dispersal and disenfranchisement of the colonised Indigenous peoples at large; there were neither Aboriginal voices nor Aboriginal authors, which made the textual space of the Australian crime novel a discursive terra nullius. This paper will look at the only Indigenous-Australian author to date with a substantial body of work in crime fiction, Philip McLaren, and elucidate how his four crime novels break new ground in Australian crime fiction by embedding themselves within a political framework of Aboriginal resilience and resistance to neo/colonialism. Written as of the 1990s, McLaren’s oeuvre is eclectic in that it does not respond to traditional formats of Australian crime fiction, shifts between generic subtypes and makes incursions into other genres. The paper concludes that McLaren’s oeuvre has not been conceived of as the work of a crime writer per se, but rather that its form and content are deeply informed by the racist violence
Jay Maddock; Nicole K. Taniguchi
BACKGROUND: Genetic research has potential benefits for improving health, such as identifying molecular characteristics of a disease, understanding disease prevalence and treatment, and developing treatments tailored to patients based on individual genetic characteristics of their disease. Indigenous people are often targeted for genetic research because genes are easier to study in communities that practice endogamy. Therefore, populations perceived to be more homogenous, such as Indigenous ...
West, Matthew; Chuter, Vivienne; Munteanu, Shannon; Hawke, Fiona
The Aboriginal and Torres Strait Islander community has an increased risk of developing chronic illnesses including diabetes. Among people with diabetes, foot complications are common and make a significant contribution to the morbidity and mortality associated with this disease. The aim of this review was to systematically evaluate the literature comparing the rates of diabetes related foot complications in Aboriginal and Torres Strait Islander Australians to non-Indigenous Australians. MEDLINE, EMBASE, The Cochrane Library; PUBMED and CINAHL were searched from inception until August 2016. Inclusion criteria were: published cross-sectional or longitudinal studies reporting the prevalence of diabetes related foot complications in both a cohort of Aboriginal and Torres Strait Islander Australians and a cohort of one other Australian population of any age with diabetes. Risk of bias was assessed using the STROBE tool. Eleven studies including a total of 157,892 participants were included. Studies were set in Queensland, the Northern Territory and Western Australia, primarily in rural and remote areas. Aboriginal and Torres Strait Islander Australians experienced substantially more diabetes related foot complications with the mean age up to 14 years younger than non-Indigenous Australians. Aboriginality was associated with increased risk of peripheral neuropathy, foot ulceration and amputation. In several studies, Aboriginal and Torres Strait Islander Australians accounted for the vast majority of diabetes related foot complications (up to 91%) while comprising only a small proportion of the regional population. Reporting quality as assessed with the STROBE tool showed underreporting of: methods, sample description and potential sources of bias. There are no data available for some Australian states and for specific types of diabetes related foot complications. Aboriginal and Torres Strait Islander Australians have a 3-6 fold increased likelihood of experiencing a
Full Text Available Abstract Background The Aboriginal and Torres Strait Islander community has an increased risk of developing chronic illnesses including diabetes. Among people with diabetes, foot complications are common and make a significant contribution to the morbidity and mortality associated with this disease. The aim of this review was to systematically evaluate the literature comparing the rates of diabetes related foot complications in Aboriginal and Torres Strait Islander Australians to non-Indigenous Australians. Methods MEDLINE, EMBASE, The Cochrane Library; PUBMED and CINAHL were searched from inception until August 2016. Inclusion criteria were: published cross-sectional or longitudinal studies reporting the prevalence of diabetes related foot complications in both a cohort of Aboriginal and Torres Strait Islander Australians and a cohort of one other Australian population of any age with diabetes. Risk of bias was assessed using the STROBE tool. Results Eleven studies including a total of 157,892 participants were included. Studies were set in Queensland, the Northern Territory and Western Australia, primarily in rural and remote areas. Aboriginal and Torres Strait Islander Australians experienced substantially more diabetes related foot complications with the mean age up to 14 years younger than non-Indigenous Australians. Aboriginality was associated with increased risk of peripheral neuropathy, foot ulceration and amputation. In several studies, Aboriginal and Torres Strait Islander Australians accounted for the vast majority of diabetes related foot complications (up to 91% while comprising only a small proportion of the regional population. Reporting quality as assessed with the STROBE tool showed underreporting of: methods, sample description and potential sources of bias. There are no data available for some Australian states and for specific types of diabetes related foot complications. Conclusions Aboriginal and Torres Strait Islander
Nicholas Biddle; Mandy Yap
International literature clearly demonstrates the potential for gender-based inequalities to constrain development processes. In the United Nations Development Programme Gender-related Development Index, Australia ranks in the top five across 177 countries, suggesting that the loss of human development due to gender inequality is minor. However, such analysis has not been systematically applied to the Indigenous Australian population, at least in a quantitative sense. Using the 2006 Australia...
in Mexico and were among the most experienced wind developers in the world, 'their capitalist model' failed to take into account, 'the spiritual and social ties between the indigenous rural communities and the land'. According to local residents, the basic problem was a clash of cultures. This case can...... and 40 indigenous Zapotec and Huave people held rallies in front of the Danish Embassy in Mexico City. With banners and placards, the protestors demanded Vestas’s exit from the Isthmus of Tehuantepec. The indigenous people suggested that although European companies had traditionally been present...... and stakeholder involvement between MNCs, governmental officials and local communities, when implementing large-scale investment projects. The case presents a conflict which involves four actors: 1) Indigenous communities in the Isthmus of Tehuantepec region in Oaxaca, Mexico: Zapotecas, Huaves or Ikoot, 2...
Shah, Mahsood; Widin, Jacquie
Indigenous student satisfaction with the university learning and teaching experience matters. From a student perspective, retention matters as successful completion of tertiary education improves the life chances of students in relation to employment opportunities, being able to support themselves financially and contributing to the society in…
Diaz, Abbey; Baade, Peter D; Valery, Patricia C; Whop, Lisa J; Moore, Suzanne P; Cunningham, Joan; Garvey, Gail; Brotherton, Julia M L; O'Connell, Dianne L; Canfell, Karen; Sarfati, Diana; Roder, David; Buckley, Elizabeth; Condon, John R
Little is known about the impact of comorbidity on cervical cancer survival in Australian women, including whether Indigenous women's higher prevalence of comorbidity contributes to their lower survival compared to non-Indigenous women. Data for cervical cancers diagnosed in 2003-2012 were extracted from six Australian state-based cancer registries and linked to hospital inpatient records to identify comorbidity diagnoses. Five-year cause-specific and all-cause survival probabilities were estimated using the Kaplan-Meier method. Flexible parametric models were used to estimate excess cause-specific mortality by Charlson comorbidity index score (0,1,2+), for Indigenous women compared to non-Indigenous women. Of 4,467 women, Indigenous women (4.4%) compared to non-Indigenous women had more comorbidity at diagnosis (score ≥1: 24.2% vs. 10.0%) and lower five-year cause-specific survival (60.2% vs. 76.6%). Comorbidity was associated with increased cervical cancer mortality for non-Indigenous women, but there was no evidence of such a relationship for Indigenous women. There was an 18% reduction in the Indigenous: non-Indigenous hazard ratio (excess mortality) when comorbidity was included in the model, yet this reduction was not statistically significant. The excess mortality for Indigenous women was only evident among those without comorbidity (Indigenous: non-Indigenous HR 2.5, 95%CI 1.9-3.4), indicating that factors other than those measured in this study are contributing to the differential. In a subgroup of New South Wales women, comorbidity was associated with advanced-stage cancer, which in turn was associated with elevated cervical cancer mortality. Survival was lowest for women with comorbidity. However, there wasn't a clear comorbidity-survival gradient for Indigenous women. Further investigation of potential drivers of the cervical cancer survival differentials is warranted. The results highlight the need for cancer care guidelines and multidisciplinary
Full Text Available Little is known about the impact of comorbidity on cervical cancer survival in Australian women, including whether Indigenous women's higher prevalence of comorbidity contributes to their lower survival compared to non-Indigenous women.Data for cervical cancers diagnosed in 2003-2012 were extracted from six Australian state-based cancer registries and linked to hospital inpatient records to identify comorbidity diagnoses. Five-year cause-specific and all-cause survival probabilities were estimated using the Kaplan-Meier method. Flexible parametric models were used to estimate excess cause-specific mortality by Charlson comorbidity index score (0,1,2+, for Indigenous women compared to non-Indigenous women.Of 4,467 women, Indigenous women (4.4% compared to non-Indigenous women had more comorbidity at diagnosis (score ≥1: 24.2% vs. 10.0% and lower five-year cause-specific survival (60.2% vs. 76.6%. Comorbidity was associated with increased cervical cancer mortality for non-Indigenous women, but there was no evidence of such a relationship for Indigenous women. There was an 18% reduction in the Indigenous: non-Indigenous hazard ratio (excess mortality when comorbidity was included in the model, yet this reduction was not statistically significant. The excess mortality for Indigenous women was only evident among those without comorbidity (Indigenous: non-Indigenous HR 2.5, 95%CI 1.9-3.4, indicating that factors other than those measured in this study are contributing to the differential. In a subgroup of New South Wales women, comorbidity was associated with advanced-stage cancer, which in turn was associated with elevated cervical cancer mortality.Survival was lowest for women with comorbidity. However, there wasn't a clear comorbidity-survival gradient for Indigenous women. Further investigation of potential drivers of the cervical cancer survival differentials is warranted.The results highlight the need for cancer care guidelines and
Full Text Available Abstract Background There is an overwhelming burden of cardiovascular disease, type 2 diabetes and chronic kidney disease among Indigenous Australians. In this high risk population, it is vital that we are able to measure accurately kidney function. Glomerular filtration rate is the best overall marker of kidney function. However, differences in body build and body composition between Indigenous and non-Indigenous Australians suggest that creatinine-based estimates of glomerular filtration rate derived for European populations may not be appropriate for Indigenous Australians. The burden of kidney disease is borne disproportionately by Indigenous Australians in central and northern Australia, and there is significant heterogeneity in body build and composition within and amongst these groups. This heterogeneity might differentially affect the accuracy of estimation of glomerular filtration rate between different Indigenous groups. By assessing kidney function in Indigenous Australians from Northern Queensland, Northern Territory and Western Australia, we aim to determine a validated and practical measure of glomerular filtration rate suitable for use in all Indigenous Australians. Methods/Design A cross-sectional study of Indigenous Australian adults (target n = 600, 50% male across 4 sites: Top End, Northern Territory; Central Australia; Far North Queensland and Western Australia. The reference measure of glomerular filtration rate was the plasma disappearance rate of iohexol over 4 hours. We will compare the accuracy of the following glomerular filtration rate measures with the reference measure: Modification of Diet in Renal Disease 4-variable formula, Chronic Kidney Disease Epidemiology Collaboration equation, Cockcroft-Gault formula and cystatin C- derived estimates. Detailed assessment of body build and composition was performed using anthropometric measurements, skinfold thicknesses, bioelectrical impedance and a sub-study used dual
Christou, Aliki; Thompson, Sandra C
Indigenous Australians are significantly less likely to participate in colorectal cancer (CRC) screening compared to non-Indigenous people. This study aimed to identify important factors influencing the decision to undertake screening using Faecal Occult Blood Testing (FOBT) among Indigenous Australians. Very little evidence exists to guide interventions and programmatic approaches for facilitating screening uptake in this population in order to reduce the disparity in colorectal cancer outcomes. Interviewer-administered surveys were carried out with a convenience sample (n = 93) of Indigenous Western Australians between November 2009-March 2010 to assess knowledge, awareness, attitudes and behavioural intent in regard to CRC and CRC screening. Awareness and knowledge of CRC and screening were low, although both were significantly associated with exposure to media advertising (p = 0.008; p < 0.0001). Nearly two-thirds (63%; 58/92) of respondents reported intending to participate in screening, while a greater proportion (84%; 77/92) said they would participate on a doctor's recommendation. Multivariate analysis with logistic regression demonstrated that independent predictors of screening intention were, greater perceived self-efficacy (OR = 19.8, 95% CI = 5.5-71.8), a history of cancer screening participation (OR = 6.8, 95% CI = 2.0-23.3) and being aged 45 years or more (OR = 4.5, 95% CI = 1.2-16.5). A higher CRC knowledge score (medium vs. low: OR = 9.9, 95% CI = 2.4-41.3; high vs. low: 13.6, 95% CI = 3.4-54.0) and being married or in a de-facto relationship (OR = 6.9, 95% CI = 2.1-22.5) were also identified as predictors of intention to screen with FOBT. Improving CRC related knowledge and confidence to carry out the FOBT self-screening test through education and greater promotion of screening has the potential to enhance Indigenous participation in CRC screening. These findings should guide the development of interventions to encourage screening uptake and
Full Text Available Abstract Background Adult smoking has its roots in adolescence. If individuals do not initiate smoking during this period it is unlikely they ever will. In high income countries, smoking rates among Indigenous youth are disproportionately high. However, despite a wealth of literature in other populations, there is less evidence on the determinants of smoking initiation among Indigenous youth. The aim of this study was to explore the determinants of smoking among Australian Indigenous young people with a particular emphasis on the social and cultural processes that underlie tobacco use patterns among this group. Methods This project was undertaken in northern Australia. We undertook group interviews with 65 participants and individual in-depth interviews with 11 youth aged 13–20 years led by trained youth ‘peer researchers.’ We also used visual methods (photo-elicitation with individual interviewees to investigate the social context in which young people do or do not smoke. Included in the sample were a smaller number of non-Indigenous youth to explore any significant differences between ethnic groups in determinants of early smoking experiences. The theory of triadic influence, an ecological model of health behaviour, was used as an organising theory for analysis. Results Family and peer influences play a central role in smoking uptake among Indigenous youth. Social influences to smoke are similar between Indigenous and non-Indigenous youth but are more pervasive (especially in the family domain among Indigenous youth. While Indigenous youth report high levels of exposure to smoking role models and smoking socialisation practices among their family and social networks, this study provides some indication of a progressive denormalisation of smoking among some Indigenous youth. Conclusions Future initiatives aimed at preventing smoking uptake in this population need to focus on changing social normative beliefs around smoking, both at a
Doyle, Kerrie; Hungerford, Catherine
Indigenous Australians have higher levels of mental illness, self-harm, suicide and substance abuse than non-Indigenous Australians, as well as more frequent contact with the criminal justice system. These indices point to the need for strong leadership to support Close the Gap programmes that have now been implemented across Australia. This article considers leadership as a journey of learning for Australian Indigenous leaders. Through the use of story, it is suggested that a situational leadership approach, incorporating the principles of mindfulness, provides the most appropriate framework for Indigenous leaders who work with Indigenous communities. Flexible approaches are needed to meet the needs of diverse Indigenous populations, and address the complex challenges involved, including lateral violence. Such flexibility will enable Indigenous leaders and communities to work together to achieve improvements in the health outcomes, not only for Indigenous Australians, but also for Indigenous populations worldwide.
Sarnyai, Zoltán; Berger, Maximus; Jawan, Isabella
A considerable gap exists in health and social emotional well-being between Indigenous people and non-Indigenous Australians. Recent research in stress neurobiology highlights biological pathways that link early adversity and traumas as well as life stresses to ill health. We argue that the neurobiological stress response and its maladaptive changes, termed allostatic load, provide a useful framework to understand how adversity leads to physical and mental illness in Indigenous people. In this paper we review the biology of allostatic load and make links between stress-induced systemic hormonal, metabolic and immunological changes and physical and mental illnesses. Exposure to chronic stress throughout life results in an increased allostatic load that may contribute to a number of metabolic, cardiovascular and mental disorders that shorten life expectancy in Indigenous Australians. © The Royal Australian and New Zealand College of Psychiatrists 2015.
Full Text Available Abstract Background 'Caring for Country' is defined as Indigenous participation in interrelated activities with the objective of promoting ecological and human health. Ecological services on Indigenous-owned lands are belatedly attracting some institutional investment. However, the health outcomes associated with Indigenous participation in 'caring for country' activities have never been investigated. The aims of this study were to pilot and validate a questionnaire measuring caring for country as an Indigenous health determinant and to relate it to an external reference, obesity. Methods Purposively sampled participants were 301 Indigenous adults aged 15 to 54 years, recruited during a cross-sectional program of preventive health checks in a remote Australian community. Questionnaire validation was undertaken with psychometric tests of internal consistency, reliability, exploratory factor analysis and confirmatory one-factor congeneric modelling. Accurate item weightings were derived from the model and used to create a single weighted composite score for caring for country. Multiple linear regression modelling was used to test associations between the caring for country score and body mass index adjusting for socio-demographic factors and health behaviours. Results The questionnaire demonstrated adequate internal consistency, test-retest validity and proxy-respondent validity. Exploratory factor analysis of the 'caring for country' items produced a single factor solution that was confirmed via one-factor congeneric modelling. A significant and substantial association between greater participation in caring for country activities and lower body mass index was demonstrated. Adjusting for socio-demographic factors and health behaviours, an inter-quartile range rise in caring for country scores was associated with 6.1 Kg and 5.3 Kg less body weight for non-pregnant women and men respectively. Conclusion This study indicates preliminary support for
Full Text Available Most part of indigenous adults in the Guarani communities of Mato Grosso do Sul is bilingual and has one of the indigenous languages, Guarani Kaiowá or Guarani Ñandeva, as their mother tongue and Portuguese as a second language; only a few elderly and young children still who do not go to school speak only the mother tongue. In this paper, we try to verify which impression the speakers have for each of these languages and the importance they attribute to each one of them. Data analysis showed that the mother tongue is closely related to the expression of their traditional culture; in general, the indigenous claim their languages are being transmitted to new generations, and therefore preserved in an appropriate manner in the two communities. The Portuguese is also considered very important by all informants and the main motivation for its teaching/learning is the need to contact with the non-indigenous population. These results may help us understand issues related to the future of these indigenous languages and Portuguese language in the investigated communities.
Full Text Available Abstract Background Despite the well-recognised Indigenous-non-Indigenous health disparity, some reports suggest improvements in Indigenous mortality. Our aim was to quantify Indigenous mortality in Outer Regional (OR, Remote (R, and Very Remote (VR areas in New South Wales, Queensland, South Australia, Western Australia, and the Northern Territory and changes in mortality from 1998 to 2005. Methods We calculated rates, standardized mortality ratios (SMRs and percentage change in annual rates of Indigenous cardiovascular, diabetes and renal mortality mentioned anywhere on the death certificate by using ICD-10 codes and the 2001 total Australian population as the reference population. Results In 1998-2001, Indigenous SMRs for all-cause mortality were 241%, 421% and 220% in OR, R and VR, respectively. In 2001-03, corresponding SMRs were 202%, 331% and 176%. Percentage changes (95% confidence interval in annual all-cause mortality were -3.0% (-5.3%, -0.7% in OR, -4.2% (-7.4%, -0.9% in R and -0.5 (-9.1%, -0.7% in VR. In 2002-2005, compared with 1998-2001, changes in the number of Indigenous deaths were -147, -195, and -197 in OR, R and VR, respectively. Similar patterns and trends were observed for cardiovascular mortality. Conclusions Mortality was elevated about 2-fold in OR, 4-fold in R and 2-fold in VR areas. The downward trend in mortality regardless of remoteness of residence was partly attributable to a decrease in the absolute number of deaths. These patterns were observed for each of the states/territories individually.
Hersh, Deborah; Armstrong, Elizabeth; Bourke, Noni
To explore in detail the narrative of a speech pathologist (SP) working with Indigenous Australian clients with acquired communication disorders following stroke or brain injury. There is some evidence that Indigenous clients do not find speech pathology rehabilitation to be culturally appropriate but, currently, there is very little published on the nature of this service or the experiences of SPs who provide this rehabilitation. This research uses both thematic and structural narrative analysis of data from a semi-structured, in-depth interview with a SP to examine the adaptations that she made to address the needs of her adult neurological caseload of (mainly) Indigenous Australians from both urban and remote regions. The thematic analysis resulted in a core theme of flexibility and four other sub-themes: awareness of cultural context, client focus/person-centredness, being practical and working ethically. The structural narrative analysis allowed insight into the nature of clinical reasoning in a context lacking predictability and where previous clinical certainties required adaptation. Individual, detailed narratives are useful in exposing the challenges and clinical reasoning behind culturally sensitive practice. Implications for Rehabilitation Speech pathologists (SPs) can learn from hearing the clinical stories of colleagues with experience of providing rehabilitation in culturally diverse contexts, as well as from ongoing training in culturally competent and safe practices. Such stories help bridge understanding from the general to the particular. SPs working with Indigenous Australians with acquired communication disorders post-stroke and brain injury may find it helpful to consider how the themes, drawn from an interview with the clinician in this study - flexibility, awareness of cultural context, person-centredness, being practical and working ethically - might apply to their practice. Narratives may be helpful in staff training and form an important
Gould, Gillian S; Bar-Zeev, Yael; Bovill, Michelle; Atkins, Lou; Gruppetta, Maree; Clarke, Marilyn J; Bonevski, Billie
Indigenous smoking rates are up to 80% among pregnant women: prevalence among pregnant Australian Indigenous women was 45% in 2014, contributing significantly to the health gap for Indigenous Australians. We aimed to develop an implementation intervention to improve smoking cessation care (SCC) for pregnant Indigenous smokers, an outcome to be achieved by training health providers at Aboriginal Medical Services (AMS) in a culturally competent approach, developed collaboratively with AMS. The Behaviour Change Wheel (BCW), incorporating the COM-B model (capability, opportunity and motivation for behavioural interventions), provided a framework for the development of the Indigenous Counselling and Nicotine (ICAN) QUIT in Pregnancy implementation intervention at provider and patient levels. We identified evidence-practice gaps through (i) systematic literature reviews, (ii) a national survey of clinicians and (iii) a qualitative study of smoking and quitting with Aboriginal mothers. We followed the three stages recommended in Michie et al.'s "Behaviour Change Wheel" guide. Targets identified for health provider behaviour change included the following: capability (psychological capability, knowledge and skills) by training clinicians in pharmacotherapy to assist women to quit; motivation (optimism) by presenting evidence of effectiveness, and positive testimonials from patients and clinicians; and opportunity (environmental context and resources) by promoting a whole-of-service approach and structuring consultations using a flipchart and prompts. Education and training were selected as the main intervention functions. For health providers, the delivery mode was webinar, to accommodate time and location constraints, bringing the training to the services; for patients, face-to-face consultations were supported by a booklet embedded with videos to improve patients' capability, opportunity and motivation. The ICAN QUIT in Pregnancy was an intervention to train health
Pert, Petina L; Ens, Emilie J; Locke, John; Clarke, Philip A; Packer, Joanne M; Turpin, Gerry
With growing international calls for the enhanced involvement of Indigenous peoples and their biocultural knowledge in managing conservation and the sustainable use of physical environment, it is timely to review the available literature and develop cross-cultural approaches to the management of biocultural resources. Online spatial databases are becoming common tools for educating land managers about Indigenous Biocultural Knowledge (IBK), specifically to raise a broad awareness of issues, identify knowledge gaps and opportunities, and to promote collaboration. Here we describe a novel approach to the application of internet and spatial analysis tools that provide an overview of publically available documented Australian IBK (AIBK) and outline the processes used to develop the online resource. By funding an AIBK working group, the Australian Centre for Ecological Analysis and Synthesis (ACEAS) provided a unique opportunity to bring together cross-cultural, cross-disciplinary and trans-organizational contributors who developed these resources. Without such an intentionally collaborative process, this unique tool would not have been developed. The tool developed through this process is derived from a spatial and temporal literature review, case studies and a compilation of methods, as well as other relevant AIBK papers. The online resource illustrates the depth and breadth of documented IBK and identifies opportunities for further work, partnerships and investment for the benefit of not only Indigenous Australians, but all Australians. The database currently includes links to over 1500 publically available IBK documents, of which 568 are geo-referenced and were mapped. It is anticipated that as awareness of the online resource grows, more documents will be provided through the website to build the database. It is envisaged that this will become a well-used tool, integral to future natural and cultural resource management and maintenance. Copyright © 2015. Published
Du, Jia Tina; Haines, Jelina
Introduction: This paper reports the first stage of an ongoing information behaviour research project undertaken with a rural Indigenous community in South Australia. Method: Twenty-one Ngarrindjeri volunteers participated in the field study. Permission was granted and extensive community consultations were conducted. Analysis: Questionnaires and…
Katherine A Thurber
Full Text Available Aboriginal and Torres Strait Islander Australians are more likely than non-Indigenous Australians to be obese and experience chronic disease in adulthood--conditions linked to being overweight in childhood. Birthweight and prenatal exposures are associated with increased Body Mass Index (BMI in other populations, but the relationship is unclear for Indigenous children. The Longitudinal Study of Indigenous Children is an ongoing cohort study of up to 1,759 children across Australia. We used a multilevel model to examine the association between children's birthweight and BMI z-score in 2011, at age 3-9 years, adjusted for sociodemographic and maternal factors. Complete data were available for 682 of the 1,264 children participating in the 2011 survey; we repeated the analyses in the full sample with BMI recorded (n=1,152 after multilevel multiple imputation. One in ten children were born large for gestational age, and 17% were born small for gestational age. Increasing birthweight predicted increasing BMI; a 1-unit increase in birthweight z-score was associated with a 0.22-unit (95% CI:0.13, 0.31 increase in childhood BMI z-score. Maternal smoking during pregnancy was associated with a significant increase (0.25; 95% CI:0.05, 0.45 in BMI z-score. The multiple imputation analysis indicated that our findings were not distorted by biases in the missing data. High birthweight may be a risk indicator for overweight and obesity among Indigenous children. National targets to reduce the incidence of low birthweight which measure progress by an increase in the population's average birthweight may be ignoring a significant health risk; both ends of the spectrum must be considered. Interventions to improve maternal health during pregnancy are the first step to decreasing the prevalence of high BMI among the next generation of Indigenous children.
Hefler, Marita; Kerrigan, Vicki; Henryks, Joanna; Freeman, Becky; Thomas, David P
Despite the enormous potential of social media for health promotion, there is an inadequate evidence base for how they can be used effectively to influence behaviour. In Australia, research suggests social media use is higher among Aboriginal and Torres Strait Islander people than the general Australian population; however, health promoters need a better understanding of who uses technologies, how and why. This qualitative study investigates what types of health content are being shared among Aboriginal and Torres Strait people through social media networks, as well as how people engage with, and are influenced by, health-related information in their offline life. We present six social media user typologies together with an overview of health content that generated significant interaction. Content ranged from typical health-related issues such as mental health, diet, alcohol, smoking and exercise, through to a range of broader social determinants of health. Social media-based health promotion approaches that build on the social capital generated by supportive online environments may be more likely to generate greater traction than confronting and emotion-inducing approaches used in mass media campaigns for some health topics.
Ha, Diep H; Do, Loc G; Luzzi, Liana; Mejia, Gloria C; Jamieson, Lisa
Dental diseases have shown to be influenced by area-level socioeconomic status. This study aims to assess the effects of change in area-level SES on the oral health of Australian Indigenous children. Data were collected from a national surveillance survey for children's dental health at two points of time (2000-2002/2007-2010). The study examines caries experienced by area-level SES and whether changes in area-level SES (stable-high, upwardly-mobile, downwardly-mobile and stable low) affects caries experience. Dental caries in both the deciduous and permanent dentition increased significantly among Indigenous children during the study period. In stable low-SES areas, the experience of decayed, missing and overall dmft/DMFT in both dentitions was highest compared with other groups at both Time 1(2.15 vs 1.61, 1.77, 1.87 and 0.86 vs 0.55, 0.67, 0.70 respectively) and Time 2 (3.23 vs 2.08, 2.17, 2.02 and 1.49 vs 1.18, 1.21 respectively). A change in area-level SES was associated with experience of dental disease among Indigenous Australian children.
Schumacher, Tracy L; Oldmeadow, Christopher; Clausen, Don; Weatherall, Loretta; Keogh, Lyniece; Pringle, Kirsty G; Rae, Kym M
Indigenous Australians experience high rates of cardiovascular disease (CVD). The origins of CVD may commence during pregnancy, yet few serum reference values for CVD biomarkers exist specific to the pregnancy period. The Gomeroi gaaynggal research project is a program that undertakes research and provides some health services to pregnant Indigenous women. Three hundred and ninety-nine non-fasting samples provided by the study participants (206 pregnancies and 175 women) have been used to construct reference intervals for CVD biomarkers during this critical time. A pragmatic design was used, in that women were not excluded for the presence of chronic or acute health states. Percentile bands for non-linear relationships were constructed according to the methods of Wright and Royston (2008), using the xriml package in StataIC 13.1. Serum cholesterol, triglycerides, cystatin-C and alkaline phosphatase increased as gestational age progressed, with little change seen in high-sensitivity C-Reactive Protein and γ glutamyl transferase. Values provided in the reference intervals are consistent with findings from other research projects. These reference intervals will form a basis with which future CVD biomarkers for pregnant Indigenous Australian women can be compared.
Cheng, W Y C; Blum, P; Spain, B
This prospective study was designed to elucidate barriers limiting effective perioperative communication between indigenous Australians and anaesthetists, and to identify strategies for improving communication. A questionnaire was used to collect data on 1040 consecutive patients undergoing anaesthesia at Royal Darwin Hospital between February and March 2003. 27.1% of these patients described themselves as Aboriginal. Aboriginal patients were more likely to undergo emergency surgery and were more likely to be classified as ASA 3, 4 or 5 than non-indigenous patients. Communication difficulties were identified in 28.7% of all Aboriginal patients, which was 31 times higher than those in non-Aboriginal patients. The most common reason identified for this was difficulty in speaking English. Only 17.7% of Aboriginal patients presenting to the operating theatre spoke English as their first language. Unfortunately, the anaesthetic team utilized the Aboriginal interpreter service in only a minority of cases. Communication difficulty in indigenous Australians is pervasive and often goes unrecognized. The results suggest that heath care providers may need staff training in cross-cultural communication and that protocols need to be developed within the health care system so that interpreters are called upon automatically early in the admission process.
Full Text Available There are significant and enduring inequities in education and employment outcomes between Indigenous and non-Indigenous Australians. In taking a ‘life-first’ approach to service provision the Building Family Opportunities Program (BFO was able to successfully increase Indigenous Australians’ engagement with education and employment in South Australia. The evaluation of the BFO included quantitative administrative and survey data for 110 Indigenous families collected over a three year period, and qualitative data from interviews with 13 Indigenous jobseekers and focus groups with 24 case managers. Quantitative data revealed that similar proportions of Indigenous and non-Indigenous jobseekers achieved positive education/training and employment outcomes as a result of the program. Qualitative data were able to identify the strengths of this program as perceived by Indigenous families and case managers, including the practical and socio-emotional support offered to whole families, using a strengths-based, life-first approach. In the context of broader education and employment disadvantages experienced by Indigenous Australians, these results are significant and illustrate key lessons which can inform future policy and service delivery initiatives aiming to close the gap.
Neville, Helen A; Oyama, Kathleen E; Odunewu, Latifat O; Huggins, Jackie G
Sense of belonging is a key aspect of racial and ethnic identity. Interestingly, there is little exploration of the multiple characteristics of belongingness within the racial and ethnic identity literature. Through individual interviews and a focus group, we explored the sense of racial-ethnic-cultural (REC) belonging among 19 self-identified Black Indigenous Australians (Aborigines and Torres Strait Islanders). Using dimensional analysis, we uncovered 5 core interrelated dimensions of REC belonging: History/Memory, Place, and Peoplehood; Sense of Community; Acceptance and Pride; Shared Language and Culture; and Interconnections. We also uncovered 3 main barriers undermining participants' sense of REC belonging: phenotype, social identity, and history of colonization. PsycINFO Database Record (c) 2014 APA, all rights reserved.
McNamara, Bridgette J; Banks, Emily; Gubhaju, Lina; Joshy, Grace; Williamson, Anna; Raphael, Beverley; Eades, Sandra
To explore factors associated with high psychological distress among Aboriginal and non-Aboriginal Australians and their contribution to the elevated distress prevalence among Aboriginal people. Questionnaire data from 1,631 Aboriginal and 233,405 non-Aboriginal 45 and Up Study (NSW, Australia) participants aged ≥45 years were used to calculate adjusted prevalence ratios for high psychological distress (Kessler-10 score ≥22) for socio-demographic, health and disability-related factors, and to quantify contributions to differences in distress prevalence. While high-distress prevalence was increased around three-fold in Aboriginal versus non-Aboriginal participants, distress-related risk factors were similar. Morbidity and physical disability had the strongest associations; high distress affected 43.8% of Aboriginal and 20.9% of non-Aboriginal participants with severe physical limitations and 9.5% and 3.9% of those without limitations, respectively. Differences in distress prevalence between Aboriginal and non-Aboriginal participants were essentially attributable to differences in SES, morbidity, disability/functional limitations and social support (fully-adjusted PR 1.19 [95% 1.08, 1.30]); physical morbidity and disability explained the bulk. The markedly elevated prevalence of high distress among older Aboriginal Australians appears largely attributable to greater physical morbidity and disability. Implications for public health: Addressing upstream determinants of physical morbidity and improved integration of social and emotional wellbeing care into primary care and chronic disease management are essential. © 2018 The Authors.
Natalie C. Ban
Full Text Available Community and resource user support has often been declared as essential to achieving globally agreed targets for marine protection. Given that indigenous people in Canada have resource use rights, we engaged two indigenous communities in British Columbia for their views on marine planning and protected areas. We developed a three-phased approach for executing our research: building research partnerships, carrying out individual interviews, and holding community discussion sessions. Participants expressed a common goal of recovering depleted species and ensuring the sustainability of indigenous fishing. We found strong support for spatial protection measures, and significant overlaps amongst participants in the areas suggested for protection. The most common type of protection recommended by participants was the exclusion of commercial and recreational fisheries while allowing for indigenous fishing; this stands in contrast to the emphasis on strict no-take MPAs advocated in the literature. Similarities in the goal, and level and areas of protection point to a gap in conservation approaches: the conservation of important areas and resources to indigenous people, allowing the continued practice and adaptation of their culture.
Full Text Available Abstract Background The global rise of Type 2 diabetes and its complications has drawn attention to the burden of non-communicable diseases on populations undergoing epidemiological transition. The life course approach of a birth cohort has the potential to increase our understanding of the development of these chronic diseases. In 1987 we sought to establish an Australian Indigenous birth cohort to be used as a resource for descriptive and analytical studies with particular attention on non-communicable diseases. The focus of this report is the methodology of recruiting and following-up an Aboriginal birth cohort of mobile subjects belonging to diverse cultural and language groups living in a large sparsely populated area in the Top End of the Northern Territory of Australia. Methods A prospective longitudinal study of Aboriginal singletons born at the Royal Darwin Hospital 1987–1990, with second wave cross-sectional follow-up examination of subjects 1998–2001 in over 70 different locations. A multiphase protocol was used to locate and collect data on 686 subjects with different approaches for urban and rural children. Manual chart audits, faxes to remote communities, death registries and a full time subject locator with past experience of Aboriginal communities were all used. Discussion The successful recruitment of 686 Indigenous subjects followed up 14 years later with vital status determined for 95% of subjects and examination of 86% shows an Indigenous birth cohort can be established in an environment with geographic, cultural and climatic challenges. The high rates of recruitment and follow up indicate there were effective strategies of follow-up in a supportive population.
Green, Donna; Bambrick, Hilary; Tait, Peter; Goldie, James; Schultz, Rosalie; Webb, Leanne; Alexander, Lisa; Pitman, Andrew
The health gap between Indigenous and non-Indigenous Australians may be exacerbated by climate change if temperature extremes have disproportionate adverse effects on Indigenous people. To explore this issue, we analysed the effect of temperature extremes on hospital admissions for respiratory diseases, stratified by age, Indigenous status and sex, for people living in two different climates zones in the Northern Territory during the period 1993–2011. We examined admissions for both acute and chronic respiratory diagnoses, controlling for day of the week and seasonality variables. Our analysis showed that: (1) overall, Indigenous hospital admission rates far exceeded non-Indigenous admission rates for acute and chronic diagnoses, and Top End climate zone admission rates exceeded Central Australia climate zone admission rates; (2) extreme cold and hot temperatures were associated with inconsistent changes in admission rates for acute respiratory disease in Indigenous and non-Indigenous children and older adults; and (3) no response to cold or hot temperature extremes was found for chronic respiratory diagnoses. These findings support our two hypotheses, that extreme hot and cold temperatures have a different effect on hospitalisations for respiratory disease between Indigenous and non-Indigenous people, and that these health risks vary between the different climate zones. We did not, however, find that there were differing responses to temperature extremes in the two populations, suggesting that any increased vulnerability to climate change in the Indigenous population of the Northern Territory arises from an increased underlying risk to respiratory disease and an already greater existing health burden. PMID:26633456
Full Text Available The health gap between Indigenous and non-Indigenous Australians may be exacerbated by climate change if temperature extremes have disproportionate adverse effects on Indigenous people. To explore this issue, we analysed the effect of temperature extremes on hospital admissions for respiratory diseases, stratified by age, Indigenous status and sex, for people living in two different climates zones in the Northern Territory during the period 1993–2011. We examined admissions for both acute and chronic respiratory diagnoses, controlling for day of the week and seasonality variables. Our analysis showed that: (1 overall, Indigenous hospital admission rates far exceeded non-Indigenous admission rates for acute and chronic diagnoses, and Top End climate zone admission rates exceeded Central Australia climate zone admission rates; (2 extreme cold and hot temperatures were associated with inconsistent changes in admission rates for acute respiratory disease in Indigenous and non-Indigenous children and older adults; and (3 no response to cold or hot temperature extremes was found for chronic respiratory diagnoses. These findings support our two hypotheses, that extreme hot and cold temperatures have a different effect on hospitalisations for respiratory disease between Indigenous and non-Indigenous people, and that these health risks vary between the different climate zones. We did not, however, find that there were differing responses to temperature extremes in the two populations, suggesting that any increased vulnerability to climate change in the Indigenous population of the Northern Territory arises from an increased underlying risk to respiratory disease and an already greater existing health burden.
Martin, Karen L.
Whilst early childhood education is regarded as important for young Indigenous Australians and it has been a feature of policy since the 1960s, it does not receive the same attention as compulsory schooling for Indigenous Australian students. A serious lack of large-scale research contributes to the devaluing of early childhood education for young…
In view of the limitations of mainstream Western psychology, the necessity of indigenous psychology for the development of global community psychology is discussed in the context of multiculturalism. In addition to this general introduction, four articles underlying a common theme were designed to discuss (a) various types of value conflicts…
access funding from government and/or other donors. Working in groups is indigenous to. African communities and has far-reaching effects, which reverberate beyond the boundaries of these groups and has historically been an embodiment of the way of life, custodian of customs, traditions and cultures and provide venue ...
Johnston, Vanessa; Thomas, David P
To explore the perceptions of remote Indigenous community members and health staff regarding the acceptability and effectiveness of different tobacco control health promotion interventions. Qualitative methods were used for this exploratory study, including interviews with remote Indigenous community members and health staff, as well as observations of the delivery of different tobacco control activities in three remote communities in the Northern Territory (NT). Several tobacco control interventions for which there is strong evidence in other settings were generally perceived as acceptable and efficacious in the remote Indigenous setting. Primary care interventions, such as brief advice and pharmaceutical quitting aids, when available and accessible, were perceived as important and effective strategies to help people quit, as were the promotion of smokefree areas. By contrast unmodified Quit programs were perceived to have questionable application in this context and there were conflicting findings regarding taxation increases on tobacco and social marketing campaigns. Several evidence-based 'mainstream' activities are perceived to be acceptable to this population, but we may also need to address the concerns raised by health staff and community members about the acceptability of some unmodified activities. Additionally, organisational barriers within the health system may be contributing to the reduced effectiveness of tobacco control in this setting.
Cole, Anne Jodon; Brooks, Eva Irene
Histories of Indigenous peoples did not begin when European colonized their native lands: In Australia it began with the Dreaming some 40 to 60,000 years ago. Museum studies specify the need for museums to be socially responsible in their representation of cultures. This article examines two...... that the semiotic landscape of the museum was framed by the voices of Aboriginal and Torres Strait Islanders’ narratives and represented a diversity of voices; personal and political. The curator’s understanding of the need to partner with the Indigenous community, suggests that curators are in position...
Full Text Available In the Indigenous Australian oral culture, Tradition and Law are transmitted orally – through songs, tales, legends, etc. – and by visual expressions – engravings and drawings made on rocks, on the ground, on material objects, on bark and on the human body–. Drawings and engravings transform the surface on which they are made from profane to sacred, since they are the transmitters of cultural myths and beliefs, generation after generation. The body, one of the supports of visual expression, actively participates in the transmission of myths, relegating the design to a secondary place. The most important thing is the transmission of the myth and not the way it is transmitted, or the result. The mythological narrative or legend surpasses the aesthetic line of vision. This paper intends to expose the primacy of the use of the body -- human or not–, as a transmitter of the myths and history of the Indigenous Australian culture. In this way the body speaks a non-oral language full of symbolism and meaning.
This paper presents an Early Mathematical Patterning Assessment (EMPA) tool that provides early childhood educators with a valuable opportunity to identify young children's mathematical thinking and patterning skills through a series of hands-on and drawing tasks. EMPA was administered through one-to-one assessment interviews to children aged 4 to 5 years in the year prior to formal school. Two hundred and seventeen assessments indicated that the young low socioeconomic and predominantly Australian Indigenous children in the study group had varied patterning and counting skills. Three percent of the study group was able to consistently copy and draw an ABABAB pattern made with coloured blocks. Fifty percent could count to six by ones and count out six items with 4 % of the total group able to identify six items presented in regular formations without counting. The integration of patterning into early mathematics learning is critical to the abstraction of mathematical ideas and relationships and to the development of mathematical reasoning in young children. By using the insights into the children's thinking that the EMPA tool provides, early childhood educators can better inform mathematics teaching and learning and so help close the persistent gap in numeracy between Indigenous and non-Indigenous children.
The demand for equality of recognition or respect is the dominant passion of modernity. The 20th century experienced a giant leap in technological inventiveness and ruthless use of technological power. In the 21st century, human welfare and environmental wellbeing demand fundamental political appraisal. We have the means, if we choose, to eradicate poverty and to responsibly protect the global environment. However, economic, political and cultural systems act to differentially allocate the benefits and risks for growth between socioeconomic groups. For example, it is a matter of pride that the neonatal mortality rate in affluent societies has dropped substantially since the late 1970s. However, the level of infant mortality (three times the national average) and low birthweight (13%) among the Indigenous Australian population is the highest in the country. With hindsight we now know that is the inevitable legacy of Australia's colonial history. Chronic physical and psychological stress is recognized as an important etiological factor in many lifestyle diseases of the cardiovascular, immune and reproductive systems. Diseases of adaptation are further advanced by non-adaptive lifestyle choices, depression, alcoholism and other drug dependencies. This review describes the principles of bioscience ethics and targets equity issues as they affect human reproduction across generations with particular reference to the Indigenous population of Australia. The review also considers ways we may advance global and cultural maturity from the Indigenous Australian perspective and proposes an ecologically based model of preventative care. If we are to embrace fundamental social change and protect future children without threatening parents' basic freedoms, then new beliefs and priorities--based on a compassionate understanding of biological systems--must evolve from the general public. Belief in human rights arising from a sense of human dignity is a collective outcome originating
M. F. Fauzi
Full Text Available The citizen science program to supplement authoritative data in tree inventory has been well implemented in various countries. However, there is a lack of study that assesses correctness and accuracy of tree data supplied by citizens. This paper addresses the issue of tree data quality supplied by semi-literate indigenous group. The aim of this paper is to assess the correctness of attributes (tree species name, height and diameter at breast height and the accuracy of tree horizontal positioning data supplied by indigenous people. The accuracy of the tree horizontal position recorded by GNSS-enable smart phone was found to have a RMSE value of ± 8m which is not suitable to accurately locate individual tree position in tropical rainforest such as the Royal Belum State Park. Consequently, the tree species names contributed by indigenous people were only 20 to 30 percent correct as compared with the reference data. However, the combination of indigenous respondents comprising of different ages, experience and knowledge working in a group influence less attribute error in data entry and increase the use of free text rather than audio methods. The indigenous community has a big potential to engage with scientific study due to their local knowledge with the research area, however intensive training must be given to empower their skills and several challenges need to be addressed.
Bombara, C; Dürr, S; Gongora, J; Ward, M P
To investigate the roaming of Indigenous community dogs and potential interaction with wild dogs and dingoes. Cross-sectional survey and longitudinal follow-up study. Six remote Indigenous communities in Cape York Peninsula and Arnhem Land in northern Australia were selected. Hair samples were collected from community dogs and microsatellite DNA analyses were used to determine hybrid (>10% dingo DNA) status. Dogs were fitted with GPS collars and home range (ha) was estimated during monitoring periods of up to 3 days. In Cape York Peninsula, 6% of the 35 dogs sampled were dingo hybrids, whereas in Arnhem Land 41% of the 29 dogs sampled were hybrids. The median extended home range was estimated to be 4.54 ha (interquartile range, 3.40 - 7.71). Seven community dogs were identified with an estimated home range > 20 ha and home ranges included the bushland surrounding communities. No significant difference in home ranges was detected between hybrid and non-hybrid dogs. Study results provide some evidence (dingo hybridisation, bushland forays) of the potential interaction between domestic and wild dogs in northern Australia. The nature of this interaction needs further investigation to determine its role in disease transmission; for example, in the case of a rabies incursion in this region. © 2017 Australian Veterinary Association.
Olds, Jessica; Reilly, Rachel; Yerrell, Paul; Stajic, Janet; Micklem, Jasmine; Morey, Kim; Brown, Alex
International frameworks supported by national principles in Australia stipulate that prisoners should be provided with health services equivalent to those provided in the general community. However, a number of barriers unique to the prison system may hinder the provision of equitable healthcare for this population. In Australia, Indigenous people carry a greater burden of cancer mortality, which the Cancer Data and Aboriginal Disparities (CanDAD) project is seeking to address. During the course of recruiting participants to the CanDAD study, Indigenous Australian prisoners with cancer emerged as an important, under-researched but difficult to access sub-group. This scoping review sought to identify barriers and facilitators of access to adequate and equitable healthcare for Indigenous Australian prisoners with cancer in Australia. This review demonstrated a lack of research and, as such, the scoping review was extended to prisoners with cancer in Australia, New Zealand, the United States and Canada. This approach was taken in order to summarise the existing body of evidence regarding the barriers and facilitators of access to adequate and equitable healthcare for those who are incarcerated and suffering from cancer, and highlight areas that may require further investigation. Eight studies or commentaries were found to meet the inclusion criteria. This limited set of findings pointed to a range of possible barriers faced by prisoners with cancer, including a tension between the prisons' concern with security versus the need for timely access to medical care. Findings identified here offer potential starting points for research and policy development. Further research is needed to better elucidate how barriers to adequate cancer care for prisoners may be identified and overcome, in Australia and internationally. Furthermore, given Indigenous Australians' over-burden of cancer mortality and over-representation in the prison system, further research is needed to
Kamaljit Kaur Sangha
Full Text Available Despite calls by various international agencies, considerable work is still required to understand and incorporate the importance of earth's ecosystems for informing public policies. Savannas comprise nearly one third of global terrestrial ecosystems and support many local and Indigenous communities, but the value of their ecosystem services (ES is insufficiently understood. This study proposes an integrated ES valuation framework and applies it to assess ES for an Indigenous savanna estate in northern Australia, describing how capabilities along with biophysical and socio-cultural ES benefits play a vital role for peoples' wellbeing. We estimated the monetary value of ES by applying a conventional Basic Value Transfer (BVT method for biophysical benefits (USD 84 M y-1, and a wellbeing approach for valuing socio-cultural benefits and capabilities (USD 4 M y-1. The latter offers a relatively nominal estimate but underscores the importance of including peoples' capabilities in order to demonstrate wellbeing benefits for Indigenous people who regularly visit and utilize their lands. We explore two scenarios, Business as Usual (pastoral land use and ES-based economies (implying customary land use, particularly through fire management to project plausible broader benefits for the community over a longer term. This research describes how inclusion of Indigenous peoples' capabilities and socio-cultural values are critical for ES assessments, and indicates that an integrated approach is essential for appropriately informing local, regional and global development policies.
Cockburn, Nicole; Gartner, Coral; Ford, Pauline J
Reducing smoking prevalence among Indigenous Australians is a vital part of closing the health gap between Indigenous and non-Indigenous Australians. Community-controlled health clinics are an important setting for delivering smoking cessation advice and assistance. This study measured tobacco and e-cigarette use, knowledge of smoking-related health effects, motivations to quit and interest in cessation aids. Clients of Aboriginal & Torres Strait Islander Community Health Service dental clinics in Southeast Queensland (n = 421) completed a brief written questionnaire while in the waiting room. Nearly half (n = 184, 47%) of the participants currently smoked daily, of which 9% (n = 7) currently used e-cigarettes. Few smokers (8%, n = 13) had no intention to quit smoking. For current smokers, previously used quit methods were abrupt cessation (42%, n = 78), nicotine replacement therapies (NRT; 25%, n = 45), prescription medications (23%, n = 43), e-cigarettes (9%, n = 17) and other methods (3%, n = 6). Current smokers were most interested in cutting down (85%, n = 110), abrupt cessation (75%, n = 98) and free NRT (72%, n = 101). Fewer (34%, n = 36) were interested in purchasing NRT for smoking cessation. Our study found there was interest in accessing smoking cessation aids among the clients of this community-controlled health clinic, particularly if provided free of charge. Embedding smoking cessation advice and assistance into a range of community-controlled health clinics could provide opportunities for addressing the high smoking prevalence among Indigenous Australians. © 2018 Australasian Professional Society on Alcohol and other Drugs.
The Australian government has long maintained that the standard of healthcare provided in its immigration detention centres is broadly comparable with health services available within the Australian community. Drawing on the literature from prison healthcare, this article examines (1) whether the principle of equivalency is being applied in Australian immigration detention and (2) whether this standard of care is achievable given Australia's current policies. This article argues that the principle of equivalency is not being applied and that this standard of health and healthcare will remain unachievable in Australian immigration detention without significant reform. Alternate approaches to addressing the well documented issues related to health and healthcare in Australian immigration detention are discussed.
Tagliarino, Nicholas Korte
L. Alden Wily, N. Tagliarino, Harvard Law and International Development Society (LIDS), A. Vidal, C. Salcedo-La Vina, S. Ibrahim, and B. Almeida. 2016. Indicators of the Legal Security of Indigenous and Community Lands. Data file from LandMark: The Global Platform of Indigenous and Community Lands.
Whop, Lisa J; Diaz, Abbey; Baade, Peter; Garvey, Gail; Cunningham, Joan; Brotherton, Julia M L; Canfell, Karen; Valery, Patricia C; O'Connell, Dianne L; Taylor, Catherine; Moore, Suzanne P; Condon, John R
To evaluate the feasibility and reliability of record linkage of existing population-based data sets to determine Indigenous status among women receiving Pap smears. This method may allow for the first ever population measure of Australian Indigenous women's cervical screening participation rates. A linked data set of women aged 20-69 in the Queensland Pap Smear Register (PSR; 1999-2011) and Queensland Cancer Registry (QCR; 1997-2010) formed the Initial Study Cohort. Two extracts (1995-2011) were taken from Queensland public hospitals data (Queensland Hospital Admitted Patient Data Collection, QHAPDC) for women, aged 20-69, who had ever been identified as Indigenous (extract 1) and had a diagnosis or procedure code relating to cervical cancer (extract 2). The Initial Study Cohort was linked to extract 1, and women with cervical cancer in the initial cohort were linked to extract 2. The proportion of women in the Initial Cohort who linked with the extracts (true -pairs) is reported, as well as the proportion of potential pairs that required clerical review. After assigning Indigenous status from QHAPDC to the PSR, the proportion of women identified as Indigenous was calculated using 4 algorithms, and compared. There were 28,872 women (2.1%) from the Initial Study Cohort who matched to an ever Indigenous record in extract 1 (n=76,831). Women with cervical cancer in the Initial Study Cohort linked to 1385 (71%) records in extract 2. The proportion of Indigenous women ranged from 2.00% to 2.08% when using different algorithms to define Indigenous status. The Final Study Cohort included 1,372,823 women (PSR n=1,374,401; QCR n=1955), and 5,062,118 records. Indigenous status in Queensland cervical screening data was successfully ascertained through record linkage, allowing for the crucial assessment of the current cervical screening programme for Indigenous women. Our study highlights the need to include Indigenous status on Pap smear request and report forms in any
Smith, Joshua E; Tucker, David; Watson, Kenneth; Jones, Graham Lloyd
This paper reports on the isolation and identification of antibacterial constituents from the indigenous Australian medicinal plant Eremophila duttonii F. Muell. (Myoporaceae). Preparations derived from this plant are used by indigenous populations in the topical treatment of minor wounds, otitis and ocular complaints, and as a gargle for sore throat. Several authors have reported extracts of this plant to effect rapid bacteriolysis and inhibit growth of a wide range of Gram-positive micro-organisms. In other studies involving screening of native medicinal plants for antibacterial activity, extracts of Eremophila duttonii have been reported to consistently exhibit the highest potency amongst all species included. From a hexane extract, we identified two diterpenes of the serrulatane class, the principal constituents responsible for antibacterial activity and present as major constituents of the resinous leaf cuticle: serrulat-14-en-7,8,20-triol (1) and serrulat-14-en-3,7,8,20-tetraol (2). In addition, a hydroxylated furanosesquiterpene with mild antibacterial activity which appeared to be a novel compound was isolated from the extract and tentatively identified as 4-hydroxy-4-methyl-1-(2,3,4,5-tetrahydro-5-methyl[2,3'-bifuran]-5-yl) pentan-2-one. Minimum inhibitory concentrations for each of the compounds against three Gram-positive bacteria: Staphylococcus aureus (ATCC 29213), Staphylococcus epidermidis (ATCC 12228) and Streptococcus pneumoniae (ARL 10582), were determined using a micro-titre plate broth dilution assay.
Sarkar, Atanu; Hanrahan, Maura; Hudson, Amy
Canada has the second highest per capita water consumption in the world. However, little is known about complex socio-economic and cultural dynamics of water insecurities in Indigenous communities and the multiple health consequences. Most studies have concentrated on a simplified interpretation of accessibility, availability and quality issues, including some common water-borne infections as the only health outcomes. Thus, several government initiatives on potable water supply, particularly for remotely located communities, have failed to sustain and promote a healthy lifestyle. The objective was to explore the water insecurity, coping strategies and associated health risks in a small and isolated sub-Arctic Indigenous (Inuit) community in Canada. The study was based on a community-based survey (2013) in one of the most remote Inuit communities of Labrador. In-depth, open-ended key informant (KI) interviews (community leader (1), woman (1), nurse (1), teacher (1), and elder (1)) and focus group discussions (FGDs) were conducted with community leaders (5), community members (25), women (5), and high school students (8). Convenience sampling was followed in selection of the subjects for FGDs and approached some KIs. All the water sources (five in April and seven in October) were visited and tested for their physical, chemical and microbiological parameters. The FGDs and KI interviews were audio recorded and transcribed. In the analysis, the data (qualitative and quantitative) were broadly categorized into (a) water sources, access and quality, (b) coping, (c) health risks and (d) challenges to run a public water system. The community did not have any piped water supply. Their regular sources of water consisted of several unmonitored local streams, brooks, and ponds. The public water system was not affordable to the majority of community members who solely depended on government aid. Animal fecal contamination (in natural sources such as streams, brooks, and ponds
This article describes the formation and development of Aboriginal Community-Controlled Health Services in Australia, with emphasis on the Redfern Aboriginal Medical Service in Sydney. These organizations were established in the 1970s by Indigenous Australians who were excluded from and denied access to mainstream health services. The aim of this research was to explore notions of Indigenous agency against a historical backdrop of dispossession, colonialism, and racism. Aboriginal Community-Controlled Health Services act as a primary source of healthcare for many Indigenous communities in rural and urban areas. This study examined their philosophy of healthcare, the range of services provided, their problems with state bureaucracies and government funding bodies, and the imposition of managerialist techniques and strategies on their governance. Essentially, these organizations transcend individualistic, biomedical, and bureaucratic paradigms of health services by conceptualizing and responding to Indigenous health needs at a grassroots level and in a broad social and political context. They are based on a social model of health. © SAGE Publications 2015.
Roberts-Thomson Kaye F
Full Text Available Abstract Background Oral health impairment comprises three conceptual domains; pain, appearance and function. This study sought to: (1 estimate the prevalence of severe oral health impairment as assessed by a summary oral health impairment measure, including aspects of dental pain, dissatisfaction with dental appearance and difficulty eating, among a birth cohort of Indigenous Australian young adults (n = 442, age range 16-20 years; (2 compare prevalence according to demographic, socio-economic, behavioural, dental service utilisation and oral health outcome risk indicators; and (3 ascertain the independent contribution of those risk indicators to severe oral health impairment in this population. Methods Data were from the Aboriginal Birth Cohort (ABC study, a prospective longitudinal investigation of Aboriginal individuals born 1987-1990 at an Australian regional hospital. Data for this analysis pertained to Wave-3 of the study only. Severe oral health impairment was defined as reported experience of toothache, poor dental appearance and food avoidance in the last 12 months. Logistic regression models were used to evaluate effects of demographic, socio-economic, behavioural, dental service utilisation and clinical oral disease indicators on severe oral health impairment. Effects were quantified as odds ratios (OR. Results The percent of participants with severe oral health impairment was 16.3 (95% CI 12.9-19.7. In the multivariate model, severe oral health impairment was associated with untreated dental decay (OR 4.0, 95% CI 1.6-9.6. In addition to that clinical indicator, greater odds of severe oral health impairment were associated with being female (OR 2.0, 95% CI 1.2-3.6, being aged 19-20 years (OR 2.1, 95% CI 1.2-3.6, soft drink consumption every day or a few days a week (OR 2.6, 95% 1.2-5.6 and non-ownership of a toothbrush (OR 1.9, 95% CI 1.1-3.4. Conclusions Severe oral health impairment was prevalent among this population. The findings
Kwiatkowski, Roy E.
The Environmental Health Research Division (EHRD) of the First Nations and Inuit Health Branch, Health Canada conducts science-based activities and research with Canadian Indigenous communities in areas such as climate change adaptation, environmental contaminants, water quality, biomonitoring, risk assessment, health impact assessment, and food safety and nutrition. EHRD's research activities have been specifically designed to not only inform Health Canada's policy decision-makers but as well, Indigenous community decision-makers. This paper will discuss the reasons why Indigenous community engagement is important, what are some of the barriers preventing community engagement; and the efforts by EHRD to carry out community-based participatory research activities with Indigenous peoples.
Anderson, Heather; Kowal, Emma
The poor health of Indigenous Australians is well established. However, the health of residents of one remote community in the Northern Territory of Australia called Utopia has been found recently to be much better than expected. In this article, we draw on historical anthropological research to explain this finding. We trace how cultural and social structures were maintained through changing eras of government policy from the 1930s, and show how these structures strengthened psychosocial determinants of health. We argue that the mainstream psychosocial determinants of social cohesion and self-efficacy are usefully reconceptualized in an Indigenous context as connectedness to culture and land, and collective efficacy, respectively. Continuity of cultural and social structures into the 1940s was facilitated by a combination of factors including the relatively late colonial occupation, the intercultural practices typical of the pastoral industry, the absence of a mission or government settlement, and the individual personalities and histories of those connected to Utopia.
Indigenous community resilience is rooted in the seasoned lifeways, developed over generations, incorporated into systems of knowledge, and realized in artifacts of infrastructure through keen observations of the truth and consequences of their interactions with the environment found in place over time. Their value lies, not in their nature as artifacts, but in the underlying patterns and processes of culture: how previous adaptations were derived and evolved, and how the principles and processes of detailed observation may inform future adaptations. This presentation examines how such holistic community approaches, reflected in design and practice, can be applied to contemporary issues of energy and housing in a rapidly changing climate. The Indigenous Peoples of the Great Plains seek to utilize the latest scientific climate modeling to support the development of large, utility scale distributed renewable energy projects and to re-invigorate an indigenous housing concept of straw bale construction, originating in this region. In the energy context, we explore the potential for the development of an intertribal wind energy dynamo on the Great Plains, utilizing elements of existing federal policies for Indian energy development and existing federal infrastructure initially created to serve hydropower resources, which may be significantly altered under current and prospective drought scenarios. For housing, we consider the opportunity to address the built environment in Indian Country, where Tribes have greater control as it consists largely of residences needed for their growing populations. Straw bale construction allows for greater use of local natural and renewable materials in a strategy for preparedness for the weather extremes and insurance perils already common to the region, provides solutions to chronic unemployment and increasing energy costs, while offering greater affordable comfort in both low and high temperature extremes. The development of large
Lilian Patricia Rodríguez-Burgos
Full Text Available The purpose of this article is to analyze the psycho-cultural processes involved in knitting “mochilas” (traditional bags, a common craft in the Arhuaco indigenous community located in the Sierra Nevada de Santa Marta, Colombia. The article is structured in three parts, as follows: first, issues related to child development are discussed; then, the analysis method used to study the processes involved in the practice of knitting is presented and, finally, we reflect on the importance of recovering the sense and meaning of this everyday practice as a way to study child development.
McCalman, Janya; Bainbridge, Roxanne; Russo, Sandra; Rutherford, Katrina; Tsey, Komla; Wenitong, Mark; Shakeshaft, Anthony; Doran, Chris; Jacups, Susan
The proposed study was developed in response to increased suicide risk identified in Aboriginal and Torres Strait Islander students who are compelled to attend boarding schools across Queensland when there is no secondary schooling provision in their remote home communities. It will investigate the impact of a multicomponent mentoring intervention to increase levels of psychosocial resilience. We aim to test the null hypothesis that students' resilience is not positively influenced by the intervention. The 5-year project was funded by the Australian National Health and Medical Research Council from December 2014. An integrated mixed methods approach will be adopted; each component iteratively informing the other. Using an interrupted time series design, the primary research methods are quantitative: 1) assessment of change in students' resilience, educational outcomes and suicide risk; and 2) calculation of costs of the intervention. Secondary methods are qualitative: 3) a grounded theoretical model of the process of enhancing students' psychosocial resilience to protect against suicide. Additionally, there is a tertiary focus on capacity development: more experienced researchers in the team will provide research mentorship to less experienced researchers through regular meetings; while Indigenous team members provide cultural mentorship in research practices to non-Indigenous members. Australia's suicide prevention policy is progressive but a strong service delivery model is lacking, particularly for Indigenous peoples. The proposed research will potentially improve students' levels of resilience to mitigate against suicide risk. Additionally, it could reduce the economic and social costs of Indigenous youth suicide by obtaining agreement on what is good suicide prevention practice for remote Indigenous students who transition to boarding schools for education, and identifying the benefits-costs of an evidence-based multi-component mentoring intervention to
Estevez, José; Kaidonis, Georgia; Henderson, Tim; Craig, Jamie E; Landers, John
Visual impairment significantly impairs the length and quality of life, but little is known of its impact in Indigenous Australians. To investigate the association of disease-specific causes of visual impairment with all-cause mortality. A retrospective cohort analysis. A total of 1347 Indigenous Australians aged over 40 years. Participants visiting remote medical clinics underwent clinical examinations including visual acuity, subjective refraction and slit-lamp examination of the anterior and posterior segments. The major ocular cause of visual impairment was determined. Patients were assessed periodically in these remote clinics for the succeeding 10 years after recruitment. Mortality rates were obtained from relevant departments. All-cause 10-year mortality and its association with disease-specific causes of visual impairment. The all-cause mortality rate for the entire cohort was 29.3% at the 10-year completion of follow-up. Of those with visual impairment, the overall mortality rate was 44.9%. The mortality rates differed for those with visual impairment due to cataract (59.8%), diabetic retinopathy (48.4%), trachoma (46.6%), 'other' (36.2%) and refractive error (33.4%) (P visual impairment from diabetic retinopathy were any more likely to die during the 10 years of follow-up when compared with those without visual impairment (HR 1.70; 95% CI, 1.00-2.87; P = 0.049). Visual impairment was associated with all-cause mortality in a cohort of Indigenous Australians. However, diabetic retinopathy was the only ocular disease that significantly increased the risk of mortality. Visual impairment secondary to diabetic retinopathy may be an important predictor of mortality. © 2017 Royal Australian and New Zealand College of Ophthalmologists.
Biddle, Nicholas; Yap, Mandy
Across almost all standard indicators, the Indigenous population of Australia has worse outcomes than the non-Indigenous population. Despite the abundance of statistics and a plethora of government reports on Indigenous outcomes, there is very little information on how Indigenous disadvantage accumulates or is mitigated through time at the individual level. The research that is available highlights two key findings. Firstly, that Indigenous disadvantage starts from a very early age and widens...
Hindle, Rawiri; Hynds, Anne; Averill, Robin; Meyer, Luanna; Faircloth, Susan
We propose the use of an ontological perspective to shift current thinking about the phenomenon of home/school partnerships, particularly through an examination of school leaders (leadership team)--community relationships that seek to better serve Indigenous students and their communities. We reanalysed focus group interviews of indigenous Maori…
Urrieta, Luis, Jr.
This article explores how children and youth learned indigenous heritage "saberes" (knowings) through intent community participation in Nocutzepo, Mexico. The "familia" (family) and "comunidad" (community)-based saberes were valuable for skills acquisition, but most important for learning indigenous forms of…
This research study will investigate community music engagement by both Chinese-Australians and Chinese older people at two different older people’s organizations with the aim of exploring the affects of music engagement on older people. The study seeks to explore cultural differences between Chinese-Australian older people and Chinese older people as they relate to their music engagement. The research contentions were that (1) active music engagement can enhance the quality of the life of ol...
Mazel, Odette; Ewen, Shaun
The Leaders in Indigenous Medical Education (LIME) Network aims to improve the quality and effectiveness of Indigenous health in medical education as well as best practice in the recruitment, retention, and graduation of Indigenous medical students. In this article we explore the utility of Etienne Wenger's "communities of practice" (CoP) concept in providing a theoretical framework to better understand the LIME Network as a form of social infrastructure to further knowledge and innovation in this important area of health care education reform. The Network operates across all medical schools in Australia and New Zealand. Utilizing a model of evaluation of communities of practice developed by Fung-Kee-Fung et al., we seek to analyze the outcomes of the LIME Network as a CoP and assess its approach and contribution to improving the implementation of Indigenous health in the medical curriculum and the graduation of Indigenous medical students. By reflecting on the Network through a community of practice lens, this article highlights the synthesis between the LIME Network and Wenger's theory and provides a framework with which to measure Network outputs. It also posits an opportunity to better capture the impact of Network activities into the future to ensure that it remains a relevant and sustainable entity.
Bishop, Brian; Colquhoun, Simon; Johnson, Gemma
Sense of community (SOC) is central to an individual's psychological wellbeing (Sarason, 1974). Eleven participants, mainly from the North West of Western Australia, took part in semistructured interviews investigating Australian Aboriginal notions of community and SOC. Five key themes emerged from the data. These included: kinship structure,…
Kinchin, Irina; Jacups, Susan; Hunter, Gary; Rogerson, Bernadette
An increase in the number of Indigenous homeless persons in Cairns, Northern Australia, prompted the Queensland Police Service (QPS) to commence a pilot 'Return to Country' (R2C) program. The program was designed to assist homeless people who were voluntarily seeking to return to their home communities. This study assesses the costs of running the program and evaluates its net economic impact. Retrospective uncontrolled cost, cost-effectiveness and cost-offset analyses were undertaken from a societal perspective. All costs were expressed in 2014 AU$. The R2C program successfully assisted 140 participants to return home, reducing the prevalence of homelessness in the regional center by 9.6%. The total program cost was estimated as AU$ 135,831 or AU$ 970 per participant. The economic analysis indicated that R2C was value for money, potentially saving AU$ 2,714,460. Limitations of the study included retrospective data collection and no established alternative comparison group. R2C is a relatively simple, minimal cost program, which can be utilized by policy makers to offer one solution to homelessness. This economic evaluation informs the QPS of the effects of the R2C program in order to guide further program initiatives. The R2C model may be applied to assist temporarily stranded Indigenous people in other locations within Australia or internationally to return home. No funding was obtained for conducting this study. Copyright © 2016 Elsevier Ltd. All rights reserved.
Hussain, Sameera; Ruano, Ana Lorena; Rahman, Atiya; Rashid, Sabina Faiz; Hill, Peter S
Indigenous peoples are among the most marginalized peoples in the world due to issues relating to well-being, political representation, and economic production. The research consortium Goals and Governance for Global Health (Go4Health) conducted a community consultation process among marginalized groups across the global South aimed at including their voices in the global discourse around health in the post-2015 development agenda. This paper presents findings from the consultations carried out among indigenous communities in Bangladesh. For this qualitative study, our research team consulted the Tripura and Mro communities in Bandarban district living in the isolated Chittagong Hill Tracts region. Community members, leaders, and key informants working in health service delivery were interviewed. Data was analyzed using thematic analysis. Our findings show that remoteness shapes the daily lives of the communities, and their lack of access to natural resources and basic services prevents them from following health promotion messages. The communities feel that their needs are impossible to secure in a politically indifferent and sometimes hostile environment. Communities are keen to participate and work with duty bearers in creating the conditions that will lead to their improved quality of life. Clear policies that recognize the status of indigenous peoples are necessary in the Bangladeshi context to allow for the development of services and infrastructure.
If you can't comply with dialysis, how do you expect me to trust you with transplantation? Australian nephrologists' views on indigenous Australians' 'non-compliance' and their suitability for kidney transplantation
Full Text Available Abstract Introduction Indigenous Australians suffer markedly higher rates of end-stage kidney disease (ESKD but are less likely than their non-Indigenous counterparts to receive a transplant. This difference is not fully explained by measurable clinical differences. Previous work suggests that Indigenous Australian patients may be regarded by treating specialists as 'non-compliers', which may negatively impact on referral for a transplant. However, this decision-making is not well understood. The objectives of this study were to investigate: whether Indigenous patients are commonly characterised as 'non-compliers'; how estimations of patient compliance factor into Australian nephrologists' decision-making about transplant referral; and whether this may pose a particular barrier for Indigenous patients accessing transplants. Methods Nineteen nephrologists, from eight renal units treating the majority of Indigenous Australian renal patients, were interviewed in 2005-06 as part of a larger study. Thematic analysis was undertaken to investigate how compliance factors in specialists' decision-making, and its implications for Indigenous patients' likelihood of obtaining transplants. Results Specialists commonly identified Indigenous patients as both non-compliers and high-risk transplant candidates. Definition and assessment of 'compliance' was neither formal nor systematic. There was uncertainty about the value of compliance status in predicting post-transplant outcomes and the issue of organ scarcity permeated participants' responses. Overall, there was marked variation in how specialists weighed perceptions of compliance and risk in their decision-making. Conclusion Reliance on notions of patient 'compliance' in decision-making for transplant referral is likely to result in continuing disadvantage for Indigenous Australian ESKD patients. In the absence of robust evidence on predictors of post-transplant outcomes, referral decision-making processes
Claudia, C; Ju, X; Mejia, G; Jamieson, L
This study aimed to test the association between maternal smoking during pregnancy and parental-reported experience of dental caries in Indigenous Australian children. Data were from the Longitudinal Study of Indigenous Children (LSIC); a population-based cohort study in Australia. Participants were 1,687 Indigenous Australian children aged 5 or less. Biological, social and behavioural variables were tested using log-linear modelling with binomial regression to determine the association with parental-reported experience of dental caries. Markov Chain Monte Carlo methods were used for multiple imputation of missing data. Overall 25.8% of Indigenous Australian children had dental caries as reported by a carer. In the multivariable model, increased prevalence of parental-reported caries was significantly associated with low maternal education levels (RR=1.60, 95%CI 1.17,2.20) and high sugar consumption (RR= 1.60, 95%CI 1.26,2.02). In the group of children whose mothers smoked tobacco during pregnancy, the association with parent-reported dental caries approached the threshold of significance, but was not significantly associated with caries status in children (RR=1.19, 95%CI 0.99,1.43). After multiple imputation, the most significant association was evident in children of the least educated mothers (RR=1.57, 95%CI 1.25,1.95), breastfeeding more than 12 months (RR=1.26, 95%CI 1.01,1.56), sweet intake more than 30% (RR=1.42, 95%CI 1.15,1.74) and 20-30% (RR=1.29 95%CI 1.04,1.59) and residing in outer regional (RR=1.56, 95%CI 1.19,2.05) or inner regional locations (RR=1.50, 95%CI 1.19,1.88). Mothers' tobacco smoking status showed a weak association with parent-reported dental decay (RR=1.42, 95%CI 1.20,1.68). This study suggests there is a weak association between maternal smoking during pregnancy and prevalence of parentally-reported dental caries in Indigenous Australian children. Copyright© 2016 Dennis Barber Ltd
Diabetic retinopathy in a remote Indigenous primary healthcare population: a Central Australian diabetic retinopathy screening study in the Telehealth Eye and Associated Medical Services Network project.
Brazionis, L; Jenkins, A; Keech, A; Ryan, C; Brown, A; Boffa, J; Bursell, S
To determine diabetic retinopathy prevalence and severity among remote Indigenous Australians. A cross-sectional diabetic retinopathy screening study of Indigenous adults with Type 2 diabetes was conducted by locally trained non-ophthalmic retinal imagers in a remote Aboriginal community-controlled primary healthcare clinic in Central Australia and certified non-ophthalmic graders in a retinal grading centre in Melbourne, Australia. The main outcome measure was prevalence of any diabetic retinopathy and sight-threatening diabetic retinopathy. Among 301 participants (33% male), gradable image rates were 78.7% (n = 237) for diabetic retinopathy and 83.1% (n = 250) for diabetic macular oedema, and 77.7% (n = 234) were gradable for both diabetic retinopathy and diabetic macular oedema. For the gradable subset, the median (range) age was 48 (19-86) years and known diabetes duration 9.0 (0-24) years. The prevalence of diabetic retinopathy was 47% (n = 110) and for diabetic macular oedema it was 14.4% (n = 36). In the fully gradable imaging studies, sight-threatening diabetic retinopathy prevalence was 16.2% (n = 38): 14.1% (n = 33) for clinically significant macular oedema, 1.3% (n = 3) for proliferative diabetic retinopathy and 0.9% (n = 2) for both. Sight-threatening diabetic retinopathy had been treated in 78% of detected cases. A novel telemedicine diabetic retinopathy screening service detected a higher prevalence of 'any' diabetic retinopathy and sight-threatening diabetic retinopathy in a remote primary care setting than reported in earlier surveys among Indigenous and non-Indigenous populations. Whether the observed high prevalence of diabetic retinopathy was attributable to greater detection, increasing diabetic retinopathy prevalence, local factors, or a combination of these requires further investigation and, potentially, specific primary care guidelines for diabetic retinopathy management in remote Australia. Clinical Trials registration number: Australia and
Trofimovs, Julian; Dowse, Leanne
Indigenous Australians experience significant social risk, vulnerability and disadvantage. Nowhere is this more starkly demonstrated than in the levels of contact that Indigenous Australians have with the criminal justice system, particularly the police. Utilizing a linked dataset of extant criminal justice, human and health service administrative data in New South Wales (NSW) Australia, this paper explores patterns of police contact and custody for a cohort of Indigenous males with complex needs. Four significant factors are identified that alone or in combination appear to impact on the frequency with which these men experience police contact and custody, including young age at first police contact, experiencing out of home care as a child, alcohol misuse, and limited locational mobility. Whilst it might be expected that the presence of mental ill-health and/or cognitive disability would be a key predictor of the frequency and intensity of police contact and custody, the findings suggest rather that the presence of multiple disadvantages beginning in the early years and compounding throughout individuals' lives, in which mental illness may or may not be a factor, is more significant than the presence of any one diagnosis in precipitating police contact and custody for this group. Copyright © 2014 Elsevier Ltd. All rights reserved.
Almeida, Osvaldo P.; Flicker, Leon; Fenner, Stephen; Smith, Kate; Hyde, Zoe; Atkinson, David; Skeaf, Linda; Malay, Roslyn; LoGiudice, Dina
Objective This study aimed to develop a culturally acceptable and valid scale to assess depressive symptoms in older Indigenous Australians, to determine the prevalence of depressive disorders in the older Kimberley community, and to investigate the sociodemographic, lifestyle and clinical factors associated with depression in this population. Methods Cross-sectional survey of adults aged 45 years or over from six remote Indigenous communities in the Kimberley and 30% of those living in Derby, Western Australia. The 11 linguistic and culturally sensitive items of the Kimberley Indigenous Cognitive Assessment of Depression (KICA-dep) scale were derived from the signs and symptoms required to establish the diagnosis of a depressive episode according to the DSM-IV-TR and ICD-10 criteria, and their frequency was rated on a 4-point scale ranging from ‘never’ to ‘all the time’ (range of scores: 0 to 33). The diagnosis of depressive disorder was established after a face-to-face assessment with a consultant psychiatrist. Other measures included sociodemographic and lifestyle factors, and clinical history. Results The study included 250 participants aged 46 to 89 years (mean±SD = 60.9±10.7), of whom 143 (57.2%) were women. The internal reliability of the KICA-dep was 0.88 and the cut-point 7/8 (non-case/case) was associated with 78% sensitivity and 82% specificity for the diagnosis of a depressive disorder. The point-prevalence of a depressive disorder in this population was 7.7%; 4.0% for men and 10.4% for women. Heart problems were associated with increased odds of depression (odds ratio = 3.3, 95% confidence interval = 1.2,8.8). Conclusions The KICA-dep has robust psychometric properties and can be used with confidence as a screening tool for depression among older Indigenous Australians. Depressive disorders are common in this population, possibly because of increased stressors and health morbidities. PMID:24740098
Osvaldo P Almeida
Full Text Available OBJECTIVE: This study aimed to develop a culturally acceptable and valid scale to assess depressive symptoms in older Indigenous Australians, to determine the prevalence of depressive disorders in the older Kimberley community, and to investigate the sociodemographic, lifestyle and clinical factors associated with depression in this population. METHODS: Cross-sectional survey of adults aged 45 years or over from six remote Indigenous communities in the Kimberley and 30% of those living in Derby, Western Australia. The 11 linguistic and culturally sensitive items of the Kimberley Indigenous Cognitive Assessment of Depression (KICA-dep scale were derived from the signs and symptoms required to establish the diagnosis of a depressive episode according to the DSM-IV-TR and ICD-10 criteria, and their frequency was rated on a 4-point scale ranging from 'never' to 'all the time' (range of scores: 0 to 33. The diagnosis of depressive disorder was established after a face-to-face assessment with a consultant psychiatrist. Other measures included sociodemographic and lifestyle factors, and clinical history. RESULTS: The study included 250 participants aged 46 to 89 years (mean±SD = 60.9±10.7, of whom 143 (57.2% were women. The internal reliability of the KICA-dep was 0.88 and the cut-point 7/8 (non-case/case was associated with 78% sensitivity and 82% specificity for the diagnosis of a depressive disorder. The point-prevalence of a depressive disorder in this population was 7.7%; 4.0% for men and 10.4% for women. Heart problems were associated with increased odds of depression (odds ratio = 3.3, 95% confidence interval = 1.2,8.8. CONCLUSIONS: The KICA-dep has robust psychometric properties and can be used with confidence as a screening tool for depression among older Indigenous Australians. Depressive disorders are common in this population, possibly because of increased stressors and health morbidities.
Ward, Paul R; Coffey, Cushla; Javanparast, Sara; Wilson, Carlene; Meyer, Samantha B
Colorectal cancer (CRC) has the second highest cancer mortality rate in Australia. The Australian National Bowel Cancer Screening Program (NBCSP) aims to increase early detection of CRC by offering free Faecal Occult Blood Testing (FOBT), although uptake is low for culturally and linguistically diverse (CALD) groups. To present data on trust and mistrust in the NBCSP by population groups with low uptake and thus to highlight areas in need of policy change. A qualitative study was undertaken in South Australia, involving interviews with 94 people from four CALD groups: Greek, Iranian, Anglo-Australian, and Indigenous peoples. Our study highlights the complexities of institutional trust, which involves considerations of trust at interpersonal, local and national levels. In addition, trust and mistrust was found in more abstract systems such as the medical knowledge of doctors to diagnose or treat cancer or the scientific procedures in laboratories to test the FOBTs. The object of institutional (mis)trust differed between cultural groups - Anglo-Australian and Iranian groups indicated a high level of trust in the government, whereas Indigenous participants were much less trusting. The level and nature of trust in the screening process varied between the CALD groups. Addressing program misconceptions, clarifying the FOBT capabilities and involving medical services in collecting and transporting the samples may increase trust in the NBCSP. However, broader and more enduring mistrust in services and institutions may need to be dealt with in order to increase trust and participation. © 2014 John Wiley & Sons Ltd.
Jamieson Lisa M
Full Text Available Abstract Objectives To determine oral health literacy (REALD-30 and oral health literacy-related outcome associations, and to calculate if oral health literacy-related outcomes are risk indicators for poor self-reported oral health among rural-dwelling Indigenous Australians. Methods 468 participants (aged 17-72 years, 63% female completed a self-report questionnaire. REALD-30 and oral health literacy-related outcome associations were determined through bivariate analysis. Multivariate modelling was used to calculate risk indicators for poor self-reported oral health. Results REALD-30 scores were lower among those who believed teeth should be infrequently brushed, believed cordial was good for teeth, did not own a toothbrush or owned a toothbrush but brushed irregularly. Tooth removal risk indicators included being older, problem-based dental attendance and believing cordial was good for teeth. Poor self-rated oral health risk indicators included being older, healthcare card ownership, difficulty paying dental bills, problem-based dental attendance, believing teeth should be brushed infrequently and irregular brushing. Perceived need for dental care risk indicators included being female and problem-based dental attendance. Perceived gum disease risk indicators included being older and irregular brushing. Feeling uncomfortable about oro-facial appearance risk indicators included problem-based dental attendance and irregular brushing. Food avoidance risk indicators were being female, difficulty paying dental bills, problem-based dental attendance and irregular brushing. Poor oral health-related quality of life risk indicators included difficulty paying dental bills and problem-based dental attendance. Conclusions REALD-30 was significantly associated with oral health literacy-related outcomes. Oral health literacy-related outcomes were risk indicators for each of the poor self-reported oral health domains among this marginalised population.
Tang, Wen; Grace, Blair; McDonald, Stephen P.; Hawley, Carmel M.; Badve, Sunil V.; Boudville, Neil C.; Brown, Fiona G.; Clayton, Philip A.; Johnson, David W.
♦ Background: The aim of the present study was to investigate the relationship between socio-economic status (SES) and peritoneal dialysis (PD)-related peritonitis. ♦ Methods: Associations between area SES and peritonitis risk and outcomes were examined in all non-indigenous patients who received PD in Australia between 1 October 2003 and 31 December 2010 (peritonitis outcomes). SES was assessed by deciles of postcode-based Australian Socio-Economic Indexes for Areas (SEIFA), including Index of Relative Socio-economic Disadvantage (IRSD), Index of Relative Socio-economic Advantage and Disadvantage (IRSAD), Index of Economic Resources (IER) and Index of Education and Occupation (IEO). ♦ Results: 7,417 patients were included in the present study. Mixed-effects Poisson regression demonstrated that incident rate ratios for peritonitis were generally lower in the higher SEIFA-based deciles compared with the reference (decile 1), although the reductions were only statistically significant in some deciles (IRSAD deciles 2 and 4 – 9; IRSD deciles 4 – 6; IER deciles 4 and 6; IEO deciles 3 and 6). Mixed-effects logistic regression showed that lower probabilities of hospitalization were predicted by relatively higher SES, and lower probabilities of peritonitis-associated death were predicted by less SES disadvantage status and greater access to economic resources. No association was observed between SES and the risks of peritonitis cure, catheter removal and permanent hemodialysis (HD) transfer. ♦ Conclusions: In Australia, where there is universal free healthcare, higher SES was associated with lower risks of peritonitis-associated hospitalization and death, and a lower risk of peritonitis in some categories. PMID:24497587
Waterworth, Pippa; Pescud, Melanie; Braham, Rebecca; Dimmock, James; Rosenberg, Michael
Disparities between the health of Indigenous and non-Indigenous populations continue to be prevalent within Australia. Research suggests that Indigenous people participate in health risk behaviour more often than their non-Indigenous counterparts, and that such behaviour has a substantial impact on health outcomes. Although this would indicate that reducing health risk behaviour may have positive effects on health outcomes, the factors that influence Indigenous health behaviour are still poorly understood. This study aimed to interview people who support Indigenous groups to gain an understanding of their views on the factors influencing health behaviour within Indigenous groups in Western Australia. Twenty nine people participated in the study. The emergent themes were mapped against the social ecological model. The results indicated that: (1) culture, social networks, history, racism, socioeconomic disadvantage, and the psychological distress associated with some of these factors interact to affect health behaviour in a complex manner; (2) the desire to retain cultural identity and distinctiveness may have both positive and negative influence on health risk behaviour; (3) strong social connections to family and kin that is intensified by cultural obligations, appears to affirm and disrupt positive health behaviour; (4) the separation between Indigenous and non-Indigenous social connection/networks that appeared to be fostered by marginalisation and racism may influence the effect of social networks on health behaviour; and (5) communication between Indigenous and non-Indigenous people may be interrupted by distrust between the groups, which reduces the influence of some non-Indigenous sources on the health behaviour of Indigenous people.
Waterworth, Pippa; Pescud, Melanie; Braham, Rebecca; Dimmock, James; Rosenberg, Michael
Disparities between the health of Indigenous and non-Indigenous populations continue to be prevalent within Australia. Research suggests that Indigenous people participate in health risk behaviour more often than their non-Indigenous counterparts, and that such behaviour has a substantial impact on health outcomes. Although this would indicate that reducing health risk behaviour may have positive effects on health outcomes, the factors that influence Indigenous health behaviour are still poorly understood. This study aimed to interview people who support Indigenous groups to gain an understanding of their views on the factors influencing health behaviour within Indigenous groups in Western Australia. Twenty nine people participated in the study. The emergent themes were mapped against the social ecological model. The results indicated that: (1) culture, social networks, history, racism, socioeconomic disadvantage, and the psychological distress associated with some of these factors interact to affect health behaviour in a complex manner; (2) the desire to retain cultural identity and distinctiveness may have both positive and negative influence on health risk behaviour; (3) strong social connections to family and kin that is intensified by cultural obligations, appears to affirm and disrupt positive health behaviour; (4) the separation between Indigenous and non-Indigenous social connection/networks that appeared to be fostered by marginalisation and racism may influence the effect of social networks on health behaviour; and (5) communication between Indigenous and non-Indigenous people may be interrupted by distrust between the groups, which reduces the influence of some non-Indigenous sources on the health behaviour of Indigenous people. PMID:26599437
Donatuto, Jamie; Grossman, Eric E.; Konovsky, John; Grossman, Sarah; Campbell, Larry W.
This article describes a pilot study evaluating the sensitivity of Indigenous community health to climate change impacts on Salish Sea shorelines (Washington State, United States and British Columbia, Canada). Current climate change assessments omit key community health concerns, which are vital to successful adaptation plans, particularly for Indigenous communities. Descriptive scaling techniques, employed in facilitated workshops with two Indigenous communities, tested the efficacy of ranking six key indicators of community health in relation to projected impacts to shellfish habitat and shoreline archaeological sites stemming from changes in the biophysical environment. Findings demonstrate that: when shellfish habitat and archaeological resources are impacted, so is Indigenous community health; not all community health indicators are equally impacted; and, the community health indicators of highest concern are not necessarily the same indicators most likely to be impacted. Based on the findings and feedback from community participants, exploratory trials were successful; Indigenous-specific health indicators may be useful to Indigenous communities who are assessing climate change sensitivities and creating adaptation plans.
Davíd-Chavez, D. M.; Gavin, M. C.
Indigenous communities worldwide have maintained their own knowledge systems for millennia informed through careful observation of dynamics of environmental changes. Withstanding centuries of challenges to their rights to maintain and practice these knowledge systems, Indigenous peoples continually speak to a need for quality standards for research in their communities. Although, international and Indigenous peoples' working groups emphasize Indigenous knowledge systems and the communities who hold them as critical resources for understanding and adapting to climate change, there has yet to be a comprehensive, evidence based analysis into how diverse knowledge systems are integrated in scientific studies. Do current research practices challenge or support Indigenous communities in their efforts to maintain and appropriately apply their knowledge systems? This study addresses this question using a systematic literature review and meta-analysis assessing levels of Indigenous community participation and decision-making in all stages of the research process (initiation, design, implementation, analysis, dissemination). Assessment is based on reported quality indicators such as: outputs that serve the community, ethical guidelines in practice (free, prior, and informed consent and intellectual property rights), and community access to findings. These indicators serve to identify patterns between levels of community participation and quality standards in practice. Meta-analysis indicates most climate studies practice an extractive model in which Indigenous knowledge systems are co-opted with minimal participation or decision-making authority from communities who hold them. Few studies report outputs that directly serve Indigenous communities, ethical guidelines in practice, or community access to findings. Studies reporting the most quality indicators were initiated in mutual agreement between Indigenous communities and outside researchers or by communities themselves
Renwick, Anna R; Robinson, Catherine J; Garnett, Stephen T; Leiper, Ian; Possingham, Hugh P; Carwardine, Josie
Much biodiversity lives on lands to which Indigenous people retain strong legal and management rights. However this is rarely quantified. Here we provide the first quantitative overview of the importance of Indigenous land for a critical and vulnerable part of biodiversity, threatened species, using the continent of Australia as a case study. We find that three quarters of Australia's 272 terrestrial or freshwater vertebrate species listed as threatened under national legislation have projected ranges that overlap Indigenous lands. On average this overlap represents 45% of the range of each threatened species while Indigenous land is 52% of the country. Hotspots where multiple threatened species ranges overlap occur predominantly in coastal Northern Australia. Our analysis quantifies the vast potential of Indigenous land in Australia for contributing to national level conservation goals, and identifies the main land management arrangements available to Indigenous people which may enable them to deliver those goals should they choose to do so.
Muecke, A; Lenthall, S; Lindeman, M
Culture shock or cultural adaptation is a significant issue confronting non-Indigenous health professionals working in remote Indigenous communities in Australia. This article is presented in two parts. The first part provides a thorough background in the theory of culture shock and cultural adaptation, and a comprehensive analysis of the consequences, causes, and current issues around the phenomenon in the remote Australian healthcare context. Second, the article presents the results of a comprehensive literature review undertaken to determine if existing studies provide tools which may measure the cultural adaptation of remote health professionals. A comprehensive literature review was conducted utilising the meta-databases CINAHL and Ovid Medline. While there is a plethora of descriptive literature about culture shock and cultural adaptation, empirical evidence is lacking. In particular, no empirical evidence was found relating to the cultural adaptation of non-Indigenous health professionals working in Indigenous communities in Australia. In all, 15 international articles were found that provided empirical evidence to support the concept of culture shock. Of these, only 2 articles contained tools that met the pre-determined selection criteria to measure the stages of culture shock. The 2 instruments identified were the Culture Shock Profile (CSP) by Zapf and the Culture Shock Adaptation Inventory (CSAI) by Juffer. There is sufficient evidence to determine that culture shock is a significant issue for non-Indigenous health professionals working in Indigenous communities in Australia. However, further research in this area is needed. The available empirical evidence indicates that a measurement tool is possible but needs further development to be suitable for use in remote Indigenous communities in Australia.
.... Arguing that the interests of Indigenous peoples, settlers, and immigrants are fundamentally shared, it proposes adaptation on both sides, but particularly for the descendants of settlers and immigrants...
One of the major tasks of the United Nations Permanent Forum on Indigenous Issues (UNPFII) following its establishment in 2000 has been to establish statistical profiles of the world's Indigenous peoples. As part of this broad task, it has recommended that the Millennium Development Goals and other global reporting frameworks should be assessed…
Kari, Fatimah Binti; Masud, Muhammad Mehedi; Yahaya, Siti Rohani Binti; Saifullah, Md Khaled
"Indigenous people" have been acknowledged as among the poorest and most socio-economically and culturally marginalized all over the world. This paper explores the socio-economic status of the indigenous people and their poverty profile within watershed and environmentally protected areas in Peninsular Malaysia. The findings of the study indicate that the "indigenous community" is likely to be poor if they live in environmentally sensitive and unprotected areas as compared to families under the new resettlement scheme. Inadequate access to basic education and employment contributed significantly to their poor economic status. The findings further reveal that the indigenous community is facing difficulties in receiving access and support in terms of basic needs such as housing, education, economic livelihood, and other social infrastructure. Moreover, the regulatory structure for the management of watershed areas as well as the emphasis for commodity crops such as palm oil and natural rubber have indirectly contributed toward the poverty level of the indigenous people.
Australia is rapidly losing its Indigenous multicultural and multilingual identity. This vast continent has lost 90 per cent of its Indigenous languages and cultures, without adequate documentation, and risks losing the rest by 2050 if action is not taken. There are formal, accredited linguistics courses designed specifically for Indigenous…
Indigenous people are among the most directly affected by climate change. Yet, there is limited understanding of the health dimensions of climate change and opportunities for adaptation among indigenous populations. Researchers have tended to focus on other vulnerable regions or on populations as a whole.
Hughes, J T; Maple-Brown, L J; Piers, L S; Meerkin, J; O'Dea, K; Ward, L C
To describe the development of a single-frequency bioimpedance prediction equation for fat-free mass (FFM) suitable for adult Aboriginal and Torres Strait Islander peoples with and without diabetes or indicators of chronic kidney disease (CKD). FFM was measured by whole-body dual-energy X-ray absorptiometry in 147 adult Indigenous Australians. Height, weight, body circumference and resistance were also measured. Adults with and without diabetes and indicators of CKD were examined. A random split sample with internal cross-validation approach was used to predict and subsequently validate FFM using resistance, height, weight, age and gender against measured FFM. Among 147 adults with a median body mass index of 31 kg/m(2), the final model of FFM was FFM (kg)=0.432 (height, cm(2)/resistance, ohm)-0.086 (age, years)+0.269 (weight, kg)-6.422 (if female)+16.429. Adjusted R(2) was 0.94 and the root mean square error was 3.33 kg. The concordance was high (rc=0.97) between measured and predicted FFM across a wide range of FFM (31-85 kg). In the context of the high burden of diabetes and CKD among adult Indigenous Australians, this new equation for FFM was both accurate and precise and based on easily acquired variables (height, weight, age, gender and resistance) among a heterogeneous adult cohort.
Cristiane do Nascimento Brandao
Full Text Available This survey was conducted in three indigenous communities in the state of Roraima. They found in tourism a way of achieving local sustainable development. This activity can bring positive and negative consequences, so the aim of this study is to analyze the social, cultural, economic and environmental impacts of tourism in indigenous communities. We used the quantitative method with questionnaires. The units of analysis were the indigenous inhabitants of the surveyed communities. The survey sample consisted of 210 valid responses. In the data analysis, we used descriptive statistics and multivariate analysis. The study found that tourism can bring economic, social, cultural and environmental benefits for communities. Must develop actions that aim to transform existing initiatives in destinations of excellence in Indigenous tourism.
Jones, Louise; Jacklin, Kristen; O'Connell, Megan E
Older Indigenous adults encounter multiple challenges as their age intersects with health inequities. Research suggests that a majority of older Indigenous adults prefer to age in place, and they will need culturally safe assistive technologies to do so. The aim of this critical review was to examine literature concerning use, adaptation, and development of assistive technologies for health purposes by Indigenous peoples. Working within Indigenous research methodologies and from a decolonizing approach, searches of peer-reviewed academic and gray literature dated to February 2016 were conducted using keywords related to assistive technology and Indigenous peoples. Sources were reviewed and coded thematically. Of the 34 sources captured, only 2 concerned technology specifically for older Indigenous adults. Studies detailing technology with Indigenous populations of all ages originated primarily from Canada (n=12), Australia (n=10), and the United States (n=9) and were coded to four themes: meaningful user involvement and community-based processes in development, the digital divide, Indigenous innovation in technology, and health technology needs as holistic and interdependent. A key finding is the necessity of meaningful user involvement in technology development, especially in communities struggling with the digital divide. In spite of, or perhaps because of this divide, Indigenous communities are enthusiastically adapting mobile technologies to suit their needs in creative, culturally specific ways. This enthusiasm and creativity, coupled with the extensive experience many Indigenous communities have with telehealth technologies, presents opportunity for meaningful, culturally safe development processes. ©Louise Jones, Kristen Jacklin, Megan E O'Connell. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 20.07.2017.
Durey, A; Wynaden, D; O'Kane, M
This paper uses the 'intercultural space' as an educational strategy to prepare nurses to work respectfully with Indigenous patients in a forensic mental health context; offers an educational approach that introduces nurses to Indigenous knowledge, beliefs and values, examines power relations in colonized countries between the dominant white cultural group and the Indigenous population and encourages nurses to critically reflect on their health care practice; and explores the intercultural space as a shared space between cultures fostering open and robust inquiry where neither culture dominates and new positions, representations and understandings can emerge. Given the disproportionately high number of Indigenous people imprisoned in colonized countries, this paper responds to research from Western Australia on the need to prepare forensic mental health nurses to deliver care to Indigenous patients with mental health disorders. The paper highlights the nexus between theory, research and education that can inform the design and implementation of programmes to help nurses navigate the complex, layered and contested 'intercultural space' and deliver culturally safe care to Indigenous patients. Nurses are encouraged to critically reflect on how beliefs and values underpinning their cultural positioning impact on health care to Indigenous patients. The paper draws on intercultural theory to offer a pedagogical framework that acknowledges the negative impacts of colonization on Indigenous health and well-being, repositions and revalues Indigenous cultures and knowledges and fosters open and robust inquiry. This approach is seen as a step towards working more effectively in the intercultural space where ultimately binary oppositions that privilege one culture over another and inhibit robust inquiry are avoided, paving the way for new, more inclusive positions, representations and understandings to emerge. While the intercultural space can be a place of struggle, tension
Magnus, Anne; Moodie, Marj L; Ferguson, Megan; Cobiac, Linda J; Liberato, Selma C; Brimblecombe, Julie
To estimate the cost-effectiveness of fiscal measures applied in remote community food stores for Aboriginal Australians. Six price discount strategies on fruit, vegetables, diet drinks and water were modelled. Baseline diet was measured as 12 months' actual food sales data in three remote Aboriginal communities. Discount-induced changes in food purchases were based on published price elasticity data while the weight of the daily diet was assumed constant. Dietary change was converted to change in sodium and energy intake, and body mass index (BMI) over a 12-month period. Improved lifetime health outcomes, modelled for the remote population of Aboriginal and Torres Strait Islanders, were converted to disability adjusted life years (DALYs) saved using a proportional multistate lifetable model populated with diet-related disease risks and Aboriginal and Torres Strait Islander rates of disease. While dietary change was small, five of the six price discount strategies were estimated as cost-effective, below a $50,000/DALY threshold. Stakeholders are committed to finding ways to reduce important inequalities in health status between Aboriginal and Torres Strait Islanders and non-Indigenous Australians. Price discounts offer potential to improve Aboriginal and Torres Strait Islander health. Verification of these results by trial-based research coupled with consideration of factors important to all stakeholders is needed. © 2015 The Authors.
.... Advancing the body of knowledge in the field of the anthropology of policy and public administration, this empirical study is a must-read for policy-makers, academics, and indigenous peoples alike.
.... It provides a unique overview of the trajectory of current policy, advancing a new consolidated approach to Indigenous policy that moves beyond the debate over self-determination and assimilation...
Comprehensive and optimistic, this examination describes current Indigenous affairs policy in Australia, concentrating on the period following the end of the Aboriginal and Torres Strait Islander Commission in 2004...
Menzies, Robert Ian; Bremner, Kyla Margaret; Wang, Han; Beard, Frank Hudson; McIntyre, Peter Bruce
Among indigenous populations with high incidence and early onset of invasive Haemophilus influenzae type b (Hib) disease, PRP-OMP vaccines are used in the United States and PRP-T vaccines in Canada. In Australia, PRP-OMP vaccines were exclusively used in indigenous children from 1993 until they were replaced by PRP-T between late 2005 and 2009. Analytic descriptive study of 20 years of enhanced surveillance data (1993-2013) for invasive Hib disease in Australian children PRP-OMP period (1993-1996) to 6.2 (95% CI: 4.0, 9.2) and 4.7 (95% CI: 1.7, 10.3) in the later PRP-OMP (1996-2009) and PRP-T periods (2009-2013), respectively. The indigenous:nonindigenous incidence rate ratio increased to 43 (95% CI: 16, 145) and 58 (95% CI: 7, 2660) in the later PRP-OMP and PRP-T periods, respectively, more than 10-fold higher than in lesser-incidence Australian regions. We found no change in Hib incidence among indigenous Australian children living in high-incidence regions in the first 4 years following a change to PRP-T-containing combination vaccines. This may be of relevance to North American indigenous populations characterized by suboptimal living conditions and young age of onset for whom PRP-OMP continues to be recommended, such as Alaska Natives.
This article extends visual anthropological concerns into a new subject area that of contemporary Indigenous Australian photography. It presents what could be described as an ethnography of one artistic photograph created by artist Christian Thompson, taking into account both the work's intended
Webb, Michael; Fienberg, Thomas
This article arises from the authors' belief that there is a need to develop motivating ways for students across Australia to meaningfully encounter Australian indigenous music, the breadth and richness of which is beginning to be conveyed via a diverse range of mainstream media texts. Engaging with theoretical insights from the ethnomusicology of…
Full Text Available Abstract Background Indigenous Australians experience an overwhelming burden of chronic disease, including cardiovascular diseases. Periodontal disease (inflammation of the tissues surrounding teeth is also widespread, and may contribute to the risk of cardiovascular diseases via pathogenic inflammatory pathways. This study will assess measures of vascular health and inflammation in Indigenous Australian adults with periodontal disease, and determine if intensive periodontal therapy improves these measures over a 12 month follow-up. The aims of the study are: (i to determine whether there is a dose response relationship between extent and severity of periodontal disease and measures of vascular health and inflammation among Indigenous Australian adults with moderate to severe periodontal disease; and (ii to determine the effects of periodontal treatment on changes in measures of vascular health and inflammation in a cohort of Indigenous Australians. Methods/Design This study will be a randomised, controlled trial, with predominantly blinded assessment of outcome measures and blinded statistical analysis. All participants will receive the periodontal intervention benefits (with the intervention delayed 12 months in participants who are randomised to the control arm. Participants will be Indigenous adults aged ≥25 years from urban centres within the Top End of the Northern Territory, Australia. Participants assessed to have moderate or severe periodontal disease will be randomised to the study's intervention or control arm. The intervention involves intensive removal of subgingival and supragingival calculus and plaque biofilm by scaling and root-planing. Study visits at baseline, 3 and 12 months, will incorporate questionnaires, non-fasting blood and urine samples, body measurements, blood pressure, periodontal assessment and non-invasive measures of vascular health (pulse wave velocity and carotid intima-media thickness. Primary outcome
Kelly Claire M
Full Text Available Abstract Background Ethnic minority groups are under-represented in mental health care services because of barriers such as poor mental health literacy. In 2007, the Mental Health First Aid (MHFA program implemented a cultural adaptation of its first aid course to improve the capacity of Indigenous Australians to recognise and respond to mental health issues within their own communities. It became apparent that the content of this training would be improved by the development of best practice guidelines. This research aimed to develop culturally appropriate guidelines for providing first aid to an Australian Aboriginal or Torres Strait Islander person who is experiencing a mental health crisis or developing a mental illness. Methods A panel of Australian Aboriginal people who are experts in Aboriginal mental health, participated in six independent Delphi studies investigating depression, psychosis, suicidal thoughts and behaviours, deliberate self-injury, trauma and loss, and cultural considerations. The panel varied in size across the studies, from 20-24 participants. Panellists were presented with statements about possible first aid actions via online questionnaires and were encouraged to suggest additional actions not covered by the survey content. Statements were accepted for inclusion in a guideline if they were endorsed by ≥ 90% of panellists as essential or important. Each study developed one guideline from the outcomes of three Delphi questionnaire rounds. At the end of the six Delphi studies, participants were asked to give feedback on the value of the project and their participation experience. Results From a total of 1,016 statements shown to the panel of experts, 536 statements were endorsed (94 for depression, 151 for psychosis, 52 for suicidal thoughts and behaviours, 53 for deliberate self-injury, 155 for trauma and loss, and 31 for cultural considerations. The methodology and the guidelines themselves were found to be useful
Sumida Huaman, Elizabeth; Valdiviezo, Laura Alicia
In this article, we propose to approach Indigenous education beyond the formal/non-formal dichotomy. We argue that there is a critical need to conscientiously include Indigenous knowledge in education processes from the school to the community; particularly, when formal systems exclude Indigenous cultures and languages. Based on ethnographic…
Prabhu, Anil; Tully, Phillip J; Bennetts, Jayme S; Tuble, Sigrid C; Baker, Robert A
Though Indigenous Australian peoples reportedly have poorer survival outcome after cardiac surgery, few studies have jointly documented the experience of major morbidity, and considered the influence of patient geographic remoteness. From January 1998 to September 2008, major morbidity events and survival were recorded for 2748 consecutive patients undergoing coronary artery bypass graft surgery. Morbidity and survival analyses adjusted for propensity deciles based on patient ethnicity and age, sex, left ventricular ejection fraction, recent myocardial infarction, tobacco smoking, diabetes, renal disease and history of stroke. Sensitivity analyses controlled for the patient accessibility/remoteness index of Australia (ARIA). The 297 Indigenous Australian patients (10.8% of total) had greater odds for total morbidity (adjusted odds ratio = 1.55; 95% confidence interval [CI] 1.04-2.30) and prolonged ventilation (adjusted odds ratio = 2.08; 95% confidence interval [CI] 1.25-3.44) in analyses adjusted for propensity deciles and geographic remoteness. With a median follow-up of 7.5 years (interquartile range 5.2-10.2), Indigenous Australian patients were found to experience 30% greater mortality risk (unadjusted hazard ratio = 1.30; 95% CI: 1.03-1.64, p = 0.03). The effect size strengthened after adjustment for propensity score (adjusted hazard ratio = 1.49; 95% CI: 1.13-1.96, p = .004). Adjustment for ARIA categorisation strengthened the effect size (adjusted HR = 1.54 (95% CI: 1.11-2.13, p = .009). Indigenous Australian peoples were at greater risk for prolonged ventilation and combined morbidity outcome, and experienced poorer survival in the longer term. Higher mortality risk among Indigenous Australians was evident even after controlling for remoteness and accessibility to services. Crown Copyright © 2013. Published by Elsevier B.V. All rights reserved.
Turner, Karen; Sanders, Matthew
Indigenous children and youth are at greater risk of emotional and behavioural problems than non-Indigenous youth, with family life stresses and parenting style identified as common risk factors. There is substantial evidence that parenting programs can improve family relationships and improve child outcomes, however little research has focused on Indigenous communities. Our team is conducting research to evaluate a culturally sensitive adaptation of a mainstream intervention, the Group Triple P---Positive Parenting Program, for Indigenous families. This paper shares some of the insights into research and clinical issues gained as non-Indigenous researchers working with urban, rural and remote Indigenous communities. The experience of the research team and feedback from practitioners and parents have been drawn on for this discussion. Parenting programs need to be sensitive to the political and cultural context in which parenting takes place, flexibly incorporate cultural practices and expectations, and develop an evidence base of outcomes for families in diverse communities. As research is needed to evaluate the acceptability and effectiveness of these programs, culturally sensitive research practices are also necessary and the value of program evaluation and its benefit to the community must be clear. Community acceptance of the research process and the intervention itself is vital and may be influenced by community perceptions, current priorities, and local issues. If our overall aim is to increase the skilled health and mental health workforce in Indigenous communities and their use of evidence-based interventions, ongoing collaborative relationships between research institutions and service providers will serve to further this aim.
Kim M Hare
Full Text Available BACKGROUND: Indigenous children in Australia and Alaska have very high rates of chronic suppurative lung disease (CSLD/bronchiectasis. Antibiotics, including frequent or long-term azithromycin in Australia and short-term beta-lactam therapy in both countries, are often prescribed to treat these patients. In the Bronchiectasis Observational Study we examined over several years the nasopharyngeal carriage and antibiotic resistance of respiratory bacteria in these two PCV7-vaccinated populations. METHODS: Indigenous children aged 0.5-8.9 years with CSLD/bronchiectasis from remote Australia (n = 79 and Alaska (n = 41 were enrolled in a prospective cohort study during 2004-8. At scheduled study visits until 2010 antibiotic use in the preceding 2-weeks was recorded and nasopharyngeal swabs collected for culture and antimicrobial susceptibility testing. Analysis of respiratory bacterial carriage and antibiotic resistance was by baseline and final swabs, and total swabs by year. RESULTS: Streptococcus pneumoniae carriage changed little over time. In contrast, carriage of Haemophilus influenzae declined and Staphylococcus aureus increased (from 0% in 2005-6 to 23% in 2010 in Alaskan children; these changes were associated with increasing age. Moraxella catarrhalis carriage declined significantly in Australian, but not Alaskan, children (from 64% in 2004-6 to 11% in 2010. While beta-lactam antibiotic use was similar in the two cohorts, Australian children received more azithromycin. Macrolide resistance was significantly higher in Australian compared to Alaskan children, while H. influenzae beta-lactam resistance was higher in Alaskan children. Azithromycin use coincided significantly with reduced carriage of S. pneumoniae, H. influenzae and M. catarrhalis, but increased carriage of S. aureus and macrolide-resistant strains of S. pneumoniae and S. aureus (proportion of carriers and all swabs, in a 'cumulative dose-response' relationship
Benyei, Petra; Turreira Garcia, Nerea; Orta-Martínez, Martí
In a globalized world, environmental conflicts affecting indigenous communities (including hunter-gatherer groups) have intensified and grown in their transnational character. These changes have affected the choice of manners of contestation of these groups, favouring in some cases the emergence...... activities and confront conflicts through a truly bottom-up approach. The chapter ends discussing how, despite the potential of such new manners of contestation, the power imbalances that currently underpin many indigenous conflicts are first to be addressed....
Styres, Sandra D.; Zinga, Dawn M.
This article introduces an emergent research theoretical framework, the community-first Land-centred research framework. Carefully examining the literature within Indigenous educational research, we noted the limited approaches for engaging in culturally aligned and relevant research within Indigenous communities. The community-first Land-centred…
Phil O′B. Lyver
Full Text Available Efforts to resolve indigenous peoples′ grievances about the negative impacts of protected areas established on their customary estates by governments are driving the development of shared governance and management. The Tϋhoe people have sought that the settlement of their grievances against the New Zealand government include unencumbered rights to manage Te Urewera, guided by scientific and traditional knowledge and practices, for conservation and social benefits for the Tϋhoe people and the broader public. We led a study tour to allow Tϋhoe and other Mβori representatives to gain first-hand experience of long-standing jointly managed protected areas in Australia that the New Zealand government had drawn on in proposing mechanisms to resolve the Tϋhoe claim. We found that these areas were a poor fit to the study tour participants′ aspirations that indigenous world views would underpin governance and that indigenous people would be empowered. Our findings highlight that settlement must be transformational in terms of attitudes and relationships. Collaborative problem-solving processes that build trust can contribute. In areas like Te Urewera, where tenure boundaries fragment a landscape that is a coherent whole in indigenous world views, settlement processes can offer the prospect of landscape-scale outcomes for social justice and conservation.
Verdon, Sarah; McLeod, Sharynne
Internationally, cultural renewal and language revitalisation are occurring among Indigenous people whose lands were colonised by foreign nations. In Australia, the Aboriginal and Torres Strait Islander people are striving for the re-voicing of their mother tongue and the re-practicing of their mother culture to achieve cultural renewal in the…
Bennet, Maria; Moriarty, Beverley
This article focuses on the initial stage of a longitudinal study whose eventual aim is to produce educators with the capacity, knowledge and cultural competence to engage effectively with Indigenous students in cross-cultural environments. The initial stage of the study involved 24 second-year pre-service teachers working individually with…
Waterman, Stephanie J.; Harrison, Irvin D.
Special interest groups (SIGs) offer spaces for interests that may not be supported or adequately addressed by the larger organization. NASPA: Student Affairs Administrators in Higher Education (NASPA) calls its SIGs "knowledge communities." This article describes the ways the members of the Indigenous Peoples knowledge community (IPKC)…
Datta, Ranjan Kumar
This auto-ethnographic article explores how land-based education might challenge Western environmental science education (ESE) in an Indigenous community. This learning experience was developed from two perspectives: first, land-based educational stories from Dene First Nation community Elders, knowledge holders, teachers, and students; and…
This study is designed to find out how people in rural communities residing in the middle Himalayas use indigenous knowledge to support environmental decisions while addressing water and land use related concerns. The study not only serves to enrich our understanding of community decision-making, especially as connected to land use and ecological…
This article introduces case studies of innovative approaches to pedagogy among indigenous Mayan communities in Chiapas (Mexico) and Lencan communities in Intibuca (Honduras). Innovative approaches to researching alternative theories and practices of pedagogy are used by the author to develop an epistemology of critical pedagogy and its potential…
Marsh Robyn L
Full Text Available Abstract Background Otitis media is endemic in remote Indigenous communities of Australia’s Northern Territory. Alloiococcus otitidis is an outer ear commensal and putative middle ear pathogen that has not previously been described in acute otitis media (AOM in this population. The aims of this study were to determine the presence, antibiotic susceptibility and bacterial load of A. otitidis in nasopharyngeal and ear discharge swabs collected from Indigenous Australian children with AOM with perforation. Methods Paired nasopharyngeal and ear discharge swabs from 27 children with AOM with perforation were tested by A. otitidis quantitative PCR (qPCR. Positive swabs were cultured for 21 days. Total and respiratory pathogen bacterial loads in A. otitidis-positive swabs were determined by qPCR. Results A. otitidis was detected by qPCR in 11 ear discharge swabs from 10 of 27 (37% children, but was not detected in paired nasopharyngeal swabs. A. otitidis was cultured from 5 of 11 qPCR-positive swabs from four children. All A. otitidis isolates had minimum inhibitory concentrations consistent with macrolide resistance. All A. otitidis qPCR-positive swabs were culture-positive for other bacteria. A. otitidis bacterial load ranged from 2.2 × 104-1.1 × 108 cells/swab (median 1.8 × 105 cells/swab. The relative abundance of A. otitidis ranged from 0.01% to 34% of the total bacterial load (median 0.7%. In 6 of 11 qPCR-positive swabs the A. otitidis relative abundance was A. otitidis bacterial load and relative abundance measures were comparable to that of Haemophilus influenzae. Conclusions A. otitidis can be a dominant species in the bacterial communities present in the ear discharge of Indigenous children with AOM with perforation. The absence of A. otitidis in nasopharyngeal swabs suggests the ear canal as the likely primary reservoir. The significance of A. otitidis at low relative abundance is unclear; however, at higher relative
Issues of intellectual and cultural hegemony have long been critical foci in education debates in South Africa. This is evidenced in present times by the call for an African Renaissance in education, as well as, a growing discourse that demands the acknowledgement and inclusion of indigenous knowledge systems in the ...
Greenstein, Caroline; Lowell, Anne; Thomas, David
What are the experiences of Indigenous children with physical disability and their carers of their community-based physiotherapy service? What factors influence their experiences of the physiotherapy service and how could the service be improved? A qualitative study using in-depth, semi-structured open-ended interviews consistent with the researchers' interpretivist perspectives and ethical principles of Indigenous health research. Interviews were audio recorded, transcribed and coded for themes with qualitative research software using inductive analysis. The interviews were then checked for transcription accuracy and the themes were confirmed with the participants. Nine parents and foster carers of children with physical disability aged 0 to 21 years, five children and youth with physical disability aged 8 to 21 years. The data generated three themes, which informed practice recommendations: carers of children with physical disability experience increased demands and complexity in their lives; relationships involving caring, consistency and communication are important to consumers using the physiotherapy service; and being Indigenous influences consumers' experiences in ways that may not be obvious to non-Indigenous service providers. The issue of communication underpinned the participants' experiences throughout these themes. The research highlighted the importance of effective communication, developing relationships, viewing the child wholistically and recognising the influence of being Indigenous on clients' healthcare needs and experiences. The results suggested that community-based physiotherapists adopt a family/person-centred, context-specific approach when working with Indigenous children with a physical disability and their carers. Copyright © 2015 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.
Munro, Alice; Shakeshaft, Anthony; Clifford, Anton
Given the well-established evidence of disproportionately high rates of substance-related morbidity and mortality after release from incarceration for Indigenous Australians, access to comprehensive, effective and culturally safe residential rehabilitation treatment will likely assist in reducing recidivism to both prison and substance dependence for this population. In the absence of methodologically rigorous evidence, the delivery of Indigenous drug and alcohol residential rehabilitation services vary widely, and divergent views exist regarding the appropriateness and efficacy of different potential treatment components. One way to increase the methodological quality of evaluations of Indigenous residential rehabilitation services is to develop partnerships with researchers to better align models of care with the client's, and the community's, needs. An emerging research paradigm to guide the development of high quality evidence through a number of sequential steps that equitably involves services, stakeholders and researchers is community-based participatory research (CBPR). The purpose of this study is to articulate an Indigenous drug and alcohol residential rehabilitation service model of care, developed in collaboration between clients, service providers and researchers using a CBPR approach. This research adopted a mixed methods CBPR approach to triangulate collected data to inform the development of a model of care for a remote Indigenous drug and alcohol residential rehabilitation service. Four iterative CBPR steps of research activity were recorded during the 3-year research partnership. As a direct outcome of the CBPR framework, the service and researchers co-designed a Healing Model of Care that comprises six core treatment components, three core organisational components and is articulated in two program logics. The program logics were designed to specifically align each component and outcome with the mechanism of change for the client or organisation
Full Text Available Abstract Background Indigenous Australians experience disproportionately high prevalence of, and morbidity and mortality from chronic illness such as diabetes, renal disease and cardiovascular disease. Improving the understanding of how Indigenous primary care systems are organised to deliver chronic illness care will inform efforts to improve the quality of care for Indigenous people. Methods This cross-sectional study was conducted in 12 Indigenous communities in Australia's Northern Territory. Using the Chronic Care Model as a framework, we carried out a mail-out survey to collect information on material, financial and human resources relating to chronic illness care in participating health centres. Follow up face-to-face interviews with health centre staff were conducted to identify successes and difficulties in the systems in relation to providing chronic illness care to community members. Results Participating health centres had distinct areas of strength and weakness in each component of systems: 1 organisational influence – strengthened by inclusion of chronic illness goals in business plans, appointment of designated chronic disease coordinators and introduction of external clinical audits, but weakened by lack of training in disease prevention and health promotion and limited access to Medicare funding; 2 community linkages – facilitated by working together with community organisations (e.g. local stores and running community-based programs (e.g. "health week", but detracted by a shortage of staff especially of Aboriginal health workers working in the community; 3 self management – promoted through patient education and goal setting with clients, but impeded by limited focus on family and community-based activities due to understaffing; 4 decision support – facilitated by distribution of clinical guidelines and their integration with daily care, but limited by inadequate access to and support from specialists; 5 delivery system
Knott, V E; Gilligan, G; Maksimovic, L; Shen, D; Murphy, M
Despite the need to urgently reduce smoking rates among Indigenous Australians, in order to close-the-gap in life expectancy, little is known regarding how this can be achieved. This study aimed to explore whether a focus on gender specific determinants of smoking among Indigenous Australians could be identified, thus providing a potentially novel approach to underpin future efforts at intervention. A qualitative research design was employed. Eighty-two participants, comprised of 43 Indigenous women (mean age 32.15, SD, 12.47) and 39 Indigenous men (mean age 34.91, SD, 11.26), participated in one of 12 focus groups held in metropolitan, regional and rural locations in South Australia. Facilitators prompted discussion in response to the question: 'What is it like being a smoker these days?' Two experienced coders assessed data for themes using Attride-Stirling's (2002) method of analysis. Two global themes emerged for men and women. The first theme, 'It's Harder to Smoke Nowadays', encompassed sub-themes capturing changed smoking practices in response to tobacco control strategies implemented in Australia. Sub-themes of 'smoking in secrecy' coupled with an 'awareness of the effects of passive smoking' were identified among women. Among men, sub-themes that depicted tension between 'a desire to be a role model' and 'guilt about smoking' emerged. The second theme, 'Push and Pull Factors', identified a range of gender specific determinants of smoking. While similar reasons for smoking ('pull factors') were identified in men and women (e.g. addiction, boredom, stress, pleasure, mood stabiliser), different 'push factors' (reasons for not wanting to smoke) emerged. For men, sport, fitness and children were identified as reasons for not wanting to smoke, whereas women identified factors such as respect for non-smokers, and body image concerns. The current findings suggest that there may be fundamental differences in the determinants of smoking (pull factors) as well as
I Ketut Sardiana
Full Text Available Abstract Community-based ecotourism involves conservation, business, and community development. It is a subset of nature-based tourism that are owned and managed by the community and used to improve the well-being of its community members. Research conducted in Indigenous Tenganan Dauh Tukad Village, Bali. This paper examines the linkage of community participation in ecotourism with the conservation practices and perspectives. This study revealed that there is a positive linkage between community participation to their practices and perspective of conservation. This includes conservation of biodiversity environment and cultural heritage of the local community.
This position paper develops the case for a greater focus on the teaching of local histories in the Australian Curriculum: History. It takes as its starting point an Indigenous epistemology that understands knowledge to be embedded in the land. This connection between knowledge and country is used to examine recent literature on whether the…
Mistry, Jayalaxshmi; Bilbao, Bibiana A; Berardi, Andrea
Fire plays an increasingly significant role in tropical forest and savanna ecosystems, contributing to greenhouse gas emissions and impacting on biodiversity. Emerging research shows the potential role of Indigenous land-use practices for controlling deforestation and reducing CO2 emissions. Analysis of satellite imagery suggests that Indigenous lands have the lowest incidence of wildfires, significantly contributing to maintaining carbon stocks and enhancing biodiversity. Yet acknowledgement of Indigenous peoples' role in fire management and control is limited, and in many cases dismissed, especially in policy-making circles. In this paper, we review existing data on Indigenous fire management and impact, focusing on examples from tropical forest and savanna ecosystems in Venezuela, Brazil and Guyana. We highlight how the complexities of community owned solutions for fire management are being lost as well as undermined by continued efforts on fire suppression and firefighting, and emerging approaches to incorporate Indigenous fire management into market- and incentive-based mechanisms for climate change mitigation. Our aim is to build a case for supporting Indigenous fire practices within all scales of decision-making by strengthening Indigenous knowledge systems to ensure more effective and sustainable fire management.This article is part of the themed issue 'The interaction of fire and mankind'. © 2016 The Author(s).
Minichiello, Alexa; Lefkowitz, Ayla R F; Firestone, Michelle; Smylie, Janet K; Schwartz, Robert
All over the world, Indigenous populations have remarkably high rates of commercial tobacco use compared to non-Indigenous groups. The high rates of commercial tobacco use in Indigenous populations have led to a variety of health issues and lower life expectancy than the general population. The objectives of this systematic review were to investigate changes in the initiation, consumption and quit rates of commercial tobacco use as well as changes in knowledge, prevalence, community interest, and smoke-free environments in Indigenous populations. We also aimed to understand which interventions had broad reach, what the common elements that supported positive change were and how Aboriginal self-determination was reflected in program implementation. We undertook a systematic review of peer-reviewed publications and grey literature selected from seven databases and 43 electronic sources. We included studies between 1994 and 2015 if they addressed an intervention (including provision of a health service or program, education or training programs) aimed to reduce the use of commercial tobacco use in Indigenous communities globally. Systematic cross-regional canvassing of informants in Canada and internationally with knowledge of Indigenous health and/or tobacco control provided further leads about commercial tobacco reduction interventions. We extracted data on program characteristics, study design and learnings including successes and challenges. In the process of this review, we investigated 73 commercial tobacco control interventions in Indigenous communities globally. These interventions incorporated a myriad of activities to reduce, cease or protect Indigenous peoples from the harms of commercial tobacco use. Interventions were successful in producing positive changes in initiation, consumption and quit rates. Interventions also facilitated increases in the number of smoke-free environments, greater understandings of the harms of commercial tobacco use and a
Full Text Available http://dx.doi.org/10.5007/2175-8026.2016v69n2p17 In Australia, powerful stories expressing resistance to a white, postcolonising hegemony continue to be articulated in Indigenous women’s fictional texts, including those from the 1990s onwards that are discussed in this paper. Their particular historically-distinctive mode of satire or irony challenges postcolonising regimes and institutions, the legacy of colonialism, and the persisting dominance of whiteness. These more recent texts continue a central preoccupation of the earlier fiction by Indigenous women with the achievement of agency in contexts of unequal social and economic power; marginalised characters engage with current questions and conditions. The paper considers how these fictions represent some aspects of Aboriginal separation from land and place; separation from families; outsider and outcast identities, and how far these continue to mean disempowerment; Indigenous people’s epistemological relationships with their land and bodies of water, and the question of sovereignty in relation to Country and environment.
Farnbach, Sara; Eades, Anne-Maree; Fernando, Jamie K; Gwynn, Josephine D; Glozier, Nick; Hackett, Maree L
Objectives and importance of the study: Primary health care research focused on Aboriginal and Torres Strait Islander (Indigenous) people is needed to ensure that key frontline services provide evidence based and culturally appropriate care. We systematically reviewed the published primary health care literature to identify research designs, processes and outcomes, and assess the scientific quality of research focused on social and emotional wellbeing. This will inform future research to improve evidence based, culturally appropriate primary health care. Systematic review in accordance with PRISMA and MOOSE guidelines. Four databases and one Indigenous-specific project website were searched for qualitative, quantitative and mixed-method published research. Studies that were conducted in primary health care services and focused on the social and emotional wellbeing of Indigenous people were included. Scientific quality was assessed using risk-of-bias assessment tools that were modified to meet our aims. We assessed community acceptance by identifying the involvement of community governance structures and representation during research development, conduct and reporting. Data were extracted using standard forms developed for this review. We included 32 articles, which reported on 25 studies. Qualitative and mixed methods were used in 18 studies. Twelve articles were judged as high or unclear risk of bias, four as moderate and five as low risk of bias. Another four studies were not able to be assessed as they did not align with the risk-of-bias tools. Of the five articles judged as low risk of bias, two also had high community acceptance and both of these were qualitative. One used a phenomenological approach and the other combined participatory action research with a social-ecological perspective and incorporated 'two-way learning' principles. Of the 16 studies where a primary outcome was identified, eight aimed to identify perceptions or experiences. The
Full Text Available Objectives and importance of the study: Primary health care research focused on Aboriginal and Torres Strait Islander (Indigenous people is needed to ensure that key frontline services provide evidence based and culturally appropriate care. We systematically reviewed the published primary health care literature to identify research designs, processes and outcomes, and assess the scientific quality of research focused on social and emotional wellbeing. This will inform future research to improve evidence based, culturally appropriate primary health care. Study type: Systematic review in accordance with PRISMA and MOOSE guidelines. Methods: Four databases and one Indigenous-specific project website were searched for qualitative, quantitative and mixed-method published research. Studies that were conducted in primary health care services and focused on the social and emotional wellbeing of Indigenous people were included. Scientific quality was assessed using risk-of-bias assessment tools that were modified to meet our aims. We assessed community acceptance by identifying the involvement of community governance structures and representation during research development, conduct and reporting. Data were extracted using standard forms developed for this review. Results: We included 32 articles, which reported on 25 studies. Qualitative and mixed methods were used in 18 studies. Twelve articles were judged as high or unclear risk of bias, four as moderate and five as low risk of bias. Another four studies were not able to be assessed as they did not align with the risk-of-bias tools. Of the five articles judged as low risk of bias, two also had high community acceptance and both of these were qualitative. One used a phenomenological approach and the other combined participatory action research with a social–ecological perspective and incorporated ‘two-way learning’ principles. Of the 16 studies where a primary outcome was identified, eight aimed
Lois M. Meyer
Full Text Available In an era when U.S. and Mexican teachers are valued more for their academic achievements than their community-based knowledge and local/ethnic identity (e.g. Teach for America, or its off-shoot, Teach for Mexico, this study provides initial results of a one-year (2011-2012 intensive professional development experience (called a diplomado for 35 indigenous teachers of Initial Education who are “teaching their own babies” in marginalized communities of Oaxaca, Mexico, as documented in portfolios of written and photographic evidence produced by the teachers as their final diplomado product. The goal was to enrich these local teachers' background knowledge and equip them with research skills to investigate and honor the communal practices, governance, and perspectives (known as comunalidad of the rural indigenous communities where they teach, in order to generate an authentic, community-based approach to Initial Education for pregnant mothers, babies and toddlers up to 3 years old – a ground-breaking alternative to the Mexican government’s homogeneous Initial Education approach. Early findings indicate that these Oaxacan indigenous teachers faced a complex of internal and external challenges in this radical, regenerative work: they are young, female, mostly novice teachers, they lack professional preparation, and they have confronted racism throughout their own lives, especially and intensely in Mexican public schools. In the process of documenting communal life and early childhood socialization practices in rural communities where they teach, they confronted their own (often uneasy biculturalism and bilingualism. “Communalizing” early education in indigenous Oaxaca involves reconstructing and revitalizing the indigenous identities and language use of children and teachers alike. Preparing these local indigenous teachers to “teach their own babies” is a challenging but invaluable and achievable task.
This paper offers an ethnographic analysis of indigenous Peruvian Amazonian youth pursuing higher education through urban migration to contribute to the resilience of their communities, place-based livelihoods, and indigenous Amazonian identities. Youth and their communities promoted education and migration as powerful tools in the context of…
Full Text Available Indigenous children and young people are overrepresented in the Australian out-of-home care (OOHC system. To date, specific research has not been undertaken on workers' perspectives regarding the Indigenous-specific and non-Indigenous supports and services available to Indigenous young people exiting the system. This exploratory research involved focus group consultations with workers from seven child and family welfare agencies to examine the current support services available to Indigenous young people who are in or will be leaving out-of-home care in the State of Victoria. Findings suggest that Aboriginal Community Controlled Organisations (ACCOs play a positive role in working with non-Indigenous agencies to assist Indigenous care leavers. Participants identified some key strategies to improve outcomes, such as facilitating stronger relationships between Indigenous and non-Indigenous services, and improving the resourcing of ACCOs.
Barr, Elizabeth Lm; Maple-Brown, Louise J; Barzi, Federica; Hughes, Jaquelyne T; Jerums, George; Ekinci, Elif I; Ellis, Andrew G; Jones, Graham Rd; Lawton, Paul D; Sajiv, Cherian; Majoni, Sandawana W; Brown, Alex Dh; Hoy, Wendy E; O'Dea, Kerin; Cass, Alan; MacIsaac, Richard J
The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation that combines creatinine and cystatin C is superior to equations that include either measure alone in estimating glomerular filtration rate (GFR). However, whether cystatin C can provide any additional benefits in estimating GFR for Indigenous Australians, a population at high risk of end-stage kidney disease (ESKD) is unknown. Using a cross-sectional analysis from the eGFR Study of 654 Indigenous Australians at high risk of ESKD, eGFR was calculated using the CKD-EPI equations for serum creatinine (eGFRcr), cystatin C (eGFRcysC) and combined creatinine and cystatin C (eGFRcysC+cr). Reference GFR (mGFR) was determined using a non-isotopic iohexol plasma disappearance technique over 4h. Performance of each equation to mGFR was assessed by calculating bias, % bias, precision and accuracy for the total population, and according to age, sex, kidney disease, diabetes, obesity and c-reactive protein. Data were available for 542 participants (38% men, mean [sd] age 45  years). Bias was significantly greater for eGFRcysC (15.0mL/min/1.73m 2 ; 95% CI 13.3-16.4, pcreatinine remains the preferred equation in Indigenous Australians. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.
Leung, S. Alvin; Chen, Ping-Hwa
This article examines the need to develop an indigenous counseling psychology in Chinese communities in Asia. The cross-cultural limitations and applications of counseling psychology are discussed, using the literature on multicultural counseling and competence as illustrations. The authors elaborate on the scope and nature of indigenous…
Data derived from remotely sensed images were utilized to conduct land cover assessments of three indigenous communities in northern Nicaragua. Historical land use, present land cover and land cover change processes were all identified through the use of a geographic informat...
The dynamic conservation and sustainable utilization of native crop genetic resources are crucial for food sovereignty of Native American communities. Indigenous knowledge of crop diversity when linked to food traditions, local practices and social norms provide the basis for building sovereign comm...
Nkem, J.N.; Somorin, O.A.; Jum, C.; Idinoba, M.E.; Bele, Y.M.; Sonwa, D.J.
The livelihood strategies of indigenous communities in the Congo Basin are inseparable from the forests, following their use of forest ecosystem goods and services (FEGS). Climate change is expected to exert impacts on the forest and its ability to provide FEGS. Thus, human livelihoods that depend
Full Text Available Aborigines and other Australians have not met with amity. Memorials to the Aboriginal people of Australia are not common and some of the more prominent are regularly damaged. Eddies of past tempests slap disturbingly at modern day memorials thousands of kilometres and several generations removed from the eye of furious storms. This article traces a difficult story of what seems at first sight to be blind racism, at a second sight, a rampant colonialism, and at a more reflective third, perhaps, the economy of the pastoralist and the farmer in deadly disharmony to that of the hunter gatherer. Whatever the origins, the consequences of conflict endure for centuries.
Macridis, Soultana; Garcia Bengoechea, Enrique; McComber, Alex M; Jacobs, Judi; Macaulay, Ann C
School-based physical activity (PA) interventions, including school active transportation (AT), provide opportunities to increase daily PA levels, improves fitness, and reduces risk of diseases, such as type 2 diabetes. Based on a community-identified need, the Kahnawake Schools Diabetes Prevention Project, within an Indigenous community, undertook school travel planning to contribute to PA programming for two elementary schools. Using community-based participatory research, the Active & Safe Routes to School's School Travel Planning (STP) process was undertaken in two schools with an STP-Committee comprised of community stakeholders and researchers. STP activities were adapted for local context including: school profile form, family survey, in-class travel survey, pedestrian-traffic observations, walkability checklist, and student mapping. STP data were jointly collected, analyzed and interpreted by researchers and community. Traffic-pedestrian observations, walkability and parent surveys identified key pedestrian-traffic locations, helped develop safe/direct routes, and traffic calming strategies. In-class travel and mapping surveys identified a need and student desire to increase school AT. The STP-Committee translated findings into STP-action plans for two schools, which were implemented in 2014-2015 school year. Combining CBPR with STP merges community and researcher expertise. This project offered evidence-informed practice for active living promotions. Experience and findings could benefit Indigenous and non-Indigenous communities. Copyright © 2016 Elsevier Ltd. All rights reserved.
Ulian, Tiziana; Sacandé, Moctar; Mattana, Efisio
Kew's Millennium Seed Bank partnership (MSBP) is one of the largest ex situ plant conservation initiatives, which is focused on saving plants in and from regions most at risk, particularly in drylands. Seeds are collected and stored in seed banks in the country of origin and duplicated in the Millennium Seed Bank in the UK. The MSBP also strengthens the capacity of local communities to successfully conserve and sustainably use indigenous plants, which are important for their wellbeing. Since 2007, high quality seed collections and research information have been gathered on ca. 700 useful indigenous plant species that were selected by communities in Botswana, Kenya, Mali, Mexico and South Africa through Project MGU - The Useful Plants Project. These communities range from various farmer's groups and organisations to traditional healers, organic cotton/crop producers and primary schools. The information on seed conservation and plant propagation was used to train communities and to propagate ca. 200 species that were then planted in local gardens, and as species reintroduced for reforestation programmes and enriching village forests. Experimental plots have also been established to further investigate the field performance (plant survival and growth rate) of indigenous species, using low cost procedures. In addition, the activities support revenue generation for local communities directly through the sustainable use of plant products or indirectly through wider environmental and cultural services. This project has confirmed the potential of biodiversity conservation to improve food security and human health, enhance community livelihoods and strengthen the resilience of land and people to the changing climate. This approach of using indigenous species and having local communities play a central role from the selection of species to their planting and establishment, supported by complementary research, may represent a model for other regions of the world, where
Sara D Leonhardt
Full Text Available Bacterial symbionts of insects have received increasing attention due to their prominent role in nutrient acquisition and defense. In social bees, symbiotic bacteria can maintain colony homeostasis and fitness, and the loss or alteration of the bacterial community may be associated with the ongoing bee decline observed worldwide. However, analyses of microbiota associated with bees have been largely confined to the social honeybees (Apis mellifera and bumblebees (Bombus spec., revealing--among other taxa--host-specific lactic acid bacteria (LAB, genus Lactobacillus that are not found in solitary bees. Here, we characterized the microbiota of three Australian stingless bee species (Apidae: Meliponini of two phylogenetically distant genera (Tetragonula and Austroplebeia. Besides common plant bacteria, we find LAB in all three species, showing that LAB are shared by honeybees, bumblebees and stingless bees across geographical regions. However, while LAB of the honeybee-associated Firm4-5 clusters were present in Tetragonula, they were lacking in Austroplebeia. Instead, we found a novel clade of likely host-specific LAB in all three Australian stingless bee species which forms a sister clade to a large cluster of Halictidae-associated lactobacilli. Our findings indicate both a phylogenetic and geographical signal of host-specific LAB in stingless bees and highlight stingless bees as an interesting group to investigate the evolutionary history of the bee-LAB association.
Leonhardt, Sara D.; Kaltenpoth, Martin
Bacterial symbionts of insects have received increasing attention due to their prominent role in nutrient acquisition and defense. In social bees, symbiotic bacteria can maintain colony homeostasis and fitness, and the loss or alteration of the bacterial community may be associated with the ongoing bee decline observed worldwide. However, analyses of microbiota associated with bees have been largely confined to the social honeybees (Apis mellifera) and bumblebees (Bombus spec.), revealing – among other taxa – host-specific lactic acid bacteria (LAB, genus Lactobacillus) that are not found in solitary bees. Here, we characterized the microbiota of three Australian stingless bee species (Apidae: Meliponini) of two phylogenetically distant genera (Tetragonula and Austroplebeia). Besides common plant bacteria, we find LAB in all three species, showing that LAB are shared by honeybees, bumblebees and stingless bees across geographical regions. However, while LAB of the honeybee-associated Firm4–5 clusters were present in Tetragonula, they were lacking in Austroplebeia. Instead, we found a novel clade of likely host-specific LAB in all three Australian stingless bee species which forms a sister clade to a large cluster of Halictidae-associated lactobacilli. Our findings indicate both a phylogenetic and geographical signal of host-specific LAB in stingless bees and highlight stingless bees as an interesting group to investigate the evolutionary history of the bee-LAB association. PMID:25148082
Full Text Available Indigenous peoples of Guerrero show different tradeoffs in their ways of dealing with such adverse reality that afflicts them , first struggling to maintain the traditions and customs , using their customary community practices to maintain unity and confront the inhumane living conditions through what has been called community organization , considered part of the concept of social capital and the other institutions that do their thing trying to find solutions to this problem , however the methods collide and sometimes opposed. The community Assembly, the safety, the slaughter, the tequio are part of some of these practices, which despite maintained indigenous families living conditions have not improved substantially and increasingly is more noticeable migration in search of employment, in different scenarios. The majority indigenous population inhabiting the Amuzgos of Guerrero State, Mixtecos, Tlapanecos and Nahuas, looking each one with its own peculiarities, survive. Poverty, marginalization and physical-geographical conditions determine the circle of the dire living conditions of these indigenous people. As happened in 2013 with the tropical storm "Manuel", where we witnessed the way how adverse natural phenomena stick stronger to weaker.
Chin Hoong Wong
Full Text Available Since 2013, medical students from the International Medical University (IMU in Malaysia have been providing primary healthcare services, under the supervision of faculty members, to the indigenous people living in Kampung Sebir. The project has allowed the students to learn experientially within a rural setting. This study aims to examine the cultural competence of IMU medical students through an examination of their perspective of the indigenous people who they serve and the role of this community service in their personal and professional development. Students who participated in the project were required to complete a questionnaire after each community engagement activity to help them reflect on the above areas. We analysed the responses of students from January to December 2015 using a thematic analysis approach to identify overarching themes in the students’ responses. Students had differing perceptions of culture and worldviews when compared to the indigenous people. However, they lacked the self-reflection skills necessary to understand how such differences can affect their relationship with the indigenous people. Because of this, the basis of their engagement with the indigenous community (as demonstrated by their views of community service is focused on their agenda of promoting health from a student’s perspective rather than connecting and building relationships first. Students also lacked the appreciation that building cultural competency is a continuous process. The results show that the medical students have a developing cultural competence. The project in Kampung Sebir is an experiential learning platform of great value to provide insights into and develop the cultural competency of participating students. This study also reflects on the project itself, and how the relationship with stakeholders, the competence and diversity of academic staff, and the support of the university can contribute toward training in cultural
White, Peta E; Donaldson, Alex; Sullivan, S John; Newton, Joshua
Background Preventing concussion in sport is a global challenge. To assess community-level adult male Australian Football players’ views on following the Australian Football League's (AFL) concussion guidelines. Methods 3 focus groups, each comprising 6 players from 1 regional league, were conducted until saturation of issues raised. Discussions followed a semistructured script and were audio-recorded and transcribed verbatim. Thematic analysis was conducted by 2 coders independently. Results Identified advantages of the guidelines included highlighting the seriousness of concussion; changing the culture around playing with concussion and shifting return-to-play decision responsibility from players to others. Disadvantages included players being removed from play unnecessarily; removal of players’ rights to decide if they are fit to play and players changing their behaviours to avoid being removed from play. Identified facilitators to guideline use included local league enforcement; broad information dissemination and impartial medically trained staff to assess concussion. Identified barriers to guideline use included players’ desire to play at all costs; external pressure that encouraged players to return to play prematurely; and inconvenience and cost. Conclusions Players generally understand that the AFL concussion guidelines protect their long-term welfare. However, their desire to play at all costs and help their team win is a common barrier to reporting concussion and adhering to guidelines. Leagues should take a lead role by mandating and enforcing the use of the guidelines and educating coaches, game day medical providers and players. The return-to-play component of the guidelines is complex and needs further consideration in the context of community sport. PMID:28890801
Mohkamsing-den Boer, E.P.
This thesis offers a fresh interpretation on the way dreams function among two small-scale societies with a living oral tradition, viz. the Aborigines of Australia and the Amerindian communities of Suriname. It is based on pertinent literature on both communities, but supplemented by fresh fieldwork
Full Text Available forestry, South Africa The Importance of Woodlots to Local Communities, Small-scale Entrepreneurs and Indigenous Forest Conservation A case study Cori Ham ii The Importance of Woodlots to Local Communities, Small Scale Entrepreneurs... by the financial support of the UK Department for International Development and the European Commission iii Citation: Ham, C. 2000. The importance of woodlots to local communities, small scale entrepreneurs and indigenous forest conservation– A case study...
Bradford, Lori E A; Okpalauwaekwe, Udoka; Waldner, Cheryl L; Bharadwaj, Lalita A
Many Indigenous communities in Canada live with high-risk drinking water systems and drinking water advisories and experience health status and water quality below that of the general population. A scoping review of research examining drinking water quality and its relationship to Indigenous health was conducted. The study was undertaken to identify the extent of the literature, summarize current reports and identify research needs. A scoping review was designed to identify peer-reviewed literature that examined challenges related to drinking water and health in Indigenous communities in Canada. Key search terms were developed and mapped on five bibliographic databases (MEDLINE/PubMED, Web of Knowledge, SciVerse Scopus, Taylor and Francis online journal and Google Scholar). Online searches for grey literature using relevant government websites were completed. Sixteen articles (of 518; 156 bibliographic search engines, 362 grey literature) met criteria for inclusion (contained keywords; publication year 2000-2015; peer-reviewed and from Canada). Studies were quantitative (8), qualitative (5) or mixed (3) and included case, cohort, cross-sectional and participatory designs. In most articles, no definition of "health" was given (14/16), and the primary health issue described was gastrointestinal illness (12/16). Challenges to the study of health and well-being with respect to drinking water in Indigenous communities included irregular funding, remote locations, ethical approval processes, small sample sizes and missing data. Research on drinking water and health outcomes in Indigenous communities in Canada is limited and occurs on an opportunistic basis. There is a need for more research funding, and inquiry to inform policy decisions for improvements of water quality and health-related outcomes in Indigenous communities. A coordinated network looking at First Nations water and health outcomes, a database to store and create access to research findings, increased
Lori E. A. Bradford
Full Text Available Background: Many Indigenous communities in Canada live with high-risk drinking water systems and drinking water advisories and experience health status and water quality below that of the general population. A scoping review of research examining drinking water quality and its relationship to Indigenous health was conducted. Objective: The study was undertaken to identify the extent of the literature, summarize current reports and identify research needs. Design: A scoping review was designed to identify peer-reviewed literature that examined challenges related to drinking water and health in Indigenous communities in Canada. Key search terms were developed and mapped on five bibliographic databases (MEDLINE/PubMED, Web of Knowledge, SciVerse Scopus, Taylor and Francis online journal and Google Scholar. Online searches for grey literature using relevant government websites were completed. Results: Sixteen articles (of 518; 156 bibliographic search engines, 362 grey literature met criteria for inclusion (contained keywords; publication year 2000–2015; peer-reviewed and from Canada. Studies were quantitative (8, qualitative (5 or mixed (3 and included case, cohort, cross-sectional and participatory designs. In most articles, no definition of “health” was given (14/16, and the primary health issue described was gastrointestinal illness (12/16. Challenges to the study of health and well-being with respect to drinking water in Indigenous communities included irregular funding, remote locations, ethical approval processes, small sample sizes and missing data. Conclusions: Research on drinking water and health outcomes in Indigenous communities in Canada is limited and occurs on an opportunistic basis. There is a need for more research funding, and inquiry to inform policy decisions for improvements of water quality and health-related outcomes in Indigenous communities. A coordinated network looking at First Nations water and health outcomes, a
Julián Jiménez Ramírez
Full Text Available This study provides partial results of a 200-hour intensive training experience (called a diplomado lasting one school year (2011-2012 for 35 indigenous teachers of Initial education who attend children 0 to 3 years old in marginalized communities of Oaxaca, mexico. Children’s spontaneous activities and those planned by teachers, presented through photographs and accompanying teacher’ narratives, are part of the written and photographic evidence submitted by the participants in their final diplomado portfolio of tasks. the purposes of the diplomado were to enrich teachers’communal knowledge and equip them with research skills to investigate and honor the communal practices, forms of governance, and the perspectives of the rural indigenous communities where they teach, in order to generate an authentic, alternative, community-based approach to initial education for babies and toddlers.
Iyoro Abiodun Olaide
Full Text Available This paper reviews the existing literature on how the management of indigenous knowledge could lead to its effective utilization. Indigenous knowledge is different from other types of knowledge. It could be an important tool to ensure the sustainability of societal development of local communities.
Kirsten Vinyeta; Kyle Powys Whyte; Kathy Lynn
The scientific and policy literature on climate change increasingly recognizes the vulnerabilities of indigenous communities and their capacities for resilience. The role of gender in defining how indigenous peoples experience climate change in the United States is a research area that deserves more attention. Advancing climate change threatens the continuance of many...
Oxfam encourages its partners to integrate gender issues into their work. Accordingly, the organization drew a team of six researchers from local partners to conduct a gender-needs assessment in Arakan Valley, North Cotabo, on the island of Mindanao, Philippines. There are five million indigenous people in the Philippines belonging to more than forty different tribal groups. They are oppressed and exploited by foreign and local elites, with many having lost their ancestral lands to agribusiness plantations, ranches, mining and logging concessions of multinational corporations, and government projects. Focus group discussions, participant observation, key informant feedback, and case studies conducted over a twelve-month period found the existence of physical violence between husbands and wives; men typically having two-three wives, with women pressuring men to take more wives so that there will be more labor for farming and housework; incest is taboo, but it is not unusual for sisters to be married to one man; and women's labor responsibilities relative to men's have increased. Study results are being shared with participants in the local language.
Maple-Brown Louise J
Full Text Available Abstract Background Indigenous populations of Australia and Canada experience disproportionately high rates of chronic disease. Our goal was to compare cardiovascular (CVD risk profile and diabetes complications from three recent comprehensive studies of diabetes complications in different Indigenous populations in Australia and Canada. Methods We compared participants from three recent studies: remote Indigenous Australians (2002-2003, n = 37 known diabetes, urban Indigenous Australians (2003-2005, n = 99 known diabetes, and remote Aboriginal Canadians (2001-2002, n = 188 known diabetes. Results The three groups were similar for HbA1c, systolic BP, diabetes duration. Although leaner by body-mass-index criteria, remote Indigenous Australians displayed a more adverse CVD risk profile with respect to: waist-hip-ratio (1.03, 0.99, 0.94, remote Indigenous Australians, urban Indigenous Australians, remote Canadians, p Conclusions Although there are many similarities in diabetes phenotype in Indigenous populations, this comparison demonstrates that CVD risk profiles and diabetes complications may differ among groups. Irrespective, management and intervention strategies are required from a young age in Indigenous populations and need to be designed in consultation with communities and tailored to community and individual needs.
and extremes, suppress diseases and crop pests and usd to conserve soil moisture so as to increase ..... materials such as leaves, grass clippings, kitchen scraps and yard wastes. As a result, ... consumption in urban and rural communities.
Clough, Alan R; Fitts, Michelle S; Robertson, Jan A; Shakeshaft, Anthony; Miller, Adrian; Doran, Christopher M; Muller, Reinhold; Ypinazar, Valmae; Martin, David; McDermott, Robyn; Sanson-Fisher, Rob; Towle, Simon; Margolis, Stephen A; West, Caryn
In 2002/03 the Queensland Government responded to high rates of alcohol-related harm in discrete Indigenous communities by implementing alcohol management plans (AMPs), designed to include supply and harm reduction and treatment measures. Tighter alcohol supply and carriage restrictions followed in 2008 following indications of reductions in violence and injury. Despite the plans being in place for over a decade, no comprehensive independent review has assessed to what level the designed aims were achieved and what effect the plans have had on Indigenous community residents and service providers. This study will describe the long-term impacts on important health, economic and social outcomes of Queensland's AMPs. The project has two main studies, 1) outcome evaluation using de-identified epidemiological data on injury, violence and other health and social indicators for across Queensland, including de-identified databases compiled from relevant routinely-available administrative data sets, and 2) a process evaluation to map the nature, timing and content of intervention components targeting alcohol. Process evaluation will also be used to assess the fidelity with which the designed intervention components have been implemented, their uptake and community responses to them and their perceived impacts on alcohol supply and consumption, injury, violence and community health. Interviews and focus groups with Indigenous residents and service providers will be used. The study will be conducted in all 24 of Queensland's Indigenous communities affected by alcohol management plans. This evaluation will report on the impacts of the original aims for AMPs, what impact they have had on Indigenous residents and service providers. A central outcome will be the establishment of relevant databases describing the parameters of the changes seen. This will permit comprehensive and rigorous surveillance systems to be put in place and provided to communities empowering them with the
Therese M Kearns
Full Text Available Strongyloides seroprevalence is hyper-endemic in many Australian Aboriginal and Torres Strait Islander communities, ranging from 35-60%. We report the impact on Strongyloides seroprevalence after two oral ivermectin mass drug administrations (MDAs delivered 12 months apart in a remote Australian Aboriginal community.Utilizing a before and after study design, we measured Strongyloides seroprevalence through population census with sequential MDAs at baseline and month 12. Surveys at months 6 and 18 determined changes in serostatus. Serodiagnosis was undertaken by ELISA that used sonicated Strongyloides ratti antigen to detect anti-Strongyloides IgG. Non-pregnant participants weighing ≥15 kg were administered a single 200 μg/kg ivermectin dose, repeated after 10-42 days if Strongyloides and/or scabies was diagnosed; others followed a standard alternative algorithm. A questionnaire on clinical symptoms was administered to identify adverse events from treatment and self-reported symptoms associated with serostatus.We surveyed 1013 participants at the baseline population census and 1060 (n = 700 from baseline cohort and 360 new entrants at month 12. Strongyloides seroprevalence fell from 21% (175/818 at baseline to 5% at month 6. For participants from the baseline cohort this reduction was sustained at month 12 (34/618, 6%, falling to 2% at month 18 after the second MDA. For new entrants to the cohort at month 12, seroprevalence reduced from 25% (75/297 to 7% at month 18. Strongyloides positive seroconversions for the baseline cohort six months after each MDA were 2.5% (4/157 at month 6 and 1% at month 18, whilst failure to serorevert remained unchanged at 18%. At 12 months, eosinophilia was identified in 59% of baseline seropositive participants and 89% of seropositive new entrants, compared with 47%baseline seronegative participants and 51% seronegative new entrants. Seropositivity was not correlated with haemoglobin or any self-reported clinical
Víctor Manuel Santos Chávez
Full Text Available SUMMARY The assumption of new studies about the indigenous movement in Mexico involves the need for articulating political and cultural dimensions of some social groups, as well as the reformulation of how that kind of studies should be done: In this study the need for combining the political dimensions (local power structure and cultural dimensions (ethnic identity redefinitions is established in order to examine the implications that such relationship has in the uprising of new indigenous movements and the emergence of de facto indigenous autonomies: To carry out this study, we had to think about the researching questions from a given referent , in this case it was a community from Los Altos the Chiapas. This community gave us the actual elements for the discussion of concrete research, the new indigenous movement in Chiapas and the indigenous autonomy.
Fitzpatrick, Emily F M; Carter, Maureen; Oscar, June; Lawford, Tom; Martiniuk, Alexandra L C; D'Antoine, Heather A; Elliott, Elizabeth J
Research with Indigenous populations is not always designed with cultural sensitivity. Few publications evaluate or describe in detail seeking consent for research with Indigenous participants. When potential participants are not engaged in a culturally respectful manner, participation rates and research quality can be adversely affected. It is unethical to proceed with research without truly informed consent. We describe a culturally appropriate research protocol that is invited by Aboriginal communities of the Fitzroy Valley in Western Australia. The Picture Talk Project is a research partnership with local Aboriginal leaders who are also chief investigators. We will interview Aboriginal leaders about research, community engagement and the consent process and hold focus groups with Aboriginal community members about individual consent. Cultural protocols will be applied to recruit and conduct research with participants. Transcripts will be analysed using NVivo10 qualitative software and themes synthesised to highlight the key issues raised by the community about the research process. This protocol will guide future research with the Aboriginal communities of the Fitzroy Valley and may inform the approach to research with other Indigenous communities of Australia or the world. It must be noted that no community is the same and all research requires local consultation and input. To conduct culturally sensitive research, respected local people from the community who have knowledge of cultural protocol and language are engaged to guide each step of the research process from the project design to the delivery of results. Ethics approval was granted by the University of Sydney Human Research Ethics Committee (No. 2012/348, reference:14760), the Western Australia Country Health Service Ethics Committee (No. 2012:15), the Western Australian Aboriginal Health Ethics Committee and reviewed by the Kimberley Aboriginal Health Planning Forum Research Sub-Committee (No. 2012
Jul 18, 2008 ... Available online at http://www.academicjournals.org/AJB ... considerably to livelihood as a food supplement and for income generation among local communities. However, U. .... the different forest reserves for consumption, marketing or both. ..... The Status of medicinal trees used in child healthcare in ten.
Bialek, Hilton; Nabokov, Peter
Four rural communities in northern Maine were the setting for a pilot program in Indian adult education that featured a new kind of instructional model. Developed by the Human Resources Research Organization (HumRRO), it featured peer instruction, strict performance orientation, and insistance on mastery of certain skills. A HumRRO representative…
Institutional success of an instructional model that featured peer instruction, a strict performance orientation, and an insistence on mastery of specific skills led developers to believe the same model could be used by communities to disseminate skills and information at low cost and with efficiency. The system was utilized in setting up an…
Cabada, Miguel M; Castellanos-Gonzalez, Alejandro; Lopez, Martha; Caravedo, María Alejandra; Arque, Eulogia; White, Arthur Clinton
Fasciola hepatica is a zoonotic infection with a worldwide distribution. Autochthonous cases have not been reported in the Amazon region of Peru. Operculated eggs resembling F. hepatica were identified in the stools of five out of 215 subjects in a remote indigenous community of the Peruvian jungle. Polymerase chain reaction targeting Fasciola hepatica cytochrome oxidase subunit 1 (COI) gene and sequencing of the products confirmed Fasciola infection. © The American Society of Tropical Medicine and Hygiene.
Cabada, Miguel M.; Castellanos-Gonzalez, Alejandro; Lopez, Martha; Caravedo, Mar��a Alejandra; Arque, Eulogia; White, Arthur Clinton
Fasciola hepatica is a zoonotic infection with a worldwide distribution. Autochthonous cases have not been reported in the Amazon region of Peru. Operculated eggs resembling F. hepatica were identified in the stools of five out of 215 subjects in a remote indigenous community of the Peruvian jungle. Polymerase chain reaction targeting Fasciola hepatica cytochrome oxidase subunit 1 (COI) gene and sequencing of the products confirmed Fasciola infection.
Carlos SABORÍO VÍQUEZ
Full Text Available The key areas that determine the food and nutrition security are: availability, access, consumption and biological utilization. For this reason it is necessary to promote the health of vulnerable groups, in this case, indigenous communities, protecting and establishing conditions to ensure the human right to food. The initial plan focuses ondeveloping facilities for small swine and poultry farms, familiar, non-commercial. The main objective of the pigs raised at the site will be the production of animal waste in order to implement digesters for the production of biogas as an alternative energy source, the production of meat stays in the background, thinking only about the community consumption and helping to ensure their food source, from this perspective, the technologies applied to rural and indigenous progress are environmentally friendly, socially just, economically viable and culturally acceptable. The theme of rural and indigenous Development is focused on their food security and the use of alternative energies, considering that energy is a key element in achieving sustainable development in all sectors, therefore sought from a broad perspective solidarity and actively promote greater and more rational use of energy and the environment in remote communities, through diversification of supply sources and efficient use, thereby contributing toenvironmental conservation and reduction of health problems through the use of appropriate technologies.
Mendham, Amy E; Duffield, Rob; Marino, Frank; Coutts, Aaron J
This study assessed the effect of a 12-week sports-based exercise intervention on glucose regulation, anthropometry and inflammatory markers associated with the prevalence of type 2 diabetes mellitus (T2DM) in Indigenous Australian men. Twenty-six inactive Indigenous Australian men (48.6±6.6 years) were randomized into exercise (n=16) or control (n=10)conditions. Training included ∼2-3 days/week for 12 weeks of sports and gym exercises in a group environment, whilst control participants maintained normal activity and dietary patterns. Pre- and post-intervention testing included: anthropometry, peak aerobic capacity, fasting blood chemistry of inflammatory cytokines, adiponectin, leptin, cholesterol, glucose, insulin and C-peptide. An oral glucose tolerance test measured glucose, insulin and C-peptide 30, 60, 90 and 120min post 75g glucose ingestion. The exercise condition decreased insulin area under the curve (25±22%), increased estimated insulin sensitivity (35±62%) and decreased insulin resistance (9±35%; p0.05). The exercise condition decreased in body mass index, waist circumference and waist to hip ratio (p0.05). Leptin decreased in the exercise group, with no changes for adiponectin (p>0.05) or inflammatory markers (p>0.05) in either condition. Aerobic fitness variables showed significant increases in peak oxygen consumption for the exercise condition compared to no change in control (p>0.05). Findings indicate positive clinical outcomes in metabolic, anthropometric and aerobic fitness variables. This study provides evidence for sport and group-based activities leading to improved clinical risk factors associated with T2DM development in clinically obese Indigenous Australian men. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Full Text Available BACKGROUND: HTLV-1 infection is endemic among people of Melanesian descent in Papua New Guinea, the Solomon Islands and Vanuatu. Molecular studies reveal that these Melanesian strains belong to the highly divergent HTLV-1c subtype. In Australia, HTLV-1 is also endemic among the Indigenous people of central Australia; however, the molecular epidemiology of HTLV-1 infection in this population remains poorly documented. FINDINGS: Studying a series of 23 HTLV-1 strains from Indigenous residents of central Australia, we analyzed coding (gag, pol, env, tax and non-coding (LTR genomic proviral regions. Four complete HTLV-1 proviral sequences were also characterized. Phylogenetic analyses implemented with both Neighbor-Joining and Maximum Likelihood methods revealed that all proviral strains belong to the HTLV-1c subtype with a high genetic diversity, which varied with the geographic origin of the infected individuals. Two distinct Australians clades were found, the first including strains derived from most patients whose origins are in the North, and the second comprising a majority of those from the South of central Australia. Time divergence estimation suggests that the speciation of these two Australian clades probably occurred 9,120 years ago (38,000-4,500. CONCLUSIONS: The HTLV-1c subtype is endemic to central Australia where the Indigenous population is infected with diverse subtype c variants. At least two Australian clades exist, which cluster according to the geographic origin of the human hosts. These molecular variants are probably of very ancient origin. Further studies could provide new insights into the evolution and modes of dissemination of these retrovirus variants and the associated ancient migration events through which early human settlement of Australia and Melanesia was achieved.
Full Text Available Abstract. Nowadays, an integrated location, descriptive inventory data and geographical information are required for a better decision making in Indigenous community management activities. The management system can improve productivity and to save time, money and man power. Conventional maps and Indigenous inventories on papers or spread sheet are lack of meeting these requirements which are not static and subjected to change rapidly. The Geographic Information Systems (GIS and Database Management (DBM System are capabilities and confined in manipulation of location and descriptive data, respectively. A GIS system is chosen in Management Information and Infrastructure of Indigenous Communities because its meets all the requirements that can help the authorities to managed the community. GIS able to manipulate location and descriptive data as well as the relationships between them are dynamic. This paper will discussed briefly the conceptual design of GIS activities and Indigenous community in Royal Belum State Park, Malaysia, then terminology and theoretical concepts of GIS, Indigenous community management and the link between them are reviewed. Keywords: Management, information, infrastructure, conceptual design, Indigenous community
Full Text Available Abstract. Nowadays, an integrated location, descriptive inventory data and geographical information are required for a better decision making in Indigenous community management activities. The management system can improve productivity and to save time, money and man power. Conventional maps and Indigenous inventories on papers or spread sheet are lack of meeting these requirements which are not static and subjected to change rapidly. The Geographic Information Systems (GIS and Database Management (DBM System are capabilities and confined in manipulation of location and descriptive data, respectively. A GIS system is chosen in Management Information and Infrastructure of Indigenous Communities because its meets all the requirements that can help the authorities to managed the community. GIS able to manipulate location and descriptive data as well as the relationships between them are dynamic. This paper will discussed briefly the conceptual design of GIS activities and Indigenous community in Royal Belum State Park, Malaysia, then terminology and theoretical concepts of GIS, Indigenous community management and the link between them are reviewed.Keywords: Management, information, infrastructure, conceptual design, Indigenous community
Zhao, Yuejen; Thomas, Susan L; Guthridge, Steven L; Wakerman, John
Indigenous residents living in remote communities in Australia's Northern Territory experience higher rates of preventable chronic disease and have poorer access to appropriate health services compared to other Australians. This study compared health outcomes and costs at different levels of primary care utilisation to determine if primary care represents an efficient use of resources for Indigenous patients with common chronic diseases namely hypertension, diabetes, ischaemic heart disease, chronic obstructive pulmonary disease and renal disease. This was an historical cohort study involving a total of 14,184 Indigenous residents, aged 15 years and over, who lived in remote communities and used a remote clinic or public hospital from 2002 to 2011. Individual level demographic and clinical data were drawn from primary care and hospital care information systems using a unique patient identifier. A propensity score was used to improve comparability between high, medium and low primary care utilisation groups. Incremental cost-effectiveness ratios and acceptability curves were used to analyse four health outcome measures: total and, avoidable hospital admissions, deaths and years of life lost. Compared to the low utilisation group, medium and high levels of primary care utilisation were associated with decreases in total and avoidable hospitalisations, deaths and years of life lost. Higher levels of primary care utilisation for renal disease reduced avoidable hospitalisations by 82-85%, deaths 72-75%, and years of life lost 78-81%. For patients with ischaemic heart disease, the reduction in avoidable hospitalisations was 63-78%, deaths 63-66% and years of life lost 69-73%. In terms of cost-effectiveness, primary care for renal disease and diabetes ranked as more cost-effective, followed by hypertension and ischaemic heart disease. Primary care for chronic obstructive pulmonary disease was the least cost-effective of the five conditions. Primary care in remote
Roder, Giulia; Ruljigaljig, Tjuku; Lin, Ching-Weei; Tarolli, Paolo
The purpose of this work is to investigate the natural hazard knowledge and risk perception of Wujie indigenous community, located in Fazhi Village in the Central Mountain Range of Taiwan. Taiwan has encountered many different types of natural hazards (e.g. landslides and debris flows) that have increased sharply in the last century. Because of that, they are one of the most critical issues for the government and for the people living in mountainous areas. These areas are mainly populated by indigenous people that have experienced economic competition and military conflict with a series of colonizing periods causing a progressive loss of their original cultural identity. The motivation of selecting the case study of Wujie community is because (i) it has suffered, more than others, generations of devastating colonial oppression by foreign governments; (ii) the consequences of hydroelectric projects that moved a lot of water and sediment to the valley and modified the path of the river through the years; (iii) the documented landslides and debris flows occurred in the region during the last decades. Two questions appear spontaneously: How indigenous people are nowadays living with natural hazards? Have land use change or any other human footprint affected their knowledge and perception on natural hazards? This research, the first carried out in Taiwan involving an indigenous community, can offer a unique opportunity to answer these questions. The investigation utilized a variety of participatory methods conducted at the household and community level by the use of 65 face-to-face interviews. Results revealed that residents felt a higher worry about landslide and flood risks, and a slight preparedness to face them. This discrepancy may derive from an unsatisfactory level of communication and information, and the most considerable differences were found between the evaluations of individual subjects as opposed to overall communities. Results revealed also the complexity
Hugo Florencio Centurión Mereles
Full Text Available The Word offers us a critical glance about the economic and socio-cultural impacts of the transgenic crops in peasant and indigenous communities of the eastern region of Paraguay, it is given special attention to the use of Roundup, with the undoubted environment cost and the uncertain risks to human and animal health. The impacts and interactions that the techno-commoditization of the organisms genetically modified OGM have on the affected populations and the environment-species, soil, water, woods, flora, fauna is discussed in the Word.The extent of use of glyphosate on transgenic crops would involve not only the environment of the crop, but go to generate profound cultural changes, technological, of management, environmental, economical, social and legal, whose effects we already see them come with the decline of peasant and indigenous communities, that at not finding adequate strategies to face them, collapse as collectivity. The Word contains important elements to renew the debate and the critical thought in relation to the problematic of transgenic crop and its impact in indigenous and peasant populations.
Torres Sanabria, Camilo; Cuartas Ricaurte, Jorge Armando
In general terms, Amazonian soils are infertile and have several constraints for agricultural production. However, use by ancient human societies since pre-columbian times has driven landscape transformation of massive areas and development of anthropogenic soils called Terra Preta do Indio (TP) or Amazonian Dark Earths (ADE). ADE characterization, in terms of fertility and composition, has allowed the development of intensive agricultural activities over time. The current use of ADE for the Brazilian amazon peasants (Caboclos) is different from the indigenous communities in Colombia. The indigenous people in Colombia (Tikunas) no use this type of soils on behalf of cultural restrictions that avoid the use of ancient places. We are comparing the institutional conditions, migrations, social characterization and cultural factors that determine the use/no-use of these soils by the Amazonian societies.
In 2005 the Centre for Contemporary Photography in Melbourne presented the Indigenous photo-media exhibition Black on White. Promising to explore Indigenous perspectives on non-Aboriginality, its catalogue set forth two questions: how do Aboriginal artists see the people and culture that surrounds
Rahman, A.; Sakurai, A.; Munadi, K.
Knowledge accumulation and production embedded in communities through social interactions meant that the Smong tradition of indigenous knowledge of tsunami risk successfully alerted people to the 2004 tsunami, on the island of Simeulue, in Aceh, Indonesia. Based on this practical example, an indigenous management model was developed for Smong information. This knowledge management method involves the transformation of indigenous knowledge into applicable ways to increase community resilience, including making appropriate decisions and taking action in three disaster phases. First, in the pre-disaster stage, the community needs to be willing to mainstream and integrate indigenous knowledge of disaster risk reduction issues into related activities. Second, during disasters, the Smong tradition should make the community able to think clearly, act based on informed decisions, and protect themselves and others by using their indigenous knowledge. Last, in the post-disaster phase, the community needs to be strong enough to face challenges and support each other and “building back better” efforts, using local resources. The findings for the Smong tradition provide valuable knowledge about community resilience. Primary community resilience to disasters is strongly related to existing knowledge that triggers appropriate decisions and actions during pre-disaster, disaster, and post-disaster phases.
Enrique de la Montaña
Full Text Available Many indigenous communities living in the Amazon rely on hunting and fishing to meet the majority of their protein needs. Despite the importance of these practices, few studies from the region have analyzed the socioeconomic drivers of hunting and fishing at the household level. We propose a household production model to assess the effect of key economic parameters on hunting and fishing in small indigenous communities located in the Ecuadorian Amazon, whose principal source of protein is derived from hunting and fishing. The model was validated using empirical data from two communities that reflect different levels of market integration and forest conservation. Demand and supply functions were generated from household data gathered over 19 months. Elasticities were derived to determine the sensitivity of the decision to engage in hunting to exogenous parameters such as off-farm wages, hunting costs, bushmeat price, penalties for the illegal sale of bushmeat, and biological characteristics of the game species. After calibrating the model, we simulated changes in the key economic parameters. The parameter that most directly affected hunting activity in both communities was off-farm wages. Simulating a 10% wage increase resulted in a 16-20% reduction in harvested biomass, while a 50% increase diminished harvested biomass by > 50%. Model simulations revealed that bushmeat price and penalties for illegal trade also had important effects on hunter behavior in terms of amount of bushmeat sold, but not in terms of total harvest. As a tool for understanding hunters' economic decision-making, the model provides a basis for developing strategies that promote sustainable hunting and wildlife conservation while protecting indigenous livelihoods.
Full Text Available Nutrient deficiency severely impairs the catabolic activity of indigenous microorganisms in hydrocarbon rich environments (HREs and limits the rate of intrinsic bioremediation. The present study aimed to characterize the microbial community in refinery waste and evaluate the scope for biostimulation based in situ bioremediation. Samples recovered from the wastewater lagoon of Guwahati refinery revealed a hydrocarbon enriched high total petroleum hydrocarbon (TPH, oxygen-, moisture-limited, reducing environment. Intrinsic biodegradation ability of the indigenous microorganisms was enhanced significantly (>80% reduction in TPH by 90 days with nitrate amendment. Preferred utilization of both higher- (>C30 and middle- chain (C20-30 length hydrocarbons were evident from GC-MS analysis. Denaturing gradient gel electrophoresis (DGGE and community level physiological profiling (CLPP analyses indicated distinct shift in community’s composition and metabolic abilities following nitrogen (N amendment. High throughput deep sequencing of 16S rRNA gene showed that the native community was mainly composed of hydrocarbon degrading, syntrophic, methanogenic, nitrate/iron/sulfur reducing facultative anaerobic bacteria and archaebacteria, affiliated to γ- and δ-Proteobacteria and Euryarchaeota respectively. Genes for aerobic and anaerobic alkane metabolism (alkB and bssA, methanogenesis (mcrA, denitrification (nirS and narG and N2 fixation (nifH were detected. Concomitant to hydrocarbon degradation, lowering of dissolve O2 and increase in oxidation-reduction potential (ORP marked with an enrichment of N2 fixing, nitrate reducing aerobic/facultative anaerobic members e.g., Azovibrio, Pseudoxanthomonas and Commamonadaceae members was evident in N amended microcosm. This study highlighted that indigenous community of refinery sludge was intrinsically diverse, yet appreciable rate of in situ bioremediation could be achieved by supplying adequate N sources.
Sarkar, Jayeeta; Kazy, Sufia K.; Gupta, Abhishek; Dutta, Avishek; Mohapatra, Balaram; Roy, Ajoy; Bera, Paramita; Mitra, Adinpunya; Sar, Pinaki
Nutrient deficiency severely impairs the catabolic activity of indigenous microorganisms in hydrocarbon rich environments (HREs) and limits the rate of intrinsic bioremediation. The present study aimed to characterize the microbial community in refinery waste and evaluate the scope for biostimulation based in situ bioremediation. Samples recovered from the wastewater lagoon of Guwahati refinery revealed a hydrocarbon enriched [high total petroleum hydrocarbon (TPH)], oxygen-, moisture-limited, reducing environment. Intrinsic biodegradation ability of the indigenous microorganisms was enhanced significantly (>80% reduction in TPH by 90 days) with nitrate amendment. Preferred utilization of both higher- (>C30) and middle- chain (C20-30) length hydrocarbons were evident from GC-MS analysis. Denaturing gradient gel electrophoresis and community level physiological profiling analyses indicated distinct shift in community’s composition and metabolic abilities following nitrogen (N) amendment. High throughput deep sequencing of 16S rRNA gene showed that the native community was mainly composed of hydrocarbon degrading, syntrophic, methanogenic, nitrate/iron/sulfur reducing facultative anaerobic bacteria and archaebacteria, affiliated to γ- and δ-Proteobacteria and Euryarchaeota respectively. Genes for aerobic and anaerobic alkane metabolism (alkB and bssA), methanogenesis (mcrA), denitrification (nirS and narG) and N2 fixation (nifH) were detected. Concomitant to hydrocarbon degradation, lowering of dissolve O2 and increase in oxidation-reduction potential (ORP) marked with an enrichment of N2 fixing, nitrate reducing aerobic/facultative anaerobic members [e.g., Azovibrio, Pseudoxanthomonas and Comamonadaceae members] was evident in N amended microcosm. This study highlighted that indigenous community of refinery sludge was intrinsically diverse, yet appreciable rate of in situ bioremediation could be achieved by supplying adequate N sources. PMID:27708623
Olesen, Sarah C; Berry, Helen L
This study considered whether community participation during later adulthood is more strongly associated with mental health during retirement than it is while in employment; i.e. in the absence of paid work. Participants were 322 men and 311 women aged 45 years and older, who were part of a random sample of an Australian coastal community. The frequency of participation across 14 types of community-based activities was assessed. Overall mental health was measured on a 10-item Kessler Psychological Distress Scale. Linear regression models tested the multivariate associations between distress and community participation, and whether this association differed for retired and working people. Retirees did not participate in their communities more than working people. The association between community participation and psychological distress did not differ by retirement status when people of all ages were considered together; however, stronger associations between several activities and (less) distress were found for retirees compared to their working peers in a younger cohort (aged 45 to 54). This cohort coincides with the average age of transition to retirement in Australia. These findings offer some support for the view that community participation may assist in managing the mental health implications of the transition from work to retirement.
Pelcastre-Villafuerte, Blanca; Ruiz, Myriam; Meneses, Sergio; Amaya, Claudia; Márquez, Margarita; Taboada, Arianna; Careaga, Katherine
Indigenous women in Mexico represent a vulnerable population in which three kinds of discrimination converge (ethnicity, gender and class), having direct repercussions on health status. The discrimination and inequity in health care settings brought this population to the fore as a priority group for institutional action. The objective of this study was to evaluate the processes and performance of the "Casa de la Mujer Indígena", a community based project for culturally and linguistically appropriate service delivery for indigenous women. The evaluation summarizes perspectives from diverse stakeholders involved in the implementation of the model, including users, local authorities, and institutional representatives. The study covered five Casas implementation sites located in four Mexican states. A qualitative process evaluation focused on systematically analyzing the Casas project processes and performance was conducted using archival information and semi-structured interviews. Sixty-two interviews were conducted, and grounded theory approach was applied for data analysis. Few similarities were observed between the proposed model of service delivery and its implementation in diverse locations, signaling discordant operating processes. Evidence gathered from Casas personnel highlighted their ability to detect obstetric emergencies and domestic violence cases, as well as contribute to the empowerment of women in the indigenous communities served by the project. These themes directly translated to increases in the reporting of abuse and referrals for obstetric emergencies. The model's cultural and linguistic competency, and contributions to increased referrals for obstetric emergencies and abuse are notable successes. The flexibility and community-based nature of the model has allowed it to be adapted to the particularities of diverse indigenous contexts. Local, culturally appropriate implementation has been facilitated by the fact that the Casas have been
Clough, Alan R; Bird, Katrina
Very high rates of injury and death during the 1990s were linked with increased alcohol availability and misuse in discrete Indigenous communities in rural and remote Queensland (Australia). To address widespread concerns about a public health crisis, from 2002, the Queensland Government implemented alcohol control strategies known as 'Alcohol Management Plans' (AMPs) in 19 of these communities. Although resources for prevention and treatment were promised, AMPs became increasingly focused on local prohibition, restricted access to alcohol and punitive measures for breaching restrictions. An examination of legislation, regulations, explanatory notes, and published documents indicates this focus evolved across four phases since 2002. The first phase, from 2002 to 2004, saw 'restricted areas' with alcohol 'carriage limits' introduced, restricting the amounts and types of liquor permitted within some communities. The second phase (2002-2007) featured evaluations and reviews by the Queensland Government bringing recommendations for more stringent controls. Additionally, beyond the 'restricted areas', licenced premises situated within the 'catchments' of the targeted communities, mainly located in the nearby regional towns, became subject to 'minimising harm' provisions. These more stringent controls were implemented widely in the third phase (2008-2011) when: the operations of seven community-managed liquor outlets were terminated; the trading arrangements of two others were modified; Police powers to search and seize were increased; and 'attempting' to take liquor into a 'restricted area' also became an offence. Some communities have seen a reduction in alcohol-related harms that have been attributed to these alcohol control strategies. This commentary maps the recent regulatory history of Queensland's alcohol controls targeting discrete Indigenous communities highlighting their increasing focus on punitive measures to reduce access to alcohol. With AMPs in Queensland
Viscogliosi, Chantal; Asselin, Hugo; Basile, Suzy; Couturier, Yves; Drolet, Marie-Josée; Gagnon, Dominique; Torrie, Jill; Levasseur, Mélanie
Indigenous elders have traditionally played an important role in maintaining social cohesion within their communities. Today, part of this role has been taken over by government social and healthcare services, but they are having limited success in addressing social challenges. Increasing elders' social participation and intergenerational solidarity might foster community development and benefit young people, families, communities and the elders themselves. However, knowledge of the contribution of elders' social participation and intergenerational solidarity to wellness is scattered and needs to be synthesised. This protocol presents a scoping review on the social participation of indigenous elders, intergenerational solidarity and their influence on individual and community wellness. This scoping review protocol is based on an innovative methodological framework designed to gather information from the scientific and grey literature and from indigenous sources. It was developed by an interdisciplinary team including indigenous scholars/researchers, knowledge users and key informants. In addition to searching information databases in fields such as public health and indigenous studies, an advisory committee will ensure that information is gathered from grey literature and indigenous sources. The protocol was approved by the Ethics Review Board of the Université du Québec en Abitibi-Témiscamingue and the First Nations of Quebec and Labrador Health and Social Services Commission. The comprehensive synthesis of the scientific and grey literature and indigenous sources proposed in this protocol will not only raise awareness within indigenous communities and among healthcare professionals and community organisations, but will also enable decision-makers to better meet the needs of indigenous people. The innovative methodological framework proposed in this scoping review protocol will yield richer information on the contribution of elders to community wellness. This
Ju, Xiangqun; Jamieson, Lisa M; Mejia, Gloria C
To estimate the effect of mothers' education on Indigenous Australian children's dental caries experience while controlling for the mediating effect of children's sweet food intake. The Longitudinal Study of Indigenous Children is a study of two representative cohorts of Indigenous Australian children, aged from 6 months to 2 years (baby cohort) and from 3.5 to 5 years (child cohort) at baseline. The children's primary caregiver undertook a face-to-face interview in 2008 and repeated annually for the next 4 years. Data included household demographics, child health (nutrition information and dental health), maternal conditions and highest qualification levels. Mother's educational level was classified into four categories: 0-9 years, 10 years, 11-12 years and >12 years. Children's mean sweet food intake was categorized as 30%. After multiple imputation of missing values, a marginal structural model with stabilized inverse probability weights was used to estimate the direct effect of mothers' education level on children's dental decay experience. From 2008 to 2012, complete data on 1720 mother-child dyads were available. Dental caries experience for children was 42.3% over the 5-year period. The controlled direct effect estimates of mother's education on child dental caries were 1.21 (95% CI: 1.01-1.45), 1.03 (95% CI: 0.91-1.18) and 1.07 (95% CI: 0.93-1.22); after multiple imputation of missing values, the effects were 1.21 (95% CI: 1.05-1.39), 1.06 (95% CI: 0.94-1.19) and 1.06 (95% CI: 0.95-1.19), comparing '0-9', '10' and '11-12' years to > 12 years of education. Mothers' education level had a direct effect on children's dental decay experience that was not mediated by sweet food intake and other risk factors when estimated using a marginal structural model. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Full Text Available This paper provides an overview of discourses of the movement for national reconciliation prevailing within the Australian socio-political context since the inception of the Council for Aboriginal Reconciliation in 1991, to the national apology delivered by the Prime Minister Kevin Rudd on 13th February 2008. It provides an framework for the various discourses of reconciliation, by exploring and analysing the accrued meanings to such terms such as ‘genuine’, substantive or ‘true’ reconciliation; the Howard’s Government’s ‘practical reconciliation’ and the Rudd government’s great attempt at ‘symbolic’ reconciliation in the national apology to Indigenous Australians. In the changing political context in Australia today this paper revisits the debates on reconciliation, and endeavours to locate the movement solidly within a human rights framework that includes first nation rights. This requires an examination of the roots of the reconciliation movement including community attitudes to reconciliation and the nature of the peoples’ movement as well as the differing perspectives of policy makers, politicians and of course, Indigenous peoples. It asks crucial questions about the progress of reconciliation and the type of reconciliation mainstream Australians will accept. In truth therefore, was the ‘National Apology’ a grand symbolic gesture by mainstream Australia to maintain the status quo and divert our eyes from the more searching questions of the ‘unfinished business’ of ‘substantive’ reconciliation which encompasses first nations rights for Indigenous peoples.
Kim, Seong-Hye; Han, Hyo-Yeol; Lee, You-Jin; Kim, Chul Woong; Yang, Ji-Won
Electrokinetic remediation has been successfully used to remove organic contaminants and heavy metals within soil. The electrokinetic process changes basic soil properties, but little is known about the impact of this remediation technology on indigenous soil microbial activities. This study reports on the effects of electrokinetic remediation on indigenous microbial activity and community within diesel contaminated soil. The main removal mechanism of diesel was electroosmosis and most of the bacteria were transported by electroosmosis. After 25 days of electrokinetic remediation (0.63 mA cm(-2)), soil pH developed from pH 3.5 near the anode to pH 10.8 near the cathode. The soil pH change by electrokinetics reduced microbial cell number and microbial diversity. Especially the number of culturable bacteria decreased significantly and only Bacillus and strains in Bacillales were found as culturable bacteria. The use of EDTA as an electrolyte seemed to have detrimental effects on the soil microbial activity, particularly in the soil near the cathode. On the other hand, the soil dehydrogenase activity was enhanced close to the anode and the analysis of microbial community structure showed the increase of several microbial populations after electrokinetics. It is thought that the main causes of changes in microbial activities were soil pH and direct electric current. The results described here suggest that the application of electrokinetics can be a promising soil remediation technology if soil parameters, electric current, and electrolyte are suitably controlled based on the understanding of interaction between electrokinetics, contaminants, and indigenous microbial community. Copyright 2010 Elsevier B.V. All rights reserved.
Fuenmayor-Boscán, Alisbeth D; Hernández, Ileana M; Valero, Kutchynskaya J; Paz, América M; Sandrea, Lisette B; Rivero, Zulbey
Helicobacter pylori (Hp) and enteroparasite infections are highly prevalent in populations with poor living conditions, like the Amerindian communities. Identifying associations between both types of infectious agents could help to detect shared risk factors or transmission routes in these minority ethnic groups. Therefore, the prevalence and association between Hp and enteroparasites were investigated in an indigenous community whose living conditions favor such infectious diseases. Seropositivity (anti-Hp-specific IgG) and active infection (stool antigen test), intestinal parasitosis (direct and concentrated coproparasitological test, methylene blue, and Kinyoun stains), and risk factors for fecal-oral transmission were determined in 167 children and 151 adults of the Añu indigenous community living at the Sinamaica Lagoon, in Venezuela. A high rate of Hp infection (seropositivity and active infection) and enteroparasitosis was evidenced, as expected. Some significant associations were detected: direct associations between Hp and polyparasitic infection, helminths, and protozoan (particularly in children); inverse association between Hp and Giardia lamblia. No shared epidemiological factors were identified for Hp and the detected intestinal parasites, probably due to overlapping factors. Direct associations detected support the participation of the fecal-oral route in the transmission of the involved infectious agents. Inverse relationship (Hp) and G. lamblia may suggest the existence of antagonistic interactions between them. Further research is required to elucidate the mechanisms underlying these associations.
Juan Pulido Secundino
Full Text Available The study of indigenous groups everywhere in the world indicates a thorough knowledge in natural resources, including soils, plants, animals, and more widely in landscape and landscape management in space and time. During centuries indigenous communities have established a strong relationship with their natural environments, and have developed knowledge systems and classificatory frameworks for both biotic and non biotic landscape components. The vision is however integrated, holistic, and society is actually perceived as embedded in nature. Studying these knowledge systems is important because despite their contribution to landscape understanding especially in tropical regions, they run the risk of being lost together with the societies that create them. In addition, in spite of substantial research efforts, these systems have been poorly documented. The purpose of this article is to document and analyze the ethnogeographic, landscape knowledge in Comachuen, a purepecha community in the State of Michoacán, and to highlight its usefulness in natural resource management. To this end, we developed a co-investigation, participatory scheme, involving a group of community members, with whom we work during several months, in the field, between 2008 and 2010. Field work consisted on geographic transects along forests and cropland, coupled to in-depth interviews, to 24 local producers, all of them native speakers of the purepecha language.
Mahoney, A. R.; Zappa, C. J.; Betcher, S. R.; Hauser, D.; Whiting, A.; Goodwin, J.; Harris, C.; Schaefer, B.; Schaefer, R.
Ikaavik Sikukuun (Ice Bridges) is a newly-launched research partnership in Kotzebue, Alaska, that adopts an end-to-end community-based approach to study fundamental processes underlying the mechanisms and impacts of the changing sea ice in coastal Alaska. Under guidance from a local advisory council, we will use state-of-the-art observing techniques including long-range unmanned aerial systems (UAS) to study under-observed sea ice regions during critical periods of marine mammal migration, molting and reproduction. Here, we describe what, to the best of our knowledge, is a precedent-setting approach to co-creating research questions and hypotheses that integrate indigenous knowledge (IK) and interdisciplinary scientific methods. A key element of this approach is that we established an advisory committee of local IK holders before defining specific research questions. This has enabled us to iteratively develop hypotheses that incorporate IK and respond to the research needs of the local community while also addressing key geophysical and ecological questions related to changes in the seasonal ice zone. The advisory committee will be key participants in the project team, ensuring that IK is incorporated into the design of the observing plan and the synthesis and dissemination of findings. In addition to building bridges between the scientific community and indigenous residents of Kotzebue, the legacy of our project will include a video documentary that will allow us to share the story of this partnership and our findings with a broad audience.
Torri, Maria Costanza
Community participation in local health has assumed a central role in the reforms of public healthcare, being increasingly associated with the issue of decentralization of the health system. The aim of this paper is to raise questions regarding the structural approaches to multicultural social policy in Chile and to analyze the results of its implementation. The article analyzes the case study of Makewe Hospital, one of the pioneering experiences of intercultural health initiative in Chile. The Makewe Hospital, which involves the indigenous community of the Mapuche, provides interesting insights to understand the dynamics of multicultural social policy and presents an example of a successful initiative that has succeeded in involving local communities in multicultural health policy. This case study discusses the effectiveness of grassroots participation in multicultural healthcare provision and presents the main strengths and challenges for the replicability of this experience in other settings. Copyright © 2011 John Wiley & Sons, Ltd.
Assessing the Association between Serum Ferritin, Transferrin Saturation, and C-Reactive Protein in Northern Territory Indigenous Australian Patients with High Serum Ferritin on Maintenance Haemodialysis
Sandawana William Majoni
Full Text Available Objective. To determine the significance of high serum ferritin observed in Indigenous Australian patients on maintenance haemodialysis in the Northern Territory, we assessed the relationship between ferritin and transferrin saturation (TSAT as measures of iron status and ferritin and C-reactive protein (CRP as markers of inflammation. Methods. We performed a retrospective cohort analysis of data from adult patients (≥18 years on maintenance haemodialysis (>3 months from 2004 to 2011. Results. There were 1568 patients. The mean age was 53.9 (11.9 years. 1244 (79.3% were Indigenous. 44.2% (n=693 were male. Indigenous patients were younger (mean age [52.3 (11.1 versus 57.4 (15.2, p<0.001] and had higher CRP [14.7 mg/l (7–35 versus 5.9 mg/l (1.9–17.5, p<0.001], higher median serum ferritin [1069 µg/l (668–1522 versus 794.9 µg/l (558.5–1252.0, p<0.001], but similar transferrin saturation [26% (19–37 versus 28% (20–38, p=0.516]. We observed a small positive correlation between ferritin and TSAT (r2=0.11, p<0.001, no correlation between ferritin and CRP (r2 = 0.001, p<0.001, and positive association between high serum ferritin and TSAT (p<0.001, Indigenous ethnicity (p<0.001, urea reduction ratio (p=0.001, and gender (p<0.001 after adjustment in mixed regression analysis. Conclusion. Serum ferritin and TSAT may inadequately reflect iron status in this population. The high ferritin was poorly explained by inflammation.
Manning, Richard F.
This article draws upon a "tale from the feld" (Van Maanen, 1988) to encourage New Zealand and Australian teachers of history and social studies to appraise how their own perceptions of place and teaching about Indigenous peoples' histories impact upon their students' learning. Moreover, it explains why Uri Bronfenbrenner's (1979)…
Clough, Alan R; d'Abbs, Peter; Cairney, Sheree; Gray, Dennis; Maruff, Paul; Parker, Robert; O'Reilly, Bridie
We investigated adverse mental health effects and their associations with levels of cannabis use among indigenous Australian cannabis users in remote communities in the Northern Territory. Local indigenous health workers and key informants assisted in developing 28 criteria describing mental health symptoms. Five symptom clusters were identified using cluster analysis of data compiled from interviews with 103 cannabis users. Agreement was assessed (method comparison approach, kappa-statistic) with a clinician's classification of the 28 criteria into five groups labelled: 'anxiety', 'dependency', 'mood', 'vegetative' and 'psychosis'. Participants were described as showing 'anxiety', 'dependency' etc., if they reported half or more of the symptoms comprising the cluster. Associations between participants' self-reported cannabis use and each symptom cluster were assessed (logistic regression adjusting for age, sex, other substance use). Agreement between two classifications of 28 criteria into five groups was 'moderate' (64%, kappa = 0.55, p < 0.001). When five clusters were combined into three, 'anxiety-dependency', 'mood-vegetative' and 'psychosis', agreement rose to 71% (kappa = 0.56, p < 0.001). 'Anxiety-dependency' was positively associated with number of 'cones' usually smoked per week and this remained significant when adjusted for confounders (p = 0.020) and tended to remain significant in those who had never sniffed petrol (p = 0.052). Users of more than five cones per week were more likely to display 'anxiety-dependency' symptoms than those who used one cone per week (OR = 15.8, 1.8-141.2, p = 0.013). A crude association between the 'mood-vegetative' symptom cluster and number of cones usually smoked per week (p = 0.014) also remained statistically significant when adjusted for confounders (p = 0.012) but was modified by interactions with petrol sniffing (p = 0.116) and alcohol use (p = 0.276). There were no associations between cannabis use and 'psychosis
Full Text Available Abstract Background Plants have traditionally been used as a source of medicine in India by indigenous people of different ethnic groups inhabiting various terrains for the control of various ailments afflicting human and their domestic animals. The indigenous community of snake charmers belongs to the 'Nath' community in India have played important role of healers in treating snake bite victims. Snake charmers also sell herbal remedies for common ailments. In the present paper an attempt has been made to document on ethno botanical survey and traditional medicines used by snake charmers of village Khetawas located in district Jhajjar of Haryana, India as the little work has been made in the past to document the knowledge from this community. Methods Ethno botanical data and traditional uses of plants information was obtained by semi structured oral interviews from experienced rural folk, traditional herbal medicine practitioners of the 'Nath' community. A total of 42 selected inhabitants were interviewed, 41 were male and only one woman. The age of the healers was between 25 years and 75 years. The plant specimens were identified according to different references concerning the medicinal plants of Haryana and adjoining areas and further confirmation from Forest Research Institute, Dehradun. Results The present study revealed that the people of the snake charmer community used 57 medicinal plants species that belonged to 51 genera and 35 families for the treatment of various diseases. The study has brought to light that the main diseases treated by this community was snakebite in which 19 different types of medicinal plants belongs to 13 families were used. Significantly higher number of medicinal plants was claimed by men as compared to women. The highest numbers of medicinal plants for traditional uses utilized by this community were belonging to family Fabaceae. Conclusion This community carries a vast knowledge of medicinal plants but as
McLean, M. A.; Brown, J.; Hoeberechts, M.
Ocean Networks Canada (ONC), an initiative of the University of Victoria, develops, operates, and maintains cabled ocean observatory systems. Technologies developed on the world-leading NEPTUNE and VENUS observatories have been adapted for small coastal installations called "community observatories," which enable community members to directly monitor conditions in the local ocean environment. In 2014, ONC pioneered an innovative educational program, Ocean Sense: Local observations, global connections, which introduces students and teachers to the technologies installed on community observatories. The program introduces middle and high school students to research methods in biology, oceanography and ocean engineering through hands-on activities. Ocean Sense includes a variety of resources and opportunities to excite students and spark curiosity about the ocean environment. The program encourages students to connect their local observations to global ocean processes and the observations of students in other geographic regions. The connection to place and local relevance of the program is further enhanced through an emphasis on Indigenous and place-based knowledge. ONC is working with coastal Indigenous communities in a collaborative process to include local knowledge, culture, and language in Ocean Sense materials. For this process to meaningful and culturally appropriate, ONC is relying on the guidance and oversight of Indigenous community educators and knowledge holders. Ocean Sense also includes opportunities for Indigenous youth and teachers in remote communities to connect in person, including an annual Ocean Science Symposium and professional development events for teachers. Building a program which embraces multiple perspectives is effective both in making ocean science more relevant to Indigenous students and in linking Indigenous knowledge and place-based knowledge to ocean science.
Julián-Santiago, Flor; García-García, Conrado; García-Olivera, Imelda; Goycochea-Robles, María Victoria; Pelaez-Ballestas, Ingris
This study aimed to estimate the prevalence of musculoskeletal (MSK) disorders and rheumatic diseases in the Chontal and Mixtec indigenous communities in the state of Oaxaca, Mexico, using the Community-Oriented Program for the Control of Rheumatic Diseases (COPCORD) methodology. After cross-culturally validating the COPCORD questionnaire for these communities, we conducted a cross-sectional, analytical, community-based census study using a house-to-house method. Positive cases of MSK disorders were assessed by primary care physicians and rheumatologists. The study population included participants aged ≥18 years from the indigenous communities of San Antonio Huitepec and San Carlos Yautepec. A total of 1061 persons participated in the study. Mean age was 46.9 years (standard deviation 19.9; age range 18-97 years); 642 (60.5 %) were women; 483 participants (45.5; 42.4-48.5 %) had MSK pain in the previous 7 days. Diagnoses were back pain 170 (16.0 %; 95 % confidence interval [CI] 13.8-18.3); osteoarthritis 157 (14.7 %; 95 % CI 12.7-17.0); rheumatic regional pain syndrome 53 (4.9 %; 95 % CI 3.7-6.4); rheumatoid arthritis 4 (0.3 %; 95 % CI 0.1-0.9); dermatomyositis 1 (0.09 %; 95 % CI 0.0-0.5); ankylosing spondylitis 1 (0.09 %; 95 % CI 0.0-0.5); systemic lupus erythematosus 1 (0.09 %; 95 % CI 0.02-0.5); and gout 1 (0.09 %; 95 % CI 0.0-0.5). 53.2 % had not received medical treatment for their disease. The prevalence of MSK disorders in indigenous communities in the Mixtec and Chontal regions is very high. The most common rheumatic diseases found were back pain and osteoarthritis. A high percentage of participants had not received medical care.
Sue E. Jackson
Full Text Available Studies that apply indigenous ecological knowledge to contemporary resource management problems are increasing globally; however, few of these studies have contributed to environmental water management. We interviewed three indigenous landowning groups in a tropical Australian catchment subject to increasing water resource development pressure and trialed tools to integrate indigenous and scientific knowledge of the biology and ecology of freshwater fish to assess their water requirements. The differences, similarities, and complementarities between the knowledge of fish held by indigenous people and scientists are discussed in the context of the changing socioeconomic circumstances experienced by indigenous communities of north Australia. In addition to eliciting indigenous knowledge that confirmed field fish survey results, the approach generated knowledge that was new to both science and indigenous participants, respectively. Indigenous knowledge influenced (1 the conceptual models developed by scientists to understand the flow ecology and (2 the structure of risk assessment tools designed to understand the vulnerability of particular fish to low-flow scenarios.
Bharti, Nidhi; Barnawal, Deepti; Maji, Deepamala; Kalra, Alok
The resilience of soil microbial populations and processes to environmental perturbation is of increasing interest as alteration in rhizosphere microbial community dynamics impacts the combined functions of plant-microbe interactions. The present study was conducted to investigate the effect of inoculation with halotolerant rhizobacteria Bacillus pumilus (STR2), Halomonas desiderata (STR8), and Exiguobacterium oxidotolerans (STR36) on the indigenous root-associated microbial (bacterial and fungal) communities in maize under non-saline and salinity stress. Plants inoculated with halotolerant rhizobacteria recorded improved growth as illustrated by significantly higher shoot and root dry weight and elongation in comparison to un-inoculated control plants under both non-saline and saline conditions. Additive main effect and multiplicative interaction ordination analysis revealed that plant growth promoting rhizobacteria (PGPR) inoculations as well as salinity are major drivers of microbial community shift in maize rhizosphere. Salinity negatively impacts microbial community as analysed through diversity indices; among the PGPR-inoculated plants, STR2-inoculated plants recorded higher values of diversity indices. As observed in the terminal-restriction fragment length polymorphism analysis, the inoculation of halotolerant rhizobacteria prevents major shift of the microbial community structure, thus enhancing the resilience capacity of the microbial communities.
Nugus, Peter; Désalliers, Julie; Morales, Juana; Graves, Lisa; Evans, Andrea; Macaulay, Ann C
This participatory research study examines the tensions and opportunities in accessing allopathic medicine, or biomedicine, in the context of a cervical cancer screening program in a rural indigenous community of Northern Ecuador. Focusing on the influence of social networks, the article extends research on "re-appropriation" of biomedicine. It does so by recognizing two competing tensions expressed through social interactions: suspicion of allopathic medicine and the desire to maximize one's health. Semistructured individual interviews and focus groups were conducted with 28 women who had previously participated in a government-sponsored cervical screening program. From inductive thematic analysis, the article traces these women's active agency in navigating coherent paths of health. Despite drawing on social networks to overcome formidable challenges, the participants faced enduring system obstacles-the organizational effects of the networks of allopathic medicine. Such obstacles need to be understood to reconcile competing knowledge systems and improve health care access in underresourced communities.
Marcela Georgina Gómez Zermeño
Full Text Available This article shows the results of an exploratory-descriptive study on intercultural competencies in community instructors of the National Council for Educational Development (CONAFE providing service in the Modality of Educational Attention to the Indigenous Population (MAEPI in the region of San Cristobal de las Casas, Chiapas. It describes the historical background of Indian education in Mexico, and the contributions to community education, and develops concepts regarding intercultural education and intercultural competencies. The research methodology adopted a mixed method based on a non-experimental, trans-sectional and naturalistic ethnographic design of convergent triangulation. The conclusions outline the need to strengthen teacher training so as to build an educational model that would fully incorporate the intercultural approach.
Full Text Available Objective. To analyze the perception in relation to when and how to perform actions for the early detection of breast and cervical cancer among women and health care providers in communities with a high percentage of indigenous population in Morelos, Mexico. Materials and methods. Ten health providers and 58 women users of health services were interviewed which have a first level of attention in five communities. The analysis was developed under the approach of the Grounded Theory. Results. Providers are poorly informed about current regulations and specific clinical indications for the detection of cervical and breast cancer. Few propitiate health literacy under intercultural sensitization. The users have imprecise or wrong notions of the early detection. Conclusions. The need for training in adherence to norms is evident. It is urgent to assume a culturally relevant approach to enable efficient communication and promote health literacy for early detection of these two cancers.
Full Text Available This article analyses an online forum on Indigenous Community-Based Economic Development (CED, in which twenty-two participants from Canada and Latin America shared and reflected on experiences ranging from cultural tourism in Bolivia to a food processing co-op in Northern British Columbia. The forum demonstrated that at least some Indigenous peoples in Canada and Latin America share common values that guide the kind of development they want in their territories and communities; and that their orientation toward collective and participatory approaches to development can be grouped together under the concept of CED. The article has two main conclusions. First, that CED can be understood as a potential path to Indigenous-defined development and complement to self-determination movements. Second, that online media is a viable option for creating spaces for learning and exchange between Indigenous peoples across national and language borders, with the potential to contribute to the creation of translocal networks.RÉSUMÉCet article analyse un forum en ligne sur les questions autochtones de développement économique communautaire (DEC, où vingt-deux participants du Canada et de l'Amérique latine partagé et réfléchi sur les expériences allant du tourisme culturel en Bolivie à un traitement coopérative alimentaire dans le Nord de la Colombie-Britannique. Le forum a démontré qu'au moins certains des peuples autochtones du Canada et de l'Amérique latine part des valeurs communs qui guident le type de développement qu'ils veulent dans leurs territoires et les communautés, et que leur orientation vers des approches collectives et participatives de développement peuvent être regroupés sous le concept de DEC. L'article a deux principales conclusions. Tout d'abord, que DEC peut être comprise comme une voie potentielle pour les communautés autochtones défini le développement et un complément de mouvements d'autodétermination. Deuxi
Hughes, J T; Barzi, F; Hoy, W E; Jones, G R D; Rathnayake, G; Majoni, S W; Thomas, M A B; Sinha, A; Cass, A; MacIsaac, R J; O'Dea, K; Maple-Brown, L J
Low serum bilirubin concentrations are reported to be strongly associated with cardio-metabolic disease, but this relationship has not been reported among Indigenous Australian people who are known to be at high risk for diabetes and chronic kidney disease (CKD). serum bilirubin will be negatively associated with markers of chronic disease, including CKD and anaemia among Indigenous Australians. A cross-sectional analysis of 594 adult Aboriginal and Torres Strait Islander (TSI) people in good health or with diabetes and markers of CKD. Measures included urine albumin: creatinine ratio (ACR), estimated glomerular filtration rate (eGFR), haemoglobin (Hb) and glycated haemoglobin (HbA1c). Diabetes was defined by medical history, medications or HbA1c≥6.5% or ≥48mmol/mol. Anaemia was defined as Hbbilirubin was performed. Participants mean (SD) age was 45.1 (14.5) years, and included 62.5% females, 71.7% Aboriginal, 41.1% with diabetes, 16.7% with anaemia, 41% with ACR>3mg/mmol and 18.2% with eGFRbilirubin concentration was lower in females than males (6 v 8μmol/L, pbilirubin; Hb and cholesterol (both positively related) and ACR, triglycerides, Aboriginal ethnicity and female gender (all inversely related). Serum bilirubin concentrations were positively associated with Hb and total cholesterol, and inversely associated with ACR. Further research to determine reasons explaining lower bilirubin concentrations among Aboriginal compared with TSI participants are needed. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.
Lalloo, Ratilal; Kroon, Jeroen; Tut, Ohnmar; Kularatna, Sanjeewa; Jamieson, Lisa M; Wallace, Valda; Boase, Robyn; Fernando, Surani; Cadet-James, Yvonne; Scuffham, Paul A; Johnson, Newell W
The aim of the study is to reduce the high prevalence of tooth decay in children in a remote, rural Indigenous community in Australia, by application of a single annual dental preventive intervention. The study seeks to (1) assess the effectiveness of an annual oral health preventive intervention in slowing the incidence of dental caries in children in this community, (2) identify the mediating role of known risk factors for dental caries and (3) assess the cost-effectiveness and cost-benefit of the intervention. The intervention is novel in that most dental preventive interventions require regular re-application, which is not possible in resource constrained communities. While tooth decay is preventable, self-care and healthy habits are lacking in these communities, placing more emphasis on health services to deliver an effective dental preventive intervention. Importantly, the study will assess cost-benefit and cost-effectiveness for broader implementation across similar communities in Australia and internationally. There is an urgent need to reduce the burden of dental decay in these communities, by implementing effective, cost-effective, feasible and sustainable dental prevention programs. Expected outcomes of this study include improved oral and general health of children within the community; an understanding of the costs associated with the intervention provided, and its comparison with the costs of allowing new lesions to develop, with associated treatment costs. Findings should be generalisable to similar communities around the world. The research is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), registration number ACTRN12615000693527; date of registration: 3rd July 2015.
Pringle, K G; Lee, Y Q; Weatherall, L; Keogh, L; Diehm, C; Roberts, C T; Eades, S; Brown, A; Smith, R; Lumbers, E R; Brown, L J; Collins, C E; Rae, K M
Childhood obesity rates are higher among Indigenous compared with non-Indigenous Australian children. It has been hypothesized that early-life influences beginning with the intrauterine environment predict the development of obesity in the offspring. The aim of this paper was to assess, in 227 mother-child dyads from the Gomeroi gaaynggal cohort, associations between prematurity, Gestation Related-Optimal Weight (GROW) centiles, maternal adiposity (percentage body fat, visceral fat area), maternal non-fasting plasma glucose levels (measured at mean gestational age of 23.1 weeks) and offspring BMI and adiposity (abdominal circumference, subscapular skinfold thickness) in early childhood (mean age 23.4 months). Maternal non-fasting plasma glucose concentrations were positively associated with infant birth weight (P=0.005) and GROW customized birth weight centiles (P=0.008). There was a significant association between maternal percentage body fat (P=0.02) and visceral fat area (P=0.00) with infant body weight in early childhood. Body mass index (BMI) in early childhood was significantly higher in offspring born preterm compared with those born at term (P=0.03). GROW customized birth weight centiles was significantly associated with body weight (P=0.01), BMI (P=0.007) and abdominal circumference (P=0.039) at early childhood. Our findings suggest that being born preterm, large for gestational age or exposed to an obesogenic intrauterine environment and higher maternal non-fasting plasma glucose concentrations are associated with increased obesity risk in early childhood. Future strategies should aim to reduce the prevalence of overweight/obesity in women of child-bearing age and emphasize the importance of optimal glycemia during pregnancy, particularly in Indigenous women.
Bailie, Ross; Matthews, Veronica; Larkins, Sarah; Thompson, Sandra; Burgess, Paul; Weeramanthri, Tarun; Bailie, Jodie; Cunningham, Frances; Kwedza, Ru; Clark, Louise
To examine the impact of state/territory policy support on (1) uptake of evidence-based continuous quality improvement (CQI) activities and (2) quality of care for Indigenous Australians. Mixed-method comparative case study methodology, drawing on quality-of-care audit data, documentary evidence of policies and strategies and the experience and insights of stakeholders involved in relevant CQI programmes. We use multilevel linear regression to analyse jurisdictional differences in quality of care. Indigenous primary healthcare services across five states/territories of Australia. 175 Indigenous primary healthcare services. A range of national and state/territory policy and infrastructure initiatives to support CQI, including support for applied research. PRIMARY AND SECONDARY OUTCOME MEASURES: (i) Trends in the consistent uptake of evidence-based CQI tools available through a research-based CQI initiative (the Audit and Best Practice in Chronic Disease programme) and (ii) quality of care (as reflected in adherence to best practice guidelines). Progressive uptake of evidence-based CQI activities and steady improvements or maintenance of high-quality care occurred where there was long-term policy and infrastructure support for CQI. Where support was provided but not sustained there was a rapid rise and subsequent fall in relevant CQI activities. Health authorities should ensure consistent and sustained policy and infrastructure support for CQI to enable wide-scale and ongoing improvement in quality of care and, subsequently, health outcomes. It is not sufficient for improvement initiatives to rely on local service managers and clinicians, as their efforts are strongly mediated by higher system-level influences. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Herman-Mercer, N. M.; Mutter, E. A.; Wilson, N. J.; Toohey, R.; Schuster, P. F.
The Indigenous Observation Network (ION) is a collaborative Community-Based Monitoring (CBM) program with both permafrost and water-quality monitoring components operating in the Yukon River Basin (YRB) of Alaska and Canada. ION is jointly facilitated by the Yukon River Inter-Tribal Watershed Council (YRITWC), an indigenous non-profit organization, and the US Geological Survey (USGS), a federal agency. The YRB is the fourth largest drainage basin in North America encompassing 855,000 square kilometers in northwestern Canada and central Alaska and is essential to the ecosystems of the Bering and Chuckchi Seas. Water is also fundamental to the subsistence and culture of the 76 Tribes and First Nations that live in the YRB providing sustenance in the form of drinking water, fish, wildlife, and vegetation. Despite the ecological and cultural significance of the YRB, the remote geography of sub-Arctic and Arctic Alaska and Canada make it difficult to collect scientific data in these locations and led to a lack of baseline data characterizing this system until recently. In response to community concerns about the quality of the YR and a desire by USGS scientists to create a long term water-quality database, the USGS and YRITWC collaborated to create ION in 2005. Surface water samples are collected by trained community technicians from Tribal Environmental Programs or First Nation Lands and Resources staff from over 35 Alaska Native Tribes and First Nations that reside along the YR and/or one of the major tributaries. Samples are analyzed at USGS laboratories in Boulder, CO and results are disseminated to participating YRB communities and the general public. This presentation will focus on the factors that have enabled the longevity and success of this program over the last decade, as well as the strategies ION uses to ensure the credibility of the data collected by community members and best practices that have facilitated the collection of surface water data in remote
Wilson, Annabelle M.; Mehta, Kaye; Miller, Jacqueline; Yaxley, Alison; Thomas, Jolene; Jackson, Kathryn; Wray, Amanda; Miller, Michelle D.
This article describes a review undertaken in 2012-2013 by Nutrition and Dietetics, Flinders University, to assess the Indigenous health curriculum of the Bachelor of Nutrition and Dietetics (BND) and Masters of Nutrition and Dietetics (MND). An action research framework was used to guide and inform inquiry. This involved four stages, each of…
Wood, Lydia; Kamper, David; Swanson, Kate
This article addresses an apparent paradox between academic and policy depictions of American Indian reservations as "broken" and "unhealthy" places, and Indigenous youth perceptions of reservations as spaces of "health" and "wellness." Public health literature often frames reservations as damaged, health-denying places, chronicling the extraordinarily high rates of suicide, substance abuse, as well as vast health disparities. Despite these dire statistics, our research with Native youth in San Diego County found that young people chose to primarily emphasize their positive experiences with, and attachments to, their reservations. In this article, we share strength- and desire-based narratives to explore how reservations can serve as spaces of wellness for Indigenous youth, despite ongoing settler colonial harm. We seek to expand the discussion on the unintended consequences of deficit-centered scholarship by arguing that health research should also engage with the narratives of hope and desire that are reflective of the way many Native youth feel about their communities. In this article, we urge scholars and practitioners to rethink how we conduct health research to include methodologies that listen to the narratives and experiences of those who, day in and day out, navigate settler colonial landscapes, while continuing to create spaces of hope and healing. Copyright © 2018 Elsevier Ltd. All rights reserved.
Velasco, Judith; González, Fanny; Díaz, Tulia; Peña-Guillén, Jesús; Araque, María
In Latin America, gastrointestinal infections represent one of the main causes of death among indigenous groups, with a mortality rate three times greater than in the general population. In this study, the carrier state of enteropathogens and the epidemiological risk factor in asymptomatic children from indigenous communities of Mérida, Venezuela, were determined. Fifty-eight healthy children, 5 years of age and under, were clinically and epidemiologically evaluated. Fecal samples were tested for a range of classic enteropathogens. Antimicrobial susceptibility tests (AST) were performed by dilution methods. Of the specimens studied, there were 34 (58.6%) positive samples, and a single enteropathogen was detected in 22 (64.6%) of these. Associations of two and three enteropathogens were observed in 10 (29.3%) and two (5.8%) cases, respectively. Blastocystis hominis (16; 47.0%) and Salmonella spp. (15; 43.9%) were the most frequently detected enteropathogens. Carriage of enteropathogens was most frequent in children older than two years. The variety of food in the daily diet was the risk factor strongly associated with the presence of parasites and/or enteric bacteria (p = 0.024 mortality due to gastrointestinal infections.
Smirnov, Andrew; Kemp, Robert; Ward, James; Henderson, Suzanna; Williams, Sidney; Dev, Abhilash; Najman, Jake M
Despite over-representation of Indigenous Australians in sentinel studies of injecting drug use, little is known about relevant patterns of drug use and dependence. This study compares drug dependence and possible contributing factors in Indigenous and non-Indigenous Australians who inject drugs. Respondent-driven sampling was used in major cities and 'peer recruitment' in regional towns of Queensland to obtain a community sample of Indigenous (n = 282) and non-Indigenous (n = 267) injectors. Data are cross sectional. Multinomial models were developed for each group to examine types of dependence on injected drugs (no dependence, methamphetamine-dependent only, opioid-dependent only, dependent on methamphetamine and opioids). Around one-fifth of Indigenous and non-Indigenous injectors were dependent on both methamphetamine and opioids in the previous 12 months. Psychological distress was associated with dual dependence on these drugs for Indigenous [adjusted relative risk (ARR) 4.86, 95% confidence interval (CI) 2.08-11.34] and non-Indigenous (ARR 4.14, 95% CI 1.59-10.78) participants. Unemployment (ARR 8.98, 95% CI 2.25-35.82) and repeated (> once) incarceration as an adult (ARR 3.78, 95% CI 1.43-9.97) were associated with dual dependence for Indigenous participants only. Indigenous participants had high rates of alcohol dependence, except for those dependent on opioids only. The drug dependence patterns of Indigenous and non-Indigenous people who inject drugs were similar, including the proportions dependent on both methamphetamine and opioids. However, for Indigenous injectors, there was a stronger association between drug dependence and contextual factors such as unemployment and incarceration. Expansion of treatment options and community-level programs may be required. [Smirnov A, Kemp R, Ward J, Henderson S, Williams S, Dev A, Najman J M. Patterns of drug dependence in a Queensland (Australia) sample of Indigenous and non-Indigenous people who
Pelz, M.; Hoeberechts, M.; Hale, C.; McLean, M. A.
This presentation describes Ocean Networks Canada's (ONC) Youth Science Ambassador Program. The Youth Science Ambassadors are a growing network of youth in Canadian coastal communities whose role is to connect ocean science, ONC data, and Indigenous knowledge. By directly employing Indigenous youth in communities in which ONC operates monitoring equipment, ONC aims to encourage wider participation and interest in ocean science and exploration. Further, the Youth Science Ambassadors act as role models and mentors to other local youth by highlighting connections between Indigenous and local knowledge and current marine science efforts. Ocean Networks Canada, an initiative of the University of Victoria, develops, operates, and maintains cabled ocean observatory systems. These include technologies developed on the world-leading NEPTUNE and VENUS observatories as well as community observatories in the Arctic and coastal British Columbia. These observatories, large and small, enable communities, users, scientists, teachers, and students to monitor real-time and historical data from the local marine environment from anywhere on the globe. Youth Science Ambassadors are part of the Learning and Engagement team whose role includes engaging Indigenous communities and schools in ocean science through ONC's K-12 Ocean Sense education program. All of the data collected by ONC are freely available over the Internet for non-profit use, including disaster planning, community-based decision making, and education. The Youth Science Ambassadors support collaboration with Indigenous communities and schools by facilitating educational programming, encouraging participation in ocean data collection and analysis, and fostering interest in ocean science. In addition, the Youth Science Ambassadors support community collaboration in decision-making for instrument deployment locations and identify ways in which ONC can help to address any areas of concern raised by the community. This
Schurer, J M; Phipps, K; Okemow, C; Beatch, H; Jenkins, E
Free-roaming dog populations are a global concern for animal and human health including transmission of infectious disease (e.g. rabies, distemper and parasites), dog bite injuries/mortalities, animal welfare and adverse effects on wildlife. In Saskatchewan (SK), Canada, veterinary care is difficult to access in the remote and sparsely inhabited northern half of the province, where the population is predominately Indigenous. Even where veterinary clinics are readily available, there are important barriers such as cost, lack of transportation, unique cultural perspectives on dog husbandry and perceived need for veterinary care. We report the effects of introducing a community action plan designed to improve animal and human health, increase animal health literacy and benefit community well-being in two Indigenous communities where a dog-related child fatality recently occurred. Initial door-to-door dog demographic surveys indicated that most dogs were sexually intact (92% of 382 dogs), and few had ever been vaccinated (6%) or dewormed (6%). Approximately three animal-related injuries requiring medical care were reported in the communities per 1000 persons per year (95% CL: 1.6-6.6), and approximately 86% of 145 environmentally collected dog faecal samples contained parasites, far above levels reported in other urban or rural settings in SK. Following two subsidized spay/neuter clinics and active rehoming of dogs, parasite levels in dog faeces decreased significantly (P important changes were observed in the dog demographic profile. This project demonstrates the importance of engaging people using familiar, local resources and taking a community specific approach. As well, it highlights the value of integrated, cross-jurisdictional cooperation, utilizing the resources of university researchers, veterinary personnel, public health, environmental health and community-based advocates to work together to solve complex issues in One Health. On-going surveillance on dog
Gone, Joseph P
In a 2014 presentation at an academic conference featuring an American Indian community audience, I critically engaged the assumptions and commitments of Indigenous Research Methodologies. These methodologies have been described as approaches and procedures for conducting research that stem from long-subjugated Indigenous epistemologies (or "ways of knowing"). In my presentation, I described a Crow Indian religious tradition known as a skull medicine as an example of an indigenous way of knowing, referring to a historical photograph of a skull medicine bundle depicted on an accompanying slide. This occasioned consternation among many in attendance, some of whom later asserted that it was unethical for me to have presented this information because of Indigenous cultural proscriptions against publicizing sacred knowledge and photographing sacred objects. This ethical challenge depends on enduring religious sensibilities in Northern Plains Indian communities, as embedded within a postcolonial political critique concerning the accession of sacred objects by Euro-American collectors during the early 20th century. I complicate these ethical claims by considering competing goods that are valued by community psychologists, ultimately acknowledging that the associated ethical challenge resists resolution in terms that would be acceptable to diverse constituencies. © Society for Community Research and Action 2017.
José M. Andrade
Full Text Available This paper reports the results of an ethnobotanical survey on the use of medicinal plants by community healers “Hampiyachakkuna” in the San Lucas Parish, province of Loja, Ecuador. A particular ethnic group, the indigenous Saraguros, inhabits this region. This study reports 183 plant species used in 75 different curative therapies by the Saraguro healers.
Andrade, José M; Lucero Mosquera, Hernán; Armijos, Chabaco
This paper reports the results of an ethnobotanical survey on the use of medicinal plants by community healers "Hampiyachakkuna" in the San Lucas Parish, province of Loja, Ecuador. A particular ethnic group, the indigenous Saraguros, inhabits this region. This study reports 183 plant species used in 75 different curative therapies by the Saraguro healers.
Lucero Mosquera, Hernán; Armijos, Chabaco
This paper reports the results of an ethnobotanical survey on the use of medicinal plants by community healers “Hampiyachakkuna” in the San Lucas Parish, province of Loja, Ecuador. A particular ethnic group, the indigenous Saraguros, inhabits this region. This study reports 183 plant species used in 75 different curative therapies by the Saraguro healers. PMID:28744470
Godinho, Sally Caroline; Woolley, Marilyn; Webb, Jessie; Winkel, Kenneth Daniel
Sustainable partnership formation in a remote Indigenous community involves social, cultural and political considerations. This article reports on the project, "Sharing Place, Learning Together: Supporting Sustainable Educational Partnerships to Advance Social Equity," funded by the Melbourne Social Equity Institute (MSEI) at the…
Pearson, Cecil A. L.; Chatterjee, Samir Ranjan
It is widely accepted that the concepts and practices of management can only be of benefit when they are anchored to the contextual architecture of people, processes, structures, and technologies. The challenge of establishing a bridging program for providing managerial competencies to Australian Indigenous people has become a serious one for…
Tibby, David; Corpus, Rohan; Walters, Darren L
Cardiovascular diseases are the leading cause of mortality in Indigenous Australians. Indigneous Australians present at a younger age and have a greater incidence of cardiac risk including smoking and diabetes than non-Indigenous Australians. Access to specialist health services is an important determinant of health care outcomes for these patients. We describe an innovative and successful for model for providing Outreach Cardiac Specialist services to Indigenous communities in rural and remote locations. The approach involves a step-wise process of a) community engagement, b) delivering recovery interventions to improve health outcomes, c) building community capacity to self manage chronic illness and promoting health and well being with the aim of d) community self governance of chronic disease and health promotion. Key elements to this process are community participation in the program, disease self-management led by local health care workers, open access that is all-inclusive utilising community-generated referral, and the translation of scientific knowledge of disease processes into community understanding and making culturally relevant connections. Specialist cardiac services and point of care diagnostics have been provided to 18 sites across rural and remote Queensland. More than 1400 episodes of care have been provided to Indigenous Australians with rheumatic heart disease, ischaemic heart disease and congenital heart conditions. Traditional values can work harmoniously with an inclusive medical approach in this relational model. Crown Copyright 2010. Published by Elsevier B.V. All rights reserved.
Sultan, Abida; Frisvad, Jens Christian; Andersen, Birgit
The indigenous fungal species populating cereal grains produce numerous plant cell wall-degrading enzymes including xylanases, which could play important role in plant-pathogen interactions and in adaptation of the fungi to varying carbon sources. To gain more insight into the grain surface......-associated enzyme activity, members of the populating fungal community were isolated, and their secretomes and xylanolytic activities assessed. Twenty-seven different fungal species were isolated from grains of six barley cultivars over different harvest years and growing sites. The isolated fungi were grown...... on medium containing barley flour or wheat arabinoxylan as sole carbon source. Their secretomes and xylanase activities were analyzed using SDS-PAGE and enzyme assays and were found to vary according to species and carbon source. Secretomes were dominated by cell wall degrading enzymes with xylanases...
Full Text Available In recent years there has been a broad conceptual discussion on processes of Social Learning (SL as the driving force of territorial management processes. Similarly, there has been a discussion on the role of the government and its implications on groups of territorial action. However, there are no studies that deal with SL in indigenous communities with the same ethnic roots but with a contrasting relation with the government and its institutionality. The present work takes on this comparison within the framework of cultural control in order to explain the course of their processes of development and territorial management. While one group shows goals towards education and spirituality, the other reveals technical and productive interests. Nevertheless, both processes exhibit a trajectory towards a culture of appropriation and self-management, against internal and external pressures. In this sense, we bring to light different local possibilities that replace the unfullfilness and backwardness of the centralized government.
Full Text Available This paper explores how to practice posthumanism in everyday life. This idea has increasingly come under scrutiny by posthumanist theorists, who are addressing fundamental ontological and epistemological questions in regard to defining an essential ‘human,' as well as the elastic boundary work between the human and nonhuman subject. Posthumanism is essential for considering today’s environmental problems and environmental science education. This paper then has three goals: developing posthumanist ontology, exploring methodology, and investigating whether environmental science education and practices can help students, teachers, and community in learning, teaching, and practicing processes. I demonstrate the complementary contributions from two Indigenous communities’ field studies that can be made when a researcher moves beyond an exclusive focus on western interests and considers participants as co-researchers. This paper concludes with a discussion of implications for this field.
Brown, Kevin; Lipsig-Mumme, Carla; Zajdow, Grazyna
Volunteering is often seen as an essential element in active citizenship and community participation, and existing literature suggests that those who volunteer young are more likely to volunteer through later stages of life. Analysis of Longitudinal Surveys of Australian Youth (LSAY), which identified factors that contribute to volunteering for…
Gordon, M.; Lockwood, M.; Schirmer, Jacki; Vanclay, F.; Hanson, D.
This paper provides practical insight into what can be done to improve the adoption of community engagement (CE) in the corporate culture of two Australian forest plantation companies. Previous research has identified that CE can be limited by corporate cultures that promote a narrow range of CE
Crellin, Ian R.
Telecottages originated in Scandinavia in the 1980s in an attempt to reverse the decline of isolated communities by giving them access to information and services, facilities for training and distance education, and the opportunity to produce income through telecommuting. In 1992-1993, the Australian government began funding the Telecentre…
Cooke, Penelope R.; Hemmings, Brian C.
The authors of this article report on a qualitative study of Australian community-based natural resource management groups known as Landcare groups. They discuss how four Landcare groups contributed to sustainability practices and how a policy change implemented in 2003 influenced the efforts of the groups to remain active in their activities.…
Cargo, Margaret; Delormier, Treena; Lévesque, Lucie; Horn-Miller, Kahente; McComber, Alex; Macaulay, Ann C
Democratic or equal participation in decision making is an ideal that community and academic stakeholders engaged in participatory research strive to achieve. This ideal, however, may compete with indigenous peoples' right to self-determination. Study objectives were to assess the perceived influence of multiple community (indigenous) and academic stakeholders engaged in the Kahnawake Schools Diabetes Prevention Project (KSDPP) across six domains of project decision making and to test the hypothesis that KSDPP would be directed by community stakeholders. Self-report surveys were completed by 51 stakeholders comprising the KSDPP Community Advisory Board (CAB), KSDPP staff, academic researchers and supervisory board members. KSDPP staff were perceived to share similar levels of influence with (i) CAB on maintaining partnership ethics and CAB activities and (ii) academic researchers on research and dissemination activities. KSDPP staff were perceived to carry significantly more influence than other stakeholders on decisions related to annual activities, program operations and intervention activities. CAB and staff were the perceived owners of KSDPP. The strong community leadership aligns KSDPP with a model of community-directed research and suggests that equitable participation-distinct from democratic or equal participation-is reflected by indigenous community partners exerting greater influence than academic partners in decision making.
Stores Healthy Options Project in Remote Indigenous Communities (SHOP@RIC): a protocol of a randomised trial promoting healthy food and beverage purchases through price discounts and in-store nutrition education.
Brimblecombe, Julie; Ferguson, Megan; Liberato, Selma C; Ball, Kylie; Moodie, Marjory L; Magnus, Anne; Miles, Edward; Leach, Amanda J; Chatfield, Mark D; Ni Mhurchu, Cliona; O'Dea, Kerin; Bailie, Ross S
Indigenous Australians suffer a disproportionate burden of preventable chronic disease compared to their non-Indigenous counterparts--much of it diet-related. Increasing fruit and vegetable intakes and reducing sugar-sweetened soft-drink consumption can reduce the risk of preventable chronic disease. There is evidence from some general population studies that subsidising healthier foods can modify dietary behaviour. There is little such evidence relating specifically to socio-economically disadvantaged populations, even though dietary behaviour in such populations is arguably more likely to be susceptible to such interventions.This study aims to assess the impact and cost-effectiveness of a price discount intervention with or without an in-store nutrition education intervention on purchases of fruit, vegetables, water and diet soft-drinks among remote Indigenous communities. We will utilise a randomised multiple baseline (stepped wedge) design involving 20 communities in remote Indigenous Australia. The study will be conducted in partnership with two store associations and twenty Indigenous store boards. Communities will be randomised to either i) a 20% price discount on fruit, vegetables, water and diet soft-drinks; or ii) a combined price discount and in-store nutrition education strategy. These interventions will be initiated, at one of five possible time-points, spaced two-months apart. Weekly point-of-sale data will be collected from each community store before, during, and for six months after the six-month intervention period to measure impact on purchasing of discounted food and drinks. Data on physical, social and economic factors influencing weekly store sales will be collected in order to identify important covariates. Intervention fidelity and mediators of behaviour change will also be assessed. This study will provide original evidence on the effectiveness and cost-effectiveness of price discounts with or without an in-store nutrition education
Dender, Alma M; Stagnitti, Karen E
Culturally relevant assessments of Australian Indigenous children's social pretend play do not exist. This study investigated the content validity and cultural validity of the Indigenous Play Partner Scale (I-PPS). Six pairs of children (i.e. 12 children) aged four-six years from a remote Australian town were videoed playing in pairs, and 14 community elders and mothers participated across three focus groups. The social interactions between the children were transcribed from the videos. Nineteen verbs, grouped into five categories of social interaction, described the social interactions between the pairs of children. The descriptions of the social interaction verbs were presented to the community elders and mothers in a focus group. The themes from the focus groups were 'background of Indigenous understanding of play' and 'proposed social interaction verbs'. The first theme reflected community collaboration, children playing in multi-aged groups and the role of older children within the play. Guided by the focus group discussion, the videos were re-analysed and 20 social interaction verbs were described that reflected the cultural context of play. The content and cultural validity of the I-PPS was established through community consultation. Twenty social interaction verbs, which form the basis of the items of the I-PPS, reflected Indigenous cultural values of being non-judgemental of Indigenous children's social interactions during pretend play. Culturally relevant assessments for Australian Indigenous children do not disadvantage this population group and are essential for practice in occupational therapy. © 2017 Occupational Therapy Australia.
Keel, Stuart; Xie, Jing; Foreman, Joshua; Taylor, Hugh R; Dirani, Mohamed
To determine the prevalence of vision loss due to ocular trauma in Australia. The National Eye Health Survey (NEHS) is a population-based cross-sectional study that examined 3098 non-Indigenous Australians (aged 50-98 years) and 1738 Indigenous Australians (aged 40-92 years) living in 30 randomly selected sites, stratified by remoteness. An eye was considered to have vision loss due to trauma if the best-corrected visual acuity was worse than 6/12 and the main cause was attributed to ocular trauma. This determination was made by two independent ophthalmologists and any disagreements were adjudicated by a third senior ophthalmologist. The sampling weight adjusted prevalence of vision loss due to ocular trauma in non-Indigenous Australians aged 50 years and older and Indigenous Australians aged 40 years and over was 0.24% (95%CI: 0.10, 0.52) and 0.79% (95%CI: 0.56, 1.13), respectively. Trauma was attributed as an underlying cause of bilateral vision loss in one Indigenous participant, with all other cases being monocular. Males displayed a higher prevalence of vision loss from ocular trauma than females in both the non-Indigenous (0.47% vs. 1.25%, p=0.03) and Indigenous populations (0.12% vs. 0.38%, p=0.02). After multivariate adjustments, residing in Very Remote geographical areas was associated with higher odds of vision loss from ocular trauma. We estimate that 2.4 per 1000 non-Indigenous and 7.9 per 1000 Indigenous Australian adults have monocular vision loss due to a previous severe ocular trauma. Our findings indicate that males, Indigenous Australians and those residing in Very Remote communities may benefit from targeted health promotion to improve awareness of trauma prevention strategies. Copyright © 2017 Elsevier Ltd. All rights reserved.
Full Text Available The Healthy Native Communities Fellowship (HNCF is a grassroots evidence-based mentorship and leadership program that develops the skills and community-building capacities of leaders and community teams to improve health status through several intermediate social and cultural mechanisms: (a strengthening social participation (also known as social capital or cohesion; (b strengthening cultural connectedness and revitalization of cultural identity; and (c advocating for health-enhancing policies, practices, and programs that strengthen systems of prevention and care, as well as address the structural social determinants of health. This leadership program uses a community-based participatory research (CBPR approach and participatory evaluation to investigate how the work of local American Indian and Alaska Native leaders (fellows and their community coalitions contributes to individual, family, and community level health outcomes.
Caxaj, Claudia Susana; Parroquia de San Miguel Ixtahuacan, Kolol Qnan Tx'otx'
The presence of large-scale mining operations poses many threats to communities. In a rural community in Guatemala, community leaders were motivated to address divisiveness and local conflict that have been exacerbated since the arrival of a mining company in the region. Prior research by our team identified spiritual and cultural strengths as important sources of strength and resilience in the community. We piloted a community-based intervention centred on spiritual and cultural practices in the region, to address divisiveness and build community harmony. One hundred and seventeen participants from over 18 villages in the municipality participated in the workshops and follow-up focus groups. Community leaders facilitated the intervention and partnered with the academic researcher throughout the research process. Overall, community members and facilitators expressed satisfaction with the workshop. Further, our analysis revealed three important processes important to the development of community harmony in the region: (a) mutual recognition and collectivisation; (b) affirmation of ancestral roots and connections to Mother Earth and (c) inspiring action and momentum towards solutions. These mechanisms, and the socio-political contexts that undermine them, have important implications for how global health programmes are developed and how collective processes for well-being are understood within an inequitable, conflict-laden world.
Miller, Brant G.; Roehrig, Gillian
Opportunities for American Indian youth to meaningfully engage in school-based science, technology, engineering, and mathematics (STEM) experiences have historically been inadequate. As a consequence, American Indian students perform lower on standardized assessments of science education than their peers. In this article we describe the emergence of meaning for students—as well as their community—resulting from Indigenous culturally-based STEM curriculum that used an American Indian tradition as a focal context. Specifically, the game of snow snakes ( Gooneginebig in Ojibwe) afforded an opportunity for STEM and culturally-based resources to work in unison. A case study research design was used with the bounded case represented by the community associated with the snow snake project. The research question guiding this study was: What forms of culturally relevant meaning do students and the community form as a result of the snow snake game? Results indicate evidence of increased student and community engagement through culturally-based STEM experiences in the form of active participation and the rejuvenation of a traditional game. Implications are discussed for using culturally-based contexts for STEM learning.
Full Text Available In June 2007, the Australian federal government sent military and policy into Indigenous communities in the Northern Territory on the premise that sexual abuse of children was rampant and a national crisis. This article draws on Foucault’s work on sovereignty and rights to argue that patriarchal white sovereignty as a regime of power deploys a discourse of pathology in the exercising of sovereign right to subjugate and discipline Indigenous people as good citizens.
Dare, Melanie (Lain); Vanclay, Frank; Schirmer, Jacki
The rapid expansion of timber plantations across Australia has been contentious, with ongoing debate in rural communities about the social, economic and environmental impacts of plantations. The need for effective and ongoing community engagement (CE) has been highlighted by this ongoing contention
Choy, Seow Huey; Al-Mekhlafi, Hesham M.; Mahdy, Mohammed A. K.; Nasr, Nabil N.; Sulaiman, Maria; Lim, Yvonne A. L.; Surin, Johari
This study was carried out to investigate the prevalence and risk factors of Giardia infection among indigenous people in rural Malaysia. Faecal samples were collected from 1,330 participants from seven states of Malaysia and examined by wet mount and formalin-ether sedimentation methods while demographic, socioeconomic and environmental information was collected using a pre-tested questionnaire. The overall prevalence of Giardia infection was 11.6% and was significantly higher among those aged ≤ 12 years compared to their older counterparts. Multivariate logistic regression identified age of ≤12 years, lacking of toilet at household, not washing hands before eating, not washing hands after playing with animals, not boiling water before consumption, bathing in the river, and not wearing shoes when outside as the significant risk factors of Giardia infection among these communities. Based on a multilocus genotyping approach (including tpi, gdh and bg gene sequences), 69 isolates were identified as assemblage A, and 69 as assemblage B. No association between the assemblages and presence of symptoms was found. Providing proper sanitation, as well as provision of clean drinking water and proper health education regarding good personal hygiene practices will help significantly in reducing the prevalence and burden of Giardia infection in these communities. PMID:25366301
Ferguson, Megan; O'Dea, Kerin; Chatfield, Mark; Moodie, Marjory; Altman, Jon; Brimblecombe, Julie
To determine the average price difference between foods and beverages in remote Indigenous community stores and capital city supermarkets and explore differences across products. A cross-sectional survey compared prices derived from point-of-sale data in 20 remote Northern Territory stores with supermarkets in capital cities of the Northern Territory and South Australia for groceries commonly purchased in remote stores. Average price differences for products, supply categories and food groups were examined. The 443 products examined represented 63% of food and beverage expenditure in remote stores. Remote products were, on average, 60% and 68% more expensive than advertised prices for Darwin and Adelaide supermarkets, respectively. The average price difference for fresh products was half that of packaged groceries for Darwin supermarkets and more than 50% for food groups that contributed most to purchasing. Strategies employed by manufacturers and supermarkets, such as promotional pricing, and supermarkets' generic products lead to lower prices. These opportunities are not equally available to remote customers and are a major driver of price disparity. Food affordability for already disadvantaged residents of remote communities could be improved by policies targeted at manufacturers, wholesalers and/or major supermarket chains. © 2015 The Authors.
Choy, Seow Huey; Al-Mekhlafi, Hesham M; Mahdy, Mohammed A K; Nasr, Nabil N; Sulaiman, Maria; Lim, Yvonne A L; Surin, Johari
This study was carried out to investigate the prevalence and risk factors of Giardia infection among indigenous people in rural Malaysia. Faecal samples were collected from 1,330 participants from seven states of Malaysia and examined by wet mount and formalin-ether sedimentation methods while demographic, socioeconomic and environmental information was collected using a pre-tested questionnaire. The overall prevalence of Giardia infection was 11.6% and was significantly higher among those aged ≤ 12 years compared to their older counterparts. Multivariate logistic regression identified age of ≤ 12 years, lacking of toilet at household, not washing hands before eating, not washing hands after playing with animals, not boiling water before consumption, bathing in the river, and not wearing shoes when outside as the significant risk factors of Giardia infection among these communities. Based on a multilocus genotyping approach (including tpi, gdh and bg gene sequences), 69 isolates were identified as assemblage A, and 69 as assemblage B. No association between the assemblages and presence of symptoms was found. Providing proper sanitation, as well as provision of clean drinking water and proper health education regarding good personal hygiene practices will help significantly in reducing the prevalence and burden of Giardia infection in these communities.
Aziz, Muhammad Abdul; Khan, Amir Hasan; Adnan, Muhammad; Ullah, Habib
The pastoral lifestyle of Indigenous communities of Bajaur Agency is bringing them close to natural remedies for treating their domestic animals. Several studies have been conducted across the globe describing the importance of traditional knowledge in veterinary care. Therefore, this study was planned with the aim to record knowledge on ethnoveterinary practices from the remote areas and share sit with other communities through published literature. Data was gathered from community members through semi-structured interviews and analyzed through informant consensus factor (Fic) to evaluate the consent of current ethnoveterinary practices among the local people. In total, 73 medicinal plants were recorded under the ethnoveterinary practices. Most widely used medicinal plants with maximum use reports (URs) were Visnaga daucoides Gaertn., Foeniculum vulgare Mill., Solanum virginianum L., Withania somnifera (L.) Dunal, Glycyrrhiza glabra L., and Curcuma longa L. New medicinal values were found with confidential level of citations for species including Heracleum candicans and Glycerhiza glabra. Family Apiaceae was the utmost family with high number (7 species) of medicinal plants. Maximum number of medicinal plants (32) was used for gastric problems. High Fic was recorded for dermatological (0.97) followed by reproductive (0.93) and gastrointestinal disorders (0.92). The main route of remedies administration was oral. Current study revealed that the study area has sufficient knowledge on ethnoveterinary medicinal plants. This knowledge is in the custody of nomadic grazers, herders, and aged community members. Plants with new medicinal uses need to be validated phytochemically and pharmacologically for the development of new alternative drugs for veterinary purposes.
Full Text Available Abstract Background Drinking water insecurity and related health outcomes often disproportionately impact Indigenous communities internationally. Understanding media coverage of these water-related issues can provide insight into the ways in which public perceptions are shaped, with potential implications for decision-making and action. This study aimed to examine the extent, range, and nature of newspaper coverage of drinking water security in Canadian Indigenous communities. Methods Using ProQuest database, we systematically searched for and screened newspaper articles published from 2000 to 2015 from Canadian newspapers: Windspeaker, Toronto Star, The Globe and Mail, and National Post. We conducted descriptive quantitative analysis and thematic qualitative analysis on relevant articles to characterize framing and trends in coverage. Results A total of 1382 articles were returned in the search, of which 256 articles were identified as relevant. There was limited coverage of water challenges for Canadian Indigenous communities, especially for Métis (5% and Inuit (3% communities. Most stories focused on government responses to water-related issues, and less often covered preventative measures such as source water protection. Overall, Indigenous peoples were quoted the most often. Double-standards of water quality between Indigenous and non-Indigenous communities, along with conflict and cooperation efforts between stakeholders were emphasized in many articles. Conclusion Limited media coverage could undermine public and stakeholder interest in addressing water-related issues faced by many Canadian Indigenous communities.
May, Samantha; Rapee, Ronald M; Coello, Mariano; Momartin, Shakeh; Aroche, Jorge
This study investigated differences in mental health knowledge and beliefs between participants from the Iraqi and Sudanese refugee communities, and Australian-born individuals, in Sydney, Australia. Ninety-seven participants were given vignettes of characters describing symptoms of major depressive disorder and posttraumatic stress. They were required to identify psychological symptoms as disorders, rate beliefs about the causes of and helpful treatments for these disorders, and rate attitude statements regarding the two characters. Australian participants recognized the presented symptoms as specific mental disorders significantly more than Iraqi and Sudanese participants did, and reported causal and treatment beliefs which were more congruent with expert beliefs as per the western medical model of mental disorder. The Sudanese group endorsed supernatural and religious causal beliefs regarding depression and posttraumatic stress symptoms most often; but both Sudanese and Iraqi participants strongly supported options from the supernatural and religious treatment items. However, evidence for pluralistic belief systems was also found. Although sampling was non-random, suggesting caution in the interpretation of results, it appears that the mental health literacy of lay Australians may be more aligned with the western medical model of mental disorder than that of Iraqi and Sudanese refugee communities. Mental health literacy support needs of Iraqi and Sudanese refugee communities resettled in western countries such as Australia might include education about specific symptoms and causes of mental disorder and the effectiveness of psychiatric treatments. These findings provide useful directions for the promotion of optimal service utilization among such communities.
Kildea, Sue; Tracy, Sally; Sherwood, Juanita; Magick-Dennis, Fleur; Barclay, Lesley
The well established disparities in health outcomes between Indigenous and non-Indigenous Australians include a significant and concerning higher incidence of preterm birth, low birth weight and newborn mortality. Chronic diseases (eg, diabetes, hypertension, cardiovascular and renal disease) that are prevalent in Indigenous Australian adults have their genesis in utero and in early life. Applying interventions during pregnancy and early life that aim to improve maternal and infant health is likely to have long lasting consequences, as recognised by Australia's National Maternity Services Plan (NMSP), which set out a 5-year vision for 2010-2015 that was endorsed by all governments (federal and state and territory). We report on the actions targeting Indigenous women, and the progress that has been achieved in three priority areas: The Indigenous maternity workforce; Culturally competent maternity care; and; Developing dedicated programs for "Birthing on Country". The timeframe for the NMSP has expired without notable results in these priority areas. More urgent leadership is required from the Australian government. Funding needs to be allocated to the priority areas, including for scholarships and support to train and retain Indigenous midwives, greater commitment to culturally competent maternity care and the development and evaluation of Birthing on Country sites in urban, rural and particularly in remote and very remote communities. Tools such as the Australian Rural Birth Index and the National Maternity Services Capability Framework can help guide this work.
Demaio, Alessandro; Drysdale, Marlene; de Courten, Maximilian
Health promotion for Australian Aboriginal and Torres Strait Islander communities and their people has generally had limited efficacy and poor sustainability. It has largely failed to recognise and appreciate the importance of local cultures and continues to have minimal emphasis on capacity building, community empowerment and local ownership. Culturally Appropriate Health Promotion is a framework of principles developed in 2008 with the World Health Organization and the Global Alliance for Health Promotion. It serves as a guide for community-focused health promotion practice to be built on and shaped by the respect for understanding and utilisation of local knowledge and culture. Culturally Appropriate Health Promotion is not about targeting, intervening or responding. Rather, it encourages health programme planners and policymakers to have a greater understanding, respect, a sense of empowerment and collaboration with communities, and their sociocultural environment to improve health. This commentary aims to examine and apply the eight principles of Culturally Appropriate Health Promotion to the Australian Aboriginal and Torres Strait Islander context. It proposes a widespread adoption of the framework for a more respectful, collaborative, locally suitable and therefore appropriate approach to Australian Aboriginal and Torres Strait Islander health promotion.
Herman-Mercer, Nicole M.; Matkin, Elli; Laituri, Melinda J.; Toohey, Ryan C; Massey, Maggie; Elder, Kelly; Schuster, Paul F.; Mutter, Edda A.
Indigenous Arctic and Subarctic communities currently are facing a myriad of social and environmental changes. In response to these changes, studies concerning indigenous knowledge (IK) and climate change vulnerability, resiliency, and adaptation have increased dramatically in recent years. Risks to lives and livelihoods are often the focus of adaptation research; however, the cultural dimensions of climate change are equally important because cultural dimensions inform perceptions of risk. Furthermore, many Arctic and Subarctic IK climate change studies document observations of change and knowledge of the elders and older generations in a community, but few include the perspectives of the younger population. These observations by elders and older generations form a historical baseline record of weather and climate observations in these regions. However, many indigenous Arctic and Subarctic communities are composed of primarily younger residents. We focused on the differences in the cultural dimensions of climate change found between young adults and elders. We outlined the findings from interviews conducted in four indigenous communities in Subarctic Alaska. The findings revealed that (1) intergenerational observations of change were common among interview participants in all four communities, (2) older generations observed more overall change than younger generations interviewed by us, and (3) how change was perceived varied between generations. We defined “observations” as the specific examples of environmental and weather change that were described, whereas “perceptions” referred to the manner in which these observations of change were understood and contextualized by the interview participants. Understanding the differences in generational observations and perceptions of change are key issues in the development of climate change adaptation strategies.
Mohammad O. Faruque
Full Text Available This study documents information on significant ethnomedicinal plants, which was collected from the traditional healers of three indigenous communities of Bangladesh. The documented data were quantitatively analyzed for the first time in this area. The information was obtained through open-ended, semi-structured questionnaires. The benefits, importance and coverage of ethnomedicine were expressed through several quantitative indices including Informant Consensus Factor (ICF, Use Value (UV, Frequency of Citation (FC, Relative Frequency of Citation (RFC and Relative Importance Index (RI. The agreement of homogeneity between the present and previous studies and among the indigenous communities was evaluated using the Jaccard Index (JI. A total of 159 ethnomedicinal plant species, which were distributed in 132 genera under 62 families, were documented from 174 informants. Of these, 128 plants were native and 31 were exotic. Of a majority of documented species, herbs and leaves were the most utilized plant parts for the preparation of ethnomedicines (45.28% whereas pastes (63.03% were the most popular formulations. Among the documented species, the dominant families were the Asteraceae (14 species and the Lamiaceae (12 species. The highest ICF value was 0.77 for digestive system disorders. Based on UVs, the five most commonly used ethnomedicinal plant species in the study area were Duabanga grandiflora (0.43, Zingiber officinale (0.41, Congea tomentosa (0.40, Matricaria chamomilla (0.33 and Engelhardtia spicata (0.28. The highest RFC was recorded for Rauvolfia serpentina (0.25. The highest RI value was calculated for both Scoparia dulcis and Leucas aspera (0.83. Importantly, 16 species were reported with new therapeutic uses and to our knowledge, 7 species described herein have never been ethnobotanically and pharmacologically studied, viz: Agastache urticifolia, Asarum cordifolium, C. tomentosa, E. spicata, Hypserpa nitida, Merremia vitifolia and
Faruque, Mohammad O.; Uddin, Shaikh B.; Barlow, James W.; Hu, Sheng; Dong, Shuang; Cai, Qian; Li, Xiaohua; Hu, Xuebo
This study documents information on significant ethnomedicinal plants, which was collected from the traditional healers of three indigenous communities of Bangladesh. The documented data were quantitatively analyzed for the first time in this area. The information was obtained through open-ended, semi-structured questionnaires. The benefits, importance and coverage of ethnomedicine were expressed through several quantitative indices including Informant Consensus Factor (ICF), Use Value (UV), Frequency of Citation (FC), Relative Frequency of Citation (RFC) and Relative Importance Index (RI). The agreement of homogeneity between the present and previous studies and among the indigenous communities was evaluated using the Jaccard Index (JI). A total of 159 ethnomedicinal plant species, which were distributed in 132 genera under 62 families, were documented from 174 informants. Of these, 128 plants were native and 31 were exotic. Of a majority of documented species, herbs and leaves were the most utilized plant parts for the preparation of ethnomedicines (45.28%) whereas pastes (63.03%) were the most popular formulations. Among the documented species, the dominant families were the Asteraceae (14 species) and the Lamiaceae (12 species). The highest ICF value was 0.77 for digestive system disorders. Based on UVs, the five most commonly used ethnomedicinal plant species in the study area were Duabanga grandiflora (0.43), Zingiber officinale (0.41), Congea tomentosa (0.40), Matricaria chamomilla (0.33) and Engelhardtia spicata (0.28). The highest RFC was recorded for Rauvolfia serpentina (0.25). The highest RI value was calculated for both Scoparia dulcis and Leucas aspera (0.83). Importantly, 16 species were reported with new therapeutic uses and to our knowledge, 7 species described herein have never been ethnobotanically and pharmacologically studied, viz: Agastache urticifolia, Asarum cordifolium, C. tomentosa, E. spicata, Hypserpa nitida, Merremia vitifolia and
Faruque, Mohammad O; Uddin, Shaikh B; Barlow, James W; Hu, Sheng; Dong, Shuang; Cai, Qian; Li, Xiaohua; Hu, Xuebo
This study documents information on significant ethnomedicinal plants, which was collected from the traditional healers of three indigenous communities of Bangladesh. The documented data were quantitatively analyzed for the first time in this area. The information was obtained through open-ended, semi-structured questionnaires. The benefits, importance and coverage of ethnomedicine were expressed through several quantitative indices including Informant Consensus Factor (ICF), Use Value (UV), Frequency of Citation (FC), Relative Frequency of Citation (RFC) and Relative Importance Index (RI). The agreement of homogeneity between the present and previous studies and among the indigenous communities was evaluated using the Jaccard Index (JI). A total of 159 ethnomedicinal plant species, which were distributed in 132 genera under 62 families, were documented from 174 informants. Of these, 128 plants were native and 31 were exotic. Of a majority of documented species, herbs and leaves were the most utilized plant parts for the preparation of ethnomedicines (45.28%) whereas pastes (63.03%) were the most popular formulations. Among the documented species, the dominant families were the Asteraceae (14 species) and the Lamiaceae (12 species). The highest ICF value was 0.77 for digestive system disorders. Based on UVs, the five most commonly used ethnomedicinal plant species in the study area were Duabanga grandiflora (0.43), Zingiber officinale (0.41), Congea tomentosa (0.40), Matricaria chamomilla (0.33) and Engelhardtia spicata (0.28). The highest RFC was recorded for Rauvolfia serpentina (0.25). The highest RI value was calculated for both Scoparia dulcis and Leucas aspera (0.83). Importantly, 16 species were reported with new therapeutic uses and to our knowledge, 7 species described herein have never been ethnobotanically and pharmacologically studied, viz: Agastache urticifolia, Asarum cordifolium, C. tomentosa, E. spicata, Hypserpa nitida, Merremia vitifolia and
This qualitative study critically explores the barriers experienced by diverse rural community stakeholders in facilitating environments that enable age-friendly social participation. Twenty-six semi-structured interviews were conducted across two rural Australian communities with stakeholders from local government, health, social care, and community organizations. Findings identify that rural community stakeholders face significant difficulties in securing resources for groups and activities catering to older adults, which subsequently impacts their capacity to undertake outreach to older adults. However, in discussing these issues, questions were raised in relation to whose responsibility it is to provide resources for community groups and organizations providing social initiatives and whose responsibility it is to engage isolated seniors. These findings provide a much-needed critical perspective on current age-friendly research by acknowledging the responsibilities of various macro-level social structures-different community-level organizations, local government, and policy in fostering environments to enable participation of diverse rural older adults.
Afonso, G. B.
We have performed observations of the sky alongside with the Indians of all Brazilian regions that made it possible localize many indigenous constellations. Some of these constellations are the same as the other South American Indians and Australian aborigines constellations. The scientific community does not have much of this information, which may be lost in one or two generations. In this work, we present a planetary-observatory that we have made in the Park of Science Newton Freire-Maia of Paraná State, in order to popularize the astronomical knowledge of the Brazilian Indians. The planetary consists, essentially, of a sphere of six meters in diameter and a projection cylinder of indigenous constellations. In this planetary we can identify a lot of constellations that we have gotten from the Brazilian Indians; for instance, the four seasonal constellations: the Tapir (spring), the Old Man (summer), the Deer (autumn) and the Rhea (winter). A two-meter height wooden staff that is posted vertically on the horizontal ground similar to a Gnomon and stones aligned with the cardinal points and the soltices directions constitutes the observatory. A stone circle of ten meters in diameter surrounds the staff and the aligned stones. During the day we observe the Sun apparent motions and at night the indigenous constellations. Due to the great community interest in our work, we are designing an itinerant indigenous planetary-observatory to be used in other cities mainly by indigenous and primary schools teachers.
Gaieski, Jill B; Owings, Amanda C; Vilar, Miguel G; Dulik, Matthew C; Gaieski, David F; Gittelman, Rachel M; Lindo, John; Gau, Lydia; Schurr, Theodore G
Discovered in the early 16th century by European colonists, Bermuda is an isolated set of islands located in the mid-Atlantic. Shortly after its discovery, Bermuda became the first English colony to forcibly import its labor by trafficking in enslaved Africans, white ethnic minorities, and indigenous Americans. Oral traditions circulating today among contemporary tribes from the northeastern United States recount these same events, while, in Bermuda, St. David's Islanders consider their histories to be linked to a complex Native American, European, and African past. To investigate the influence of historical events on biological ancestry and native cultural identity, we analyzed genetic variation in 111 members of Bermuda's self-proclaimed St. David's Island Native Community. Our results reveal that the majority of mitochondrial DNA (mtDNA) and Y-chromosome haplotypes are of African and West Eurasian origin. However, unlike other English-speaking New World colonies, most African mtDNA haplotypes appear to derive from central and southeast Africa, reflecting the extent of maritime activities in the region. In light of genealogical and oral historical data from the St. David's community, the low frequency of Native American mtDNA and NRY lineages may reflect the influence of genetic drift, the demographic impact of European colonization, and historical admixture with persons of non-native backgrounds, which began with the settlement of the islands. By comparing the genetic data with genealogical and historical information, we are able to reconstruct the complex history of this Bermudian community, which is unique among New World populations. Copyright © 2011 Wiley-Liss, Inc.
Kandasamy, Sujane; Vanstone, Meredith; Oremus, Mark; Hill, Trista; Wahi, Gita; Wilson, Julie; Davis, A Darlene; Jacobs, Ruby; Anglin, Rebecca; Anand, Sonia Savitri
Women play important roles in translating health knowledge, particularly around pregnancy and birth, in Indigenous societies. We investigated elder Indigenous women's perceptions around optimal perinatal health. Using a methodological framework that integrated a constructivist grounded-theory approach with an Indigenous epistemology, we conducted and analyzed in-depth interviews and focus groups with women from the Six Nations community in southern Ontario who self-identified as grandmothers. Our purposive sampling strategy was guided by a Six Nations advisory group and included researcher participation in a variety of local gatherings as well as personalized invitations to specific women, either face-to-face or via telephone. Three focus groups and 7 individual interviews were conducted with 18 grandmothers. The participants' experiences converged on 3 primary beliefs: pregnancy is a natural phase, pregnancy is a sacred period for the woman and the unborn child, and the requirements of immunity, security (trust), comfort, social development and parental responsibility are necessary for optimal postnatal health. Participants also identified 6 communal responsibilities necessary for families to raise healthy children: access to healthy and safe food, assurance of strong social support networks for mothers, access to resources for postnatal support, increased opportunities for children to participate in physical activity, more teachings around the impact of maternal behaviours during pregnancy and more teachings around spirituality/positive thinking. We also worked with the Six Nations community on several integrated knowledge-translation elements, including collaboration with an Indigenous artist to develop a digital story (short film). Elder women are a trusted and knowledgeable group who are able to understand and incorporate multiple sources of knowledge and deliver it in culturally meaningful ways. Thus, tailoring public health programming to include elder women
Full Text Available Though non-canonical Anglophone courses in the curriculum of European English departments are no longer seen as oddity, they are often regarded as “marginal” in comparison to the British and American canon. However, courses focusing on the cultural output of postcolonial voices, moreover of the most marginal of postcolonial voices, do not only challenge the extent to which we have managed to shift from Eurocentrism in literary theory, but also reveal the complexities of the current cultural trends, such as the frequently evoked policy of multiculturalism. The paper argues that courses which include texts by Indigenous Australian authors reveal the story of survival in a country that is literally multicultural, and stress the importance of one’s own place of utterance, which is as local as it is global. The above issues are exemplified by the works of the famous Aboriginal writers Doris Pilkington/Nugi Garimara (Follow the Rabbit-Proof Fence, 1996, John Muk Muk Burke (Bridge of Triangles, 1994 and Alexis Wright (Carpentaria, 2006.
Peña-Venegas, C.P.; Stomph, T.J.; Verschoor, G.; Echeverri, J.A.; Struik, P.C.
Outsiders often oversimplify Amazon soil use by assuming that abundantly available natural soils are poorly suited to agriculture and that sporadic anthropogenic soils are agriculturally productive. Local perceptions about the potentials and limitations of soils probably differ, but information on these perceptions is scarce. We therefore examined how four indigenous communities in the Middle Caquetá River region in the Colombian Amazon classify and use natural and anthropogenic soils. The st...
David Chen; Álvaro Rivera-Andrade; Jessica González; David Burt; Carlos Mendoza-Montano; James Patrie; Max Luna
ABSTRACT Objective To describe the prevalence of noncommunicable disease (NCD) risk factors and assess knowledge of those risk factors in the indigenous community of Santiago Atitlán in Guatemala, a lower-middle income country. Methods A population-based, cross-sectional study was conducted using a modified version of the World Health Organization’s STEPS protocol. Adults aged 20–65 years were surveyed regarding demographics and NCD risk factors, and the survey was followed by anthropometri...
Taylor, Judy; Carlisle, Karen; Farmer, Jane; Larkins, Sarah; Dickson-Swift, Virginia; Kenny, Amanda
In this paper, we consider factors significant in the success of community participation in the implementation of new oral health services. Our analysis draws on data from the Rural Engaging Communities in Oral Health (Rural ECOH) study (2014-2016). We aimed to assess the Australian relevance of a Scottish community participation framework for health service development; Remote Service Futures. Internationally, community participation in planning of health initiatives is common, but less common in new service implementation. Health managers query the legitimacy of "lay" community members, whether they will persist, and whether they can act as change agents. Our data provide evidence that helps answer these queries. Six communities, located within regions covered by two large rural primary healthcare organisations (Medicare Locals), were selected in two Australian states. Two university-based facilitators worked with a group of local residents (for each community) to monitor implementation of new oral health initiatives designed through participatory processes. Data about implementation were collected through interviews with 28 key stakeholders at the beginning of implementation and 12 months later. Data were coded, themed and analysed abductively. Five themes emerged; the inter-relationship between community motivation to participate with the fortunes of the oral health initiatives, having the "right" people involved, continuing involvement of sponsors and/or significant people, trusting working relationships between participants and perceiving benefits from participation. Findings provide evidence of a role for community participation in implementing new community services if solid partnerships with relevant providers can be negotiated and services are seen to be relevant and useful to the community. © 2017 John Wiley & Sons Ltd.
Van Nevel, Sam; De Roy, Karen; Boon, Nico
In drinking water (DW) and the distribution systems, bacterial growth and biofilm formation have to be controlled both for limiting taste or odour development and preventing clogging or biocorrosion problems. After a contamination with undesired bacteria, factors like nutrient availability and temperature will influence the survival of these invaders. Understanding the conditions enabling invaders to proliferate is essential for a holistic approach towards microbial risk assessment in DW. Pseudomonas putida was used as a model invader because this easy-growing bacterium can use a wide range of substrates. Invasion experiments in oligo- to eutrophic waters showed the requirement of both a carbon and phosphate source for survival of P. putida in DW. Addition of C, N and P enabled P. putida to grow in DW from 5.80 × 10(4) to 1.84 × 10(8) cells mL(-1) and survive for at least 12 days. However, in surface water with similar nutrient concentrations, P. putida did not survive, indicating the concomitant importance of the present indigenous microbial community of the specific water sample. Either extensive carbon or phosphate limitation can be used in water treatment design in order to obtain a DW which is not susceptible for unwanted bacterial growth. © 2013 Federation of European Microbiological Societies. Published by John Wiley & Sons Ltd. All rights reserved.
Mirna Mrkonjić Fuka
Full Text Available The objective of this study is to describe the diversity of indigenous cultivable community of the lactobacilli associated with the production of traditional Istrian cheese and to get a collection of well characterized strains. Raw milk and cheese samples were collected from three different farms in Istria during ripening. A total of 212 mesophilic and thermophilic Lactobacillus isolates as well as bulk colonies (consortia were investigated using culture-dependent approach combining phenotyping and genotyping. Biochemical fingerprinting with PhenePlate-LB system preliminary grouped 212 isolates in 16 distinct PhP types. Only one representative isolate from each PhP cluster was further analyzed by genotyping for a reliable identification at the genus and species level by employing PCR techniques and sequencing of 16S rRNA genes. Sequence analysis of 16S rRNA revealed the presence of Lactobacillus plantarum, Lactobacillus brevis, Lactobacillus casei, Lactobacillus paracasei and Lactobacillus rhamnosus. Lactobacilli were screened for possible resistance against seven selected antibiotics: ampicillin, tetracycline, penicillin, rifampin, clindamycin, erythromycin and vancomycin. Although there was no clear pattern of antimicrobial susceptibility to most tested antibiotics, all representative isolates were resistant to vancomycin. The analysis of bulk colonies by denaturing gradient gel electrophoresis (DGGE identified Lactobacillus plantarum and Lactobacillus brevis as predominant members of Lactobacillus population. Pediococcus pentosaceus, Pediococcus acidilactici, Streptococcus sp. and Leuconostoc mesenteroides were also detected as part of the analysed consortia. The prevalence of identified species and community members of lactobacilli agrees with other studies of raw milk cheese and represents a useful base for further selection.
Stanley, Linda R; Swaim, Randall C; Kaholokula, Joseph Keawe'aimoku; Kelly, Kathleen J; Belcourt, Annie; Allen, James
Health disparities exact a devastating toll upon Indigenous people in the USA. However, there has been scant research investment to develop strategies to address these inequities in Indigenous health. We present a case for increased health promotion, prevention, and treatment research with Indigenous populations, providing context to the recent NIH investment in the Intervention Research to Improve Native American Health (IRINAH) network. We discuss the disproportionate costs and consequences of disparities borne by Indigenous groups, the limited evidence base on effective intervention for this population, how population uniqueness often makes transfer of existing intervention models difficult, and additional challenges in creating interventions for Indigenous settings. Given the history of colonial disruption that has included genocide, forced removal from lands, damaging federal, state and local policies and practices, environmental contamination, and most recently, climate change, we conclude research that moves beyond minor transformations of existing majority population focused interventions, but instead truly respects Indigenous wisdom, knowledge, traditions, and aspirations is needed, and that investment in intervention science to address Indigenous health disparities represent a moral imperative.
Rasmus, Stacy M
The process that community based participatory research (CBPR) implementation takes in indigenous community contexts has serious implications for health intervention outcomes and sustainability. An evaluation of the Elluam Tungiinun (Towards Wellness) Project aimed to explore the experience of a Yup'ik Alaska Native community engaged within a CBPR process and describe the effects of CBPR process implementation from an indigenous community member perspective. CBPR is acknowledged as an effective strategy for engaging American Indian and Alaska Native communities in research process, but we still know very little about the experience from a local, community member perspective. What are the perceived outcomes of participation in CBPR from a local, community member perspective? Qualitative methods were used to elicit community member perspectives of participation in a CBPR process engaged with one Yup'ik community in southwest Alaska. Results focus on community member perceptions of CBPR implementation, involvement in the process and partnership, ownership of the project with outcomes observed and perceived at the community, family and individual levels, and challenges. A discussion of findings demonstrates how ownership of the intervention arose from a translational and indigenizing process initiated by the community that was supported and enhanced through the implementation of CBPR. Community member perspectives of their participation in the research reveal important process points that stand to contribute meaningfully to implementation science for interventions developed by and for indigenous and other minority and culturally diverse peoples.
Wang, Jian; Sandoval, Kathia; Ding, Yan [Southeaest Environmental Research Center, Florida International University, North Miami Beach, FL 33181 (United States); Stoeckel, Donald; Minard-Smith, Angela [Battelle 505 King Ave, Columbus, OH 43201 (United States); Andersen, Gary; Dubinsky, Eric A. [Earth Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA 94720 (United States); Atlas, Ronald [Department of Biology, University of Louisville, Louisville, KY 40292 (United States); Gardinali, Piero, E-mail: firstname.lastname@example.org [Southeaest Environmental Research Center, Florida International University, North Miami Beach, FL 33181 (United States); Department of Chemistry & Biochemistry, Florida International University, Miami, FL 33199 (United States)
Because of the extreme conditions of the Deepwater Horizon (DWH) release (turbulent flow at 1500 m depth and 5 °C water temperature) and the sub-surface application of dispersant, small but neutrally buoyant oil droplets < 70 μm were formed, remained in the water column and were subjected to in-situ biodegradation processes. In order to investigate the biodegradation of Macondo oil components during the release, we designed and performed an experiment to evaluate the interactions of the indigenous microbial communities present in the deep waters of the Gulf of Mexico (GOM) with oil droplets of two representative sizes (10 μm and 30 μm median volume diameter) created with Macondo source oil in the presence of Corexit 9500 using natural seawater collected at the depth of 1100–1300 m in the vicinity of the DWH wellhead. The evolution of the oil was followed in the dark and at 5 °C for 64 days by collecting sacrificial water samples at fixed intervals and analyzing them for a wide range of chemical and biological parameters including volatile components, saturated and aromatic hydrocarbons, dispersant markers, dissolved oxygen, nutrients, microbial cell counts and microbial population dynamics. A one phase exponential decay from a plateau model was used to calculate degradation rates and lag times for more than 150 individual oil components. Calculations were normalized to a conserved petroleum biomarker (30αβ-hopane). Half-lives ranged from about 3 days for easily degradable compounds to about 60 days for higher molecular weight aromatics. Rapid degradation was observed for BTEX, 2–3 ring PAHs, and n-alkanes below n-C23. The results in this experimental study showed good agreement with the n-alkane (n-C13 to n-C26) half-lives (0.6–9.5 days) previously reported for the Deepwater Horizon plume samples and other laboratory studies with chemically dispersed Macondo oil conducted at low temperatures (< 8 °C). The responses of the microbial populations also
Saenz Quitian, Alejandra; Rodríguez, Gloria Amparo
Indigenous peoples within the Murray-Darling Basin have traditionally struggled for the recognition of their cultural, social, environmental, spiritual, commercial and economic connection to the waters that they have traditionally used, as well as their right to engage in all stages of water planning processes. Despite Australian national and federal frameworks providing for the inclusion of Indigenous Australians' objectives in planning frameworks, water plans have rarely addressed these objectives in water, or the strategies to achieve them. Indeed, insufficient resources, a lack of institutional capacity in both Indigenous communities and agencies and an inadequate understanding of Indigenous people's objectives in water management have limited the extent to which Indigenous objectives are addressed in water plans within the Murray-Darling Basin. In this context, the adoption of specific guidelines to meet Indigenous requirements in relation to basin water resources is crucial to support Indigenous engagement in water planning processes. Using insights from participatory planning methods and human rights frameworks, this article outlines a set of alternative and collaborative guidelines to improve Indigenous involvement in water planning and to promote sustainable and just water allocations.
Rosso, Edoardo; McGrath, Richard
Issue addressed: Recently arrived migrants and refugees from a culturally and linguistically diverse background (CALD) may be particularly vulnerable to social exclusion. Participation in sport is endorsed as a vehicle to ease the resettlement process; however, in Australia, this is often thought as a simple matter of integration into existing sport structures (e.g. clubs). This approach fails to place actual community needs at the centre of sport engagement efforts. Methods: A consultation framework was established with South Australian CALD community leaders and organisations to scope needs for community-based alternatives to participation in traditional sport (e.g. clubs), co-design a suitable community sport program and pilot it in five communities. Interviews and questionnaire surveys were conducted with participants, community representatives, stakeholders and volunteers. Results: Regular, free soccer activities engaged 263 young people from a great variety of nationalities, including over 50% refugees, in secondary state school and community-based sites. Conclusion: Alternative community sport programs can provide a basic but valuable forum to promote physical activity and associated well being in CALD and refugee communities. So what?: Alternative approaches can extend the health benefits of sport participation to disadvantaged children and youth who are excluded from traditional sport participation opportunities.
Gauthier, G Robin; Francisco, Sara C; Khan, Bilal; Dombrowski, Kirk
Throughout North America, indigenous women experience higher rates of intimate partner violence and sexual violence than any other ethnic group, and so it is of particular importance to understand sources of support for Native American women. In this article, we use social network analysis to study the relationship between social integration and women's access to domestic violence support by examining the recommendations they would give to another woman in need. We ask two main questions: First, are less integrated women more likely to make no recommendation at all when compared with more socially integrated women? Second, are less integrated women more likely than more integrated women to nominate a formal source of support rather than an informal one? We use network data collected from interviews with 158 Canadian women residing in an indigenous community to measure their access to support. We find that, in general, less integrated women are less likely to make a recommendation than more integrated women. However, when they do make a recommendation, less integrated women are more likely to recommend a formal source of support than women who are more integrated. These results add to our understanding of how access to two types of domestic violence support is embedded in the larger set of social relations of an indigenous community.
Wong, Chin Hoong; Chen, Lee Ping; Koh, Kwee Choy; Chua, Siew Houy; Jong, Darren Chee Hiung; Mohd Fauzi, Nurliyana Mardhiah; Lim, Sue Yin
Since 2013, medical students from the International Medical University (IMU) in Malaysia have been providing primary healthcare services, under the supervision of faculty members, to the indigenous people living in Kampung Sebir. The project has allowed the students to learn experientially within a rural setting. This study aims to examine the cultural competence of IMU medical students through an examination of their perspective of the indigenous people who they serve and the role of this co...
Hattingh, H Laetitia; Scahill, Shane; Fowler, Jane L; Wheeler, Amanda J
Australian general practitioners primarily treat mental health problems by prescribing medication dispensed by community pharmacists. Pharmacists therefore have regular interactions with mental health consumers and carers. This narrative review explored the potential role of community pharmacy in mental health services. Medline, CINAHL, ProQuest, Emerald, PsycINFO, Science Direct, PubMed, Web of Knowledge and IPA were utilised. The Cochrane Library as well as grey literature and "lay" search engines such as GoogleScholar were also searched. Four systematic reviews and ten community pharmacy randomised controlled trials were identified. Various relevant reviews outlining the impact of community pharmacy based disease state or medicines management services were also identified. International studies involving professional service interventions for mental health consumers could be contextualised for the Australian setting. Australian studies of pharmacy professional services for chronic physical health conditions provided further guidance for the expansion of community pharmacy mental health professional services.
Lautenschlager, Karin; Hwang, Chiachi; Ling, Fangqiong; Liu, Wen-Tso; Boon, Nico; Köster, Oliver; Egli, Thomas; Hammes, Frederik
Indigenous bacterial communities are essential for biofiltration processes in drinking water treatment systems. In this study, we examined the microbial community composition and abundance of three different biofilter types (rapid sand, granular activated carbon, and slow sand filters) and their respective effluents in a full-scale, multi-step treatment plant (Zürich, CH). Detailed analysis of organic carbon degradation underpinned biodegradation as the primary function of the biofilter biomass. The biomass was present in concentrations ranging between 2-5 × 10(15) cells/m(3) in all filters but was phylogenetically, enzymatically and metabolically diverse. Based on 16S rRNA gene-based 454 pyrosequencing analysis for microbial community composition, similar microbial taxa (predominantly Proteobacteria, Planctomycetes, Acidobacteria, Bacteriodetes, Nitrospira and Chloroflexi) were present in all biofilters and in their respective effluents, but the ratio of microbial taxa was different in each filter type. This change was also reflected in the cluster analysis, which revealed a change of 50-60% in microbial community composition between the different filter types. This study documents the direct influence of the filter biomass on the microbial community composition of the final drinking water, particularly when the water is distributed without post-disinfection. The results provide new insights on the complexity of indigenous bacteria colonizing drinking water systems, especially in different biofilters of a multi-step treatment plant. Copyright © 2014 Elsevier Ltd. All rights reserved.
Kuhnlein, Harriet V
Traditional knowledge and practice of Indigenous Peoples related to their food use and well-being is a wealth of information for academic study and for public health nutrition. Despite unique long-evolved heritages of knowledge of ecosystem resources, Indigenous Peoples comprise 15% of the global poor, but only 5% of the world's population, and they experience poverty, discrimination, and poor nutritional health at far greater rates than mainstream populations in their nations of residence. These disparities are unacceptable in all human rights frameworks, and the call to alleviate them resonates through all human development programmes and the United Nations organizations. The scholars contributing to this special issue of Maternal and Child Nutrition describe how gender roles and the right to food for several cultures of Indigenous Peoples can be fostered to protect their unique foods and traditions, providing food sovereignty and food and nutrition security benefits, especially for women and children. Aspects of societal maternal or paternal lineality and locality, division of labour, spirituality and decision-making are described. These factors structure the impact of gender roles with Indigenous worldviews on the dynamics of family food access, its availability and use, and the use of local food biodiversity. Cultures of Indigenous Peoples in Ecuador, Nigeria, Thailand, India, Canada, Japan, and Morocco are discussed. This publication is a work of the Task Force on Traditional, Indigenous and Cultural Food and Nutrition of the International Union of Nutritional Sciences. © 2018 John Wiley & Sons Ltd.
Purcell, Rosemary; Pathé, Michele; Mullen, Paul E
This study examines the extent and nature of stalking victimisation in a random community sample. A postal survey was distributed to 3700 adult men and women selected from the electoral roll in the State of Victoria. Outcome measures included the lifetime and annual cumulative incidence of stalking, the duration and methods of harassment, rates of associated violence and responses to victimisation. Almost one in four respondents (23.4%;432) had been stalked, the unwanted behaviour they were subjected to being both repeated and fear-provoking. One in 10 (197) had experienced a protracted course of stalking involving multiple intrusions spanning a period of at least one month. Women were twice as likely as men to report having been stalked at some time in their lives, though the rates of victimisation in the 12 months prior to the study did not differ significantly according to gender. Younger people were significantly more likely than older respondents to report having been stalked. Victims were pursued by strangers in 42% of cases. The most common methods of harassment involved unwanted telephone calls, intrusive approaches and following. Associated threats (29%) and physical assaults (18%) frequently arose out of the stalking. Significant social and economic disruption was created by the stalking for 63% of victims. Most sought assistance to manage their predicament (69%). The experience of being stalked is common and appears to be increasing. Ten percent of people have been subjected at some time to an episode of protracted harassment. Assaults by stalkers are disturbingly frequent. Most victims report significant disruption to their daily functioning irrespective of exposure to associated violence.
Boreland, F; Lesjak, M; Lyle, D
In 1994 a comprehensive program was established to reduce children's blood lead levels in Broken Hill, NSW, Australia. Home remediation (abatement of lead hazards in a child's home) was included as part of a case management strategy for children with blood lead levels >or=15 microg/dL. Children with blood lead levels >or=30 microg/dL were offered immediate home remediation. Children with blood lead levels of 15-29 microg/dL were allocated to 'immediate' or 'delayed' home remediation; a subset of these participated in a randomized controlled trial (RCT) to evaluate the effectiveness of home remediation for reducing blood lead levels. One hundred and seventeen children received home remediation. One hundred and thirteen returned for follow-up blood tests, 88 of whom participated in the RCT. On average children's blood lead levels decreased by 1.7 microg/dL (10%) in the 6 months after remediation and by 2.2 microg/dL (13%) in the 6-12 months after remediation. However, remediation did not significantly change the rate of decline in blood lead levels (P=0.609). There was no evidence of association between change in children's blood lead levels and changes in lead loading in their homes. The results are consistent with the published literature, which suggests that home remediation does not reduce children's exposure to lead sufficiently to cause a moderate or greater decrease in their blood lead level. In communities where lead is widely dispersed, the study suggests that it is important to assess potential sources and pathways by which children are exposed to lead when developing an intervention plan, and the need for multiple interventions to effectively reduce blood lead levels. The findings reinforce the ongoing need for rigorous epidemiological evaluation of lead management programs to improve the evidence base, and for effective primary prevention to avoid children being exposed to lead in the first place.
Sultan, Abida; Frisvad, Jens C; Andersen, Birgit; Svensson, Birte; Finnie, Christine
The indigenous fungal species populating cereal grains produce numerous plant cell wall-degrading enzymes including xylanases, which could play important role in plant-pathogen interactions and in adaptation of the fungi to varying carbon sources. To gain more insight into the grain surface-associated enzyme activity, members of the populating fungal community were isolated, and their secretomes and xylanolytic activities assessed. Twenty-seven different fungal species were isolated from grains of six barley cultivars over different harvest years and growing sites. The isolated fungi were grown on medium containing barley flour or wheat arabinoxylan as sole carbon source. Their secretomes and xylanase activities were analyzed using SDS-PAGE and enzyme assays and were found to vary according to species and carbon source. Secretomes were dominated by cell wall degrading enzymes with xylanases and xylanolytic enzymes being the most abundant. A 2-DE-based secretome analysis of Aspergillus niger and the less-studied pathogenic fungus Fusarium poae grown on barley flour and wheat arabinoxylan resulted in identification of 82 A. niger and 31 F. poae proteins many of which were hydrolytic enzymes, including xylanases. The microorganisms that inhabit the surface of cereal grains are specialized in production of enzymes such as xylanases, which depolymerize plant cell walls. Integration of gel-based proteomics approach with activity assays is a powerful tool for analysis and characterization of fungal secretomes and xylanolytic activities which can lead to identification of new enzymes with interesting properties, as well as provide insight into plant-fungal interactions, fungal pathogenicity and adaptation. Understanding the fungal response to host niche is of importance to uncover novel targets for potential symbionts, anti-fungal agents and biotechnical applications. Copyright © 2017 Elsevier B.V. All rights reserved.
Ashleigh R. Tuite
Full Text Available Abstract Background In Canada, active tuberculosis (TB disease rates remain disproportionately higher among the Indigenous population, especially among the Inuit in the north. We used mathematical modeling to evaluate how interventions might enhance existing TB control efforts in a region of Nunavut. Methods We developed a stochastic, agent-based model of TB transmission that captured the unique household and community structure. Evaluated interventions included: (i rapid treatment of active cases; (ii rapid contact tracing; (iii expanded screening programs for latent TB infection (LTBI; and (iv reduced household density. The outcomes of interest were incident TB infections and total diagnosed active TB disease over a 10- year time period. Results Model-projected incidence in the absence of additional interventions was highly variable (range: 33–369 cases over 10 years. Compared to the ‘no additional intervention’ scenario, reducing the time between onset of active TB disease and initiation of treatment reduced both the number of new TB infections (47% reduction, relative risk of TB = 0.53 and diagnoses of active TB disease (19% reduction, relative risk of TB = 0.81. Expanding general population screening was also projected to reduce the burden of TB, although these findings were sensitive to assumptions around the relative amount of transmission occurring outside of households. Other potential interventions examined in the model (school-based screening, rapid contact tracing, and reduced household density were found to have limited effectiveness. Conclusions In a region of northern Canada experiencing a significant TB burden, more rapid treatment initiation in active TB cases was the most impactful intervention evaluated. Mathematical modeling can provide guidance for allocation of limited resources in a way that minimizes disease transmission and protects population health.
Pearson, Elissa; Mellish, Sarah; Sanders, Ben; Litchfield, Carla
Highlights: • Marine debris and marine wildlife entanglement remains a significant global issue. • We examined awareness of this issue in an Australian community sample. • Findings reveal gaps exist in terms of what entanglement is and the risks posed. • Enhancing community understanding may facilitate greater conservation action. • The ‘Seal the Loop’ initiative provides one potential mechanism for such education. - Abstract: Marine debris remains a global challenge, with significant impacts on wildlife. Despite this, there is a paucity of research examining public understanding about marine wildlife entanglement [MWE], particularly within an Australian context. The present study surveyed two hundred and thirteen participants across three coastal sites to assess familiarity with MWE and the effectiveness of a new community education initiative ‘Seal the Loop’ [STL]. Results revealed attitudes toward marine wildlife were very positive (M 40.5, SD 4.12); however 32% of participants were unable to correctly explain what MWE is and risks to wildlife were under-estimated. STL may be one method to enhance public understanding and engagement-if community familiarity with the program can be increased. For those aware of STL (<13% of the sample at the time of the study), findings revealed this was having a positive impact (e.g. learning something new, changed waste disposal behaviours)
Geia, Lynore K; Hayes, Barbara; Usher, Kim
There is increasing recognition of Indigenous perspectives from various parts of the world in relation to storytelling, research and its effects on practice. The recent emergence of storytelling or yarning as a research method in Australian Aboriginal and Torres Strait Island studies and other Indigenous peoples of the world is gaining momentum. Narratives, stories, storytelling and yarning are emerging methods in research and has wide ranging potential to shape conventional research discourse making research more meaningful and accessible for researchers. In this paper we argue for the importance of Indigenous research methods and Indigenous method(ology), within collaborative respectful partnerships with non-Indigenous researchers. It is imperative to take these challenging steps together towards better outcomes for Indigenous people and their communities. In the Australian context we as researchers cannot afford to allow the gap between Aboriginal and Torres Strait Islanders and mainstream Australia health outcomes to grow even wider. One such pathway is the inclusion of Aboriginal storytelling or yarning from an Aboriginal and Torres Strait perspective within Indigenous and non-Indigenous research paradigms. Utilising Aboriginal storytelling or yarning will provide deeper understanding; complementing a two-way research paradigm for collaborative research. Furthermore, it has significant social implications for research and clinical practice amongst Indigenous populations; thus complementing the biomedical medical paradigm.
Donaldson, Alex; Finch, Caroline F
First-aid is a recommended injury prevention and risk management strategy in community sport; however, little is known about the sport-specific competencies required by first-aid providers. To achieve expert consensus on the competencies required by community Australian Football (community-AF) sports trainers. A three-round online Delphi process. Community-AF. 16 Australian sports first-aid and community-AF experts. Rating of competencies as either 'essential', 'expected', 'ideal' or 'not required'. Results After Round 3, 47 of the 77 (61%) competencies were endorsed as 'essential' or 'expected' for a sports trainer to effectively perform the activities required to the standards expected at a community-AF club by ≥75% of experts. These competencies covered: the role of the sports trainer; the responsibilities of the sports trainer; emergency management; injury and illness assessment and immediate management; taping; and injury prevention and risk management. Four competencies (5%) were endorsed as 'ideal' or 'not required' by ≥85% of experts and were excluded from further consideration. The 26 competencies where consensus was not reached were retained as second-tier, optional competencies. Sports trainers are important members of on-field first-aid teams, providing support to both injured players and other sports medicine professionals. The competencies identified in this study provide the basis of a proposed two-tiered community-AF-specific sports trainer education structure that can be implemented by the peak sports body. This includes six mandatory modules, relating to the 'required' competencies, and a further six optional modules covering competencies on which consensus was not reached.
Naqshbandi Hayward, Mariam; Paquette-Warren, Jann; Harris, Stewart B
Given the dramatic rise and impact of chronic diseases and gaps in care in Indigenous peoples in Canada, a shift from the dominant episodic and responsive healthcare model most common in First Nations communities to one that places emphasis on proactive prevention and chronic disease management is urgently needed. The Transformation of Indigenous Primary Healthcare Delivery (FORGE AHEAD) Program partners with 11 First Nations communities across six provinces in Canada to develop and evaluate community-driven quality improvement (QI) initiatives to enhance chronic disease care. FORGE AHEAD is a 5-year research program (2013-2017) that utilizes a pre-post mixed-methods observational design rooted in participatory research principles to work with communities in developing culturally relevant innovations and improved access to available services. This intensive program incorporates a series of 10 inter-related and progressive program activities designed to foster community-driven initiatives with type 2 diabetes mellitus as the action disease. Preparatory activities include a national community profile survey, best practice and policy literature review, and readiness tool development. Community-level intervention activities include community and clinical readiness consultations, development of a diabetes registry and surveillance system, and QI activities. With a focus on capacity building, all community-level activities are driven by trained community members who champion QI initiatives in their community. Program wrap-up activities include readiness tool validation, cost-analysis and process evaluation. In collaboration with Health Canada and the Aboriginal Diabetes Initiative, scale-up toolkits will be developed in order to build on lessons-learned, tools and methods, and to fuel sustainability and spread of successful innovations. The outcomes of this research program, its related cost and the subsequent policy recommendations, will have the potential to
Frank, Sarah M; Durden, T Elizabeth
The emerging epidemic of obesity and type II diabetes in Mexico has recently propelled the nation into the public health spotlight. In the state of Yucatán, the experience of diabetes is greatly impacted by two cultural constructions of disease. In this setting, elements of Yucatec Mayan health practices as well as the biomedical model affect the approach to type II diabetes. Both frameworks offer unique understandings of the etiology of diabetes and recommend different ways to manage the condition. Based on in-depth and semi-structured interviews with both community members and clinicians, the present study seeks to understand how diabetes is understood and treated in indigenous settings in rural Yucatán. We explore the context in which community members navigate between locally available healthcare options, choose one over the other, or incorporate strategies from both into their diabetes care regimens. The tension between indigenous community members and their biomedical healthcare providers, the changing food environment of this community, and the persistence of traditional gender constructions affect the management of type II diabetes and its associated symptoms. Copyright © 2016 Elsevier Ltd. All rights reserved.
Anderson, Ian C; Bastias, Brigitte A; Genney, David R; Parkin, Pamela I; Cairney, John W G
Soil basidiomycetes play key roles in forest nutrient and carbon cycling processes, yet the diversity and structure of below ground basidiomycete communities remain poorly understood. Prescribed burning is a commonly used forest management practice and there is evidence that single fire events can have an impact on soil fungal communities but little is known about the effects of repeated prescribed burning. We have used internal transcribed spacer (ITS) terminal restriction fragment length polymorphism (T-RFLP) analysis to investigate the impacts of repeated prescribed burning every two or four years over a period of 30 years on soil basidiomycete communities in an Australian wet sclerophyll forest. Detrended correspondence analysis of ITS T-RFLP profiles separated basidiomycete communities in unburned control plots from those in burned plots, with those burned every two years being the most different from controls. Burning had no effect on basidiomycete species richness, thus these differences appear to be due to changes in community structure. Basidiomycete communities in the unburned control plots were vertically stratified in the upper 20 cm of soil, but no evidence was found for stratification in the burned plots, suggesting that repeated prescribed burning results in more uniform basidiomycete communities. Overall, the results demonstrate that repeated prescribed burning alters soil basidiomycete communities, with the effect being greater with more frequent burning.
Demaio, Alessandro Rhyll; Drysdale, Marlene; de Courten, Maximilian
building, community empowerment and local ownership. Culturally-Appropriate Health Promotion is a framework of principles developed in 2008 with the World Health Organization (Geneva) and Global Alliance for Health Promotion. It guides community-focused health promotion practice built on and shaped...... by the respect, understanding and utilisation of local knowledge and culture. Culturally-Appropriate Health Promotion is not about ‘targeting’, ‘intervening’ or ‘responding’. Rather, it results in health program planners and policy-makers understanding, respecting, empowering and collaborating with communities......, and their socio-cultural environment, towards better health. This commentary aims to examine and apply the 8 principles of Culturally-Appropriate Health Promotion to the Australian Aboriginal and Torres Strait Islander context. It proposes its widespread adoption as a framework for a more respectful...
Durey, Angela; McEvoy, Suzanne; Swift-Otero, Val; Taylor, Kate; Katzenellenbogen, Judith; Bessarab, Dawn
Effectively addressing health disparities between Aboriginal and non-Aboriginal Australians is long overdue. Health services engaging Aboriginal communities in designing and delivering healthcare is one way to tackle the issue. This paper presents findings from evaluating a unique strategy of community engagement between local Aboriginal people and health providers across five districts in Perth, Western Australia. Local Aboriginal community members formed District Aboriginal Health Action Groups (DAHAGs) to collaborate with health providers in designing culturally-responsive healthcare. The purpose of the strategy was to improve local health service delivery for Aboriginal Australians. The evaluation aimed to identify whether the Aboriginal community considered the community engagement strategy effective in identifying their health service needs, translating them to action by local health services and increasing their trust in these health services. Participants were recruited using purposive sampling. Qualitative data was collected from Aboriginal participants and health service providers using semi-structured interviews or yarning circles that were recorded, transcribed and independently analysed by two senior non-Aboriginal researchers. Responses were coded for key themes, further analysed for similarities and differences between districts and cross-checked by the senior lead Aboriginal researcher to avoid bias and establish reliability in interpreting the data. Three ethics committees approved conducting the evaluation. Findings from 60 participants suggested the engagement process was effective: it was driven and owned by the Aboriginal community, captured a broad range of views and increased Aboriginal community participation in decisions about their healthcare. It built community capacity through regular community forums and established DAHAGs comprising local Aboriginal community members and health service representatives who met quarterly and were
Hunter, Ernest; Travers, Helen; Gibson, Julie; Campion, Jonathan
The use of innovative information technology is now well established in health. However, while the gap in health status between Indigenous and other Australians is both significant and unchanging, there is limited application of these new approaches to addressing this national health priority. This may in part reflect the 'digital divide', which is another facet of Indigenous disadvantage. This paper describes an approach to address both issues in remote Indigenous settings. The Health Interactive Technology Network began as a proof-of-concept study of touchscreen technology in two Indigenous health settings. It has subsequently expanded to a number of remote Indigenous communities and developed new platforms and applications to respond to emerging health issues. In creating narrative, interactive approaches to address choices in relation to health behaviours, the community development and engagement effects of the creative process have been highlighted. These findings suggest that these approaches will be suited to further expansion in the area of mental health.
Richard Ansong Omari; Sonoko Dorothea Bellingrath-Kimura; Elsie Sarkodee Addo; Yosei Oikawa; Yoshiharu Fujii
Efforts to improve soil productive capacity aimed at boosting crop production in the Northern Ghana has primarily focused on field-based experiments with little documentation on farmer practice and local indigenous knowledge of soil management. A sample group of 114 farmers from five farming communities in the Guinea Savannah was interviewed to evaluate their indigenous knowledge of crop production practices in the context of soil health, fertilization management, and crop yield. Data were co...
Full Text Available The claim that in natural resource management (NRM a change from anthropocentric values and ethics to eco-centric ones is necessary to achieve sustainability leads to the search for eco-centric models of relationship with the environment. Indigenous cultures can provide such models; hence, there is the need for multicultural societies to further include their values in NRM. In this article, we investigate the environmental values placed on a freshwater environment of the Wet Tropics by a community of indigenous Australians. We discuss their environmental values as human values, and so as beliefs that guide communities’ understanding of how the natural world should be viewed and treated by humans. This perspective represents a step forward in our understanding of indigenous environmental values, and a way to overcome the paradigm of indigenous values as valued biophysical attributes of the environment or processes happening in landscapes. Our results show that the participant community holds biospheric values. Restoring these values in the NRM of the Wet Tropics could contribute to sustainability and environmental justice in the area.
Peña-Venegas, C P; Stomph, T J; Verschoor, G; Echeverri, J A; Struik, P C
Outsiders often oversimplify Amazon soil use by assuming that abundantly available natural soils are poorly suited to agriculture and that sporadic anthropogenic soils are agriculturally productive. Local perceptions about the potentials and limitations of soils probably differ, but information on these perceptions is scarce. We therefore examined how four indigenous communities in the Middle Caquetá River region in the Colombian Amazon classify and use natural and anthropogenic soils. The study was framed in ethnopedology: local classifications, preferences, rankings, and soil uses were recorded through interviews and field observations. These communities recognized nine soils varying in suitability for agriculture. They identified anthropogenic soils as most suitable for agriculture, but only one group used them predominantly for their swiddens. As these communities did not perceive soil nutrient status as limiting, they did not base crop-site selection on soil fertility or on the interplay between soil quality and performance of manioc genetic resources.
Full Text Available Abstract Background Australian Aboriginal children living in remote communities still experience a high burden of common infectious diseases which are generally attributed to poor hygiene and unsanitary living conditions. The objective of this systematic literature review was to examine the epidemiological evidence for a relationship between various hygiene and public health intervention strategies, separately or in combination, and the occurrence of common preventable childhood infectious diseases. The purpose was to determine what intervention/s might most effectively reduce the incidence of skin, diarrhoeal and infectious diseases experienced by children living in remote Indigenous communities. Methods Studies were identified through systematically searching electronic databases and hand searching. Study types were restricted to those included in Cochrane Collaboration Effective Practice and Organisation of Care Review Group (EPOC guidelines and reviewers assessed the quality of studies and extracted data using the same guidelines. The types of participants eligible were Indigenous populations and populations of developing countries. The types of intervention eligible for inclusion were restricted to those likely to prevent conditions caused by poor personal hygiene and poor living environments. Results The evidence showed that there is clear and strong evidence of effect of education and handwashing with soap in preventing diarrhoeal disease among children (consistent effect in four studies. In the largest well-designed study, children living in households that received plain soap and encouragement to wash their hands had a 53% lower incidence of diarrhoea (95% CI, 0.35, 0.59. There is some evidence of an effect of education and other hygiene behaviour change interventions (six studies, as well as the provision of water supply, sanitation and hygiene education (two studies on reducing rates of diarrhoeal disease. The size of these effects is
Native American and indigenous populations experience the greatest behavioural health disparities in the world. A constellation of factors impacting Native American Tribes contributes to high rates and co-morbidity of mental health disorders, substance use and sexually transmitted infection (STI),
Lúcia Helena Sasseron Roberto
Full Text Available This a report of an indigenous teachers' trainning experience undertaken by the São Paulo State Education Secretariat for Terena, Kaingang, Krenak, Guarani e Tupi-Guarani ethnic groups. Bilingual and intercultural teaching is an old demand and has been made obligatory through the I996-Brazilian Education Legislation (LDB. The planning for an Indigenous Teachers Trainning Course started in 1999 and the first course was held in 2002. Sixty Indians graduated the 2,220-hour course - 360h of which were face-to-face teaching -In September 2003. The course was based on themes of interest of the students among which: garbage disposal, biodiversity, life cycles, solar system and electricity. The teaching group faced problemas when it chose to present non Indigenous concepts about the universe and were questioned by the students. They presented their interpretation of scientific concepts. These were the most productive and successful teaching/learning moments as they were dedicated to investigate problems according to the students' own perceptions and value system. The building of concepts and intellectual I development were the highlights of the activities and representative of the Indigenous world vision and their way of building scientific knowledge based on their own culture
Ramirez-Gomez, Sara O I; Brown, Greg; Verweij, Pita A.; Boot, René
Large-scale development projects often overlap forest areas that support the livelihoods of indigenous peoples, threatening in situ conservation strategies for the protection of biological and cultural diversity. To address this problem, there is a need to integrate spatially-explicit information on
George, Amanda M; Olesen, Sarah; Tait, Robert J
Longitudinal, population-based studies can better assess the relationship of ecstasy use with depression. We examined whether change in ecstasy use was associated with change in depressive symptoms/probable depression over a 4-year period, among a large Australian sample. The Personality and Total Health project is a longitudinal general community study of Australians from Canberra and Queanbeyan. Data from the youngest cohort when aged 24-30 (N = 2, 128) and 4 years later (N = 1, 977) was included. The Goldberg depression scale and the Brief Patient Health Questionnaire measured depressive symptoms and probable depression, respectively. Multilevel growth models also considered demographics, psychosocial characteristics, and other drug use. Ecstasy use was not associated with long-term depressive symptoms or greater odds of depression in multivariate analyses. Users had more self-reported depressive symptoms when using ecstasy compared to not using. However, differences between people who had and had not ever used ecstasy largely accounted for this. Other factors were more important in the prediction of depression. It would be premature to conclude that ecstasy use is not related to the development of long-term depressive symptoms, given the relatively low level of ecstasy and other drug use in this community sample. Results showed that other factors need to be considered when investigating ecstasy use and depression.
McCalman, Janya; Tsey, Komla; Bainbridge, Roxanne; Shakeshaft, Anthony; Singleton, Michele; Doran, Christopher
While Aboriginal Australian health providers prioritise identification of local community health needs and strategies, they do not always have the opportunity to access or interpret evidence-based literature to inform health improvement innovations. Research partnerships are therefore important when designing or modifying Aboriginal Australian health improvement initiatives and their evaluation. However, there are few models that outline the pragmatic steps by which research partners negotiate to develop, implement and evaluate community-based initiatives. The objective of this paper is to provide a theoretical model of the tailoring of health improvement initiatives by Aboriginal community-based service providers and partner university researchers. It draws from the case of the Beat da Binge community-initiated youth binge drinking harm reduction project in Yarrabah. A theoretical model was developed using the constructivist grounded theory methods of concurrent sampling, data collection and analysis. Data was obtained from the recordings of reflective Community-Based Participatory Research (CBPR) processes with Aboriginal community partners and young people, and university researchers. CBPR data was supplemented with interviews with theoretically sampled project participants. The transcripts of CBPR recordings and interviews were imported into NVIVO and coded to identify categories and theoretical constructs. The identified categories were then developed into higher order concepts and the relationships between concepts identified until the central purpose of those involved in the project and the core process that facilitated that purpose were identified. The tailored alcohol harm reduction project resulted in clarification of the underlying local determinants of binge drinking, and a shift in the project design from a social marketing awareness campaign (based on short-term events) to a more robust advocacy for youth mentoring into education, employment and
Magson, Natasha R.; Craven, Rhonda G.; Nelson, Genevieve F.; Yeung, Alexander S.; Bodkin-Andrews, Gawaian H.; McInerney, Dennis M.
This research explored gender and cross-cultural similarities and differences in the motivational profiles of Indigenous Papua New Guinean (PNG) and Indigenous and non-Indigenous Australians. Secondary students (N = 1,792) completed self-report motivational measures. Invariance testing demonstrated that the Inventory of School Motivation…
In Australia, renewable energy is under pressure in the context of a highly politicised debate about how to act on climate change. The recent repeal of an established carbon tax has seen the defunding of significant renewable energy initiatives and a controversial review of the national Renewable Energy Target is threatening key drivers for investment in renewable energy. The current regulatory focus on community ‘acceptance’ does not facilitate the active community support necessary to challenge this increasingly hostile policy context. This research considers current experiences of community engagement in wind farm governance in one Australian jurisdiction. Through documentary analysis and two qualitative case studies, it examines legal and non-legal requirements for community governance mechanisms and considers how these influence wind farm development in rural areas. Findings include a problematic reliance on procedural compliance in assessing wind farm consultation, domination by vested interests, and reduced expertise in community engagement at the time it is needed most. Recommendations include integration of best practice guidelines in current regulation; harmonisation of policy settings to ensure equity across energy sectors; and an evidence-based commitment to benefit sharing as a strategy for increasing community support of rural wind farm development. - Highlights: • Changes to renewable energy policy in Australia threaten wind farm development. • Active community support is required to ensure ongoing viability of the industry. • Benefit sharing models are shown to increase community support for wind farms. • Legal frameworks reinforce a minimum compliance paradigm and entrench vested interests. • Best practice guidelines improve implementation of community engagement procedures
Jansa, Jan; Erb, Angela; Oberholzer, Hans-Rudolf; Smilauer, Petr; Egli, Simon
Arbuscular mycorrhizal fungi (AMF) are ubiquitous soil fungi, forming mutualistic symbiosis with a majority of terrestrial plant species. They are abundant in nearly all soils, less diverse than soil prokaryotes and other intensively studied soil organisms and thus are promising candidates for universal indicators of land management legacies and soil quality degradation. However, insufficient data on how the composition of indigenous AMF varies along soil and landscape gradients have hampered the definition of baselines and effect thresholds to date. Here, indigenous AMF communities in 154 agricultural soils collected across Switzerland were profiled by quantitative real-time PCR with taxon-specific markers for six widespread AMF species. To identify the key determinants of AMF community composition, the profiles were related to soil properties, land management and site geography. Our results indicate a number of well-supported dependencies between abundances of certain AMF taxa and soil properties such as pH, soil fertility and texture, and a surprising lack of effect of available soil phosphorus on the AMF community profiles. Site geography, especially the altitude and large geographical distance, strongly affected AMF communities. Unexpected was the apparent lack of a strong land management effect on the AMF communities as compared to the other predictors, which could be due to the rarity of highly intensive and unsustainable land management in Swiss agriculture. In spite of the extensive coverage of large geographical and soil gradients, we did not identify any taxon suitable as an indicator of land use among the six taxa we studied. © 2014 John Wiley & Sons Ltd.
Mirzaei, Ardalan; Carter, Stephen R; Chen, Jenny Yimin; Rittsteuer, Claudia; Schneider, Carl R
Recent changes within community pharmacy have seen a shift towards some pharmacies providing "value-added" services. However, providing high levels of service is resource intensive yet revenues from dispensing are declining. Of significance therefore, is how consumers perceive service quality (SQ). However, at present there are no validated and reliable instruments to measure consumers' perceptions of SQ in Australian community pharmacies. The aim of this study was to build a theory-grounded model of service quality (SQ) in community pharmacies and to create a valid survey instrument to measure consumers' perceptions of service quality. Stage 1 dealt with item generation using theory, prior research and qualitative interviews with pharmacy consumers. Selected items were then subjected to content validity and face validity. Stages 2 and 3 included psychometric testing among English-speaking adult consumers of Australian pharmacies. Exploratory factor analysis was used for item reduction and to explain the domains of SQ. In stage 1, item generation for SQ initially generated 113 items which were then refined, through content and face validity, down to 61 items. In stage 2, after subjecting the questionnaire to psychometric testing on the data from the first pharmacy (n = 374), the use of the primary dimensions of SQ was abandoned leaving 32 items representing 5 domains of SQ. In stage 3, the questionnaire was subject to further testing and item reduction in 3 other pharmacies (n = 320). SQ was best described using 23 items representing 6 domains: 'health and medicines advice', 'relationship quality', 'technical quality', 'environmental quality', 'non-prescription service', and 'health outcomes'. This research presents a theoretically-grounded and robust measurement scale developed for consumer perceptions of SQ in a community pharmacy. Copyright © 2018. Published by Elsevier Inc.
Mackinlay, Elizabeth; Barney, Katelyn
This article explores the implementation of PEARL (Political, Embodied, Active, and Reflective Learning) in two courses at The University of Queensland: a first-year introductory Indigenous Studies course and a second year Indigenous Education course. We draw on findings from a 2-year (2010-2011) Office for Learning and Teaching (then ALTC) funded…
Rolls, Kaye Denise; Hansen, Margaret; Jackson, Debra; Elliott, Doug
Social media platforms can create virtual communities, enabling healthcare professionals to network with a broad range of colleagues and facilitate knowledge exchange. In 2003, an Australian state health department established an intensive care mailing list to address the professional isolation experienced by senior intensive care nurses. This article describes the social network created within this virtual community by examining how the membership profile evolved from 2003 to 2009. A retrospective descriptive design was used. The data source was a deidentified member database. Since 2003, 1340 healthcare professionals subscribed to the virtual community with 78% of these (n = 1042) still members at the end of 2009. The membership profile has evolved from a single-state nurse-specific network to an Australia-wide multidisciplinary and multiorganizational intensive care network. The uptake and retention of membership by intensive care clinicians indicated that they appeared to value involvement in this virtual community. For healthcare organizations, a virtual community may be a communications option for minimizing professional and organizational barriers and promoting knowledge flow. Further research is, however, required to demonstrate a link between these broader social networks, enabling the exchange of knowledge and improved patient outcomes.
Zimmermann, Judith; Musyoki, Mary K; Cadisch, Georg; Rasche, Frank
Our objectives were to (1) monitor the proliferation of the biocontrol agent (BCA) Fusarium oxysporum f. sp. strigae strain "Foxy-2", an effective soil-borne BCA against the parasitic weed Striga hermonthica , in the rhizosphere of maize under different agro-ecologies, and (2) investigate its impact on indigenous rhizosphere fungal community abundance and composition. Field experiments were conducted in Busia and Homa Bay districts in western Kenya during two cropping seasons to account for effects of soil type, climate, growth stage and seasonality. Maize seeds were coated with or without "Foxy-2" and soils were artificially infested with S. hermonthica seeds. One treatment with nitrogen rich organic residues ( Tithonia diversifolia ) was established to compensate hypothesized resource competition between "Foxy-2" and the indigenous fungal community. Rhizosphere soil samples collected at three growth stages (i.e., EC30, EC60, EC90) of maize were subjected to abundance measurement of "Foxy-2" and total indigenous fungi using quantitative polymerase chain reaction (qPCR) analysis. Terminal restriction fragment length polymorphism (TRFLP) analysis was used to assess potential alterations in the fungal community composition in response to "Foxy-2" presence. "Foxy-2" proliferated stronger in the soils with a sandy clay texture (Busia) than in those with a loamy sand texture (Homa Bay) and revealed slightly higher abundance in the second season. "Foxy-2" had, however, only a transient suppressive effect on total indigenous fungal abundance which ceased in the second season and was further markedly compensated after addition of T. diversifolia residues. Likewise, community structure of the indigenous fungal community was mainly altered by maize growth stages, but not by "Foxy-2". In conclusion, no adverse effects of "Foxy-2" inoculation on indigenous fungal rhizosphere communities were observed corroborating the safety of this BCA under the given agro-ecologies.
Landzelius, Kyra; Shi, Xianglin
Exploring the influence of the Internet on the lives of indigenous and diasporic peoples, Kyra Landzelius leads a team of expert anthropologists and ethnographers who go on-site and on-line to explore how a diverse range of indigenous and transnational diasporic communities actually use the Internet. From the Taino Indians of the Caribbean, the U'wa of the Amazon rainforest, and the Tunomans and Assyrians of Iraq, to the Tingas and Zapatistas, Native on the Net is a lively and intriguing exploration of how new technologies have enabled these previously isolated peoples to reach new levels of communication and community: creating new communities online, confronting global corporations, or even challenging their own native traditions. Featuring case studies ranging from the Artic to the Australian outback, this book addresses important recurrent themes, such as the relationship between identity and place, community, traditional cultures and the nature of the 'indigenous'. Native on the Net is a unique contribut...
Fornssler, Barbara; McKenzie, Holly A; Dell, Colleen Anne; Laliberte, Larry; Hopkins, Carol
Drawing on three culturally specific research projects, this paper examines how community-based knowledge brokers' engagement in brokering knowledge shaped the projects' processes. Informed by Deleuze and Guattari's (1987) conceptualization of the "rhizome," we discuss how community knowledge brokers' engagement in open research-creation practices embrace the relational foundation of Indigenous research paradigms in contrast to mainstream Western research practices that are engaged as linear, objective, and outcome-oriented activities. In turn, we offer propositions for building team environments where open research-creation practices can unfold, informing a periphery of shared space for Indigenous and Western paradigms.
Full Text Available Abstract Background This article describes the local concepts indigenous Nahua women hold regarding their reproduction. Specifically it provides a description of two indigenous illnesses—isihuayo and necaxantle, it discusses their etiology, symptoms, and treatments, and it analyzes them within the local ethnomedical framework and sociopolitical context. A perception of female vulnerability is shown to be an underlying shaper of women’s experiences of these illnesses. Methods This research took place in a small Nahua village in Mexico. Qualitative data on local perceptions of these illnesses were collected by a combination of participant observation and interviews. Ethnobotanical data was obtained through interviews, and medicinal plants were collected in home gardens, fields, stream banks, and forested areas. The total study population consisted of traditional birth attendants (N = 5, clinicians (N = 8, and laywomen (N = 48. Results Results showed that 20% of the village women had suffered from one or both of these illnesses. The article includes a detailed description of the etiology, symptoms, and treatments of these illnesses. Data shows that they were caused by mechanical, physical, and social factors related to a woman’s weakness and/or lack of support. Traditional birth attendants often treated women’s illnesses. Five medicinal plants were salient in the treatment of these illnesses: Ocimum basilicum L., Mentzelia aspera L., Pedilanthus tithymaloides (L. Poit., and Piper umbellatum L. were used for isihuayo, while Solanum wendlandii Hook f. was used for necaxantle. Conclusions The research on these two ethnomedical conditions is a useful case study to understanding how indigenous women experience reproductive health. Reproductive health is not simply about clinically-based medicine but is also about how biomedicine intersects with the local bodily concepts. By describing and analyzing indigenous women’s ill health, one can focus
Full Text Available Question: What are the experiences of Indigenous children with physical disability and their carers of their community-based physiotherapy service? What factors influence their experiences of the physiotherapy service and how could the service be improved? Design: A qualitative study using in-depth, semi-structured open-ended interviews consistent with the researchers’ interpretivist perspectives and ethical principles of Indigenous health research. Interviews were audio recorded, transcribed and coded for themes with qualitative research software using inductive analysis. The interviews were then checked for transcription accuracy and the themes were confirmed with the participants. Participants: Nine parents and foster carers of children with physical disability aged 0 to 21 years, five children and youth with physical disability aged 8 to 21 years. Results: The data generated three themes, which informed practice recommendations: carers of children with physical disability experience increased demands and complexity in their lives; relationships involving caring, consistency and communication are important to consumers using the physiotherapy service; and being Indigenous influences consumers’ experiences in ways that may not be obvious to non-Indigenous service providers. The issue of communication underpinned the participants’ experiences throughout these themes. Conclusion: The research highlighted the importance of effective communication, developing relationships, viewing the child wholistically and recognising the influence of being Indigenous on clients’ healthcare needs and experiences. The results suggested that community-based physiotherapists adopt a family/person-centred, context-specific approach when working with Indigenous children with a physical disability and their carers. [Greenstein C, Lowell A, Thomas D (2016 Communication and context are important to Indigenous children with physical disability and their carers
Full Text Available The paper begins by noting the low level of reference to Indigenous Australians in the Commonwealth Constitution at the start of Federation, and goes on to discuss the limits to what was achieved by the 1967 amendments. The situation represents a marked contrast with the USA and Canada in terms of treaties and constitutional recognition. In Australia, particularly during the period of the ‘Reconciliation’ process in the 1990s, important steps were taken by Indigenous Australians to identify items of ‘unfinished business’ in a ‘Statement of Indigenous Rights’. But there has been limited progress to meet these aspirations. And Australian law still lacks a tradition of recognition of human rights generally, let alone Indigenous rights. International law, too, largely lacked recognition of human rights, generally prior to the adoption in 1945 of the Charter of the United Nations. The brief references in the Charter were subsequently developed in a range of declarations and of treaties. These applied to people generally, with scant reference to Indigenous peoples. But, since the 1970s, there has been growing international recognition of the rights of Indigenous peoples under existing declarations and treaties. Since the 1990s, in particular, the UN system has established specific mechanisms for addressing such issues. On 13 September 2007, the General Assembly finally adopted a Declaration on the Rights of Indigenous Peoples.
Callaway, Libby; Winkler, Dianne; Tippett, Alice; Herd, Natalie; Migliorini, Christine; Willer, Barry
Consideration of the relationship between meaningful participation, health and wellbeing underpins occupational therapy intervention, and drives measurement of community integration following acquired brain injury (ABI). However, utility of community integration measures has been limited to date by lack of normative data against which to compare outcomes, and none examine the growing use of electronic social networking (ESN) for social participation. This research had four aims: (i) develop and pilot items assessing ESN to add to the Community Integration Questionnaire, producing the Community Integration Questionnaire-Revised (CIQ-R); (ii) examine factor structure of the CIQ-R; (iii) collect Australian CIQ-R normative data; and (iv) assess test-retest reliability of the revised measure. Australia. A convenience sample of adults without ABI (N = 124) was used to develop and pilot ESN items. A representative general population sample of adults without ABI aged 18-64 years (N = 1973) was recruited to gather normative CIQ-R data. Cross-sectional survey. Demographic items and the CIQ-R. The CIQ-R demonstrated acceptable psychometric properties, with minor modification to the original scoring based on the factor analyses provided. Large representative general population CIQ-R normative data have been established, detailing contribution of a range of independent demographic variables to community integration. The addition of electronic social networking items to the CIQ-R offers a contemporary method of assessing community integration following ABI. Normative CIQ-R data enhance the understanding of community integration in the general population, allowing occupational therapists and other clinicians to make more meaningful comparisons between groups. © 2016 Occupational Therapy Australia.
Dell'Arciprete, Ana; Braunstein, José; Touris, Cecilia; Dinardi, Graciela; Llovet, Ignacio; Sosa-Estani, Sergio
Ninety percent of the aboriginal communities of Argentina are located in areas of endemic vectorial transmission of Chagas disease. Control activities in these communities have not been effective. The goal of this research was to explore the role played by beliefs, habits, and practices of Pilaga and Wichi indigenous communities in their interaction with the local health system in the province of Formosa. This article contributes to the understanding of the cultural barriers that affect the communication process between indigenous peoples and their health care providers. Twenty-nine open ended interviews were carried out with members of four indigenous communities (Pilaga and Wichi) located in central Formosa. These interviews were used to describe and compare these communities' approach to health and disease as they pertain to Chagas as well as their perceptions of Western medicine and its incarnation in local health practice. Five key findings are presented: 1) members of these communities tend to see disease as caused by other people or by the person's violation of taboos instead of as a biological process; 2) while the Pilaga are more inclined to accept Western medicine, the Wichi often favour the indigenous approach to health care over the Western approach; 3) members of these communities do not associate the vector with the transmission of the disease and they have little awareness of the need for vector control activities; 4) indigenous individuals who undergo diagnostic tests and accept treatment often do so without full information and knowledge; 5) the clinical encounter is rife with conflict between the expectations of health care providers and those of members of these communities. Our analysis suggests that there is a need to consider the role of the cultural patterning of health and disease when developing interventions to prevent and control Chagas disease among indigenous communities in Northern Argentina. This is especially important when
Gruen, Russell; Bailie, Ross
People in remote Aboriginal communities in the Northern Territory have greater morbidity and mortality than other Australians, but face considerable barriers when accessing hospital-based specialist services. The Specialist Outreach Service, which began in 1997, was a novel policy initiative to improve access by providing a regular multidisciplinary visiting specialist services to remote communities. It led to two interesting juxtapositions: that of 'state of the art' specialist services alongside under-resourced primary care in remote and relatively traditional Aboriginal communities; and that of attempts to develop an evidence base for the effectiveness of outreach, while meeting the short-term evaluative requirements of policy-makers. In this essay, first we describe the development of the service in the Northern Territory and its initial process evaluation. Through a Cochrane systematic review we then summarise the published research on the effectiveness of specialist outreach in improving access to tertiary and hospital-based care. Finally we describe the findings of an observational population-based study of the use of specialist services and the impact of outreach to three remote communities over 11 years. Specialist outreach improves access to specialist care and may lessen the demand for both outpatient and inpatient hospital care. Specialist outreach is, however, dependent on well-functioning primary care. According to the way in which outreach is conducted and the service is organised, it can either support primary care or it can hinder primary care and, as a result, reduce its own effectiveness.
Full Text Available The community structure of the alimentary tract bacteria of two Australian fruit fly species, Bactrocera cacuminata (Hering and Bactrocera tryoni (Froggatt, was studied using a molecular cloning method based on the 16S rRNA gene. Differences in the bacterial community structure were shown between the crops and midguts of the two species and sexes of each species. Proteobacteria was the dominant bacterial phylum in the flies, especially bacteria in the order Gammaproteobacteria which was prominent in all clones. The total bacterial community consisted of Proteobacteria (more than 75% of clones, except in the crop of B. cacuminata where more than 50% of clones belonged to Firmicutes. Firmicutes gave the number of the secondary community structure in the fly’s gut. Four orders, Alpha-, Beta-, Delta- and Gammaproteobacteria and the phyla Firmicutes and Actinobacteria were found in both fruit fly species, while the order Epsilonproteobacteria and the phylum Bacteroidetes were found only in B. tryoni. Two phyla, Actinobacteria and Bacteroidetes, were rare and less frequent in the flies. There was a greater diversity of bacteria in the crop of the two fruit fly species than in the midgut. The midgut of B. tryoni females and the midgut of B. cacuminata males had the lowest bacterial diversity.
Full Text Available Critics suggest that Reducing Emissions from Deforestation and forest Degradation (REDD+ may not generate improvements in well-being for participating stakeholders, and may in fact undermine indigenous rights. To ensure positive social benefits from REDD+ projects, the United Nations REDD Programme has proposed core safeguards, including local stakeholder participation; free, prior, and informed consent; and equitable distribution of benefits. However, there is little experience to date in implementing and evaluating these safeguards. We apply these core safeguards as a framework to study how people in indigenous communities in the Ecuadorian Amazon perceive and benefit from Programa Socio Bosque, a conservation incentive program in Ecuador's national REDD+ Programme portfolio. We interviewed 101 individuals in five communities that had participated in the Programa Socio Bosque for at least 18 months. Close to 80% of respondents reported that the decision to join Socio Bosque was made democratically, that they were familiar with the conservation goals of Socio Bosque, and that they were aware which area their community had selected for conservation. However, only 17% were familiar with the overall terms of the conservation agreement, implying that they were either not fully informed of or did not fully understand what they were consenting to in joining the program. Although the terms of the program require a community investment plan to be democratically developed by community members, less than half of respondents were aware of the existence of the investment plan, and fewer than 20% had participated in its development. The majority of respondents (61% reported that they did not know the amount of incentives that their community currently receives, and only 44% stated that incentives were managed democratically in communal assemblies. Moreover, although a slight majority (53% said they had noticed benefits to the community from participating in
Sun, Wei; Qian, Xun; Gu, Jie; Wang, Xiao-Juan; Li, Yang; Duan, Man-Li
Three different organic-phosphorus-min