Design and implementation of a dental caries prevention trial in remote Canadian Aboriginal communities.

Science.gov (United States)

Harrison, Rosamund; Veronneau, Jacques; Leroux, Brian

2010-05-13

The goal of this cluster randomized trial is to test the effectiveness of a counseling approach, Motivational Interviewing, to control dental caries in young Aboriginal children. Motivational Interviewing, a client-centred, directive counseling style, has not yet been evaluated as an approach for promotion of behaviour change in indigenous communities in remote settings. Aboriginal women were hired from the 9 communities to recruit expectant and new mothers to the trial, administer questionnaires and deliver the counseling to mothers in the test communities. The goal is for mothers to receive the intervention during pregnancy and at their child's immunization visits. Data on children's dental health status and family dental health practices will be collected when children are 30-months of age. The communities were randomly allocated to test or control group by a random "draw" over community radio. Sample size and power were determined based on an anticipated 20% reduction in caries prevalence. Randomization checks were conducted between groups. In the 5 test and 4 control communities, 272 of the original target sample size of 309 mothers have been recruited over a two-and-a-half year period. A power calculation using the actual attained sample size showed power to be 79% to detect a treatment effect. If an attrition fraction of 4% per year is maintained, power will remain at 80%. Power will still be > 90% to detect a 25% reduction in caries prevalence. The distribution of most baseline variables was similar for the two randomized groups of mothers. However, despite the random assignment of communities to treatment conditions, group differences exist for stage of pregnancy and prior tooth extractions in the family. Because of the group imbalances on certain variables, control of baseline variables will be done in the analyses of treatment effects. This paper explains the challenges of conducting randomized trials in remote settings, the importance of thorough

Factors that drive the gap in diabetes rates between Aboriginal and non-Aboriginal people in non-remote NSW.

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Reeve, Rebecca; Church, Jody; Haas, Marion; Bradford, Wylie; Viney, Rosalie

2014-10-01

To identify factors underpinning the gap in diabetes rates between Aboriginal and non-Aboriginal people in non-remote NSW. This will indicate appropriate target areas for policy and for monitoring progress towards reducing the gap. Data from the 2004-05 National Health Survey and National Aboriginal and Torres Strait Islander Health Survey were used to estimate differences in self-reported diabetes rates and risk/prevention factors between Aboriginal and non-Aboriginal people in non-remote NSW. Logistic regression models were used to investigate the contribution of each factor to predicting the probability of diabetes. Risk factors for diabetes are more prevalent and diabetes rates 2.5 to 4 times higher in Aboriginal compared to non-Aboriginal adults in non-remote NSW. The odds of (known) diabetes for both groups are significantly higher for older people, those with low levels of education and those who are overweight or obese. In the Aboriginal sample, the odds of diabetes are significantly higher for people reporting forced removal of their relatives. Differences in BMI and education appear to be driving the diabetes gap, together with onset at younger ages in the Aboriginal population. Psychological distress, indicated by removal of relatives, may contribute to increased risk of diabetes in the Aboriginal population. The results imply that improved nutrition and exercise, capacity to access and act upon health care information and early intervention are required to reduce the diabetes gap. Current strategies appear to be appropriately aligned with the evidence; however, further research is required to determine whether implementation methods are effective. © 2014 Public Health Association of Australia.

'Gotta be sit down and worked out together': views of Aboriginal caregivers and service providers on ways to improve dementia care for Aboriginal Australians.

Science.gov (United States)

Smith, Kate; Flicker, Leon; Shadforth, Geraldine; Carroll, Emily; Ralph, Naomi; Atkinson, David; Lindeman, Melissa; Schaper, Frank; Lautenschlager, Nicola T; LoGiudice, Dina

2011-01-01

Dementia is five-fold more prevalent among Aboriginal than non-Aboriginal Australians. Despite this, the quality of care available to people living with dementia in remote Aboriginal communities is poor. The objective of this study was to determine ways to overcome factors affecting the successful delivery of services to Aboriginal people with dementia living in remote communities, and to their families and communities. This qualitative research took place in the Kimberley Region of Western Australia. Data collection occurred in three stages: (1) interviews with service providers to identify the services available; (2) interviews with the caregivers of Aboriginal people living with dementia and community-based care workers; and (3) focus groups with community representatives and community care staff. Each stage was concluded when no new themes emerged. At each stage the transcribed information was analysed and joint interpretation identified common themes. In total, 42 service providers, 31 caregivers and community-based care workers were interviewed and 3 focus groups were conducted. Obstacles to accessing quality care were mentioned and recommendations on ways to improve care were made. The key themes that emerged were caregiver role, perspectives of dementia, community and culturally-appropriate care, workforce, education and training, issues affecting remote communities and service issues. Detailed information on how each theme affects the successful delivery of dementia care is provided. These research findings indicate that people living with dementia and their caregivers in remote Aboriginal communities are struggling to cope. They are requesting and require better community care. Implementing a culturally safe model of dementia care for remote Aboriginal communities that encompasses the recommendations made and builds on the strengths of the communities could potentially deliver the required improvements to dementia care for this population.

Evaluating a handwashing with soap program in Australian remote Aboriginal communities: a pre and post intervention study design.

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McDonald, Elizabeth; Cunningham, Teresa; Slavin, Nicola

2015-11-27

The No Germs on Me (NGoM) Social Marketing Campaign to promote handwashing with soap to reduce high rates of infection among children living in remote Australian Aboriginal communities has been ongoing since 2007. Recently three new television commercials were developed as an extension of the NGoM program. This paper reports on the mass media component of this program, trialling an evaluation design informed by the Theory of Planned Behaviour (TPB). A survey questionnaire taking an ecological approach and based on the principals and constructs of the TPB was developed. Surveys were completed in six discrete Aboriginal communities immediately before and on completion of four weeks intensive televising of the three new commercials. Across the six communities access in the home to a television that worked ranged from 49 to 83 % (n = 415). Seventy-seven per cent (n = 319) of participants reported having seen one or more of the new commercials. Levels of acceptability and comprehension of the content of the commercials was high (97 % n = 308). Seventy-five per cent (n = 651) of participants reported they would buy more soap, toilet paper and facial tissues if these were not so expensive in their communities. For TPB constructs demonstrated to have good internal reliability the findings were mixed and these need to be interpreted with caution due to limitations in the study design. Cultural, social-economic and physical barriers in remote communities make it challenging to promote adults and children wash their hands with soap and maintain clean faces such that these behaviours become habit. Low levels of access to a television in the home illustrate the extreme level of disadvantage experienced in these communities. Highlighting that social marketing programs have the potential to increase disadvantage if expensive items such as television sets are needed to gain access to information. This trial of a theory informed evaluation design allowed for new and rich

The Role of Aboriginal Literacy in Improving English Literacy in Remote Aboriginal Communities: An Empirical Systems Analysis with the Interplay Wellbeing Framework

Science.gov (United States)

Wilson, Byron; Quinn, Stephen J.; Abbott, Tammy; Cairney, Sheree

2018-01-01

Indigenous language endangerment is critical in Australia, with only 120 of 250 known languages remaining, and only 13 considered strong. A related issue is the gap in formal education outcomes for Aboriginal and Torres Strait Islander people compared with other Australians, with the gap wider in remote regions. Little empirical research exists in…

Healthy Buddies[TM] Reduces Body Mass Index Z-Score and Waist Circumference in Aboriginal Children Living in Remote Coastal Communities

Science.gov (United States)

Ronsley, Rebecca; Lee, Andrew S.; Kuzeljevic, Boris; Panagiotopoulos, Constadina

2013-01-01

Background: Aboriginal children are at increased risk for obesity and type 2 diabetes. Healthy Buddies [TM]-First Nations (HB) is a curriculum-based, peer-led program promoting healthy eating, physical activity, and self-esteem. Methods: Although originally designed as a pilot pre-/post-analysis of 3 remote Aboriginal schools that requested and…

Research protocol for the Picture Talk Project: a qualitative study on research and consent with remote Australian Aboriginal communities.

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Fitzpatrick, Emily F M; Carter, Maureen; Oscar, June; Lawford, Tom; Martiniuk, Alexandra L C; D'Antoine, Heather A; Elliott, Elizabeth J

2017-12-28

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

Strongyloides seroprevalence before and after an ivermectin mass drug administration in a remote Australian Aboriginal community.

Directory of Open Access Journals (Sweden)

Therese M Kearns

2017-05-01

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

Long-term trends in supply and sustainability of the health workforce in remote Aboriginal communities in the Northern Territory of Australia.

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Zhao, Yuejen; Russell, Deborah J; Guthridge, Steven; Ramjan, Mark; Jones, Michael P; Humphreys, John S; Carey, Timothy A; Wakerman, John

2017-12-19

International evidence suggests that a key to improving health and attaining more equitable health outcomes for disadvantaged populations is a health system with a strong primary care sector. Longstanding problems with health workforce supply and turnover in remote Aboriginal communities in the Northern Territory (NT), Australia, jeopardise primary care delivery and the effort to overcome the substantial gaps in health outcomes for this population. This research describes temporal changes in workforce supply in government-operated clinics in remote NT communities through a period in which there has been a substantial increase in health funding. Descriptive and Markov-switching dynamic regression analysis of NT Government Department of Health payroll and financial data for the resident health workforce in 54 remote clinics, 2004-2015. The workforce included registered Remote Area Nurses and Midwives (nurses), Aboriginal Health Practitioners (AHPs) and staff in administrative and logistic roles. total number of unique employees per year; average annual headcounts; average full-time equivalent (FTE) positions; agency employed nurse FTE estimates; high and low supply state estimates. Overall increases in workforce supply occurred between 2004 and 2015, especially for administrative and logistic positions. Supply of nurses and AHPs increased from an average 2.6 to 3.2 FTE per clinic, although supply of AHPs has declined since 2010. Each year almost twice as many individual NT government-employed nurses or AHPs are required for each FTE position. Following funding increases, some clinics doubled their nursing and AHP workforce and achieved relative stability in supply. However, most clinics increased staffing to a much smaller extent or not at all, typically experiencing a "fading" of supply following an initial increase associated with greater funding, and frequently cycling periods of higher and lower staffing levels. Overall increases in workforce supply in remote NT

No germs on me: a social marketing campaign to promote hand-washing with soap in remote Australian Aboriginal communities.

Science.gov (United States)

McDonald, Elizabeth; Slavin, Nicola; Bailie, Ross; Schobben, Xavier

2011-03-01

A social marketing campaign promoting hand-washing with soap was implemented to reduce the high burden of infection experienced by Australian Aboriginal children living in remote communities. Epidemiological evidence of effect and other evidence were used to identify the hygiene intervention and health promotion approach for the project. We drew on the findings of: (i) a systematic literature review to identify the intervention for which there is strong effect in similar populations and contexts; and (ii) a narrative literature review to determine our health promotion approach. This process provided practitioners with confidence and understanding so they could address a complex problem in a politically and otherwise sensitive context.

A program to respond to otitis media in remote Australian Aboriginal communities: a qualitative investigation of parent perspectives.

Science.gov (United States)

Jones, Caroline; Sharma, Mridula; Harkus, Samantha; McMahon, Catherine; Taumoepeau, Mele; Demuth, Katherine; Mattock, Karen; Rosas, Lee; Wing, Raelene; Pawar, Sulabha; Hampshire, Anne

2018-03-06

Indigenous infants and children in Australia, especially in remote communities, experience early and chronic otitis media (OM) which is difficult to treat and has lifelong impacts in health and education. The LiTTLe Program (Learning to Talk, Talking to Learn) aimed to increase infants' access to spoken language input, teach parents to manage health and hearing problems, and support children's school readiness. This paper aimed to explore caregivers' views about this inclusive, parent-implemented early childhood program for 0-3 years in an Aboriginal community health context. Data from in-depth, semi-structured interviews with 9 caregivers of 12 children who had participated in the program from one remote Aboriginal community in the Northern Territory are presented. Data were analysed thematically. Caregivers provided overall views on the program. In addition, three key areas of focus in the program are also presented here: speech and language, hearing health, and school readiness. Caregivers were positive about the interactive speech and language strategies in the program, except for some strategies which some parents found alien or difficult: such as talking slowly, following along with the child's topic, using parallel talk, or baby talk. Children's hearing was considered by caregivers to be important for understanding people, enjoying music, and detecting environmental sounds including signs of danger. Caregivers provided perspectives on the utility of sign language and its benefits for communicating with infants and young children with hearing loss, and the difficulty of getting young community children to wear a conventional hearing aid. Caregivers were strongly of the opinion that the program had helped prepare children for school through familiarising their child with early literacy activities and resources, as well as school routines. But caregivers differed as to whether they thought the program should have been located at the school itself. The

Improving healthcare for Aboriginal Australians through effective engagement between community and health services.

Science.gov (United States)

Durey, Angela; McEvoy, Suzanne; Swift-Otero, Val; Taylor, Kate; Katzenellenbogen, Judith; Bessarab, Dawn

2016-07-07

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

Proceedings of Canada Forum 4. annual conference : powering up Aboriginal energy : clean energy driving Aboriginal economic development across Canada

Energy Technology Data Exchange (ETDEWEB)

Henderson, C. [Lumos Energy, Ottawa, ON (Canada); Aboriginal Clean Energy Network, Ottawa, ON (Canada); Buckell, J. [Michipicoten First Nation, Wawa, ON (Canada)] (comps.)

2010-07-01

This conference provided a form to discuss issues related to renewable energy and methods of creating successful and sustainable business models and plans in Aboriginal communities. The Government of Canada's new Federal Framework for Aboriginal Economic Development promotes partnerships supporting Aboriginal businesses in order to maximize access to capital. More than $350 billion in major resource and energy developments have been identified in or near Aboriginal communities. The tools available for small, medium and large-sized Aboriginal businesses were discussed along with financing sources and mechanisms for creating equity in renewable energy projects. Speakers also addressed the need for new transmission to serve renewable generation; recognition of rights in sharing the land; and Ontario's Aboriginal Energy Partnerships Program which provides an opportunity for First Nations and Metis to work with the government and private sector to build, own and operate new electricity transmission. Other topics presented at the conference included biomass district heating; bioenergy projects; wind partnerships with Aboriginal communities; hydroelectric development; and northern and remote communities. The conference featured 11 presentations, of which 3 have been catalogued separately for inclusion in this database. refs., tabs., figs.

Proceedings of Canada Forum 4. annual conference : powering up Aboriginal energy : clean energy driving Aboriginal economic development across Canada

International Nuclear Information System (INIS)

Henderson, C.; Buckell, J.

2010-01-01

This conference provided a form to discuss issues related to renewable energy and methods of creating successful and sustainable business models and plans in Aboriginal communities. The Government of Canada's new Federal Framework for Aboriginal Economic Development promotes partnerships supporting Aboriginal businesses in order to maximize access to capital. More than $350 billion in major resource and energy developments have been identified in or near Aboriginal communities. The tools available for small, medium and large-sized Aboriginal businesses were discussed along with financing sources and mechanisms for creating equity in renewable energy projects. Speakers also addressed the need for new transmission to serve renewable generation; recognition of rights in sharing the land; and Ontario's Aboriginal Energy Partnerships Program which provides an opportunity for First Nations and Metis to work with the government and private sector to build, own and operate new electricity transmission. Other topics presented at the conference included biomass district heating; bioenergy projects; wind partnerships with Aboriginal communities; hydroelectric development; and northern and remote communities. The conference featured 11 presentations, of which 3 have been catalogued separately for inclusion in this database.

Kick the habit: a social marketing campaign by Aboriginal communities in NSW.

Science.gov (United States)

Campbell, M A; Finlay, S; Lucas, K; Neal, N; Williams, R

2014-01-01

Tackling smoking is an integral component of efforts to improve health outcomes in Aboriginal communities. Social marketing is an effective strategy for promoting healthy attitudes and influencing behaviours; however, there is little evidence for its success in reducing smoking rates in Aboriginal communities. This paper outlines the development, implementation and evaluation of Kick the Habit Phase 2, an innovative tobacco control social marketing campaign in Aboriginal communities in New South Wales (NSW). The Aboriginal Health & Medical Research Council worked with three Aboriginal communities and a creative agency to develop locally tailored, culturally relevant social marketing campaigns. Each community determined the target audience and main messages, and identified appropriate local champions and marketing tools. Mixed methods were used to evaluate the campaign, including surveys and interviews with community members and Aboriginal Community Controlled Health Service staff. Community survey participants demonstrated high recall of smoking cessation messages, particularly for messages and images specific to the Kick the Habit campaign. Staff participating in interviews reported an increased level of interest from community members in smoking cessation programs, as well as increased confidence and skills in developing further social marketing campaigns. Aboriginal community-driven social marketing campaigns in tobacco control can build capacity, are culturally relevant and lead to high rates of recall in Aboriginal communities.

Mortality in a cohort of remote-living Aboriginal Australians and associated factors.

Science.gov (United States)

Hyde, Zoë; Smith, Kate; Flicker, Leon; Atkinson, David; Almeida, Osvaldo P; Lautenschlager, Nicola T; Dwyer, Anna; LoGiudice, Dina

2018-01-01

We aimed to describe mortality in a cohort of remote-living Aboriginal Australians using electronic record linkage. Between 2004 and 2006, 363 Aboriginal people living in remote Western Australia (WA) completed a questionnaire assessing medical history and behavioural risk factors. We obtained mortality records for the cohort from the WA Data Linkage System and compared them to data for the general population. We used Cox proportional hazards regression to identify predictors of mortality over a 9-year follow-up period. The leading causes of mortality were diabetes, renal failure, and ischaemic heart disease. Diabetes and renal failure accounted for 28% of all deaths. This differed from both the Australian population as a whole, and the general Indigenous Australian population. The presence of chronic disease did not predict mortality, nor did behaviours such as smoking. Only age, male sex, poor mobility, and cognitive impairment were risk factors. To reduce premature mortality, public health practitioners should prioritise the prevention and treatment of diabetes and renal disease in Aboriginal people in remote WA. This will require a sustained and holistic approach.

Providing choices for a marginalized community. A community-based project with Malaysian aborigines.

Science.gov (United States)

Kaur, P

1994-01-01

In 1991, the Family Planning Association (FPA) of the Malaysian state of Perak initiated a community-based development project in the remote Aborigine village of Kampung Tisong. The community consists of approximately 34 households who survive on an average income of about US $37. Malnutrition is pervasive, even minor ailments cause death, more serious afflictions are prevalent, and the closest government clinic is 20 kilometers away and seldom used by the Aborigines. 70% of the children have access to education, but parental illiteracy is a serious educational obstacle. The goals of the FPA program are to 1) promote maternal and child health and responsible parenthood, 2) provide health education, 3) encourage women to seek self-determination, and 4) encourage the development of self-reliance in the community as a whole. The first step was to survey the community's culture, beliefs, and health status with the help of the Aborigines Department and the village headman. After a series of preliminary meetings with other agencies, the FPA began to provide activities including health talks, health courses and demonstrations, medical examinations and check-ups, and first aid training. Environmental protection and sanitation measures were included in the educational activities, and following the traditional "mutual aid system," a small plot of land was cleared for vegetable production. Vegetable gardens and needlecraft will become income-producing activities for the women. Attempts to motivate the women to use family planning have been hindered by the fact that the health of 2 women deteriorated after they began using oral contraceptives. Positive changes are occurring slowly and steadily, however, and the FPA has been instrumental in having the settlement included in a program for the hardcore poor which will provide new housing and farming projects.

Food and beverage price discounts to improve health in remote Aboriginal communities: mixed method evaluation of a natural experiment.

Science.gov (United States)

Ferguson, Megan; O'Dea, Kerin; Holden, Stacey; Miles, Eddie; Brimblecombe, Julie

2017-02-01

Retrospectively evaluate food price discounts in remote Aboriginal community stores. Four price discount strategies of 10% were designed in 2010, aiming to influence grocery, fruit, vegetables and diet soft-drink sales. This natural experiment across a group of stores was evaluated using an explanatory, sequential mixed method design through analysis of store point-of-sale, document, observation and interview data. The outcome was measured by change in: 1) percentage of grocery sales to total food and beverage; 2) fruit and vegetable sales; and 3) diet soft-drink sales. Qualitative data enabled the interpretation of outcomes through understanding perceived success and benefits, and enablers and barriers to implementation. Eighteen community stores and 54 informants participated. While targeted price discounts were considered important to improving health, no discernible effect was evident, due to inadequate design and communication of discount promotion, and probably inadequate magnitude of discount. Strategy impact on food and beverage sales was limited by promotion and magnitude of discount. Implication for Public Health: This study demonstrates key factors and commitment required to design, communicate, implement and monitor strategies to improve health in this challenging remote retail context. Evaluation of natural experiments can contribute evidence to policy-making. © 2016 The Authors.

Workforce insights on how health promotion is practised in an Aboriginal Community Controlled Health Service.

Science.gov (United States)

McFarlane, Kathryn; Devine, Sue; Judd, Jenni; Nichols, Nina; Watt, Kerrianne

2017-07-01

Aboriginal Community Controlled Health Services deliver holistic and culturally appropriate primary health care to over 150 communities in Australia. Health promotion is a core function of comprehensive primary health care; however, little has been published on what enables or challenges health promotion practice in an Aboriginal Community Controlled Health Service. Apunipima Cape York Health Council (Apunipima) delivers primary health care to 11 remote north Queensland communities. The workforce includes medical, allied health, Aboriginal and Torres Strait Islander health workers and health practitioners and corporate support staff. This study aimed to identify current health promotion practices at Apunipima, and the enablers and challenges identified by the workforce, which support or hinder health promotion practice. Sixty-three staff from across this workforce completed an online survey in February 2015 (42% response rate). Key findings were: (1) health promotion is delivered across a continuum of one-on-one approaches through to population advocacy and policy change efforts; (2) the attitude towards health promotion was very positive; and (3) health promotion capacity can be enhanced at both individual and organisational levels. Workforce insights have identified areas for continued support and areas that, now identified, can be targeted to strengthen the health promotion capacity of Apunipima.

Communication between hospitals and isolated aboriginal community health clinics.

Science.gov (United States)

Mackenzie, G; Currie, B J

1999-04-01

This study described the communication dynamics, identified problems and recommended changes to improve patient follow-up and communication between Royal Darwin Hospital (RDH) and isolated Aboriginal community health clinics (CHC) in the Northern Territory (NT). In 1995, staff interviews were conducted and an audit of isolated Aboriginal patients' RDH discharge summaries (DS). Eighteen per cent of RDH DSs never arrived in CHCs. DSs were often prepared late and more likely to be in CHC records if written on time and if the referral source was specified. Interviews revealed discontent between CHCs and RDH regarding: communication, DS documentation, the supply of discharge medication, as well as different hospital and community perceptions of Aboriginies' reliability to carry a DS and CHC desire for patients to be given DSs at discharge. Aboriginal patients should be given a DS at discharge and resident medical officers should be educated as to the function and importance of the DS. In 18 months following this study, RDH appointed unit-based Aboriginal health workers and a policy was produced for written communication between hospital and CHCs, as well as a discharge planning manual for Aboriginal communities. Projects investigating communication between hospitals and isolated Aboriginal clinics and patient follow-up may result in significant policy changes concerning these processes.

Building relationships with Aboriginal Communities and the Energy and Utilities Board

Energy Technology Data Exchange (ETDEWEB)

Barber, R.; Handel, J.; Healy, D. [Alberta Energy and Utilities Board, Calgary, AB (Canada)

2004-07-01

One of the challenges facing the oil and gas industry in Alberta is building a relationship between industry, government and Aboriginal people. The Alberta Energy and Utilities Board (EUB) is promoting and developing positive relationships with Aboriginal communities in terms of land-use issues and land claim agreements. A study was commissioned in 2000 by the EUB to identify concerns to communities affected by sour gas development. The study identified the need to improve working relations with Aboriginal communities. This paper describes the experience of the Field Surveillance Branch of the EUB over the past few years in building such relationships. Historical information provides insight that helps in establishing effective working relationships with Aboriginal communities. An important ingredient is appreciation of the perspective of these communities, which is achieved through awareness training. The use of local Aboriginal resource people as part of the training is recommended in order to address local issues. 1 ref.

[Oxidation of sulfur-containing substrates by aboriginal and experimentally designed microbial communities].

Science.gov (United States)

Pivovarova, T A; Bulaev, A G; Roshchupko, P V; Belyĭ, A V; Kondrat'eva, T F

2012-01-01

Aboriginal and experimental (constructed of pure microbial cultures) communities of acidophilic chemolithotrophs have been studied. The oxidation of elemental sulfur, sodium thiosulfate, and potassium tetrathionate as sole sources of energy has been monitored. The oxidation rate of the experimental community is higher as compared to the aboriginal community isolated from a flotation concentrate of pyrrhotine-containing pyrite-arsenopyrite gold-arsenic sulfide ore. The degree of oxidation of the mentioned S substrates amounts to 17.91, 68.30, and 93.94% for the experimental microbial community and to 10.71, 56.03, and 79.50% for the aboriginal community, respectively. The degree of oxidation of sulfur sulfide forms in the ore flotation concentrate is 59.15% by the aboriginal microbial community and 49.40% by the experimental microbial community. Despite a higher rate of oxidation of S substrates as a sole source of energy by the experimental microbial community, the aboriginal community oxidizes S substrates at a higher rate in the flotation concentrate of pyrrhotine-containing pyrite-arsenopyrite gold-arsenic sulfide ore, from which it was isolated. Bacterial-chemical oxidation of the flotation concentrate by the aboriginal microbial community allows for the extraction of an additional 32.3% of gold from sulfide minerals, which is by 5.7% larger compared to the yield obtained by the experimental microbial community.

Education in Aboriginal Communities: Dilemmas around Empowerment.

Science.gov (United States)

Taylor, Donald M.; And Others

1993-01-01

Sudden empowerment of Canadian Aboriginal communities has raised many dilemmas concerning community controlled education, including issues related to educational planning and decision making by inexperienced administrators, focusing educational goals on the community versus mainstream society, discontinuities between community and school culture,…

Soil-Transmitted Helminths in Children in a Remote Aboriginal Community in the Northern Territory: Hookworm is Rare but Strongyloides stercoralis and Trichuris trichiura Persist

Directory of Open Access Journals (Sweden)

Deborah C. Holt

2017-10-01

Full Text Available (1 Background: soil-transmitted helminths are a problem worldwide, largely affecting disadvantaged populations. The little data available indicates high rates of infection in some remote Aboriginal communities in Australia. Studies of helminths were carried out in the same remote community in the Northern Territory in 1994–1996 and 2010–2011; (2 Methods: fecal samples were collected from children aged <10 years and examined for helminths by direct smear microscopy. In the 2010–2011 study, some fecal samples were also analyzed by agar plate culture and PCR for Strongyloides stercoralis DNA. Serological analysis of fingerprick dried blood spots using a S. stercoralis NIE antigen was also conducted; (3 Results and Conclusions: a reduction in fecal samples positive for S. stercoralis, hookworm and Trichuris trichiura was seen between the studies in 1994–1996 and 2010–2011, likely reflecting public health measures undertaken in the region to reduce intestinal helminths. Comparison of methods to detect S. stercoralis showed that PCR of fecal samples and serological testing of dried blood spots was at least as sensitive as direct smear microscopy and agar plate culture. These methods have advantages for use in remote field studies.

Aboriginal premature mortality within South Australia 1999-2006: a cross-sectional analysis of small area results

Directory of Open Access Journals (Sweden)

McDermott Robyn

2011-05-01

Full Text Available Abstract Background This paper initially describes premature mortality by Aboriginality in South Australia during 1999 to 2006. It then examines how these outcomes vary across area level socio-economic disadvantage and geographic remoteness. Methods The retrospective, cross-sectional analysis uses estimated resident population by sex, age and small areas based on the 2006 Census, and Unit Record mortality data. Premature mortality outcomes are measured using years of life lost (YLL. Subsequent intrastate comparisons are based on indirect sex and age adjusted YLL results. A multivariate model uses area level socio-economic disadvantage rank, geographic remoteness, and an interaction between the two variables to predict premature mortality outcomes. Results Aboriginal people experienced 1.1% of total deaths but 2.2% of YLL and Aboriginal premature mortality rates were 2.65 times greater than the South Australian average. Premature mortality for Aboriginal and non-Aboriginal people increased significantly as area disadvantage increased. Among Aboriginal people though, a significant main effect for area remoteness was also observed, together with an interaction between disadvantage and remoteness. The synergistic effect shows the social gradient between area disadvantage and premature mortality increased as remoteness increased. Conclusions While confirming the gap in premature mortality rates between Aboriginal South Australians and the rest of the community, the study also found a heterogeneity of outcomes within the Aboriginal community underlie this difference. The results support the existence of relationship between area level socio-economic deprivation, remoteness and premature mortality in the midst of an affluent society. The study concludes that vertically equitable resourcing according to population need is an important response to the stark mortality gap and its exacerbation by area socio-economic position and remoteness.

Community as Teacher Model: Health Profession Students Learn Cultural Safety from an Aboriginal Community

Science.gov (United States)

Kline, Cathy C.; Godolphin, William J.; Chhina, Gagun S.; Towle, Angela

2013-01-01

Communication between health care professionals and Aboriginal patients is complicated by cultural differences and the enduring effects of colonization. Health care providers need better training to meet the needs of Aboriginal patients and communities. We describe the development and outcomes of a community-driven service-learning program in…

Roaming behaviour of dogs in four remote Aboriginal communities in the Northern Territory, Australia: preliminary investigations.

Science.gov (United States)

Molloy, S; Burleigh, A; Dürr, S; Ward, M P

2017-03-01

To estimate the home range (HR) and investigate the potential predictors for roaming of 58 dogs in four Aboriginal communities in the Northern Territory. Prospective study. Global positioning system (GPS) collars were attached to the dogs for 1-4 days, recording location fixes every 1-3 min. Utilisation distributions (UDs) and extended (95% isopleth) and core (50% isopleth) HRs of dogs were determined. Potential predictors of roaming were assessed. Estimated core (median, 0.27 ha) and extended (median, 3.1 ha) HRs differed significantly (P = 0.0225 and 0.0345, respectively) between the four communities; dogs in the coastal community travelled significantly (P < 0.0001) more per day than dogs in the three inland communities studied. Significant associations were found between extended HR size and sex (P = 0.0050) and sex + neuter (P = 0.0218), and between core HR size and sex (P = 0.0010), neuter status (P = 0.0255) and sex + neuter (P = 0.0025). Entire males roamed more than neutered females. The core HR of dogs with poor/fair body condition scores (BCSs) was larger than dogs with ideal/obese BCSs (P = 0.0394). Neutered male dogs also travelled more per day than entire female dogs (P = 0.0475). Roaming information can be used to inform the management of dogs in remote communities and to design disease control programs. Widespread data collection across the Northern Territory should be undertaken to further investigate the associations found in this study, considering that data were collected during relatively short periods of time in one season. © 2017 Australian Veterinary Association.

Perceived community environment and physical activity involvement in a northern-rural Aboriginal community

Directory of Open Access Journals (Sweden)

Lévesque Lucie

2007-12-01

Full Text Available Abstract Background Type 2 diabetes disproportionately affects Aboriginal peoples in Canada. Ample evidence shows that regular physical activity (PA plays an important role in the prevention and treatment of type 2 diabetes. Evidence is beginning to emerge linking PA to the physical environment but little is known about the relationship between remote rural environments and PA involvement in Aboriginal peoples. This study's purpose was to investigate the relationship between perceptions of the environment and PA and walking patterns in Aboriginal adults in order to inform the planning and implementation of community-relevant PA interventions. Methods Two hundred and sixty three residents (133 women, mean age = 35.6 years, SD = 12.3 and 130 men, mean age = 37.2 years, SD = 13.1 from Moose Factory, Ontario were asked about environmental factors related to walking and PA involvement. Survey items were drawn from standardized, validated questionnaires. Descriptive statistics (means, standard deviations, percentages were calculated. A series of hierarchical multiple regressions were performed to determine associations between walking and overall PA with perceived environmental variables. Results Hierarchical multiple regression to predict walking revealed significant associations between walking and perceived safety and aesthetics. Owning home exercise equipment predicted strenuous PA. Different aspects of the physical environment appear to influence different types of physical activities. The significant amount of variance in behaviour accounted for by perceived environmental variables (5.3% walking included safety, aesthetics, convenience, owning home exercise equipment and comfortable shoes for walking. Conclusion Results suggest that a supportive physical environment is important for PA involvement and that walking and activities of different intensity appear to be mediated by different perceived environmental variables. Implications for PA

Disparities in cancer stage at diagnosis and survival of Aboriginal and non-Aboriginal South Australians.

Science.gov (United States)

Banham, David; Roder, David; Keefe, Dorothy; Farshid, Gelareh; Eckert, Marion; Cargo, Margaret; Brown, Alex

2017-06-01

This study tested the utility of retrospectively staging cancer registry data for comparing stage and stage-specific survivals of Aboriginal and non-Aboriginal people. Differences by area level factors were also explored. This test dataset comprised 950 Aboriginal cases and all other cases recorded on the South Australian cancer registry with a 1977-2010 diagnosis. A sub-set of 777 Aboriginal cases diagnosed in 1990-2010 were matched with randomly selected non-Aboriginal cases by year of birth, diagnostic year, sex, and primary site of cancer. Competing risk regression summarised associations of Aboriginal status, stage, and geographic attributes with risk of cancer death. Aboriginal cases were 10 years younger at diagnosis, more likely to present in recent diagnostic years, to be resident of remote areas, and have primary cancer sites of head & neck, lung, liver and cervix. Risk of cancer death was associated in the matched analysis with more advanced stage at diagnosis. More Aboriginal than non-Aboriginal cases had distant metastases at diagnosis (31.3% vs 22.0, pAboriginal residents had higher risks of cancer death than Aboriginal residents of metropolitan areas. Non-Aboriginal cases had the lowest risk of cancer death. Retrospective staging proved to be feasible using registry data. Results indicated more advanced stages for Aboriginal than matched non-Aboriginal cases. Aboriginal people had higher risks of cancer death, which persisted after adjusting for stage, and applied irrespective of remoteness of residence, with highest risk of death occurring among Aboriginal people from remote areas. Copyright © 2017 Elsevier Ltd. All rights reserved.

Best practices for effective working relationships between industry, First Nations and Aboriginal communities

Energy Technology Data Exchange (ETDEWEB)

Shibley, B. [Travers Food Service Ltd., Edmonton, AB (Canada)

2006-07-01

In 2004, Travers Food Service Ltd. was presented with the Aboriginal Relations Best Practice Award of Distinction by Indian and Northern Affairs Canada. The company has formal partnerships, joint ventures and working relationships with over 20 First Nations and aboriginal communities throughout northern Canada. The Travers workforce is approximately 40 per cent aboriginal, and nearly 60 per cent of the company's gross revenue is attributed to their partnerships with aboriginal communities. Partners within the company are encouraged to approach other aboriginal communities to form partnerships with the company. Partnership agreements place an emphasis on respecting land usage and environmental stewardship, and include employment obligations; training and scholarship obligations; equity options and financing; and marketing and profit sharing options. The company also gives financial support to community events, and has provided support for day care facilities, truck stops, open camps and contracts for support services. It was suggested that in order to develop successful partnerships, oil and gas industry leaders should consider that communities are fearful of the environmental and social impacts of resource development. Time must be spent in communities to take part in community activities, ask questions and understand perspectives. It was concluded that partnerships have been beneficial to Travers, and provide opportunities to aboriginal communities through employment, training, education and economic opportunities. refs., tabs., figs.

Unfinished dreams: community healing and the reality of aboriginal self-government

National Research Council Canada - National Science Library

Warry, Wayne

1998-01-01

... of community development and cultural revitalization that are essential precursors to self-government. Warry's notion of 'community healing' involves efforts to rebuild the human foundations for self-governing Aboriginal societies. The book analyses key areas such as health care and the judicial and political systems where Aboriginal peoples ...

Educational Pathways to Remote Employment in Isolated Communities

Directory of Open Access Journals (Sweden)

David Denkenberger

2015-01-01

Full Text Available Those who live in isolated communities often lack reliable, skilled employment opportunities, which fundamentally undermines their human security. For individuals who wish to remain in their isolated communities for family, religious, philosophical or other reasons, their attachment to their communities creates a disincentive for higher education. This promotes low educational achievement, which in turn results in low socioeconomic status, lack of social mobility, and a generational cycle of poverty. The human misery that results from such a feedback loop is observed in isolated communities throughout North America, including aboriginal communities in Canada. Fortunately, maturation of information and communication technologies now offers individuals the potential to gain high-skilled employment while living in an isolated community, using both (i virtual work/remote work and (ii remote training and education. To examine that potential, this study: 1 categorizes high-skill careers that demand a higher education and are widely viable for remote work, 2 examines options for obtaining the required education remotely, and 3 performs an economic analysis of investing in remote education, quantifying the results in return on investment. The results show that the Internet has now opened up the possibility of both remote education and remote work. Though the investment in college education is significant, there are loans available and the return on investment is generally far higher than the interest rate on the loans. The results identified several particularly promising majors and dozens of high-income careers. The ability to both obtain an education and employment remotely offers the potential to lift many people living in isolated communities out of poverty, reduce inequality overall, and provide those living in isolated communities with viable means of employment security, which not only allows personal sustainability, but also the potential for

Facilitators of community participation in an Aboriginal sexual health promotion initiative.

Science.gov (United States)

Hulme Chambers, Alana; Tomnay, Jane; Stephens, Kylie; Crouch, Alan; Whiteside, Mary; Love, Pettina; McIntosh, Leonie; Waples Crowe, Peter

2018-04-01

Community participation is a collaborative process aimed at achieving community-identified outcomes. However, approaches to community participation within Aboriginal health promotion initiatives have been inconsistent and not well documented. Smart and Deadly was a community-led initiative to develop sexual health promotion resources with young Aboriginal people in regional Victoria, Australia. The principles of community-centred practice, authentic participatory processes and respect for the local cultural context guided the initiative. The aim of this article is to report factors that facilitated community participation undertaken in the Smart and Deadly initiative to inform future projects and provide further evidence in demonstrating the value of such approaches. A summative evaluation of the Smart and Deadly initiative was undertaken approximately 2 years after the initiative ended. Five focus groups and 13 interviews were conducted with a purposive sample of 32 participants who were involved with Smart and Deadly in one of the following ways: project participant, stakeholder or project partner, or project developer or designer. A deductive content analysis was undertaken and themes were compared to the YARN model, which was specifically created for planning and evaluating community participation strategies relating to Aboriginal sexual health promotion. A number of factors that facilitated community participation approaches used in Smart and Deadly were identified. The overarching theme was that trust was the foundation upon which the facilitators of community participation ensued. These facilitators were cultural safety and cultural literacy, community control, and legacy and sustainability. Whilst the YARN model was highly productive in identifying these facilitators of community participation, the model did not have provision for the element of trust between workers and community. Given the importance of trust between the project team and the Aboriginal

Aboriginal Review 2003/2004

Energy Technology Data Exchange (ETDEWEB)

NONE

2004-07-01

This report presents information on Syncrude's efforts and achievements in working with Aboriginal communities and leaders in Alberta since 2002 through its Aboriginal Development Program. The report discusses the six key commitment areas of the Program. First, the report provides an overview of Syncrude's achievements in the area of corporate leadership including participation in the Aboriginal Affairs and Northern Development Industry Advisory Committee; recognition by the Canadian Council for Aboriginal Business as a leader in Aboriginal relations through the Aboriginal Relations program; supporting the National Aboriginal Achievement Foundation; championing the Aboriginal Human Resources Development Council of Canada; membership of the Alberta Chamber of Resources Aboriginal Programs Project; Conference Board of Canada's Council on Corporate Aboriginal Relations; and, chairing the Mining Association of Canada. The report discusses business development of Aboriginal entrepreneurs and business owners including Syncrude's employment targets for Aboriginal employment in the Syncrude workforce. It discusses community development in Aboriginal communities such as long distance learning; the Fort Chipewyan day care centre; the Chipewyan Prairie Dene First Nation Multi-Purpose Community Centre in Janvier; and, an elder care facility in Fort McKay First Nation community. It discusses education and training including the Alberta Aboriginal Apprenticeship Project; Syncrude Aboriginal/Women Education Awards Program; University of Alberta Aboriginal Careers Initiative; and, the Aboriginal Financial Management Internship. The report also discusses Syncrude's consultations with Aboriginal communities on environmental issues such as end-land use, air quality and how further expansion can occur without long-term impacts on traditional land uses. The report also contains questions and answers with Aboriginal leaders to discuss the impact of oil sands

Aboriginal Review 2003/2004

International Nuclear Information System (INIS)

2004-01-01

This report presents information on Syncrude's efforts and achievements in working with Aboriginal communities and leaders in Alberta since 2002 through its Aboriginal Development Program. The report discusses the six key commitment areas of the Program. First, the report provides an overview of Syncrude's achievements in the area of corporate leadership including participation in the Aboriginal Affairs and Northern Development Industry Advisory Committee; recognition by the Canadian Council for Aboriginal Business as a leader in Aboriginal relations through the Aboriginal Relations program; supporting the National Aboriginal Achievement Foundation; championing the Aboriginal Human Resources Development Council of Canada; membership of the Alberta Chamber of Resources Aboriginal Programs Project; Conference Board of Canada's Council on Corporate Aboriginal Relations; and, chairing the Mining Association of Canada. The report discusses business development of Aboriginal entrepreneurs and business owners including Syncrude's employment targets for Aboriginal employment in the Syncrude workforce. It discusses community development in Aboriginal communities such as long distance learning; the Fort Chipewyan day care centre; the Chipewyan Prairie Dene First Nation Multi-Purpose Community Centre in Janvier; and, an elder care facility in Fort McKay First Nation community. It discusses education and training including the Alberta Aboriginal Apprenticeship Project; Syncrude Aboriginal/Women Education Awards Program; University of Alberta Aboriginal Careers Initiative; and, the Aboriginal Financial Management Internship. The report also discusses Syncrude's consultations with Aboriginal communities on environmental issues such as end-land use, air quality and how further expansion can occur without long-term impacts on traditional land uses. The report also contains questions and answers with Aboriginal leaders to discuss the impact of oil sands development. figs

Fatherhood in Australian Aboriginal and Torres Strait Islander communities: An Examination of Barriers and Opportunities to Strengthen the Male Parenting Role.

Science.gov (United States)

Reilly, Lyndon; Rees, Susan

2018-03-01

Traditional Australian Aboriginal and Torres Strait Islander societies value men's role as parents; however, the importance of promoting fatherhood as a key social determinant of men's well-being has not been fully appreciated in Western medicine. To strengthen the Aboriginal and Torres Strait Islander male parenting role, it is vital to examine current barriers and opportunities. The first author (a male Aboriginal health project officer) conducted yarning sessions in three remote Australian communities, two being Aboriginal, the other having a high Aboriginal population. An expert sample of 25 Aboriginal and 6 non-Aboriginal stakeholders, including maternal and child health workers and men's group facilitators, considered barriers and opportunities to improve men's parenting knowledge and role, with an aim to inform services and practices intended to support men's parenting. A specific aim was to shape an existing men's group program known as Strong Fathers, Strong Families. A thematic analysis of data from the project identified barriers and opportunities to support men's role as parents. Challenges included the transition from traditional to contemporary parenting practices and low level of cultural and male gender sensitivity in maternal and child health services. Services need to better understand and focus on men's psychological empowerment and to address shame and lack of confidence around parenting. Poor literacy and numeracy are viewed as contributing to disempowerment. Communities need to champion Aboriginal and Torres Strait Islander male father role models. Biases and barriers should be addressed to improve service delivery and better enable men to become empowered and confident fathers.

Modern contact investigation methods for enhancing tuberculosis control in Aboriginal communities

Directory of Open Access Journals (Sweden)

Victoria J. Cook

2012-05-01

Full Text Available The Aboriginal communities in Canada are challenged by a disproportionate burden of TB infection and disease. Contact investigation (CI guidelines exist but these strategies do not take into account the unique social structure of different populations. Because of the limitations of traditional CI, new approaches are under investigation and include the use of social network analysis, geographic information systems and genomics, in addition to the widespread use of genotyping to better understand TB transmission. Guidelines for the routine use of network methods and other novel methodologies for TB CI and outbreak investigation do not exist despite the gathering evidence that these approaches can positively impact TB control efforts, even in Aboriginal communities. The feasibility and efficacy of these novel approaches to CI in Aboriginal communities requires further investigation. The successful integration of these novel methodologies will require community involvement, capacity building and ongoing support at every level. The outcome will not only be the systematic collection, analysis, and interpretation of CI data in high-burden communities to assess transmission but the prioritization of contacts who are candidates for treatment of LTBI which will break the cycle of transmission. Ultimately, the measure of success will be a clear and sustained decline in TB incidence in Aboriginal communities.

Doctor-patient communications in the Aboriginal community: towards the development of educational programs.

Science.gov (United States)

Towle, Angela; Godolphin, William; Alexander, Ted

2006-09-01

Aboriginal people in Canada have poorer health than the rest of the population. Reasons for health disparities are many and include problems in communication between doctor and patient. The objective of this study was to understand doctor-patient communication in Aboriginal communities in order to design educational interventions for medical students based on the needs and experiences of patients. Experiences of good and poor communication were studied by semi-structured interviews or focus groups with 22 Aboriginal community members, 2 community health representatives and 2 Aboriginal trainee physicians. Transcribed data were coded and subjected to thematic analysis. Positive and negative experiences of communicating with physicians fell into three broad and interrelated themes: their histories as First Nations citizens; the extent to which the physician was trusted; time in the medical interview. Aboriginal peoples' history affects their communication with physicians; barriers may be overcome when patients feel they have a voice and the time for it to be heard. Physicians can improve communication with Aboriginal patients by learning about their history, building trust and giving time.

The consultation challenge in small remote northern communities

Energy Technology Data Exchange (ETDEWEB)

Malcolm, D.G., E-mail: david.malcolm@mcri.ca [Malcolm and Associates, Inuvik, Northwest Territories (Canada)

2014-07-01

There is a strong necessity for nuclear power project proponents to begin consultation with community leaders at the concept design stage as the first step in a licensing process. The paper discusses the physical and social challenges of reliable and environmentally sound electricity generation in remote northern Aboriginal communities in Canada. There are several hundred remote communities in the boreal region and throughout the Arctic. Electrical energy requirements are usually a few megawatts. Access to some Arctic remote communities is by air and small water craft only, except when winters are cold enough for winter roads to be constructed for a few weeks each year. These communities, as well as new mining operations and their camp communities, provide a market segment for very small reactors. However, there are social acceptance hurdles to be addressed, as well as the legal requirement at all government levels of the duty to consult. Trust-building is a must when working with First Nations, Metis, and Inuit communities, and this requires community presence of the project developers long before proposals for new generation facilities are presented for license approval. Input from communities and other stakeholders is a vital part of the licensing process. Community members need to feel comfortable with the project proponents as well as the project itself. In some cases a project is rejected because the community council or development corporation feels left out of economic benefits that might be obtained through a negotiation process. (author)

The consultation challenge in small remote northern communities

International Nuclear Information System (INIS)

Malcolm, D.G.

2014-01-01

There is a strong necessity for nuclear power project proponents to begin consultation with community leaders at the concept design stage as the first step in a licensing process. The paper discusses the physical and social challenges of reliable and environmentally sound electricity generation in remote northern Aboriginal communities in Canada. There are several hundred remote communities in the boreal region and throughout the Arctic. Electrical energy requirements are usually a few megawatts. Access to some Arctic remote communities is by air and small water craft only, except when winters are cold enough for winter roads to be constructed for a few weeks each year. These communities, as well as new mining operations and their camp communities, provide a market segment for very small reactors. However, there are social acceptance hurdles to be addressed, as well as the legal requirement at all government levels of the duty to consult. Trust-building is a must when working with First Nations, Metis, and Inuit communities, and this requires community presence of the project developers long before proposals for new generation facilities are presented for license approval. Input from communities and other stakeholders is a vital part of the licensing process. Community members need to feel comfortable with the project proponents as well as the project itself. In some cases a project is rejected because the community council or development corporation feels left out of economic benefits that might be obtained through a negotiation process. (author)

Early identification and preventive care for elevated cardiovascular disease risk within a remote Australian Aboriginal primary health care service

Directory of Open Access Journals (Sweden)

O'Dea Kerin

2011-01-01

Full Text Available Abstract Background Cardiovascular disease (CVD is the single greatest contributor to the gap in life expectancy between Indigenous and non-Indigenous Australians. Our objective is to determine if holistic CVD risk assessment, introduced as part of the new Aboriginal and Torres Strait Islander Adult Health Check (AHC, results in better identification of elevated CVD risk, improved delivery of preventive care for CVD and improvements in the CVD risk profile for Aboriginal adults in a remote community. Methods Interrupted time series study over six years in a remote primary health care (PHC service involving Aboriginal adults identified with elevated CVD risk (N = 64. Several process and outcome measures were audited at 6 monthly intervals for three years prior to the AHC (the intervention and three years following: (i the proportion of guideline scheduled CVD preventive care services delivered, (ii mean CVD medications prescribed and dispensed, (iii mean PHC consultations, (iv changes in participants' CVD risk factors and estimated absolute CVD risk and (v mean number of CVD events and iatrogenic events. Results Twenty-five percent of AHC participants were identified as having elevated CVD risk. Of these, 84% had not been previously identified during routine care. Following the intervention, there were significant improvements in the recorded delivery of preventive care services for CVD (30% to 53%, and prescription of CVD related medications (28% to 89% (P P = 0.004 following the intervention. However, there were no significant changes in the mean number of PHC consultations or mean number of CVD events or iatrogenic events. Conclusions Holistic CVD risk assessment during an AHC can lead to better and earlier identification of elevated CVD risk, improvement in the recorded delivery of preventive care services for CVD, intensification of treatment for CVD, and improvements in participants' CVD risk profile. Further research is required on

Aboriginal community controlled health services: leading the way in primary care.

Science.gov (United States)

Panaretto, Kathryn S; Wenitong, Mark; Button, Selwyn; Ring, Ian T

2014-06-16

The national Closing the Gap framework commits to reducing persisting disadvantage in the health of Aboriginal and Torres Strait Islander people in Australia, with cross-government-sector initiatives and investment. Central to efforts to build healthier communities is the Aboriginal community controlled health service (ACCHS) sector; its focus on prevention, early intervention and comprehensive care has reduced barriers to access and unintentional racism, progressively improving individual health outcomes for Aboriginal people. There is now a broad range of primary health care data that provides a sound evidence base for comparing the health outcomes for Indigenous people in ACCHSs with the outcomes achieved through mainstream services, and these data show: models of comprehensive primary health care consistent with the patient-centred medical home model; coverage of the Aboriginal population higher than 60% outside major metropolitan centres; consistently improving performance in key performance on best-practice care indicators; and superior performance to mainstream general practice. ACCHSs play a significant role in training the medical workforce and employing Aboriginal people. ACCHSs have risen to the challenge of delivering best-practice care and there is a case for expanding ACCHSs into new areas. To achieve the best returns, the current mainstream Closing the Gap investment should be shifted to the community controlled health sector.

'No more strangers': Investigating the experiences of women, midwives and others during the establishment of a new model of maternity care for remote dwelling aboriginal women in northern Australia.

Science.gov (United States)

Josif, Cathryn M; Barclay, Lesley; Kruske, Sue; Kildea, Sue

2014-03-01

to describe the experiences of women, midwives and others during the establishment of a new model of maternity care for remote dwelling Aboriginal women transferred to a regional centre in northern Australia for maternity care and birth. a mixed method design within a Participatory Action Research approach was used. Qualitative findings are presented here. Data for this paper were collected from semi-structured interviews, field notes and observations and analysed thematically. the 'top end' of the Northern Territory of Australia. a total of 66 participants included six MGP midwives, two Aboriginal Health Workers and one Senior Aboriginal Woman working in the new model; eight hospital midwives; 34 Department of Health staff, three staff from other agencies; and 12 remote dwelling Aboriginal women who used the service. the study generated one overarching theme, it's not a perfect system but it's changing. This encompassed improvements to the services evident to all participants. Core themes related to the previous maternity service which was described as the arduous journey, the new model was seen as a new way of working and a resultant very different journey occurred for Aboriginal women using the service. there was a dissonance between the previous culture of maternity services and the woman centred focus of the new model. Over 12 months initial resistance to the new model diminished and it became highly valued. The transfer of information between the regional service and remote community health centres improved as did the safety and quality of care. Aboriginal women can access continuity of carer in the regional centre for the first time and reported a more positive experience with maternity services. The new model appears to have changed the cultural responsiveness of the regional maternity service; and care provided for remote dwelling women within this service. The qualitative findings inform others seeking to implement a similar model of care for remote

Confronting barriers and recognizing opportunities: Developing effective community-based environmental monitoring programs to meet the needs of Aboriginal communities

International Nuclear Information System (INIS)

McKay, Ariana J.; Johnson, Chris J.

2017-01-01

Aboriginal communities can be negatively affected by resource development, but often they do not have a full opportunity to participate in project review and the resulting monitoring and mitigation activities. Cumulative impacts of resource development are also typically neglected in monitoring protocols that focus on a limited number of environmental values, rather than adopting a long-term, holistic view of development over time and space. Community-based environmental monitoring (CBEM) is emerging as a way to meaningfully include local Aboriginal citizens in the decision-making process as well as the assessment of the long-term impacts of the development of natural resources. We explored opportunities and barriers for developing CBEM programs that meet the needs of small and rural Aboriginal communities that are faced with the rapid and wide-spread development of natural resources. We conducted interviews with a local Aboriginal community, and natural resource management practitioners who could provide perspectives on the application of CBEM to resource management in north-central British Columbia, Canada. Results demonstrate that CBEM offers a locally adapted and culturally appropriate approach to facilitate the participation of Aboriginal communities in natural resource decision making and management. The interpretation of the specific role and purpose of CBEM differed among participants, depending on their objectives for and concerns about natural resource development. However, all parties were consistent in viewing CBEM as an effective method for engaging in dialogue, cooperation, and tracking environmental change. The development or improvement of CBEM programs should consider the efficacy of monitoring protocols, social cohesion and relationships, ability to inform decision-making, and effectiveness of CBEM for the members of the community. - Highlights: • We explored how to develop effective CBEM with a focus on Aboriginal communities. • We identified

Confronting barriers and recognizing opportunities: Developing effective community-based environmental monitoring programs to meet the needs of Aboriginal communities

Energy Technology Data Exchange (ETDEWEB)

McKay, Ariana J., E-mail: ariana.mckay@outlook.com; Johnson, Chris J., E-mail: chris.johnson@unbc.ca

2017-05-15

Aboriginal communities can be negatively affected by resource development, but often they do not have a full opportunity to participate in project review and the resulting monitoring and mitigation activities. Cumulative impacts of resource development are also typically neglected in monitoring protocols that focus on a limited number of environmental values, rather than adopting a long-term, holistic view of development over time and space. Community-based environmental monitoring (CBEM) is emerging as a way to meaningfully include local Aboriginal citizens in the decision-making process as well as the assessment of the long-term impacts of the development of natural resources. We explored opportunities and barriers for developing CBEM programs that meet the needs of small and rural Aboriginal communities that are faced with the rapid and wide-spread development of natural resources. We conducted interviews with a local Aboriginal community, and natural resource management practitioners who could provide perspectives on the application of CBEM to resource management in north-central British Columbia, Canada. Results demonstrate that CBEM offers a locally adapted and culturally appropriate approach to facilitate the participation of Aboriginal communities in natural resource decision making and management. The interpretation of the specific role and purpose of CBEM differed among participants, depending on their objectives for and concerns about natural resource development. However, all parties were consistent in viewing CBEM as an effective method for engaging in dialogue, cooperation, and tracking environmental change. The development or improvement of CBEM programs should consider the efficacy of monitoring protocols, social cohesion and relationships, ability to inform decision-making, and effectiveness of CBEM for the members of the community. - Highlights: • We explored how to develop effective CBEM with a focus on Aboriginal communities. • We identified

What are the social concerns? consultation and respect for the rights of aboriginal peoples

International Nuclear Information System (INIS)

Larcombe, P.

2003-01-01

Large scale developments, whether hydroelectric development, mining, or forestry, to name a few types, have the potential to broadly and adversely impact on Aboriginal peoples and communities. Perhaps more so than any other segment of Canadian society, Aboriginal peoples, and particularly those residing in remote communities, are heavily reliant upon healthy environments and healthy natural resources in order to preserve and maintain their lifestyles, cultures, and economies. Further, Aboriginal peoples in Canada have the unique circumstance of having Treaty and Aboriginal rights protected under the terms of Treaties, Land Claims, and/or the Constitution of Canada Act, 1982. As with other forms of large scale Development - Nuclear fuel waste storage and management projects may have the potential to adversely impact on Aboriginal peoples. The following presentation outlines some key considerations relevant to understanding the social concerns, consultation requirements, and best practices for involving Aboriginal peoples - the key ingredients to enhancing the confidence of Aboriginal Peoples in nuclear fuel waste storage and management projects. (author)

Aboriginal and Torres Strait Islander community governance of health research: Turning principles into practice.

Science.gov (United States)

Gwynn, Josephine; Lock, Mark; Turner, Nicole; Dennison, Ray; Coleman, Clare; Kelly, Brian; Wiggers, John

2015-08-01

Gaps exist in researchers' understanding of the 'practice' of community governance in relation to research with Aboriginal and Torres Strait Islander peoples. We examine Aboriginal community governance of two rural NSW research projects by applying principles-based criteria from two independent sources. One research project possessed a strong Aboriginal community governance structure and evaluated a 2-year healthy lifestyle program for children; the other was a 5-year cohort study examining factors influencing the mental health and well-being of participants. The National Health and Medical Research Council of Australia's 'Values and ethics: guidelines for ethical conduct in Aboriginal and Torres Strait Islander research' and 'Ten principles relevant to health research among Indigenous Australian populations' described by experts in the field. Adopt community-based participatory research constructs. Develop clear governance structures and procedures at the beginning of the study and allow sufficient time for their establishment. Capacity-building must be a key component of the research. Ensure sufficient resources to enable community engagement, conduct of research governance procedures, capacity-building and results dissemination. The implementation of governance structures and procedures ensures research addresses the priorities of the participating Aboriginal and Torres Strait Islander communities, minimises risks and improves outcomes for the communities. Principles-based Aboriginal and Torres Strait Islander community governance of research is very achievable. Next steps include developing a comprehensive evidence base for appropriate governance structures and procedures, and consolidating a suite of practical guides for structuring clear governance in health research. © 2015 National Rural Health Alliance Inc.

Psychological Sense of Community: An Australian Aboriginal Experience

Science.gov (United States)

Bishop, Brian; Colquhoun, Simon; Johnson, Gemma

2006-01-01

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,…

Community-associated methicillin-resistant Staphylococcus aureus infections in Aboriginal children attending hospital emergency departments in a regional area of New South Wales, Australia: a seven-year descriptive study

Directory of Open Access Journals (Sweden)

Susan Thomas

2017-12-01

Full Text Available Objective: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA can cause bacterial skin infections that are common problems for Aboriginal children in New South Wales (NSW. MRSA is not notifiable in NSW and surveillance data describing incidence and prevalence are not routinely collected. The study aims to describe the epidemiology of CA-MRSA in Aboriginal children in the Hunter New England Local Health District (HNELHD. Methods: We linked data from Pathology North Laboratory Management System (AUSLAB and the HNELHD patient administration system from 33 hospital emergency departments. Data from 2008–2014 for CA-MRSA isolates were extracted. Demographic characteristics included age, gender, Aboriginality, rurality and seasonality. Results: Of the 1222 individuals in this study, 408 (33.4% were Aboriginal people. Aboriginal people were younger with 45.8% aged less than 10 years compared to 25.9% of non-Aboriginal people. Most isolates came from Aboriginal people who attended the regional Tamworth Hospital (193/511 isolates from 149 people. A larger proportion of Aboriginal people, compared to non-Aboriginal people, resided in outer regional (64.9% vs 37.2% or remote/very remote areas (2.5% vs 0.5%. Most infections occurred in summer and early autumn. For Aboriginal patients, there was a downward trend through autumn, continuing through winter and spring. Discussion: Aboriginal people at HNELHD emergency departments appear to represent a greater proportion of people with skin infections with CA-MRSA than non-Aboriginal people. CA-MRSA is not notifiable in NSW; however, pathology and hospital data are available and can provide valuable indicative data to health districts for planning and policy development.

An Aboriginal Adult Literacy Campaign Pilot Study in Australia using Yes I Can

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Bob Boughton

2013-06-01

Full Text Available In 2012, the remote Aboriginal community of Wilcannia in western NSW hosted the first Australian pilot of a Cuban mass adult literacy campaign model known as Yes I Can. The aim was to investigate the appropriateness of this model in Aboriginal Australia. Building on an intensive community development process of ‘socialisation and mobilisation’, sixteen community members with very low literacy graduated from the basic literacy course, with the majority continuing on into post-literacy activities, further training and/or employment. The pilot was initiated by the National Aboriginal Adult Literacy Campaign Steering Committee (NAALCSC consisting of Aboriginal leaders from the education and health sectors, and managed by the University of New England (UNE, working in partnership with the Wilcannia Local Aboriginal Land Council as the local lead agency. The pilot was supported by a Cuban academic who came to Australia for this purpose, and included a Participatory Action Research (PAR evaluation led by the UNE Project Manager. In this paper, members of the project team and the NAALCSC describe the pilot and reflect on its outcomes.

The Koori Growing Old Well Study: investigating aging and dementia in urban Aboriginal Australians.

Science.gov (United States)

Radford, Kylie; Mack, Holly A; Robertson, Hamish; Draper, Brian; Chalkley, Simon; Daylight, Gail; Cumming, Robert; Bennett, Hayley; Jackson Pulver, Lisa; Broe, Gerald A

2014-06-01

Dementia is an emerging health priority in Australian Aboriginal communities, but substantial gaps remain in our understanding of this issue, particularly for the large urban section of the population. In remote Aboriginal communities, high prevalence rates of dementia at relatively young ages have been reported. The current study is investigating aging, cognitive decline, and dementia in older urban/regional Aboriginal Australians. We partnered with five Aboriginal communities across the eastern Australian state of New South Wales, to undertake a census of all Aboriginal men and women aged 60 years and over residing in these communities. This was followed by a survey of the health, well-being, and life history of all consenting participants. Participants were also screened using three cognitive instruments. Those scoring below designated cut-offs, and a 20% random sample of those scoring above (i.e. "normal" range), completed a contact person interview (with a nominated family member) and medical assessment (blind to initial screening results), which formed the basis of "gold standard" clinical consensus determinations of cognitive impairment and dementia. This paper details our protocol for a population-based study in collaboration with local Aboriginal community organizations. The study will provide the first available prevalence rates for dementia and cognitive impairment in a representative sample of urban Aboriginal people, across city and rural communities, where the majority of Aboriginal Australians live. It will also contribute to improved assessment of dementia and cognitive impairment and to the understanding of social determinants of successful aging, of international significance.

Structuring oil and gas joint ventures with aboriginal communities: conference papers conference

International Nuclear Information System (INIS)

1999-01-01

The Insight Conference featured twelve articles on the following topics: 1 - researching and understanding your legal partners; II - an aboriginal game plan - a plan for success; III - legal and management issues relating to aboriginal ventures; IV - tax status of reserve-based aboriginal people and businesses under the Indian Act; v - first nations as exempt bodies under the Income Tax Act; V I - innovative options for structuring oil and gas leases and exploration permits on aboriginal lands; VII - joint venture and partnership arrangements; V III - the impact of taxation on aboriginal ventures; I X - bankruptcy and insolvency issues for on-reserve businesses; X - financing options for oil and gas ventures with first nations; XI - Syncrude's commitment to aboriginal development; and X II - structuring oil and gas ventures with aboriginal communities. Articles abstracted/indexed separately include: I, II, V I (2), V III, X, XI, and X II

[Health system and aboriginal communities in the province of Formosa, Argentina].

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Mirassou, Cristina S

2013-01-01

The author comments her experience in the practice of medicine and public health among aborigines in Formosa, a long neglected province in northeast Argentina. Her experience goes through a span of 34 years, 11 in a small community in a far off region. The province has 530162 inhabitants, 43358 (6.5%) aborigines of the Wichí, Qom, and Pilagá ethnicities. Some particular public health problems of these aborigines are due to the great distance between communities and the regular medical assistance while others are related to cultural differences. The situation has gradually improved in the last 30 years due to government awareness in providing easy and close access to medical care, making the most of the abilities of local aborigines midwifes, teaching health assistants and conventional measures. The most apparent results are the decrease in infant mortality rates and the lower incidence of tuberculosis, with no deaths due to tuberculous meningitis since 1999. No less important was the opening of new opportunities for education and the teaching of both native and Spanish language in the schools retaining local customs. The changes have brought about new risks and challenges such as: traffic accidents involving youngsters riding motorcycles, alcoholism, obesity, diabetes (undiagnosed beforehand), high rate of adolescence pregnancy, and crisis of leadership within the communities.

Final report on the comprehensive approach to energy conservation for the Aboriginal community in Ontario

Energy Technology Data Exchange (ETDEWEB)

Fox, C.D. [Fort William First Nation, Thunder Bay, ON (Canada)

2006-03-13

This report presented a comprehensive approach to energy conservation programming for the Fort William First Nation, located in Thunder Bay, Ontario. The report outlined the historical context of the relationship between the Canadian government and Aboriginal people. The Aboriginal community in Ontario was described with reference to the difference between First Nations population, Metis, and Inuit. Statistics on the Aboriginal population in Ontario was broken down. Different Aboriginal organizations as well as organizations serving Aboriginal peoples were identified and described. The report also described the political process and administrative protocol for energy conservation and energy efficiency. Energy conservation in the Aboriginal community was also explained. Last, the report provided several recommendations related to awareness and education; translation; incentives; delivery mechanisms; and pilot projects. The report concluded with an agreement to hold a provincial conference in Toronto on the issues raised in the report. The report concluded that an Aboriginal unit within the Bureau of Conservation of the Ontario Power Authority was envisioned to plan, develop, implement, manage and monitor the deliverables resulting from the report.

Not just bricks and mortar: planning hospital cancer services for Aboriginal people

Science.gov (United States)

2011-01-01

Background Aboriginal people in Australia experience higher mortality from cancer compared with non-Aboriginal Australians, despite an overall lower incidence. A notable contributor to this disparity is that many Aboriginal people do not take up or continue with cancer treatment which almost always occurs within major hospitals. Thirty in-depth interviews with urban, rural and remote Aboriginal people affected by cancer were conducted between March 2006 and September 2007. Interviews explored participants' beliefs about cancer and experiences of cancer care and were audio-recorded, transcribed verbatim and coded independently by two researchers. NVivo7 software was used to assist data management and analysis. Information from interviews relevant to hospital services including and building design was extracted. Findings Relationships and respect emerged as crucial considerations of participants although many aspects of the hospital environment were seen as influencing the delivery of care. Five themes describing concerns about the hospital environment emerged: (i) being alone and lost in a big, alien and inflexible system; (ii) failure of open communication, delays and inefficiency in the system; (iii) practicalities: costs, transportation, community and family responsibilities; (iv) the need for Aboriginal support persons; and (v) connection to the community. Conclusions Design considerations and were identified but more important than the building itself was the critical need to build trust in health services. Promotion of cultural safety, support for Aboriginal family structures and respecting the importance of place and community to Aboriginal patients are crucial in improving cancer outcomes. PMID:21401923

Not just bricks and mortar: planning hospital cancer services for Aboriginal people

Directory of Open Access Journals (Sweden)

Durey Angela

2011-03-01

Full Text Available Abstract Background Aboriginal people in Australia experience higher mortality from cancer compared with non-Aboriginal Australians, despite an overall lower incidence. A notable contributor to this disparity is that many Aboriginal people do not take up or continue with cancer treatment which almost always occurs within major hospitals. Thirty in-depth interviews with urban, rural and remote Aboriginal people affected by cancer were conducted between March 2006 and September 2007. Interviews explored participants' beliefs about cancer and experiences of cancer care and were audio-recorded, transcribed verbatim and coded independently by two researchers. NVivo7 software was used to assist data management and analysis. Information from interviews relevant to hospital services including and building design was extracted. Findings Relationships and respect emerged as crucial considerations of participants although many aspects of the hospital environment were seen as influencing the delivery of care. Five themes describing concerns about the hospital environment emerged: (i being alone and lost in a big, alien and inflexible system; (ii failure of open communication, delays and inefficiency in the system; (iii practicalities: costs, transportation, community and family responsibilities; (iv the need for Aboriginal support persons; and (v connection to the community. Conclusions Design considerations and were identified but more important than the building itself was the critical need to build trust in health services. Promotion of cultural safety, support for Aboriginal family structures and respecting the importance of place and community to Aboriginal patients are crucial in improving cancer outcomes.

Feasibility of a novel participatory multi-sector continuous improvement approach to enhance food security in remote Indigenous Australian communities.

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Brimblecombe, J; Bailie, R; van den Boogaard, C; Wood, B; Liberato, S C; Ferguson, M; Coveney, J; Jaenke, R; Ritchie, J

2017-12-01

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

"Rebuilding our community": hearing silenced voices on Aboriginal youth suicide.

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Walls, Melissa L; Hautala, Dane; Hurley, Jenna

2014-02-01

This paper brings forth the voices of adult Aboriginal First Nations community members who gathered in focus groups to discuss the problem of youth suicide on their reserves. Our approach emphasizes multilevel (e.g., individual, family, and broader ecological systems) factors viewed by participants as relevant to youth suicide. Wheaton's conceptualization of stressors and Evans-Campbell's multilevel classification of the impacts of historical trauma are used as theoretical and analytic guides. Thematic analysis of qualitative data transcripts revealed a highly complex intersection of stressors, traumas, and social problems seen by community members as underlying mechanisms influencing heightened levels of Aboriginal youth suicidality. Our multilevel coding approach revealed that suicidal behaviors were described by community members largely as a problem with deep historical and contemporary structural roots, as opposed to being viewed as individualized pathology.

The impact of a community-led program promoting weight loss and healthy living in Aboriginal communities: the New South Wales Knockout Health Challenge

OpenAIRE

Passmore, Erin; Shepherd, Brooke; Milat, Andrew; Maher, Louise; Hennessey, Kiel; Havrlant, Rachael; Maxwell, Michelle; Hodge, Wendy; Christian, Fiona; Richards, Justin; Mitchell, Jo

2017-01-01

Background Aboriginal people in Australia experience significant health burden from chronic disease. There has been limited research to identify effective healthy lifestyle programs to address risk factors for chronic disease among Aboriginal people. Methods The Knockout Health Challenge is a community-led healthy lifestyle program for Aboriginal communities across New South Wales, Australia. An evaluation of the 2013 Knockout Health Challenge was undertaken. Participants’ self-reported physi...

Carbon profiles of remote Australian Indigenous communities: A base for opportunities

International Nuclear Information System (INIS)

Stewart, J.; Anda, M.; Harper, R.J.

2016-01-01

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.

"I just feel comfortable out here, there's something about the place": staff and client perceptions of a remote Australian Aboriginal drug and alcohol rehabilitation service.

Science.gov (United States)

Munro, Alice; Allan, Julaine; Shakeshaft, Anthony; Breen, Courtney

2017-12-06

The need for effective, culturally safe residential rehabilitation services for Aboriginal people is widely acknowledged, however the combination of treatment components that is optimally effective, is not well defined. Most existing Aboriginal residential rehabilitation research has focused on describing client characteristics, and largely ignored the impact of treatment and service factors, such as the nature and quality of therapeutic components and relationships with staff. This qualitative study was undertaken as part of a three-year mixed methods community-based participatory research (CBPR) project that aimed to empirically describe a remote Aboriginal drug and alcohol rehabilitation service. Researchers utilised purposive sampling to conduct 21 in-depth, semi-structured interviews. The interviews used a 'research yarning' approach, a form of culturally appropriate conversation that is relaxed and narrative-based. The interview transcripts were thematically coded using iterative categorization. The emerging themes were then analysed from an Interpretative Phenomenological Analysis, focusing on how participants' lived experiences before and during their admission to the service shaped their perceptions of the program. A total of 12 clients (mean age 35 years, SD 9.07, 91% Aboriginal) and 9 staff (2 female, 7 male, mean age 48 years, SD 8.54, 67% Aboriginal) were interviewed. Five themes about specific program components were identified in the interview data: healing through culture and country; emotional safety and relationships; strengthening life skills; improved wellbeing; and perceived areas for improvement. This research found that Aboriginal drug and alcohol residential rehabilitation is not just about length of time in treatment, but also about the culture, activities and relationships that are part of the treatment process. This study highlights that cultural elements were highly valued by both clients and staff of a remote Aboriginal residential

Closing the Gap: some unsettling assumptions - A remote region case study

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Ann Ingamells

2010-04-01

Full Text Available Australian governments are committed to closing the gap between Indigenous and other Australians, yet progress is slow. This paper draws links between these policy efforts and a study of a remote shire in Western Queensland where indicators suggest better than usual socioeconomic outcomes for Aboriginal people. The study conducted over a three year period, and with significant input from Aboriginal people, examines the pathway through which these outcomes have been achieved. Local accounts suggest relations between long term families of both cultures have been a significant factor and are the outcome of an iterative dynamic between people, place and resources, that has a long history, and path dependence. Despite almost full engagement of Aboriginal people in employment over the past 100 years however, indicators do not yet converge, suggesting policy targets are ambitious. The persistent ‘gap’ may be the effect of insistence on making equality conditional on acceptance of settler norms, at significant cost to the lived expression of Aboriginal culture. Whilst this community has managed these tensions, nevertheless their experiences imply that access to community services in remote areas, rather than being a right, is precariously dependent on the vicissitudes of relationship, and these may often depend on the choices Aboriginal people make in response to assimilatory pressures. Keywords: 'Closing the Gap', remote settlements, Aboriginal, Indigenous, intervention, governmentality

Prevalence of dementia in urban and regional Aboriginal Australians.

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Radford, Kylie; Mack, Holly A; Draper, Brian; Chalkley, Simon; Daylight, Gail; Cumming, Robert; Bennett, Hayley; Delbaere, Kim; Broe, Gerald A

2015-03-01

This study aimed to determine the prevalence of dementia in collaboration with urban/regional Aboriginal communities. A census of Aboriginal and Torres Strait Islander men and women aged 60 years and above in the target communities identified 546 potential participants, with 336 (61.5%) participating in this cross-sectional study. Participants completed a structured interview and cognitive screening tests. One hundred fifty-three participants also completed a detailed medical assessment. Assessment data were reviewed by a panel of clinicians who determined a diagnosis of dementia or mild cognitive impairment (MCI) according to standard criteria. Crude prevalence of dementia was 13.4%, and age-standardized prevalence was 21.0%. The most common types of dementia were Alzheimer's dementia (44%) and mixed dementia diagnoses (29%). Estimated prevalence of MCI was 17.7%. Consistent with previous findings in a remote population, urban and regional Aboriginal Australians face high rates of dementia at younger ages, most commonly Alzheimer's dementia. Copyright © 2015 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Are hygiene and public health interventions likely to improve outcomes for Australian Aboriginal children living in remote communities? A systematic review of the literature

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Brewster David

2008-05-01

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

The role of Aboriginal community attachment in promoting lifestyle changes after hepatitis C diagnosis

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Loren Brener

2015-08-01

Full Text Available This research assessed whether greater attachment to an Aboriginal community buffers against the negative effects of stigma and promotes positive health outcomes. Aboriginal Australians ( n  = 203 living with hepatitis C completed a survey assessing community attachment, stigma, resilience, quality of life, treatment intent, hepatitis C knowledge and positive lifestyle changes. A stronger sense of community attachment was associated with greater resilience, increased quality of life, less hepatitis C–related stigma and with increased lifestyle changes after diagnosis. Hence, community attachment can buffer against the negative health effects of stigma and may promote the resources to engage in positive behaviour changes, ultimately increasing long-term health outcomes.

Structuring joint ventures and resource development arrangements between Aboriginal communities and the petroleum industry : Proceedings of an Insight Conference

International Nuclear Information System (INIS)

1998-01-01

The 15 presentations at this conference focused on the structuring of joint ventures with the petroleum industry and First Nations communities in the wake of the recent Delgamuukw decision of the Supreme Court of Canada, issued in December 1997. This decision asserted the right of Aboriginal communities to exclusive use and occupation of their land. The decision has created an urgent need to re-examine business relationships with Aboriginal communities and led to an increase in interest by resource industry people in Aboriginal practices, customs and traditions. Accordingly, speakers at this conference explored the consequences of self government by native communities, native cultural issues that influence the way Aboriginal people conduct business and the effect of the Supreme Court decision on land use planning in the resource-rich provinces of Canada. refs., tabs., figs

Coronary heart disease events in Aboriginal Australians: incidence in an urban population.

Science.gov (United States)

Bradshaw, Pamela J; Alfonso, Helman S; Finn, Judith C; Owen, Julie; Thompson, Peter L

2009-05-18

To determine the incidence of coronary heart disease (CHD) events in an urban Aboriginal population. Cohort study of 906 Aboriginal people without CHD from 998 who had undergone risk-factor assessment in the Perth Aboriginal Atherosclerosis Risk Study (PAARS) in 1998-1999. PAARS cohort data were electronically linked to a range of databases that included Western Australian hospital morbidity data and death registry data. We analysed data from January 1980 to December 2006 to identify previous admissions for CHD from 1980 to baseline (1998-1999) and new events from baseline to 2006. First CHD event (hospital admission or death). There were 891 linked records for the 906 participants without previous CHD. The event rate was 12.6/1000 person-years (95% CI, 10.2-15.6/1000 person-years). Annual CHD event rates ranged from 8 to 18/1000 person-years. After adjustment for age (sex was not associated with the risk factors assessed), factors associated with risk of a CHD event in the PAARS cohort were a history of diabetes, overweight or obesity (indicated by body mass index), smoking, and hypertension, but not waist circumference. People with these risk factors were 1.9-2.7 times more likely to experience a CHD event. Compared with previously published information from a remote Aboriginal community in the Northern Territory, the incidence of CHD events among urban-dwelling Aboriginal people was not significantly different (P > 0.05 overall and for subgroups defined by age and sex). City-dwelling Aboriginal Australians have an incidence of CHD events comparable to that of Aboriginal people living in remote northern Australia.

Working With an Aboriginal Community to Understand Drinking Water Perceptions and Acceptance in Rural New South Wales

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Fidelis Jaravani

2017-09-01

Full Text Available This study explored the Walhallow Aboriginal community’s experiences with drinking water to gain a shared understanding about community concerns and to develop ways to address these concerns together. There is a strong connection between people and water, as well as a need to appreciate the social factors associated with the unique cultural and socioeconomic factors that the provision of drinking water has for Aboriginal communities. We used a mixed method design within a community-based participatory action Research (PAR framework. Water hardness and parental influence were the key factors associated with participants’ decisions to drink rainwater. This study provides important insights for water supply authorities when assessing health risks and when choosing appropriate mitigation measures for water quality improvement programs in Aboriginal communities.

Supporting youth wellbeing with a focus on eating well and being active: views from an Aboriginal community deliberative forum.

Science.gov (United States)

Street, Jackie; Cox, Heather; Lopes, Edilene; Motlik, Jessie; Hanson, Lisa

2018-04-01

Including and prioritising community voice in policy development means policy is more likely to reflect community values and priorities. This project trialled and evaluated a storyboard approach in a deliberative community forum to engage Australian Aboriginal people in health policy priority setting. The forum was co-constructed with two Aboriginal community-controlled organisations. A circle storyboard was used to centre Aboriginal community knowledge and values and encourage the group to engage with broader perspectives and evidence. The forum asked a diverse (descriptively representative) group of Aboriginal people in a rural town what governments should do to support the wellbeing of children and youth, particularly to encourage them to eat well and be active. The storyboard provided a tactile device to allow shared stories and identification of community issues. The group identified policies they believed governments should prioritise, including strategies to combat racism and provide local supports and outlets for young people. An informed deliberative storyboard approach offers a novel way of engaging with Aboriginal communities in a culturally appropriate and inclusive manner. Implications for public health: The identification of racism as a major issue of concern in preventing children from living healthy lifestyles highlights the need for policy responses in this area. © 2018 The Authors.

Tailoring a response to youth binge drinking in an Aboriginal Australian community: a grounded theory study.

Science.gov (United States)

McCalman, Janya; Tsey, Komla; Bainbridge, Roxanne; Shakeshaft, Anthony; Singleton, Michele; Doran, Christopher

2013-08-07

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

Aboriginal review 1997

International Nuclear Information System (INIS)

1997-01-01

The relationship between Syncrude Canada Ltd., and the aboriginal people of Northeast Alberta was discussed. In 1970, Syncrude began development of its oil sands mega-project in the Fort McMurray region. Since then, the company has worked in partnership with the aboriginal communities to maximize their productive participation in the oil sands. Syncrude has provided opportunities in employment, education, and business and community development. Their goals for aboriginal employment are: (1) to attain 10 per cent aboriginal employees in the Company's direct workforce, and (2) to attain 13 per cent aboriginal employees in the overall workforce, including contractors. Currently, Syncrude Canada employs 315 aboriginal people in various career positions. The Company is also committed to the protection of the environment. As proof of this commitment, when a mine site is reclaimed, the Company does all that is required to ensure that the land can support both industry and traditional land uses such as hunting, fishing and trapping. Syncrude also works on air quality issues dealing with odors and sulfur dioxide emissions as shown by a two million dollar company-sponsored program to examine local air quality and its effect on people and their health. figs

Disparities in acute in-hospital cardiovascular care for Aboriginal and non-Aboriginal South Australians.

Science.gov (United States)

Tavella, Rosanna; McBride, Katharine; Keech, Wendy; Kelly, Janet; Rischbieth, Amanda; Zeitz, Christopher; Beltrame, John F; Tideman, Philip A; Brown, Alex

2016-09-05

To assess differences in the rates of angiography and subsequent revascularisation for Aboriginal and non-Aboriginal South Australians who presented with an acute coronary syndrome (ACS); to explore the reasons for any observed differences. Analysis of administrative data with logistic regression modelling to assess the relationship between Aboriginal status and the decision to undertake diagnostic angiography. A detailed medical record review of Aboriginal admissions was subsequently undertaken. Emergency ACS admissions to SA cardiac catheterisation hospitals, 2007-2012. 13 701 admissions of patients with an ACS, including 274 Aboriginal patients (2.1%). Rates of coronary angiography and revascularisation; documentation of justification for non-invasive management. After adjustment for age, comorbidities and remoteness, Aboriginal patients presenting with an ACS were significantly less likely than non-Aboriginal patients to undergo angiography (odds ratio [OR], 0.4; 95% CI, 0.3-0.5; P Aboriginal and non-Aboriginal patients who had undergone angiography. Reasons for Aboriginal patients not undergoing angiography included symptoms being deemed non-cardiac (16%), non-invasive test performed (8%), and discharge against medical advice (11%); the reasons were unclear for 36% of Aboriginal patients. After controlling for age and other factors, the rate of coronary angiography was lower among Aboriginal patients with an ACS in SA. The reasons for this disparity are complex, including patient-related factors and their preferences, as well as the appropriateness of the intervention. Improved consideration of the hospital experience of Aboriginal patients must be a priority for reducing health care disparities.

Successful chronic disease care for Aboriginal Australians requires cultural competence.

Science.gov (United States)

Liaw, Siaw Teng; Lau, Phyllis; Pyett, Priscilla; Furler, John; Burchill, Marlene; Rowley, Kevin; Kelaher, Margaret

2011-06-01

To review the literature to determine the attributes of culturally appropriate healthcare to inform the design of chronic disease management (CDM) models for Aboriginal patients in urban general practice. A comprehensive conceptual framework, drawing on the Access to Care, Pathway to Care, Chronic Care, Level of Connectedness, and Cultural Security, Cultural Competency and Cultural Respect models, was developed to define the search strategy, inclusion criteria and appraisal methods for the literature review. Selected papers were reviewed in detail if they examined a chronic disease intervention for an Aboriginal population and reported on its evaluation, impacts or outcomes. In the 173 papers examined, only 11 programs met the inclusion criteria. All were programs conducted in rural and remote Aboriginal community-controlled health services. Successful chronic disease care and interventions require adequate Aboriginal community engagement, utilising local knowledge, strong leadership, shared responsibilities, sustainable resources and integrated data and systems. These success factors fitted within the conceptual framework developed. Research and development of culturally appropriate CDM models concurrently in both urban and rural settings will enable more rigorous evaluation, leading to stronger evidence for best practice. A partnership of mainstream and Aboriginal-controlled health services is essential to successfully 'close the gap'. Findings will inform and guide the development, implementation and evaluation of culturally appropriate CDM in mainstream general practice and primary care. © 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia.

Breastfeeding Duration and Residential Isolation amid Aboriginal Children in Western Australia

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Stephen R. Zubrick

2012-12-01

Full Text Available Objectives: To examine factors that impact on breastfeeding duration among Western Australian Aboriginal children. We hypothesised that Aboriginal children living in remote locations in Western Australia were breastfed for longer than those living in metropolitan locations. Methods: A population-based cross-sectional survey was conducted from 2000 to 2002 in urban, rural and remote settings across Western Australia. Cross-tabulations and multivariate logistic regression analyses were performed, using survey weights to produce unbiased estimates for the population of Aboriginal children. Data on demographic, maternal and infant characteristics were collected from 3932 Aboriginal birth mothers about their children aged 0–17 years (representing 22,100 Aboriginal children in Western Australia. Results: 71% of Aboriginal children were breastfed for three months or more. Accounting for other factors, there was a strong gradient for breastfeeding duration by remoteness, with Aboriginal children living in areas of moderate isolation being 3.2 times more likely to be breastfed for three months or more (p < 0.001 compared to children in metropolitan Perth. Those in areas of extreme isolation were 8.6 times more likely to be breastfed for three months or longer (p < 0.001. Conclusions: Greater residential isolation a protective factor linked to longer breastfeeding duration for Aboriginal children in our West Australian cohort.

Starting Points and Pathways in Aboriginal Students' Learning of Number: Recognising Different World Views

Science.gov (United States)

Treacy, Kaye; Frid, Sandra; Jacob, Lorraine

2015-01-01

This research was designed to investigate the conceptualisations and thinking strategies Indigenous Australian students use in counting tasks. Eighteen Aboriginal students, in years 1 to 11 at a remote community school, were interviewed using standard counting tasks and a "counting" task that involved fetching "maku" (witchetty…

Development opportunities for northern aboriginal communities from Saskatchewan's uranium mining industry

International Nuclear Information System (INIS)

Richards, A.

2003-01-01

A. Richards, a public relations specialist from Cogema Resources Inc., discussed the programmes for human resource and community development in northern Saskatchewan. This region has the world's largest known high-grade deposits of uranium as well as a high level of provincial, public and northern community support. A mainly Aboriginal population of around 35 000 with a very high proportion of young persons entering the work force, lives in small, dispersed communities in a landscape of forest and lakes. All of the uranium mines are in remote locations with 'local impact' communities often several hundred kilometres away. In the late 1970's a public board of inquiry set none operating conditions that included maximizing opportunities for northern business and employment. Dozens of joint initiatives have since been developed and resulted in innovative hiring, training and transportation programmes, as well as support programmes to improve health, education, professional and business development and quality of life in the communities. Residents of northern Saskatchewan, like all other Canadians, are not prepared to accept environmental risks in return for economic opportunities. Three regional Environmental Quality Committees, with representatives froth all of the northern communities, work with Provincial agencies and the uranium mining industry to ensure community concerns are included in decisions. Northern hunters and fishermen, whose close links with the land are respected, provide relevant data to the Environmental Monitoring Program. Mutual trust is developed through constant interaction and dialogue in one-to-one relationships. Traditional activities like trapping are given their full importance. A Community Vitality Project jointly monitors social well being as defined by northern interests and culture. Compensations and company donations in some cases provide resources for community activities. (author)

Obesity and its association with sociodemographic factors, health behaviours and health status among Aboriginal and non-Aboriginal adults in New South Wales, Australia.

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Thurber, Katherine Ann; Joshy, Grace; Korda, Rosemary; Eades, Sandra J; Wade, Vicki; Bambrick, Hilary; Liu, Bette; Banks, Emily

2018-06-01

High body mass index (BMI) is the second leading contributor to Australia's burden of disease and is particularly prevalent among Aboriginal peoples. This paper aims to provide insight into factors relating to obesity among Aboriginal adults and Aboriginal-non-Aboriginal differences. Cross-sectional analysis of data from the 45 and Up Study, comparing obesity (BMI ≥30 kg/m 2 ) prevalence and risk factors among 1515 Aboriginal and 213 301 non-Aboriginal adults in New South Wales. Age-sex-adjusted prevalence ratios (PRs) for obesity by sociodemographic factors, health behaviours and health status were estimated (multivariable log-binomial regression) for Aboriginal and non-Aboriginal participants separately. We quantified the extent to which key factors (physical activity, screen time, education, remoteness, area-level disadvantage) accounted for any excess Aboriginal obesity prevalence. Obesity prevalence was 39% among Aboriginal and 22% among non-Aboriginal participants (PR=1.65, 95% CI 1.55 to 1.76). Risk factors for obesity were generally similar for Aboriginal and non-Aboriginal participants and included individual-level and area-level disadvantage, physical inactivity, and poor physical and mental health, with steeper gradients observed among non-Aboriginal participants for some factors (P interaction 40% of the excess Aboriginal obesity prevalence. A substantial proportion of the excess obesity prevalence among Aboriginal versus non-Aboriginal participants was explained by physical activity, screen time, education, remoteness and area-level disadvantage. Socioeconomic and health behaviour factors are potential targets for promoting healthy BMI, but these must be considered within the context of upstream social and cultural factors. Adults with health needs and disability require particular attention. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted

Complicated grief in Aboriginal populations.

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Spiwak, Rae; Sareen, Jitender; Elias, Brenda; Martens, Patricia; Munro, Garry; Bolton, James

2012-06-01

To date there have been no studies examining complicated grief (CG) in Aboriginal populations. Although this research gap exists, it can be hypothesized that Aboriginal populations may be at increased risk for CG, given a variety of factors, including increased rates of all-cause mortality and death by suicide. Aboriginal people also have a past history of multiple stressors resulting from the effects of colonization and forced assimilation, a significant example being residential school placement. This loss of culture and high rates of traumatic events may place Aboriginal individuals at increased risk for suicide, as well as CG resulting from traumatic loss and suicide bereavement. Studies are needed to examine CG in Aboriginal populations. These studies must include cooperation with Aboriginal communities to help identify risk factors for CG, understand the role of culture among these communities, and identify interventions to reduce poor health outcomes such as suicidal behavior.

The Strong Family Program: an innovative model to engage Aboriginal and Torres Strait Islander youth and Elders with reproductive and sexual health community education.

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Duley, P; Botfield, J R; Ritter, T; Wicks, J; Brassil, A

2017-08-01

Issue addressed Aboriginal youth in Australia often experience high rates of intimate partner violence (family violence) and poorer reproductive and sexual health than their non-Aboriginal counterparts. To address some of the disparities, the Strong Family Program was developed to deliver reproductive and sexual health education to Aboriginal communities in New South Wales. Methods Development of the program was based on an extensive consultation process with Aboriginal communities. It was implemented in three communities, with two groups from each hosting Aboriginal youth and Elders in a yarning circle within the culturally respectful frameworks of 'men and boys'' and 'women and girls'' business. An evaluation was conducted to measure reproductive and sexual health knowledge and attitude changes upon program completion, using pre- and post-program surveys and yarning (focus group discussions). Results Program participants comprised 48 females and 28 males. Overall, mean knowledge and attitude scores improved upon completion of the program (from 77% to 82% and from 4.15 to 4.32 out of 5, respectively). Among participants aged 20 years and under (the youngest participant was 13 years), there was an increase in knowledge (P=0.034); among participants aged over 20 years (the oldest participant was 78 years), there was an increase in positive attitudes (P=0.001). Participants perceived the information provided to be useful and relevant, with many reporting improved knowledge and attitudes around rights and respectful relationships. Conclusions Reproductive and sexual health education in Aboriginal communities should be based on community consultations and carried out within a culturally appropriate framework to promote greater success. Continued implementation of the Strong Family Program will promote increased understanding of respectful relationships and improved health outcomes for Aboriginal young people. So what? The Strong Family Program was based on an extensive

An Opportunity for Healing and Holistic Care: Exploring the Roles of Health Care Providers Working Within Northern Canadian Aboriginal Communities.

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Rahaman, Zaida; Holmes, Dave; Chartrand, Larry

2016-05-22

The purpose of this qualitative study was exploring what the roles and challenges of health care providers working within Northern Canadian Aboriginal communities are and what resources can help support or impede their efforts in working toward addressing health inequities within these communities. The qualitative research conducted was influenced by a postcolonial epistemology. The works of theorists Fanon on colonization and racial construction, Kristeva on semiotics and abjection, and Foucault on power/knowledge, governmentality, and biopower were used in providing a theoretical framework. Critical discourse analysis of 25 semistructured interviews with health care providers was used to gain a better understanding of their roles and challenges while working within Northern Canadian Aboriginal communities. Within this research study, three significant findings emerged from the data. First, the Aboriginal person's identity was constructed in relation to the health care provider's role of delivering essential health services. Second, health care providers were not treating the "ill" patient, but rather treating the patient for being "ill." Third, health care providers were treating the Aboriginal person for being "Aboriginal" by separating the patient from his or her identity. The treatment involved reforming the Aboriginal patient from the condition of being "Aboriginal." © The Author(s) 2016.

Comorbidities contribute to the risk of cancer death among Aboriginal and non-Aboriginal South Australians: Analysis of a matched cohort study.

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Banham, David; Roder, David; Brown, Alex

2018-02-01

Aboriginal Australians have poorer cancer survival than other Australians. Diagnoses at later stages and correlates of remote area living influence, but do not fully explain, these disparities. Little is known of the prevalence and influence of comorbid conditions experienced by Aboriginal people, including their effect on cancer survival. This study quantifies hospital recorded comorbidities using the Elixhauser Comorbidity Index (ECI), examines their influence on risk of cancer death, then considers effect variation by Aboriginality. Cancers diagnosed among Aboriginal South Australians in 1990-2010 (N = 777) were matched with randomly selected non-Aboriginal cases by birth year, diagnostic year, sex, and primary site, then linked to administrative hospital records to the time of diagnosis. Competing risk regression summarised associations of Aboriginal status, stage, geographic attributes and comorbidities with risk of cancer death. A threshold of four or more ECI conditions was associated with increased risk of cancer death (sub-hazard ratio SHR 1.66, 95%CI 1.11-2.46). Alternatively, the presence of any one of a subset of ECI conditions was associated with similarly increased risk (SHR = 1.62, 95%CI 1.23-2.14). The observed effects did not differ between Aboriginal and matched non-Aboriginal cases. However, Aboriginal cases experienced three times higher exposure than non-Aboriginal to four or more ECI conditions (14.2% versus 4.5%) and greater exposure to the subset of ECI conditions (20.7% versus 8.0%). Comorbidities at diagnosis increased the risk of cancer death in addition to risks associated with Aboriginality, remoteness of residence and disease stage at diagnosis. The Aboriginal cohort experienced comparatively greater exposure to comorbidities which adds to disparities in cancer outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Aboriginal Business Capacity Building Programs in the Central Interior of British Columbia: A Collaborative Project between the University and Communities

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Kunkel, Titi; Schorcht, Blanca; Brazzoni, Randall

2011-01-01

Aboriginal communities in Canada are typically marginalized, have very low employment participation rates, and have limited economic infrastructure. The downturn in global economies further marginalized these communities. The University of Northern British Columbia's (UNBC) Continuing Studies department piloted an Aboriginal and Small Business…

Australian Curriculum Implementation in a Remote Aboriginal School: A Curriculum Leader's Search for a Transformational Compromise

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Parkinson, Chloe

2015-01-01

This paper examines the trial implementation of the Australian Curriculum in a remote Aboriginal school. It was a school that at the time was beginning to achieve successes with the development of dual-knowledge, transformational outcomes based curriculum that had its justification in the Northern Territory Curriculum Framework. Drawing on the…

Patterns of resident health workforce turnover and retention in remote communities of the Northern Territory of Australia, 2013-2015.

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Russell, Deborah J; Zhao, Yuejen; Guthridge, Steven; Ramjan, Mark; Jones, Michael P; Humphreys, John S; Wakerman, John

2017-08-15

The geographical maldistribution of the health workforce is a persisting global issue linked to inequitable access to health services and poorer health outcomes for rural and remote populations. In the Northern Territory (NT), anecdotal reports suggest that the primary care workforce in remote Aboriginal communities is characterised by high turnover, low stability and high use of temporary staffing; however, there is a lack of reliable information to guide workforce policy improvements. This study quantifies current turnover and retention in remote NT communities and investigates correlations between turnover and retention metrics and health service/community characteristics. This study used the NT Department of Health 2013-2015 payroll and financial datasets for resident health workforce in 53 remote primary care clinics. Main outcome measures include annual turnover rates, annual stability rates, 12-month survival probabilities and median survival. At any time point, the clinics had a median of 2.0 nurses, 0.6 Aboriginal health practitioners (AHPs), 2.2 other employees and 0.4 additional agency-employed nurses. Mean annual turnover rates for nurses and AHPs combined were extremely high, irrespective of whether turnover was defined as no longer working in any remote clinic (66%) or no longer working at a specific remote clinic (128%). Stability rates were low, and only 20% of nurses and AHPs remain working at a specific remote clinic 12 months after commencing. Half left within 4 months. Nurse and AHP turnover correlated with other workforce measures. However, there was little correlation between most workforce metrics and health service characteristics. NT Government-funded remote clinics are small, experience very high staff turnover and make considerable use of agency nurses. These staffing patterns, also found in remote settings elsewhere in Australia and globally, not only incur higher direct costs for service provision-and therefore may compromise long

Bioethics for clinicians: 18. Aboriginal cultures

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Ellerby, Jonathan H.; McKenzie, John; McKay, Stanley; Gariépy, Gilbert J.; Kaufert, Joseph M.

2000-01-01

Although philosophies and practices analogous to bioethics exist in Aboriginal cultures, the terms and categorical distinctions of "ethics" and "bioethics" do not generally exist. In this article we address ethical values appropriate to Aboriginal patients, rather than a preconceived "Aboriginal bioethic." Aboriginal beliefs are rooted in the context of oral history and culture. For Aboriginal people, decision-making is best understood as a process and not as the correct interpretation of a unified code. Aboriginal cultures differ from religious and cultural groups that draw on Scripture and textual foundations for their ethical beliefs and practices. Aboriginal ethical values generally emphasize holism, pluralism, autonomy, community- or family-based decision-making, and the maintenance of quality of life rather than the exclusive pursuit of a cure. Most Aboriginal belief systems also emphasize achieving balance and wellness within the domains of human life (mental, physical, emotional and spiritual). Although these bioethical tenets are important to understand and apply, examining specific applications in detail is not as useful as developing a more generalized understanding of how to approach ethical decision-making with Aboriginal people. Aboriginal ethical decisions are often situational and highly dependent on the values of the individual within the context of his or her family and community. PMID:11033715

Syncrude's commitment to Aboriginal development

International Nuclear Information System (INIS)

Loader, R.K.

1999-01-01

The paper describes how the Syncrude relationship with Aboriginal communities in the region came about, and how Syncrude maintains that relationship and share in the community at its oil sands operation in Alberta, Canada. Syncrude is a world leader in oil sands development and in promoting the quality of the working life and employment of native peoples. The remainder of the presentation is devoted to that particular achievement. The partnerships Syncrude has built are based on mutual respect, a sustainable capability, a professional relationship, support of community, and self-reliance. Syncrude recognized very early on that Aboriginal people would have a major interest in the company's future and sought to integrate the company's program into operations as a normal way of doing business. Today, Aboriginal people play a vital role in the oil sands industry, working at a variety of skilled occupations. The education component of Syncrude's program is designed to equip Aboriginal people with the training they need to claim their fair share of the employment pie at Syncrude. Contractors servicing Syncrude are about one-fifth Aboriginal-owned and run operations and they are in turn encouraged to hire Aboriginal employees. There are three direct elements of the program: employment, education and business development, but partnerships go beyond just that: they extend to the community such that Syncrude is dedicated to working with local people, when requested, to help them define and meet their needs and to achieve self-reliance

Tuberculosis in Aboriginal Canadians

Directory of Open Access Journals (Sweden)

Vernon H Hoeppner

2000-01-01

Full Text Available Endemic tuberculosis (TB was almost certainly present in Canadian aboriginal people (aboriginal Canadians denotes status Indians, Inuit, nonstatus Indians and metis as reported by Statistics Canada before the Old World traders arrived. However, the social changes that resulted from contact with these traders created the conditions that converted endemic TB into epidemic TB. The incidence of TB varied inversely with the time interval from this cultural collision, which began on the east coast in the 16th century and ended in the Northern Territories in the 20th century. This relatively recent epidemic explains why the disease is more frequent in aboriginal children than in Canadian-born nonaboriginal people. Treatment plans must account for the socioeconomic conditions and cultural characteristics of the aboriginal people, especially healing models and language. Prevention includes bacillus Calmette-Guerin vaccination and chemoprophylaxis, and must account for community conditions, such as rates of suicide, which have exceeded the rate of TB. The control of TB requires a centralized program with specifically directed funding. It must include a program that works in partnership with aboriginal communities.

Exploring cross-sectional associations between common childhood illness, housing and social conditions in remote Australian Aboriginal communities

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Brewster David

2010-03-01

Full Text Available Abstract Background There is limited epidemiological research that provides insight into the complex web of causative and moderating factors that links housing conditions to a variety of poor health outcomes. This study explores the relationship between housing conditions (with a primary focus on the functional state of infrastructure and common childhood illness in remote Australian Aboriginal communities for the purpose of informing development of housing interventions to improve child health. Methods Hierarchical multi-level analysis of association between carer report of common childhood illnesses and functional and hygienic state of housing infrastructure, socio-economic, psychosocial and health related behaviours using baseline survey data from a housing intervention study. Results Multivariate analysis showed a strong independent association between report of respiratory infection and overall functional condition of the house (Odds Ratio (OR 3.00; 95%CI 1.36-6.63, but no significant association between report of other illnesses and the overall functional condition or the functional condition of infrastructure required for specific healthy living practices. Associations between report of child illness and secondary explanatory variables which showed an OR of 2 or more included: for skin infection - evidence of poor temperature control in the house (OR 3.25; 95%CI 1.06-9.94, evidence of pests and vermin in the house (OR 2.88; 95%CI 1.25-6.60; for respiratory infection - breastfeeding in infancy (OR 0.27; 95%CI 0.14-0.49; for diarrhoea/vomiting - hygienic state of food preparation and storage areas (OR 2.10; 95%CI 1.10-4.00; for ear infection - child care attendance (OR 2.25; 95%CI 1.26-3.99. Conclusion These findings add to other evidence that building programs need to be supported by a range of other social and behavioural interventions for potential health gains to be more fully realised.

Optimisation modelling to assess cost of dietary improvement in remote Aboriginal Australia.

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Brimblecombe, Julie; Ferguson, Megan; Liberato, Selma C; O'Dea, Kerin; Riley, Malcolm

2013-01-01

The cost and dietary choices required to fulfil nutrient recommendations defined nationally, need investigation, particularly for disadvantaged populations. We used optimisation modelling to examine the dietary change required to achieve nutrient requirements at minimum cost for an Aboriginal population in remote Australia, using where possible minimally-processed whole foods. A twelve month cross-section of population-level purchased food, food price and nutrient content data was used as the baseline. Relative amounts from 34 food group categories were varied to achieve specific energy and nutrient density goals at minimum cost while meeting model constraints intended to minimise deviation from the purchased diet. Simultaneous achievement of all nutrient goals was not feasible. The two most successful models (A & B) met all nutrient targets except sodium (146.2% and 148.9% of the respective target) and saturated fat (12.0% and 11.7% of energy). Model A was achieved with 3.2% lower cost than the baseline diet (which cost approximately AUD$13.01/person/day) and Model B at 7.8% lower cost but with a reduction in energy of 4.4%. Both models required very large reductions in sugar sweetened beverages (-90%) and refined cereals (-90%) and an approximate four-fold increase in vegetables, fruit, dairy foods, eggs, fish and seafood, and wholegrain cereals. This modelling approach suggested population level dietary recommendations at minimal cost based on the baseline purchased diet. Large shifts in diet in remote Aboriginal Australian populations are needed to achieve national nutrient targets. The modeling approach used was not able to meet all nutrient targets at less than current food expenditure.

Optimisation modelling to assess cost of dietary improvement in remote Aboriginal Australia.

Directory of Open Access Journals (Sweden)

Julie Brimblecombe

Full Text Available The cost and dietary choices required to fulfil nutrient recommendations defined nationally, need investigation, particularly for disadvantaged populations.We used optimisation modelling to examine the dietary change required to achieve nutrient requirements at minimum cost for an Aboriginal population in remote Australia, using where possible minimally-processed whole foods.A twelve month cross-section of population-level purchased food, food price and nutrient content data was used as the baseline. Relative amounts from 34 food group categories were varied to achieve specific energy and nutrient density goals at minimum cost while meeting model constraints intended to minimise deviation from the purchased diet.Simultaneous achievement of all nutrient goals was not feasible. The two most successful models (A & B met all nutrient targets except sodium (146.2% and 148.9% of the respective target and saturated fat (12.0% and 11.7% of energy. Model A was achieved with 3.2% lower cost than the baseline diet (which cost approximately AUD$13.01/person/day and Model B at 7.8% lower cost but with a reduction in energy of 4.4%. Both models required very large reductions in sugar sweetened beverages (-90% and refined cereals (-90% and an approximate four-fold increase in vegetables, fruit, dairy foods, eggs, fish and seafood, and wholegrain cereals.This modelling approach suggested population level dietary recommendations at minimal cost based on the baseline purchased diet. Large shifts in diet in remote Aboriginal Australian populations are needed to achieve national nutrient targets. The modeling approach used was not able to meet all nutrient targets at less than current food expenditure.

Sociodemographic variations in the amount, duration and cost of potentially preventable hospitalisation for chronic conditions among Aboriginal and non-Aboriginal Australians: a period prevalence study of linked public hospital data.

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Banham, David; Chen, Tenglong; Karnon, Jonathan; Brown, Alex; Lynch, John

2017-10-15

To determine disparities in rates, length of stay (LOS) and hospital costs of potentially preventable hospitalisations (PPH) for selected chronic conditions among Aboriginal and non-Aboriginal South Australians (SA), then examine associations with area-level socioeconomic disadvantage and remoteness. Period prevalence study using linked, administrative public hospital records. Participants included all SA residents in 2005-2006 to 2010-2011. Analysis focused on those individuals experiencing chronic PPH as defined by the Australian Institute of Health and Welfare. Number and rates (unadjusted, then adjusted for sex and age) of chronic PPH, total LOS and direct hospital costs by Aboriginality. Aboriginal SAs experienced higher risk of index chronic PPH compared with non-Aboriginals (11.5 and 6.2 per 1000 persons per year, respectively) and at younger ages (median age 48 vs 70 years). Once hospitalised, Aboriginal people experienced more chronic PPH events, longer total LOS with higher costs than non-Aboriginal people (2.6 vs 1.9 PPH per person; 11.7 vs 9.0 days LOS; at $A17 928 vs $A11 515, respectively). Compared with population average LOS, the standardised rate ratio of LOS among Aboriginal people increased by 0.03 (95% CI 0.00 to 0.07) as disadvantage rank increased and 1.04 (95% CI 0.63 to 1.44) as remoteness increased. Non-Aboriginal LOS also increased as disadvantage increased but at a lower rate (0.01 (95% CI 0.01 to 0.01)). Costs of Aboriginal chronic PPH increased by 0.02 (95% CI 0.00 to 0.06) for each increase in disadvantage and 1.18 (95% CI 0.80 to 1.55) for increased remoteness. Non-Aboriginal costs also increased as disadvantage increased but at lower rates (0.01 (95% CI 0.01 to 0.01)). Aboriginal people's heightened risk of chronic PPH resulted in more time in hospital and greater cost. Systematic disparities in chronic PPH by Aboriginality, area disadvantage and remoteness highlight the need for improved uptake of effective primary care. Routine

Innovations on a shoestring: a study of a collaborative community-based Aboriginal mental health service model in rural Canada

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Graham Douglas

2009-12-01

Full Text Available Abstract Background Collaborative, culturally safe services that integrate clinical approaches with traditional Aboriginal healing have been hailed as promising approaches to ameliorate the high rates of mental health problems in Aboriginal communities in Canada. Overcoming significant financial and human resources barriers, a mental health team in northern Ontario is beginning to realize this ideal. We studied the strategies, strengths and challenges related to collaborative Aboriginal mental health care. Methods A participatory action research approach was employed to evaluate the Knaw Chi Ge Win services and their place in the broader mental health system. Qualitative methods were used as the primary source of data collection and included document review, ethnographic interviews with 15 providers and 23 clients; and 3 focus groups with community workers and managers. Results The Knaw Chi Ge Win model is an innovative, community-based Aboriginal mental health care model that has led to various improvements in care in a challenging rural, high needs environment. Formal opportunities to share information, shared protocols and ongoing education support this model of collaborative care. Positive outcomes associated with this model include improved quality of care, cultural safety, and integration of traditional Aboriginal healing with clinical approaches. Ongoing challenges include chronic lack of resources, health information and the still cursory understanding of Aboriginal healing and outcomes. Conclusions This model can serve to inform collaborative care in other rural and Indigenous mental health systems. Further research into traditional Aboriginal approaches to mental health is needed to continue advances in collaborative practice in a clinical setting.

Aboriginal parent support: A partnership approach.

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Munns, Ailsa; Toye, Christine; Hegney, Desley; Kickett, Marion; Marriott, Rhonda; Walker, Roz

2018-02-01

This study was positioned within a larger action research study relating to a peer-led Aboriginal home visiting parent support program in an urban Western Australian setting. The aims for this study component were to identify program elements, exploring participants' perceptions of the program's suitability, feasibility, acceptability and effectiveness to inform program model recommendations and add to the body of knowledge on effective Aboriginal peer-led program models. The ability of Aboriginal parents to develop positive family environments is crucial, with parent support needing to be reflexive to local needs and sociocultural influences. Culturally appropriate service provision needs meaningful and acceptable strategies. This study was situated within a critical paradigm supporting Participatory Action Research methodology, using Action Learning Sets as the participant engagement and data collection setting. Within ten Action Learning Sets, focus group interviews were carried out with Aboriginal peer support workers, a non-Aboriginal parent support worker, an Aboriginal program coordinator, an Aboriginal education support officer and non-Aboriginal program managers (n = 8), and individual interviews with parents (n = 2) and community agencies (n = 4). Data were analysed using thematic analysis. Five themes were derived from peer support worker and community agency cohorts: peer support worker home visiting skills; responding to impacts of social determinants of health; client support and engagement; interagency collaboration; and issues addressing program sustainability. Parent responses augmented these themes. Participants identified five key elements relating to peer-led home visiting support for Aboriginal parents. These are uniquely placed to inform ongoing program development as there is little additional evidence in wider national and international contexts. Engagement with communities and peer support workers to develop culturally relevant

"If I Wanted to Have More Opportunities and Go to a Better School, I Just Had to Get Used to It": Aboriginal Students' Perceptions of Going to Boarding School in Western Australia

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Mander, David J.; Cohen, Lynne; Pooley, Julie Ann

2015-01-01

This study explored the experiences of 32 male Aboriginal students from regional and remote towns and communities while they attended a metropolitan boarding school away from home and family in Perth, Western Australia. Using narrative interviews it specifically investigated how these Aboriginal students construct meaning around the transition…

Improving palliative care outcomes for Aboriginal Australians: service providers' perspectives.

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Shahid, Shaouli; Bessarab, Dawn; van Schaik, Katherine D; Aoun, Samar M; Thompson, Sandra C

2013-07-23

Aboriginal Australians have a lower rate of utilisation of palliative care services than the general population. This study aimed to explore care providers' experiences and concerns in providing palliative care for Aboriginal people, and to identify opportunities for overcoming gaps in understanding between them and their Aboriginal patients and families. In-depth, qualitative interviews with urban, rural and remote palliative care providers were undertaken in inpatient and community settings in Western Australia. Interviews were audio-recorded, transcribed verbatim and coded independently by two researchers with QSR NVivo 10 software used to help manage data. Data analysis was informed by multiple theoretical standpoints, including the social ecological model, critical cultural theories and the 'cultural security' framework. Thematic analysis was carried out that identified patterns within data. Fifteen palliative care providers were interviewed. Overall they reported lack of understanding of Aboriginal culture and being uncertain of the needs and priorities of Aboriginal people during end-of-life care. According to several participants, very few Aboriginal people had an understanding of palliative care. Managing issues such as anger, denial, the need for non-medical support due to socioeconomic disadvantage, and dealing with crises and conflicts over funeral arrangements were reported as some of the tensions between Aboriginal patients and families and the service providers. Early referral to palliative care is important in demonstrating and maintaining a caring therapeutic relationship. Paramount to meeting the needs for Aboriginal patients was access to appropriate information and logistical, psychological and emotional support. These were often seen as essential but additional to standard palliative care services. The broader context of Aboriginal history and historical distrust of mainstream services was seen to impinge on Aboriginal people's willingness and

Improving palliative care outcomes for Aboriginal Australians: service providers’ perspectives

Science.gov (United States)

2013-01-01

Background Aboriginal Australians have a lower rate of utilisation of palliative care services than the general population. This study aimed to explore care providers’ experiences and concerns in providing palliative care for Aboriginal people, and to identify opportunities for overcoming gaps in understanding between them and their Aboriginal patients and families. Methods In-depth, qualitative interviews with urban, rural and remote palliative care providers were undertaken in inpatient and community settings in Western Australia. Interviews were audio-recorded, transcribed verbatim and coded independently by two researchers with QSR NVivo 10 software used to help manage data. Data analysis was informed by multiple theoretical standpoints, including the social ecological model, critical cultural theories and the ‘cultural security’ framework. Thematic analysis was carried out that identified patterns within data. Results Fifteen palliative care providers were interviewed. Overall they reported lack of understanding of Aboriginal culture and being uncertain of the needs and priorities of Aboriginal people during end-of-life care. According to several participants, very few Aboriginal people had an understanding of palliative care. Managing issues such as anger, denial, the need for non-medical support due to socioeconomic disadvantage, and dealing with crises and conflicts over funeral arrangements were reported as some of the tensions between Aboriginal patients and families and the service providers. Conclusion Early referral to palliative care is important in demonstrating and maintaining a caring therapeutic relationship. Paramount to meeting the needs for Aboriginal patients was access to appropriate information and logistical, psychological and emotional support. These were often seen as essential but additional to standard palliative care services. The broader context of Aboriginal history and historical distrust of mainstream services was seen to

Exploring disparities in acute myocardial infarction events between Aboriginal and non-Aboriginal Australians: roles of age, gender, geography and area-level disadvantage.

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Randall, D A; Jorm, L R; Lujic, S; Eades, S J; Churches, T R; O'Loughlin, A J; Leyland, A H

2014-07-01

We investigated disparities in rates of acute myocardial infarction (AMI) between Aboriginal and non-Aboriginal people in the 199 Statistical Local Areas (SLAs) in New South Wales, Australia. Using routinely collected and linked hospital and mortality data from 2002 to 2007, we developed multilevel Poisson regression models to estimate the relative rates of first AMI events in the study period accounting for area of residence. Rates of AMI in Aboriginal people were more than two times that in non-Aboriginal people, with the disparity greatest in more disadvantaged and remote areas. AMI rates in Aboriginal people varied significantly by SLA, as did the Aboriginal to non-Aboriginal rate ratio. We identified almost 30 priority areas for universal and targeted preventive interventions that had both high rates of AMI for Aboriginal people and large disparities in rates. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Aboriginal Language Knowledge and Youth Suicide

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Hallett, Darcy; Chandler, Michael J.; Lalonde, Christopher E.

2007-01-01

This brief report details a preliminary investigation into how community-level variability in knowledge of Aboriginal languages relate to "band"-level measures of youth suicide. In Canada, and, more specifically, in the province of British Columbia (BC), Aboriginal youth suicide rates vary substantially from one community to another. The…

Diabetes screening of children in a remote First Nations community on the west coast of Canada: challenges and solutions.

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Panagiotopoulos, C; Rozmus, J; Gagnon, R E; Macnab, A J

2007-01-01

Type 2 diabetes (T2D) and its precursor, impaired glucose tolerance (IGT), are now reaching epidemic proportions among Aboriginal Canadians. Of particular concern is the appearance and increasing prevalence of T2D and IGT among Aboriginal youth. At the request of three communities in the Tsimshian nation on the northern coast of British Columbia (with which the Department of Pediatrics, University of British Columbia, had a pre-existing partnership) a screening program was undertaken to determine the prevalence of T2D and IGT among the children. The long-term goal was the collaborative development of intervention programs for each community. The challenges of meeting this request included the sociological and ethical issues associated with research in First Nations communities, as well as the pragmatic issues of conducting complex research in remote communities. Three separate visits were undertaken to respect the cultural dynamics and capacity of the community to accommodate a project of this magnitude. The process began with dialogue, listening and presentations to the community. Only then began the planning of logistics and application for funding. Next, the team visited the communities to ensure understanding of exactly what was involved for the community, each child and family, and to be certain that consent was fully informed. For the diabetes screening visit, special arrangements including chartering a Beaver float plane were needed for the transport of the five-member team with all the necessary equipment, including a -20(o)C freezer to safeguard the integrity of blood samples. The 100% consent rate, successful conduct of study, and retention of community support achieved by the process, indicate that population-based clinical research is possible in remote First Nations communities. This is best achieved with appropriate dialogue, care, respect and planning to overcome the sociological, ethical and practical challenges.

The role of primary health care services to better meet the needs of Aboriginal Australians transitioning from prison to the community.

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Lloyd, Jane E; Delaney-Thiele, Dea; Abbott, Penny; Baldry, Eileen; McEntyre, Elizabeth; Reath, Jennifer; Indig, Devon; Sherwood, Juanita; Harris, Mark F

2015-07-22

Aboriginal Australians are more likely than other Australians to cycle in and out of prison on remand or by serving multiple short sentences-a form of serial incarceration and institutionalisation. This cycle contributes to the over-representation of Aboriginal Australians in prison and higher rates of recidivism. Our research examined how primary health care can better meet the health care and social support needs of Aboriginal Australians transitioning from prison to the community. Purposive sampling was used to identify 30 interviewees. Twelve interviews were with Aboriginal people who had been in prison; ten were with family members and eight with community service providers who worked with former inmates. Thematic analysis was conducted on the interviewees' description of their experience of services provided to prisoners both during incarceration and on transition to the community. Interviewees believed that effective access to primary health care on release and during transition was positively influenced by providing appropriate healthcare to inmates in custody and by properly planning for their release. Further, interviewees felt that poor communication between health care providers in custody and in the community prior to an inmate's release, contributed to a lack of comprehensive management of chronic conditions. System level barriers to timely communication between in-custody and community providers included inmates being placed on remand which contributed to uncertainty regarding release dates and therefore difficulties planning for release, cycling in and out of prison on short sentences and being released to freedom without access to support services. For Aboriginal former inmates and family members, release from prison was a period of significant emotional stress and commonly involved managing complex needs. To support their transition into the community, Aboriginal former inmates would benefit from immediate access to culturally- responsive

Mortality after admission for acute myocardial infarction in Aboriginal and non-Aboriginal people in New South Wales, Australia: a multilevel data linkage study

Directory of Open Access Journals (Sweden)

Randall Deborah A

2012-04-01

Full Text Available Abstract Background Heart disease is a leading cause of the gap in burden of disease between Aboriginal and non-Aboriginal Australians. Our study investigated short- and long-term mortality after admission for Aboriginal and non-Aboriginal people admitted with acute myocardial infarction (AMI to public hospitals in New South Wales, Australia, and examined the impact of the hospital of admission on outcomes. Methods Admission records were linked to mortality records for 60047 patients aged 25–84 years admitted with a diagnosis of AMI between July 2001 and December 2008. Multilevel logistic regression was used to estimate adjusted odds ratios (AOR for 30- and 365-day all-cause mortality. Results Aboriginal patients admitted with an AMI were younger than non-Aboriginal patients, and more likely to be admitted to lower volume, remote hospitals without on-site angiography. Adjusting for age, sex, year and hospital, Aboriginal patients had a similar 30-day mortality risk to non-Aboriginal patients (AOR: 1.07; 95% CI 0.83-1.37 but a higher risk of dying within 365 days (AOR: 1.34; 95% CI 1.10-1.63. The latter difference did not persist after adjustment for comorbid conditions (AOR: 1.12; 95% CI 0.91-1.38. Patients admitted to more remote hospitals, those with lower patient volume and those without on-site angiography had increased risk of short and long-term mortality regardless of Aboriginal status. Conclusions Improving access to larger hospitals and those with specialist cardiac facilities could improve outcomes following AMI for all patients. However, major efforts to boost primary and secondary prevention of AMI are required to reduce the mortality gap between Aboriginal and non-Aboriginal people.

Appropriate health promotion for Australian Aboriginal and Torres Strait Islander communities: crucial for closing the gap.

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Demaio, Alessandro; Drysdale, Marlene; de Courten, Maximilian

2012-06-01

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.

Syncrude's commitment to Aboriginal development

International Nuclear Information System (INIS)

Loader, R. K.

1999-01-01

Syncrude's program designed to maintain good relations with Aboriginal communities in all areas where Syncrude operation impact upon Aboriginal peoples and their traditional ways of life are described. The program extends from employment through education to business and community development, the preservation of traditional lifestyles, and the protection of the environment. As examples, some 13 per cent of Syncrude's workforce is made up of Aboriginal people, at an average annual salary of $58,000. The company offers $ 2,000 each, specifically to Aboriginal persons, wanting to further their education particularly in disciplines related to oil sands. A five-year $ 500,000 program has been established by Syncrude at the University of Alberta specifically for Aboriginal people to pursue careers in engineering, medicine , education and business. Other career programs are also offered through Keyano College, Athabasca University and the Northern Alberta Development Council, and there is a strong commitment by the company to encouraging adults to go back to school and for kids to stay in school. Last year the company spent $ 54 million with Aboriginal-owned and operated businesses; the company also support several programs to foster the appreciation of Aboriginal culture not only in Alberta but throughout the country. Environment is the fifth and final element of the Aboriginal Development Program. It involves consultation and working with local communities on environmental matters involving issues ranging from land reclamation to emission reduction. Some six million dollars are spent annually on reclaiming land and reintroducing native animal and plant species wherever possible. An outstanding example of this is the Wood Bison Trail on 210 hectares of reclaimed land managed by the Fort McKay First Nations. It is readily acknowledged that dealing with Aboriginal concerns has not been an easy road to travel and that there are still many things to do. Nevertheless, there

Help bring back the celebration of life: A community-based participatory study of rural Aboriginal women’s maternity experiences and outcomes

Directory of Open Access Journals (Sweden)

Varcoe Colleen

2013-01-01

Full Text Available Abstract Background Despite clear evidence regarding how social determinants of health and structural inequities shape health, Aboriginal women’s birth outcomes are not adequately understood as arising from the historical, economic and social circumstances of their lives. The purpose of this study was to understand rural Aboriginal women’s experiences of maternity care and factors shaping those experiences. Methods Aboriginal women from the Nuxalk, Haida and 'Namgis First Nations and academics from the University of British Columbia in nursing, medicine and counselling psychology used ethnographic methods within a participatory action research framework. We interviewed over 100 women, and involved additional community members through interviews and community meetings. Data were analyzed within each community and across communities. Results Most participants described distressing experiences during pregnancy and birthing as they grappled with diminishing local maternity care choices, racism and challenging economic circumstances. Rural Aboriginal women’s birthing experiences are shaped by the intersections among rural circumstances, the effects of historical and ongoing colonization, and concurrent efforts toward self-determination and more vibrant cultures and communities. Conclusion Women’s experiences and birth outcomes could be significantly improved if health care providers learned about and accounted for Aboriginal people’s varied encounters with historical and ongoing colonization that unequivocally shapes health and health care. Practitioners who better understand Aboriginal women’s birth outcomes in context can better care in every interaction, particularly by enhancing women’s power, choice, and control over their experiences. Efforts to improve maternity care that account for the social and historical production of health inequities are crucial.

Uranium royalties and Aboriginal economic development

International Nuclear Information System (INIS)

O'Faircheallaigh, C.

1988-01-01

In 1978 and 1979 agreements were negotiated under the Land Rights Act for development of the Ranger and Nabarlek uranium deposits, both located in the Alligator River Region. Over the period between March 1979 and June 1986, some $70 million have been paid to Aboriginal communities by these two projects. This paper is concerned with expenditure of uranium revenues by Aboriginal associations which have been established to receive up front and rental payments provided for in these agreements as well as the 30% of statutory royalties payable to Aboriginal communities affected by mining operations

Hypertension: high prevalence and a positive association with obesity among Aboriginal and Torres Strait Islander youth in far north Queensland.

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Esler, Danielle; Raulli, Alexandra; Pratt, Rohan; Fagan, Patricia

2016-04-01

Hypertension and other chronic disease risks are common among Aboriginal and Torres Strait Islander adults but there is little evidence regarding the epidemiology of these risk factors during adolescence. This study examines the prevalence of pre-hypertension, hypertension and other cardiovascular risk factors in Aboriginal and Torres Strait Islander people aged 15-24 years living in remote Indigenous communities in north Queensland. In so doing, it aims to better inform the approach to cardiovascular disease in this population. This is a descriptive study that retrospectively examines health service data from a program of community screening, the Young Persons Check (YPC). Participants were 1,883 Aboriginal and Torres Strait Islander people aged 15-24 years who attended for a YPC in 11 remote communities in north Queensland between March 2009 and April 2011. Overall, the prevalence of pre-hypertension was 34.0%; stage I hypertension was 17.7% and stage II hypertension was 3.3%. The prevalence of elevated waist circumference was 47.6%, overweight or obesity 45.9%, elevated triglycerides 18.3%, decreased HDL 54.8% and proteinuria 24.3%. The prevalence of hypertension (stage I or II) among Torres Strait Islander males was 34.1%, Aboriginal males 26.9%, Torres Strait Islander females 12.6% and Aboriginal females 13.0%. Hypertension was associated with sex (males) (OR= 4.37, p<0.000), overweight (OR=2.46, p<0.000), obesity (OR=4.59, p<0.000) and elevated triglycerides (OR=2.38, p<0.000). Pre-hypertension, hypertension and other cardiovascular risk in this population is highly prevalent. Hypertension was particularly prevalent among male participants. The results reiterate the importance of early life experience in cardiovascular disease prevention. © 2015 The Authors.

Enabling Voice: Aboriginal Parents, Experiences and Perceptions of Sending a Child to Boarding School in Western Australia

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Mander, David J.

2015-01-01

This study explored the experience of having a child educated away from home at boarding school for Aboriginal parents living in regional and remote communities in Western Australia (WA). In-depth interviews were conducted with 11 participants and thematic analysis found the following major themes emerged from the data: (1) Access, Standards and…

Antenatal services for Aboriginal women: the relevance of cultural competence.

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Reibel, Tracy; Walker, Roz

2010-01-01

Due to persistent significantly poorer Aboriginal perinatal outcomes, the Women's and Newborns' Health Network, Western Australian Department of Health, required a comprehensive appraisal of antenatal services available to Aboriginal women as a starting point for future service delivery modelling. A services audit was conducted to ascertain the usage frequency and characteristics of antenatal services used by Aboriginal women in Western Australia (WA). Telephone interviews were undertaken with eligible antenatal services utilising a purpose specific service audit tool comprising questions in five categories: 1) general characteristics; 2) risk assessment; 3) treatment, risk reduction and education; 4) access; and 5) quality of care. Data were analysed according to routine antenatal care (e.g. risk assessment, treatment and risk reduction), service status (Aboriginal specific or non-specific) and application of cultural responsiveness. Significant gaps in appropriate antenatal services for Aboriginal women in metropolitan, rural and remote regions in WA were evident. Approximately 75% of antenatal services used by Aboriginal women have not achieved a model of service delivery consistent with the principles of culturally responsive care, with few services incorporating Aboriginal specific antenatal protocols/programme, maintaining access or employing Aboriginal Health Workers (AHWs). Of 42 audited services, 18 Aboriginal specific and 24 general antenatal services reported utilisation by Aboriginal women. Of these, nine were identified as providing culturally responsive service delivery, incorporating key indicators of cultural security combined with highly consistent delivery of routine antenatal care. One service was located in the metropolitan area and eight in rural or remote locations. The audit of antenatal services in WA represents a significant step towards a detailed understanding of which services are most highly utilised and their defining characteristics

Blending Aboriginal and Western healing methods to treat intergenerational trauma with substance use disorder in Aboriginal peoples who live in northeastern Ontario, Canada.

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Marsh, Teresa Naseba; Coholic, Diana; Cote-Meek, Sheila; Najavits, Lisa M

2015-05-20

As with many Indigenous groups around the world, Aboriginal communities in Canada face significant challenges with trauma and substance use. The complexity of symptoms that accompany intergenerational trauma and substance use disorders represents major challenges in the treatment of both disorders. There appears to be an underutilization of substance use and mental health services, substantial client dropout rates, and an increase in HIV infections in Aboriginal communities in Canada. The aim of this paper is to explore and evaluate current literature on how traditional Aboriginal healing methods and the Western treatment model "Seeking Safety" could be blended to help Aboriginal peoples heal from intergenerational trauma and substance use disorders. A literature search was conducted using the keywords: intergenerational trauma, historical trauma, Seeking Safety, substance use, Two-Eyed Seeing, Aboriginal spirituality, and Aboriginal traditional healing. Through a literature review of Indigenous knowledge, most Indigenous scholars proposed that the wellness of an Aboriginal community can only be adequately measured from within an Indigenous knowledge framework that is holistic, inclusive, and respectful of the balance between the spiritual, emotional, physical, and social realms of life. Their findings indicate that treatment interventions must honour the historical context and history of Indigenous peoples. Furthermore, there appears to be strong evidence that strengthening cultural identity, community integration, and political empowerment can enhance and improve mental health and substance use disorders in Aboriginal populations. In addition, Seeking Safety was highlighted as a well-studied model with most populations, resulting in healing. The provided recommendations seek to improve the treatment and healing of Aboriginal peoples presenting with intergenerational trauma and addiction. Other recommendations include the input of qualitative and quantitative

A Guide for Health Professionals Working with Aboriginal Peoples: Executive Summary

Science.gov (United States)

2013-01-01

Objective to provide Canadian health professionals with a network of information and recommendations regarding Aboriginal health. Options health professionals working with Aboriginal individuals and communities in the area of women’s health care. Outcomes improved health status of Aboriginal peoples in Canada. Appropriateness and accessibility of women’s health services for Aboriginal peoples. Improved communication and clinical skills of health professionals in the area of Aboriginal health. Improved quality of relationship between health professionals and Aboriginal individuals and communities. Improved quality of relationship between health care professionals and Aboriginal individuals and communities. Evidence recommendations are based on expert opinion and a review of the literature. Published references were identified by a Medline search of all review articles, randomized clinical control trials, meta-analyses, and practice guidelines from 1966 to February 1999, using the MeSH headings “Indians, North American or Eskimos” and “Health.”* Subsequently published articles were brought to the attention of the authors in the process of writing and reviewing the document. Ancillary and unpublished references were recommended by members of the SOGC Aboriginal Health Issues Committee and the panel of expert reviewers. Values information collected was reviewed by the principal author. The social, cultural, political, and historic context of Aboriginal peoples in Canada, systemic barriers regarding the publication of information by Aboriginal authors, the diversity of Aboriginal peoples in Canada, and the need for a culturally appropriate and balanced presentation were carefully considered in addition to more traditional scientific evaluation. The majority of information collected consisted of descriptive health and social information and such evaluation tools as the evidence guidelines of the Canadian Task Force on the Periodic Health exam were not

Sustaining health education research programs in Aboriginal communities.

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Wisener, Katherine; Shapka, Jennifer; Jarvis-Selinger, Sandra

2017-09-01

Despite evidence supporting the ongoing provision of health education interventions in First Nations communities, there is a paucity of research that specifically addresses how these programs should be designed to ensure sustainability and long-term effects. Using a Community-Based Research approach, a collective case study was completed with three Canadian First Nations communities to address the following research question: What factors are related to sustainable health education programs, and how do they contribute to and/or inhibit program success in an Aboriginal context? Semi-structured interviews and a sharing circle were completed with 19 participants, including members of community leadership, external partners, and program staff and users. Seven factors were identified to either promote or inhibit program sustainability, including: 1) community uptake; 2) environmental factors; 3) stakeholder awareness and support; 4) presence of a champion; 5) availability of funding; 6) fit and flexibility; and 7) capacity and capacity building. Each factor is provided with a working definition, influential moderators, and key evaluation questions. This study is grounded in, and builds on existing research, and can be used by First Nations communities and universities to support effective sustainability planning for community-based health education interventions.

Developing a culturally appropriate branding for a social and emotional wellbeing intervention in an Aboriginal community.

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Donovan, Robert J; Murray, Lesley; Hicks, Jolleen; Nicholas, Amberlee; Anwar-McHenry, Julia

2018-02-22

An initial consultation process to implement a culturally appropriate social and emotional wellbeing campaign in an Aboriginal community indicated that the fundamental principles of the Act-Belong-Commit mental health promotion campaign were acceptable, but that a cultural adaptation of the branding should be sought. A competition was held inviting community members to design a brand logo for the campaign in their community. Local judges selected "winners" in various categories, and six of the submissions were selected for testing in the broader community via street intercept interviews. Respondents were asked which logo they liked best, their perceived meanings of the designs and the perceived appropriateness of the designs for a social and emotional wellbeing campaign. A convenience sample of N = 26 local Aboriginal people who lived and/or worked in Roebourne completed the questionnaire. There was a clear majority preference for logo "D," which communicated appropriate meanings of pride and strength in standing together, and reflected the underlying strengths and capacities of Aboriginal people which this project seeks to harness and support. The approach of using a logo competition to develop the campaign brand was highly successful and enabled further meaningful engagement with the community and other service providers in the town. The success of the competition process resulted from an emphasis on relationship building, listening to the local community and involving the community in decision-making. So what? By conforming to established, but not always adhered to, recommendations for community consultation, successful and more enduring outcomes are likely. © 2018 Australian Health Promotion Association.

Substance misuse in Aboriginal Australians.

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Gracey, M

1998-01-01

Australia's Aborigines lived in isolation from the rest of humanity as successful hunter-gatherers for tens of thousands of years. That isolation ended abruptly with British colonization in the late 18th century and was followed by a traumatic 200 years for Aborigines who are now seriously disadvantaged, socio-economically and in terms of their health standards. It has often been assumed that the Aborigines had no access to psychotropic substances before permanent European contact but several pieces of evidence dispute this view. The history of Aboriginal contact with and usage of intoxicating substances, including alcohol, is extremely complex and affected by a maze of restrictive government policies. These interact with a wide range of other Federal and State policies which have changed rapidly since the late 1960s when Aborigines were first granted the franchise; access to unrestricted drinking followed soon afterwards. Today Aborigines suffer disproportionately to other Australians from the physical and social consequences of excess alcohol consumption, tobacco usage, petrol and other solvent sniffing, usage of marijuana, amphetamines, cocaine and heroin, as well as other drugs. The Aboriginal population is dispersed in cities, towns, fringe settlements, rural and remote areas over this vast continent and there are different patterns of drug usage from place to place. This review attempts to synthesize some of this information in order to give an overview to the history, background, current status of substance misuse by Aborigines as well as some strategies being used to try to overcome this serious problem.

Community-Based Suicide Prevention Research in Remote On-Reserve First Nations Communities

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Isaak, Corinne A.; Campeau, Mike; Katz, Laurence Y.; Enns, Murray W.; Elias, Brenda; Sareen, Jitender

2010-01-01

Suicide is a complex problem linked to genetic, environmental, psychological and community factors. For the Aboriginal population more specifically, loss of culture, history of traumatic events, individual, family and community factors may also play a role in suicidal behaviour. Of particular concern is the high rate of suicide among Canadian…

Inequalities in pediatric avoidable hospitalizations between Aboriginal and non-Aboriginal children in Australia: a population data linkage study.

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Falster, Kathleen; Banks, Emily; Lujic, Sanja; Falster, Michael; Lynch, John; Zwi, Karen; Eades, Sandra; Leyland, Alastair H; Jorm, Louisa

2016-10-21

Australian Aboriginal children experience a disproportionate burden of social and health disadvantage. Avoidable hospitalizations present a potentially modifiable health gap that can be targeted and monitored using population data. This study quantifies inequalities in pediatric avoidable hospitalizations between Australian Aboriginal and non-Aboriginal children. This statewide population-based cohort study included 1 121 440 children born in New South Wales, Australia, between 1 July 2000 and 31 December 2012, including 35 609 Aboriginal children. Using linked hospital data from 1 July 2000 to 31 December 2013, we identified pediatric avoidable, ambulatory care sensitive and non-avoidable hospitalization rates for Aboriginal and non-Aboriginal children. Absolute and relative inequalities between Aboriginal and non-Aboriginal children were measured as rate differences and rate ratios, respectively. Individual-level covariates included age, sex, low birth weight and/or prematurity, and private health insurance/patient status. Area-level covariates included remoteness of residence and area socioeconomic disadvantage. There were 365 386 potentially avoidable hospitalizations observed over the study period, most commonly for respiratory and infectious conditions; Aboriginal children were admitted more frequently for all conditions. Avoidable hospitalization rates were 90.1/1000 person-years (95 % CI, 88.9-91.4) in Aboriginal children and 44.9/1000 person-years (44.8-45.1) in non-Aboriginal children (age and sex adjusted rate ratio = 1.7 (1.7-1.7)). Rate differences and rate ratios declined with age from 94/1000 person-years and 1.9, respectively, for children aged primary care, have potential to narrow this gap.

Surface rights on Aboriginal lands

International Nuclear Information System (INIS)

McElhanney, W.L.

1998-01-01

Several issues regarding access and activity by petroleum industry on Aboriginal and Metis lands are discussed. Some alternative means by which both industry and Aboriginal groups can approach the matter of surface rights are presented. A historical account of how surface rights have been interpreted in the past was given. It was emphasized that the approach to surface rights compensation and negotiation for both aboriginal and industry parties must begin with adequate consultation. Rigid adherence to the usual past practice of geologically identifying locations, surveying and requesting a lease will no longer suffice. The aboriginal community must be consulted with as much lead time as possible, even assisted financially to identify traditional use areas that require protection, or cannot be disturbed, or require particular mitigation measures. Once this has been done, the operator can proceed to outline the scope of his project, detailing the timing, location, business and employment opportunities and other economic opportunities to the community. 21 refs

Otitis Media, Learning and Community.

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McSwan, David; Clinch, Emma; Store, Ron

2001-01-01

A 3-year research project in Queensland (Australia) implemented educational and health strategies to ameliorate effects of otitis media at three schools in remote Aboriginal communities. The interdisciplinary model brought together health and education professionals, teacher aides, and the community, with the school being the lead agency. However,…

Associations of television viewing, physical activity and dietary behaviours with obesity in aboriginal and non-aboriginal Canadian youth.

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Ng, Carmina; Young, T Kue; Corey, Paul N

2010-09-01

To determine associations of diet, physical activity and television (TV) viewing time with obesity among aboriginal and non-aboriginal youth in conjunction with socio-economic variables. Cross-sectional study of differences between aboriginal and non-aboriginal groups and associations between lifestyle and socio-economic factors with obesity were examined. Population data from the Canadian Community Health Survey Cycle 2.2 conducted in 2004 in the ten provinces of Canada. A total of 198 aboriginal and 4448 non-aboriginal Canadian youth aged 12-17 years. Compared to non-aboriginal youth, physical activity participation among aboriginal youth was higher, but consumption of vegetables and dairy products was lower, and more aboriginal youth were 'high' TV watchers. Low income adequacy was associated with decreased odds for obesity among aboriginal youth in contrast to higher odds among non-aboriginal youth. Non-aboriginal 'high' TV watchers consumed more soft drinks and non-whole-grain products than did 'low' TV watchers. Physical activity participation did not differ between 'high' and 'low' TV watchers for both groups, and was associated with lowered odds for obesity only among aboriginal youth. Sociodemographic and lifestyle risk factors associated with obesity differ between aboriginal and non-aboriginal youth. These findings may be useful for guiding intervention efforts.

Awareness and impact of the 'Bubblewrap' advertising campaign among Aboriginal smokers in Western Australia.

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Boyle, Terry; Shepherd, Carrington C J; Pearson, Glenn; Monteiro, Heather; McAullay, Daniel; Economo, Kristina; Stewart, Susan

2010-02-01

Antismoking mass media campaigns have been shown to reduce smoking prevalence in the mainstream community, however there is little published research on their effect on Aboriginal Australian smokers. To evaluate the awareness and impact of a mainstream mass media advertising campaign (the 'Bubblewrap' campaign) on Aboriginal smokers in the state of Western Australia. A personal intercept survey was conducted in July 2008 across three sites (the Perth metropolitan area and the non-metropolitan towns of Kalgoorlie and Broome). An opportunity or convenience sampling strategy was used to recruit Aboriginal participants, and face-to-face interviews were conducted with 198 Aboriginal smokers to ascertain awareness of the campaign advertisements, whether they were seen as believable and relevant, and the impact the advertisements had on smoking behaviour. The majority of the participants interviewed had seen and/or heard the 'Bubblewrap' campaign advertisements, although there was considerably greater awareness of the television advertisement than the radio advertisements. Both forms of advertising were considered to be believable and relevant by the majority of Aboriginal smokers. Most of the smokers interviewed thought about cutting down and/or quitting after seeing or hearing the advertisements. Our findings suggest that mainstream antismoking mass media campaigns can positively influence the thoughts and behaviours that Aboriginal smokers have, and exhibit, towards quitting smoking. Notwithstanding this, advertisers should continue to look for better ways to incorporate Aboriginal themes in campaign messages. Future mainstream antismoking campaigns should source sufficient funds to ensure that advertising messages reach the large Aboriginal populations in regional and remote Australia.

Aboriginal women in rural Australia; a small study of infant feeding behaviour.

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Helps, Catherine; Barclay, Lesley

2015-06-01

Aboriginal women in rural areas have lower rates of breastfeeding than Australian averages. The reasons for this are poorly understood. Aboriginal people experience higher morbidity and increased rates of chronic disease throughout the life cycle. The protective effects of sustained breastfeeding could benefit rural Aboriginal communities. To explore the factors impacting upon infant feeding choices in a rural Aboriginal Community. Semi-structured interviews were conducted with eight Aboriginal rural dwelling first time mothers. These women received a continuity of midwife and Aboriginal Health Worker model of care. Interviews were also undertaken with five Aboriginal Health Workers and two Aboriginal community breastfeeding champions. The analysis was integrated with a conventional literature review and was further developed and illustrated with historical literature. Indigenist methodology guided the study design, analysis and the dissemination of results. Three key themes were identified. These were "I'm doing the best thing for..." which encompasses the motivations underpinning infant feeding decisions; "this is what I know..." which explores individual and community knowledge regarding infant feeding; and "a safe place to feed" identifying the barriers that negative societal messages pose for women as they make infant feeding decisions. It appears loss of family and community breastfeeding knowledge resulting from colonisation still influences the Aboriginal women of today. Aboriginal women value and trust knowledge which is passed to them from extended family members and women within their Community. Cultural, historical and socioeconomic factors all strongly influence the infant feeding decisions of individuals in this study. Efforts to normalise breastfeeding in the culture of rural dwelling Aboriginal women and their supporting community appear to be necessary and may promote breastfeeding more effectively than optimal professional care of individuals can

Effects of Community Singing Program on Mental Health Outcomes of Australian Aboriginal and Torres Strait Islander People: A Meditative Approach.

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Sun, Jing; Buys, Nicholas

2016-03-01

To evaluate the impact of a meditative singing program on the health outcomes of Aboriginal and Torres Strait Islander people. The study used a prospective intervention design. The study took place in six Aboriginal and Torres Strait Islander communities and Community Controlled Health Services in Queensland, Australia. Study participants were 210 Australian Aboriginal and Torres Strait Islander adults aged 18 to 71 years, of which 108 were in a singing intervention group and 102 in a comparison group. A participative community-based community singing program involving weekly singing rehearsals was conducted over an 18-month period. Standardized measures in depression, resilience, sense of connectedness, social support, and singing related quality of life were used. The general linear model was used to compare differences pre- and postintervention on outcome variables, and structural equation modeling was used to examine the pathway of the intervention effect. Results revealed a significant reduction in the proportion of adults in the singing group classified as depressed and a concomitant significant increase in resilience levels, quality of life, sense of connectedness, and social support among this group. There were no significant changes for these variables in the comparison group. The participatory community singing approach linked to preventative health services was associated with improved health, resilience, sense of connectedness, social support, and mental health status among Aboriginal and Torres Strait Islander adults. © The Author(s) 2016.

Design of environmental education module towards the needs of aboriginal community learning

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Dasman, Siti Mariam; Yasin, Ruhizan Mohammad

2017-05-01

Non-formal education (NFE) refers to a program that is designed for personal and social education for learners to improve the level of skills and competencies outside formal educational curriculum. Issues related to geography and environment of different Aboriginal communities with other communities play an important role in determining the types and methods that should be made available to the minority community groups. Thus, this concept paper is intended to cater for educational environment through the design and development of learning modules based on non-formal education to the learning of Aboriginal community. Methods and techniques in the design and construction of the modules is based on the Design and Development Research (DDR) that was based on instructional design model of Morrison, Kemp and Ross which is more flexible and prioritizes the needs and characteristics of learners who were involved in the learning modules of the future. The discussion is related to the module development which is suitable to the learning needs of the community and there are several recommendations which may be applied in the implementation of this approach. In conclusion, the community of Orang Asli should be offered the same education as other communities but it is important to distinguish acceptance of learning techniques or approaches used in the education system to meet their standards. The implications of this concept paper is to meet the educational needs of the environment which includes a few aspects of science and some learning activities using effective approaches such as playing and building their own knowledge of meaning.

Prevalence and incidence of frailty in Aboriginal Australians, and associations with mortality and disability.

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Hyde, Zoë; Flicker, Leon; Smith, Kate; Atkinson, David; Fenner, Stephen; Skeaf, Linda; Malay, Roslyn; Lo Giudice, Dina

2016-05-01

Frailty represents a loss of homeostasis, markedly increasing the risk of death and disability. Frailty has been measured in several ethnic groups, but not, to our knowledge, in Aboriginal Australians. We aimed to determine the prevalence and incidence of frailty, and associations with mortality and disability, in remote-living Aboriginal people. Between 2004 and 2006, we recruited 363 Aboriginal people aged ≥ 45 years from 6 remote communities and one town in the Kimberley region of Western Australia (wave 1). Between 2011 and 2013, 182 surviving participants were followed-up (wave 2). We assessed frailty with an index, comprising 20 health-related items. Participants with ≥ 4 deficits (frailty index ≥ 0.2) were considered frail. Disability was assessed by family/carer report. Those unable to do ≥ 2 of 6 key or instrumental activities of daily living were considered disabled. We investigated associations between frailty, and disability and mortality, with logistic regression and Cox proportional hazards models. At wave 1 (W1), 188 participants (65.3%) were frail, and of robust people at W1 who participated in wave 2, 38 (51.4%) had become frail. Frailty emerged at a younger age than expected. A total of 109 people died (30.0%), of whom 80 (73.4%) were frail at W1. Frailty at W1 was not associated with becoming disabled, but was associated with mortality (HR = 1.9; 95% CI 1.2, 3.0). Frailty in remote-living Aboriginal Australians is highly prevalent; substantially higher than in other populations. Research to understand the underlying causes of frailty in this population, and if possible, reverse frailty, is urgently needed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Raising Awareness of Australian Aboriginal Peoples Reality: Embedding Aboriginal Knowledge in Social Work Education through the Use of Field Experiences

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Duthie, Deb; King, Julie; Mays, Jenni

2013-01-01

Effective social work practice with Aboriginal peoples and communities requires knowledge of operational communication skills and practice methods. In addition, there is also a need for practitioners to be aware of the history surrounding white engagement with Aboriginal communities and their cultures. Indeed, the Australian Association of Social…

Quality improvement in practice: improving diabetes care and patient outcomes in Aboriginal Community Controlled Health Services.

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Stoneman, Alice; Atkinson, David; Davey, Maureen; Marley, Julia V

2014-10-07

Management of chronic disease, including diabetes, is a central focus of most Aboriginal Community Controlled Health Services (ACCHSs) in Australia. We have previously demonstrated that diabetes monitoring and outcomes can be improved and maintained over a 10-year period at Derby Aboriginal Health Service (DAHS). While continuous quality improvement (CQI) has been shown to improve service delivery rates and clinical outcome measures, the process of interpreting audit results and developing strategies for improvement is less well described. This paper describes the evaluation of care of patients with type 2 diabetes mellitus (T2DM) and features of effective CQI in ACCHSs in the remote Kimberley region of north Western Australia. Retrospective audit of records for Aboriginal and Torres Strait Islander primary care patients aged ≥15 years with a confirmed diagnosis of T2DM at four Kimberley ACCHSs from 1 July 2011 to 30 June 2012. Interviews with health service staff and focus group discussions with patients post audit. diabetes care related activities, clinical outcome measures and factors influencing good diabetes related care and effective CQI. A total of 348 patients from the four ACCHSs were included in the study. Clinical care activities were generally high across three of the four health services (at least 71% of patients had cholesterol recorded, 89% blood pressure, 84% HbA1c). Patients from DAHS had lower median cholesterol levels (4.4 mmol/L) and the highest proportion of patients meeting clinical targets for HbA1c (31% v 16% ACCHS-3; P = 0.02). Features that facilitated good care included clearly defined staff roles for diabetes management, support and involvement of Aboriginal Health Workers, efficient recall systems, and well-coordinated allied health services. Effective CQI features included seamless and timely data collection, local ownership of the process, openness to admitting deficiencies and willingness to embrace change. Well

Factors affecting job satisfaction of Aboriginal mental health workers working in community mental health in rural and remote New South Wales.

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Cosgrave, Catherine; Maple, Myfanwy; Hussain, Rafat

2017-12-01

Objective The aim of the present study was to identify factors affecting the job satisfaction and subsequent retention of Aboriginal mental health workers (AMHWs). Methods Five AMHWs working in New South Wales (NSW) for NSW Health in rural and remote community mental health (CMH) services participated in in-depth, semi-structured interviews to understand how employment and rural living factors affected workers' decisions to stay or leave their CMH positions. Results Using a constructivist grounded theory analysis, three aspects negatively impacting the job satisfaction of AMHWs were identified: (1) difficulties being accepted into the team and organisation; (2) culturally specific work challenges; and (3) professional differences and inequality. Conclusions Policy and procedural changes to the AMHW training program may address the lower remuneration and limited career opportunities identified with regard to the Bachelor Health Sciences (Mental Health) qualification. Delivering training to increase levels of understanding about the AMHW training program, and cultural awareness generally, to CMH staff and NSW Health management may assist in addressing the negative team, organisational and cultural issues identified. What is known about the topic? The Bachelor Health Sciences (Mental Health) qualification and traineeship pathway undertaken by AMHWs differs significantly from that of other health professionals working in NSW Health's CMH services. The health workforce literature identifies that each health professional group has its own culture and specific values and that forming and maintaining a profession-specific identity is an extremely important aspect of job satisfaction for health workers. What does the paper add? AMHWs working in rural and remote NSW CMH services commonly experience low levels of job satisfaction, especially while undertaking the embedded training program. Of particular concern is the health sciences qualification not translating into NSW

Comets in Australian Aboriginal Astronomy

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Hamacher, Duane W.; Norris, Ray P.

2011-03-01

We present 25 accounts of comets from 40 Australian Aboriginal communities, citing both supernatural perceptions of comets and historical accounts of historically bright comets. Historical and ethnographic descriptions include the Great Comets of 1843, 1861, 1901, 1910, and 1927. We describe the perceptions of comets in Aboriginal societies and show that they are typically associated with fear, death, omens, malevolent spirits, and evil magic, consistent with many cultures around the world. We also provide a list of words for comets in 16 different Aboriginal languages.

Mediating Tragedy: Facebook, Aboriginal Peoples and Suicide

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Bronwyn Lee Carlson

2015-11-01

Full Text Available Some Australian Aboriginal communities experience suicide rates that are among the highest in the world. They are also, however, avid social media users—approximately 20% higher than the national average. This article presents some preliminary findings from a current national study, funded by the Australian Research Council, titled Aboriginal identity and community online: a sociological exploration of Aboriginal peoples’ use of online social media. The purpose of the study is to gain insights into how Aboriginal peoples utilise and interact on social media, and how these technologies can assist with suicide prevention strategies. It found that Aboriginal people are engaging with Facebook to both seek and offer help for issues relating to suicide and self-harm. An existing continuum of suicide prevention strategies was evident—from light emotional support to direct suicide intervention involving health services. These strategies can be leveraged to implement effective and appropriate suicide prevention programs.

Smoking and Other Drug Characteristics of Aboriginal and Non-Aboriginal Prisoners in Australia

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Robyn L. Richmond

2013-01-01

Full Text Available Introduction and Aim. Although tobacco and alcohol use have declined substantially in the Australian community, substance use among prisoners remains high. The aim was to compare the smoking, drug, and alcohol characteristics, sociodemographic profile, and general health of Aboriginal and non-Aboriginal male prisoners in a smoking cessation intervention. Design and Methods. This study was a descriptive cross-sectional analysis of data from 425 male prisoners who joined a quit smoking trial conducted at 18 correctional centres in NSW and Queensland using data collected by standardised self-report instruments. Results. Average age was 33 years with 15% from Aboriginal descent. Compared to non-Aboriginal prisoners, Aboriginal prisoners were significantly more likely to have left school with no qualifications, to have been institutionalised as a child, to be previously incarcerated, and commenced smoking at a younger age. The tobacco use profile of both groups was similar; most of them had a medium to high level of nicotine dependence, smoked roll your own tobacco, and were “serious” about quitting. Discussion and Conclusion. Despite differences in terms of sociodemographic characteristics and offending history, the smoking characteristics of Aboriginal and non- Aboriginal prisoners were similar. Incarceration offers an opportunity to encourage smoking cessation and reduction of drug use.

Chronic disease, medications and lifestyle: perceptions from a regional Victorian Aboriginal community

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Deacon-Crouch M

2016-09-01

Full Text Available Background: Poor medication management may contribute to the increased morbidity and mortality of Aboriginal people in Australia. Yet while there is extensive literature about the perceptions of healthcare providers on this issue, there is limited information on the perceptions of Aboriginal people themselves. Objectives: To investigate the perceptions of a group of Aboriginal people attending a Victorian regional Aboriginal Health Service (AHS with diagnosed medical conditions requiring medications, of their lifestyle, disease management and medication usage. Methods: Data was collected through one to one in depth interviews using a semi-structured ‘yarning’ process. Twenty patients were invited to participate in the study and were interviewed by Aboriginal Health Workers in a culturally appropriate manner. The interviews were recorded and transcribed verbatim. The data were analysed using descriptive statistics. Results: Our results show that the majority of participants perceived that changes in lifestyle factors such as diet, exercise, and smoking cessation would help improve their health. Most patients reported having been counselled on their medicines, and while the majority reported adherence and acknowledgement of the efficacy of their medicines, there was a lack of clarity regarding long term maintenance on regimens. Finally, while the majority reported taking over the counter products, some did not see the need to inform their doctor about this, or chose not to. Conclusion: Chronic illness was perceived as common in families and community. Patients relied mostly on their health care professionals as sources for their drug information. Patients may have benefited from further counselling in the area of complementary and other over the counter medicines, as well as on the necessity of maintenance of regimes for chronic disease management. Finally, lifestyle changes such as dietary improvements and smoking cessation were identified as

Cross-sectional comparison of point-of-care with laboratory HbA1c in detecting diabetes in real-world remote Aboriginal settings

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Marley, Julia V; Oh, May S; Hadgraft, Nyssa; Singleton, Sally; Isaacs, Kim; Atkinson, David

2015-01-01

Objectives To determine if point-of-care (POC) glycated haemoglobin (HbA1c) is sufficiently accurate in real-world remote settings to predict or exclude the diagnosis of diabetes based on laboratory HbA1c measurements. Design Cross-sectional study comparing POC capillary HbA1c results with corresponding venous HbA1c levels measured in a reference laboratory. Participants Aboriginal patients ≥15 years old who were due for diabetes screening at the participating clinics were invited to participate. Two hundred and fifty-five Aboriginal participants were enrolled and 241 were included in the analysis. Setting 6 primary healthcare sites in the remote Kimberley region of Western Australia from September 2011 to November 2013. Main outcome measures Concordance and mean differences between POC capillary blood HbA1c measurement and laboratory measurement of venous blood HbA1c level; POC capillary blood HbA1c equivalence value for screening for diabetes or a high risk of developing diabetes; sensitivity, specificity and positive-predictive value for diagnosing and screening for diabetes; barriers to conducting POC testing. Results Concordance between POC and laboratory results was good (ρ=0.88, pHbA1c measurements ≥6.5%, 48 mmol/mol had a specificity of 98.2% and sensitivity of 73.7% for laboratory measurements ≥6.5%. The POC equivalence value for screening for diabetes or a high risk of developing diabetes was ≥5.7%, 39 mmol/mol (sensitivity, 91%; specificity, 76.7% for laboratory measurements ≥6.0%, 42 mmol/mol). Staff trained by other clinic staff ‘on the job’ performed as well as people with formal accredited training. Staff reported difficulty in maintaining formal accreditation. Conclusions POC HbA1c testing is sufficiently accurate to be a useful component in screening for, and diagnosing, diabetes in remote communities. Limited local training is adequate to produce results comparable to laboratory results and accreditation processes need to

Communication disorders after stroke in Aboriginal Australians.

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Armstrong, Elizabeth; Hersh, Deborah; Hayward, Colleen; Fraser, Joan

2015-01-01

Limited research exists on acquired communication disorders (ACD) in Aboriginal Australians despite their high rates of stroke. Their uptake of rehabilitation services is low, and little information is available on functional consequences for this population. This pilot study explored consequences of ACD for Aboriginal Australians after stroke, including their experiences of services received. Semi-structured interviews were collected with 13 Aboriginal people with ACD, and family members, in Perth. Ages ranged from 30 to 78 years and time post stroke from 0.5 to 29 years. A qualitative, thematic analysis of interview transcripts was undertaken. The key themes which emerged were "getting on with life", coping with change, independence/interdependence, the importance of communication for maintaining family and community connection, role and identity issues and viewing the stroke consequences within the broader context of co-morbidities. While similar life disruptions were found to those previously reported in the general stroke population, this study highlighted differences, which reflect the particular context of ACD for Aboriginal people and which need to be considered when planning future services. While implications are limited due to small numbers, the findings emphasise the importance of a holistic approach, and integration of communication treatments into community-led social activities. Implications for Rehabilitation Aboriginal Australians frequently experience a range of concurrent and complex co-morbidities and demanding social or family circumstances at the same time as coping with communication disorders post-stroke. A holistic approach to post stroke rehabilitation may be appropriate with services that accommodate communication disorders, delivered in collaboration with Aboriginal organisations, emphasising positive attitudes and reintegration into community as fully as possible. Communication and yarning are important for maintaining family and

Consulting Whom? Lessons from the Toronto Urban Aboriginal Strategy

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Mai T. Nguyen

2014-04-01

Full Text Available The research conducted here looks at the current Urban Aboriginal Strategy (UAS in Toronto. The purpose of this Strategy is to provide long-term investments to support Aboriginal communities in urban settings by focusing on three priority areas: improving life skills; promoting job training, skills, and entrepreneurship; and supporting Aboriginal women, children, and families. This article seeks to answer the following question: Does the UAS provide Aboriginal participants with the ability to effectively participant in the consultation process? It argues that the UAS process of consulting with the urban Aboriginal community does not allow for the effective participation of Aboriginal peoples because of problematics related to consulting in an urban setting and despite the language of partnership, the federal government still reserves the right to make final decisions. These problems diminish the ability to build renewed Aboriginal-State relations based on mutual respect and trust, which has been absent within the Aboriginal-State apparatus and resulted in the political exclusion of Aboriginals in Canada. Though consultation can be a vehicle for empowering participants with decision-making authority, this is not the case in Toronto. The lack of a common vision, political buy-in, and the aura of secrecy leads to a political relationship built on mistrust. Mistrust between members and government renders the consultation process ineffective. This article combines the literature on public consultations with official government documents to identify critical components that must be evident for consultations to be fruitful and participation effective. These criteria are the benchmarks upon which to measure effectiveness. Based on interviews with the Steering Committee, this article finds that the UAS process of consulting with the Toronto Aboriginal community does not enable Aboriginal participants to effectively participate in the democratic process.

Incidence of type 2 diabetes in Aboriginal Australians: an 11-year prospective cohort study.

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Wang, Zhiqiang; Hoy, Wendy E; Si, Damin

2010-08-17

Diabetes is an important contributor to the health inequity between Aboriginal and non-Aboriginal Australians. This study aims to estimate incidence rates of diabetes and to assess its associations with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) among Aboriginal participants in a remote community. Six hundred and eighty six (686) Aboriginal Australians aged 20 to 74 years free from diabetes at baseline were followed for a median of 11 years. During the follow-up period, new diabetes cases were identified through hospital records. Cox proportional hazards models were used to assess relationships of the incidence rates of diabetes with IFG, IGT and body mass index (BMI). One hundred and twenty four (124) new diabetes cases were diagnosed during the follow up period. Incidence rates increased with increasing age, from 2.2 per 1000 person-years for those younger than 25 years to 39.9 per 1000 person-years for those 45-54 years. By age of 60 years, cumulative incidence rates were 49% for Aboriginal men and 70% for Aboriginal women. The rate ratio for developing diabetes in the presence of either IFG or IGT at baseline was 2.2 (95% CI: 1.5, 3.3), adjusting for age, sex and BMI. Rate ratios for developing diabetes were 2.2 (95% CI: 1.4, 3.5) for people who were overweight and 4.7 (95% CI: 3.0, 7.4) for people who were obese at baseline, with adjustment of age, sex and the presence of IFG/IGT. Diabetes incidence rates are high in Aboriginal people. The lifetime risk of developing diabetes among Aboriginal men is one in two, and among Aboriginal women is two in three. Baseline IFG, IGT and obesity are important predictors of diabetes.

Incidence of type 2 diabetes in Aboriginal Australians: an 11-year prospective cohort study

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Wang Zhiqiang

2010-08-01

Full Text Available Abstract Background Diabetes is an important contributor to the health inequity between Aboriginal and non-Aboriginal Australians. This study aims to estimate incidence rates of diabetes and to assess its associations with impaired fasting glucose (IFG and impaired glucose tolerance (IGT among Aboriginal participants in a remote community. Methods Six hundred and eighty six (686 Aboriginal Australians aged 20 to 74 years free from diabetes at baseline were followed for a median of 11 years. During the follow-up period, new diabetes cases were identified through hospital records. Cox proportional hazards models were used to assess relationships of the incidence rates of diabetes with IFG, IGT and body mass index (BMI. Results One hundred and twenty four (124 new diabetes cases were diagnosed during the follow up period. Incidence rates increased with increasing age, from 2.2 per 1000 person-years for those younger than 25 years to 39.9 per 1000 person-years for those 45-54 years. By age of 60 years, cumulative incidence rates were 49% for Aboriginal men and 70% for Aboriginal women. The rate ratio for developing diabetes in the presence of either IFG or IGT at baseline was 2.2 (95% CI: 1.5, 3.3, adjusting for age, sex and BMI. Rate ratios for developing diabetes were 2.2 (95% CI: 1.4, 3.5 for people who were overweight and 4.7 (95% CI: 3.0, 7.4 for people who were obese at baseline, with adjustment of age, sex and the presence of IFG/IGT. Conclusions Diabetes incidence rates are high in Aboriginal people. The lifetime risk of developing diabetes among Aboriginal men is one in two, and among Aboriginal women is two in three. Baseline IFG, IGT and obesity are important predictors of diabetes.

Australian Aboriginal Deaf People and Aboriginal Sign Language

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Power, Des

2013-01-01

Many Australian Aboriginal people use a sign language ("hand talk") that mirrors their local spoken language and is used both in culturally appropriate settings when speech is taboo or counterindicated and for community communication. The characteristics of these languages are described, and early European settlers' reports of deaf…

Appropriate Health Promotion for Australian Aboriginal and Torres Strait Islander Communities

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Demaio, Alessandro Rhyll; Drysdale, Marlene; de Courten, Maximilian

2012-01-01

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...

The impact of a community-led program promoting weight loss and healthy living in Aboriginal communities: the New South Wales Knockout Health Challenge.

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Passmore, Erin; Shepherd, Brooke; Milat, Andrew; Maher, Louise; Hennessey, Kiel; Havrlant, Rachael; Maxwell, Michelle; Hodge, Wendy; Christian, Fiona; Richards, Justin; Mitchell, Jo

2017-12-13

Aboriginal people in Australia experience significant health burden from chronic disease. There has been limited research to identify effective healthy lifestyle programs to address risk factors for chronic disease among Aboriginal people. The Knockout Health Challenge is a community-led healthy lifestyle program for Aboriginal communities across New South Wales, Australia. An evaluation of the 2013 Knockout Health Challenge was undertaken. Participants' self-reported physical activity and diet were measured at four time points - at the start and end of the Challenge (via paper form), and 5 and 9 months after the Challenge (via telephone survey). Participants' weight was measured objectively at the start and end of the Challenge, and self-reported (via telephone survey) 5 and 9 months after the Challenge. Changes in body composition, physical activity and diet between time points were analysed using linear mixed models. As part of the telephone survey participants were also asked to identify other impacts of the Challenge; these were analysed descriptively (quantitative items) and thematically (qualitative items). A total of 586 people registered in 22 teams to participate in the Challenge. The mean weight at the start was 98.54kg (SD 22.4), and 94% of participants were overweight or obese. Among participants who provided data at all four time points (n=122), the mean weight loss from the start to the end of the Challenge was 2.3kg (95%CI -3.0 to -1.9, pChallenge was 2.3kg (95%CI -3.3 to -1.3, pChallenge, and 0.8kg/m 2 (95%CI -1.2 to -0.4, pChallenge, participants reported they were more physically active and had increased fruit and vegetable consumption compared with the start of the Challenge, and identified a range of other positive impacts. The Challenge was effective in reducing weight and promoting healthy lifestyles among Aboriginal people across New South Wales, and has potential to contribute to closing the health gap between Aboriginal and non-Aboriginal

Aboriginal Gambling and Problem Gambling: A Review

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Breen, Helen; Gainsbury, Sally

2013-01-01

The prevention of gambling-related problems amongst Aboriginal communities has been neglected by most public health strategies which concentrate on mainstream populations. Research indicates that rates of problem gambling are higher for Aboriginal groups than the general population. Specific cultural, familial, and social patterns influence…

Research methods of Talking About The Smokes: an International Tobacco Control Policy Evaluation Project study with Aboriginal and Torres Strait Islander Australians.

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Thomas, David P; Briggs, Viki L; Couzos, Sophia; Davey, Maureen E; Hunt, Jennifer M; Panaretto, Kathryn S; van der Sterren, Anke E; Stevens, Matthew; Nicholson, Anna K; Borland, Ron

2015-06-01

To describe the research methods and baseline sample of the Talking About The Smokes (TATS) project. The TATS project is a collaboration between research institutions and Aboriginal community-controlled health services (ACCHSs) and their state and national representative bodies. It is one of the studies within the International Tobacco Control Policy Evaluation Project, enabling national and international comparisons. It includes a prospective longitudinal study of Aboriginal and Torres Strait Islander smokers and recent ex-smokers; a survey of non-smokers; repeated cross-sectional surveys of ACCHS staff; and descriptions of the tobacco policies and practices at the ACCHSs. Community members completed face-to-face surveys; staff completed surveys on paper or online. We compared potential biases and the distribution of variables common to the main community baseline sample and unweighted and weighted results of the 2008 National Aboriginal and Torres Strait Islander Social Survey (NATSISS). The baseline survey (Wave 1) was conducted between April 2012 and October 2013. 2522 Aboriginal and Torres Strait Islander people in 35 locations (the communities served by 34 ACCHSs and one community in the Torres Strait), and 645 staff in the ACCHSs. Sociodemographic and general health indicators, smoking status, number of cigarettes smoked per day and quit attempts. The main community baseline sample closely matched the distribution of the Aboriginal and Torres Strait Islander population in the weighted NATSISS by age, sex, jurisdiction and remoteness. There were inconsistent differences in some sociodemographic factors between our sample and the NATSISS: our sample had higher proportions of unemployed people, but also higher proportions who had completed Year 12 and who lived in more advantaged areas. In both surveys, similar percentages of smokers reported having attempted to quit in the past year, and daily smokers reported similar numbers of cigarettes smoked per day. The

The Development of Cross-Cultural Relations with a Canadian Aboriginal Community through Sport Research

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Schinke, Robert J.; Hanrahan, Stephanie J.; Eys, Mark A.; Blodgett, Amy; Peltier, Duke; Ritchie, Stephen Douglas; Pheasant, Chris; Enosse, Lawrence

2008-01-01

When sport psychology researchers from the mainstream work with people from marginalized cultures, they can be challenged by cultural differences as well as mistrust. For this article, researchers born in mainstream North America partnered with Canadian Aboriginal community members. The coauthors have worked together for 5 years. What follows is…

Socio-economic impacts between the nuclear industry and Aboriginal people

International Nuclear Information System (INIS)

Malcolm, D.G.

1996-01-01

The paper explores several aspects of the socio-economic impact of the nuclear industry on Aboriginal people in northern Canada. The issues discussed include decision-making by consensus, community-based development, the role of Traditional Ecological Knowledge and Management Systems (TEKMS), relationships with land and nature, and social and health issues. The issues are discussed with respect to the divergence between Aboriginal and non-Aboriginal cultures, which affect the timelines for project viability as well as the continued harmony between industry and community. It is concluded that economic gains can be achieved through continuous community dialogue from the moment of project inception. (author)

Aboriginal groups taking leadership positions in power sector

Energy Technology Data Exchange (ETDEWEB)

Kishewitsch, S.

2009-09-15

First Nations and Metis communities are now initiating and managing projects in the Canadian energy sector. Federal and provincial governments are now developing training programs to ensure that Aboriginal communities develop the skills needed to successfully manage energy projects. The Supreme Court of Canada has issued a number of rulings ensuring that companies and government agencies have a duty to consult with Aboriginal people when Crown decisions impact Treaty or Aboriginal rights. The Ministry of Energy and Infrastructure has now set up a unit to provide advice and guidance to facilitate partnership opportunities with First Nations and Metis communities. Major companies in Ontario have also developed consultation policies that focus on relationship building, internal education, and promoting business and workforce development. The Pic River First Nation group now owns a minority interest in the Wawatay generating station. A 23 MW facility is fully owned by the First Nations group. The province of Ontario has made a provision for up to $250 million to serve as loan guarantees for First Nations groups. It was concluded that the Electricity Sector Council (ESC) has developed an Aboriginal participation engagement project designed to increase Aboriginal awareness of opportunities within the electricity and renewable energy sector. 3 figs.

HIV Testing and Care in Canadian Aboriginal Youth: A community based mixed methods study

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Myers Ted

2008-10-01

Full Text Available Abstract Background HIV infection is a serious concern in the Canadian Aboriginal population, particularly among youth; however, there is limited attention to this issue in research literature. The purpose of this national study was to explore HIV testing and care decisions of Canadian Aboriginal youth. Methods A community-based mixed-method design incorporating the Aboriginal research principles of Ownership, Control, Access and Possession (OCAP was used. Data were collected through surveys (n = 413 and qualitative interviews (n = 28. Eleven community-based organizations including urban Aboriginal AIDS service organizations and health and friendship centres in seven provinces and one territory assisted with the recruitment of youth (15 to 30 years. Results Average age of survey participants was 21.5 years (median = 21.0 years and qualitative interview participants was 24.4 years (median = 24.0. Fifty-one percent of the survey respondents (210 of 413 youth and 25 of 28 interview participants had been tested for HIV. The most common reason to seek testing was having sex without a condom (43.6% or pregnancy (35.4% while common reasons for not testing were the perception of being low HIV risk (45.3% or not having had sex with an infected person (34.5%. Among interviewees, a contributing reason for not testing was feeling invulnerable. Most surveyed youth tested in the community in which they lived (86.5% and 34.1% visited a physician for the test. The majority of surveyed youth (60.0% had tested once or twice in the previous 2 years, however, about one-quarter had tested more than twice. Among the 26 surveyed youth who reported that they were HIV-positive, 6 (23.1% had AIDS at the time of diagnosis. Delays in care-seeking after diagnosis varied from a few months to seven years from time of test. Conclusion It is encouraging that many youth who had tested for HIV did so based on a realistic self-assessment of HIV risk behaviours; however, for others

An ethnobotanical study of medicinal plants used by the Yaegl Aboriginal community in northern New South Wales, Australia.

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Packer, Joanne; Brouwer, Nynke; Harrington, David; Gaikwad, Jitendra; Heron, Ronald; Yaegl Community Elders; Ranganathan, Shoba; Vemulpad, Subramanyam; Jamie, Joanne

2012-01-06

Documentation of Australian bush medicines is of utmost importance to the preservation of this disappearing and invaluable knowledge. This collaboration between the Yaegl Aboriginal community in northern New South Wales (NSW), Australia and an academic institution, demonstrates an effective means of preserving and adding value to this information. Questionnaire-guided interviews were performed with community Elders under a framework of participatory action research. Medicinal plant knowledge was collated in a handbook to aid interviews and to be used as an ongoing resource by the community. Specimens for all non-cultivar plants that were discussed were collected and deposited in herbaria with unique voucher numbers. This medicinal knowledge was checked against the literature for reports of related use and studies of biological activity. Nineteen Elders were interviewed, leading to discussions on fifty four plant preparations used for medicinal purposes. These plant preparations involved thirty two plants coming from twenty one families, reflecting the botanical diversity of the area. The plants retained in the Yaegl pharmacopoeia correspond to their accessibility and ease of preparation, reflected in their ongoing utilisation. Several plant uses did not appear elsewhere in the literature. This study is the first comprehensive documentation of the medicinal knowledge of the Yaegl Aboriginal community. It has been conducted using participatory action research methods and adds to the recorded customary knowledge of the region. The customary medicinal knowledge retained by the Yaegl Aboriginal community is related to the evolving needs of the community and accessibility of plants. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Exploration of the beliefs and experiences of Aboriginal people with cancer in Western Australia: a methodology to acknowledge cultural difference and build understanding

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Howat Peter

2009-08-01

Full Text Available Abstract Background Aboriginal Australians experience poorer outcomes, and are 2.5 times more likely to die from cancer than non-Aboriginal people, even after adjustment for stage of diagnosis, cancer treatment and comorbidities. They are also less likely to present early as a result of symptoms and to access treatment. Psycho-social factors affect Aboriginal people's willingness and ability to participate in cancer-related screening and treatment services, but little exploration of this has occurred within Australia to date. The current research adopted a phenomenological qualitative approach to understand and explore the lived experiences of Aboriginal Australians with cancer and their beliefs and understanding around this disease in Western Australia (WA. This paper details considerations in the design and process of conducting the research. Methods/Design The National Health and Medical Research Council (NHMRC guidelines for ethical conduct of Aboriginal research were followed. Researchers acknowledged the past negative experiences of Aboriginal people with research and were keen to build trust and relationships prior to conducting research with them. Thirty in-depth interviews with Aboriginal people affected by cancer and twenty with health service providers were carried out in urban, rural and remote areas of WA. Interviews were audio-recorded, transcribed verbatim and coded independently by two researchers. NVivo7 software was used to assist data management and analysis. Participants' narratives were divided into broad categories to allow identification of key themes and discussed by the research team. Discussion and conclusion Key issues specific to Aboriginal research include the need for the research process to be relationship-based, respectful, culturally appropriate and inclusive of Aboriginal people. Researchers are accountable to both participants and the wider community for reporting their findings and for research translation so

Starting points and pathways in Aboriginal students' learning of number: recognising different world views

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Treacy, Kaye; Frid, Sandra; Jacob, Lorraine

2015-09-01

This research was designed to investigate the conceptualisations and thinking strategies Indigenous Australian students use in counting tasks. Eighteen Aboriginal students, in years 1 to 11 at a remote community school, were interviewed using standard counting tasks and a `counting' task that involved fetching `maku' (witchetty grubs) to have enough to give a maku to each person in a picture. The tasks were developed with, and the interviews conducted by, an Aboriginal research assistant, to ensure appropriate cultural and language contexts. A main finding was that most of the students did not see the need to use counting to make equivalent sets, even though they were able to demonstrate standard counting skills. The findings highlight a need to further examine the world views, orientations and related mathematical concepts and processes that Indigenous students bring to school.

"There's a housing crisis going on in Sydney for Aboriginal people": focus group accounts of housing and perceived associations with health.

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Andersen, Melanie J; Williamson, Anna B; Fernando, Peter; Redman, Sally; Vincent, Frank

2016-05-24

Poor housing is widely cited as an important determinant of the poor health status of Aboriginal Australians, as for indigenous peoples in other wealthy nations with histories of colonisation such as Canada, the United States of America and New Zealand. While the majority of Aboriginal Australians live in urban areas, most research into housing and its relationship with health has been conducted with those living in remote communities. This study explores the views of Aboriginal people living in Western Sydney about their housing circumstances and what relationships, if any, they perceive between housing and health. Four focus groups were conducted with clients and staff of an Aboriginal community-controlled health service in Western Sydney (n = 38). Inductive, thematic analysis was conducted using framework data management methods in NVivo10. Five high-level themes were derived: the battle to access housing; secondary homelessness; overcrowding; poor dwelling conditions; and housing as a key determinant of health. Participants associated their challenging housing experiences with poor physical health and poor social and emotional wellbeing. Housing issues were said to affect people differently across the life course; participants expressed particular concern that poor housing was harming the health and developmental trajectories of many urban Aboriginal children. Housing was perceived as a pivotal determinant of health and wellbeing that either facilitates or hinders prospects for full and healthy lives. Many of the specific health concerns participants attributed to poor housing echo existing epidemiological research findings. These findings suggest that housing may be a key intervention point for improving the health of urban Aboriginal Australians.

Improving mental health awareness among rural Aboriginal men: perspectives from Gippsland.

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Isaacs, Anton; Maybery, Darryl

2012-04-01

To identify views of Aboriginal people in rural areas about improving mental health awareness among Aboriginal men. Semi-structured interviews were conducted with 17 Aboriginal people, including men, carers and health workers. Participants highlighted the need for mental health awareness programs in the community. They described the type of programs to be conducted as well as their method, content and frequency. This study demonstrates that mental health awareness programs designed specifically for rural Aboriginal men need to involve local Elders and other significant individuals from the community, be de-stigmatised by including mental health under Men's Health and by embedding the messages within a cultural framework.

The economic impact on Aboriginal communities of the Ranger Project: 1979-1985

International Nuclear Information System (INIS)

O'Faircheallaigh, C.

1986-01-01

What are the benefits generated for Aboriginal people by mining projects like the Ranger Project? Are these projects likely to fulfill the expectations of Aborigines who support the controlled exploitation of mineral resources on their land? This article examines the economic impact of the Ranger uranium project on Aboriginal people. Its principal aim is to provide detailed information on the use of royalty-related payments made to traditional owners as a result of Ranger's operations, and the consequent employment, training and social service opportunities for Aborigines

Contextual determinants of health behaviours in an aboriginal community in Canada: pilot project

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Joseph Pamela

2012-11-01

Full Text Available Abstract Background Rapid change in food intake, physical activity, and tobacco use in recent decades have contributed to the soaring rates of obesity, type 2 diabetes and cardiovascular disease (CVD in Aboriginal populations living in Canada. The nature and influence of contextual factors on Aboriginal health behaviours are not well characterized. Methods To describe the contextual determinants of health behaviours associated with cardiovascular risk factors on the Six Nations reserve, including the built environment, access and affordability of healthy foods, and the use of tobacco. In this cross-sectional study, 63 adults from the Six Nations Reserve completed the modified Neighbourhood Environment Walkability Scale (NEWS, questionnaire assessing food access and availability, tobacco pricing and availability, and the Environmental Profile of Community Health (EPOCH tool. Results The structured environment of Six Nations Reserve scored low for walkability, street connectivity, aesthetics, safety, and access to walking and cycling facilities. All participants purchased groceries off-reserve, although fresh fruits and vegetables were reported to be available and affordable both on and off-reserve. On average $151/week is spent on groceries per family. Ninety percent of individuals report tobacco use is a problem in the community. Tobacco is easily accessible for children and youth, and only three percent of community members would accept increased tobacco taxation as a strategy to reduce tobacco access. Conclusions The built environment, access and affordability of healthy food and tobacco on the Six Nations Reserve are not perceived favourably. Modification of these contextual factors described here may reduce adverse health behaviours in the community.

Participation of Aboriginal peoples in resource development

International Nuclear Information System (INIS)

Welsh, J.; Snow, J.D.

1998-01-01

The means by which the petroleum industry can establish a successful relationship with Aboriginal people and their community are described. It was emphasized that industry and Aboriginals must define training, employment and business objectives jointly for the longer term. Suncor's Oil Sands Group operates in an area considered to be traditional lands by the First Nation and Metis people of Fort McKay. Suncor recognizes its responsibilities to Fort McKay and has taken the approach to support Aboriginal community development through written agreements and protocols which identify the social, economic, environmental and political issues that are important to them. The Memorandum of Understanding between Suncor Energy Oil Sands, Fort McKay First Nation, and Fort McKay Metis Local 122 is used as an example of one major company's initiatives to establish a mutually supportive and interdependent relationship

Trying to keep a balance: the meaning of health and diabetes in an urban aboriginal community.

Science.gov (United States)

Thompson, S J; Gifford, S M

2000-11-01

Although the predominant paradigm of epidemiological investigation continues to focus narrowly on the individual and on individual risk factors, there is a growing body of work that calls for a rethinking of the current epidemiological models. In this paper we illustrate the need for a more comprehensive epidemiological approach towards understanding the risks for diabetes, by exploring the lived experiences of diabetes and lay meanings of risk among Aborigines living in Melbourne, Australia. Ethnographic fieldwork was conducted within the Melbourne Aboriginal community in the state of Victoria over a 22-month period (1994-1996). Melbourne Aborigines see non-insulin dependent diabetes mellitus (NIDDM) as the result of living a life out of balance, a life of lost or severed connections with land and kin and a life with little control over past, present or future. The lay model regarding diabetes that is derived from the narratives of Melbourne Aborigines, consists of three levels of connectedness important in determining an individual's susceptibility not only to diabetes but to all disease--(1) family, (2) community and (3) society. This structure of interactive systems at successive levels from the individual to the population fits within the framework of an ecological paradigm. The strength of ethnography as applied to epidemiology is that it has the capacity to discover previously unknown components of a system at several different levels, and to build models to explain how these components interact. This framework, developed using an ethno-epidemiological approach, has application in other indigenous populations who have been dispossessed of their land, their pasts and their future. There is great potential to apply this approach to the major public health challenges presented by rapid global socio-cultural and environmental change that are impacting negatively on population health.

Effective Nutrition Education for Aboriginal Australians: Lessons from a Diabetes Cooking Course

Science.gov (United States)

Abbott, Penelope A.; Davison, Joyce E.; Moore, Louise F.; Rubinstein, Raechelle

2012-01-01

Objectives: To examine the experiences of Aboriginal Australians with or at risk of diabetes who attended urban community cooking courses in 2002-2007; and to develop recommendations for increasing the uptake and effectiveness of nutrition education in Aboriginal communities. Methods: Descriptive qualitative approach using semistructured…

Increasing Pap smear rates at an urban Aboriginal Community Controlled Health Service through translational research and continuous quality improvement.

Science.gov (United States)

Dorrington, Melanie S; Herceg, Ana; Douglas, Kirsty; Tongs, Julie; Bookallil, Marianne

2015-01-01

This article describes translational research (TR) and continuous quality improvement (CQI) processes used to identify and address barriers and facilitators to Pap smear screening within an urban Aboriginal Community Controlled Health Service (ACCHS). Rapid Plan-Do-Study-Act (PDSA) cycles were conducted, informed by client surveys, a data collection tool, focus groups and internal research. There was a statistically significant increase in Pap smear numbers during PDSA cycles, continuing at 10 months follow up. The use of TR with CQI appears to be an effective and acceptable way to affect Pap smear screening. Community and service collaboration should be at the core of research in Aboriginal and Torres Strait Islander health settings. This model is transferrable to other settings and other health issues.

Providing culturally appropriate mental health first aid to an Aboriginal or Torres Strait Islander adolescent: development of expert consensus guidelines

Science.gov (United States)

2014-01-01

Background It is estimated that the prevalence of mental illness is higher in Aboriginal and Torres Strait Islander adolescents compared to non-Aboriginal adolescents. Despite this, only a small proportion of Aboriginal youth have contact with mental health services, possibly due to factors such as remoteness, language barriers, affordability and cultural sensitivity issues. This research aimed to develop culturally appropriate guidelines for anyone who is providing first aid to an Australian Aboriginal or Torres Strait Islander adolescent who is experiencing a mental health crisis or developing a mental illness. Methods A panel of Australian Aboriginal people who are experts in Aboriginal youth mental health, participated in a Delphi study investigating how members of the public can be culturally appropriate when helping an Aboriginal or Torres Strait Islander adolescent with mental health problems. The panel varied in size across the three sequential rounds, from 37–41 participants. Panellists were presented with statements about cultural considerations and communication strategies via online questionnaires and were encouraged to suggest additional content. All statements endorsed as either Essential or Important by ≥ 90% of panel members were written into a guideline document. To assess the panel members’ satisfaction with the research method, participants were invited to provide their feedback after the final survey. Results From a total of 304 statements shown to the panel of experts, 194 statements were endorsed. The methodology was found to be useful and appropriate by the panellists. Conclusion Aboriginal and Torres Strait Islander Youth mental health experts were able to reach consensus about what the appropriate communication strategies for providing mental health first aid to an Aboriginal and Torres Strait Islander adolescent. These outcomes will help ensure that the community provides the best possible support to Aboriginal adolescents who

Providing culturally appropriate mental health first aid to an Aboriginal or Torres Strait Islander adolescent: development of expert consensus guidelines.

Science.gov (United States)

Chalmers, Kathryn J; Bond, Kathy S; Jorm, Anthony F; Kelly, Claire M; Kitchener, Betty A; Williams-Tchen, Aj

2014-01-28

It is estimated that the prevalence of mental illness is higher in Aboriginal and Torres Strait Islander adolescents compared to non-Aboriginal adolescents. Despite this, only a small proportion of Aboriginal youth have contact with mental health services, possibly due to factors such as remoteness, language barriers, affordability and cultural sensitivity issues. This research aimed to develop culturally appropriate guidelines for anyone who is providing first aid to an Australian Aboriginal or Torres Strait Islander adolescent who is experiencing a mental health crisis or developing a mental illness. A panel of Australian Aboriginal people who are experts in Aboriginal youth mental health, participated in a Delphi study investigating how members of the public can be culturally appropriate when helping an Aboriginal or Torres Strait Islander adolescent with mental health problems. The panel varied in size across the three sequential rounds, from 37-41 participants. Panellists were presented with statements about cultural considerations and communication strategies via online questionnaires and were encouraged to suggest additional content. All statements endorsed as either Essential or Important by ≥ 90% of panel members were written into a guideline document. To assess the panel members' satisfaction with the research method, participants were invited to provide their feedback after the final survey. From a total of 304 statements shown to the panel of experts, 194 statements were endorsed. The methodology was found to be useful and appropriate by the panellists. Aboriginal and Torres Strait Islander Youth mental health experts were able to reach consensus about what the appropriate communication strategies for providing mental health first aid to an Aboriginal and Torres Strait Islander adolescent. These outcomes will help ensure that the community provides the best possible support to Aboriginal adolescents who are developing mental illnesses or are in a

A clash of paradigms? Western and indigenous views on health research involving Aboriginal peoples.

Science.gov (United States)

Campbell, Theresa Diane

2014-07-01

To explore the issues of data management and data ownership with regard to health research conducted in aboriginal or indigenous populations in Canada. Research with aboriginal communities in Canada has often been conducted by researchers who had little or no understanding of the community in which the research was taking place. This led to 'helicopter' research, which benefitted the researcher but not the community. National aboriginal leadership developed the ownership, control, access, and possession (OCAP) principles, which outline how to manage research data regarding aboriginal people and to counteract disrespectful methodologies. However, these principles present their own set of challenges to those who would conduct research with aboriginal populations. Documents from the Assembly of First Nations, the Government of Canada, Aboriginal writers and researchers, and Nursing theorists and researchers. This is a methodology paper that reviews the issues of data ownership when conducting research with Aboriginal populations. The authors explore indigenous and Western views of knowledge development, outline and discuss the OCAP principles, and present the Canadian Institute of Health Research's guidelines for health research involving aboriginal people as a guide for those who want to carry out ethical and culturally competent research, do no harm and produce research that can benefit aboriginal peoples. There are special considerations associated with conducting research with Aboriginal populations. The Assembly of First Nations wants researchers to use the Ownership, Control, Access and Possession (OCAP) principles with First Nations data. These principles are restrictive and need to be discussed with stakeholders before research is undertaken. In Canada, it is imperative that researchers use the Canadian Institute of Health Research Guidelines for Health Research Involving Aboriginal People to ensure culturally sensitive and ethical conduct during the course of

Physical activity among indigenous Australian children and youth in remote and non-remote areas.

Science.gov (United States)

Evans, John Robert; Wilson, Rachel; Coleman, Clare; Man, Wing Young Nicola; Olds, Tim

2018-04-17

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.

An Aboriginal game plan - a plan for success

International Nuclear Information System (INIS)

Favelle, G.

1999-01-01

A presentation is included of some of the more intangible and hands-on types of advice that a corporation should consider when they decide to do business with Canadian Aboriginal peoples. Although there are numerous areas of business concern (both legally and culturally) to consider when working with Aboriginal people and communities, developing a proactive strategy and approach to this segment of Canadian society is just as important and compelling as environmental or gender-related issues because they too can be seen to affect the company operations at any level. Having good corporate business relations with Aboriginal communities is going to take some thinking 'outside of the box,' but with committed understanding and focus on open communications, there is no reason why a company should not be able to develop a corporate-wide approach with relative ease. By being open to learning and listening, companies can begin to develop 'Aboriginal Relations' strategies that will become an automatic inclusion item at corporate strategy meetings and planning discussions. This would be in keeping with the corporation's choice to negotiate and not litigate

Killing the Mockingbird: Systems Failure and a Radical Hope for Re-Grounding Responsibility and Access to Health Care in a Mallee Town Community

Science.gov (United States)

Coldwell, Ian

2010-01-01

The plight of Aboriginal health and the question of Aboriginal health care in a remote rural community came into focus when I realised that "the system" was peppered with in-built racist beliefs and values that discriminate against and disadvantage minority groups. Cyborg theory assists the difficulties of explaining the paradoxes that…

Sociodemographic variations in the amount, duration and cost of potentially preventable hospitalisation for chronic conditions among Aboriginal and non-Aboriginal Australians: a period prevalence study of linked public hospital data

OpenAIRE

Banham, David; Chen, Tenglong; Karnon, Jonathan; Brown, Alex; Lynch, John

2017-01-01

Objectives To determine disparities in rates, length of stay (LOS) and hospital costs of potentially preventable hospitalisations (PPH) for selected chronic conditions among Aboriginal and non-Aboriginal South Australians (SA), then examine associations with area-level socioeconomic disadvantage and remoteness. Setting Period prevalence study using linked, administrative public hospital records. Participants Participants included all SA residents in 2005–2006 to 2010–2011. Analysis focused on...

Outpatient alcohol withdrawal management for Aboriginal and Torres Strait Islander peoples.

Science.gov (United States)

Brett, Jonathan; Lawrence, Leanne; Ivers, Rowena; Conigrave, Kate

2014-08-01

There is concern from within Aboriginal and Torres Strait Islander communities about the lack of access to alcohol withdrawal management ('detox') services. Outpatient detox is described within national Australian guidelines as a safe option for selected drinkers. However, uncertainly exists as to how suited Aboriginal and Torres Strait Islander peoples are to this approach. 
 Consultations were conducted with stakeholders of four health services providing outpatient detox for Aboriginal and Torres Strait Islander peoples in NSW. Thematic analysis was performed to determine elements perceived as important for success. Key themes that emerged were individual engagement, flexibility, assessment of suitability, Aboriginal staff and community engagement, practical support, counselling, staff education and support, coping with relapse and contingency planning. 
 There is a need to improve access to alcohol detox services for Aboriginal and Torres Strait Islander peoples. The outpatient setting seems to be a feasible and safe environment to provide this kind of service for selected drinkers.

The acceptability to Aboriginal Australians of a family-based intervention to reduce alcohol-related harms.

Science.gov (United States)

Calabria, Bianca; Clifford, Anton; Shakeshaft, Anthony; Allan, Julaine; Bliss, Donna; Doran, Christopher

2013-05-01

Cognitive-behavioural interventions that use familial and community reinforcers in an individual's environment are effective for reducing alcohol-related harms. Such interventions have considerable potential to reduce the disproportionately high burden of alcohol-related harm among Aboriginal Australians if they can be successfully tailored to their specific needs and circumstances. The overall aim of this paper is to describe the perceived acceptability of two cognitive-behavioural interventions, the Community Reinforcement Approach (CRA) and Community Reinforcement and Family Training (CRAFT), to a sample of Aboriginal people. Descriptive survey was administered to 116 Aboriginal people recruited through an Aboriginal Community Controlled Health Service and a community-based drug and alcohol treatment agency in rural New South Wales, Australia. Participants perceived CRA and CRAFT to be highly acceptable for delivery in their local Aboriginal community. Women were more likely than men to perceive CRAFT as highly acceptable. Participants expressed a preference for counsellors to be someone they knew and trusted, and who has experience working in their local community. CRA was deemed most acceptable for delivery to individuals after alcohol withdrawal and CRAFT for people who want to help a relative/friend start alcohol treatment. There was a preference for five or more detailed sessions. Findings of this study suggest that CRA and CRAFT are likely to be acceptable for delivery to some rural Aboriginal Australians, and that there is potential to tailor these interventions to specific communities. © 2012 Australasian Professional Society on Alcohol and other Drugs.

Transfers to metropolitan hospitals and coronary angiography for rural Aboriginal and non-Aboriginal patients with acute ischaemic heart disease in Western Australia.

Science.gov (United States)

Lopez, Derrick; Katzenellenbogen, Judith M; Sanfilippo, Frank M; Woods, John A; Hobbs, Michael S T; Knuiman, Matthew W; Briffa, Tom G; Thompson, Peter L; Thompson, Sandra C

2014-05-01

Aboriginal people have a disproportionately higher incidence rate of ischaemic heart disease (IHD) than non-Aboriginal people. The findings on Aboriginal disparity in receiving coronary artery procedures are inconclusive. We describe the profile and transfers of IHD patients admitted to rural hospitals as emergency admissions and investigate determinants of transfers and coronary angiography. Person-linked hospital and mortality records were used to identify 28-day survivors of IHD events commencing at rural hospitals in Western Australia. Outcome measures were receipt of coronary angiography, transfer to a metropolitan hospital, and coronary angiography if transferred to a metropolitan hospital. Compared to non-Aboriginal patients, Aboriginal patients with IHD were more likely to be younger, have more co-morbidities, reside remotely, but less likely to have private insurance. After adjusting for demographic characteristics, Aboriginal people with MI were less likely to be transferred to a metropolitan hospital, and if transferred were less likely to receive coronary angiography. These disparities were not significant after adjusting for comorbidities and private insurance. In the full multivariate model age, comorbidities and private insurance were adversely associated with transfer to a metropolitan hospital and coronary angiography. Disparity in receiving coronary angiography following emergency admission for IHD to rural hospitals is mediated through the lower likelihood of being transferred to metropolitan hospitals where this procedure is performed. The likelihood of a transfer is increased if the patient has private insurance, however, rural Aboriginal people have a lower rate of private insurance than their non-Aboriginal counterparts. Health practitioners and policy makers can continue to claim that they treat Aboriginal and non-Aboriginal people alike based upon clinical indications, as private insurance is acting as a filter to reduce rural residents

“There’s a housing crisis going on in Sydney for Aboriginal people”: focus group accounts of housing and perceived associations with health

Directory of Open Access Journals (Sweden)

Melanie J. Andersen

2016-05-01

Full Text Available Abstract Background Poor housing is widely cited as an important determinant of the poor health status of Aboriginal Australians, as for indigenous peoples in other wealthy nations with histories of colonisation such as Canada, the United States of America and New Zealand. While the majority of Aboriginal Australians live in urban areas, most research into housing and its relationship with health has been conducted with those living in remote communities. This study explores the views of Aboriginal people living in Western Sydney about their housing circumstances and what relationships, if any, they perceive between housing and health. Methods Four focus groups were conducted with clients and staff of an Aboriginal community-controlled health service in Western Sydney (n = 38. Inductive, thematic analysis was conducted using framework data management methods in NVivo10. Results Five high-level themes were derived: the battle to access housing; secondary homelessness; overcrowding; poor dwelling conditions; and housing as a key determinant of health. Participants associated their challenging housing experiences with poor physical health and poor social and emotional wellbeing. Housing issues were said to affect people differently across the life course; participants expressed particular concern that poor housing was harming the health and developmental trajectories of many urban Aboriginal children. Conclusions Housing was perceived as a pivotal determinant of health and wellbeing that either facilitates or hinders prospects for full and healthy lives. Many of the specific health concerns participants attributed to poor housing echo existing epidemiological research findings. These findings suggest that housing may be a key intervention point for improving the health of urban Aboriginal Australians.

Lifetime risk of developing coronary heart disease in Aboriginal Australians: a cohort study.

Science.gov (United States)

Wang, Zhiqiang; Hoy, Wendy E

2013-01-30

Lifetime risk of coronary heart disease (CHD) is an important yardstick by which policy makers, clinicians and the general public can assess and promote the awareness and prevention of CHD. The lifetime risk in Aboriginal people is not known. Using a cohort with up to 20 years of follow-up, we estimated the lifetime risk of CHD in Aboriginal people. A cohort study. A remote Aboriginal region. 1115 Aboriginal people from one remote tribal group who were free from CHD at baseline were followed for up to 20 years. During the follow-up period, new CHD incident cases were identified through hospital and death records. We estimated the lifetime risks of CHD with and without adjusting for the presence of competing risk of death from non-CHD causes. Participants were followed up for 17 126 person-years, during which 185 developed CHD and 144 died from non-CHD causes. The average age at which the first CHD event occurred was 48 years for men and 49 years for women. The risk of developing CHD increased with age until 60 years and then decreased with age. Lifetime cumulative risk without adjusting for competing risk was 70.7% for men and 63.8% for women. Adjusting for the presence of competing risk of death from non-CHD causes, the lifetime risk of CHD was 52.6% for men and 49.2% for women. Lifetime risk of CHD is as high as one in two in both Aboriginal men and women. The average age of having first CHD events was under 50 years, much younger than that reported in non-Aboriginal populations. Our data provide useful knowledge for health education, screening and prevention of CHD in Aboriginal people.

Child Care and the Family-Work Balance: An International Perspective on Needs and Responses in Aboriginal Communities.

Science.gov (United States)

Colbert, Judith A.

1999-01-01

Suggests that aboriginal child-care needs relate to educational, social, and cultural requirements, as well as parental workforce participation. Contends that research is needed to test the validity of findings from mainstream societies when applied to indigenous communities. Presents examples of child-care problems and solutions to needs from…

"Listening to the silence quietly": investigating the value of cultural immersion and remote experiential learning in preparing midwifery students for clinical practice.

Science.gov (United States)

Thackrah, Rosalie D; Thompson, Sandra C; Durey, Angela

2014-10-02

Cultural immersion programs are increasingly offered to medical and health science students in an effort to provide experiential learning opportunities that focus on 'the self' as well as 'the other'. Immersion programs encourage self-reflection on attitudes towards cultural differences, provide opportunities to build relationships and work with community members, and allow students to apply knowledge and skills learned in training programs in a supervised practice setting. The aim of this paper is to describe midwifery students' reflections on a remote Aboriginal clinical placement that has been offered at a Western Australian university since 2010. Interviews were conducted over a period of 15 months with the first seven participants who completed the program. At the time of interview, four participants were in the final year of their undergraduate degree and three were practicing midwives. In addition, access was given to a detailed journal kept by one participant during the placement. Interviews also were conducted with midwifery staff at the university and practice setting, although the focus of this paper is upon the student experience. Student selection, preparation and learning experiences as well as implications of the placement for midwifery practice are described. The remote clinical placement was highly valued by all students and recommended to others as a profound learning experience. Highlights centred on connections made with community members and cultural knowledge learned experientially, while challenges included geographic and professional isolation and the complexities of health care delivery in remote settings, especially to pregnant and birthing Aboriginal women. All students recognised the transferability of the knowledge and skills acquired to urban settings, and some had already incorporated these learnings into clinical practice. Cultural immersion programs have the potential to provide students with rich learning experiences that cannot be

‘Doing the hard yards’: carer and provider focus group perspectives of accessing Aboriginal childhood disability services

Science.gov (United States)

2013-01-01

Background Despite a high prevalence of disability, Aboriginal Australians access disability services in Australia less than non-Aboriginal Australians with a disability. The needs of Aboriginal children with disability are particularly poorly understood. They can endure long delays in treatment which can impact adversely on development. This study sought to ascertain the factors involved in accessing services and support for Aboriginal children with a disability. Methods Using the focus group method, two community forums, one for health and service providers and one for carers of Aboriginal children with a disability, were held at an Aboriginal Community Controlled Health Service (ACCHS) in the Sydney, metropolitan area of New South Wales, Australia. Framework analysis was applied to qualitative data to elucidate key issues relevant to the dimensions of access framework. Independent coding consistency checks were performed and consensus of analysis verified by the entire research team, several of whom represented the local Aboriginal community. Results Seventeen health and social service providers representing local area government and non-government-funded health and social service organisations and five carers participated in two separate forums between September and October 2011. Lack of awareness of services and inadequate availability were prominent concerns in both groups despite geographic proximity to a major metropolitan area with significant health infrastructure. Carers noted racism, insufficient or non-existent services, and the need for an enhanced role of ACCHSs and AHWs in disability support services. Providers highlighted logistical barriers and cultural and historical issues that impacted on the effectiveness of mainstream services for Aboriginal people. Conclusions Despite dedicated disability services in an urban community, geographic proximity does not mitigate lack of awareness and availability of support. This paper has enumerated a number of

Meaningful and efficient? Enduring challenges to Aboriginal participation in environmental assessment

International Nuclear Information System (INIS)

Udofia, Aniekan; Noble, Bram; Poelzer, Greg

2017-01-01

This paper explores the underlying practice-based challenges to meaningful and efficient Aboriginal participation in environmental assessment (EA) - participation that provides meaningful opportunities for Aboriginal communities to shape EA, yet assures a degree of efficiency for project proponents who need to obtain EA approvals in a timely and financially viable manner. We do so based on an analysis of the EA policy community's experience with uranium exploration and mining in Saskatchewan, Canada. Many of the challenges to meaningful and efficient Aboriginal participation that emerged are multi-dimensional, often concerning participation processes, decision-making, and relationships. Although scholars have explored many of these issues and have proposed numerous solutions, challenges persist in practice. Several other issues also emerged from our study that have received limited attention, including the non-commitment to early and ongoing participation by smaller project proponents, and the EA exemption of exploration projects; the limited availability of information to project developers on local right holders and Aboriginal interests; expectations about the integration of traditional knowledge and land use in EA not aligning with the information that is available to proponents; confusion about who is responsible for initiating early participation and consultation processes; the lack of early relationship building with potentially affected communities, particularly by governments; and the lack of other viable avenues, outside EA, for Aboriginal communities to raise more strategic issues of concern that affect traditional lands and treaty rights.

The Study of Environment on Aboriginal Resilience and Child Health (SEARCH: study protocol

Directory of Open Access Journals (Sweden)

2010-05-01

Full Text Available Abstract Background Aboriginal Australians have a life expectancy more than ten years less than that of non-Aboriginal Australians, reflecting their disproportionate burden of both communicable and non-communicable disease throughout the lifespan. Little is known about the health and health trajectories of Aboriginal children and, although the majority of Aboriginal people live in urban areas, data are particularly sparse in relation to children living in urban areas. Methods/Design The Study of Environment on Aboriginal Resilience and Child Health (SEARCH is a cohort study of Aboriginal children aged 0-17 years, from urban and large regional centers in New South Wales, Australia. SEARCH focuses on Aboriginal community identified health priorities of: injury; otitis media; vaccine-preventable conditions; mental health problems; developmental delay; obesity; and risk factors for chronic disease. Parents/caregivers and their children are invited to participate in SEARCH at the time of presentation to one of the four participating Aboriginal Community Controlled Health Organisations at Mount Druitt, Campbelltown, Wagga Wagga and Newcastle. Questionnaire data are obtained from parents/caregivers and children, along with signed permission for follow-up through repeat data collection and data linkage. All children have their height, weight, waist circumference and blood pressure measured and complete audiometry, otoscopy/pneumatic otoscopy and tympanometry. Children aged 1-7 years have speech and language assessed and their parents/caregivers complete the Parental Evaluation of Developmental Status. The Study aims to recruit 1700 children by the end of 2010 and to secure resources for long term follow up. From November 2008 to March 2010, 1010 children had joined the study. From those 446 children with complete data entry, participating children ranged in age from 2 weeks to 17 years old, with 144 aged 0-3, 147 aged 4-7, 75 aged 8-10 and 79 aged 11

Aboriginal health learning in the forest and cultivated gardens: building a nutritious and sustainable food system.

Science.gov (United States)

Stroink, Mirella L; Nelson, Connie H

2009-01-01

Sustainable food systems are those in which diverse foods are produced in close proximity to a market. A dynamic, adaptive knowledge base that is grounded in local culture and geography and connected to outside knowledge resources is essential for such food systems to thrive. Sustainable food systems are particularly important to remote and Aboriginal communities, where extensive transportation makes food expensive and of poorer nutritional value. The Learning Garden program was developed and run with two First Nation communities in northwestern Ontario. With this program, the team adopted a holistic and experiential model of learning to begin rebuilding a knowledge base that would support a sustainable local food system. The program involved a series of workshops held in each community and facilitated by a community-based coordinator. Topics included cultivated gardening and forest foods. Results of survey data collected from 20 Aboriginal workshop participants are presented, revealing a moderate to low level of baseline knowledge of the traditional food system, and a reliance on the mainstream food system that is supported by food values that place convenience, ease, and price above the localness or cultural connectedness of the food. Preliminary findings from qualitative data are also presented on the process of learning that occurred in the program and some of the insights we have gained that are relevant to future adaptations of this program.

Supporting aboriginal knowledge and practice in health care: lessons from a qualitative evaluation of the strong women, strong babies, strong culture program.

Science.gov (United States)

Lowell, Anne; Kildea, Sue; Liddle, Marlene; Cox, Barbara; Paterson, Barbara

2015-02-05

The Strong Women, Strong Babies, Strong Culture Program (the Program) evolved from a recognition of the value of Aboriginal knowledge and practice in promoting maternal and child health (MCH) in remote communities of the Northern Territory (NT) of Australia. Commencing in 1993 it continues to operate today. In 2008, the NT Department of Health commissioned an evaluation to identify enabling factors and barriers to successful implementation of the Program, and to identify potential pathways for future development. In this paper we focus on the evaluation findings related specifically to the role of Aborignal cultural knowledge and practice within the Program. A qualitative evaluation utilised purposive sampling to maximise diversity in program history and Aboriginal culture. Semi-structured, in-depth interviews with 76 participants were recorded in their preferred language with a registered Interpreter when required. Thematic analysis of data was verified or modified through further discussions with participants and members of the evaluation team. Although the importance of Aboriginal knowledge and practice as a fundamental component of the Program is widely acknowledged, there has been considerable variation across time and location in the extent to which these cultural dimensions have been included in practice. Factors contributing to this variation are complex and relate to a number of broad themes including: location of control over Program activities; recognition and respect for Aboriginal knowledge and practice as a legitimate component of health care; working in partnership; communication within and beyond the Program; access to transport and working space; and governance and organisational support. We suggest that inclusion of Aboriginal knowledge and practice as a fundamental component of the Program is key to its survival over more than twenty years despite serious challenges. Respect for the legitimacy of Aboriginal knowledge and practice within health

Distributed generation in small remote Northern communities

International Nuclear Information System (INIS)

Malcolm, D.G.

2012-01-01

The presentation discusses the physical and social challenges of reliable and environmentally sound electricity generation in remote northern communities in Canada. There are several hundred remote communities in the boreal region of Canada and throughout the Arctic. Electrical energy requirements are usually a few megawatts. Access to some Arctic remote communities is by air and small water craft only, except when winters are cold enough for winter roads to be constructed for a few weeks each year. These communities, as well as new mining operations and their camp communities, provide a market segment for small reactors. However, there are social acceptance hurdles to be addressed. Trust-building is a must when working with First Nations, Metis, and Inuit communities, and this requires community presence long before proposals for new generation facilities are presented.

Distributed generation in small remote Northern communities

Energy Technology Data Exchange (ETDEWEB)

Malcolm, D.G. [Yellowknife, North West Territories (Canada)

2012-07-01

The presentation discusses the physical and social challenges of reliable and environmentally sound electricity generation in remote northern communities in Canada. There are several hundred remote communities in the boreal region of Canada and throughout the Arctic. Electrical energy requirements are usually a few megawatts. Access to some Arctic remote communities is by air and small water craft only, except when winters are cold enough for winter roads to be constructed for a few weeks each year. These communities, as well as new mining operations and their camp communities, provide a market segment for small reactors. However, there are social acceptance hurdles to be addressed. Trust-building is a must when working with First Nations, Metis, and Inuit communities, and this requires community presence long before proposals for new generation facilities are presented.

Remote community electrification program - small wind integration in BC's offgrid communities

Energy Technology Data Exchange (ETDEWEB)

Lafaille, Julien [BC Hydro (Canada)

2011-07-01

The paper presents the Remote Community Electrification (RCE) program and wind integration in BC's off grid communities. The program offers electric utility service to eligible remote communities in BC. Most of them are offered off-grid services although it is cheaper to connect a community to a grid. BC hydro serves some communities that are not connected to the main grid. Local diesel or small hydro-generating stations are used to serve remote communities. The renewable energy program target is to reach 50% of remote communities. The reason that wind is a small part of the renewables is that hydro and biomass are abundant in BC. Some other barriers include high installation costs, durability concerns, and lack of in-house technical expertise. Some small Wind initiatives that have been taken were relatively few and fairly small. It can be concluded that due to a poor wind resource and the relatively low cost of diesel, there is limited potential for wind in BC remote communities.

"Try to Understand Us":Aboriginal Elders’ Views on Exceptionality

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Ron Phillips

2010-07-01

Full Text Available Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} This article provides an analysis of the views of four Elders at the “A Window to Seeing the World Differently, National Symposium on Aboriginal Special Education” that was held in October 2005 at First Nations University of Canada in Regina.  The symposium was an opportunity to provide educators, students, parents, and community members with information on Aboriginal views on special education.  Concern had been expressed over the high numbers of Aboriginal students being identified as “special needs” attending schools on reserves throughout Canada.  There was also concern over difficulties with the current special education system, e.g., funding, assessment, and service issues.  It was believed that the Aboriginal worldview of students with special needs as having special gifts from the Creator was not integrated into the curriculum or into teaching practices.  The article concludes with suggestions for educators on how to address exceptionalities in Aboriginal communities. Keywords: Aboriginal education, Elders, exceptionality, special education, Aboriginal special   education.

Context, Diversity and Engagement: Early Intervention with Australian Aboriginal Families in Urban and Remote Contexts

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Robinson, Gary; Tyler, William; Jones, Yomei; Silburn, Sven; Zubrick, Stephen R.

2012-01-01

This article describes challenges met implementing an early intervention programme for Aboriginal parents and their children in the NT (Northern Territory) of Australia in the context of efforts to remediate Aboriginal disadvantage. The intervention is an adaptation of an 8- to 10-week, manualised parenting programme designed for four- to…

The contribution of socio-economic position to the excesses of violence and intimate partner violence among aboriginal versus non-Aboriginal Women in Canada.

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Daoud, Nihaya; Smylie, Janet; Urquia, Marcelo; Allan, Billie; O'Campo, Patricia

2013-07-25

To examine the contribution of socio-economic position (SEP) in explaining the excess of any abuse and intimate partner violence (IPV) among Aboriginal versus non-Aboriginal women in Canada. This comparison has not been studied before. We conducted logistic regression analysis, using nationwide data from a weighted sample of 57,318 Canadian-born mothers of singletons who participated in the Canadian Maternity Experiences Survey 2006-7. The unadjusted odds of any abuse and IPV were almost four times higher among Aboriginal compared to non-Aboriginal mothers; OR 3.91 (95% CI 3.12-4.89) and OR 3.78 (2.87-4.97), respectively. Adjustment for SEP reduced the unadjusted OR of any abuse and IPV by almost 40%. However, even with this adjustment, the odds of any abuse and IPV for Aboriginal mothers remained twice that of non-Aboriginal mothers; OR 2.34 (1.82-2.99) and OR 2.19 (1.60-3.00), respectively. SEP is a predominant contributor to the excess of abuse against Aboriginal vs. non-Aboriginal women in Canada. Reducing violence against Aboriginal women can be achieved mostly by improving their SEP, and simultaneously be informed by social processes and services that can mitigate abuse. The fact that SEP did not fully explain the excess of abuse among the Aboriginal women might lend support to "colonization or postcolonial theories," and related contextual factors such as differences in community social resources (e.g., social capital) and services. The effect of these factors on the excess of abuse warrants future research.

Aboriginal traditional knowledge - panel presentation

International Nuclear Information System (INIS)

Barnaby, J.; Duiven, M.; Garibaldi, A.; McGregor, D.; Straker, J.; Patton, P.

2011-01-01

Aboriginal peoples in Canada are playing a more active role in land use and resource management decisions around industrial development in their traditional territories and communities. Both indigenous and non-indigenous people are therefore increasing efforts to collaborate in decision-making and to effectively interweave Aboriginal Traditional Knowledge (ATK) and Western knowledge or science. Challenges exist, in part because non-Aboriginal people often find it difficult to define ATK and to understand the differences from Western perspectives. ATK is best defined as a holistic system that involves not only knowledge but principles of conduct and a strong relationship component. Research has focused on approaches to more easily bridge ATK and Western knowledge, through dialogue/negotiation and shared decision-making that is complementary to both. There are some examples of organizations and communities that have achieved success in this bridging of the two forms of knowledge. The Skeena Fisheries Commission (SFC) in British Columbia manages the fish resource in the Skeena Watershed and generates scientific research through links to ATK. The observations of indigenous people about apparent changes in the resource are subjected to scientific assessment, which has led to changes in how fish are caught, and in how and by whom data is collected. Traditional knowledge has also been incorporated into the reclamation of lands and species in Fort McKay, Alberta, an indigenous community whose traditional way of life has been significantly affected by development of the oil sands. New models have been developed to incorporate ATK into long-term planning for land use. This includes using ATK to develop a 50-to 60-year projection of probable future effects from development and to build strategies for achieving a 'desired future landscape.' To plan for post-mining land reclamation projects, another project makes use of cultural keystone species (CKS), through which

Aboriginal traditional knowledge - panel presentation

Energy Technology Data Exchange (ETDEWEB)

Barnaby, J. [JB, Consultant, Paris (France); Duiven, M. [Skeena Fisheries Commission, Kispiox, BC (Canada); Garibaldi, A. [Integral Ecology Group, Ltd., Victoria, BC (Canada); McGregor, D. [Univ. of Toronto, Dept. of Geography and Aboriginal Studies, Toronto, ON (Canada); Straker, J. [Integral Ecology Group, Ltd., Victoria, BC (Canada); Patton, P. [Nuclear Waste Management Organization, Toronto, ON (Canada)

2011-07-01

Aboriginal peoples in Canada are playing a more active role in land use and resource management decisions around industrial development in their traditional territories and communities. Both indigenous and non-indigenous people are therefore increasing efforts to collaborate in decision-making and to effectively interweave Aboriginal Traditional Knowledge (ATK) and Western knowledge or science. Challenges exist, in part because non-Aboriginal people often find it difficult to define ATK and to understand the differences from Western perspectives. ATK is best defined as a holistic system that involves not only knowledge but principles of conduct and a strong relationship component. Research has focused on approaches to more easily bridge ATK and Western knowledge, through dialogue/negotiation and shared decision-making that is complementary to both. There are some examples of organizations and communities that have achieved success in this bridging of the two forms of knowledge. The Skeena Fisheries Commission (SFC) in British Columbia manages the fish resource in the Skeena Watershed and generates scientific research through links to ATK. The observations of indigenous people about apparent changes in the resource are subjected to scientific assessment, which has led to changes in how fish are caught, and in how and by whom data is collected. Traditional knowledge has also been incorporated into the reclamation of lands and species in Fort McKay, Alberta, an indigenous community whose traditional way of life has been significantly affected by development of the oil sands. New models have been developed to incorporate ATK into long-term planning for land use. This includes using ATK to develop a 50-to 60-year projection of probable future effects from development and to build strategies for achieving a 'desired future landscape.' To plan for post-mining land reclamation projects, another project makes use of cultural keystone species (CKS), through which

Years of life lost to incarceration: inequities between Aboriginal and non-Aboriginal Canadians.

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Owusu-Bempah, Akwasi; Kanters, Steve; Druyts, Eric; Toor, Kabirraaj; Muldoon, Katherine A; Farquhar, John W; Mills, Edward J

2014-06-11

Aboriginal representation in Canadian correctional institutions has increased rapidly over the past decade. We calculated "years of life lost to incarceration" for Aboriginal and non-Aboriginal Canadians. Incarceration data from provincial databases were used conjointly with demographic data to estimate rates of incarceration and years of life lost to provincial incarceration in (BC) and federal incarceration, by Aboriginal status. We used the Sullivan method to estimate the years of life lost to incarceration. Aboriginal males can expect to spend approximately 3.6 months in federal prison and within BC spend an average of 3.2 months in custody in the provincial penal system. Aboriginal Canadians on average spend more time in custody than their non-Aboriginal counterparts. The ratio of the Aboriginal incarceration rate to the non-Aboriginal incarceration rate ranged from a low of 4.28 in Newfoundland and Labrador to a high of 25.93 in Saskatchewan. Rates of incarceration at the provincial level were highest among Aboriginals in Manitoba with an estimated rate of 1377.6 individuals in prison per 100,000 population (95% confidence interval [CI]: 1311.8-1443.4). The results indicate substantial differences in life years lost to incarceration for Aboriginal versus non-Aboriginal Canadians. In light of on-going prison expansion in Canada, future research and policy attention should be paid to the public health consequences of incarceration, particularly among Aboriginal Canadians.

Feasibility of a novel participatory multi-sector continuous improvement approach to enhance food security in remote Indigenous Australian communities

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J. Brimblecombe

2017-12-01

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.

Factors associated with dementia in Aboriginal Australians.

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Smith, Kate; Flicker, Leon; Dwyer, Anna; Atkinson, David; Almeida, Osvaldo P; Lautenschlager, Nicola T; LoGiudice, Dina

2010-10-01

Although the prevalence of dementia in remote living Aboriginal Australians is one of the highest in the world, the factors associated with dementia in this population are yet to be examined. This study was designed to determine the demographic, lifestyle and clinical factors associated with dementia in Aboriginal Australians living in the Kimberley region of Western Australia. A total of 363 Aboriginal Australians aged over 45 years from the Kimberley region were selected by semi-purposeful sampling. The factors analysed for association with dementia were age, sex, education, smoking, chewing tobacco, alcohol, head injury, heart disease, hypertension, diabetes, previous stroke, epilepsy, falls, mobility, incontinence, urinary problems, vision and hearing. This exposure data was collected from participants' and informants' reports using the Kimberley Indigenous Cognitive Assessment and specialist review, and medical records. Factors associated with dementia included older age, male gender (OR 3.1, 95%CI 1.4, 6.8) and no formal education (OR 2.7, 95%CI 1.1, 6.7) and after adjusting for age, sex and education, dementia was associated with current smoking (OR 4.5, 95%CI 1.1, 18.6), previous stroke (OR 17.9, 95%CI 5.9, 49.7), epilepsy (OR 33.5, 95%CI 4.8, 232.3), head injury (OR 4.0, 95%CI 1.7, 9.4), and poor mobility, incontinence and falls. Interventions aimed at better management or prevention of the modifiable factors identified could reduce dementia risk in Aboriginal populations.

Measuring emotional and social wellbeing in Aboriginal and Torres Strait Islander populations: an analysis of a Negative Life Events Scale

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Gunthorpe Wendy

2007-11-01

Full Text Available Abstract Aboriginal and Torres Strait Islander Australians experience widespread socioeconomic disadvantage and health inequality. In an attempt to make Indigenous health research more culturally-appropriate, Aboriginal and Torres Strait Islander Australians have called for more attention to the concept of emotional and social wellbeing (ESWB. Although it has been widely recognised that ESWB is of crucial importance to the health of Aboriginal and Torres Strait Islander peoples, there is little consensus on how to measure in Indigenous populations, hampering efforts to better understand and improve the psychosocial determinants of health. This paper explores the policy and political context to this situation, and suggests ways to move forward. The second part of the paper explores how scales can be evaluated in a health research setting, including assessments of endorsement, discrimination, internal and external reliability. We then evaluate the use of a measure of stressful life events, the Negative Life Events Scale (NLES, in two samples of Aboriginal people living in remote communities in the Northern Territory of Australia. We argue that the Negative Life Events Scale is a promising assessment of psychosocial wellbeing in Aboriginal and Torres Strait Islander populations. Evaluation of the scale and its performance in other samples of Aboriginal and Torres Strait Islander populations is imperative if we hope to develop better, rather than more, scales for measuring ESWB among Indigenous Australians. Only then will it be possible to establish standardized methods of measuring ESWB and develop a body of comparable literature that can guide both a better understanding of ESWB, and evaluation of interventions designed to improve the psychosocial health of Indigenous populations and decrease health inequalities.

Peer-led Aboriginal parent support: Program development for vulnerable populations with participatory action research.

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Munns, Ailsa; Toye, Christine; Hegney, Desley; Kickett, Marion; Marriott, Rhonda; Walker, Roz

2017-10-01

Participatory action research (PAR) is a credible, culturally appropriate methodology that can be used to effect collaborative change within vulnerable populations. This PAR study was undertaken in a Western Australian metropolitan setting to develop and evaluate the suitability, feasibility and effectiveness of an Aboriginal peer-led home visiting programme. A secondary aim, addressed in this paper, was to explore and describe research methodology used for the study and provide recommendations for its implementation in other similar situations. PAR using action learning sets was employed to develop the parent support programme and data addressing the secondary, methodological aim were collected through focus groups using semi-structured and unstructured interview schedules. Findings were addressed throughout the action research process to enhance the research process. The themes that emerged from the data and addressed the methodological aim were the need for safe communication processes; supportive engagement processes and supportive organisational processes. Aboriginal peer support workers (PSWs) and community support agencies identified three important elements central to their capacity to engage and work within the PAR methodology. This research has provided innovative data, highlighting processes and recommendations for child health nurses to engage with the PSWs, parents and community agencies to explore culturally acceptable elements for an empowering methodology for peer-led home visiting support. There is potential for this nursing research to credibly inform policy development for Aboriginal child and family health service delivery, in addition to other vulnerable population groups. Child health nurses/researchers can use these new understandings to work in partnership with Aboriginal communities and families to develop empowering and culturally acceptable strategies for developing Aboriginal parent support for the early years. Impact Statement Child

Forming mutually beneficial Aboriginal partnerships

Energy Technology Data Exchange (ETDEWEB)

Brewster, L.; Shaw, M. [ATCO Frontec, Edmonton, AB (Canada)

2002-07-01

The Alberta-based ATCO Group is engaged in power generation, utilities logistics and energy services and technologies in Alaska, Canada's north, and around the world. In 2001, 56 per cent of ATCO's revenue came from Aboriginal joint ventures. ATCO's foundation for successful partnerships is a mutual trust, an understanding of the environment, and constant communication. The partnerships begin with a long term vision, resulting in community-based northern businesses that benefit Aboriginal partners, shareholders, customers and local staff. This paper described 2 unique joint venture case studies: (1) the north warning system in Cambridge Bay, a radar and communication service for government, and (2) Yellowknife's Tli Cho logistics site for support and municipal services to the mining industry. The north warning system joint venture includes Pan Arctic Inuit Logistics (PAIL), representing Inuvialuit, Labrador, Nunavik and Nunavut, while the Tli Cho joint venture includes participation of the Dog Rib Rae band. Management practices in all joint ventures reflect cultural differences, and Aboriginal people are involved in long term jobs relating to northern pipeline development. 21 figs.

The pattern of psychiatric morbidity in a Victorian urban aboriginal general practice population.

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McKendrick, J; Cutter, T; Mackenzie, A; Chiu, E

1992-03-01

Victorian Aboriginal people, most of whom live an urban lifestyle, form a distinct cultural group within the wider Victorian community. This paper describes a unique psychosocial study of urban Aboriginal adults attending a general practitioner at the Victorian Aboriginal Health Service in Fitzroy. The frequency and nature of psychiatric disorders among survey respondents is reported, together with a discussion of the association between this morbidity and certain sociodemographic variables.

Temporal trends in Inuit, First Nations and non-Aboriginal birth outcomes in rural and northern Quebec.

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Simonet, Fabienne; Wilkins, Russell; Luo, Zhong-Cheng

2012-01-01

The objective was to assess trends in Inuit, First Nations and non-Aboriginal birth outcomes in the rural and northern regions of Quebec. In a birth cohort-based study of all births to residents of rural and northern Quebec from 1991 through 2000 (n = 177,193), we analyzed birth outcomes and infant mortality for births classified by maternal mother tongue (Inuit, First Nations or non-Aboriginal) and by community type (predominantly First Nations, Inuit or non-Aboriginal). From 1991-1995 to 1996-2000, there was a trend of increasing rates of preterm birth for all 6 study groups. In all rural and northern areas, low birth weight rates increased significantly only for the Inuit mother tongue group [RR1.45 (95% CI 1.05-2.01)]. Stillbirth rates showed a non-significant increase for the Inuit mother tongue group [RR1.76 (0.64-4.83)]. Neonatal mortality rates decreased significantly in the predominantly non-Aboriginal communities and in the non-Aboriginal mother tongue group [RR0.78 (0.66-0.92)], and increased non-significantly for the First Nations mother tongue group [RR2.17 (0.71-6.62)]. Perinatal death rates increased for the First Nations mother tongue grouping in northern areas [RR2.19 (0.99-4.85)]. There was a disconcerting rise of some mortality outcomes for births to First Nations and Inuit mother tongue women and to women in predominantly First Nations and Inuit communities, in contrast to some improvements for births to non-Aboriginal mother tongue women and to women in predominantly non-Aboriginal communities in rural or northern Quebec, indicating a need for improving perinatal and neonatal health for Aboriginal populations in rural and northern regions.

Temporal trends in Inuit, First Nations and non-Aboriginal birth outcomes in rural and northern Quebec

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Fabienne Simonet

2012-06-01

Full Text Available Objectives. The objective was to assess trends in Inuit, First Nations and non-Aboriginal birth outcomes in the rural and northern regions of Quebec. Study design and methods. In a birth cohort-based study of all births to residents of rural and northern Quebec from 1991 through 2000 (n = 177,193, we analyzed birth outcomes and infant mortality for births classified by maternal mother tongue (Inuit, First Nations or non-Aboriginal and by community type (predominantly First Nations, Inuit or non-Aboriginal. Results. From 1991–1995 to 1996–2000, there was a trend of increasing rates of preterm birth for all 6 study groups. In all rural and northern areas, low birth weight rates increased significantly only for the Inuit mother tongue group [RR1.45 (95% CI 1.05–2.01]. Stillbirth rates showed a non-significant increase for the Inuit mother tongue group [RR1.76 (0.64–4.83]. Neonatal mortality rates decreased significantly in the predominantly non-Aboriginal communities and in the non-Aboriginal mother tongue group [RR0.78 (0.66–0.92], and increased non-significantly for the First Nations mother tongue group [RR2.17 (0.71–6.62]. Perinatal death rates increased for the First Nations mother tongue grouping in northern areas [RR2.19 (0.99–4.85]. Conclusion. There was a disconcerting rise of some mortality outcomes for births to First Nations and Inuit mother tongue women and to women in predominantly First Nations and Inuit communities, in contrast to some improvements for births to non-Aboriginal mother tongue women and to women in predominantly non-Aboriginal communities in rural or northern Quebec, indicating a need for improving perinatal and neonatal health for Aboriginal populations in rural and northern regions.

Principles for the development of Aboriginal health interventions: culturally appropriate methods through systemic empathy.

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Kendall, Elizabeth; Barnett, Leda

2015-01-01

To increase Aboriginal participation in mainstream health services, it is necessary to understand the factors that influence health service usage. This knowledge can contribute to the development of culturally appropriate health services that respect Aboriginal ways of being. We used a community-based participatory approach to examine the reasons for underutilization of health services by Aboriginal Australians. Based on three focus groups and 18 interviews with Aboriginal health professionals, leaders, and community members in rural, regional, and urban settings, we identified five factors that influenced usage, including (1) negative historical experiences, (2) cultural incompetence, (3) inappropriate communication, (4) a collective approach to health, and (5) a more holistic approach to health. Given that these factors have shaped negative Aboriginal responses to health interventions, they are likely to be principles by which more appropriate solutions are generated. Although intuitively sensible and well known, these principles remain poorly understood by non-Aboriginal health systems and even less well implemented. We have conceptualized these principles as the foundation of an empathic health system. Without empathy, health systems in Australia, and internationally, will continue to face the challenge of building effective services to improve the state of health for all minority populations.

The feasibility of the interferon gamma release assay and predictors of discordance with the tuberculin skin test for the diagnosis of latent tuberculosis infection in a remote Aboriginal community.

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Gonzalo G Alvarez

Full Text Available The tuberculin skin test (TST is the standard test used to screen for latent TB infection (LTBI in the northern Canadian territory of Nunavut. Interferon gamma release assays (IGRA are T cell blood-based assays to diagnose LTBI. The Bacillus Calmette-Guerin (BCG vaccine is part of the routine immunization schedule in Nunavut. The objective of this study was to test the feasibility, and predictors of discordance between the Tuberculin Skin Test (TST and the IGRA assay in a medically under-serviced remote arctic Aboriginal population.Both the TST and QuantiFERON-TB Gold (Qiagen group IGRA tests were offered to people in their homes as part of a public health campaign aimed at high TB risk residential areas in Iqaluit, Nunavut, Canada. Feasibility was measured by the capacity of the staff to do the test successfully as measured by the proportion of results obtained.In this population of predominantly young Inuit who were mostly BCG vaccinated, the use of IGRA for the diagnosis of LTBI was feasible. IGRA testing resulted in more available test results reaching patients (95.6% vs 90.9% p = 0.02 but took longer (median 8 days (IGRA vs 2 days (TST, p value < 0.0001. 44/256 participants (17.2% had discordant results. Multivariable regression analysis suggested that discordant results were most likely to have received multiple BCG vaccinations (RR 20.03, 95% CI, 3.94-101.82, followed by BCG given post infancy (RR 8.13, 95% CI, 2.54-26.03 and then to a lesser degree when BCG was given in infancy (RR 6.43, 95% CI, 1.72-24.85.IGRA is feasible in Iqaluit, Nunavut, a remote Arctic community. IGRA testing results in more test results available to patients compared to TST. This test could result in fewer patients requiring latent TB treatment among those previously vaccinated with BCG in a region with limited public health human resources.

Early mortality from external causes in Aboriginal mothers: a retrospective cohort study

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Jenny Fairthorne

2016-06-01

Full Text Available Abstract Background Maternal loss can have a deep-rooted impact on families. Whilst a disproportionate number of Aboriginal women die from potentially preventable causes, no research has investigated mortality in Aboriginal mothers. We aimed to examine the elevated mortality risk in Aboriginal mothers with a focus on external causes. Methods We linked data from four state administrative datasets to identify all women who had a child from 1983 to 2010 in Western Australia and ascertained their Aboriginality, socio-demographic details, and their dates and causes of death prior to 2011. Comparing Aboriginal mothers with other mothers, we estimated the hazard ratios (HRs for death by any external cause and each of the sub-categories of accident, suicide, and homicide, and the corresponding age of their youngest child. Results Compared to non-Aboriginal mothers and after adjustment for parity, socio-economic status and remoteness, Aboriginal mothers were more likely to die from accidents [HR = 6.43 (95 % CI: 4.9, 8.4], suicide [HR = 3.46 (95 % CI: 2.2, 5.4], homicide [HR = 17.46 (95 % CI: 10.4, 29.2] or any external cause [HR = 6.61 (95 % CI: 5.4, 8.1]. For mothers experiencing death, the median age of their youngest child was 4.8 years. Conclusion During the study period, Aboriginal mothers were much more likely to die than other mothers and they usually left more and younger children. These increased rates were only partly explained by socio-demographic circumstances. Further research is required to examine the risk factors associated with these potentially preventable deaths and to enable the development of informed health promotion to increase the life chances of Aboriginal mothers and their children.

Improving Aboriginal maternal and infant health services in the 'Top End' of Australia; synthesis of the findings of a health services research program aimed at engaging stakeholders, developing research capacity and embedding change.

Science.gov (United States)

Barclay, Lesley; Kruske, Sue; Bar-Zeev, Sarah; Steenkamp, Malinda; Josif, Cathryn; Narjic, Concepta Wulili; Wardaguga, Molly; Belton, Suzanne; Gao, Yu; Dunbar, Terry; Kildea, Sue

2014-06-02

Health services research is a well-articulated research methodology and can be a powerful vehicle to implement sustainable health service reform. This paper presents a summary of a five-year collaborative program between stakeholders and researchers that led to sustainable improvements in the maternity services for remote-dwelling Aboriginal women and their infants in the Top End (TE) of Australia. A mixed-methods health services research program of work was designed, using a participatory approach. The study area consisted of two large remote Aboriginal communities in the Top End of Australia and the hospital in the regional centre (RC) that provided birth and tertiary care for these communities. The stakeholders included consumers, midwives, doctors, nurses, Aboriginal Health Workers (AHW), managers, policy makers and support staff. Data were sourced from: hospital and health centre records; perinatal data sets and costing data sets; observations of maternal and infant health service delivery and parenting styles; formal and informal interviews with providers and women and focus groups. Studies examined: indicator sets that identify best care, the impact of quality of care and remoteness on health outcomes, discrepancies in the birth counts in a range of different data sets and ethnographic studies of 'out of hospital' or health centre birth and parenting. A new model of maternity care was introduced by the health service aiming to improve care following the findings of our research. Some of these improvements introduced during the five-year research program of research were evaluated. Cost effective improvements were made to the acceptability, quality and outcomes of maternity care. However, our synthesis identified system-wide problems that still account for poor quality of infant services, specifically, unacceptable standards of infant care and parent support, no apparent relationship between volume and acuity of presentations and staff numbers with the

Is Aboriginal nutrition a priority for local government? A policy analysis.

Science.gov (United States)

Helson, Catherine; Walker, Ruth; Palermo, Claire; Rounsefell, Kim; Aron, Yudit; MacDonald, Catherine; Atkinson, Petah; Browne, Jennifer

2017-11-01

The present study aimed to explore how Australian local governments prioritise the health and well-being of Aboriginal populations and the extent to which nutrition is addressed by local government health policy. In the state of Victoria, Australia, all seventy-nine local governments' public health policy documents were retrieved. Inclusion of Aboriginal health and nutrition in policy documents was analysed using quantitative content analysis. Representation of Aboriginal nutrition 'problems' and 'solutions' was examined using qualitative framing analysis. The socio-ecological framework was used to classify the types of Aboriginal nutrition issues and strategies within policy documents. Victoria, Australia. Local governments' public health policy documents (n 79). A small proportion (14 %, n 11) of local governments addressed Aboriginal health and well-being in terms of nutrition. Where strategies aimed at nutrition existed, they mostly focused on individual factors rather than the broader macroenvironment. A limited number of Victorian local governments address nutrition as a health issue for their Aboriginal populations in policy documents. Nutrition needs to be addressed as a community and social responsibility rather than merely an individual 'behaviour'. Partnerships are required to ensure Aboriginal people lead government policy development.

Politics, pain and pleasure: the art of art-making for ‘settled’ Aboriginal Australians

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Lorraine Gibson

2011-03-01

Full Text Available Since the emergence of the ‘acrylic art movement’ which came out of Papunya in the Western Desert of Australia in the 1970s, Aboriginal art and cultures have become intertwined in public discourse, through government policy, and in visual art worlds. It is arguably through their artworks that Australian Aboriginal people have become increasingly known both within Australia and overseas (Merlan 2001; cf. Fourmille 1994.i Indeed, in many ways, Aboriginal art has come to represent Aboriginal people and their culture (Myers 2002. But what kind of art is acceptably deemed Aboriginal in mainstream art worlds, by Australian Aboriginal people, and why? What does this mean personally, socially and economically for those Aboriginal artists who are located in the south-eastern parts of Australia which were first colonised? For the most part these people are deemed by the mainstream population to have ‘lost their culture’. More than this, they are spoken of by some other Aboriginal people from the more remote and later colonised parts of the continent in similar terms. Based on long-term ethnographic fieldwork with the Barkindji people of Wilcannia, a small country town in the south-east of Australia, this paper explores the role of art making and art talk and the ways in which these are implicated in the politics of culture, in cultural subjectivity, and in the consolidation and (recreation of cultural identity.

Distinct modes of transmission of tuberculosis in aboriginal and non-aboriginal populations in Taiwan.

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Yih-Yuan Chen

Full Text Available Tuberculosis incidence among aborigines is significantly higher than for Han Chinese in Taiwan, but the extent to which Mycobacterium tuberculosis (MTB strain characteristics contribute to this difference is not well understood. MTB isolates from aborigines and Han Chinese living in eastern and southern Taiwan, the major regions of aborigines, were analyzed by spoligotyping and 24-loci MIRU-VNTR. In eastern Taiwan, 60% of aboriginal patients were ≤20 years old, significantly younger than the non-aboriginal patients there; aborigines were more likely to have clustered MTB isolates than Han Chinese (odds ratio (OR = 5.98, p<0.0001. MTB lineages with high clustering were EAI (54.9% among southern people, and Beijing (62.5% and Haarlem (52.9% among eastern aborigines. Resistance to first-line drugs and multidrug resistance (MDR were significantly higher among eastern aborigines (≥15% than in any other geographic and ethnic group (p<0.05; MDR was detected in 5 of 28 eastern aboriginal patients ≤20 years old. Among patients from the eastern region, clustered strains (p = 0.01 and aboriginal ethnicity (p = 0.04 were independent risk factors for MDR. The lifestyles of aborigines in eastern Taiwan may explain why the percentage of infected aborigines is much higher than for their Han Chinese counterparts. The significantly higher percentage of the MDR-MTB strains in the aboriginal population warrants close attention to control policy and vaccination strategy.

Growing health partnerships in rural and remote communities: what drives the joint efforts of primary schools and universities in maintaining service learning partnerships?

Science.gov (United States)

Kirby, Sue; Held, Fabian P; Jones, Debra; Lyle, David

2018-01-10

Aim This study explored the partnership between universities and local primary schools to deliver a classroom-based paediatric communication impairment service provided by undergraduate speech pathology students. It aimed to understand how partnerships work to facilitate programme replication. The partners included universities sending students on rural clinical placement, local host academic units and primary schools who worked together to provide paediatric speech and language services in primary schools in three sites in Australia. Rural and remote communities experience poorer health outcomes because of chronic workforce shortages, social disadvantage and high Aboriginality, poor access to services and underfunding. The study was in twofold: qualitative analysis of data from interviews/focus group with the partners in the university and education sectors, and quantitative social network analysis of data from an electronic survey of the partners. Findings Factors supporting partnerships were long-term, work and social relationships, commitment to community, trust and an appetite for risk-taking. We postulate that these characteristics are more likely to exist in rural communities.

Astronomical Heritage and Aboriginal People: Conflicts and Possibilities

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López, Alejandro Martín

2016-10-01

In this presentation we address issues relating to the astronomical heritage of contemporary aboriginal groups and other minorities. We deal specially with intangible astronomical heritage and its particularities. Also, we study (from ethnographic experience with Aboriginal groups, Creoles and Europeans in the Argentine Chaco) the conflicts referring to the different ways in which the natives' knowledge and practice are categorized by the natives themselves, by scientists, state politicians, professional artists and NGOs. Furthermore, we address several cases that illustrate these kinds of conflicts. We aim to analyze the complexities of patrimonial policies when they are applied to practices and representations of contemporary communities involved in power relations with national states and the global system. The essentialization of identities, the folklorization of representations and practices, and the fossilization of aboriginal peoples are some of the risks of applying the label ``cultural heritage'' without a careful consideration of each specific case. In particular we suggest possible ways in which the international scientific community could collaborate to improve the agenda of national states instead of reproducing colonial prejudices. In this way, we aim to contribute to the promotion of respect for ethnic and religious minorities.

Planning for Community Based Tourism in a Remote Location

Directory of Open Access Journals (Sweden)

Sharon Harwood

2010-07-01

Full Text Available Remote areas are difficult to access, tend to lack critical infrastructure, are highly susceptible to shocks in the marketplace, and are perceived by industry to possess limited development opportunities. Accordingly a community orientated and territorial approach to development planning in a remote area will be more successful than a top down industry based approach [1]. Given the limitations of being remote, the case study community examined in this research manages and sustains a bird watching tourism product within a global market place. This paper examines how a remotely located community in the Arfak Mountains of West Papua overcomes these difficulties and plans for community based tourism (CBT in their locale.

Closing the (service) gap: exploring partnerships between Aboriginal and mainstream health services.

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Taylor, Kate P; Thompson, Sandra C

2011-08-01

Although effective partnerships between Aboriginal and mainstream health services are critical to improve Aboriginal health outcomes, many factors can cause these partnerships to be tenuous and unproductive. Understanding the elements of best practice for successful partnerships is essential. A literature review was conducted in 2009 using keyword searches of electronic databases. Sourced literature was assessed for relevance regarding the benefits, challenges, lessons learnt and factors contributing to successful Aboriginal and mainstream partnerships. Key themes were collated. Although there is much literature regarding general partnerships generally, few specifically examine Aboriginal and mainstream health service partnerships. Twenty-four sources were reviewed in detail. Benefits include broadening service capacity and improving the cultural security of healthcare. Challenges include the legacy of Australia's colonial history, different approaches to servicing clients and resource limitations. Recommendations for success include workshopping tensions early, building trust and leadership. Although successful partnerships are crucial to optimise Aboriginal health outcomes, failed collaborations risk inflaming sensitive Aboriginal-non-Aboriginal relationships. Factors supporting successful partnerships remind us to develop genuine, trusting relationships that are tangibly linked to the Aboriginal community. Failure to invest in this relational process and push forward with 'business as usual' can ultimately have negative ramifications on client outcomes.

Grannies, elders, and friends: aging Aboriginal women in Toronto.

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Baskin, Cyndy; Davey, Caitlin J

2015-01-01

Based on a research project in Toronto, Canada, this article highlights the strengths and resiliency of 12 female Aboriginal Elders and seniors as they age together. For these women, being actively involved in their families and the Aboriginal community gives them a solid grounding in who they are, what their roles are and how they contribute to the whole. Of particular significance is the support and friendship the women offer each other through their commonalities, activities, and sense of humor.

Aboriginal health workers experience multilevel barriers to quitting smoking: a qualitative study.

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Dawson, Anna P; Cargo, Margaret; Stewart, Harold; Chong, Alwin; Daniel, Mark

2012-05-23

society was an overarching challenge to quitting. Aboriginal Health Workers experience multilevel barriers to quitting smoking that include personal, social, cultural and environmental factors. Multidimensional smoking cessation programs are needed that reduce the stress and burden for Aboriginal Health Workers; provide access to culturally relevant quitting resources; and address the prevailing normalisation of smoking in the family, workplace and community.

The impact of health promotion on trachoma knowledge, attitudes and practice (KAP of staff in three work settings in remote Indigenous communities in the Northern Territory.

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Fiona D Lange

2017-05-01

Full Text Available Globally, trachoma is the leading cause of infectious blindness and Australia is the only developed country with endemic trachoma. It is found in remote Indigenous communities burdened with poverty, overcrowding and poor hygiene. Lack of culturally appropriate health promotion, a small trachoma workforce and lack of awareness and support for trachoma elimination in general, were early barriers.A cross-sectional pre-post study using a convenience sample, was conducted in clinics, schools and community work-settings from 63 of the 82 remote Aboriginal communities identified as being at risk of trachoma in the Northern Territory (NT. The study assessed the effect of a multi-component health promotion strategy aimed at increasing knowledge, attitude and practice amongst health, education and community support settings staff. Data were collected between 2010 and 2012. The health promotion initiatives were introduced in communities in staggered delivery over a one-year period; 272 participants were surveyed at baseline and 261 at follow-up.Trachoma related knowledge, attitudes and practice increased across all settings and for all primary outcome measures. Across all settings, there was a significant increase in the proportion of participants reporting the most important thing to do if a child has a 'dirty' face is to 'wash it every time its dirty' (61.6% cf 69.7%; X2p = 0.047, a significant reduction in the proportion of respondents answering 'no' to the question "Is it normal for kids to have dirty faces in your community' (40.5% cf 29.6%; X2p = 0.009 and a significant increase in reported capacity to teach others about trachoma prevention (70.8% cf 83.3%; X2p <0.001.Health promotion was associated with increased trachoma knowledge, attitude and practice amongst health, education and community support staff working with children and in remote NT communities. In the early stages of the trachoma health promotion program, this increased trachoma

Perinatal depression and screening among Aboriginal Australians in the Kimberley.

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Kotz, Jayne; Munns, Ailsa; Marriott, Rhonda; Marley, Julia V

2016-02-01

Adhoc culturally questionable perinatal mental-health screening among Aboriginal women in the Kimberley. Mental-health issues, substance abuse and suicide attempts are high among young Aboriginal women in Australia. There is no evidence that the Edinburgh Postnatal Depression Scale (EPDS) is effective or culturally safe. Screening practices are complicated by limited understanding of the complex cultural interface between Western and Aboriginal beliefs and notions about health and mental-health. What is the current context of perinatal mental-health screening practices among Aboriginal women in the Kimberley and what might be considered a culturally safe approach? A review of the literature and exploration of current screening practices preceded community participatory action research (CPAR) of perinatal mental-health screening. More than 100 Kimberley women and 72 health practitioners contributed to this joint strategic body of work. Recommendations for practice include one single culturally appropriate Kimberley version of the EPDS.

Opportunistic screening to detect atrial fibrillation in Aboriginal adults in Australia

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Flaskas, Yvonne; O'Brien, Ciaran; Jeffries, Thomas Lee; McCowen, Debbie; Finlayson, Heather; Martin, Tanya; Neubeck, Lis; Freedman, Ben

2016-01-01

Introduction There is a 10-year gap in life expectancy between Aboriginal and non-Aboriginal Australians. The leading cause of death for Aboriginal Australians is cardiovascular disease, including myocardial infarction and stroke. Although atrial fibrillation (AF) is a known precursor to stroke there are no published studies about the prevalence of AF for Aboriginal people and limited evidence about AF in indigenous populations globally. Methods and analysis This mixed methods study will recruit and train Aboriginal health workers to use an iECG device attached to a smartphone to consecutively screen 1500 Aboriginal people aged 45 years and older. The study will quantify the proportion of people who presented for follow-up assessment and/or treatment following a non-normal screening and then estimate the prevalence and age distribution of AF of the Australian Aboriginal population. The study includes semistructured interviews with the Aboriginal health workers about the effectiveness of the iECG device in their practice as well as their perceptions of the acceptability of the device for their patients. Thematic analysis will be undertaken on the qualitative data collected in the study. If the device and approach are acceptable to the Aboriginal people and widely adopted, it may help prevent the effects of untreated AF including ischaemic stroke and early deaths or impairment in Aboriginal people. Ethics and dissemination This mixed methods study received ethics approval from the Aboriginal Health and Medical Research Council (1135/15) and the Australian Health Council of Western Australia (HREC706). Ethics approval is being sought in the Northern Territory. The findings of this study will be shared with Aboriginal communities, in peer reviewed publications and at conferences. There are Aboriginal investigators in each state/territory where the study is being conducted who have been actively involved in the study. They will also be involved in data analysis

Emerging opportunities between the Aboriginal communities and the petroleum industry

International Nuclear Information System (INIS)

Crowfoot, S.J.

1998-01-01

The management of oil and gas resources from Indian Reserve lands across Canada is the responsibility of Indian Oil and Gas Canada (IOGC). The IOGC issues and executes all agreements relating to exploration and development of oil and gas on Indian lands. Band Council signs all agreements as consenters. In the last two years, activity levels at the IOGC have exceeded average normal levels. In 1997-98, a total of 116 new wells were drilled on First Nation Lands; in 1996-97 the number of new wells drilled was 130. Currently, there are a total of 800 wells administered by the IOGC. A total of 179 oil and gas companies operate on 76 First Nation reserves in Alberta, Saskatchewan, British Columbia and Manitoba. There are 14 First Nation-owned oil and gas companies holding leases on reserve lands. This paper reviews the changes in the structuring of joint ventures and resource development arrangement with Aboriginal communities in light of the recent Delgamuukw decision

Aboriginal Education with Anti-Racist Education: Building Alliances across Cultural and Racial Identity Politics

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St. Denis, Verna

2007-01-01

A critical race analysis could provide both Aboriginal students and their university student advisors with knowledge to understand and potentially challenge the effects and processes of racialization that have historically, legally, and politically divided Aboriginal communities and families. Coalition and alliances can be made within and across…

The role of Aboriginal family workers in delivering a child safety focused home visiting program for Aboriginal families in an urban region of NSW.

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Clapham, Kathleen; Bennett-Brook, Keziah; Hunter, Kate

2018-05-09

Aboriginal Australian children experience higher rates of injury than other Australian children. However few culturally acceptable programs have been developed or evaluated. The Illawarra Aboriginal Medical Service (IAMS) developed the Safe Homes Safe Kids program as an injury prevention program targeting disadvantaged Aboriginal families with children aged 0-5 in an urban region of NSW. Delivered by Aboriginal Family Workers the program aims to reduce childhood injury by raising awareness of safety in the home. A program evaluation was conducted to determine the effectiveness of the home visiting model as an injury prevention program. This paper reports on the qualitative interviews which explored the ways in which clients, IAMS staff, and external service providers experienced the program and assessed its delivery by the Aboriginal Family Workers. A qualitative program evaluation was conducted between January 2014 and June 2015. We report here on the semi-structured interviews undertaken with 34 individuals. The results show increased client engagement in the program; improved child safety knowledge and skills; increased access to services; improved attitudes to home and community safety; and changes in the home safety environment. Safe Homes Safe Kids provides a culturally appropriate child safety program delivered by Aboriginal Family Workers to vulnerable families. Clients, IAMS staff, and external service were satisfied with the family workers' delivery of the program and the holistic model of service provision. SO WHAT?: This promising program could be replicated in other Aboriginal health services to address unintentional injury to vulnerable Aboriginal children. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Aboriginal Australians' experience of social capital and its relevance to health and wellbeing in urban settings.

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Browne-Yung, Kathryn; Ziersch, Anna; Baum, Fran; Gallaher, Gilbert

2013-11-01

Social capital has been linked to physical and mental health. While definitions of social capital vary, all include networks of social relationships and refer to the subsequent benefits and disadvantages accrued to members. Research on social capital for Aboriginal Australians has mainly focused on discrete rural and remote Aboriginal contexts with less known about the features and health and other benefits of social capital in urban settings. This paper presents findings from in-depth interviews with 153 Aboriginal people living in urban areas on their experiences of social capital. Of particular interest was how engagement in bonding and bridging networks influenced health and wellbeing. Employing Bourdieu's relational theory of capital where resources are unequally distributed and reproduced in society we found that patterns of social capital are strongly associated with economic, social and cultural position which in turn reflects the historical experiences of dispossession and disadvantage experienced by Aboriginal Australians. Social capital was also found to both reinforce and influence Aboriginal cultural identity, and had both positive and negative impacts on health and wellbeing. Copyright © 2013 Elsevier Ltd. All rights reserved.

Acceptability of Mental Health Apps for Aboriginal and Torres Strait Islander Australians: A Qualitative Study.

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Povey, Josie; Mills, Patj Patj Janama Robert; Dingwall, Kylie Maree; Lowell, Anne; Singer, Judy; Rotumah, Darlene; Bennett-Levy, James; Nagel, Tricia

2016-03-11

Aboriginal and Torres Strait Islander Australians experience high rates of mental illness and psychological distress compared to their non-Indigenous counterparts. E-mental health tools offer an opportunity for accessible, effective, and acceptable treatment. The AIMhi Stay Strong app and the ibobbly suicide prevention app are treatment tools designed to combat the disproportionately high levels of mental illness and stress experienced within the Aboriginal and Torres Strait Islander community. This study aimed to explore Aboriginal and Torres Strait Islander community members' experiences of using two culturally responsive e-mental health apps and identify factors that influence the acceptability of these approaches. Using qualitative methods aligned with a phenomenological approach, we explored the acceptability of two culturally responsive e-mental health apps through a series of three 3-hour focus groups with nine Aboriginal and Torres Strait Islander community members. Thematic analysis was conducted and coresearcher and member checking were used to verify findings. Findings suggest strong support for the concept of e-mental health apps and optimism for their potential. Factors that influenced acceptability related to three key themes: personal factors (eg, motivation, severity and awareness of illness, technological competence, and literacy and language differences), environmental factors (eg, community awareness, stigma, and availability of support), and app characteristics (eg, ease of use, content, graphics, access, and security and information sharing). Specific adaptations, such as local production, culturally relevant content and graphics, a purposeful journey, clear navigation, meaningful language, options to assist people with language differences, offline use, and password protection may aid uptake. When designed to meet the needs of Aboriginal and Torres Strait Islander Australians, e-mental health tools add an important element to public health

Factors contributing to delayed diagnosis of cancer among Aboriginal people in Australia: a qualitative study

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Shahid, Shaouli; Teng, Tiew-Hwa Katherine; Bessarab, Dawn; Aoun, Samar; Baxi, Siddhartha; Thompson, Sandra C

2016-01-01

Background/objectives Delayed presentation of symptomatic cancer is associated with poorer survival. Aboriginal patients with cancer have higher rates of distant metastases at diagnosis compared with non-Aboriginal Australians. This paper examined factors contributing to delayed diagnosis of cancer among Aboriginal Australians from patient and service providers' perspectives. Methods In-depth, open-ended interviews were conducted in two stages (2006–2007 and 2011). Inductive thematic analysis was assisted by use of NVivo looking around delays in presentation, diagnosis and referral for cancer. Participants Aboriginal patients with cancer/family members (n=30) and health service providers (n=62) were recruited from metropolitan Perth and six rural/remote regions of Western Australia. Results Three broad themes of factors were identified: (1) Contextual factors such as intergenerational impact of colonisation and racism and socioeconomic deprivation have negatively impacted on Aboriginal Australians' trust of the healthcare professionals; (2) health service-related factors included low accessibility to health services, long waiting periods, inadequate numbers of Aboriginal professionals and high staff turnover; (3) patient appraisal of symptoms and decision-making, fear of cancer and denial of symptoms were key reasons patients procrastinated in seeking help. Elements of shame, embarrassment, shyness of seeing the doctor, psychological ‘fear of the whole health system’, attachment to the land and ‘fear of leaving home’ for cancer treatment in metropolitan cities were other deterrents for Aboriginal people. Manifestation of masculinity and the belief that ‘health is women's domain’ emerged as a reason why Aboriginal men were reluctant to receive health checks. Conclusions Solutions to improved Aboriginal cancer outcomes include focusing on the primary care sector encouraging general practitioners to be proactive to suspicion of symptoms with appropriate

Development of the Aboriginal Communication Assessment After Brain Injury (ACAABI): A screening tool for identifying acquired communication disorders in Aboriginal Australians.

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Armstrong, Elizabeth M; Ciccone, Natalie; Hersh, Deborah; Katzenellebogen, Judith; Coffin, Juli; Thompson, Sandra; Flicker, Leon; Hayward, Colleen; Woods, Deborah; McAllister, Meaghan

2017-06-01

Acquired communication disorders (ACD), following stroke and traumatic brain injury, may not be correctly identified in Aboriginal Australians due to a lack of linguistically and culturally appropriate assessment tools. Within this paper we explore key issues that were considered in the development of the Aboriginal Communication Assessment After Brain Injury (ACAABI) - a screening tool designed to assess the presence of ACD in Aboriginal populations. A literature review and consultation with key stakeholders were undertaken to explore directions needed to develop a new tool, based on existing tools and recommendations for future developments. The literature searches revealed no existing screening tool for ACD in these populations, but identified tools in the areas of cognition and social-emotional wellbeing. Articles retrieved described details of the content and style of these tools, with recommendations for the development and administration of a new tool. The findings from the interview and focus group views were consistent with the approach recommended in the literature. There is a need for a screening tool for ACD to be developed but any tool must be informed by knowledge of Aboriginal language, culture and community input in order to be acceptable and valid.

Aboriginal Health Workers experience multilevel barriers to quitting smoking: a qualitative study

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Dawson Anna P

2012-05-01

level barriers. The normalisation of smoking in Aboriginal society was an overarching challenge to quitting. Conclusions Aboriginal Health Workers experience multilevel barriers to quitting smoking that include personal, social, cultural and environmental factors. Multidimensional smoking cessation programs are needed that reduce the stress and burden for Aboriginal Health Workers; provide access to culturally relevant quitting resources; and address the prevailing normalisation of smoking in the family, workplace and community.

Suicide ideation and attempt in a community cohort of urban Aboriginal youth: a cross-sectional study.

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Luke, Joanne N; Anderson, Ian P; Gee, Graham J; Thorpe, Reg; Rowley, Kevin G; Reilly, Rachel E; Thorpe, Alister; Stewart, Paul J

2013-01-01

There has been increasing attention over the last decade on the issue of indigenous youth suicide. A number of studies have documented the high prevalence of suicide behavior and mortality in Australia and internationally. However, no studies have focused on documenting the correlates of suicide behavior for indigenous youth in Australia. To examine the prevalence of suicide ideation and attempt and the associated factors for a community1 cohort of Koori2 (Aboriginal) youth. Data were obtained from the Victorian Aboriginal Health Service (VAHS) Young People's Project (YPP), a community initiated cross-sectional data set. In 1997/1998, self-reported data were collected for 172 Koori youth aged 12-26 years living in Melbourne, Australia. The data were analyzed to assess the prevalence of current suicide ideation and lifetime suicide attempt. Principal components analysis (PCA) was used to identify closely associated social, emotional, behavioral, and cultural variables at baseline and Cox regression modeling was then used to identify associations between PCA components and suicide ideation and attempt. Ideation and attempt were reported at 23.3% and 24.4%, respectively. PCA yielded five components: (1) emotional distress, (2) social distress A, (3) social distress B, (4) cultural connection, (5) behavioral. All were positively and independently associated with suicide ideation and attempt, while cultural connection showed a negative association. Suicide ideation and attempt were common in this cross-section of indigenous youth with an unfavorable profile for the emotional, social, cultural, and behavioral factors.

Aboriginal and Torres Strait Islander Worldviews and Cultural Safety Transforming Sexual Assault Service Provision for Children and Young People

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Leticia Funston

2013-08-01

Full Text Available Child Sexual Assault (CSA in Aboriginal and Torres Strait Islander communities is a complex issue that cannot be understood in isolation from the ongoing impacts of colonial invasion, genocide, assimilation, institutionalised racism and severe socio-economic deprivation. Service responses to CSA are often experienced as racist, culturally, financially and/or geographically inaccessible. A two-day forum, National Yarn Up: Sharing the Wisdoms and Challenges of Young People and Sexual Abuse, was convened by sexual assault services to identify the main practice and policy concerns regarding working with Aboriginal and Torres Strait Islander children and young people (C&YP, families and communities in the context of CSA. The forum also aimed to explore how services can become more accountable and better engaged with the communities they are designed to support. The forum was attended by eighty invited Aboriginal and Torres Strait Islander and non-Aboriginal youth sexual assault managers and workers representing both “victim” and “those who sexually harm others” services. In keeping with Aboriginal Community-Based Research methods forum participants largely directed discussions and contributed to the analysis of key themes and recommendations reported in this article. The need for sexual assault services to prioritise cultural safety by meaningfully integrating Aboriginal and Torres Strait Islander Worldviews emerged as a key recommendation. It was also identified that collaboration between “victims” and “those who sexually harm” services are essential given Aboriginal and Torres Strait Islander C&YP who sexually harm others may have also been victims of sexual assault or physical violence and intergenerational trauma. By working with the whole family and community, a collaborative approach is more likely than the current service model to develop cultural safety and thus increase the accessibility of sexual assault services.

Research Ethics Review and Aboriginal Community Values: Can the Two be Reconciled?

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Glass, Kathleen Cranley; Kaufert, Joseph

2007-06-01

CONTEMPORARY RESEARCH ETHICS REVIEW COMMITTEES (RECs) are heavily influenced by the established academic or health care institutional frameworks in which they operate, sharing a cultural, methodological and ethical perspective on the conduct of research involving humans. The principle of autonomous choice carries great weight in what is a highly individualistic decision-making process in medical practice and research. This assumes that the best protection lies in the ability of patients or research participants to make competent, voluntary, informed choices, evaluating the risks and benefits from a personal perspective. Over the past two decades, North American and international indigenous researchers, policy makers and communities have identified key issues of relevance to them, but ignored by most institutional or university-based RECs. They critique the current research review structure, and propose changes on a variety of levels in an attempt to develop more community sensitive research ethics review processes. In doing so, they have emphasized recognition of collective rights including community consent. Critics see alternative policy guidelines and community-based review bodies as challenging the current system of ethics review. Some view them as reflecting a fundamental difference in values. In this paper, we explore these developments in the context of the political, legal and ethical frameworks that have informed REC review. We examine the process and content of these frameworks and ask how this contrasts with emerging Aboriginal proposals for community-based research ethics review. We follow this with recommendations on how current REC review models might accommodate the requirements of both communities and RECs.

Red Dirt Thinking on Remote Educational Advantage

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Guenther, John; Bat, Melodie; Osborne, Sam

2014-01-01

The discourse of remote education is often characterised by a rhetoric of disadvantage. This is reflected in statistics that on the surface seem unambiguous in their demonstration of poor outcomes for remote Aboriginal and Torres Strait Islander students. A range of data support this view, including National Assessment Program-Literacy and…

Social determinants in the sexual health of adolescent Aboriginal Australians: a systematic review.

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MacPhail, Catherine; McKay, Kathy

2018-03-01

While research indicates that Aboriginal and Torres Strait Islander adolescents may be at increased risk of some sexually transmitted infections, there is limited information about factors that may place these young people at more risk of adverse sexual health than their non-Indigenous counterparts. Current research has tended to focus on surveillance-type data, but there is an increasing need to understand social determinants of sexual health risk. This systematic review assessed the evidence of social determinants impacting on Aboriginal and Torres Strait Islander adolescents' sexual health in Australia. Published, English-language literature was searched across key databases from 2003 to 2015. Fourteen studies were included in the qualitative synthesis. Findings suggest that social determinants such as access to healthcare, poverty, substance use, educational disadvantage, sociocultural context, gender inequalities, status and identity, and social disadvantage impacted on Indigenous adolescents' sexual behaviours and sexual health risk. Evidence from the literature included in the review suggests that peer education may be an acceptable and appropriate approach for addressing such issues. There remains a need for programmes and services to be community-developed and community-led, thus ensuring cultural appropriateness and relevance. However, there is also a significant need for such programmes to be effectively and rigorously evaluated with data that goes beyond surveillance, and seeks to unpack how sexual norms are experienced by Indigenous adolescents, particularly outside of remote Australia - and how these experiences act as either risk or protective factors to good sexual health and positive social and emotional well-being. © 2016 John Wiley & Sons Ltd.

Wind power projects and Aboriginal consultation

Energy Technology Data Exchange (ETDEWEB)

Isaac, T. [McCarthy Tetrault LLP, Vancouver, BC (Canada)

2006-07-01

This presentation outlined some of the legal aspects related to Aboriginal involvement in wind power development consultation processes and disputes. Aboriginal rights are rights held by Aboriginal people that are an element of a practice, custom, or tradition integral to the culture of groups claiming such rights. Wind power developers should understand that Aboriginal rights claims may include fishing; whaling; transportation; and cultural and spiritual activities. Aboriginal title is a subcategory of Aboriginal rights, and is a right to land itself, and an encumbrance on the Crown's underlying title to land. Weak Aboriginal claims where potential infringement by energy developers is minor may only require notice and information. Strong prima facie cases for Aboriginal rights and title where the potential for infringement is of high significance may result in more extensive consultation involving interim solutions; formal Aboriginal participation in decision-making processes; and written responses demonstrating how Aboriginal concerns have been considered. There are a number of circumstances requiring a case-by-case approach, and the Crown may make decisions in the face of Aboriginal disagreement. However, energy developers should ensure that consultation processes are fair and reasonable. Conflicting interests can often be successfully resolved through consultation, and accommodation to Aboriginal rights may include mitigation, avoiding interference, and agreeing to as little infringement as possible. Aboriginal title may attach to private land but only to the Crown's underlying title. The Crown has no duty to consult respecting Aboriginal title on private land because title has already been infringed. In these cases, duty to consult and accommodate may be discharged through other regulatory processes such as environmental impact assessments. It was concluded that wind power project proponents should build a relationship with the Crown, as avoiding

Exploring factors impacting early childhood health among Aboriginal and Torres Strait Islander families and communities: protocol for a population-based cohort study using data linkage (the ‘Defying the Odds’ study)

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Gubhaju, Lina; Jorm, Louisa; Preen, David; Jones, Jocelyn; Joshy, Grace; Shepherd, Carrington; McAullay, Daniel; Eades, Sandra; Ball, Stephen

2018-01-01

Introduction Empirical evidence on family and community risk and protective factors influencing the comparatively high rates of potentially preventable hospitalisations and deaths among Aboriginal and Torres Strait Islander infants and children is limited. As is evidence on geographical variation in these risks. The ‘Defying the Odds’ study aims to explore the impact of perinatal outcomes, maternal social and health outcomes and level of culturally secure service availability on the health outcomes of Western Australian (WA) Aboriginal infants and children aged 0–5 years. Methods and analysis The study combines a retrospective cohort study that uses state-wide linked health and administrative data from 12 data sources for multiple generations within Aboriginal families in WA, with specifically collected survey data from health and social services supporting Aboriginal families in regions of WA. Data sources include perinatal/birth registration, hospital, emergency department, mental health services, drug and alcohol service use, mortality, infectious disease notifications, and child protection and family services. Multilevel regression models will be used to examine the intensity of admissions and presentations, mortality, intensity of long stays and morbidity-free survival (no admissions) for Aboriginal children born in WA in 2000–2013. Relationships between maternal (and grand-maternal) health and social factors and child health outcomes will be quantified. Community-level variation in outcomes for Aboriginal children and factors contributing to this variation will be examined, including the availability of culturally secure services. Online surveys were sent to staff members at relevant services to explore the scope, reach and cultural security of services available to support Aboriginal families across selected regions of WA. Ethics and dissemination Ethics approvals have been granted for the study. Interpretation and dissemination are guided by the

Transposing reform pedagogy into new contexts: complex instruction in remote Australia

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Sullivan, Peter; Jorgensen, Robyn; Boaler, Jo; Lerman, Steve

2013-03-01

This article draws on the outcomes of a 4-year project where complex instruction was used as the basis for a reform in mathematics teaching in remote Aboriginal communities in Australia. The article describes the overall project in terms of the goals and aspirations for learning mathematics among remote Indigenous Australians. Knowing that the approach had been successful in a diverse setting in California, the project team sought to implement and evaluate the possibilities of such reform in a context in which the need for a culturally responsive pedagogy was critical. Elements of complex instruction offered considerable possibilities in aligning with the cultures of the remote communities, but with recognition of the possibility that some elements may not be workable in these contexts. Complex instruction also valued deep knowledge of mathematics rather than a tokenistic, impoverished mathematics. The strategies within complex instruction allowed for mathematical and cultural scaffolding to promote deep learning in mathematics. Such an approach was in line with current reforms in Indigenous education in Australia where there are high expectations of learners in order to break away from the deficit thinking that has permeated much education in remote Australia. The overall intent is to demonstrate what pedagogies are possible within the constraints of the remote context.

A cross sectional study of animal and human colonization with Methicillin-Resistant Staphylococcus aureus (MRSA in an Aboriginal community

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Peter Daley

2016-07-01

Full Text Available Abstract Background Methicillin-resistant Staphylococcus aureus (MRSA infections are common among humans in Aboriginal communities in Canada, for unknown reasons. Methods Cross sectional study of humans and dogs in an Aboriginal community of approximately 1200 persons. Our objectives were to measure community-based prevalence of nasal MRSA colonization among humans, use multivariable logistic regression to analyze risk factors for MRSA colonization, and perform molecular typing of Staphylococci isolated to investigate interspecies transmission. Results 461 humans were approached for consent and 442 provided complete data. 109/442 (24.7 %, 95 % C.I. = 20.7–28.7 % of humans were colonized with MRSA. 169/442 (38.2 % of humans had received antibiotics in the last 12 months. Only number of rooms in the house (OR 0.86, p = 0.023 and recreational dog use (OR 7.7, p = 0.002 were significant risk factors for MRSA colonization. 95/109 (87.1 % of MRSA strains from humans were of the same spa type (CMRSA10/USA300. 8/157 (5.1 %, 95 % C.I. = 1.7–8.5 % of dogs were colonized with methicillin-susceptible S. aureus, and no dogs were colonized with MRSA. Conclusions Human MRSA colonization in this community is very common, and a single clone is predominant, suggesting local transmission. Antibiotic use is also very common. Crowding may partially explain high colonization, but most considered risk factors including animal exposure were not predictive. Very few dogs carried human Staphylococcal strains.

Gender variations in waist circumference levels between Aboriginal and non-Aboriginal Australian populations: a systematic review.

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Adegbija, Odewumi Oluwarotimi; Wang, Zhiqiang

2014-01-01

To compare gender-specific waist circumference (WC) levels of Aboriginal Australians with non-Aboriginal Australians. A systematic search on Medline, PubMed, EMBASE and Google Scholar databases was conducted to identify papers that reported gender-specific waist circumference (WC) estimates of participants from the age of 15 years and above among Aboriginal and non-Aboriginal Australians. Means and their 95% confidence intervals of gender differences in WC, height and weight were recorded or calculated where they were not provided. Gender-specific WC, height and weight mean estimates were pooled and the I(2) statistic was used to test heterogeneity among Aboriginal and non-Aboriginal Australians. Of 17 selected cross-sectional studies, 9 focused on Aboriginal and 8 on non-Aboriginal Australians. Seven studies reported significantly higher WC estimates among indigenous females than males. On the other hand, non-indigenous males had significantly higher WC levels than females. Males had greater height and weight estimates than females in both groups. Although indigenous women were shorter and had lower weight estimates, they had greater WC levels than indigenous men. This is the first systematic review to assess the gender-specific differences between Aboriginal and non-Aboriginal Australians. The findings of this review warrant more efforts to understand and reduce the high prevalence of central obesity and related chronic diseases among Aboriginal women. Copyright © 2014 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Aurorae in Australian Aboriginal Traditions

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Hamacher, Duane W.

2013-07-01

Transient celestial phenomena feature prominently in the astronomical knowledge and traditions of Aboriginal Australians. In this paper, I collect accounts of the Aurora Australis from the literature regarding Aboriginal culture. Using previous studies of meteors, eclipses, and comets in Aboriginal traditions, I anticipate that the physical properties of aurora, such as their generally red colour as seen from southern Australia, will be associated with fire, death, blood, and evil spirits. The survey reveals this to be the case and also explores historical auroral events in Aboriginal cultures, aurorae in rock art, and briefly compares Aboriginal auroral traditions with other global indigenous groups, including the Maori of New Zealand.

Men, hearts and minds: developing and piloting culturally specific psychometric tools assessing psychosocial stress and depression in central Australian Aboriginal men.

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Brown, Alex; Mentha, Ricky; Howard, Michael; Rowley, Kevin; Reilly, Rachel; Paquet, Catherine; O'Dea, Kerin

2016-02-01

The health inequalities experienced by Aboriginal and Torres Strait Islander Australians are well documented but there are few empirical data outlining the burden, consequences, experience and expression of depressive illness. This paper seeks to address the lack of accessible, culturally specific measures of psychosocial stress, depression or quality of life developed for, and validated within, this population. Building on an extensive qualitative phase of research, a psychosocial questionnaire comprising novel and adapted scales was developed and piloted with 189 Aboriginal men across urban and remote settings in central Australia. With a view to refining this tool for future use, its underlying structure was assessed using exploratory factor analysis, and the predictive ability of the emergent psychosocial constructs assessed with respect to depressive symptomatology. The latent structure of the psychosocial questionnaire was conceptually aligned with the components of the a priori model on which the questionnaire was based. Regression modelling indicated that depressive symptoms were driven by a sense of injury and chronic stress and had a non-linear association with socioeconomic position. This represents the first community-based survey of psychosocial stress and depression in Aboriginal men. It provides both knowledge of, and an appropriate process for, the further development of psychometric tools, including quality of life, in this population. Further research with larger and more diverse samples of Aboriginal people is required to refine the measurement of key constructs such as chronic stress, socioeconomic position, social support and connectedness. The further refinement, validation against criterion-based methods and incorporation within primary care services is essential.

Childhood Stress and Adversity is Associated with Late-Life Dementia in Aboriginal Australians.

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Radford, Kylie; Delbaere, Kim; Draper, Brian; Mack, Holly A; Daylight, Gail; Cumming, Robert; Chalkley, Simon; Minogue, Cecilia; Broe, Gerald A

2017-10-01

High rates of dementia have been observed in Aboriginal Australians. This study aimed to describe childhood stress in older Aboriginal Australians and to examine associations with late-life health and dementia. A cross-sectional study with a representative sample of community-dwelling older Aboriginal Australians. Urban and regional communities in New South Wales, Australia. 336 Aboriginal and/or Torres Strait Islander Australians aged 60-92 years, of whom 296 were included in the current analyses. Participants completed a life course survey of health, well-being, cognition, and social history including the Childhood Trauma Questionnaire (CTQ), with consensus diagnosis of dementia and Alzheimer disease. CTQ scores ranged from 25-117 (median: 29) and were associated with several adverse childhood indicators including separation from family, poor childhood health, frequent relocation, and growing up in a major city. Controlling for age, higher CTQ scores were associated with depression, anxiety, suicide attempt, dementia diagnosis, and, specifically, Alzheimer disease. The association between CTQ scores and dementia remained significant after controlling for depression and anxiety variables (OR: 1.61, 95% CI: 1.05-2.45). In contrast, there were no significant associations between CTQ scores and smoking, alcohol abuse, diabetes, or cardiovascular risk factors. Childhood stress appears to have a significant impact on emotional health and dementia for older Aboriginal Australians. The ongoing effects of childhood stress need to be recognized as people grow older, particularly in terms of dementia prevention and care, as well as in populations with greater exposure to childhood adversity, such as Aboriginal Australians. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

"It's almost expected": rural Australian Aboriginal women's reflections on smoking initiation and maintenance: a qualitative study.

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Passey, Megan E; Gale, Jennifer T; Sanson-Fisher, Robert W

2011-12-09

Despite declining smoking rates among the general Australian population, rates among Indigenous Australians remain high, with 47% of the Indigenous population reporting daily smoking - twice that of other Australians. Among women, smoking rates are highest in younger age groups, with more than half of Aboriginal women smoking during pregnancy. A lack of research focused on understanding the social context of smoking by Aboriginal women in rural Australia limits our ability to reduce these rates. This study aimed to explore the factors contributing to smoking initiation among rural Aboriginal women and girls and the social context within which smoking behaviour occurs. We conducted three focus groups with 14 Aboriginal women and service providers and 22 individual interviews with Aboriginal women from four rural communities to explore their perceptions of the factors contributing to smoking initiation among Aboriginal girls. Four inter-related factors were considered important to understanding the social context in which girls start smoking: colonisation and the introduction of tobacco; normalization of smoking within separate Aboriginal social networks; disadvantage and stressful lives; and the importance of maintaining relationships within extended family and community networks. Within this context, young girls use smoking to attain status and as a way of asserting Aboriginal identity and group membership, a way of belonging, not of rebelling. Family and social structures were seen as providing strong support, but limited the capacity of parents to influence children not to smoke. Marginalization was perceived to contribute to limited aspirations and opportunities, leading to pleasure-seeking in the present rather than having goals for the future. The results support the importance of addressing contextual factors in any strategies aimed at preventing smoking initiation or supporting cessation among Aboriginal girls and women. It is critical to acknowledge

"It's almost expected": rural Australian Aboriginal women's reflections on smoking initiation and maintenance: a qualitative study

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Passey Megan E

2011-12-01

Full Text Available Abstract Background Despite declining smoking rates among the general Australian population, rates among Indigenous Australians remain high, with 47% of the Indigenous population reporting daily smoking - twice that of other Australians. Among women, smoking rates are highest in younger age groups, with more than half of Aboriginal women smoking during pregnancy. A lack of research focused on understanding the social context of smoking by Aboriginal women in rural Australia limits our ability to reduce these rates. This study aimed to explore the factors contributing to smoking initiation among rural Aboriginal women and girls and the social context within which smoking behaviour occurs. Methods We conducted three focus groups with 14 Aboriginal women and service providers and 22 individual interviews with Aboriginal women from four rural communities to explore their perceptions of the factors contributing to smoking initiation among Aboriginal girls. Results Four inter-related factors were considered important to understanding the social context in which girls start smoking: colonisation and the introduction of tobacco; normalization of smoking within separate Aboriginal social networks; disadvantage and stressful lives; and the importance of maintaining relationships within extended family and community networks. Within this context, young girls use smoking to attain status and as a way of asserting Aboriginal identity and group membership, a way of belonging, not of rebelling. Family and social structures were seen as providing strong support, but limited the capacity of parents to influence children not to smoke. Marginalization was perceived to contribute to limited aspirations and opportunities, leading to pleasure-seeking in the present rather than having goals for the future. Conclusions The results support the importance of addressing contextual factors in any strategies aimed at preventing smoking initiation or supporting cessation

An Australian Aboriginal birth cohort: a unique resource for a life course study of an Indigenous population. A study protocol

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Flynn Kathryn

2003-03-01

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.

Predicting absolute risk of type 2 diabetes using age and waist circumference values in an aboriginal Australian community.

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Odewumi Adegbija

Full Text Available To predict in an Australian Aboriginal community, the 10-year absolute risk of type 2 diabetes associated with waist circumference and age on baseline examination.A sample of 803 diabetes-free adults (82.3% of the age-eligible population from baseline data of participants collected from 1992 to 1998 were followed-up for up to 20 years till 2012. The Cox-proportional hazard model was used to estimate the effects of waist circumference and other risk factors, including age, smoking and alcohol consumption status, of males and females on prediction of type 2 diabetes, identified through subsequent hospitalisation data during the follow-up period. The Weibull regression model was used to calculate the absolute risk estimates of type 2 diabetes with waist circumference and age as predictors.Of 803 participants, 110 were recorded as having developed type 2 diabetes, in subsequent hospitalizations over a follow-up of 12633.4 person-years. Waist circumference was strongly associated with subsequent diagnosis of type 2 diabetes with P<0.0001 for both genders and remained statistically significant after adjusting for confounding factors. Hazard ratios of type 2 diabetes associated with 1 standard deviation increase in waist circumference were 1.7 (95%CI 1.3 to 2.2 for males and 2.1 (95%CI 1.7 to 2.6 for females. At 45 years of age with baseline waist circumference of 100 cm, a male had an absolute diabetic risk of 10.9%, while a female had a 14.3% risk of the disease.The constructed model predicts the 10-year absolute diabetes risk in an Aboriginal Australian community. It is simple and easily understood and will help identify individuals at risk of diabetes in relation to waist circumference values. Our findings on the relationship between waist circumference and diabetes on gender will be useful for clinical consultation, public health education and establishing WC cut-off points for Aboriginal Australians.

Understanding food security issues in remote Western Australian Indigenous communities.

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Pollard, Christina M; Nyaradi, Anett; Lester, Matthew; Sauer, Kay

2014-08-01

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.

Conference proceedings of the Canadian Aboriginal Minerals Association : certainty through partnership

International Nuclear Information System (INIS)

2004-01-01

This conference presents a series of papers concerning resource development in the Aboriginal community in which partnership is a key issue. The challenges facing resource industries regarding investments and securing land tenure were discussed. These uncertainties can be alleviated through partnerships between industry and Aboriginal communities, where each partner brings their experience, access to knowledge, and access to capital. Perspectives of the diamond, mining and biomass industries were given. In addition, issues concerning accessing funds for business development, practices for local employment and sustainability were examined. An update on pipelines is presented, as well as an overview and examination of the suppliers to the resource industry. This conference featured 9 presentations of which 2 have been catalogued separately for inclusion in this database. tabs., figs

Defining the gap: a systematic review of the difference in rates of diabetes-related foot complications in Aboriginal and Torres Strait Islander Australians and non-Indigenous Australians.

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West, Matthew; Chuter, Vivienne; Munteanu, Shannon; Hawke, Fiona

2017-01-01

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

Oral cavity squamous cell carcinoma - characteristics and survival in aboriginal and non-aboriginal Western australians.

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Frydrych, A M; Slack-Smith, L M; Parsons, R; Threlfall, T

2014-01-01

Squamous cell carcinoma (SCC) is the most common type of malignancy affecting the oral cavity. While exposures to main risk factors for oral SCC such as smoking and alcohol use are higher amongst the Aboriginal people, little is known about oral cancer in this population. This study aimed to describe characteristics and survival of oral SCC in Aboriginal and non-Aboriginal Western Australians. All primary oral SCC cases reported to the Western Australian Cancer Registry (WACR) between 1990 and 1999 were analysed with respect to person characteristics including: date of birth, sex and indigenous status; and disease characteristics including: date of biopsy, disease stage and site as well as date of recurrence and date of death. Exclusion criteria included diagnosis not based on incisional or excisional biopsy, diagnosis other than oral SCC or a history of another malignant neoplasm. Aboriginal individuals were more likely to reside in rural areas. No statistically significant differences in oral SCC characteristics and survival were noted between Aboriginal and non-Aboriginal Western Australians. This study provides new information on person and disease characteristics of Aboriginal Western Australians diagnosed with oral SCC.

Cancer Data and Aboriginal Disparities (CanDAD)—developing an Advanced Cancer Data System for Aboriginal people in South Australia: a mixed methods research protocol

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Yerrell, Paul Henry; Roder, David; Cargo, Margaret; Reilly, Rachel; Banham, David; Micklem, Jasmine May; Morey, Kim; Stewart, Harold Bundamurra; Stajic, Janet; Norris, Michael; Brown, Alex

2016-01-01

Introduction In Australia, Aboriginal and Torres Strait Islander People carry a greater burden of cancer-related mortality than non-Aboriginal Australians. The Cancer Data and Aboriginal Disparities Project aims to develop and test an integrated, comprehensive cancer monitoring and surveillance system capable of incorporating epidemiological and narrative data to address disparities and advocate for clinical system change. Methods and analysis The Advanced Cancer Data System will integrate routinely collected unit record data from the South Australian Population Cancer Registry and a range of other data sources for a retrospective cohort of indigenous people with cancers diagnosed from 1990 to 2010. A randomly drawn non-Aboriginal cohort will be matched by primary cancer site, sex, age and year at diagnosis. Cross-tabulations and regression analyses will examine the extent to which demographic attributes, cancer stage and survival vary between the cohorts. Narratives from Aboriginal people with cancer, their families, carers and service providers will be collected and analysed using patient pathway mapping and thematic analysis. Statements from the narratives will structure both a concept mapping process of rating, sorting and prioritising issues, focusing on issues of importance and feasibility, and the development of a real-time Aboriginal Cancer Measure of Experience for ongoing linkage with epidemiological data in the Advanced Cancer Data System. Aboriginal Community engagement underpins this Project. Ethics and dissemination The research has been approved by relevant local and national ethics committees. Findings will be disseminated in local and international peer-reviewed journals and conference presentations. In addition, the research will provide data for knowledge translation activities across the partner organisations and feed directly into the Statewide Cancer Control Plan. It will provide a mechanism for monitoring and evaluating the implementation of

Measuring organisational-level Aboriginal cultural climate to tailor cultural safety strategies.

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Gladman, Justin; Ryder, Courtney; Walters, Lucie K

2015-01-01

Australian medical schools have taken on a social accountability mandate to provide culturally safe contexts in order to encourage Aboriginal and Torres Strait Islander people to engage in medical education and to ensure that present and future clinicians provide health services that contribute to improving the health outcomes of Aboriginal and Torres Strait Islander peoples. Many programs have sought to improve cultural safety through training at an individual level; however, it is well recognised that learners tend to internalise the patterns of behaviour to which they are commonly exposed. This project aimed to measure and reflect on the cultural climate of an Australian rural clinical school (RCS) as a whole and the collective attitudes of three different professional groups: clinicians, clinical academics and professional staff. The project then drew on Mezirow's Transformative Learning theory to design strategies to build on the cultural safety of the organisation. Clinicians, academic and professional staff at an Australian RCS were invited to participate in an online survey expressing their views on Aboriginal health using part of a previously validated tool. Survey response rate was 63%. All three groups saw Aboriginal health as a social priority. All groups recognised the fundamental role of community control in Aboriginal health; however, clinical academics were considerably more likely to disagree that the Western medical model suited the health needs of Aboriginal people. Clinicians were more likely to perceive that they treated Aboriginal patients the same as other patients. There was only weak evidence of future commitments to Aboriginal health. Importantly, clinicians, academics and professional staff demonstrated differences in their cultural safety profile which indicated the need for a tailored approach to cultural safety learning in the future. Through tailored approaches to cross-cultural training opportunities we are likely to ensure

Culturally appropriate methodology in obtaining a representative sample of South Australian Aboriginal adults for a cross-sectional population health study: challenges and resolutions.

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Marin, Tania; Taylor, Anne Winifred; Grande, Eleonora Dal; Avery, Jodie; Tucker, Graeme; Morey, Kim

2015-05-19

The considerably lower average life expectancy of Aboriginal and Torres Strait Islander Australians, compared with non-Aboriginal and non-Torres Strait Islander Australians, has been widely reported. Prevalence data for chronic disease and health risk factors are needed to provide evidence based estimates for Australian Aboriginal and Torres Strait Islanders population health planning. Representative surveys for these populations are difficult due to complex methodology. The focus of this paper is to describe in detail the methodological challenges and resolutions of a representative South Australian Aboriginal population-based health survey. Using a stratified multi-stage sampling methodology based on the Australian Bureau of Statistics 2006 Census with culturally appropriate and epidemiological rigorous methods, 11,428 randomly selected dwellings were approached from a total of 209 census collection districts. All persons eligible for the survey identified as Aboriginal and/or Torres Strait Islander and were selected from dwellings identified as having one or more Aboriginal person(s) living there at the time of the survey. Overall, the 399 interviews from an eligible sample of 691 SA Aboriginal adults yielded a response rate of 57.7%. These face-to-face interviews were conducted by ten interviewers retained from a total of 27 trained Aboriginal interviewers. Challenges were found in three main areas: identification and recruitment of participants; interviewer recruitment and retainment; and using appropriate engagement with communities. These challenges were resolved, or at least mainly overcome, by following local protocols with communities and their representatives, and reaching agreement on the process of research for Aboriginal people. Obtaining a representative sample of Aboriginal participants in a culturally appropriate way was methodologically challenging and required high levels of commitment and resources. Adhering to these principles has resulted in a

Capacity-building and Participatory Research Development of a Community-based Nutrition and Exercise Lifestyle Intervention Program (NELIP for Pregnant and Postpartum Aboriginal Women:Information Gathered from Talking Circles.

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Katie Big-Canoe

2011-05-01

Full Text Available Objectives were to gather information from Talking Circles of Aboriginal women who participated in a maternal Nutrition and Exercise Lifestyle Intervention Program (NELIP to identify strategies to bring NELIP into the community. Twelve First Nations women participated. Several main themes were identified regarding health: balance, knowledge/education and time management. Benefits of the NELIP were improvement in health, stamina, stress, and a healthy baby, no gestational diabetes and a successful home birth, with social support as an important contributing factor for success. Suggestions for improvement for the NELIP included group walking, and incorporating more traditional foods into the meal plan. The information gathered is the first step in determining strategies using participatory research and capacity-building to develop a community-based NELIP for pregnant Aboriginal women.

Serum vitamin D levels, diabetes and cardio-metabolic risk factors in Aboriginal and Torres Strait Islander Australians.

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Maple-Brown, Louise J; Hughes, Jaquelyne T; Lu, Zhong X; Jeyaraman, Kanakamani; Lawton, Paul; Jones, Graham Rd; Ellis, Andrew; Sinha, Ashim; Cass, Alan; MacIsaac, Richard J; Jerums, George; O'Dea, Kerin

2014-01-01

Low levels of serum 25-hydroxy vitamin D (25(OH)D), have been associated with development of type 2 diabetes and cardiovascular disease (CVD); however there are limited data on serum 25(OH)D in Indigenous Australians, a population at high risk for both diabetes and CVD. We aimed to assess levels of serum 25(OH)D in Aboriginal and Torres Strait Islander Australians and to explore relationships between 25(OH)D and cardio-metabolic risk factors and diabetes. 592 Aboriginal and/or Torres Strait Islander Australian participants of The eGFR (estimated glomerular filtration rate) Study, a cross-sectional analysis of a cohort study performed in 2007-2011, from urban and remote centres within communities, primary care and tertiary hospitals across Northern Territory, Far North Queensland and Western Australia. Assessment of serum 25(OH)D, cardio-metabolic risk factors (central obesity, diabetes, hypertension, history of cardiovascular disease, current smoker, low HDL-cholesterol), and diabetes (by history or HbA1c ≥6.5%) was performed. Associations were explored between 25(OH)D and outcome measures of diabetes and number of cardio-metabolic risk factors. The median (IQR) serum 25(OH)D was 60 (45-77) nmol/L, 31% had 25(OH)D 72 nmol/L, respectively) after adjusting for known cardio-metabolic risk factors. The percentage of 25(OH)D levels Aboriginal and Torres Strait Islander Australians from Northern and Central Australia. Low 25(OH)D level was associated with adverse cardio-metabolic risk profile and was independently associated with diabetes. These findings require exploration in longitudinal studies.

Prevalence of chlamydia, gonorrhoea, syphilis and trichomonas in Aboriginal and Torres Strait Islander Australians: a systematic review and meta-analysis.

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Graham, Simon; Smith, Lucy Watchirs; Fairley, Christopher K; Hocking, Jane

2016-04-01

Higher notification rates of sexually transmissible infections (STIs) are reported among Aboriginal and Torres Strait Islander (Aboriginal) compared with non-Aboriginal people in Australia. The aim of this study is to estimate the pooled prevalence of chlamydia, gonorrhoea, syphilis and trichomonas among Aboriginal people in Australia by sex, age-group, setting (clinic vs population/community-based) and population group [adults, pregnant females, young people (12-29 years) and prisoners]. The databases Medline, PubMed and Web of Science were searched in May 2015. A meta-analysis was conducted to estimate the pooled prevalence of the four STIs in Aboriginal people and if possible, by gender, age-group, setting and population group. A total of 46 studies were included. The pooled prevalence was 11.2% (95%CI: 9.4-13.0%) for chlamydia (36 studies), 12.5% (95%CI: 10.5-14.6%) for gonorrhoea (28 studies), 16.8% (95%CI: 11.0-22.6%) for syphilis (13 studies) and 22.6% (95%CI: 18.5-26.7%) for trichomonas (11 studies); however, there was significant heterogeneity between studies (I(2) Aboriginal people through community-based programs that target asymptomatic young people.

Corporate social responsibility and aboriginal relations

International Nuclear Information System (INIS)

McIntyre, J.; Cook, H.D.

2002-01-01

All of Canada's uranium mining activity occurs in the northern half of the province of Saskatchewan in western Canada. This region has a total population of 38 000 people living in many small communities scattered over 250 000 square kilometres. Demographically, the north's population is 75% aboriginal representing the Woodland Cree, Dene, and Metis Nations. The majority of the aboriginal population of northern Saskatchewan are treaty Indians (First Nations). The dominant first nations group in the north is The Lac La Ronge Indian Band, also Saskatchewan's largest Woodland Cree First Nation. Despite the fact that the Lac La Ronge Band and other First Nations of the region do not have surface or mineral rights, other than those on their reserve lands, they have significant influence in the development process. The extraction of the mineral resources of Canada are now undertaken with very considerable input from first nations groups and with sensitivity to their treaty rights and aboriginal traditional rights. Treaty rights in Canada include, among other things, hunting and fishing, access to post secondary education and special taxation considerations. This presentation will introduce participants to a unique perspective on northern Saskatchewan's uranium mining industry. This perspective will be provided by Harry Cook, Chief of the Lac La Ronge Indian Band.In his presentation, Chief Cook will provide a first nation's perspective on industrial development generally and uranium development specifically. He will begin by outlining the challenges facing aboriginal people in Canada and will provide an insightful view of the historical conflict between industrial developers and first nations people. He will describe the aspirations of his people and the importance they place on preservation of the natural environment. He will also speak to the critical need now emerging for aboriginal people to seek a balance between retaining traditional culture and participating in the

Baseline investigations of folate status in Aboriginal and non-Aboriginal West Australians prior to the introduction of mandatory fortification.

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Maxwell, Susannah J; Brameld, Kate J; Bower, Caroline; D'Antoine, Heather; Hickling, Siobhan; Marley, Julia; O'Leary, Peter

2013-02-01

In September 2009, Australia implemented mandatory folic acid fortification of wheat flour for bread-making to reduce the incidence of neural tube defects. Our study aimed to establish baseline folate status data in Aboriginal and non-Aboriginal Western Australians. Patients who presented at a health service or collection centre for blood tests were invited to participate. One hundred and ninety-one Aboriginals and 159 non-Aboriginals were recruited between April 2008 and September 2009. Participants completed a five-minute questionnaire and had blood taken for red blood cell (RBC) folate and serum vitamin B12. Data were analysed using SPSS (version 17.0.2, SPSS Inc., Chicago, IL, USA). Ten per cent (95% confidence intervals (CI): 5, 19) of the Aboriginal women participants and 26% (95% CI: 16, 40) of men had RBC folate concentrations below 250 ng/mL, the cut-off associated with folate deficiency. None of the non-Aboriginal women (95% CI: 0, 4) and 4% of the non-Aboriginal men (95% CI: 2, 12) had RBC folate concentrations below 250 ng/mL. All participants were vitamin B12 replete. None of the 96 Aboriginal and 8% of non-Aboriginal women aged 16-44 reported consumption of supplements with a daily intake of >400 μg folic acid during the previous week. This study established a baseline of RBC folate, folate consumption and supplement use in Aboriginal and non-Aboriginal groups. We identified 10% of Aboriginal women and none of non-Aboriginal women participants with low folate concentrations. The higher prevalence of folate deficiency in Aboriginal participants suggests they are more likely to benefit from a universal program of folate fortification. © 2012 The Authors ANZJOG © 2012 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Aboriginal Agency and Marginalisation in Australian Society

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Terry Moore

2014-09-01

Full Text Available It is often argued that while state rhetoric may be inclusionary, policies and practices may be exclusionary. This can imply that the power to include rests only with the state. In some ways, the implication is valid in respect of Aboriginal Australians. For instance, the Australian state has gained control of Aboriginal inclusion via a singular, bounded category and Aboriginal ideal type. However, the implication is also limited in their respect. Aborigines are abject but also agents in their relationship with the wider society. Their politics contributes to the construction of the very category and type that governs them, and presses individuals to resist state inclusionary efforts. Aboriginal political elites police the performance of an Aboriginality dominated by notions of difference and resistance. The combined processes of governance act to deny Aborigines the potential of being both Aboriginal and Australian, being different and belonging. They maintain Aborigines’ marginality.

Psychopathology of Aboriginal and Non-Aboriginal Adolescents Living in the Mountainous Region of Southern Taiwan

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Cheng-Fang Yen

2006-11-01

Full Text Available The aim of this study was to examine the hypothesis that Taiwanese aboriginal adolescents feature more severe psychopathology than non-aboriginal adolescents who live in the same mountainous region of southern Taiwan, and to test the hypothesis by controlling other individual and environmental factors. In this study, a total of 251 aboriginal and 79 non-aboriginal Taiwanese adolescents were enrolled. Their psychopathology was measured by the Symptom Checklist-90-Revised Scale; demographic and family characteristics, and their affinity with their peer group and with their school were also assessed. The results of the multiple regression analysis revealed that aboriginal adolescents feature more severe psychopathology than non-aboriginal adolescents, and indicated that females and adolescents perceiving higher levels of family conflict and lower family support were more likely to experience more severe psychopathology than those perceiving the contrary. Those who devise strategies to improve the mental health of adolescents living in impoverished regions must take into consideration their ethnicity, gender, and family context when devising such treatment strategies.

Factors relating to participation in follow-up to the 45 and up study in Aboriginal and non-Aboriginal individuals

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Lina Gubhaju

2016-05-01

Full Text Available Abstract Background This study aimed to characterise the factors relating to participation in a postal follow-up study in Aboriginal and non-Aboriginal individuals, given the need to quantify potential biases from loss to follow-up and the lack of evidence regarding postal surveys among Aboriginal people. Methods The first 100,000 participants from the Sax Institute’s 45 and Up Study, a large scale cohort study, were posted a follow-up questionnaire gathering general demographic, health and risk factor data, emphasising Social, Economic and Environmental Factors (“The SEEF Study”. For each variable of interest, percentages of those invited who went on to participate in follow-up were tabulated separately for Aboriginal and non-Aboriginal participants and age- and sex-adjusted participation rate ratios (aPRR were calculated. Results Of the 692 Aboriginal and 97,178 non-Aboriginal invitees to the study, 314 Aboriginal (45 % and 59,175 non-Aboriginal (61 % individuals responded. While Aboriginal people were less likely to respond than non-Aboriginal people (aPRR 0.72, 95 % CI 0.66–0.78, factors related to response were similar. Follow-up study participants were more likely than non-participants to have university versus no educational qualifications (1.6, 1.3–2.0 [Aboriginal]; 1.5, 1.5–1.5 [non-Aboriginal] and an annual income of ≥70,000 versus < $20,000 (1.6, 1.3–2.0; 1.2, 1.2–1.3 [χ 2 = 7.7; p = 0.001]. Current smokers (0.55, 0.42–0.72; 0.76, 0.74–0.77 [χ 2 = 7.14; p = 0.03], those reporting poor self-rated health (0.68, 0.47–0.99; 0.65, 0.61–0.69, poor quality of life (0.63, 0.41–0.97; 0.61, 0.57–0.66 and very high psychological distress (0.71, 0.68–0.75 [non-Aboriginal] were less likely than other cohort members to respond. Conclusions Relatively large numbers of Aboriginal and non-Aboriginal individuals participated in the first 45 and Up Study follow-up suggesting that postal surveys

Offshore oil and gas and coastal British Columbia : Aboriginal rights, title and interests

Energy Technology Data Exchange (ETDEWEB)

Porter, D. [First Nations Summit, West Vancouver, BC (Canada)

2006-07-01

This presentation discussed the legal duty of offshore proponents in the oil and gas industry to consult with Aboriginal nations. The Crown court's support for Aboriginal title to ocean areas within proposed offshore regions was also discussed, and Aboriginal rights to manage ocean resources were outlined. Haida and Taku River Tlingit legal decisions have confirmed both a constitutional and fiduciary duty for the Crown to consult with Aboriginal nations who assert their rights or title to lands subject to development. Resource rights granted without meaningful consultation with Aboriginal nations can be challenged, which may result in legal and financial liability for resource companies. A consultative process that addresses ownership, capacity and benefit sharing must be developed so that Aboriginal governments can participate in the design and development of appropriate fiscal and regulatory regimes. The developed regime must consider benefit and revenue sharing, as well as the integration of traditional knowledge within western science for the lifetime of any project. All decision-making bodies must include participation from Aboriginal groups. Mechanisms must also be developed to mitigate the environmental and socio-economic consequences of resource development. Impact and benefit agreements must be negotiated with coastal nations. Dissatisfaction with the concept of consultation processes has led first nations to reconsider the role that they must play in ensuring that oil and gas developments in the coastal regions of British Columbia do not negatively impact on their communities. It was noted that Inuit land claims reserve special rights for the Inuit over 18,800 miles of tidal waters. Earlier attempts by Aboriginal societies to assert their right to control their own ocean resources free from governmental interference were also discussed. It was concluded that litigation of Aboriginal rights and title poses serious challenges to offshore oil and gas

A mental health first aid training program for Australian Aboriginal and Torres Strait Islander peoples: description and initial evaluation

Science.gov (United States)

Kanowski, Len G; Jorm, Anthony F; Hart, Laura M

2009-01-01

Background Mental Health First Aid (MHFA) training was developed in Australia to teach members of the public how to give initial help to someone developing a mental health problem or in a mental health crisis situation. However, this type of training requires adaptation for specific cultural groups in the community. This paper describes the adaptation of the program to create an Australian Aboriginal and Torres Strait Islander Mental Health First Aid (AMHFA) course and presents an initial evaluation of its uptake and acceptability. Methods To evaluate the program, two types of data were collected: (1) quantitative data on uptake of the course (number of Instructors trained and courses subsequently run by these Instructors); (2) qualitative data on strengths, weaknesses and recommendations for the future derived from interviews with program staff and focus groups with Instructors and community participants. Results 199 Aboriginal people were trained as Instructors in a five day Instructor Training Course. With sufficient time following training, the majority of these Instructors subsequently ran 14-hour AMHFA courses for Aboriginal people in their community. Instructors were more likely to run courses if they had prior teaching experience and if there was post-course contact with one of the Trainers of Instructors. Analysis of qualitative data indicated that the Instructor Training Course and the AMHFA course are culturally appropriate, empowering for Aboriginal people, and provided information that was seen as highly relevant and important in assisting Aboriginal people with a mental illness. There were a number of recommendations for improvements. Conclusion The AMHFA program is culturally appropriate and acceptable to Aboriginal people. Further work is needed to refine the course and to evaluate its impact on help provided to Aboriginal people with mental health problems. PMID:19490648

Cancer Data and Aboriginal Disparities (CanDAD)-developing an Advanced Cancer Data System for Aboriginal people in South Australia: a mixed methods research protocol.

Science.gov (United States)

Yerrell, Paul Henry; Roder, David; Cargo, Margaret; Reilly, Rachel; Banham, David; Micklem, Jasmine May; Morey, Kim; Stewart, Harold Bundamurra; Stajic, Janet; Norris, Michael; Brown, Alex

2016-12-23

In Australia, Aboriginal and Torres Strait Islander People carry a greater burden of cancer-related mortality than non-Aboriginal Australians. The Cancer Data and Aboriginal Disparities Project aims to develop and test an integrated, comprehensive cancer monitoring and surveillance system capable of incorporating epidemiological and narrative data to address disparities and advocate for clinical system change. The Advanced Cancer Data System will integrate routinely collected unit record data from the South Australian Population Cancer Registry and a range of other data sources for a retrospective cohort of indigenous people with cancers diagnosed from 1990 to 2010. A randomly drawn non-Aboriginal cohort will be matched by primary cancer site, sex, age and year at diagnosis. Cross-tabulations and regression analyses will examine the extent to which demographic attributes, cancer stage and survival vary between the cohorts. Narratives from Aboriginal people with cancer, their families, carers and service providers will be collected and analysed using patient pathway mapping and thematic analysis. Statements from the narratives will structure both a concept mapping process of rating, sorting and prioritising issues, focusing on issues of importance and feasibility, and the development of a real-time Aboriginal Cancer Measure of Experience for ongoing linkage with epidemiological data in the Advanced Cancer Data System. Aboriginal Community engagement underpins this Project. The research has been approved by relevant local and national ethics committees. Findings will be disseminated in local and international peer-reviewed journals and conference presentations. In addition, the research will provide data for knowledge translation activities across the partner organisations and feed directly into the Statewide Cancer Control Plan. It will provide a mechanism for monitoring and evaluating the implementation of the recommendations in these documents. Published by the

A genomic history of Aboriginal Australia

DEFF Research Database (Denmark)

Malaspinas, Anna-Sapfo; Westaway, Michael C.; Muller, Craig

2016-01-01

The population history of Aboriginal Australians remains largely uncharacterized. Here we generate high-coverage genomes for 83 Aboriginal Australians (speakers of Pama-Nyungan languages) and 25 Papuans from the New Guinea Highlands. We find that Papuan and Aboriginal Australian ancestors...

Aboriginal Representation: Conflict or Dialogue in the Academy

Science.gov (United States)

Leane, Jeanine

2010-01-01

This research begins with the premise that non-Aboriginal students are challenged by much Aboriginal writing and also challenge its representations as they struggle to re-position themselves in relation to possible meanings within Aboriginal writing. Many non-Aboriginal students come to read an Aboriginal narrative against their understanding of…

In Search of the Aboriginal Self

Directory of Open Access Journals (Sweden)

Lloyd Hawkeye Robertson

2014-05-01

Full Text Available Notions of aboriginal cultural reclamation and healing presuppose the existence of distinctly aboriginal selves that were damaged or lost in a process of colonization and that those selves can be “restored” in some meaningful way. Such aboriginal healing has been done without a detailed examination of the selves of individuals to be assisted in this manner. This article examines the selves of four contemporary individuals with varying relationships to the concept of aboriginality using a method of mapping the self with elemental units of culture called “memes.” It is suggested that a spectrum of healthy selves is possible for people who either identify with aboriginality culturally or satisfy a racial definition of the concept. The co-evolution of the self and culture is discussed along with the utility of various definitions of what it means to be aboriginal in a North American context.

What oil and gas activities infringe on Aboriginal interests

International Nuclear Information System (INIS)

Maas, J.

1998-01-01

Some of the experiences that First Nations communities in British Columbia have had in dealing with the petroleum industry and government are reviewed, emphasizing the past lack of consultation with First Nations whose treaty and Aboriginal rights were being infringed. The focus is primarily on Treaty 8, one of the series of numbered treaties negotiated during the 1800s, but which is still very much in effect. Changes expected as a result of the recent Delgamuukw decision which obligates regulatory authorities to consult with First Nations prior to issuing any permits for exploration or extraction of natural resources where such proposed projects might infringe on treaty and Aboriginal rights, are reviewed. Recent examples of settlements that confirm governments' and the industry's readiness to deal with aboriginal title claims as intended by the courts are cited. Other examples, showing reluctance by both governments and industry to accept the concept of mutually acceptable and meaningful consultation despite court rulings, and in the face of increasing levels of conflict, are also discussed.2 figs

Exploring Australian Aboriginal Women’s experiences of menopause: a descriptive study

Science.gov (United States)

2014-01-01

Background Despite extensive literature demonstrating differing experiences in menopause around the world, documentation of the experience of menopause in Australian Aboriginal women is scarce, and thus their menopausal experience is relatively unknown. This study aimed to understand Australian Aboriginal women’s understanding and experience of menopause and its impact on their lives. Methods The study was an exploratory qualitative study. Twenty-five Aboriginal women were recruited from a regional centre in the Mid-West region of Western Australia using opportunistic and snowballing sampling. Interviews and focus group discussions were undertaken from February 2011 to February 2012 using open-ended questioning with a yarning technique. Thematic analysis was undertaken of the transcribed interviews. Results A number of themes were revealed. These related to the language used, meanings and attitudes to menopause, symptoms experienced, the role of men, a lack of understanding, coping mechanisms and the attribution of menopausal changes to something else. The term “change of life” was more widely recognised and signified the process of ageing, and an associated gain of respect in the local community. A fear of menopausal symptoms or uncertainty about their origin was also common. Overall, many women reported insufficient understanding and a lack of available information to assist them and their family to understand the transition. Conclusion There are similarities between Aboriginal and non-Aboriginal experiences of menopause, including similar symptom profiles. The current language used within mainstream health settings may not be appropriate to this population if it fails to recognise the importance of language and reflect the attributed meaning of menopause. The fear of symptoms and uncertainty of their relationship to menopause demonstrated a need for more information which has not adequately been supplied to Australian Aboriginal women through current

Identifying barriers to aboriginal renewable energy deployment in Canada

International Nuclear Information System (INIS)

Krupa, Joel

2012-01-01

As one of the largest and wealthiest countries in the world, Canada stands well-positioned to take advantage of ongoing growth in North American demand for primary energy supply by expanding domestic delivery of renewable energy generation to internationally interconnected electric grids across the country. There are myriad benefits of adopting the renewable energy approach to development—as the province of Ontario has acknowledged through the implementation of their 2009 Green Energy Act—including drastic reductions in carbon emissions, the decommissioning of existing fossil fuel power generation that cause serious public health problems, and opportunities for sustainable development at the community level. One group in particular stands poised to shape these debates. In Canada, historically marginalized Aboriginal peoples remain one of the groups with the greatest potential for meeting these enormous renewable energy deployment needs. Aboriginal involvement in renewable energy generation in Canada has been as diverse as Canada's Aboriginal peoples and groups have already adopted a range of different solutions to meet energy supply needs. However, many significant barriers exist that prevent this diverse cultural group from reaching its full potential. The article identifies some of these shortcomings and analyzes their roots. - Highlights: ► Renewable energy is one of the most important sustainable development opportunities today. ► Aboriginal-led renewable development could dramatically increase Canadian supply. ► Surmountable barriers are identified.

Prevalence of HIV among Aboriginal and Torres Strait Islander Australians: a systematic review and meta-analysis.

Science.gov (United States)

Graham, Simon; O'Connor, Catherine C; Morgan, Stephen; Chamberlain, Catherine; Hocking, Jane

2017-06-01

Background Aboriginal and Torres Strait Islanders (Aboriginal) are Australia's first peoples. Between 2006 and 2015, HIV notifications increased among Aboriginal people; however, among non-Aboriginal people, notifications remained relatively stable. This systematic review and meta-analysis aims to examine the prevalence of HIV among Aboriginal people overall and by subgroups. In November 2015, a search of PubMed and Web of Science, grey literature and abstracts from conferences was conducted. A study was included if it reported the number of Aboriginal people tested and those who tested positive for HIV. The following variables were extracted: gender; Aboriginal status; population group (men who have sex with men, people who inject drugs, adults, youth in detention and pregnant females) and geographical location. An assessment of between study heterogeneity (I 2 test) and within study bias (selection, measurement and sample size) was also conducted. Seven studies were included; all were cross-sectional study designs. The overall sample size was 3772 and the prevalence of HIV was 0.1% (I 2 =38.3%, P=0.136). Five studies included convenient samples of people attending Australian Needle and Syringe Program Centres, clinics, hospitals and a youth detention centre, increasing the potential of selection bias. Four studies had a sample size, thus decreasing the ability to report pooled estimates. The prevalence of HIV among Aboriginal people in Australia is low. Community-based programs that include both prevention messages for those at risk of infection and culturally appropriate clinical management and support for Aboriginal people living with HIV are needed to prevent HIV increasing among Aboriginal people.

Kidney disease in Aboriginal Australians: a perspective from the Northern Territory.

Science.gov (United States)

Hoy, Wendy E

2014-12-01

This article outlines the increasing awareness, service development and research in renal disease in Aboriginal people in Australia's Northern Territory, among whom the rates of renal replacement therapy (RRT) are among the highest in the world. Kidney failure and RRT dominate the intellectual landscape and consume the most professional energy, but the underlying kidney disease has recently swung into view, with increasing awareness of its connection to other chronic diseases and to health profiles and trajectories more broadly. Albuminuria is the marker of the underlying kidney disease and the best treatment target, and glomerulomegaly and focal glomerulosclerosis are the defining histologic features. Risk factors in its multideterminant genesis reflect nutritional and developmental disadvantage and inflammatory/infectious milieu, while the major putative genetic determinants still elude detection. A culture shift of "chronic disease prevention" has been catalyzed in part by the human pain, logistic problems and great costs associated with RRT. Nowadays chronic disease management is the central focus of indigenous primary care, with defined protocols for integrated testing and management of chronic diseases and with government reimbursed service items and free medicines for people in remote areas. Blood pressure, cardiovascular risk and chronic kidney disease (CKD) are all mitigated by good treatment, which centres on renin-angiotensin system blockade and good metabolic control. RRT incidence rates appear to be stabilizing in remote Aboriginal people, and chronic disease deaths rates are falling. However, the profound levels of disadvantage in many remote settings remain appalling, and there is still much to be done, mostly beyond the direct reach of health services.

Racial discrimination, post traumatic stress, and gambling problems among urban Aboriginal adults in Canada.

Science.gov (United States)

Currie, Cheryl L; Wild, T Cameron; Schopflocher, Donald P; Laing, Lory; Veugelers, Paul; Parlee, Brenda

2013-09-01

Little is known about risk factors for problem gambling (PG) within the rapidly growing urban Aboriginal population in North America. Racial discrimination may be an important risk factor for PG given documented associations between racism and other forms of addictive behaviour. This study examined associations between racial discrimination and problem gambling among urban Aboriginal adults, and the extent to which this link was mediated by post traumatic stress. Data were collected via in-person surveys with a community-based sample of Aboriginal adults living in a mid-sized city in western Canada (N = 381) in 2010. Results indicate more than 80 % of respondents experienced discrimination due to Aboriginal race in the past year, with the majority reporting high levels of racism in that time period. Past year racial discrimination was a risk factor for 12-month problem gambling, gambling to escape, and post traumatic stress disorder (PTSD) symptoms in bootstrapped regression models adjusted for confounders and other forms of social trauma. Elevated PTSD symptoms among those experiencing high levels of racism partially explained the association between racism and the use of gambling to escape in statistical models. These findings are the first to suggest racial discrimination may be an important social determinant of problem gambling for Aboriginal peoples. Gambling may be a coping response that some Aboriginal adults use to escape the negative emotions associated with racist experiences. Results support the development of policies to reduce racism directed at Aboriginal peoples in urban areas, and enhanced services to help Aboriginal peoples cope with racist events.

Intergenerational Ethnic Mobility among Canadian Aboriginal Populations in 2001

Directory of Open Access Journals (Sweden)

Norbert Robitaille

2010-12-01

Aboriginal person and a non-Aboriginal person, the Aboriginal identity prevails over the non-Aboriginal identity. If Aboriginal identities were “not attractive” identities when declaring the ethnic affiliation of children in situations of exogamous unions, then the size of the Aboriginal population in Canada would be significantly smaller.

A genomic history of Aboriginal Australia.

Science.gov (United States)

Malaspinas, Anna-Sapfo; Westaway, Michael C; Muller, Craig; Sousa, Vitor C; Lao, Oscar; Alves, Isabel; Bergström, Anders; Athanasiadis, Georgios; Cheng, Jade Y; Crawford, Jacob E; Heupink, Tim H; Macholdt, Enrico; Peischl, Stephan; Rasmussen, Simon; Schiffels, Stephan; Subramanian, Sankar; Wright, Joanne L; Albrechtsen, Anders; Barbieri, Chiara; Dupanloup, Isabelle; Eriksson, Anders; Margaryan, Ashot; Moltke, Ida; Pugach, Irina; Korneliussen, Thorfinn S; Levkivskyi, Ivan P; Moreno-Mayar, J Víctor; Ni, Shengyu; Racimo, Fernando; Sikora, Martin; Xue, Yali; Aghakhanian, Farhang A; Brucato, Nicolas; Brunak, Søren; Campos, Paula F; Clark, Warren; Ellingvåg, Sturla; Fourmile, Gudjugudju; Gerbault, Pascale; Injie, Darren; Koki, George; Leavesley, Matthew; Logan, Betty; Lynch, Aubrey; Matisoo-Smith, Elizabeth A; McAllister, Peter J; Mentzer, Alexander J; Metspalu, Mait; Migliano, Andrea B; Murgha, Les; Phipps, Maude E; Pomat, William; Reynolds, Doc; Ricaut, Francois-Xavier; Siba, Peter; Thomas, Mark G; Wales, Thomas; Wall, Colleen Ma'run; Oppenheimer, Stephen J; Tyler-Smith, Chris; Durbin, Richard; Dortch, Joe; Manica, Andrea; Schierup, Mikkel H; Foley, Robert A; Lahr, Marta Mirazón; Bowern, Claire; Wall, Jeffrey D; Mailund, Thomas; Stoneking, Mark; Nielsen, Rasmus; Sandhu, Manjinder S; Excoffier, Laurent; Lambert, David M; Willerslev, Eske

2016-10-13

The population history of Aboriginal Australians remains largely uncharacterized. Here we generate high-coverage genomes for 83 Aboriginal Australians (speakers of Pama-Nyungan languages) and 25 Papuans from the New Guinea Highlands. We find that Papuan and Aboriginal Australian ancestors diversified 25-40 thousand years ago (kya), suggesting pre-Holocene population structure in the ancient continent of Sahul (Australia, New Guinea and Tasmania). However, all of the studied Aboriginal Australians descend from a single founding population that differentiated ~10-32 kya. We infer a population expansion in northeast Australia during the Holocene epoch (past 10,000 years) associated with limited gene flow from this region to the rest of Australia, consistent with the spread of the Pama-Nyungan languages. We estimate that Aboriginal Australians and Papuans diverged from Eurasians 51-72 kya, following a single out-of-Africa dispersal, and subsequently admixed with archaic populations. Finally, we report evidence of selection in Aboriginal Australians potentially associated with living in the desert.

Media literacy and remote community development in Eastern Indonesia Region

Science.gov (United States)

Aras, M.

2018-03-01

This study focused on media literacy phenomenon and educational development of remote communities in the eastern Indonesia region. Therefore, this study used the qualitative approach. The research was done by using direct observation and depth-interview. The research results showed that (1) the media literacy phenomenon of remote community in eastern Indonesia region was apprehensive. This was due to lack of access to information or media exposure through print media, electronic media, and social media. Therefore, the implication was the education awareness of the local community. The media literacy community has a strong relation with public awareness in improving education, and (2) the role of media in the development as facilitators or means of socialization to convey messages related to sustainable development programs in Indonesia. The current media phenomenon had become a necessity, without the exception of the remote communities. The development of an area was also characterized by the increasing education of its citizen and media became one of supporting factors that can motivate the citizen in gaining knowledge. It meant that media literacy community has strong relationships with people awareness in increasing their education. The more media literate, the more people have an awareness of self-development and their region development. Therefore, in the future, there will be no more remote areas because the media network has reached all areas.

Prevalence of asthma and chronic obstructive pulmonary disease in Aboriginal and non-Aboriginal populations: A systematic review and meta-analysis of epidemiological studies

Science.gov (United States)

Ospina, Maria B; Voaklander, Donald C; Stickland, Michael K; King, Malcolm; Senthilselvan, Ambikaipakan; Rowe, Brian H

2012-01-01

BACKGROUND: Asthma and chronic obstructive pulmonary disease (COPD) have considerable potential for inequities in diagnosis and treatment, thereby affecting vulnerable groups. OBJECTIVE: To evaluate differences in asthma and COPD prevalence between adult Aboriginal and non-Aboriginal populations. METHODS: MEDLINE, EMBASE, specialized databases and the grey literature up to October 2011 were searched to identify epidemiological studies comparing asthma and COPD prevalence between Aboriginal and non-Aboriginal adult populations. Prevalence ORs (PORs) and 95% CIs were calculated in a random-effects meta-analysis. RESULTS: Of 132 studies, eight contained relevant data. Aboriginal populations included Native Americans, Canadian Aboriginals, Australian Aboriginals and New Zealand Maori. Overall, Aboriginals were more likely to report having asthma than non-Aboriginals (POR 1.41 [95% CI 1.23 to 1.60]), particularly among Canadian Aboriginals (POR 1.80 [95% CI 1.68 to 1.93]), Native Americans (POR 1.41 [95% CI 1.13 to 1.76]) and Maori (POR 1.64 [95% CI 1.40 to 1.91]). Australian Aboriginals were less likely to report asthma (POR 0.49 [95% CI 0.28 to 0.86]). Sex differences in asthma prevalence between Aboriginals and their non-Aboriginal counterparts were not identified. One study compared COPD prevalence between Native and non-Native Americans, with similar rates in both groups (POR 1.08 [95% CI 0.81 to 1.44]). CONCLUSIONS: Differences in asthma prevalence between Aboriginal and non-Aboriginal populations exist in a variety of countries. Studies comparing COPD prevalence between Aboriginal and non-Aboriginal populations are scarce. Further investigation is needed to identify and account for factors associated with respiratory health inequalities among Aboriginal peoples. PMID:23248798

The applied technologies to access clean water for remote communities

Science.gov (United States)

Rabindra, I. B.

2018-01-01

A lot of research is done to overcome the remote communities to access clean water, yet very little is utilized and implemented by the community. Various reasons can probably be made for, which is the application of research results is assessed less practical. The aims of this paper is seeking a practical approach, how to establish criteria for the design can be easier applied, at the proper locations, the simple construction, effectively producing a volume and quality of clean water designation. The methods used in this paper is a technological model assessment of treatment/filtering clean water produced a variety of previous research, to establish a model of appropriate technology for remote communities. Various research results collected from the study of literature, while the identification of opportunities and threats to its application is done using a SWOT analysis. This article discussion is looking for alternative models of clean water filtration technology from the previous research results, to be selected as appropriate technology, easily applied and bring of many benefits to the remote communities. The conclusions resulting from the discussion in this paper, expected to be used as the basic criteria of design model of clean water filtration technologies that can be accepted and applied effectively by the remote communities.

A comparison of the effectiveness of an adult nutrition education program for Aboriginal and non-Aboriginal Australians.

Science.gov (United States)

Pettigrew, Simone; Jongenelis, Michelle I; Moore, Sarah; Pratt, Iain S

2015-11-01

Adult nutrition education is an important component of broader societal efforts to address the high prevalence of nutrition-related diseases. In Australia, Aboriginal people are a critical target group for such programs because of their substantially higher rates of these diseases. The aim of this study was to assess the relative effectiveness of an adult nutrition education program for Aboriginal and non-Aboriginal participants. Pre-and post-course evaluation data were used to assess changes in confidence in ability to buy healthy foods on a budget, nutrition knowledge, and dietary behaviours among individuals attending FOODcents nutrition education courses. The total sample of 875 Western Australians included 169 who self-identified as Aboriginal or Torres Strait Islander. Perceptions of course usefulness were very high and comparable between Aboriginal and non-Aboriginal participants. Significantly larger improvements in confidence, nutrition knowledge, and reported consumption behaviours were evident among Aboriginal participants. The findings suggest that adult nutrition education programs that address specific knowledge and skill deficits that are common among disadvantaged groups can be effective for multiple target groups, and may also assist in reducing nutrition-related inequalities. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Food and nutrition programs for Aboriginal and Torres Strait Islander Australians: an overview of systematic reviews.

Science.gov (United States)

Browne, Jennifer; Adams, Karen; Atkinson, Petah; Gleeson, Deborah; Hayes, Rick

2017-09-19

Objective To provide an overview of previous reviews of programs that aimed to improve nutritional status or diet-related health outcomes for Aboriginal and Torres Strait Islander peoples, in order to determine what programs are effective and why. Methods A systematic search of databases and relevant websites was undertaken to identify reviews of nutrition interventions for Aboriginal and Torres Strait Islander Australians. Pairs of reviewers undertook study selection and data extraction and performed quality assessment using a validated tool. Results Twelve papers reporting 11 reviews were identified. Two reviews were rated high quality, three were rated medium and six were rated low quality. The reviews demonstrated that a positive effect on nutrition and chronic disease indicators can be a result of: 1) incorporating nutrition and breastfeeding advice into maternal and child health care services; and 2) multifaceted community nutrition programs. The evidence suggests that the most important factor determining the success of Aboriginal and Torres Strait Islander food and nutrition programs is community involvement in (and, ideally, control of) program development and implementation. Conclusions Community-directed food and nutrition programs, especially those with multiple components that address the underlying causes of nutrition issues, can be effective in improving nutrition-related outcomes. What is known about the topic? More effective action is urgently required in order to reduce the unacceptable health inequalities between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians. Food insecurity and nutrition-related chronic conditions are responsible for a large proportion of the ill health experienced by Australia's First Peoples. What does this paper add? This narrative overview of 11 reviews published between 2005 and 2015 provides a synthesis of the current evidence for improving Aboriginal and Torres Strait Islander nutrition

Relation of child, caregiver, and environmental characteristics to childhood injury in an urban Aboriginal cohort in New South Wales, Australia.

Science.gov (United States)

Thurber, Katherine; Burgess, Leonie; Falster, Kathleen; Banks, Emily; Möller, Holger; Ivers, Rebecca; Cowell, Chris; Isaac, Vivian; Kalucy, Deanna; Fernando, Peter; Woodall, Cheryl; Clapham, Kathleen

2018-04-01

Despite being disproportionately affected by injury, little is known about factors associated with injury in Aboriginal children. We investigated factors associated with injury among urban Aboriginal children attending four Aboriginal Community Controlled Health Services in New South Wales, Australia. We examined characteristics of caregiver-reported child injury, and calculated prevalence ratios of 'ever-injury' by child, family, and environmental factors. Among children in the cohort, 29% (n=373/1,303) had ever broken a bone, been knocked out, required stitches or been hospitalised for a burn or poisoning; 40-78% of first injuries occurred at home and 60-91% were treated in hospital. Reported ever-injury was significantly lower (prevalence ratio ≤0.80) among children who were female, younger, whose caregiver had low psychological distress and had not been imprisoned, whose family experienced few major life events, and who hadn't experienced alcohol misuse in the household or theft in the community, compared to other cohort members. In this urban Aboriginal child cohort, injury was common and associated with measures of family and community vulnerability. Implications for public health: Prevention efforts targeting upstream injury determinants and Aboriginal children living in vulnerable families may reduce child injury. Existing broad-based intervention programs for vulnerable families may present opportunities to deliver targeted injury prevention. © 2017 The Authors.

Forms of aboriginal self-government

National Research Council Canada - National Science Library

Boisvert, David

1985-01-01

.... This paper examines how to establish aboriginal authorities within Canadian federalism, and proposed that the devolution of authority onto aboriginal governments might be the best way to establish...

Aborigines and uranium: consolidated report to the Minister for Aboriginal Affairs on the social impact of uranium mining on the aborigines of the Northern Territory

International Nuclear Information System (INIS)

1984-01-01

This consolidated report for the period October 1978 to June 1984 examines the aboriginal social environment, the impact and consequences for aborigines of uranium mining. The report looks at the question of monitoring social impact and examines in detail the findings and recommendations of the Ranger Uranium Environmental Inquiry. The social impact of mining is discussed, including the complexity of law and administration, economic consequences, health and aboriginal civic culture

'Talk, talk, cry, laugh': learning, healing and building an Aboriginal workforce to address family violence.

Science.gov (United States)

Lauw, Marlene L; Spangaro, Jo; Herring, Sigrid; McNamara, Lorna D

2013-02-01

Sexual abuse and family violence are widespread and under-reported phenomena for which Aboriginal victims face even greater barriers to asking for and receiving assistance than do others in the community. There is a need for strategies to address abuse without disempowering and alienating Aboriginal people. A program developed by the New South Wales Health Education Centre Against Violence is addressing this issue at the same time as contributing towards a strengthened Aboriginal health workforce. The training program which is a 1-year qualification course has grown from a 52% rate of graduation in its first 6 years to 92%. Three practices in the classroom have contributed to this success. These are: (i) recognition of the emotional impact of the training and its links to participants own histories; (ii) providing space to address participants negative prior educational experiences; and (iii) further developing content on the recent sociopolitical history of Aboriginal people. These practices have strengthened this successful course, which is building a skilled workforce to provide accessible, culturally sensitive services for Aboriginal people experiencing abuse.

Factors associated with pretreatment and treatment dropouts: comparisons between Aboriginal and non-Aboriginal clients admitted to medical withdrawal management

Science.gov (United States)

2013-01-01

Background Addiction treatment faces high pretreatment and treatment dropout rates, especially among Aboriginals. In this study we examined characteristic differences between Aboriginal and non-Aboriginal clients accessing an inpatient medical withdrawal management program, and identified risk factors associated with the probabilities of pretreatment and treatment dropouts, respectively. Methods 2231 unique clients (Aboriginal = 451; 20%) referred to Vancouver Detox over a two-year period were assessed. For both Aboriginal and non-Aboriginal groups, multivariate logistic regression analyses were conducted with pretreatment dropout and treatment dropout as dependent variables, respectively. Results Aboriginal clients had higher pretreatment and treatment dropout rates compared to non-Aboriginal clients (41.0% vs. 32.7% and 25.9% vs. 20.0%, respectively). For Aboriginal people, no fixed address (NFA) was the only predictor of pretreatment dropout. For treatment dropout, significant predictors were: being female, having HCV infection, and being discharged on welfare check issue days or weekends. For non-Aboriginal clients, being male, NFA, alcohol as a preferred substance, and being on methadone maintenance treatment (MMT) at referral were associated with pretreatment dropout. Significant risk factors for treatment dropout were: being younger, having a preferred substance other than alcohol, having opiates as a preferred substance, and being discharged on weekends. Conclusions Our results highlight the importance of social factors for the Aboriginal population compared to substance-specific factors for the non-Aboriginal population. These findings should help clinicians and decision-makers to recognize the importance of social supports especially housing and initiate appropriate services to improve treatment intake and subsequent retention, physical and mental health outcomes and the cost-effectiveness of treatment. PMID:24325629

Residents’ Attitude toward Aboriginal Cultural Tourism Development: An Integration of Two Theories

Directory of Open Access Journals (Sweden)

Chi-Ming Hsieh

2017-05-01

Full Text Available Understanding residents’ attitudes is critical for successfully developing cultural tourism in aboriginal protected areas. This study developed an integration model combining two theories to identify the key determinants of indigenous residents’ attitudes toward cultural tourism development. Social exchange theory stresses the impact of the benefits derived from tourism on indigenous residents’ attitudes toward tourism development. Social capital theory embeds clear rationales for strengthening the internalization process of the formation of residents’ shared values and understanding, enabling them to trust each other and thus support tourism development. The present study was conducted within two indigenous communities in Eastern Taiwan. The results revealed that cultural tourism benefits and structural and relational capital effectively predict indigenous residents’ attitudes toward tourism development; structural capital plays a critical mediating role in the relationship between tourism benefits and residents’ attitudes. The managerial implications provide recommendations for aboriginal community developers or practical sectors to avoid problems or costs caused by tourism development when promoting cultural tourism activities within indigenous communities.

Does Social Context Matter? Income Inequality, Racialized Identity, and Health Among Canada's Aboriginal Peoples Using a Multilevel Approach.

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Spence, Nicholas D

2016-03-01

Debates surrounding the importance of social context versus individual level processes have a long history in public health. Aboriginal peoples in Canada are very diverse, and the reserve communities in which they reside are complex mixes of various cultural and socioeconomic circumstances. The social forces of these communities are believed to affect health, in addition to individual level determinants, but no large scale work has ever probed their relative effects. One aspect of social context, relative deprivation, as indicated by income inequality, has greatly influenced the social determinants of health landscape. An investigation of relative deprivation in Canada's Aboriginal population has never been conducted. This paper proposes a new model of Aboriginal health, using a multidisciplinary theoretical approach that is multilevel. This study explored the self-rated health of respondents using two levels of determinants, contextual and individual. Data were from the 2001 Aboriginal Peoples Survey. There were 18,890 Registered First Nations (subgroup of Aboriginal peoples) on reserve nested within 134 communities. The model was assessed using a hierarchical generalized linear model. There was no significant variation at the contextual level. Subsequently, a sequential logistic regression analysis was run. With the sole exception culture, demographics, lifestyle factors, formal health services, and social support were significant in explaining self-rated health. The non-significant effect of social context, and by extension relative deprivation, as indicated by income inequality, is noteworthy, and the primary role of individual level processes, including the material conditions, social support, and lifestyle behaviors, on health outcomes is illustrated. It is proposed that social structure is best conceptualized as a dynamic determinant of health inequality and more multilevel theoretical models of Aboriginal health should be developed and tested.

Defining the gap: a systematic review of the difference in rates of diabetes-related foot complications in Aboriginal and Torres Strait Islander Australians and non-Indigenous Australians

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Matthew West

2017-11-01

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

Work setting, community attachment, and satisfaction among rural and remote nurses.

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Kulig, Judith C; Stewart, Norma; Penz, Kelly; Forbes, Dorothy; Morgan, Debra; Emerson, Paige

2009-01-01

To describe community satisfaction and attachment among rural and remote registered nurses (RNs) in Canada. Cross-sectional survey of rural and remote RNs in Canada as part of a multimethod study.The sample consisted of a stratified random sample of RNs living in rural areas of the western country and the total population of RNs who worked in three northern regional areas and those in outpost settings. A subset of 3,331 rural and remote RNs who mainly worked in acute care, long-term care, community health, home care, and primary care comprised the sample. The home community satisfaction scale measured community satisfaction, whereas single-item questions measured work community satisfaction and overall job satisfaction. Community variables were compared across practice areas using analysis of variance, whereas a thematic analysis was conducted of the open-ended questions. Home care and community health RNs were significantly more satisfied with their work community than RNs from other practice areas. RNs who grew up in rural communities were more satisfied with their current home community. Four themes emerged from the open-ended responses that describe community satisfaction and community attachment. Recruitment and retention strategies need to include mechanisms that focus on community satisfaction, which will enhance job satisfaction.

A genomic history of Aboriginal Australia

KAUST Repository

Malaspinas, Anna-Sapfo; Westaway, Michael C.; Muller, Craig; Sousa, Vitor C.; Lao, Oscar; Alves, Isabel; Bergströ m, Anders; Athanasiadis, Georgios; Cheng, Jade Y.; Crawford, Jacob E.; Heupink, Tim H.; Macholdt, Enrico; Peischl, Stephan; Rasmussen, Simon; Schiffels, Stephan; Subramanian, Sankar; Wright, Joanne L.; Albrechtsen, Anders; Barbieri, Chiara; Dupanloup, Isabelle; Eriksson, Anders; Margaryan, Ashot; Moltke, Ida; Pugach, Irina; Korneliussen, Thorfinn S.; Levkivskyi, Ivan P.; Moreno-Mayar, J. Ví ctor; Ni, Shengyu; Racimo, Fernando; Sikora, Martin; Xue, Yali; Aghakhanian, Farhang A.; Brucato, Nicolas; Brunak, Sø ren; Campos, Paula F.; Clark, Warren; Ellingvå g, Sturla; Fourmile, Gudjugudju; Gerbault, Pascale; Injie, Darren; Koki, George; Leavesley, Matthew; Logan, Betty; Lynch, Aubrey; Matisoo-Smith, Elizabeth A.; McAllister, Peter J.; Mentzer, Alexander J.; Metspalu, Mait; Migliano, Andrea B.; Murgha, Les; Phipps, Maude E.; Pomat, William; Reynolds, Doc; Ricaut, Francois-Xavier; Siba, Peter; Thomas, Mark G.; Wales, Thomas; Wall, Colleen Ma’ run; Oppenheimer, Stephen J.; Tyler-Smith, Chris; Durbin, Richard; Dortch, Joe; Manica, Andrea; Schierup, Mikkel H.; Foley, Robert A.; Lahr, Marta Mirazó n; Bowern, Claire; Wall, Jeffrey D.; Mailund, Thomas; Stoneking, Mark; Nielsen, Rasmus; Sandhu, Manjinder S.; Excoffier, Laurent; Lambert, David M.; Willerslev, Eske

2016-01-01

The population history of Aboriginal Australians remains largely uncharacterized. Here we generate high-coverage genomes for 83 Aboriginal Australians (speakers of Pama-Nyungan languages) and 25 Papuans from the New Guinea Highlands. We find that Papuan and Aboriginal Australian ancestors diversified 25-40 thousand years ago (kya), suggesting pre-Holocene population structure in the ancient continent of Sahul (Australia, New Guinea and Tasmania). However, all of the studied Aboriginal Australians descend from a single founding population that differentiated ∼10-32 kya. We infer a population expansion in northeast Australia during the Holocene epoch (past 10,000 years) associated with limited gene flow from this region to the rest of Australia, consistent with the spread of the Pama-Nyungan languages. We estimate that Aboriginal Australians and Papuans diverged from Eurasians 51-72 kya, following a single out-of-Africa dispersal, and subsequently admixed with archaic populations. Finally, we report evidence of selection in Aboriginal Australians potentially associated with living in the desert. © 2016 Macmillan Publishers Limited, part of Springer Nature. All rights reserved

A genomic history of Aboriginal Australia

KAUST Repository

Malaspinas, Anna-Sapfo

2016-09-20

The population history of Aboriginal Australians remains largely uncharacterized. Here we generate high-coverage genomes for 83 Aboriginal Australians (speakers of Pama-Nyungan languages) and 25 Papuans from the New Guinea Highlands. We find that Papuan and Aboriginal Australian ancestors diversified 25-40 thousand years ago (kya), suggesting pre-Holocene population structure in the ancient continent of Sahul (Australia, New Guinea and Tasmania). However, all of the studied Aboriginal Australians descend from a single founding population that differentiated ∼10-32 kya. We infer a population expansion in northeast Australia during the Holocene epoch (past 10,000 years) associated with limited gene flow from this region to the rest of Australia, consistent with the spread of the Pama-Nyungan languages. We estimate that Aboriginal Australians and Papuans diverged from Eurasians 51-72 kya, following a single out-of-Africa dispersal, and subsequently admixed with archaic populations. Finally, we report evidence of selection in Aboriginal Australians potentially associated with living in the desert. © 2016 Macmillan Publishers Limited, part of Springer Nature. All rights reserved

Challenges of Microgrids in Remote Communities: A STEEP Model Application

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Daniel Akinyele

2018-02-01

Full Text Available There is a growing interest in the application of microgrids around the world because of their potential for achieving a flexible, reliable, efficient and smart electrical grid system and supplying energy to off-grid communities, including their economic benefits. Several research studies have examined the application issues of microgrids. However, a lack of in-depth considerations for the enabling planning conditions has been identified as a major reason why microgrids fail in several off-grid communities. This development requires research efforts that consider better strategies and framework for sustainable microgrids in remote communities. This paper first presents a comprehensive review of microgrid technologies and their applications. It then proposes the STEEP model to examine critically the failure factors based on the social, technical, economic, environmental and policy (STEEP perspectives. The model details the key dimensions and actions necessary for addressing the challenge of microgrid failure in remote communities. The study uses remote communities within Nigeria, West Africa, as case studies and demonstrates the need for the STEEP approach for better understanding of microgrid planning and development. Better insights into microgrid systems are expected to address the drawbacks and improve the situation that can lead to widespread and sustainable applications in off-grid communities around the world in the future. The paper introduces the sustainable planning framework (SPF based on the STEEP model, which can form a general basis for planning microgrids in any remote location.

Challenges in assessing food environments in northern and remote communities in Canada.

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Skinner, Kelly; Burnett, Kristin; Williams, Patricia; Martin, Debbie; Stothart, Christopher; LeBlanc, Joseph; Veeraraghavan, Gigi; Sheedy, Amanda

2016-06-09

Effective tools for retail food environments in northern and remote communities are lacking. This paper examines the challenges of conducting food environment assessments in northern and remote communities in Canada encountered during our experience with a food costing project. One of the goals of the Paying for Nutrition in the North project is to develop guidelines to improve current food costing tools for northern Canada. Paying for Nutrition illustrates the complex context of measuring food environments in northern and remote communities. Through the development of a food costing methodology guide to assess northern food environments, several contextual issues emerged, including retail store oligopolies in communities; the importance of assessing food quality; informal social food economies; and the challenge of costing the acquisition and consumption of land- and water-based foods. Food environment measures designed for northern and remote communities need to reflect the geographic context in which they are being employed and must include input from local residents.

Linguistic Aspects of Australian Aboriginal English

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Butcher, Andrew

2008-01-01

It is probable that the majority of the 455 000 strong Aboriginal population of Australia speak some form of Australian Aboriginal English (AAE) at least some of the time and that it is the first (and only) language of many Aboriginal children. This means their language is somewhere on a continuum ranging from something very close to Standard…

Cultural mismatch and the education of Aboriginal youths: the interplay of cultural identities and teacher ratings.

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Fryberg, Stephanie A; Troop-Gordon, Wendy; D'Arrisso, Alexandra; Flores, Heidi; Ponizovskiy, Vladimir; Ranney, John D; Mandour, Tarek; Tootoosis, Curtis; Robinson, Sandy; Russo, Natalie; Burack, Jacob A

2013-01-01

In response to the enduring "deficit" approach to the educational attainment of Aboriginal students in North America, we hypothesized that academic underperformance is related to a cultural mismatch between Aboriginal students' cultural background, which emphasizes connectedness and interdependence, and the mainstream White model of education, which focuses on independence and assertiveness. The participants included virtually all the secondary students (N = 115) in the Naskapi community of Kawawachikamach, Quebec, Canada. We obtained self-reports of identification with Aboriginal and White culture, teacher reports of assertiveness, and official grades. We found that high identification with either Aboriginal or White culture was related to higher grades, regardless of whether the students were perceived as assertive by their teacher. Conversely, at low levels of cultural identification toward Aboriginal or White culture, being perceived as low in assertiveness by one's teacher predicted lower grades. This suggests that both high cultural identification and assertiveness can contribute to enhancing the educational outcomes of Aboriginal students, but that Aboriginal students with low levels of both cultural identification and assertiveness are at particular risk as they are mismatched with the culture of mainstream schools and do not benefit from the protective effects of identity. The relationships among identity, cultural values, and academic performance point to the need to reject the notion of an inherent deficit in education among Aboriginal youths in favor of a different framework in which success can be attained when alternative ways of being are fostered and nurtured in schools.

Oral Cavity Squamous Cell Carcinoma - Characteristics and Survival in Aboriginal and Non-Aboriginal Western Australians

OpenAIRE

Frydrych, A.M; Slack-Smith, L.M; Parsons, R; Threlfall, T

2014-01-01

Background: Squamous cell carcinoma (SCC) is the most common type of malignancy affecting the oral cavity. While exposures to main risk factors for oral SCC such as smoking and alcohol use are higher amongst the Aboriginal people, little is known about oral cancer in this population. This study aimed to describe characteristics and survival of oral SCC in Aboriginal and non-Aboriginal Western Australians. Methods: All primary oral SCC cases reported to the Western Australian Cancer Registry (...

Reduction of Family Violence in Aboriginal Communities: A Systematic Review of Interventions and Approaches1

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Shea, Beverley; Nahwegahbow, Amy; Andersson, Neil

2010-01-01

Many efforts to reduce family violence are documented in the published literature. We conducted a systematic review of interventions intended to prevent family violence in Aboriginal communities. We retrieved studies published up to October 2009; 506 papers included one systematic review, two randomized controlled trials, and fourteen nonrandomized studies or reviews. Two reviews discussed interventions relevant to primary prevention (reducing the risk factors for family violence), including parenting, role modelling, and active participation. More studies addressed secondary prevention (where risk factors exist, reducing outbreaks of violence) such as restriction on the trading hours for take away alcohol and home visiting programs for high risk families. Examples of tertiary prevention (preventing recurrence) include traditional healing circles and group counselling. Most studies contributed a low level of evidence. PMID:21052554

Meteors in Australian Aboriginal Dreamings

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Hamacher, Duane W.; Norris, Ray P.

2010-06-01

We present a comprehensive analysis of Australian Aboriginal accounts of meteors. The data used were taken from anthropological and ethnographic literature describing oral traditions, ceremonies, and Dreamings of 97 Aboriginal groups representing all states of modern Australia. This revealed common themes in the way meteors were viewed between Aboriginal groups, focusing on supernatural events, death, omens, and war. The presence of such themes around Australia was probably due to the unpredictable nature of meteors in an otherwise well-ordered cosmos.

Ethical genetic research in Indigenous communities: challenges and successful approaches.

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McWhirter, Rebekah E; Mununggirritj, Djapirri; Marika, Dipililnga; Dickinson, Joanne L; Condon, John R

2012-12-01

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.

Incidence of and case fatality following acute myocardial infarction in Aboriginal and non-Aboriginal Western Australians (2000-2004): a linked data study.

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Katzenellenbogen, Judith M; Sanfilippo, Frank M; Hobbs, Michael S T; Briffa, Tom G; Ridout, Steve C; Knuiman, Matthew W; Dimer, Lyn; Taylor, Kate P; Thompson, Peter L; Thompson, Sandra C

2010-12-01

Despite Coronary Heart Disease exacting a heavy toll among Aboriginal Australians, accurate estimates of its epidemiology are limited. This study compared the incidence of acute myocardial infarction (AMI) and 28-day case fatality (CF) among Aboriginal and non-Aboriginal Western Australians aged 25-74 years from 2000-2004. Incident (AMI hospital admission-free for 15 years) AMI events and 28-day CF were estimated using person-based linked hospital and mortality data. Age-standardised incidence rates and case fatality percentages were calculated by Aboriginality and sex. Of 740 Aboriginal and 6933 non-Aboriginal incident events, 208 and 2352 died within 28 days, respectively. The Aboriginal age-specific incidence rates were 27 (males) and 35 (females) times higher than non-Aboriginal rates in the 25-29 year age group, decreasing to 2-3 at 70-74 years. The male:female age-standardised incidence rate ratio was 2.2 in Aboriginal people 25-54 years compared with 4.5 in non-Aboriginal people. Aboriginal age-standardised CF percentages were 1.4 (males) and 1.1 (females) times higher at age 25-54 years and 1.5 times higher at age 55-74 years. These data suggest higher CF and, more importantly, AMI incidence contribute to the excess ischaemic heart disease mortality in Aboriginal Western Australians. The poorer cardiovascular health in Aboriginal women, particularly in younger age groups, should be investigated. Copyright © 2010 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. Published by Elsevier B.V. All rights reserved.

Albuminuria in Australian Aboriginal people: prevalence and associations with components of the metabolic syndrome.

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Rowley, K G; Iser, D M; Best, J D; O'Dea, K; Leonard, D; McDermott, R

2000-11-01

To examine the prevalence and associations with the metabolic syndrome of albuminuria among Australian Aboriginal people. Early-morning urine specimens were collected as part of community-based risk factor surveys assessing the prevalence of diabetes and cardiovascular disease in eight remote communities, with a sample size of 1,075 people. Microalbuminuria was defined as urinary albumin : creatinine ratio 3.4-33.9 mg/mmol, macroalbuminuria as albumin: creatinine ratio equal to or greater than 34 mg/mmol. There were high prevalences of microalbuminuria (men 22.2 %, women 26.9 %) and of macroalbuminuria (men 10.4%, women 13.5%). There were highly statistically significant linear associations of microalbuminuria and macroalbuminuria with increasing number of coexisting components of the metabolic syndrome (hypertension, glucose intolerance, dyslipidaemia, insulin resistance, abdominal obesity): among people with zero, one, two and three to five of these conditions, respectively, prevalence of microalbuminuria was 16%, 20%, 36% and 32% (p < 0.001); prevalence of macroalbuminuria was 2%, 6%, 12% and 32% (p < 0.001). There were independent associations of microalbuminuria with hypertension (odds ratio, 95% confidence interval = 2.36, 1.63-3.42) and diabetes (2.10, 1.28-3.45): macroalbuminuria was independently associated with hypertension (6.39, 3.93-10.4), diabetes (3.49, 1.93-6.28) and abdominal obesity (4.56, 2.40-8.64) and had a weaker association with insulin resistance (1.99, 1.12-3.54). Dyslipidaemia and impaired glucose tolerance were neither independently associated with microalbuminuria or macroalbuminuria, nor was insulin resistance or abdominal obesity independently associated with microalbuminuria. There was a strong clustering of albuminuria with components of the metabolic syndrome. Diabetes, hypertension and abdominal obesity are major contributors to high rates of albuminuria among Australian Aboriginal people.

Diabetes mellitus and the Aboriginal diabetic initiative in Canada: An update review

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Lawrence Leung

2016-01-01

Full Text Available Diabetes mellitus is a chronic disease of major global health concern due to its increasing prevalence in both developing and developed counties, with a projection increase of 214% from the year 2000 to 2030. Among the Aboriginal population of Canada (which includes the First Nations, Inuit and Metis, diabetes mellitus contribute significantly to their higher morbidity and increased health disparity when compared to the non-Aboriginal Canadians. In view of this, the Federal Government of Canada had launched the Aboriginal Diabetes Initiative (ADI in 1999 as part of the bigger Canadian Diabetes Strategy to provide a better framework for surveillance, public education and community-based management of diabetes. Originally, ADI was intended for a 5-year cycle, but it was renewed twice in 2005 and then 2010, with a total funding of C$523 million. Given its long history of operation and the massive amount of revenue being injected, it is worthwhile to review the background information and the relevant data that had fostered the ADI; and more importantly, to critically evaluate the benefits and impact of the ADI in terms of the actual health of the Aboriginals and their social inequalities.

First hand experiences of ventures between the petroleum industry and aboriginal peoples

International Nuclear Information System (INIS)

Phillips, B.; Barraclough, C.F.

1998-01-01

The value of building and maintaining a relationship between First Nations and the oil and gas industry is discussed. Relationship building is critical to a company's success on First Nations lands. According to government information, by the end of this millennium, one third of the total Canadian land mass will belong to First Nations, Inuit lands and Metis settlements. As industry continues to explore in more remote locations, many of these will be on Aboriginal traditional territories. Ongoing Aboriginal comprehensive land claims are being settled with the government on an ongoing basis and industry will need the support of First Nations for their projects and referrals in First National lands. It was stressed that industry can provide many opportunities for economic and social development for First Nations and that collaboration can be a 'win-win' situation for both industry and the First Nations people

The Relationship of Intelligence, Self-Concept and Locus of Control to School Achievement for Aboriginal and Non-Aboriginal Children.

Science.gov (United States)

Wright, Marilyn M.; Parker, J. L.

1978-01-01

To examine variables related to the school achievement of Aboriginal and non-Aboriginal students, 35 indigenous students and 58 non-Aboriginals in grade 8 completed a Coopersmith Self-Esteem Inventory and the Intellectual Responsibility Questionnaire. (Author/SBH)

Engaging aboriginal peoples in Canada's plan for the long-term management of used nuclear fuel

International Nuclear Information System (INIS)

Patton, P.

2011-01-01

developed communication materials with Aboriginal stakeholders, with a view to building the capacity of Aboriginal peoples to remain engaged over time. Another key process has been the establishment of the Elders Forum. As Canada moves more deeply into the process of selecting an 'informed and willing community', Aboriginal peoples and the NWMO continue to develop engagement mechanisms and to work to include ATK in plans and decision-making. The contributions of Aboriginal peoples and Elders have helped the NWMO develop its Aboriginal engagement program and have shaped broader engagement principles and strategies. Moving forward, the NWMO will continue to build on the approaches and activities for Aboriginal engagement that have brought so much value to its work and its collaboration with all Canadians. (author)

Experiencing racism in health care: the mental health impacts for Victorian Aboriginal communities.

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Kelaher, Margaret A; Ferdinand, Angeline S; Paradies, Yin

2014-07-07

To examine experiences of racism in health settings and their impact on mental health among Aboriginal Australians. A cross-sectional survey of experiences of racism and mental health was conducted in two metropolitan and two rural Victorian local government areas (LGAs) between 1 December 2010 and 31 October 2011. Participants included 755 Aboriginal Australians aged over 18 years who had resided in the relevant LGA for at least a year. The response rate across all LGAs was 99%. Being above or below the threshold for high or very high psychological distress on the Kessler Psychological Distress Scale. 221 participants reported experiences of racism in health settings in the past 12 months. The results suggested that people experiencing racism in health settings (OR, 4.49; 95% CI, 2.28-8.86) and non-health settings (OR, 2.66; 95% CI, 1.39-5.08) were more likely than people who did not experience racism to be above the threshold for high or very high psychological distress. Experiencing interpersonal racism in health settings is associated with increased psychological distress over and above what would be expected in other settings. This finding supports the rationale for improving cultural competency and reducing racism as a means of closing the health gap between Aboriginal and other Australians. Capitalising on this investment will require explicitly evaluating the impact of these initiatives on reducing patient experiences of racism.

The world's longest surviving paediatric practices: some themes of Aboriginal medical ethnobotany in Australia.

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Pearn, John

2005-01-01

Contemporary paediatric practices of Australian Aboriginal men and women, in more than 100 Aboriginal Language Groups, comprise a living discipline whose origins predate Western medicine by tens of millennia. The history of paediatrics acknowledges this surviving continuum of the world's oldest child-care practices. Because of the inextricable nexus between Aboriginal men and women and the land in which they live, medical ethnobotany forms a major part of the medical aspects of Aboriginal child care. Traditional tribal healers, called 'Nungungi' in some language groups of Central Australia, are identified as such whilst still young children and are given special education in the healing arts, especially that of medical ethnobotany, by older healers. Distinct from this specialized role, all Aboriginal men and women (and in particular grandmothers) in traditional communities use a sophisticated botanical materia medica in the treatment of sick and injured children. In cultures in transition, medical ethnobotanical practices may persist long after the local use of flora as sources of traditional food, weaponry, totemic identity and religious rites have disappeared. Some selected botanical 'cures' were adopted by early European settlers and a number of such relict uses have become part of mainstream Western life today, particularly as this applies to self-medication. Drugs and medicaments used in the treatment of children are obtained from leaves, bark, roots and flowers, usually as fresh preparations. They are prepared as infusions, decoctions and macerations and may be enjoined with emollients such as emu or kangaroo fat for topical application. Botanical drugs and medicaments are usually prepared fresh for each administration and are rarely stored. Contemporary Australian ethnobotany exploits the medicinal properties of more than 100 genera - using such extracts as antiseptics, analgesics, astringents, antipyretics, sedatives, hypnotics, expectorants and

Seeking a Pedagogy of Difference: What Aboriginal Students and Their Parents in North Queensland Say about Teaching and Their Learning

Science.gov (United States)

Lewthwaite, Brian; Osborne, Barry; Lloyd, Natalie; Llewellyn, Linda; Boon, Helen; Webber, Tammi; Laffin, Gail; Kemp, Codie; Day, Cathy; Wills, Jennifer; Harrison, Megan

2015-01-01

This study presents the outcomes of the first phase of a three phase research initiative which begins by identifying through the voices of Aboriginal students and community members the teaching practices that influence Aboriginal student engagement and learning. The study occurs within the Diocese of Townsville Catholic Education schools in North…

Injury hospitalizations due to unintentional falls among the Aboriginal population of British Columbia, Canada: incidence, changes over time, and ecological analysis of risk markers, 1991-2010.

Science.gov (United States)

Jin, Andrew; Lalonde, Christopher E; Brussoni, Mariana; McCormick, Rod; George, M Anne

2015-01-01

Aboriginal people in British Columbia (BC) have higher injury incidence than the general population. Our project describes variability among injury categories, time periods, and geographic, demographic and socio-economic groups. This report focuses on unintentional falls. We used BC's universal health care insurance plan as a population registry, linked to hospital separation and vital statistics databases. We identified Aboriginal people by insurance premium group and birth and death record notations. We identified residents of specific Aboriginal communities by postal code. We calculated crude incidence and Standardized Relative Risk (SRR) of hospitalization for unintentional fall injury, standardized for age, gender and Health Service Delivery Area (HSDA), relative to the total population of BC. We tested hypothesized associations of geographic, socio-economic, and employment-related characteristics with community SRR of injury by linear regression. During 1991 through 2010, the crude rate of hospitalization for unintentional fall injury in BC was 33.6 per 10,000 person-years. The Aboriginal rate was 49.9 per 10,000 and SRR was 1.89 (95% confidence interval 1.85-1.94). Among those living on reserves SRR was 2.00 (95% CI 1.93-2.07). Northern and non-urban HSDAs had higher SRRs, within both total and Aboriginal populations. In every age and gender category, the HSDA-standardized SRR was higher among the Aboriginal than among the total population. Between 1991 and 2010, crude rates and SRRs declined substantially, but proportionally more among the Aboriginal population, so the gap between the Aboriginal and total population is narrowing, particularly among females and older adults. These community characteristics were associated with higher risk: lower income, lower educational level, worse housing conditions, and more hazardous types of employment. Over the years, as socio-economic conditions improve, risk of hospitalization due to unintentional fall injury has

A phase II clinical trial of a dental health education program delivered by aboriginal health workers to prevent early childhood caries

Directory of Open Access Journals (Sweden)

Blinkhorn Fiona

2012-08-01

Full Text Available Abstract Background Early Childhood Caries (ECC is a widespread problem in Australian Aboriginal communities causing severe pain and sepsis. In addition dental services are difficult to access for many Aboriginal children and trying to obtain care can be stressful for the parents. The control of dental caries has been identified as a key indictor in the reduction of Indigenous disadvantage. Thus, there is a need for new approaches to prevent ECC, which reflect the cultural norms of Aboriginal communities. Methods/Design This is a Phase II single arm trial designed to gather information on the effectiveness of a dental health education program for Aboriginal children aged 6 months, followed over 2 years. The program will deliver advice from Aboriginal Health Workers on tooth brushing, diet and the use of fluoride toothpaste to Aboriginal families. Six waves of data collection will be conducted to enable estimates of change in parental knowledge and their views on the acceptability of the program. The Aboriginal Health Workers will also be interviewed to record their views on the acceptability and program feasibility. Clinical data on the child participants will be recorded when they are 30 months old and compared with a reference population of similar children when the study began. Latent variable modeling will be used to interpret the intervention effects on disease outcome. Discussion The research project will identify barriers to the implementation of a family centered Aboriginal oral health strategy, as well as the development of evidence to assist in the planning of a Phase III cluster randomized study. Trial registration ACTRN12612000712808

Tailoring a family-based alcohol intervention for Aboriginal Australians, and the experiences and perceptions of health care providers trained in its delivery.

Science.gov (United States)

Calabria, Bianca; Clifford, Anton; Rose, Miranda; Shakeshaft, Anthony P

2014-04-07

Aboriginal Australians experience a disproportionately high burden of alcohol-related harm compared to the general Australian population. Alcohol treatment approaches that simultaneously target individuals and families offer considerable potential to reduce these harms if they can be successfully tailored for routine delivery to Aboriginal Australians. The Community Reinforcement Approach (CRA) and Community Reinforcement and Family Training (CRAFT) are two related interventions that are consistent with Aboriginal Australians' notions of health and wellbeing. This paper aims to describe the process of tailoring CRA and CRAFT for delivery to Aboriginal Australians, explore the perceptions of health care providers participating in the tailoring process, and their experiences of participating in CRA and CRAFT counsellor certification. Data sources included notes recorded from eight working group meetings with 22 health care providers of a drug and alcohol treatment agency and Aboriginal Community Controlled Health Service (November 2009-February 2013), and transcripts of semi-structured interviews with seven health care providers participating in CRA and CRAFT counsellor certification (May 2012). Qualitative content analysis was used to categorise working group meeting notes and interview transcripts were into key themes. Modifying technical language, reducing the number of treatment sessions, and including an option for treatment of clients in groups, were key recommendations by health care providers for improving the feasibility and applicability of delivering CRA and CRAFT to Aboriginal Australians. Health care providers perceived counsellor certification to be beneficial for developing their skills and confidence in delivering CRA and CRAFT, but identified time constraints and competing tasks as key challenges. The tailoring process resulted in Aboriginal Australian-specific CRA and CRAFT resources. The process also resulted in the training and certification of

Development and feasibility testing of an education program to improve knowledge and self-care among Aboriginal and Torres Strait Islander patients with heart failure.

Science.gov (United States)

Clark, Robyn A; Fredericks, Bronwyn; Buitendyk, Natahlia J; Adams, Michael J; Howie-Esquivel, Jill; Dracup, Kathleen A; Berry, Narelle M; Atherton, John; Johnson, Stella

2015-01-01

There is a 70% higher age-adjusted incidence of heart failure (HF) among Aboriginal and Torres Strait Islander people, three times more hospitalisations and twice as many deaths as among non-Aboriginal people. There is a need to develop holistic yet individualised approaches in accord with the values of Aboriginal community health care to support patient education and self-care. The aim of this study was to re-design an existing HF educational resource (Fluid Watchers-Pacific Rim) to be culturally safe for Aboriginal and Torres Strait Islander peoples, working in collaboration with the local community, and to conduct feasibility testing. This study was conducted in two phases and utilised a mixed-methods approach (qualitative and quantitative). Phase 1 used action research methods to develop a culturally safe electronic resource to be provided to Aboriginal HF patients via a tablet computer. An HF expert panel adapted the existing resource to ensure it was evidence-based and contained appropriate language and images that reflects Aboriginal culture. A stakeholder group (which included Aboriginal workers and HF patients, as well as researchers and clinicians) then reviewed the resources, and changes were made accordingly. In Phase 2, the new resource was tested on a sample of Aboriginal HF patients to assess feasibility and acceptability. Patient knowledge, satisfaction and self-care behaviours were measured using a before and after design with validated questionnaires. As this was a pilot test to determine feasibility, no statistical comparisons were made. Phase 1: Throughout the process of resource development, two main themes emerged from the stakeholder consultation. These were the importance of identity, meaning that it was important to ensure that the resource accurately reflected the local community, with the appropriate clothing, skin tone and voice. The resource was adapted to reflect this, and members of the local community voiced the recordings for the

The Structure of Aboriginal Child Welfare in Canada

Directory of Open Access Journals (Sweden)

Vandna Sinha

2013-05-01

Full Text Available Aboriginal children are currently overrepresented in out-of-home care in Canada; this extends a historical pattern of child removal that began with the residential school system. The overrepresentation of Aboriginal children persists despite legislative and structural changes intended to reduce the number of Aboriginal children in care. Several recent developments suggest potential for improvement in services for Aboriginal children and families in the near future. However, greater information about the structure of Aboriginal child welfare in Canada is needed to support program and policy development. We present a broad overview of the variation in Aboriginal child welfare legislation and standards, service delivery models, and funding formulas across Canadian provinces and territories. We draw on this review to suggest specific priorities for future research.

Aboriginal experiences of cancer and care coordination: Lessons from the Cancer Data and Aboriginal Disparities (CanDAD) narratives.

Science.gov (United States)

Reilly, Rachel; Micklem, Jasmine; Yerrell, Paul; Banham, David; Morey, Kim; Stajic, Janet; Eckert, Marion; Lawrence, Monica; Stewart, Harold B; Brown, Alex

2018-04-24

Aboriginal people with cancer experience worse outcomes than other Australians for a range of complex and interrelated reasons. A younger age at diagnosis, higher likelihood of more advanced cancer or cancer type with poorer prognosis, geographic isolation and cultural and language diversity mean that patient pathways are potentially more complex for Aboriginal people with cancer. In addition, variation in the quality and acceptability of care may influence cancer outcomes. This study sought to understand how care coordination influences Aboriginal people's experiences of cancer treatment. Interviews with 29 Aboriginal patients or cancer survivors, 11 carers and 22 service providers were carried out. Interviews were semi-structured and sought to elicit experiences of cancer and the health-care system. The manifest content of the cancer narratives was entered onto a cancer pathway mapping tool and underlying themes were identified inductively. The practice of cancer care coordination was found to address the needs of Aboriginal patients and their families/carers in 4 main areas: "navigating the health system"; "information and communication"; "things to manage at home"; and "cultural safety". The CanDAD findings indicate that, when the need for cancer care coordination is met, it facilitated continuity of care in a range of ways that may potentially improve cancer outcomes. However, the need remains unmet for many. Findings support the importance of dedicated care coordination to enable Aboriginal people to receive adequate and appropriate patient-centred care, so that the unacceptable disparity in cancer outcomes between Aboriginal and non-Aboriginal people can be addressed. © 2018 The Authors. Health Expectations published by John Wiley & Sons Ltd.

Predictive Accuracy of Violence Risk Scale-Sexual Offender Version Risk and Change Scores in Treated Canadian Aboriginal and Non-Aboriginal Sexual Offenders.

Science.gov (United States)

Olver, Mark E; Sowden, Justina N; Kingston, Drew A; Nicholaichuk, Terry P; Gordon, Audrey; Beggs Christofferson, Sarah M; Wong, Stephen C P

2018-04-01

The present study examined the predictive properties of Violence Risk Scale-Sexual Offender version (VRS-SO) risk and change scores among Aboriginal and non-Aboriginal sexual offenders in a combined sample of 1,063 Canadian federally incarcerated men. All men participated in sexual offender treatment programming through the Correctional Service of Canada (CSC) at sites across its five regions. The Static-99R was also examined for comparison purposes. In total, 393 of the men were identified as Aboriginal (i.e., First Nations, Métis, Circumpolar) while 670 were non-Aboriginal and primarily White. Aboriginal men scored significantly higher on the Static-99R and VRS-SO and had higher rates of sexual and violent recidivism; however, there were no significant differences between Aboriginal and non-Aboriginal groups on treatment change with both groups demonstrating close to a half-standard deviation of change pre and post treatment. VRS-SO risk and change scores significantly predicted sexual and violent recidivism over fixed 5- and 10-year follow-ups for both racial/ancestral groups. Cox regression survival analyses also demonstrated positive treatment changes to be significantly associated with reductions in sexual and violent recidivism among Aboriginal and non-Aboriginal men after controlling baseline risk. A series of follow-up Cox regression analyses demonstrated that risk and change score information accounted for much of the observed differences between Aboriginal and non-Aboriginal men in rates of sexual recidivism; however, marked group differences persisted in rates of general violent recidivism even after controlling for these covariates. The results support the predictive properties of VRS-SO risk and change scores with treated Canadian Aboriginal sexual offenders.

The changing epidemiology of invasive pneumococcal disease in aboriginal and non-aboriginal western Australians from 1997 through 2007 and emergence of nonvaccine serotypes.

Science.gov (United States)

Lehmann, Deborah; Willis, Judith; Moore, Hannah C; Giele, Carolien; Murphy, Denise; Keil, Anthony D; Harrison, Catherine; Bayley, Kathy; Watson, Michael; Richmond, Peter

2010-06-01

BACKGROUND. In 2001, Australia introduced a unique 7-valent pneumococcal conjugate vaccine (7vPCV) 2-, 4-, and 6-month schedule with a 23-valent pneumococcal polysaccharide vaccine (23vPPV) booster for Aboriginal children, and in 2005, 7vPCV alone in a 2-, 4-, and 6-month schedule for non-Aboriginal children. Aboriginal adults are offered 23vPPV but coverage is poor. We investigated trends in invasive pneumococcal disease (IPD) in Western Australia (WA). METHODS. Enhanced IPD surveillance has been ongoing since 1996. We calculated IPD incidence rates for Aboriginal and non-Aboriginal Australians before and after introduction of 7vPCV. RESULTS. A total of 1792 cases occurred during the period 1997-2007; the IPD incidence rate was 47 cases per 100,000 population per year among Aboriginal people and 7 cases per 100,000 population per year in non-Aboriginal people. After introduction of 7vPCV, IPD rates among Aboriginal children decreased by 46% for those Aboriginal children. IPD rates decreased by >30% in non-Aboriginal people 50 years of age but increased among Aboriginal adults (eg, from 59.1 to 109.6 cases per 100,000 population per year among those 30-49 years of age). Although IPD due to 7vPCV serotypes decreased in all age groups, IPD incidence due to non-7vPCV serotypes increased, and it almost doubled among Aboriginal adults 30-49 years of age (from 48.3 to 97.0 cases per 100,000 population per year). Among non-Aboriginal children, 37% of IPD is now due to serotype 19A. CONCLUSIONS. IPD incidence rates have decreased markedly among children and non-Aboriginal adults with a 3-dose infant 7vPCV schedule. However, IPD due to non-7vPCV serotypes has increased and is of particular concern among young Aboriginal adults, for whom an intensive 23vPPV campaign is needed. An immunization register covering all age groups should be established.

Association of Modality with Mortality among Canadian Aboriginals

Science.gov (United States)

Hemmelgarn, Brenda; Rigatto, Claudio; Komenda, Paul; Yeates, Karen; Promislow, Steven; Mojica, Julie; Tangri, Navdeep

2012-01-01

Summary Background and objectives Previous studies have shown that Aboriginals and Caucasians experience similar outcome on dialysis in Canada. Using the Canadian Organ Replacement Registry, this study examined whether dialysis modality (peritoneal or hemodialysis) impacted mortality in Aboriginal patients. Design, setting, participants, & measurements This study identified 31,576 adult patients (hemodialysis: Aboriginal=1839, Caucasian=21,430; peritoneal dialysis: Aboriginal=554, Caucasian=6769) who initiated dialysis between January of 2000 and December of 2009. Aboriginal status was identified by self-report. Dialysis modality was determined 90 days after dialysis initiation. Multivariate Cox proportional hazards and competing risk models were constructed to determine the association between race and mortality by dialysis modality. Results During the study period, 939 (51.1%) Aboriginals and 12,798 (53.3%) Caucasians initiating hemodialysis died, whereas 166 (30.0%) and 2037 (30.1%), respectively, initiating peritoneal dialysis died. Compared with Caucasians, Aboriginals on hemodialysis had a comparable risk of mortality (adjusted hazards ratio=1.04, 95% confidence interval=0.96–1.11, P=0.37). However, on peritoneal dialysis, Aboriginals experienced a higher risk of mortality (adjusted hazards ratio=1.36, 95% confidence interval=1.13–1.62, P=0.001) and technique failure (adjusted hazards ratio=1.29, 95% confidence interval=1.03–1.60, P=0.03) than Caucasians. The risk of technique failure varied by patient age, with younger Aboriginals (Aboriginals on peritoneal dialysis experience higher mortality and technique failure relative to Caucasians. Reasons for this race disparity in peritoneal dialysis outcomes are unclear. PMID:22997343

Housing conditions of urban households with Aboriginal children in NSW Australia: tenure type matters.

Science.gov (United States)

Andersen, Melanie J; Williamson, Anna B; Fernando, Peter; Wright, Darryl; Redman, Sally

2017-08-01

Housing is a key determinant of the poor health of Aboriginal Australians. Most Aboriginal people live in cities and large towns, yet research into housing conditions has largely focused on those living in remote areas. This paper measures the prevalence of housing problems amongst participants in a study of urban Aboriginal families in New South Wales, Australia, and examines the relationship between tenure type and exposure to housing problems. Cross-sectional survey data was provided by 600 caregivers of 1406 Aboriginal children aged 0-17 years participating in Phase One of the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). Regression modelling of the associations between tenure type (own/mortgage, private rental or social housing) and housing problems was conducted, adjusting for sociodemographic factors. The majority (60%) of SEARCH households lived in social housing, 21% rented privately and 19% either owned their home outright or were paying a mortgage ("owned"). Housing problems were common, particularly structural problems, damp and mildew, vermin, crowding and unaffordability. Physical dwelling problems were most prevalent for those living in social housing, who were more likely to report three or more physical dwelling problems than those in owned (PR 3.19, 95%CI 1.97, 5.73) or privately rented homes (PR 1.49, 1.11, 2.08). However, those in social housing were the least likely to report affordability problems. Those in private rental moved home most frequently; children in private rental were more than three times as likely to have lived in four or more homes since birth than those in owned homes (PR 3.19, 95%CI 1.97, 5.73). Those in social housing were almost half as likely as those in private rental to have lived in four or more homes since birth (PR 0.56, 95%CI 0.14, 0.77). Crowding did not vary significantly by tenure type. The high prevalence of housing problems amongst study participants suggests that urban Aboriginal

Making rural and remote communities more age-friendly: experts' perspectives on issues, challenges, and priorities.

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Menec, Verena; Bell, Sheri; Novek, Sheila; Minnigaleeva, Gulnara A; Morales, Ernesto; Ouma, Titus; Parodi, Jose F; Winterton, Rachel

2015-01-01

With the growing interest worldwide in making communities more age-friendly, it is becoming increasingly important to understand the factors that help or hinder communities in attaining this goal. In this article, we focus on rural and remote communities and present perspectives of 42 experts in the areas of aging, rural and remote issues, and policy who participated in a consensus conference on age-friendly rural and remote communities. Discussions highlighted that strengths in rural and remote communities, such as easy access to local leaders and existing partnerships, can help to further age-friendly goals; however, addressing major challenges, such as lack of infrastructure and limited availability of social and health services, requires regional or national government buy-in and funding opportunities. Age-friendly work in rural and remote communities is, therefore, ideally embedded in larger age-friendly initiatives and supported by regional or national policies, programs, and funding sources.

Barriers and enablers to the provision of alcohol treatment among Aboriginal Australians: a thematic review of five research projects.

Science.gov (United States)

Gray, Dennis; Wilson, Mandy; Allsop, Steve; Saggers, Sherry; Wilkes, Edward; Ober, Coralie

2014-09-01

To review the results of five research projects commissioned to enhance alcohol treatment among Aboriginal Australians, and to highlight arising from them. Drafts of the papers were workshopped by project representatives, final papers reviewed and results summarised. Lessons arising were identified and described. While the impact of the projects varied, they highlight the feasibility of adapting mainstream interventions in Aboriginal Australian contexts. Outcomes include greater potential to: screen for those at risk; increase community awareness; build capacity and partnerships between organisations; and co-ordinate comprehensive referral networks and service provision. Results show a small investment can produce sustainable change and positive outcomes. However, to optimise and maintain investment, cultural difference needs to be recognised in both planning and delivery of alcohol interventions; resources and funding must be responsive to and realistic about the capacities of organisations; partnerships need to be formed voluntarily based on respect, equality and trust; and practices and procedures within organisations need to be formalised. There is no simple way to reduce alcohol-related harm in Aboriginal communities. However, the papers reviewed show that with Aboriginal control, modest investment and respectful collaboration, service enhancements and improved outcomes can be achieved. Mainstream interventions need to be adapted to Aboriginal settings, not simply transferred. The lessons outlined provide important reflections for future research. © 2014 Australasian Professional Society on Alcohol and other Drugs.

Australian Aboriginal Astronomy: Overview

OpenAIRE

Norris, Ray P.; Hamacher, Duane W.

2013-01-01

The traditional cultures of Aboriginal Australians include a significant astronomical component, perpetuated through oral tradition, ceremony, and art. This astronomical component includes a deep understanding of the motion of objects in the sky, and this knowledge was used for practical purposes, such as constructing calendars. There is also evidence that traditional Aboriginal Australians made careful records and measurements of cyclical phenomena, paid careful attention to unexpected pheno...

Exploring the mathematical confidence of Indigenous preservice teachers in a remote teacher education program

Science.gov (United States)

Thornton, Steve; Giles, Wendy; Prescott, Debbie; Rhodes, David

2011-06-01

This paper reports on the efficacy of an accelerated teacher education program ( Growing Our Own) focused in remote Indigenous communities in the Northern Territory. The program is a joint initiative of Charles Darwin University and the Northern Territory Catholic Education Office, providing an intensive two-year program designed to educate Indigenous Teacher Assistants to full teacher status. We describe the growth in knowledge and confidence that has occurred through the program using the story of one of the students in the project, Philomena, as an evocative representation of the experiences of the participants in the program. This growth is particularly evident in one lesson that Philomena taught towards the end of the program in which she was able to challenge her previously accepted role as subservient to the non-Indigenous teacher. Our discussion highlights some key issues for improving outcomes for Indigenous children, including the potential mismatch between Western and Aboriginal ways of thinking in mathematics and developing the mathematical capacity of Indigenous teacher assistants in remote settings. We suggest that the mutual respect of the participants at various levels of Growing Our Own, the situated and purposeful nature of the learning, and the capacity of students to engage in that learning without abandoning their community responsibilities have been pivotal in enhancing educational outcomes in remote communities and in providing opportunities for Indigenous people.

Enhancing Educational Performance for Remote Aboriginal Australians: What Is the Impact of Attendance on Performance?

Science.gov (United States)

Jorgensen, Robyn

2012-01-01

The educational performance of Aboriginal Australians lags behind non-Indigenous Australians with the gap increasing the longer students remain at school. The Australian government has released its Closing the Gap policy with the specific intent to redress gaps in health, education and housing, as these are seen as key indicators to life success.…

Improving the efficacy of healthcare services for Aboriginal Australians.

Science.gov (United States)

Gwynne, Kylie; Jeffries, Thomas; Lincoln, Michelle

2018-01-16

Objective The aim of the present systematic review was to examine the enablers for effective health service delivery for Aboriginal Australians. Methods This systematic review was undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Papers were included if they had data related to health services for Australian Aboriginal people and were published between 2000 and 2015. The 21 papers that met the inclusion criteria were assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Seven papers were subsequently excluded due to weak methodological approaches. Results There were two findings in the present study: (1) that Aboriginal people fare worse than non-Aboriginal people when accessing usual healthcare services; and (2) there are five enablers for effective health care services for Australian Aboriginal people: cultural competence, participation rates, organisational, clinical governance and compliance, and availability of services. Conclusions Health services for Australian Aboriginal people must be tailored and implementation of the five enablers is likely to affect the effectiveness of health services for Aboriginal people. The findings of the present study have significant implications in directing the future design, funding, delivery and evaluation of health care services for Aboriginal Australians. What is known about the topic? There is significant evidence about poor health outcomes and the 10-year gap in life expectancy between Aboriginal and non-Aboriginal people, and limited evidence about improving health service efficacy. What does this paper add? This systematic review found that with usual health care delivery, Aboriginal people experience worse health outcomes. This paper identifies five strategies in the literature that improve the effectiveness of health care services intended for Aboriginal people. What are the implications for

Structuring oil and gas ventures with Aboriginal communities

International Nuclear Information System (INIS)

Schultz, T.G.

1999-01-01

Pimee Well Servicing Ltd., a 100% Aboriginal owned company that provides safe, competitive and high quality services to the oil and gas industry, is described. Working safely at Pimee is the company's number one priority. The chiefs of each shareholder First Nation make up the board of directors. The company has learned that it is extremely important for a company's management to posses a great amount of knowledge of the business at hand, that they had to be very patient when starting up a new company, and that signed contracts are a necessity. The size of the company tripled in the past four years, and the company can provide guidance through the implementation of business and operating practices and safety and training programs

Aboriginal fractions: enumerating identity in Taiwan.

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Liu, Jennifer A

2012-01-01

Notions of identity in Taiwan are configured in relation to numbers. I examine the polyvalent capacities of enumerative technologies in both the production of ethnic identities and claims to political representation and justice. By critically historicizing the manner in which Aborigines in Taiwan have been, and continue to be, constructed as objects and subjects of scientific knowledge production through technologies of measuring, I examine the genetic claim made by some Taiwanese to be "fractionally" Aboriginal. Numbers and techniques of measuring are used ostensibly to know the Aborigines, but they are also used to construct a genetically unique Taiwanese identity and to incorporate the Aborigines within projects of democratic governance. Technologies of enumeration thus serve within multiple, and sometimes contradictory, projects of representation and knowledge production.

What constitutes 'support' for the role of the Aboriginal and Torres Strait Islander child health workforce?

Science.gov (United States)

Watson, Karen; Young, Jeanine; Barnes, Margaret

2013-02-01

As well as providing primary health care services, Aboriginal and Torres Strait Islander health workers are known to significantly contribute to the overall acceptability, access and use of health services through their role of cultural brokerage in the communities within which they work. As such they are uniquely positioned to positively influence health improvements for this vulnerable population. This study sought to identify key areas that both Aboriginal and Torres Strait Islander and non-Indigenous health professionals working within Indigenous communities felt were important in providing support for their roles. This group of workers require support within their roles particularly in relation to cultural awareness and capability, resource provision, educational opportunities, collaboration with colleagues and peers, and professional mentorship.

The role of primary health care services to better meet the needs of Aboriginal Australians transitioning from prison to the community

OpenAIRE

Lloyd, Jane E.; Delaney-Thiele, Dea; Abbott, Penny; Baldry, Eileen; McEntyre, Elizabeth; Reath, Jennifer; Indig, Devon; Sherwood, Juanita; Harris, Mark F.

2015-01-01

Background Aboriginal Australians are more likely than other Australians to cycle in and out of prison on remand or by serving multiple short sentences?a form of serial incarceration and institutionalisation. This cycle contributes to the over-representation of Aboriginal Australians in prison and higher rates of recidivism. Our research examined how primary health care can better meet the health care and social support needs of Aboriginal Australians transitioning from prison to the communit...

Delivering an empowerment intervention to a remote Indigenous child safety workforce: Its economic cost from an agency perspective.

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Kinchin, Irina; Doran, Christopher M; McCalman, Janya; Jacups, Susan; Tsey, Komla; Lines, Katrina; Smith, Kieran; Searles, Andrew

2017-10-01

The Family Wellbeing (FWB) program applies culturally appropriate community led empowerment training to enhance the personal development of Aboriginal and Torres Strait Islander people in life skills. This study sought to estimate the economic cost required to deliver the FWB program to a child safety workforce in remote Australian communities. This study was designed as a retrospective cost description taken from the perspective of a non-government child safety agency. The target population were child protection residential care workers aged 24 or older, who worked in safe houses in five remote Indigenous communities and a regional office during the study year (2013). Resource utilization included direct costs (personnel and administrative) and indirect or opportunity costs of participants, regarded as absence from work. The total cost of delivering the FWB program for 66 participants was $182,588 ($2766 per participant), with 45% ($82,995) of costs classified as indirect (i.e., opportunity cost of participants time). Training cost could be further mitigated (∼30%) if offered on-site, in the community. The costs for offering the FWB program to a remotely located workforce were high, but not substantial when compared to the recruitment cost required to substitute a worker in remote settings. An investment of $2766 per participant created an opportunity to improve social and emotional wellbeing of remotely located workforce. This cost study provided policy relevant information by identifying the resources required to transfer the FWB program to other remote locations. It also can be used to support future comparative cost and outcome analyses and add to the evidence base around the cost-effectiveness of empowerment programs. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Aboriginal Challenge − the Post-Soviet Response: Can the Aboriginal Peoples of Russia Be Rescued from the Modernisation Shock?

Directory of Open Access Journals (Sweden)

Vladislav Steljmah

1998-10-01

stability in the new conditions. However, the response of Post-Soviet society was not adequate. Since legislation was not enacted in due time on the federal level, regularisation had to be left to the regional levels. One of the first examples was the 1991 law by the Republic of Buryatia "On the legal status of Evenki village soviets". In 1992 followed the "Regulation on the status of kin property" by the Hanti-Mansi Autonomous Region and the "Regulation" of the Koryak AR. Different was the 1992 law of the Republic of Yakutia "On nomadic kin communities among small peoples of the North". It treated the teritorial-kin community as an institution of civil society between the individuals and the state authorities. The authors evaluate this regional legislation as positive. For example, the return of the kin community after a break of some 60 years creates more stabile foundations for the introduction of innovations among disorganised and disoriented aboriginal minorities. Yet solving general problems on the regional level does not ensure integration of the legislative sphere. Regions must find both conceptual and practical solutions, although general experience in the world has shown that it is best to divide the two between federal and regional authorities. With the breakdown of co-ordination the modernisation process that effects the aboriginal population is left without effective and complete regulation.

A comparison of socioeconomic status and mental health among inner-city Aboriginal and non-Aboriginal women.

Science.gov (United States)

Hamdullahpur, Kevin; Jacobs, Kahá Wi J; Gill, Kathryn J

2017-01-01

Aboriginal women in urban areas have been reported to experience high rates of poverty, homelessness, interpersonal violence, and health problems. However, there are few prior ethnocultural comparisons of urban women from similar socioeconomic backgrounds. The current study explored the mental and physical health of Aboriginal and non-Aboriginal women accessing social services agencies and shelters. Half of the sample (n=172) was Aboriginal (48.3%). The lifetime rate of physical abuse was significantly higher in Aboriginal women, and they were more likely to have been victims of violence or crime in the past year (A=50.6%, NA=35.6%, pwomen were also more likely to have previously received treatment for a drug or alcohol problem. There were no differences in self-reported physical health, medication use, hospitalisations, and current substance misuse. Irrespective of ethnicity, lifetime rates of anxiety, depression and suicide attempts were extremely high. Future research should explore the effects of individual resources (e.g. social support, family relations) and cultural beliefs on women's ability to cope with the stress of living with adverse events, particularly among low SES women with children.

Personal attitudes towards smoking in a national sample of Aboriginal and Torres Strait Islander smokers and recent quitters.

Science.gov (United States)

Nicholson, Anna K; Borland, Ron; Bennet, Pele T; van der Sterren, Anke E; Stevens, Matthew; Thomas, David P

2015-06-01

To describe attitudes towards smoking in a national sample of Aboriginal and Torres Strait Islander smokers and recent quitters and assess how they are associated with quitting, and to compare these attitudes with those of smokers in the general Australian population. The Talking About The Smokes project used a quota sampling design to recruit participants from communities served by 34 Aboriginal community-controlled health services and one community in the Torres Strait. We surveyed 1392 daily smokers, 251 non-daily smokers and 78 recent quitters from April 2012 to October 2013. Personal attitudes towards smoking and quitting, wanting to quit, and attempting to quit in the past year. Aboriginal and Torres Strait Islander daily smokers were less likely than daily smokers in the general Australian population to report enjoying smoking (65% v 81%) and more likely to disagree that smoking is an important part of their life (49% v 38%); other attitudes were similar between the two groups. In the Aboriginal and Torres Strait Islander sample, non-daily smokers generally held less positive attitudes towards smoking compared with daily smokers, and ex-smokers who had quit within the past year reported positive views about quitting. Among the daily smokers, 78% reported regretting starting to smoke and 81% reported spending too much money on cigarettes, both of which were positively associated with wanting and attempting to quit; 32% perceived smoking to be an important part of their life, which was negatively associated with both quit outcomes; and 83% agreed that smoking calms them down when stressed, which was not associated with the quitting outcomes. Aboriginal and Torres Strait Islander smokers were less likely than those in the general population to report positive reasons to smoke and held similar views about the negative aspects, suggesting that factors other than personal attitudes may be responsible for the high continuing smoking rate in this population.

Assisting an Australian Aboriginal and Torres Strait Islander person with gambling problems: a Delphi study.

Science.gov (United States)

Bond, Kathy S; Dart, Katrina M; Jorm, Anthony F; Kelly, Claire M; Kitchener, Betty A; Reavley, Nicola J

2017-08-02

Gambling problems appear to be more prevalent in the Australian Aboriginal and Torres Strait Islander population than in the non-Indigenous population. Although gambling harms can be significant, treatment-seeking rates are low. The Delphi expert consensus method was used to develop a set of guidelines on how a family or community member can assist an Aboriginal or Torres Strait Islander person with gambling problems. Building on a previous systematic review of websites, books and journal articles a questionnaire was developed that contained items about the knowledge, skills and actions needed for supporting an Aboriginal or Torres Strait Islander person with gambling problems. These items were rated over three rounds by an expert panel comprising professionals who provide treatment to or conduct research with Aboriginal and Torres Strait Islander people with gambling problems. A total of 22 experts rated 407 helping statements according to whether they thought the statements should be included in these guidelines. There were 225 helping statements that were endorsed by at least 90% of participants. These endorsed statements were used to develop the guidelines. Experts were able to reach substantial consensus on how someone can recognise the signs of gambling problems and support an Aboriginal or Torres Strait Islander person to change.

A cohort study: temporal trends in prevalence of antecedents, comorbidities and mortality in Aboriginal and non-Aboriginal Australians with first heart failure hospitalization, 2000-2009.

Science.gov (United States)

Teng, Tiew-Hwa Katherine; Katzenellenbogen, Judith M; Hung, Joseph; Knuiman, Matthew; Sanfilippo, Frank M; Geelhoed, Elizabeth; Bessarab, Dawn; Hobbs, Michael; Thompson, Sandra C

2015-08-12

Little is known about trends in risk factors and mortality for Aboriginal Australians with heart failure (HF). This population-based study evaluated trends in prevalence of risk factors, 30-day and 1-year all-cause mortality following first HF hospitalization among Aboriginal and non-Aboriginal Western Australians in the decade 2000-2009. Linked-health data were used to identify patients (20-84 years), with a first-ever HF hospitalization. Trends in demographics, comorbidities, interventions and risk factors were evaluated. Logistic and Cox regression models were fitted to test and compare trends over time in 30-day and 1-year mortality. Of 17,379 HF patients, 1,013 (5.8%) were Aboriginal. Compared with 2000-2002, the prevalence (as history) of myocardial infarction and hypertension increased more markedly in 2006-2009 in Aboriginal (versus non-Aboriginal) patients, while diabetes and chronic kidney disease remained disproportionately higher in Aboriginal patients. Risk factor trends, including the Charlson comorbidity index, increased over time in younger Aboriginal patients. Risk-adjusted 30-day mortality did not change over the decade in either group. Risk-adjusted 1-year mortality (in 30-day survivors) was non-significantly higher in Aboriginal patients in 2006-2008 compared with 2000-2002 (hazard ratio (HR) 1.44; 95% CI 0.85-2.41; p-trend = 0.47) whereas it decreased in non-Aboriginal patients (HR 0.87; 95% CI 0.78-0.97; p-trend = 0.01). Between 2000 and 2009, the prevalence of HF antecedents increased and remained disproportionately higher in Aboriginal (versus non-Aboriginal) HF patients. Risk-adjusted 1-year mortality did not improve in Aboriginal patients over the period in contrast with non-Aboriginal patients. These findings highlight the need for better prevention and post-HF care in Aboriginal Australians.

Injury hospitalizations due to unintentional falls among the Aboriginal population of British Columbia, Canada: incidence, changes over time, and ecological analysis of risk markers, 1991-2010.

Directory of Open Access Journals (Sweden)

Andrew Jin

Full Text Available Aboriginal people in British Columbia (BC have higher injury incidence than the general population. Our project describes variability among injury categories, time periods, and geographic, demographic and socio-economic groups. This report focuses on unintentional falls.We used BC's universal health care insurance plan as a population registry, linked to hospital separation and vital statistics databases. We identified Aboriginal people by insurance premium group and birth and death record notations. We identified residents of specific Aboriginal communities by postal code. We calculated crude incidence and Standardized Relative Risk (SRR of hospitalization for unintentional fall injury, standardized for age, gender and Health Service Delivery Area (HSDA, relative to the total population of BC. We tested hypothesized associations of geographic, socio-economic, and employment-related characteristics with community SRR of injury by linear regression.During 1991 through 2010, the crude rate of hospitalization for unintentional fall injury in BC was 33.6 per 10,000 person-years. The Aboriginal rate was 49.9 per 10,000 and SRR was 1.89 (95% confidence interval 1.85-1.94. Among those living on reserves SRR was 2.00 (95% CI 1.93-2.07. Northern and non-urban HSDAs had higher SRRs, within both total and Aboriginal populations. In every age and gender category, the HSDA-standardized SRR was higher among the Aboriginal than among the total population. Between 1991 and 2010, crude rates and SRRs declined substantially, but proportionally more among the Aboriginal population, so the gap between the Aboriginal and total population is narrowing, particularly among females and older adults. These community characteristics were associated with higher risk: lower income, lower educational level, worse housing conditions, and more hazardous types of employment.Over the years, as socio-economic conditions improve, risk of hospitalization due to unintentional fall

Gendering Aboriginalism : a performative gaze on indigenous Australian women

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Barney, Katelyn

2010-01-01

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.

Gendering Aboriginalism: A Performative Gaze on Indigenous Australian Women

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Katelyn Barney

2010-03-01

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.

A comparison of dietary estimates from the National Aboriginal and Torres Strait Islander Health Survey to food and beverage purchase data.

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McMahon, Emma; Wycherley, Thomas; O'Dea, Kerin; Brimblecombe, Julie

2017-12-01

We compared self-reported dietary intake from the very remote sample of the National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey (VR-NATSINPAS; n=1,363) to one year of food and beverage purchases from 20 very remote Indigenous Australian communities (servicing ∼8,500 individuals). Differences in food (% energy from food groups) and nutrients were analysed using t-test with unequal variance. Per-capita energy estimates were not significantly different between the surveys (899 MJ/person/day [95% confidence interval -152,1950] p=0.094). Self-reported intakes of sugar, cereal products/dishes, beverages, fats/oils, milk products/dishes and confectionery were significantly lower than that purchased, while intakes of meat, vegetables, cereal-based dishes, fish, fruit and eggs were significantly higher (pfood and nutrient availability in this population longitudinally; however, further evidence is needed on approaches to estimate wastage and foods sourced outside the store. There is potential for these data to complement each other to inform nutrition policies and programs in this population. © 2017 Menzies School of Health Research.

Oral hygiene risk indicators among 6- to 9-year-old Taiwanese aboriginal children.

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Hsieh, Hui-Ju; Huang, Shun-Te; Tsai, Chi-Cheng; Chiou, Meng-Jao; Liao, Cheng-Ta

2014-05-01

This study investigated the dental health status, dietary habits, oral hygiene levels, and caretaker risk indicators among Taiwanese children. This cross-sectional purposive sampling study included 256 aboriginal children, 6 to 9 years old, living in remote regions in southern Taiwan. Participants received dental examinations, and questionnaires were completed by caretakers. Data were analyzed using the χ(2) test, t test, and multiple logistic regressions. The deft (sum of decayed, extracted, and filled primary teeth) and defs (sum of the decayed, extracted, and filled primary dentition surfaces) indices were affected by the frequencies of drinking sweetened beverages (P = .0006) and daily toothbrushing (P = .0032). Caretakers' toothbrushing frequency was a significant predictor of children's oral hygiene status (P oral hygiene was 2.04 (P = .0184). Oral hygiene among aboriginal children in this study was inadequate. Caretakers' toothbrushing frequency and betel quid habit were significant predictors of poor children's oral hygiene. © 2012 APJPH.

Does the EDI Equivalently Measure Facets of School Readiness for Aboriginal and Non-Aboriginal Children?

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Muhajarine, Nazeem; Puchala, Chassidy; Janus, Magdalena

2011-01-01

The aim of the current paper was to examine the equivalence of the Early Development Instrument (EDI), a teacher rating measure of school readiness, for Aboriginal and non-Aboriginal children. The current study used an approach, which analyzes the structure and properties of the EDI at the subdomain level. Similar subdomain score distributions…

A comparison of Aboriginal and non-Aboriginal students on the inter-related dimensions of self-concept, strengths and achievement

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Jessica Whitley

2014-10-01

Full Text Available Self-concept has been found to play a key role in academic and psychosocial outcomes for students. Appreciating the factors that have a bearing upon self-concept may be of particular importance for Aboriginal students, many of whom experience poorer outcomes than non-Aboriginal Canadians. The current study explored the relationships between multidimensional self-concept, perceived strengths and academic achievement among a sample Aboriginal and non-Aboriginal students. Results indicated that perceived self-concept and strengths were largely similar across groups. However, students in the two groups drew on different strengths to comprise their general self-concept. Findings are explored within the context of existing research and theory.

A Controversial Reform in Indigenous Education: The Cape York Aboriginal Australian Academy

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McCollow, John

2012-01-01

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…

Navigating Two Worlds: Experiences of Counsellors Who Integrate Aboriginal Traditional Healing Practices

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Oulanova, Olga; Moodley, Roy

2010-01-01

There is revival in the use of traditional healing among Canadian Aboriginal communities and the therapeutic benefits of these practices have received much research attention. An argument is repeatedly made for incorporating indigenous healing into clinical interventions, yet recommendations on how this may be accomplished are lacking. The present…

Aboriginal Health Care and Bioethics: A Reflection on the Teaching of the Seven Grandfathers.

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Kotalik, Jaro; Martin, Gerry

2016-05-01

Contemporary bioethics recognizes the importance of the culture in shaping ethical issues, yet in practice, a process for ethical analysis and decision making is rarely adjusted to the culture and ethnicity of involved parties. This is of a particular concern in a health care system that is caring for a growing Aboriginal population. We raise the possibility of constructing a bioethics grounded in traditional Aboriginal knowledge. As an example of an element of traditional knowledge that contains strong ethical guidance, we present the story of the Gifts of the Seven Grandfathers. We note a resemblance of this Ojibway teaching to virtue ethics in European traditions, but we suggest that there are also important differences in how these two traditions are currently presented. We hope that further engagement with a variety of indigenous moral teachings and traditions could improve health care involving Aboriginal patients and communities, and enrich the discipline of bioethics.

A pilot study of Aboriginal health promotion from an ecological perspective

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van den Tol Gemma

2011-09-01

Full Text Available Abstract Background For health promotion to be effective in Aboriginal and Torres Strait Islander Communities, interventions (and their evaluation need to work within a complex social environment and respect Indigenous knowledge, culture and social systems. At present, there is a lack of culturally appropriate evaluation methods available to practitioners that are capable of capturing this complexity. As an initial response to this problem, we used two non-invasive methods to evaluate a community-directed health promotion program, which aimed to improve nutrition and physical activity for members of the Aboriginal community of the Goulburn-Murray region of northern Victoria, Australia. The study addressed two main questions. First, for members of an Aboriginal sporting club, what changes were made to the nutrition environment in which they meet and how is this related to national guidelines for minimising the risk of chronic disease? Second, to what degree was the overall health promotion program aligned with an ecological model of health promotion that addresses physical, social and policy environments as well as individual knowledge and behaviour? Methods Rather than monitoring individual outcomes, evaluation methods reported on here assessed change in the nutrition environment (sports club food supply as a facilitator of dietary change and the 'ecological' nature of the overall program (that is, its complexity with respect to numbers of targets, settings and strategies. Results There were favourable changes towards the provision of a food supply consistent with Australian guidelines at the sports club. The ecological analysis indicated that the design and implementation of the program were consistent with an ecological model of health promotion. Conclusions The evaluation was useful for assessing the impact of the program on the nutrition environment and for understanding the ecological nature of program activities.

The Astronomy of Aboriginal Australia

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Norris, Ray P.; Hamacher, Duane W.

2011-06-01

The traditional cultures of Aboriginal Australians include a significant astronomical component, which is usually reported in terms of songs or stories associated with stars and constellations. Here we argue that the astronomical components extend further, and include a search for meaning in the sky, beyond simply mirroring the earth-bound understanding. In particular, we have found that traditional Aboriginal cultures include a deep understanding of the motion of objects in the sky, and that this knowledge was used for practical purposes such as constructing calendars. We also present evidence that traditional Aboriginal Australians made careful records and measurements of cyclical phenomena, and paid careful attention to unexpected phenomena such as eclipses and meteorite impacts.

Recall of anti-tobacco advertising and information, warning labels and news stories in a national sample of Aboriginal and Torres Strait Islander smokers.

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Nicholson, Anna K; Borland, Ron; Sarin, Jasmine; Wallace, Sharon; van der Sterren, Anke E; Stevens, Matthew; Thomas, David P

2015-06-01

To describe recall of anti-tobacco advertising (mainstream and targeted), pack warning labels, and news stories among a national sample of Aboriginal and Torres Strait Islander smokers, and to assess the association of these messages with attitudes that support quitting, including wanting to quit. A quota sampling design was used to recruit participants from communities served by 34 Aboriginal community-controlled health services and one community in the Torres Strait. We surveyed 1643 Aboriginal and Torres Strait Islander smokers from April 2012 to October 2013. Frequency of recall of advertising and information, warning labels and news stories; recall of targeted and local advertising; attitudes about smoking and wanting to quit. More smokers recalled often noticing warning labels in the past month (65%) than recalled advertising and information (45%) or news stories (24%) in the past 6 months. When prompted, most (82%) recalled seeing a television advertisement. Just under half (48%) recalled advertising that featured an Aboriginal or Torres Strait Islander person or artwork (targeted advertising), and 16% recalled targeted advertising from their community (local advertising). Frequent recall of warning labels, news stories and advertising was associated with worry about health and wanting to quit, but only frequent advertising recall was associated with believing that society disapproves of smoking. The magnitude of association with relevant attitudes and wanting to quit increased for targeted and local advertising. Strategies to tackle Aboriginal and Torres Strait Islander smoking should sustain high levels of exposure to anti-tobacco advertising, news stories and warning labels. More targeted and local information may be particularly effective to influence relevant beliefs and subsequently increase quitting.

Yarning/Aboriginal storytelling: towards an understanding of an Indigenous perspective and its implications for research practice.

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Geia, Lynore K; Hayes, Barbara; Usher, Kim

2013-12-01

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.

Nutritional and socio-economic determinants of cognitive function and educational achievement of Aboriginal schoolchildren in rural Malaysia.

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Al-Mekhlafi, Hesham M; Mahdy, Mohammed A; Sallam, Atiya A; Ariffin, W A; Al-Mekhlafi, Abdulsalam M; Amran, Adel A; Surin, Johari

2011-10-01

A community-based cross-sectional study was carried out among Aboriginal schoolchildren aged 7-12 years living in remote areas in Pos Betau, Pahang, Malaysia to investigate the potential determinants influencing the cognitive function and educational achievement of these children. Cognitive function was measured by intelligence quotient (IQ), while examination scores of selected school subjects were used in assessing educational achievement. Blood samples were collected to assess serum Fe status. All children were screened for soil-transmitted helminthes. Demographic and socio-economic data were collected using pre-tested questionnaires. Almost two-thirds (67·6 %) of the subjects had poor IQ and most of them (72·6 %) had insufficient educational achievement. Output of the stepwise multiple regression model showed that poor IQ was significantly associated with low household income which contributed the most to the regression variance (r2 0·059; P = 0·020). Low maternal education was also identified as a significant predictor of low IQ scores (r2 0·042; P = 0·043). With educational achievement, Fe-deficiency anaemia (IDA) was the only variable to show significant association (r2 0·025; P = 0·015). In conclusion, the cognitive function and educational achievement of Aboriginal schoolchildren are poor and influenced by household income, maternal education and IDA. Thus, effective and integrated measures to improve the nutritional and socio-economic status of rural children would have a pronounced positive effect on their education.

Implementing an anti-smoking program in rural-remote communities: challenges and strategies.

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Tall, Julie A; Brew, Bronwyn K; Saurman, Emily; Jones, Therese C

2015-01-01

Rural-remote communities report higher smoking rates and poorer health outcomes than that of metropolitan areas. While anti-smoking programs are an important measure for addressing smoking and improving health, little is known of the challenges faced by primary healthcare staff implementing those programs in the rural-remote setting. The aim of this study was to explore the challenges and strategies of implementing an anti-smoking program by primary healthcare staff in rural-remote Australia. Guided by a phenomenological approach, semi-structured interviews and focus groups were conducted with health service managers, case managers and general practitioners involved in program implementation in Australian rural-remote communities between 2008 and 2010. Program implementation was reported to be challenged by limited primary and mental healthcare resources and client access to services; limited collaboration between health services; the difficulty of accessing staff training; high levels of community distress and disadvantage; the normalisation of smoking and its deleterious impact on smoking abstinence among program clients; and low morale among health staff. Strategies identified to overcome challenges included appointing tobacco-dedicated staff; improving health service collaboration, access and flexibility; providing subsidised pharmacotherapies and boosting staff morale. Findings may assist health services to better tailor anti-smoking programs for the rural-remote setting, where smoking rates are particularly high. Catering for the unique challenges of the rural-remote setting is necessary if anti-smoking programs are to be efficacious, cost-effective and capable of improving rural-remote health outcomes.

Housing conditions of urban households with Aboriginal children in NSW Australia: tenure type matters

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Melanie J Andersen

2017-08-01

Full Text Available Abstract Background Housing is a key determinant of the poor health of Aboriginal Australians. Most Aboriginal people live in cities and large towns, yet research into housing conditions has largely focused on those living in remote areas. This paper measures the prevalence of housing problems amongst participants in a study of urban Aboriginal families in New South Wales, Australia, and examines the relationship between tenure type and exposure to housing problems. Methods Cross-sectional survey data was provided by 600 caregivers of 1406 Aboriginal children aged 0–17 years participating in Phase One of the Study of Environment on Aboriginal Resilience and Child Health (SEARCH. Regression modelling of the associations between tenure type (own/mortgage, private rental or social housing and housing problems was conducted, adjusting for sociodemographic factors. Results The majority (60% of SEARCH households lived in social housing, 21% rented privately and 19% either owned their home outright or were paying a mortgage (“owned”. Housing problems were common, particularly structural problems, damp and mildew, vermin, crowding and unaffordability. Physical dwelling problems were most prevalent for those living in social housing, who were more likely to report three or more physical dwelling problems than those in owned (PR 3.19, 95%CI 1.97, 5.73 or privately rented homes (PR 1.49, 1.11, 2.08. However, those in social housing were the least likely to report affordability problems. Those in private rental moved home most frequently; children in private rental were more than three times as likely to have lived in four or more homes since birth than those in owned homes (PR 3.19, 95%CI 1.97, 5.73. Those in social housing were almost half as likely as those in private rental to have lived in four or more homes since birth (PR 0.56, 95%CI 0.14, 0.77. Crowding did not vary significantly by tenure type. Conclusions The high prevalence of housing

"If you don't believe it, it won't help you": use of bush medicine in treating cancer among Aboriginal people in Western Australia

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Bessarab Dawn

2010-06-01

Full Text Available Abstract Background Little is known about the use of bush medicine and traditional healing among Aboriginal Australians for their treatment of cancer and the meanings attached to it. A qualitative study that explored Aboriginal Australians' perspectives and experiences of cancer and cancer services in Western Australia provided an opportunity to analyse the contemporary meanings attached and use of bush medicine by Aboriginal people with cancer in Western Australia Methods Data collection occurred in Perth, both rural and remote areas and included individual in-depth interviews, observations and field notes. Of the thirty-seven interviews with Aboriginal cancer patients, family members of people who died from cancer and some Aboriginal health care providers, 11 participants whose responses included substantial mention on the issue of bush medicine and traditional healing were selected for the analysis for this paper. Results The study findings have shown that as part of their healing some Aboriginal Australians use traditional medicine for treating their cancer. Such healing processes and medicines were preferred by some because it helped reconnect them with their heritage, land, culture and the spirits of their ancestors, bringing peace of mind during their illness. Spiritual beliefs and holistic health approaches and practices play an important role in the treatment choices for some patients. Conclusions Service providers need to acknowledge and understand the existence of Aboriginal knowledge (epistemology and accept that traditional healing can be an important addition to an Aboriginal person's healing complementing Western medical treatment regimes. Allowing and supporting traditional approaches to treatment reflects a commitment by modern medical services to adopting an Aboriginal-friendly approach that is not only culturally appropriate but assists with the cultural security of the service.

Community relations

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O'Neil, C.

1997-01-01

The interaction of the oil and gas companies with the Northern communities regarding drilling activities was an important aspect of oil and gas operations conducted in the Beaufort Sea. During the 1960s the industry and aboriginal people basically ignored each other. Later, the industry put more emphasis on community consultation until finally two-way communication was established. Respect for the land and the environment were very important to aboriginal people who depended on the land and its resources for their traditional way of life. Community relations policies by the various companies involved in the area, and the impact they have had on their respective communities were recounted. Not all efforts were successful, however, the companies and the communities learned from their experiences, and by the time operations ceased, the communities seemed to be more appreciative of the ways they were being treated by the oil companies. 22 figs

Having a yarn about smoking: using action research to develop a 'no smoking' policy within an Aboriginal Health Organisation.

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Fletcher, Gillian; Fredericks, Bronwyn; Adams, Karen; Finlay, Summer; Andy, Simone; Briggs, Lyn; Hall, Robert

2011-11-01

This article reports on a culturally appropriate process of development of a smoke-free workplace policy within the peak Aboriginal Controlled Community Health Organisation in Victoria, Australia. Smoking is acknowledged as being responsible for at least 20% of all deaths in Aboriginal communities in Australia, and many Aboriginal health workers smoke. The smoke-free workplace policy was developed using the iterative, discursive and experience-based methodology of Participatory Action Research, combined with the culturally embedded concept of 'having a yarn'. Staff members initially identified smoking as a topic to be avoided within workplace discussions. This was due, in part, to grief (everyone had suffered a smoking-related bereavement). Further, there was anxiety that discussing smoking would result in culturally difficult conflict. The use of yarning opened up a safe space for discussion and debate, enabling development of a policy that was accepted across the organisation. Within Aboriginal organisations, it is not sufficient to focus on the outcomes of policy development. Rather, due attention must be paid to the process employed in development of policy, particularly when that policy is directly related to an emotionally and communally weighted topic such as smoking. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Association between early bacterial carriage and otitis media in Aboriginal and non-Aboriginal children in a semi-arid area of Western Australia: a cohort study

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2012-01-01

Background Streptococcus pneumoniae (Pnc), nontypeable Haemophilus influenzae (NTHi) and Moraxella catarrhalis (Mcat) are the most important bacterial pathogens associated with otitis media (OM). Previous studies have suggested that early upper respiratory tract (URT) bacterial carriage may increase risk of subsequent OM. We investigated associations between early onset of URT bacterial carriage and subsequent diagnosis of OM in Aboriginal and non-Aboriginal children living in the Kalgoorlie-Boulder region located in a semi-arid zone of Western Australia. Methods Aboriginal and non-Aboriginal children who had nasopharyngeal aspirates collected at age 1- children and 14%, 5% and 18% in 146 non-Aboriginal children. OM was diagnosed at least once in 71% of Aboriginal children and 43% of non-Aboriginal children. After controlling for age, sex, presence of other bacteria and environmental factors, early nasopharyngeal carriage of NTHi increased the risk of subsequent OM (odds ratio = 3.70, 95% CI 1.22-11.23) in Aboriginal children, while Mcat increased the risk of OM in non-Aboriginal children (odds ratio = 2.63, 95% CI 1.32-5.23). Early carriage of Pnc was not associated with increased risk of OM. Conclusion Early NTHi carriage in Aboriginal children and Mcat in non-Aboriginal children is associated with increased risk of OM independent of environmental factors. In addition to addressing environmental risk factors for carriage such as overcrowding and exposure to environmental tobacco smoke, early administration of pneumococcal-Haemophilus influenzae D protein conjugate vaccine to reduce bacterial carriage in infants, may be beneficial for Aboriginal children; such an approach is currently being evaluated in Australia. PMID:23256870

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

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Alan R. Clough

2017-01-01

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

'Stereotypes are reality': addressing stereotyping in Canadian Aboriginal medical education.

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Ly, Anh; Crowshoe, Lynden

2015-06-01

Efforts are underway in many parts of the world to develop medical education curricula that address the health care issues of indigenous populations. The topic of stereotypes and their impact on such peoples' health, however, has received little attention. An examination of stereotypes will shed light on dominant cultural attitudes toward Aboriginal people that can affect quality of care and health outcomes in Aboriginal patients. This study examines the views of undergraduate medical students regarding Canadian Aboriginal stereotypes and how they potentially affect Aboriginal people's health. The goal of this study was to gain insight into how medical learners perceive issues related to racism, discrimination and social stereotypes and to draw attention to gaps in Aboriginal health curricula. This study involved a convenience sample of medical learners drawn from one undergraduate medical programme in western Canada. Using a semi-structured interview guide, we conducted a total of seven focus group interviews with 38 first- and second-year undergraduate medical students. Data were analysed using a thematic content analysis approach. Medical students recognise that stereotypes are closely related to processes of racism and discrimination. However, they generally feel that stereotypes of Aboriginal people are rooted in reality. Students also identified medical school as one of the environments in which they are commonly exposed to negative views of Aboriginal people. Student responses suggest they see the cultural gap between Aboriginal and non-Aboriginal people as being both a cause and a consequence of discrimination against Aboriginal people. The results of this study suggest that teaching medical students about the realities and impacts of stereotypes on Aboriginal peoples is a good starting point from which to address issues of racism and health inequities affecting the health of Aboriginal people. © 2015 John Wiley & Sons Ltd.

Needs of Aboriginal and Torres Strait Islander clients residing in Australian residential aged-care facilities.

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Brooke, Nicole J

2011-08-01

This review was undertaken to identify evidence-based practice guidelines to support the care needs of Aboriginal and Torres Strait Islander clients residing in residential aged-care facilities. A systematic literature review was undertaken. An electronic search of online databases and subsequent manual retrieval process was undertaken to identify relevant reports and studies that explored interventions for care of an Aboriginal and Torres Strait Islander person. Very limited published material identified strategies necessary within residential aged care. Sixty-seven articles were considered for inclusion, and a subsequent review resulted in 34 being included due to direct alignment with the study aim. Strategies recommended within the review cover areas such as care, communication, palliative care, activities and the environment. Care for an Aboriginal and Torres Strait Islander person in an Australian residential aged-care facility requires a collaborative and individual approach. Cultural safety principles should be maintained across a culturally competent workforce. Aboriginal and Torres Strait Islander persons in care is a significant experience that should not be considered 'routine' as there is much to consider in the care of this person and their community. © 2011 The Author. Australian Journal of Rural Health © National Rural Health Alliance Inc.

Becoming empowered: a grounded theory study of Aboriginal women's agency.

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Bainbridge, Roxanne

2011-07-01

The study aim was to identify the process underlying the performance of agency for urban-dwelling Aboriginal women in contemporary Australian society with a view to promoting social change for Aboriginal people. Grounded theory methods were used in the conduct of 20 life history narrative interviews with Aboriginal women from across fourteen different language groups. Analysis identified a specific ecological model of Aboriginal women's empowerment, defined as "becoming empowered". "Performing Aboriginality" was identified as the core category and encompassed the women's concern for carving out a fulfilling life and carrying out their perceived responsibilities as Aboriginal women. While confirming much of the extant literature on empowerment, the analysis also offered unique contributions--a spiritual sensibility, cultural competence and an ethics of care and morality. This sheds new light on the creative ways in which Aboriginal women "disrupt" discourses and create alternate modes of existence. The findings have implications for improving quality of life for Aboriginal people by informing the practical development and delivery of social and health policies and programs.

Restoring the Balance: First Nations Women, Community, and Culture

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María del Carmen Rodríguez de France

2010-07-01

Full Text Available With empowering stories and histories from twelve Aboriginal women who are leaders in different contexts and communities, the book acknowledges and celebrates the contributions of Aboriginal women to diverse fields of work and disciplines such as art, culture, politics, language, law, community, education, and social activism. About the Authors Eric Guimond is an assistant director at the Strategic Research and Analysis Directorate at Indian and Northern Affairs Canada. Gail Guthrie Valaskakis was a Distinguished Professor Emeritus of Concordia University and was a leading authority on Aboriginal Media and Communication. She passed away in 2007. Madeleine Dion Stout is a former nurse and founding director of the Centre of Aboriginal Education, Research, and Culture at Carleton University.

Closing the Aboriginal child injury gap: targets for injury prevention.

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Möller, Holger; Falster, Kathleen; Ivers, Rebecca; Falster, Michael O; Clapham, Kathleen; Jorm, Louisa

2017-02-01

To describe the leading mechanisms of hospitalised unintentional injury in Australian Aboriginal children and identify the injury mechanisms with the largest inequalities between Aboriginal and non-Aboriginal children. We used linked hospital and mortality data to construct a whole of population birth cohort including 1,124,717 children (1,088,645 non-Aboriginal and 35,749 Aboriginal) born in the state of New South Wales (NSW), Australia, between 1 July 2000 and 31 December 2012. Injury hospitalisation rates were calculated per person years at risk for injury mechanisms coded according to the ICD10-AM classification. The leading injury mechanisms in both groups of children were falls from playground equipment. For 66 of the 69 injury mechanisms studied, Aboriginal children had a higher rate of hospitalisation compared with non-Aboriginal children. The largest relative inequalities were observed for injuries due to exposure to fire and flame, and the largest absolute inequalities for injuries due to falls from playground equipment. Aboriginal children in NSW experience a significant higher burden of unintentional injury compared with their non-Aboriginal counterparts. Implications for Public Health: We suggest the implementation of targeted injury prevention measures aimed at injury mechanism and age groups identified in this study. © 2016 The Authors.

The Effectiveness of Web-Delivered Learning with Aboriginal Students: Findings from a Study in Coastal Labrador

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Philpott, David; Sharpe, Dennis; Neville, Rose

2009-01-01

This paper outlines the findings of a study that explores perspectives of e-learning for aboriginal students in five coastal communities in Labrador, Canada. The rural nature of many communities in the province of Newfoundland and Labrador, coupled with a dramatically declining enrollment, has resulted in expanding use of e-learning as a means to…

Prevalence of fetal alcohol syndrome in a population-based sample of children living in remote Australia: the Lililwan Project.

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Fitzpatrick, James P; Latimer, Jane; Carter, Maureen; Oscar, June; Ferreira, Manuela L; Carmichael Olson, Heather; Lucas, Barbara R; Doney, Robyn; Salter, Claire; Try, Julianne; Hawkes, Genevieve; Fitzpatrick, Emily; Hand, Marmingee; Watkins, Rochelle E; Martiniuk, Alexandra L C; Bower, Carol; Boulton, John; Elliott, Elizabeth J

2015-04-01

Aboriginal leaders concerned about high rates of alcohol use in pregnancy invited researchers to determine the prevalence of fetal alcohol syndrome (FAS) and partial fetal alcohol syndrome (pFAS) in their communities. Population-based prevalence study using active case ascertainment in children born in 2002/2003 and living in the Fitzroy Valley, in Western Australia (April 2010-November 2011) (n = 134). Socio-demographic and antenatal data, including alcohol use in pregnancy, were collected by interview with 127/134 (95%) consenting parents/care givers. Maternal/child medical records were reviewed. Interdisciplinary assessments were conducted for 108/134 (81%) children. FAS/pFAS prevalence was determined using modified Canadian diagnostic guidelines. In 127 pregnancies, alcohol was used in 55%. FAS or pFAS was diagnosed in 13/108 children, a prevalence of 120 per 1000 (95% confidence interval 70-196). Prenatal alcohol exposure was confirmed for all children with FAS/pFAS, 80% in the first trimester and 50% throughout pregnancy. Ten of 13 mothers had Alcohol Use Disorders Identification Test scores and all drank at a high-risk level. Of children with FAS/pFAS, 69% had microcephaly, 85% had weight deficiency and all had facial dysmorphology and central nervous system abnormality/impairment in three to eight domains. The population prevalence of FAS/pFAS in remote Aboriginal communities of the Fitzroy Valley is the highest reported in Australia and similar to that reported in high-risk populations internationally. Results are likely to be generalisable to other age groups in the Fitzroy Valley and other remote Australian communities with high-risk alcohol use during pregnancy. Prevention of FAS/pFAS is an urgent public health challenge. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Improving forensic mental health care for Aboriginal Australians: challenges and opportunities.

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Durey, Angela; Wynaden, Dianne; Barr, Lesley; Ali, Mohammed

2014-06-01

Mental illnesses constitute a major burden of disease in Aboriginal Australians and Torres Strait Islanders (hereafter Aboriginal Australians), who are also overrepresented in the prison system. A legacy of colonization compounds such prevalence, and is further exacerbated by the persistence of racial discrimination and insensitivity across many sectors, including health. This research completed in a Western Australian forensic mental health setting identifies non-Aboriginal health professionals' support needs to deliver high-quality, culturally-safe care to Aboriginal patients. Data were collected from health professionals using an online survey and 10 semistructured interviews. Survey and interview results found that ongoing education was needed for staff to provide culturally-safe care, where Aboriginal knowledge, beliefs, and values were respected. The findings also support previous research linking Aboriginal health providers to improved health outcomes for Aboriginal patients. In a colonized country, such as Australia, education programmes that critically reflect on power relations privileging white Anglo-Australian cultural dominance and subjugating Aboriginal knowledge, beliefs, and values are important to identify factors promoting or compromising the care of Aboriginal patients and developing a deeper understanding of 'cultural safety' and its clinical application. Organizational commitment is needed to translate the findings to support non-Aboriginal health professionals deliver high-quality care to Aboriginal patients that is respectful of cultural differences. © 2013 Australian College of Mental Health Nurses Inc.

Swallowed Words: bringing up an Aboriginal past in the city

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Kristina L. Everett

2011-03-01

Full Text Available Many Aboriginal stories have not been allowed to be told historically due to the over-whelming dominance of non-Aboriginal stories. Many Aboriginal stories were once outlawed and so were forgotten, some only partially remembered, many now only told in the language of the invaders. There are other Aboriginal stories, however, especially those of particular urban Aboriginal peoples, which have lain ‘dormant’, protected by subversive family histories and embedded in objects claimed as the possessions of the Aboriginal people concerned. Some of these once ‘swallowed’ stories are now being regurgitated, re-emerging into a world that does not always recognise them as true. I am a non-Indigenous woman anthropologist and in this paper I recount some different versions of a story ‘told’ in different ways; through the signs and symbols of the Australian nation state, the movements of my Aboriginal research collaborators through what is

Strategic approaches to enhanced health service delivery for Aboriginal and Torres Strait Islander people with chronic illness: a qualitative study

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Aspin Clive

2012-06-01

Full Text Available Abstract Background Aboriginal and Torres Strait Islander people with chronic illness confront multiple challenges that contribute to their poor health outcomes, and to the health disparities that exist in Australian society. This study aimed to identify barriers and facilitators to care and support for Aboriginal and Torres Strait Islander people with chronic illness. Methods Face-to-face in-depth interviews were conducted with Aboriginal and Torres Strait Islander people with diabetes, chronic heart failure or chronic obstructive pulmonary disease (n-16 and family carers (n = 3. Interviews were transcribed verbatim and the transcripts were analysed using content analysis. Recurrent themes were identified and these were used to inform the key findings of the study. Results Participants reported both negative and positive influences that affected their health and well-being. Among the negative influences, they identified poor access to culturally appropriate health services, dislocation from cultural support systems, exposure to racism, poor communication with health care professionals and economic hardship. As a counter to these, participants pointed to cultural and traditional knowledge as well as insights from their own experiences. Participants said that while they often felt overwhelmed and confused by the burden of chronic illness, they drew strength from being part of an Aboriginal community, having regular and ongoing access to primary health care, and being well-connected to a supportive family network. Within this context, elders played an important role in increasing people’s awareness of the impact of chronic illness on people and communities. Conclusions Our study indicated that non-Indigenous health services struggled to meet the needs of Aboriginal and Torres Strait Islander people with chronic illness. To address their complex needs, health services could gain considerably by recognising that Aboriginal and Torres Strait

The Aboriginal Australian Family Wellbeing Program: A Historical Analysis of the Conditions That Enabled Its Spread

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Janya McCalman

2018-03-01

Full Text Available IntroductionSpreading proven or promising Aboriginal health programs and implementing them in new settings can make cost-effective contributions to a range of Aboriginal Australian development, health and wellbeing, and educational outcomes. Studies have theorized the implementation of Aboriginal health programs but have not focused explicitly on the conditions that influenced their spread. This study examined the broader political, institutional, social and economic conditions that influenced negotiations to transfer, implement, adapt, and sustain one Aboriginal empowerment program—the Family Wellbeing (FWB program—to at least 60 geographical sites across Australia over 24 years.Materials and methodsA historical account of the spread of the FWB Program was constructed using situational analysis, a theory-methods package derived from a poststructural interpretation of grounded theory methods. Data were collected from published empirical articles, evaluation reports and project articles, and interviews with 18 key actors in the spread of FWB. Social worlds and arenas maps were used to determine the organizations and their representative agents who were involved in FWB spread and to analyze the enabling and constraining conditions.ResultsThe program was transferred through three interwoven social arenas: employment and community development; training and capacity development; and social and emotional wellbeing promotion and empowerment research. Program spread was fostered by three primary conditions: government policies and the availability and Aboriginal control of funding and support; Aboriginal leadership, associated informal networks and capability; and research evidence that built credibility for the program.Discussion and conclusionThe continued demand-driven transfer of empowerment programs requires policies that enable Aboriginal control of funding and Aboriginal leadership and networks. Flexible and sustained coordination of

National Aboriginal and Torres Strait Islander Education Strategy 2015

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Education Council, 2015

2015-01-01

Despite determined effort much more needs to be done to close the gap in Aboriginal and Torres Strait Islander education outcomes. Aboriginal and Torres Strait Islander people are the first Australians with the oldest continuing cultures in human history. Governments across Australia affirm the right of Aboriginal and Torres Islander people to…

Serum sample levels of bromine, iron, scandium and zinc in preschool children of Atayal and Bunun aborigines living in central Taiwan

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Chien-Yi Chen; Ding-Bang Lin; Yuan-Yaw Wei

2006-01-01

This study determined bromine, iron, scandium and zinc serum levels in Taiwanese aboriginal preschool children living in remote mountainous areas to increase the understanding of the social, cultural, nutrient and ethnic background of the Taiwanese children. Seventy-three serum samples were taken from two ethnic groups of preschool children, Atayal aborigines (AAPC) and Bunun aborigines (BAPC). Sera of these children were freeze dried. Trace elements in sera were identified by instrumental neutron activation analysis (INAA). The accuracy and precision of INAA was evaluated using certified reference materials: Tomato Leaves (NIST-SRM 1570a) and Lichen (IAEA-336). Statistical analysis identified several different patterns for ethnic groups, gender and age via the two-tailed Student's t-test. Analytical results showed that the ranges of Br, Fe, Sc and Zn in sera were somewhat wide. The Zn serum levels (p < 0.05) and Br serum levels (p < 0.01) in the AAPC were significantly lower than those in the BAPC. However, there were no significant differences in Fe or Sc serum levels between the two groups. Analytical results were compared to published data for different counties. This study is the first investigating trace elements in Taiwanese aborigines and can be used to establish a much-needed serum element database. (author)

A prolonged mumps outbreak among highly vaccinated Aboriginal people in the Kimberley region of Western Australia.

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Bangor-Jones, Revle D; Dowse, Gary K; Giele, Carolien M; van Buynder, Paul G; Hodge, Meredith M; Whitty, Mary M

2009-10-05

To describe a prolonged outbreak of mumps in the Kimberley region of Western Australia in 2007-2008. Descriptive analysis of all mumps cases notified to the WA Notifiable Infectious Diseases Database for the period 1 July 2007 to 30 June 2008. Notified cases of mumps by patients' place of residence, age, Indigenous or non-Indigenous ethnicity, vaccination status and method of diagnosis. 84% (153/183) of mumps notifications in WA over the study period occurred in the Kimberley region or were directly linked to Kimberley cases. Median age of patients was 18 years (range, 2-63 years), and 54% of patients were aged less than 20 years. Almost all (92%) were Australian Aboriginal people; 67% (102/153) had received at least one dose of mumps vaccine, and 52% had received two doses. The highest notification rate (1816 cases per 100,000 population) was in the Aboriginal 15-19-years age group, and 92% of these patients had received at least one dose of mumps vaccine. Almost all outbreak cases (94%) were laboratory confirmed. Genotyping was performed on 20 mumps virus isolates: all were genotype J. A prolonged outbreak of mumps occurred in a well defined, highly vaccinated, predominantly young Aboriginal population in the remote Kimberley region of WA. This outbreak raises questions about the effectiveness and scheduling of the current vaccine (which is genotype A-derived), especially for Aboriginal people. Surveillance of circulating mumps virus genotypes and neutralisation studies will help in evaluating the protection provided by the current vaccine against genotypically different strains.

Implementing a working together model for Aboriginal patients with acute coronary syndrome: an Aboriginal Hospital Liaison Officer and a specialist cardiac nurse working together to improve hospital care.

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Daws, Karen; Punch, Amanda; Winters, Michelle; Posenelli, Sonia; Willis, John; MacIsaac, Andrew; Rahman, Muhammad Aziz; Worrall-Carter, Linda

2014-11-01

Acute coronary syndrome (ACS) contributes to the disparity in life expectancy between Aboriginal and non-Aboriginal Australians. Improving hospital care for Aboriginal patients has been identified as a means of addressing this disparity. This project developed and implemented a working together model of care, comprising an Aboriginal Hospital Liaison Officer and a specialist cardiac nurse, providing care coordination specifically directed at improving attendance at cardiac rehabilitation services for Aboriginal Australians in a large metropolitan hospital in Melbourne. A quality improvement framework using a retrospective case notes audit evaluated Aboriginal patients' admissions to hospital and identified low attendance rates at cardiac rehabilitation services. A working together model of care coordination by an Aboriginal Hospital Liaison Officer and a specialist cardiac nurse was implemented to improve cardiac rehabilitation attendance in Aboriginal patients admitted with ACS to the cardiac wards of the hospital. A retrospective medical records audit showed that there were 68 Aboriginal patients admitted to the cardiac wards with ACS from 1 July 2008 to 30 June 2011. A referral to cardiac rehabilitation was recorded for 42% of these. During the implementation of the model of care, 13 of 15 patients (86%) received a referral to cardiac rehabilitation and eight of the 13 (62%) attended. Implementation of the working together model demonstrated improved referral to and attendance at cardiac rehabilitation services, thereby, has potential to prevent complications and mortality. WHAT IS KNOWN ABOUT THE TOPIC?: Aboriginal Australians experience disparities in access to recommended care for acute coronary syndrome. This may contribute to the life expectancy gap between Aboriginal and non-Aboriginal Australians. WHAT DOES THIS PAPER ADD?: This paper describes a model of care involving an Aboriginal Hospital Liaisons Officer and a specialist cardiac nurse working

The Structural and Predictive Properties of the Psychopathy Checklist-Revised in Canadian Aboriginal and Non-Aboriginal Offenders

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Olver, Mark E.; Neumann, Craig S.; Wong, Stephen C. P.; Hare, Robert D.

2013-01-01

We examined the structural and predictive properties of the Psychopathy Checklist-Revised (PCL-R) in large samples of Canadian male Aboriginal and non-Aboriginal offenders. The PCL-R ratings were part of a risk assessment for criminal recidivism, with a mean follow-up of 26 months postrelease. Using multigroup confirmatory factor analysis, we were…

Australian Aboriginal Memoir and Memory: A Stolen Generations Trauma Narrative

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Justine Seran

2015-10-01

Full Text Available This article proposes a re-reading of Aboriginal author Sally Morgan’s Stolen Generations narrative My Place (1987 in post-Apology Australia (2008–present. The novel tells the story of Morgan’s discovery of her maternal Aboriginal origins through the life-stories of her mother and grandmother; the object of a quest for the past that is both relational and matrilineal; incorporating elements of autobiography and as-told-to memoirs to create a form of choral autoethnography. Morgan’s text explores the intergenerational consequences of child removal in the Aboriginal context and is representative of Indigenous-authored narratives in its suggestion that the children and grand-children of victims of colonial policies and practices can work through the trauma of their ancestors. I examine the literary processes of decolonization of the Indigenous writing/written self and community; as well as strategies for individual survival and cultural survivance in the Australian settler colonial context; especially visible through the interactions between traumatic memories and literary memoirs, a genre neglected by trauma theory’s concern with narrative fragmentation and the proliferation of “themed” life-writing centered on a traumatic event. This article calls for a revision of trauma theory’s Eurocentrism through scholarly engagement with Indigenous experiences such as Morgan’s and her family in order to broaden definitions and take into account collective, historical, and inherited trauma.

Water systems, sanitation, and public health risks in remote communities: Inuit resident perspectives from the Canadian Arctic.

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Daley, Kiley; Castleden, Heather; Jamieson, Rob; Furgal, Chris; Ell, Lorna

2015-06-01

Safe drinking water and wastewater sanitation are universally recognized as critical components of public health. It is well documented that a lack of access to these basic services results in millions of preventable deaths each year among vulnerable populations. Water and wastewater technologies and management practices are frequently tailored to local environmental conditions. Also important, but often overlooked in water management planning, are the social, cultural and economic contexts in which services are provided. The purpose of this qualitative case study was to identify and understand residents' perceptions of the functionality of current water and wastewater sanitation systems in one vulnerable context, that of a remote Arctic Aboriginal community (Coral Harbour, Nunavut), and to identify potential future water related health risks. Semi-structured interviews were conducted with 28 Inuit residents and 9 key informants in 2011 and 2012. Findings indicate that the population's rapid transition from a semi-nomadic hunting and gathering lifestyle to permanent settlements with municipally provided utilities is influencing present-day water usage patterns, public health perceptions, and the level of priority decision-makers place on water and wastewater management issues. Simultaneously environmental, social and cultural conditions conducive to increased human exposure to waterborne health risks were also found to exist and may be increasing in the settlements. While water and wastewater system design decisions are often based on best practices proven suitable in similar environmental conditions, this study reinforces the argument for inclusion of social, cultural, and economic variables in such decisions, particularly in remote and economically challenged contexts in Canada or elsewhere around the world. The results also indicate that the addition of qualitative data about water and wastewater systems users' behaviours to technical knowledge of systems and

Wind generation systems for remote communities: market assessment and guidelines for wind turbines selection

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Brothers, C.

1993-06-01

Wind technology and its market potential in remote communities of the Canadian North were discussed. These communities, unserviced by the main utility electricity grid, generate their own electricity using high quality, expensive diesel fuel to power diesel driven generators. The logistics of delivering fuel to these remote communities is an expensive operation. Wind resource in many of these communities is substantial and wind energy is seen as a prime candidate for supplying electricity to many potential sites in the Arctic and also areas in Quebec and Newfoundland. However, the severe service (i.e., cold climate, remote locations with limited facilities) requires special considerations to ensure that equipment installed performs reliably. This report described some demonstration projects in northern Canada over the last ten years, where an understanding of the special needs of wind turbines in remote areas has been developed. A guide which assessed the suitability of wind turbines for Arctic applications was included to assist organisations in preparing requirements to be used in acquiring wind turbines for use in cold regions. Refs., tabs., figs