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  1. Study Protocol - Accurate assessment of kidney function in Indigenous Australians: aims and methods of the eGFR Study

    PubMed Central

    2010-01-01

    Background There is an overwhelming burden of cardiovascular disease, type 2 diabetes and chronic kidney disease among Indigenous Australians. In this high risk population, it is vital that we are able to measure accurately kidney function. Glomerular filtration rate is the best overall marker of kidney function. However, differences in body build and body composition between Indigenous and non-Indigenous Australians suggest that creatinine-based estimates of glomerular filtration rate derived for European populations may not be appropriate for Indigenous Australians. The burden of kidney disease is borne disproportionately by Indigenous Australians in central and northern Australia, and there is significant heterogeneity in body build and composition within and amongst these groups. This heterogeneity might differentially affect the accuracy of estimation of glomerular filtration rate between different Indigenous groups. By assessing kidney function in Indigenous Australians from Northern Queensland, Northern Territory and Western Australia, we aim to determine a validated and practical measure of glomerular filtration rate suitable for use in all Indigenous Australians. Methods/Design A cross-sectional study of Indigenous Australian adults (target n = 600, 50% male) across 4 sites: Top End, Northern Territory; Central Australia; Far North Queensland and Western Australia. The reference measure of glomerular filtration rate was the plasma disappearance rate of iohexol over 4 hours. We will compare the accuracy of the following glomerular filtration rate measures with the reference measure: Modification of Diet in Renal Disease 4-variable formula, Chronic Kidney Disease Epidemiology Collaboration equation, Cockcroft-Gault formula and cystatin C- derived estimates. Detailed assessment of body build and composition was performed using anthropometric measurements, skinfold thicknesses, bioelectrical impedance and a sub-study used dual-energy X-ray absorptiometry. A

  2. Indigenous Australian women's colonial sexual intimacies: positioning indigenous women's agency.

    PubMed

    Sullivan, Corrinne Tayce

    2017-07-27

    Colonialist views of Indigenous bodies and sexualities continue to affect Indigenous peoples worldwide. For Indigenous Australians, this burden has resulted in repression and oppression of power, sex and desire. Focusing on the sexual intimacies of Indigenous Australian women, this paper provides an account of the dominant Australian historical discourses, finding that Indigenous women were viewed as exotic, erotic, something to be desired, yet simultaneously something to be feared. Our sexualities were described as savage, promiscuous and primitive and we were often viewed as prostitutes with our voices and views constrained by patriarchal and imperial regimes of power. But within this context, Indigenous women fought back through both individual and collective acts of agency. This paper demonstrates how Indigenous Australian women's agency not as a new phenomenon but rather as a position that disrupts the popular discourses of exploitation and victimhood that have been persistently perpetrated against Indigenous women.

  3. The gambling behavior of indigenous Australians.

    PubMed

    Hing, Nerilee; Breen, Helen; Gordon, Ashley; Russell, Alex

    2014-06-01

    The gambling activities of minority groups such as Indigenous peoples are usually culturally complex and poorly understood. To redress the scarcity of information and contribute to a better understanding of gambling by Indigenous people, this paper presents quantitative evidence gathered at three Australian Indigenous festivals, online and in several Indigenous communities. With support from Indigenous communities, the study collected and analyzed surveys from 1,259 self-selected Indigenous adults. Approximately 33 % of respondents gambled on card games while 80 % gambled on commercial gambling forms in the previous year. Gambling participation and involvement are high, particularly on electronic gaming machines (EGMs), the favorite and most regular form of gambling. Men are significantly more likely to participate in gambling and to gamble more frequently on EGMs, horse/dog races, sports betting and instant scratch tickets. This elevated participation and frequency of gambling on continuous forms would appear to heighten gambling risks for Indigenous men. This is particularly the case for younger Indigenous men, who are more likely than their older counterparts to gamble on EGMs, table games and poker. While distinct differences between the gambling behaviors of our Indigenous sample and non-Indigenous Australians are apparent, Australian Indigenous behavior appears similar to that of some Indigenous and First Nations populations in other countries. Although this study represents the largest survey of Indigenous Australian gambling ever conducted in New South Wales and Queensland, further research is needed to extend our knowledge of Indigenous gambling and to limit the risks from gambling for Indigenous peoples.

  4. Indigenous Australians are under-represented in longitudinal ageing studies.

    PubMed

    Anstey, Kaarin J; Kiely, Kim M; Booth, Heather; Birrell, Carole L; Butterworth, Peter; Byles, Julie; Luszcz, Mary A; Gibson, Richard

    2011-08-01

    Evidence-based policy depends on the availability of high-quality research that is relevant to the population. This study aimed to identify the available data on the health of older Indigenous Australians in population-based longitudinal studies of ageing. Evaluation of the Dynamic Analyses to Optimise Ageing Project (DYNOPTA) dataset that has pooled nine Australian longitudinal ageing studies, six of which were analysed here. Proportions of the DYNOPTA sample identified as Indigenous. Indigenous participants made up 0.7% of males and 0.5% of females in the weighted sample, compared with 0.8% of both sexes in the Australian population. Indigenous under-representation is greater at ages 45-54 than at older ages, despite overall greater participation in this age range. Within the existing Australian longitudinal ageing studies, Indigenous Australians are under-represented. This means there is a significant gap in the evidence base relating to the health of older Indigenous Australians. Research approaches specifically designed to address the health and wellbeing of older Indigenous Australians are urgently required. © 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia.

  5. Healthier times?: revisiting Indigenous Australian health history.

    PubMed

    Blyton, Greg

    2009-01-01

    The perception that Indigenous Australians were primitive hunters and gatherers who lived in a nomadic 'Stone Age' culture resonates through most narratives found on Indigenous people in pre-colonial times. This narrative is better placed in the realm of myth; I contest claims that the life expectancy of Indigenous Australians was only forty years in pre-colonial times, by providing suggestive evidence that there is a strong probability that longevity favoured Indigenous Australians in comparison to many poorer sectors of the European population living in slum habitats. As well, I will challenge notions that Indigenous Australians were more violent than supposedly 'civilised' nations. Finally I express the hope that future researchers will revisit archival sources to develop a more nuanced perspective on the past.

  6. Factors Affecting Indigenous West Australians' Health Behavior: Indigenous Perspectives.

    PubMed

    Waterworth, Pippa; Dimmock, James; Pescud, Melanie; Braham, Rebecca; Rosenberg, Michael

    2016-01-01

    The factors driving the disparity in health outcomes between Indigenous and non-Indigenous Australians include socio-economic factors, racism, and history. The current study focused on exploring Indigenous participants' perspectives of the factors that affect the health behavior of their community members. Participatory action research methodology and a grounded theory approach were utilized. In total, 120 members of two urban West Australian Indigenous communities participated in focus group discussions. There was substantial similarity between the themes that emerged within the discussions held in the two communities. Factors relating to culture, social connections, racism, communication, and personal aspects were particularly salient to health behavior of the participants. Several of the themes including culture, racism, communication, and distrust highlight the tension caused by being a member of a minority cultural group that has been marginalized by the practices and attitudes of the dominant cultural group. Personal choice was sometimes prioritized over health. © The Author(s) 2015.

  7. Australian Indigenous Knowledge and Libraries

    ERIC Educational Resources Information Center

    Nakata, Martin, Ed.; Langton, Marcia, Ed.

    2005-01-01

    In response to significant changes in the Indigenous information landscape, the State Library of New South Wales and Jumbunna Indigenous House of Learning, University of Technology, Sydney, hosted a Colloquium, "Libraries and Indigenous Knowledge," in December 2004. The two-day Colloquium brought together professionals, practitioners and…

  8. Australian Indigenous Knowledge and Libraries

    ERIC Educational Resources Information Center

    Nakata, Martin, Ed.; Langton, Marcia, Ed.

    2005-01-01

    In response to significant changes in the Indigenous information landscape, the State Library of New South Wales and Jumbunna Indigenous House of Learning, University of Technology, Sydney, hosted a Colloquium, "Libraries and Indigenous Knowledge," in December 2004. The two-day Colloquium brought together professionals, practitioners and…

  9. Living with aphasia: three Indigenous Australian stories.

    PubMed

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

    2012-06-01

    The incidence of cardiovascular disorders and stroke in Australian Aboriginal communities is more than twice as high as non-Indigenous Australians. Approximately 30% of people who survive stroke are left with some level of aphasia, and yet Indigenous Australians appear to be infrequent users of speech-language pathology services, and there is virtually no research literature about the experiences of aphasia for this group of people. This paper presents the stories of living with aphasia for three Indigenous Australian men living in Perth, Western Australia. Their narratives were collected by an Indigenous researcher through in-depth, supported interviews, and were explored using both within-case and cross-case analyses for common and recurring themes. It is argued that there is value for speech-language pathologists, and other health professionals, to be aware of the broad experiences of living with aphasia for Indigenous Australians because their stories are rarely heard and because, as with people with aphasia generally, they are at risk of social isolation and tend to lack visibility in the community. This study explores the key issues which emerge for these three men and highlights the need for further research in this area.

  10. Ecological Model of Australian Indigenous Men's Health.

    PubMed

    McCabe, Marita P; Mellor, David; Ricciardelli, Lina A; Mussap, Alexander J; Hallford, David J

    2016-11-01

    This study was designed to examine the health behaviors as well as the enablers and barriers to health behaviors among Indigenous Australian men. One hundred and fifty Indigenous Australian men in rural, regional, and urban locations were interviewed about their health behaviors. The results revealed several themes of importance: (a) role of community activities, (b) the Indigenous man as a leader and role model, (c) negative impact of discrimination/racism, (d) importance of partner and family, (e) positive and negative role of peer relationships, (f) central role of culturally appropriate health care facilities, and (g) association between employment and health care problems. These findings highlight the importance of broad community-based (rather than individualistic) approaches to promoting health behavior in Indigenous men.

  11. Indigenous Australian Education and Globalisation

    NASA Astrophysics Data System (ADS)

    Brady, Wendy

    1997-09-01

    This article focuses on the impact of colonisation and its associated impact on Indigenous teaching and learning. Western European institutions have dominated Indigenous ways of knowing and in Australia this has led to barriers which restrict the participation of Aboriginal people in education systems. Globally Indigenous people are attempting to bring into the introduced educational systems culturally appropriate teaching and learning practices so that a more holistic approach to education can become the norm rather than the exception. The relationship between Indigenous knowledge and western European concepts of knowledge and knowing need to placed in a framework of mutual interaction so that not only do Indigenous people benefit, but so do non-Indigenous educators and students.

  12. Indigenous Australian medical students' perceptions of their medical school training.

    PubMed

    Garvey, Gail; Rolfe, Isobel E; Pearson, Sallie-Anne; Treloar, Carla

    2009-11-01

    The Australian Medical Council requires all accredited Australian medical schools to have specific admission and recruitment policies for Indigenous Australian students. However, there is no clear evidence about how these students can be retained through to graduation. This study aimed to explore the training experiences of Indigenous undergraduate medical students and their perceptions of the factors influencing their progression through training. Methods We used a qualitative methodology involving focus groups. All participants had successfully completed at least 1 year of the Bachelor of Medicine programme at the University of Newcastle, New South Wales, Australia. Sixteen of 18 eligible students participated in the study. The factors that influence an Indigenous student's progress through medical training are multi-faceted and inter-related and are associated with student support, course content and styles of learning, personal qualities (such as confidence and coping skills), discrimination and distinctive cultural issues pertinent to Indigenous students. Both academic and non-academic factors affect the progression through training of Indigenous medical students. A number of individual and systemic interventions which actively encourage a range of support networks, increase confidence and coping skills, and reduce cultural clash by assertively addressing discrimination and stereotyping need to be introduced. The outcomes of this work may provide some guidance to medical schools engaged in implementing strategies to enroll and support Indigenous students.

  13. Indigenous Australians and Physical Activity: Using a Social-Ecological Model to Review the Literature

    ERIC Educational Resources Information Center

    Nelson, Alison; Abbott, Rebecca; Macdonald, Doune

    2010-01-01

    This paper aims to present what is currently known about Indigenous Australians and their engagement in physical activity and to then challenge some of the "taken-for-granted" ways of thinking about promoting or researching physical activity with Indigenous Australians. Major health, education and sport databases, as well as government…

  14. Social Gradients in the Health of Indigenous Australians

    PubMed Central

    Li, Jianghong; Zubrick, Stephen R.

    2012-01-01

    The pattern of association between socioeconomic factors and health outcomes has primarily depicted better health for those who are higher in the social hierarchy. Although this is a ubiquitous finding in the health literature, little is known about the interplay between these factors among indigenous populations. We begin to bridge this knowledge gap by assessing evidence on social gradients in indigenous health in Australia. We reveal a less universal and less consistent socioeconomic status patterning in health among Indigenous Australians, and discuss the plausibility of unique historical circumstances and social and cultural characteristics in explaining these patterns. A more robust evidence base in this field is fundamental to processes that aim to reduce the pervasive disparities between indigenous and nonindigenous population health. PMID:22095336

  15. The Invisible Hand of Pedagogy in Australian Indigenous Studies and Indigenous Education

    ERIC Educational Resources Information Center

    Rhea, Zane Ma; Russell, Lynette

    2012-01-01

    The Australian Learning and Teaching Council (ALTC)-funded project "Exploring Problem-Based Learning Pedagogy as Transformative Education in Indigenous Australian Studies" raised a number of issues that resonated with concerns we have had as professionals engaged in teaching and researching Australian Indigenous studies and Indigenous…

  16. Non-infectious skin disease in Indigenous Australians.

    PubMed

    Heyes, Christopher; Tait, Clare; Toholka, Ryan; Gebauer, Kurt

    2014-08-01

    The burden of non-infectious skin disease in the Indigenous Australian population has not been previously examined. This study considers the published data on the epidemiology and clinical features of a number of non-infectious skin diseases in Indigenous Australians. It also outlines hypotheses for the possible differences in the prevalence of such diseases in this group compared with the general Australian population. There is a paucity of literature on the topic but, from the material available, Indigenous Australians appear to have a reduced prevalence of psoriasis, type 1 hypersensitivity reactions and skin cancer but increased rates of lupus erythematosus, kava dermopathy and vitamin D deficiency when compared to the non-Indigenous Australian population. This article profiles the prevalence and presentation of non-infectious skin diseases in the Indigenous Australian population to synthesise our limited knowledge and highlight deficiencies in our understanding. © 2013 The Australasian College of Dermatologists.

  17. Connection, Challenge, and Change: The Narratives of University Students Mentoring Young Indigenous Australians

    ERIC Educational Resources Information Center

    O'Shea, Sarah; Harwood, Valerie; Kervin, Lisa; Humphry, Nici

    2013-01-01

    In this article, we highlighted the stories of university student mentors who are involved in the Australian Indigenous Mentoring Experience (AIME). The AIME program works with young Indigenous school students, at primary and secondary school levels, to encourage continued participation in education and to consider university as a viable life…

  18. Surgery for otitis media among Indigenous Australians.

    PubMed

    O'Leary, Stephen J; Triolo, Ross D

    2009-11-02

    Otitis media with effusion and recurrent acute otitis media are ubiquitous among Indigenous children. Otitis media causes conductive hearing loss that may persist throughout early childhood and adversely affect social interactions, language acquisition and learning. Control of otitis media usually restores hearing to adequate levels. Surgery is to be considered when otitis media has not responded to medical treatment. In non-Indigenous populations, tympanostomy tubes ("grommets"), with or without adenoidectomy, can control otitis media; how these findings relate to Indigenous Australians is not known. Tympanic membrane perforation is a frequent sequela of early childhood otitis media among Indigenous children. It occurs as early as 12 months of age and causes conductive hearing loss. Perforation is associated with recurrent aural discharge, particularly in the tropics and in desert regions. Medical and public health management is required until a child is old enough to undergo surgical closure of the perforation, usually by an age of 7-10 years. Surgical closure of the tympanic membrane stops the aural discharge and improves the hearing sufficiently to avoid the need for hearing aids in most cases. The success rate of surgery conducted in rural and remote Australia is below urban benchmarks; improving this will probably require funding for community-based follow-up.

  19. Not all semantics: similarities and differences in reminiscing function and content between Indigenous and non-Indigenous Australians.

    PubMed

    Nile, Emma; Van Bergen, Penny

    2015-01-01

    This study explored why and how Indigenous and non-Indigenous Australians remember the past. Indigenous Australians traditionally share a strong oral tradition in which customs, personal and cultural histories, and other narratives are passed across groups and between generations by word of mouth. Drawing on this tradition, in which inherent value is placed on sharing knowledge and maintaining connectedness with others, we hypothesised that Indigenous Australians would be more likely than non-Indigenous Australians to report reminiscing to fulfil social functions (but not self or directive functions). Furthermore, we hypothesised that Indigenous Australians would recall personal past experiences more elaborately than would non-Indigenous Australians. In Study 1, 33 Indigenous Australians and 76 non-Indigenous Australians completed Webster's Reminiscence Functions Scale. As predicted, Indigenous participants reported higher scores on subscales related to social functions than did non-Indigenous Australians: particularly "Teach/Inform" and "Intimacy Maintenance". They also scored higher on the "Identity" subscale. In Study 2, 15 Indigenous and 14 non-Indigenous Australians shared three memories from the distant and recent past. While Indigenous and non-Indigenous narratives did not differ in either emotion or elaboration, Indigenous Australians provided more memory context and detail by including a greater proportion of semantic memory content. Taken together, these findings suggest differences in both why and how Australians remember.

  20. Australian Directions in Indigenous Education 2005-2008

    ERIC Educational Resources Information Center

    Ministerial Council on Education, Employment, Training and Youth Affairs (NJ1), 2006

    2006-01-01

    The educational outcomes of Indigenous Australians have improved over recent decades. This is evident across a range of indicators on the enrolment, participation and achievement of Indigenous students in the early childhood education and school sectors. There has also been increased representation of Indigenous students in New Apprenticeships and…

  1. Career Decision-Making: What Matters to Indigenous Australians?

    ERIC Educational Resources Information Center

    Helme, Sue

    2010-01-01

    This article brings together and discusses three research projects that examined the vocational education and career-decision making of Indigenous Australians. These studies focused on the experiences of Indigenous people themselves, in order to provide an Indigenous perspective on vocational and career development. Four main barriers that limit…

  2. Heart failure among Indigenous Australians: a systematic review

    PubMed Central

    2012-01-01

    Background Cardiovascular diseases contribute substantially to the poor health and reduced life expectancy of Indigenous Australians. Heart failure is a common, disabling, progressive and costly complication of these disorders. The epidemiology of heart failure and the adequacy of relevant health service provision in Indigenous Australians are not well delineated. Methods A systematic search of the electronic databases PubMed, Embase, Web of Science, Cinahl Plus, Informit and Google Scholar was undertaken in April 2012 for peer-reviewed journal articles relevant to the topic of heart failure in Indigenous Australians. Additionally, a website search was done to identify other pertinent publications, particularly government reports. Results There was a paucity of relevant peer-reviewed research, and government reports dominated the results. Ten journal articles, 1 published conference abstract and 10 reports were eligible for inclusion. Indigenous Australians reportedly have higher morbidity and mortality from heart failure than their non-Indigenous counterparts (age-standardised prevalence ratio 1.7; age-standardised hospital separation ratio ≥3; crude per capita hospital expenditure ratio 1.58; age-adjusted mortality ratio >2). Despite the evident disproportionate burden of heart failure in Indigenous Australians, the accuracy of estimation from administrative data is limited by poor indigenous identification, inadequate case ascertainment and exclusion of younger subjects from mortality statistics. A recent journal article specifically documented a high prevalence of heart failure in Central Australian Aboriginal adults (5.3%), noting frequent undiagnosed disease. One study examined barriers to health service provision for Indigenous Australians in the context of heart failure. Conclusions Despite the shortcomings of available published data, it is clear that Indigenous Australians have an excess burden of heart failure. Emerging data suggest that undiagnosed

  3. Australian Indigenous Perspectives on Quality Assurance in Children's Services

    ERIC Educational Resources Information Center

    Hutchins, Teresa; Frances, Katie; Saggers, Sherry

    2009-01-01

    The Australian Government has recently committed to the development of an integrated system of assuring national quality standards for Australian childcare and preschool services (Australian Government, 2008). This article addresses two fundamental issues relating to the development of an integrated system as it applies to Indigenous children's…

  4. Cataract surgery coverage rates for Indigenous and non-Indigenous Australians: the National Eye Health Survey.

    PubMed

    Foreman, Joshua; Xie, Jing; Keel, Stuart; van Wijngaarden, Peter; Crowston, Jonathan; Taylor, Hugh R; Dirani, Mohamed

    2017-09-18

    To determine cataract surgery coverage rates for Indigenous and non-Indigenous Australians. National cross-sectional population-based survey. Thirty randomly selected Australian geographic sites, stratified by remoteness. 3098 non-Indigenous Australians aged 50 years or more and 1738 Indigenous Australians aged 40 years or more, recruited and examined in the National Eye Health Survey (NEHS) between March 2015 and April 2016. Participants underwent an interviewer-administered questionnaire that collected socio-demographic information and past ocular care history, including cataract surgery. For those with visual acuity worse than 6/12, anterior segment photography and slit lamp examinations were conducted. Cataract surgery coverage rates according to WHO and NEHS definitions; associated risk factors. Cataract surgery coverage rates calculated with the NEHS definition 1 of vision impairment (visual acuity worse than 6/12) were lower for Indigenous than non-Indigenous participants (58.5% v 88.0%; odds ratio [OR], 0.32; P < 0.001). According to the World Health Organization definition (eligibility criterion: best-corrected visual acuity worse than 6/18), coverage rates were 92.5% and 98.9% for Indigenous and non-Indigenous Australians respectively. Greater age was significantly associated with higher cataract surgery coverage in Indigenous (OR, 1.41 per 10 years; P = 0.048) and non-Indigenous Australians (OR, 1.58 per 10 years; P = 0.004). The cataract surgery coverage rate was higher for non-Indigenous than Indigenous Australians, indicating the need to improve cataract surgery services for Indigenous Australians. The WHO definition of the coverage rate may overestimate the cataract surgery coverage rate in developed nations and should be applied with caution.

  5. Intellectual disability in Indigenous Australians: issues and challenges.

    PubMed

    Balaratnasingam, Sivasankaran; Roy, Meera

    2015-12-01

    Literature on Indigenous Australians (Aboriginal and Torres Strait Islander people) and intellectual disability (ID) is summarized in order to identify current state of knowledge, gaps, and areas for further research. A selective review of psychiatric literature using relevant medical databases was undertaken. Key articles were identified and their findings described. ID is reported to be more prevalent in Indigenous Australians. Sociocultural constructs and a lack of validated psychometric measures affect what is considered to be ID in Indigenous communities. Prenatal, perinatal, and postnatal factors impair brain development and contribute to ID in Indigenous communities. Comorbid physical and psychiatric disorders need to be assessed and managed. ID is an emerging area of health concern for general and mental health professionals working with Indigenous Australians. This important area requires further research, appropriate training, and resourcing. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  6. Ethnic Differences in the Quality of the Interview Process and Implications for Survey Analysis: The Case of Indigenous Australians

    PubMed Central

    Perales, Francisco

    2015-01-01

    Comparable survey data on Indigenous and non-Indigenous Australians are highly sought after by policymakers to inform policies aimed at closing ethnic socio-economic gaps. However, collection of such data is compromised by group differences in socio-economic status and cultural norms. We use data from the Household, Income and Labour Dynamics in Australia Survey and multiple-membership multilevel regression models that allow for individual and interviewer effects to examine differences between Indigenous and non-Indigenous Australians in approximate measures of the quality of the interview process. We find that there are both direct and indirect ethnic effects on different dimensions of interview process quality, with Indigenous Australians faring worse than non-Indigenous Australians in all outcomes ceteris paribus . This indicates that nationwide surveys must feature interview protocols that are sensitive to the needs and culture of Indigenous respondents to improve the quality of the survey information gathered from this subpopulation. PMID:26091283

  7. Ethnic Differences in the Quality of the Interview Process and Implications for Survey Analysis: The Case of Indigenous Australians.

    PubMed

    Perales, Francisco; Baffour, Bernard; Mitrou, Francis

    2015-01-01

    Comparable survey data on Indigenous and non-Indigenous Australians are highly sought after by policymakers to inform policies aimed at closing ethnic socio-economic gaps. However, collection of such data is compromised by group differences in socio-economic status and cultural norms. We use data from the Household, Income and Labour Dynamics in Australia Survey and multiple-membership multilevel regression models that allow for individual and interviewer effects to examine differences between Indigenous and non-Indigenous Australians in approximate measures of the quality of the interview process. We find that there are both direct and indirect ethnic effects on different dimensions of interview process quality, with Indigenous Australians faring worse than non-Indigenous Australians in all outcomes ceteris paribus. This indicates that nationwide surveys must feature interview protocols that are sensitive to the needs and culture of Indigenous respondents to improve the quality of the survey information gathered from this subpopulation.

  8. Gender differences in the dialysis treatment of Indigenous and non-Indigenous Australians.

    PubMed

    McKercher, Charlotte; Jose, Matthew D; Grace, Blair; Clayton, Philip A; Walter, Maggie

    2017-02-01

    Access to dialysis treatment and the types of treatments employed in Australia differs by Indigenous status. We examined whether dialysis treatment utilisation in Indigenous and non-Indigenous Australians also differs by gender. Using registry data we evaluated 21,832 incident patients (aged ≥18 years) commencing dialysis, 2001-2013. Incidence rates were calculated and multivariate regression modelling used to examine differences in dialysis treatment (modality, location and vascular access creation) by race and gender. Dialysis incidence was consistently higher in Indigenous women compared to all other groups. Compared to Indigenous women, both non-Indigenous women and men were more likely to receive peritoneal dialysis as their initial treatment (non-Indigenous women RR=1.91, 95%CI 1.55-2.35; non-Indigenous men RR=1.73, 1.40-2.14) and were more likely to commence initial treatment at home (non-Indigenous women RR=2.07, 1.66-2.59; non-Indigenous men RR=1.95, 1.56-2.45). All groups were significantly more likely than Indigenous women to receive their final treatment at home. Contemporary dialysis treatment in Australia continues to benefit the dominant non-Indigenous population over the Indigenous population, with non-Indigenous men being particularly advantaged. Implications for Public Health: Treatment guidelines that incorporate a recognition of gender-based preferences and dialysis treatment options specific to Indigenous Australians may assist in addressing this disparity. © 2016 The Authors.

  9. Spirometry reference values in Indigenous Australians: a systematic review.

    PubMed

    Blake, Tamara L; Chang, Anne B; Petsky, Helen L; Rodwell, Leanne T; Brown, Michael G; Hill, Debra C; Thompson, Bruce; McElrea, Margaret S

    2016-07-04

    To evaluate published spirometry data for Australian Aboriginal and Torres Strait Islander (Indigenous) peoples to determine (i) whether their ethnicity influenced spirometry results; and (ii) if any reliable spirometry reference values exist for Indigenous Australians. Systematic review of published and grey literature. PubMed and Cochrane Library databases, references of included articles and appropriate grey literature. Last searches were conducted in April 2016. We included any study that performed spirometry on healthy Indigenous Australians and compared their results with those from people of European ancestry. Two authors independently screened titles and abstracts and then reviewed potentially relevant full-text articles for possible inclusion. We used PRISMA systematic review reporting methods to collate data. Of a possible 125 studies, 18 full-text articles were reviewed, but only nine fulfilled the inclusion criteria. None specified Torres Strait Islander inclusion. All studies reported lower spirometry values (as much as 30% lower) for Aboriginal people compared with non-Indigenous people. Five studies developed spirometry reference values for Indigenous Australians; however, none adhered to all participant inclusion and exclusion criteria outlined by the American Thoracic Society and European Respiratory Society. Hence, reported results and subsequent reference values may not be a true representation of spirometry values in healthy Indigenous people. The lower spirometry values reported for Indigenous Australians may be due to study limitations. Furthermore, there are currently no reliable spirometry reference values for Indigenous Australians that adhere to current guidelines. Developing a set of Indigenous Australian reference values will improve the accuracy of test interpretation and aid in the diagnosis of respiratory disease in this population.

  10. Brilliant Minds: A Snapshot of Successful Indigenous Australian Doctoral Students

    ERIC Educational Resources Information Center

    Trudgett, Michelle; Page, Susan; Harrison, Neil

    2016-01-01

    Drawing on demographic data collected from interviews with 50 Indigenous Australians with a doctoral qualification and 33 of their supervisors, this paper provides the first detailed picture of Indigenous doctoral education in Australia, with the focus on study modes, age of candidates, completion times and employment. It also analyses data…

  11. Potential Effectiveness of Specific Anti-Smoking Mass Media Advertisements among Australian Indigenous Smokers

    ERIC Educational Resources Information Center

    Stewart, Harold S.; Bowden, Jacqueline A.; Bayly, Megan C.; Sharplin, Greg R.; Durkin, Sarah J.; Miller, Caroline L.; Givans, Sharon E.; Warne, Charles D.; Wakefield, Melanie A.

    2011-01-01

    Aboriginal and Torres Strait Islander Australians (Indigenous Australians) have more than twice the smoking prevalence of non-Indigenous Australians. Anti-smoking campaigns have demonstrated success in the general population but little is known about their impact among Indigenous people. A total of 143 Indigenous and a comparison group of 156…

  12. Potential Effectiveness of Specific Anti-Smoking Mass Media Advertisements among Australian Indigenous Smokers

    ERIC Educational Resources Information Center

    Stewart, Harold S.; Bowden, Jacqueline A.; Bayly, Megan C.; Sharplin, Greg R.; Durkin, Sarah J.; Miller, Caroline L.; Givans, Sharon E.; Warne, Charles D.; Wakefield, Melanie A.

    2011-01-01

    Aboriginal and Torres Strait Islander Australians (Indigenous Australians) have more than twice the smoking prevalence of non-Indigenous Australians. Anti-smoking campaigns have demonstrated success in the general population but little is known about their impact among Indigenous people. A total of 143 Indigenous and a comparison group of 156…

  13. Pearls, Not Problems: Exploring Transformative Education in Indigenous Australian Studies

    ERIC Educational Resources Information Center

    Mackinlay, Elizabeth; Barney, Katelyn

    2012-01-01

    This article explores the shift in terminology that occurred in a 2-year Australian Learning and Teaching Council (ALTC)-funded curriculum renewal project that set out to broadly explore current teaching and learning practice in Indigenous Australian studies (www.teaching4change.edu.au). While we started with the term "Problem-Based…

  14. Tobacco interventions for Indigenous Australians: a review of current evidence.

    PubMed

    Power, Jennifer; Grealy, Claire; Rintoul, Duncan

    2009-12-01

    This paper reviewed effective interventions for increasing smoking cessation among Indigenous Australians and identified gaps in evidence regarding smoking cessation interventions for Indigenous Australians. A systematic review of academic literature and reports from government and non-government agencies published between 2001 and 2007 was conducted in early 2008. Initial findings from the review were tested using 16 in-depth interviews and two half-day workshops with practitioners and researchers working in the area of Indigenous health. Seven Australian programs for which there had been well-designed, rigorous evaluations were identified. A further four programs were identified that had limited evaluation information available. These studies provide evidence that face-to-face counselling or quit support used in conjunction with nicotine replacement therapy (NRT) is likely to increase quit rates among Indigenous people. Training Aboriginal Health Workers to provide brief smoking cessation intervention with patients is also likely to contribute to increased quit rates. Evidence regarding other interventions is more limited. Evidence indicates that smoking cessation strategies targeted at individuals, such as NRT and/ or counselling, may be effective smoking cessation aids for Indigenous Australians. However, there is no evidence regarding interventions likely to be effective in encouraging more Indigenous Australians to access these quit support strategies.

  15. Is resilience relevant to smoking abstinence for Indigenous Australians?

    PubMed

    Tsourtos, George; Ward, Paul R; Lawn, Sharon; Winefield, Anthony H; Hersh, Deborah; Coveney, John

    2015-03-01

    The prevalence rate of tobacco smoking remains high for Australian Indigenous people despite declining rates in other Australian populations. Given many Indigenous Australians continue to experience a range of social and economic structural problems, stress could be a significant contributing factor to preventing smoking abstinence. The reasons why some Indigenous people have remained resilient to stressful adverse conditions, and not rely on smoking to cope as a consequence, may provide important insights and lessons for health promotion policy and practice. In-depth interviews were employed to collect oral histories from 31 Indigenous adults who live in metropolitan Adelaide. Participants were recruited according to smoking status (non-smokers were compared with current smokers to gain a greater depth of understanding of how some participants have abstained from smoking). Perceived levels of stress were associated with encouraging smoking behaviour. Many participants reported having different stresses compared with non-Indigenous Australians, with some participants reporting having additional stressors such as constantly experiencing racism. Resilience often occurred when participants reported drawing upon internal psychological assets such as being motivated to quit and where external social support was available. These findings are discussed in relation to a recently developed psycho-social interactive model of resilience, and how this resilience model can be improved regarding the historical and cultural context of Indigenous Australians' experience of smoking.

  16. Breast Cancer in Australian Indigenous Women: Incidence, Mortality, and Risk Factors

    PubMed Central

    Tapia, Kriscia A; Garvey, Gail; Entee, Mark Mc; Rickard, Mary; Brennan, Patrick

    2017-01-01

    The Indigenous people of Australia face significant health gaps compared with the general population, with lower life expectancies, higher rates of death, and chronic illness occurring more often than in non-indigenous Australians. Cancer is the second largest contributor to the burden of disease with breast cancer being the most common invasive cancer diagnosed for females. Despite a lower breast cancer incidence compared with non-indigenous women, fatalities occur at an elevated rate and breast cancers have an earlier age of onset. For indigenous women there are also more advanced and distant tumours at diagnosis, fewer hospitalisations for breast cancer, and lower participation in breast screening. Concomitantly there are demographic, socio-economic and lifestyle factors associated with breast cancer risks that are heavily represented within Indigenous communities. The aim of this two-part narrative review is to examine the available evidence on breast cancer and its risk factors in Australian Indigenous women. Part One presents a summary of the latest incidence, survival and mortality data. Part Two presents the risk factors most strongly associated with breast cancer including age, place of residence, family risk, genetics, reproductive history, tobacco use, alcohol intake, physical activity, participation in screening and breast density. With increasing emphasis on personalized health care, a clear understanding of breast cancer incidence, survival, mortality, and causal agents within the Indigenous population is required if breast cancer prevention and management is to be optimized for Indigenous Australians. PMID:28545182

  17. Breast Cancer in Australian Indigenous Women: Incidence, Mortality, and Risk Factors

    PubMed

    Tapia, Kriscia A; Garvey, Gail; Mc Entee, Mark; Rickard, Mary; Brennan, Patrick

    2017-04-01

    The Indigenous people of Australia face significant health gaps compared with the general population, with lower life expectancies, higher rates of death, and chronic illness occurring more often than in non-indigenous Australians. Cancer is the second largest contributor to the burden of disease with breast cancer being the most common invasive cancer diagnosed for females. Despite a lower breast cancer incidence compared with non-indigenous women, fatalities occur at an elevated rate and breast cancers have an earlier age of onset. For indigenous women there are also more advanced and distant tumours at diagnosis, fewer hospitalisations for breast cancer, and lower participation in breast screening. Concomitantly there are demographic, socio-economic and lifestyle factors associated with breast cancer risks that are heavily represented within Indigenous communities. The aim of this two-part narrative review is to examine the available evidence on breast cancer and its risk factors in Australian Indigenous women. Part One presents a summary of the latest incidence, survival and mortality data. Part Two presents the risk factors most strongly associated with breast cancer including age, place of residence, family risk, genetics, reproductive history, tobacco use, alcohol intake, physical activity, participation in screening and breast density. With increasing emphasis on personalized health care, a clear understanding of breast cancer incidence, survival, mortality, and causal agents within the Indigenous population is required if breast cancer prevention and management is to be optimized for Indigenous Australians. Creative Commons Attribution License

  18. A review of tobacco interventions for Indigenous Australians.

    PubMed

    Ivers, Rowena G

    2003-01-01

    To conduct a review of interventions to reduce the harm resulting from tobacco use among Indigenous Australians and to discuss the likely effect of a range of tobacco interventions if conducted in this population. A systematic review of medical literature and an audit of information from 32 government departments, non-government organisations and indigenous health organisations, which was completed in March 2001. A number of small tobacco programs had been conducted. Only four tobacco interventions had been evaluated in indigenous communities: a trial of training health professionals in conducting a brief intervention for smoking cessation; a trial of a CD-ROM on tobacco for use with indigenous schoolchildren; a qualitative evaluation of the effect of a mainstream advertising campaign on Indigenous people; and a pilot study of smoke-free workplaces, evaluated by qualitative methods. None of these studies assessed smoking cessation as an outcome. Two of these studies were unable to conclusively show any effect of the interventions; training health professionals in delivering a brief intervention resulted in some changes to practice and the evaluation of the mainstream advertising campaign showed that following the campaign, knowledge about tobacco had increased. There was a major lack of research on and evaluation of tobacco interventions for Indigenous Australians. More research and evaluation is required to ensure that tobacco interventions are appropriate and effective for Indigenous people. It is time to cease chronicling the ill health of Indigenous Australians and time to ensure the availability of well-evaluated, effective tobacco programs.

  19. Gambling harms and gambling help-seeking amongst indigenous Australians.

    PubMed

    Hing, Nerilee; Breen, Helen; Gordon, Ashley; Russell, Alex

    2014-09-01

    This paper aimed to analyze the harms arising from gambling and gambling-related help-seeking behaviour within a large sample of Indigenous Australians. A self-selected sample of 1,259 Indigenous Australian adults completed a gambling survey at three Indigenous sports and cultural events, in several communities and online. Based on responses to the problem gambling severity index (PGSI), the proportions of the sample in the moderate risk and problem gambler groups were higher than those for the population of New South Wales. Many in our sample appeared to face higher risks with their gambling and experience severe gambling harms. From PGSI responses, notable harms include financial difficulties and feelings of guilt and regret about gambling. Further harms, including personal, relationship, family, community, legal and housing impacts, were shown to be significantly higher for problem gamblers than for the other PGSI groups. Most problem gamblers relied on family, extended family and friends for financial help or went without due to gambling losses. Nearly half the sample did not think they had a problem with gambling but the results show that the majority (57.7 %) faced some risk with their gambling. Of those who sought gambling help, family, extended family, friends and respected community members were consulted, demonstrating the reciprocal obligations underpinning traditional Aboriginal culture. The strength of this finding is that these people are potentially the greatest source of gambling help, but need knowledge and resources to provide that help effectively. Local Aboriginal services were preferred as the main sources of professional help for gambling-related problems.

  20. Anger in Australian Indigenous and Non-Indigenous Students

    ERIC Educational Resources Information Center

    Boman, Peter; Mergler, Amanda; Furlong, Michael; Caltabiano, Nerina

    2014-01-01

    This descriptive pilot study examined the cultural differences in the dimensions of self-reported anger in Indigenous and non-Indigenous (Caucasian) students aged 10-13 years in Far North Queensland, Australia. The Multidimensional School Anger Inventory-Revised (MSAI-R) (Boman, Curtis, Furlong, & Smith, 2006) was used to measure affective,…

  1. Anger in Australian Indigenous and Non-Indigenous Students

    ERIC Educational Resources Information Center

    Boman, Peter; Mergler, Amanda; Furlong, Michael; Caltabiano, Nerina

    2014-01-01

    This descriptive pilot study examined the cultural differences in the dimensions of self-reported anger in Indigenous and non-Indigenous (Caucasian) students aged 10-13 years in Far North Queensland, Australia. The Multidimensional School Anger Inventory-Revised (MSAI-R) (Boman, Curtis, Furlong, & Smith, 2006) was used to measure affective,…

  2. Closing the Gaps: competing estimates of Indigenous Australian life expectancy in the scientific literature

    PubMed Central

    Rosenstock, Amanda; Mukandi, Bryan; Zwi, Anthony B; Hill, Peter S

    2013-01-01

    Objective: Closing the gap in life expectancy between Indigenous and other Australians within a generation is central to national Indigenous reform policy (Closing the Gap). Over time, various methods of estimating Indigenous life expectancy and with that, the life expectancy gap, have been adopted with differing, albeit non-comparable results. We present data on the extent of the gap and elucidate the pattern of use and interpretations of the different estimates of the gap, between 2007 and 2012. Methods: An extensive search was conducted for all peer-reviewed health publications citing estimates of and/or discussing the life expectancy of Indigenous Australians, for the period 2007–2012. Results: Five predominant patterns of citation of the gap estimates were identified: 20 years, 17 years, 15–20 years, 13 years, and 11.5 years for males and 9.7 years for females. Some authors misinterpret the most recent estimates as reflecting improvement from the 17-year figure, rather than the result of different methods of estimation. Support for the direct methods used to calculate Indigenous life expectancy is indicated. Conclusions and Implications: A specific estimate of the life expectancy gap has not been established among stakeholders in Indigenous health. Agreement on the magnitude of the gap is arguably needed in order to evaluate strategies aimed at improving health outcomes for Indigenous Australians. Moreover, measuring progress towards ‘closing the gap’ depends on the availability of comparable estimates, using the same techniques of measurement to assess changes over time. PMID:23895479

  3. The Prevalence and Causes of Vision Loss in Indigenous and Non-Indigenous Australians: The National Eye Health Survey.

    PubMed

    Foreman, Joshua; Xie, Jing; Keel, Stuart; van Wijngaarden, Peter; Sandhu, Sukhpal Singh; Ang, Ghee Soon; Fan Gaskin, Jennifer; Crowston, Jonathan; Bourne, Rupert; Taylor, Hugh R; Dirani, Mohamed

    2017-07-06

    To conduct a nationwide survey on the prevalence and causes of vision loss in Indigenous and non-Indigenous Australians. Nationwide, cross-sectional, population-based survey. Indigenous Australians aged 40 years or older and non-Indigenous Australians aged 50 years and older. Multistage random-cluster sampling was used to select 3098 non-Indigenous Australians and 1738 Indigenous Australians from 30 sites across 5 remoteness strata (response rate of 71.5%). Sociodemographic and health data were collected using an interviewer-administered questionnaire. Trained examiners conducted standardized eye examinations, including visual acuity, perimetry, slit-lamp examination, intraocular pressure, and fundus photography. The prevalence and main causes of bilateral presenting vision loss (visual acuity <6/12 in the better eye) were determined, and risk factors were identified. Prevalence and main causes of vision loss. The overall prevalence of vision loss in Australia was 6.6% (95% confidence interval [CI], 5.4-7.8). The prevalence of vision loss was 11.2% (95% CI, 9.5-13.1) in Indigenous Australians and 6.5% (95% CI, 5.3-7.9) in non-Indigenous Australians. Vision loss was 2.8 times more prevalent in Indigenous Australians than in non-Indigenous Australians after age and gender adjustment (17.7%, 95% CI, 14.5-21.0 vs. 6.4%, 95% CI, 5.2-7.6, P < 0.001). In non-Indigenous Australians, the leading causes of vision loss were uncorrected refractive error (61.3%), cataract (13.2%), and age-related macular degeneration (10.3%). In Indigenous Australians, the leading causes of vision loss were uncorrected refractive error (60.8%), cataract (20.1%), and diabetic retinopathy (5.2%). In non-Indigenous Australians, increasing age (odds ratio [OR], 1.72 per decade) and having not had an eye examination within the past year (OR, 1.61) were risk factors for vision loss. Risk factors in Indigenous Australians included older age (OR, 1.61 per decade), remoteness (OR, 2.02), gender (OR, 0

  4. Culture and personality disorder: a focus on Indigenous Australians.

    PubMed

    Balaratnasingam, Sivasankaran; Janca, Aleksandar

    2017-01-01

    To examine the validity of concept and diagnosis of personality disorder in transcultural settings using Indigenous Australian people as an example. There are significant deficits in comparative research on personality disorders across cultures. There is also a dearth of information regarding Indigenous Australians, and cultural applicability and clinical utility of the diagnosis of personality disorder in this group. The concept of culture is generally ignored when making a diagnosis of personality disorder. A valid diagnosis should incorporate what would be considered understandable and adaptive behavior in a person's culture. In Indigenous Australian culture, making diagnosis of a personality disorder is complicated by historical trauma from colonization, disruption of kinship networks, and ongoing effects of poverty and social marginalization.

  5. Improving access to primary mental healthcare for Indigenous Australians.

    PubMed

    Reifels, Lennart; Bassilios, Bridget; Nicholas, Angela; Fletcher, Justine; King, Kylie; Ewen, Shaun; Pirkis, Jane

    2015-02-01

    To examine the uptake, population reach and outcomes of primary mental healthcare services provided to Indigenous Australians via the Access to Allied Psychological Services (ATAPS) program between 2003 and 2013, with particular reference to enhanced Indigenous ATAPS services introduced from 2010. Utilising ATAPS program data from a national minimum data set and comparative population data, we conducted descriptive analyses, regression analyses and t-tests to examine the uptake of ATAPS services, provider agency level predictors of service reach, and preliminary outcome data on consumer level outcomes. Between 2003 and 2013, 15,450 Indigenous client referrals were made that resulted in 55,134 ATAPS sessions. National Indigenous service volume more than doubled between 2010 and 2012, following the introduction of enhanced Indigenous ATAPS services. Non-Indigenous ATAPS service volume of primary care agencies was uniquely predictive of Indigenous service reach. Preliminary analysis of limited consumer outcome data indicated positive treatment gains and the need to enhance future outcome data collection. Concerted national efforts to enhance mainstream primary mental healthcare programs can result in significant gains in access to mental healthcare for Indigenous populations. © The Royal Australian and New Zealand College of Psychiatrists 2014.

  6. Offending, custody and opioid substitution therapy treatment utilisation among opioid-dependent people in contact with the criminal justice system: comparison of Indigenous and non-Indigenous Australians.

    PubMed

    Gisev, Natasa; Gibson, Amy; Larney, Sarah; Kimber, Jo; Williams, Megan; Clifford, Anton; Doyle, Michael; Burns, Lucy; Butler, Tony; Weatherburn, Don J; Degenhardt, Louisa

    2014-09-06

    Although Indigenous Australians are over-represented among heroin users, there has been no study examining offending, time in custody, and opioid substitution therapy (OST) treatment utilisation among Indigenous opioid-dependent (including heroin) people at the population level, nor comparing these to non-Indigenous opioid-dependent people. The aims of this study were to compare the nature and types of charges, time in custody and OST treatment utilisation between opioid-dependent Indigenous and non-Indigenous Australians in contact with the criminal justice system. This was a population-based, retrospective data linkage study using records of OST entrants in New South Wales, Australia (1985-2010), court appearances (1993-2011) and custody episodes (2000-2012). Charge rates per 100 person-years were compared between Indigenous and non-Indigenous Australians by sex, age and calendar year. Statistical comparisons were made for variables describing the cumulative time and percentage of follow-up time spent in custody, as well as characteristics of OST initiation and overall OST treatment utilisation. Of the 34,962 people in the cohort, 6,830 (19.5%) were Indigenous and 28,132 (80.5%) non-Indigenous. Among the 6,830 Indigenous people, 4,615 (67.6%) were male and 2,215 (32.4%) female. The median number of charges per person against Indigenous people (25, IQR 31) was significantly greater than non-Indigenous people (9, IQR 16) (p < 0.001). Overall, Indigenous people were charged with 33.2% of the total number of charges against the cohort and 44.0% of all violent offences. The median percentage of follow-up time that Indigenous males and females spent in custody was twice that of non-Indigenous males (21.7% vs. 10.1%, p < 0.001) and females (6.0% vs. 2.9%, p < 0.001). The percentage of Indigenous people who first commenced OST in prison (30.2%) was three times that of non-Indigenous people (11.2%) (p < 0.001). Indigenous males spent less time in OST compared to non-Indigenous

  7. Improving cross-cultural awareness. A review of Australian indigenous health for UK dentists.

    PubMed

    Popat, H; Dinnage, J

    2006-07-08

    The aim of this paper is to give an insight into the unique health issues faced by the indigenous population of Australia and their direct relationship to oral health, to help overseas dentists wishing to work in Australia to treat these groups of patients successfully and effectively. This applies equally to indigenous Australians living in remote Australia as well as to those living in general suburbia. A Medline search was carried out for any articles in dental and medical journals pertaining to Australian indigenous health and Australian oral health. Wherever possible, articles cited were obtained in full and where this was not possible, abstracts were obtained. Where no abstract was available, the article was not considered for evaluation. Articles were reviewed by a single observer and were subject to meeting inclusion criteria indicated in the review. Articles were divided into historical, diet, oral health and general health categories. Subjective descriptions were then made. The adoption of a 'westernised' diet by the Australian indigenous community has placed them as a high risk population for dental caries and periodontal disease. They also show some of the highest rates in the world for Non-Insulin Dependent Diabetes Mellitus (NIDDM) and Rheumatic Fever. The UK dentist should be aware of these health issues and their relationship to indigenous oral health before embarking on work within Australia.

  8. Regional Agreements, Higher Education and Representations of Indigenous Australian Reality (Why Wasn't I Taught That in School?).

    ERIC Educational Resources Information Center

    McConville, Greg

    2002-01-01

    Addresses the rights asserted by indigenous peoples and recognized by the United Nations and then considers Australian performance in higher education relative to these recognized rights. Presents some options aimed at making Indigenous education an enforceable right rather than a matter of administrative and political goodwill. (SLD)

  9. Correlates of physical activity among Australian Indigenous and non-Indigenous adolescents.

    PubMed

    Macniven, Rona; Hearn, Shane; Grunseit, Anne; Richards, Justin; Nutbeam, Don; Bauman, Adrian

    2016-12-13

    Physical inactivity is an important modifiable cause of the excess burden of disease among Indigenous Australians. We describe physical activity patterns and influencing factors, comparing Indigenous and non-Indigenous adolescents. Indigenous (n=359) and non-Indigenous (n=637) adolescents aged 13-17 years from disadvantaged New South Wales regions completed a health and lifestyle survey. Socio-demographic, social, psychosocial and health correlates of out of school physical activity (high vs. low) among the whole sample, and stratified by Indigenous status were examined. Only 21% of Indigenous and 28% of non-Indigenous adolescents achieved higher levels of physical activity. Overall, higher levels were associated with being male; sports team membership; lower levels of TV viewing time and having an employed mother. Indigenous girls were less active than boys (OR=0.36; 85%CI=0.24-0.54), as were those whose mothers were unemployed (OR=0.66; 95%CI=0.40-1.09). Among non-Indigenous adolescents, high levels of physical activity were associated with sports team membership (OR=2.28; 95%CI=1.39-3.74) and community involvement (OR=1.46; 95%CI=1.04-2.06). Physical activity levels were similarly low among disadvantaged Indigenous and non-Indigenous adolescents. Some influencing factors existed across the whole sample; others in stratification by Indigenous status. Implications for Public Health: Early and targeted, supportive approaches are necessary. Some apply to disadvantaged adolescents broadly; others are Indigenous or non-Indigenous specific. © 2016 Public Health Association of Australia.

  10. Oral Language, Representations and Mathematical Understanding: Indigenous Australian Students

    ERIC Educational Resources Information Center

    Warren, Elizabeth; Young, Janelle

    2008-01-01

    This paper explores the role of oral language and representations in negotiating mathematical understanding. The data were gathered from two Indigenous Australian classrooms in Northern Queensland. The first classroom, a Year 6/7 consisted of 15 students whose ages range from 10 years to 12 years with eight being Aboriginal, six from Torres Strait…

  11. Adaptive Behaviour Assessment System: Indigenous Australian Adaptation Model (ABAS: IAAM)

    ERIC Educational Resources Information Center

    du Plessis, Santie

    2015-01-01

    The study objectives were to develop, trial and evaluate a cross-cultural adaptation of the Adaptive Behavior Assessment System-Second Edition Teacher Form (ABAS-II TF) ages 5-21 for use with Indigenous Australian students ages 5-14. This study introduced a multiphase mixed-method design with semi-structured and informal interviews, school…

  12. Australian Indigenous Higher Education: Politics, Policy and Representation

    ERIC Educational Resources Information Center

    Wilson, Katie; Wilks, Judith

    2015-01-01

    The growth of Aboriginal and Torres Strait Islander participation in Australian higher education from 1959 to the present is notable statistically, but below population parity. Distinct patterns in government policy-making and programme development, inconsistent funding and political influences, together with Indigenous representation during the…

  13. Australian Indigenous Higher Education: Politics, Policy and Representation

    ERIC Educational Resources Information Center

    Wilson, Katie; Wilks, Judith

    2015-01-01

    The growth of Aboriginal and Torres Strait Islander participation in Australian higher education from 1959 to the present is notable statistically, but below population parity. Distinct patterns in government policy-making and programme development, inconsistent funding and political influences, together with Indigenous representation during the…

  14. Issues in English Language Assessment of Indigenous Australians

    ERIC Educational Resources Information Center

    Malcolm, Ian G.

    2011-01-01

    Although English is widely used by Indigenous Australians as the main means of communication, national testing has consistently raised questions as to the level of their English language and literacy achievement. This article examines contextual factors (historical, linguistic, cultural, socio-political and educational) which underlie this…

  15. Immunisation issues for Indigenous Australian children.

    PubMed

    Menzies, Robert; Andrews, Ross

    2014-10-01

    Vaccination has provided major benefits to the health of indigenous children in the face of continuing poorer socioeconomic conditions but several issues have been identified for improvement. While indigenous children are vaccinated at high rates for the standard schedule vaccines, vaccination is more commonly delayed. Coverage for 'targeted' vaccines is substantially lower, and data on coverage for indigenous adolescents is non-existent. Improved identification of indigenous clients by immunisation providers and the expansion of the childhood register are required. The progressive removal of early-acting Haemophilus influenzae type b vaccines from schedules for indigenous children because of an international shortage raises the risk of disease re-emergence and highlights the need for vigilant surveillance including carriage. The expanded use of existing vaccines (influenza) and early adoption of new vaccines (higher valency pneumococcal conjugates) are needed to maximise benefits, in particular the potential to impact on non-invasive disease such as otitis media and non-bacteraemic pneumonia that are so prevalent in indigenous children.

  16. The Contribution of Geography to Disparities in Preventable Hospitalisations between Indigenous and Non-Indigenous Australians

    PubMed Central

    Harrold, Timothy C.; Randall, Deborah A.; Falster, Michael O.; Lujic, Sanja; Jorm, Louisa R.

    2014-01-01

    Objectives To quantify the independent roles of geography and Indigenous status in explaining disparities in Potentially Preventable Hospital (PPH) admissions between Indigenous and non-Indigenous Australians. Design, setting and participants Analysis of linked hospital admission data for New South Wales (NSW), Australia, for the period July 1 2003 to June 30 2008. Main outcome measures Age-standardised admission rates, and rate ratios adjusted for age, sex and Statistical Local Area (SLA) of residence using multilevel models. Results PPH diagnoses accounted for 987,604 admissions in NSW over the study period, of which 3.7% were for Indigenous people. The age-standardised PPH admission rate was 76.5 and 27.3 per 1,000 for Indigenous and non-Indigenous people respectively. PPH admission rates in Indigenous people were 2.16 times higher than in non-Indigenous people of the same age group and sex who lived in the same SLA. The largest disparities in PPH admission rates were seen for diabetes complications, chronic obstructive pulmonary disease and rheumatic heart disease. Both rates of PPH admission in Indigenous people, and the disparity in rates between Indigenous than non-Indigenous people, varied significantly by SLA, with greater disparities seen in regional and remote areas than in major cities. Conclusions Higher rates of PPH admission among Indigenous people are not simply a function of their greater likelihood of living in rural and remote areas. The very considerable geographic variation in the disparity in rates of PPH admission between Indigenous and non-Indigenous people indicates that there is potential to reduce unwarranted variation by characterising outlying areas which contribute the most to this disparity. PMID:24859265

  17. The contribution of geography to disparities in preventable hospitalisations between indigenous and non-indigenous Australians.

    PubMed

    Harrold, Timothy C; Randall, Deborah A; Falster, Michael O; Lujic, Sanja; Jorm, Louisa R

    2014-01-01

    To quantify the independent roles of geography and Indigenous status in explaining disparities in Potentially Preventable Hospital (PPH) admissions between Indigenous and non-Indigenous Australians. Analysis of linked hospital admission data for New South Wales (NSW), Australia, for the period July 1 2003 to June 30 2008. Age-standardised admission rates, and rate ratios adjusted for age, sex and Statistical Local Area (SLA) of residence using multilevel models. PPH diagnoses accounted for 987,604 admissions in NSW over the study period, of which 3.7% were for Indigenous people. The age-standardised PPH admission rate was 76.5 and 27.3 per 1,000 for Indigenous and non-Indigenous people respectively. PPH admission rates in Indigenous people were 2.16 times higher than in non-Indigenous people of the same age group and sex who lived in the same SLA. The largest disparities in PPH admission rates were seen for diabetes complications, chronic obstructive pulmonary disease and rheumatic heart disease. Both rates of PPH admission in Indigenous people, and the disparity in rates between Indigenous than non-Indigenous people, varied significantly by SLA, with greater disparities seen in regional and remote areas than in major cities. Higher rates of PPH admission among Indigenous people are not simply a function of their greater likelihood of living in rural and remote areas. The very considerable geographic variation in the disparity in rates of PPH admission between Indigenous and non-Indigenous people indicates that there is potential to reduce unwarranted variation by characterising outlying areas which contribute the most to this disparity.

  18. Healthcare expenditure on Indigenous and non-Indigenous Australians at high risk of cardiovascular disease.

    PubMed

    Angell, Blake; Laba, Tracey-Lea; Lung, Tom; Brown, Alex; Eades, Sandra; Usherwood, Tim; Peiris, David; Billot, Laurent; Hillis, Graham; Webster, Ruth; Tonkin, Andrew; Reid, Christopher; Molanus, Barbara; Rafter, Natasha; Cass, Alan; Patel, Anushka; Jan, Stephen

    2017-06-23

    In spite of bearing a heavier burden of death, disease and disability, there is mixed evidence as to whether Indigenous Australians utilise more or less healthcare services than other Australians given their elevated risk level. This study analyses the Medicare expenditure and its predictors in a cohort of Indigenous and non-Indigenous Australians at high risk of cardiovascular disease. The healthcare expenditure of participants of the Kanyini Guidelines Adherence with the Polypill (GAP) pragmatic randomised controlled trial was modelled using linear regression methods. 535 adult (48% Indigenous) participants at high risk of cardiovascular disease (CVD) were recruited through 33 primary healthcare services (including 12 Aboriginal Medical Services) across Australia. There was no significant difference in the expenditure of Indigenous and non-Indigenous participants in non-remote areas following adjustment for individual characteristics. Indigenous individuals living in remote areas had lower MBS expenditure ($932 per year P < 0.001) than other individuals. MBS expenditure was found to increase with being aged over 65 years ($128, p = 0.013), being female ($472, p = 0.003), lower baseline reported quality of life ($102 per 0.1 decrement of utility p = 0.004) and a history of diabetes ($324, p = 0.001), gout ($631, p = 0.022), chronic obstructive pulmonary disease ($469, p = 0.019) and established CVD whether receiving guideline-recommended treatment prior to the trial ($452, p = 0.005) or not ($483, p = 0.04). When controlling for all other characteristics, morbidly obese patients had lower MBS expenditure than other individuals (-$887, p = 0.002). The findings suggest that for the majority of participants, once individuals are engaged with a primary care provider, factors other than whether they are Indigenous determine the level of Medicare expenditure for each person. Australian New Zealand Clinical Trials Registry ACTRN

  19. Estimating Cognitive Gaps between Indigenous and Non-Indigenous Australians

    ERIC Educational Resources Information Center

    Leigh, Andrew; Gong, Xiaodong

    2009-01-01

    Improving cognitive skills of young children has been suggested as a possible strategy for equalising opportunities across racial groups. Using data on four and five year olds in the Longitudinal Survey of Australian Children, we focus on two cognitive tests: the Peabody Picture Vocabulary Test, and the "Who Am I?" test. We estimate the…

  20. Strongyloides stercoralis: Systematic Review of Barriers to Controlling Strongyloidiasis for Australian Indigenous Communities

    PubMed Central

    Miller, Adrian; Smith, Michelle L.; Judd, Jenni A.; Speare, Rick

    2014-01-01

    Background Strongyloides stercoralis infects human hosts mainly through skin contact with contaminated soil. The result is strongyloidiasis, a parasitic disease, with a unique cycle of auto-infection causing a variety of symptoms and signs, with possible fatality from hyper-infection. Australian Indigenous community members, often living in rural and remote settings, are exposed to and infected with S. stercoralis. The aim of this review is to determine barriers to control of strongyloidiasis. The purpose is to contribute to the development of initiatives for prevention, early detection and effective treatment of strongyloidiasis. Methodology/Principle Findings Systematic search reviewing research published 2012 and earlier was conducted. Research articles discussing aspects of strongyloidiasis, context of infection and overall health in Indigenous Australians were reviewed. Based on the PRISMA statement, the systematic search of health databases, Academic Search Premier, Informit, Medline, PubMed, AMED, CINAHL, Health Source Nursing and Academic was conducted. Key search terms included strongyloidiasis, Indigenous, Australia, health, and community. 340 articles were retrieved with 16 original research articles published between 1969 and 2006 meeting criteria. Review found barriers to control defined across three key themes, (1) health status, (2) socioeconomic status, and (3) health care literacy and procedures. Conclusions/Significance This study identifies five points of intervention: (1) develop reporting protocols between health care system and communities; (2) test all Indigenous Australian patients, immunocompromised patients and those exposed to areas with S. stercoralis; (3) health professionals require detailed information on strongyloidiasis and potential for exposure to Indigenous Australian people; (4) to establish testing and treatment initiatives within communities; and (5) to measure and report prevalence rates specific to communities and to act

  1. Englishes and Literacies: Indigenous Australian Contexts.

    ERIC Educational Resources Information Center

    Tripcony, Penny

    Aboriginal and Torres Strait Islander students are not achieving the levels of English literacy required for satisfactory completion of Australia's school system. A national strategy has been launched to help Indigenous students achieve English literacy. However, there continues to be little recognition of the language and cultural needs of the…

  2. Can human rights discourse improve the health of Indigenous Australians?

    PubMed

    Gray, Natalie; Bailie, Ross

    2006-10-01

    Recognition of the poor health outcomes of Indigenous Australians has led to an interest in using human rights discourse as a framework for arguing that the Australian Government has an international obligation to improve Indigenous health. This paper explores two potential directions for human rights discourse in this context. The first is the development and elaboration of an asserted 'human right to health'. The second focuses on developing an understanding of the interactions between health and human rights, particularly the underlying social determinants of health, and thereby creating an advocacy framework that could be used to promote the inclusion of human rights considerations into the policy-making agenda. This paper argues that despite the symbolic force of human rights discourse, its capacity to improve the health of Indigenous Australians through international law is limited. This is so irrespective of whether recourse is made to a legal or moral imperative. The 'human right to health' is limited primarily by several barriers to its implementation, some of which are perpetuated by the current Australian Government itself. Although the potential advocacy capacity of human rights discourse is similarly limited by the hostility of the Government towards the notion of incorporating human rights considerations into its public policy decision making, it does provide a sustainable intellectual framework in which to consider the social and structural determinants of health and maintain these issues on the political agenda.

  3. Rheumatic fever in indigenous Australian children.

    PubMed

    Parnaby, Matthew G; Carapetis, Jonathan R

    2010-09-01

    Rheumatic heart disease (RHD) caused by acute rheumatic fever (ARF) is a disease of poverty, poor hygiene and poor living standards. RHD remains one of the major causes of childhood cardiac disease in developing nations. Within developed nations, there has been a dramatic drop in the prevalence of RHD because of the improvement of living standards, access to health care and the widespread availability of penicillin-based drugs. Despite a dramatic reduction of RHD in Australia overall, it continues to be a major contributor to childhood and adult cardiac disease in Indigenous communities throughout northern and central Australia. Currently, Australia has among the highest recorded rates of ARF and RHD in the world. The most accurate epidemiological data in Australia come from the Northern Territory's RHD control programme. In the Northern Territory, 92% of people with RHD are Indigenous, of whom 85% live in remote communities and towns. The incidence of ARF is highest in 5-14-year-olds, ranging from 150 to 380 per 100,000. Prevalence rates of RHD since 2000 have steadily increased to almost 2% of the Indigenous population in the Northern Territory, 3.2% in those aged 35-44 years. Living in remote communities is a contributing factor to ARF/RHD as well as a major barrier for adequate follow-up and care. Impediments to ARF/RHD control include the paucity of specialist services, rapid turnover of health staff, lack of knowledge of ARF/RHD by health staff, patients and communities, and the high mobility of the Indigenous population. Fortunately, the recently announced National Rheumatic Fever Strategy, comprising recurrent funding to the Northern Territory, Queensland and Western Australia for control programmes, as well as the creation of a National Coordination Unit suggest that RHD control in Australia is now a tangible prospect. For the disease to be eradicated, Australia will have to address the underpinning determinants of poverty, social and living conditions.

  4. Renal biopsy findings among Indigenous Australians: a nationwide review.

    PubMed

    Hoy, Wendy E; Samuel, Terence; Mott, Susan A; Kincaid-Smith, Priscilla S; Fogo, Agnes B; Dowling, John P; Hughson, Michael D; Sinniah, Rajalingam; Pugsley, David J; Kirubakaran, Meshach G; Douglas-Denton, Rebecca N; Bertram, John F

    2012-12-01

    Australia's Indigenous people have high rates of chronic kidney disease and kidney failure. To define renal disease among these people, we reviewed 643 renal biopsies on Indigenous people across Australia, and compared them with 249 biopsies of non-Indigenous patients. The intent was to reach a consensus on pathological findings and terminology, quantify glomerular size, and establish and compare regional biopsy profiles. The relative population-adjusted biopsy frequencies were 16.9, 6.6, and 1, respectively, for Aboriginal people living remotely/very remotely, for Torres Strait Islander people, and for non-remote-living Aboriginal people. Indigenous people more often had heavy proteinuria and renal failure at biopsy. No single condition defined the Indigenous biopsies and, where biopsy rates were high, all common conditions were in absolute excess. Indigenous people were more often diabetic than non-Indigenous people, but diabetic changes were still present in fewer than half their biopsies. Their biopsies also had higher rates of segmental sclerosis, post-infectious glomerulonephritis, and mixed morphologies. Among the great excess of biopsies in remote/very remote Aborigines, females predominated, with younger age at biopsy and larger mean glomerular volumes. Glomerulomegaly characterized biopsies with mesangiopathic changes only, with IgA deposition, or with diabetic change, and with focal segmental glomerulosclerosis (FSGS). This review reveals great variations in biopsy rates and findings among Indigenous Australians, and findings refute the prevailing dogma that most indigenous renal disease is due to diabetes. Glomerulomegaly in remote/very remote Aboriginal people is probably due to nephron deficiency, in part related to low birth weight, and probably contributes to the increased susceptibility to kidney disease and the predisposition to FSGS.

  5. Indigenous Australian Students' Participation Rates in Higher Education: Exploring the Role of Universities

    ERIC Educational Resources Information Center

    Pechenkina, Ekaterina; Kowal, Emma; Paradies, Yin

    2011-01-01

    Indigenous Australians are underrepresented and considerably disadvantaged within the Australian system of higher education. The various measures taken by Australian universities over the past decades have produced varying levels of success in increasing Indigenous participation and completion rates. In order to continue improving Indigenous…

  6. Comparison of outcomes in Australian indigenous and non-indigenous children and adolescents undergoing cardiac surgery.

    PubMed

    Justo, Edward R; Reeves, Benjamin M; Ware, Robert S; Johnson, Janelle C; Karl, Tom R; Alphonso, Nelson D; Justo, Robert N

    2017-06-01

    Population-based registries report 95% 5-year survival for children undergoing surgery for CHD. This study investigated paediatric cardiac surgical outcomes in the Australian indigenous population. All children who underwent cardiac surgery between May, 2008 and August, 2014 were studied. Demographic information including socio-economic status, diagnoses and co-morbidities, and treatment and outcome data were collected at time of surgery and at last follow-up. A total of 1528 children with a mean age 3.4±4.6 years were studied. Among them, 123 (8.1%) children were identified as indigenous, and 52.7% (62) of indigenous patients were in the lowest third of the socio-economic index compared with 28.2% (456) of non-indigenous patients (p⩽0.001). The indigenous sample had a significantly higher Comprehensive Aristotle Complexity score (indigenous 9.4±4.2 versus non-indigenous 8.7±3.9, p=0.04). The probability of having long-term follow-up did not differ between groups (indigenous 93.8% versus non-indigenous 95.6%, p=0.17). No difference was noted in 30-day mortality (indigenous 3.2% versus non-indigenous 1.4%, p=0.13). The 6-year survival for the entire cohort was 95.9%. The Cox survival analysis demonstrated higher 6-year mortality in the indigenous group - indigenous 8.1% versus non-indigenous 5.0%; hazard ratio (HR)=2.1; 95% confidence intervals (CI): 1.1, 4.2; p=0.03. Freedom from surgical re-intervention was 79%, and was not significantly associated with the indigenous status (HR=1.4; 95% CI: 0.9, 1.9; p=0.11). When long-term survival was adjusted for the Comprehensive Aristotle Complexity score, no difference in outcomes between the populations was demonstrated (HR=1.6; 95% CI: 0.8, 3.2; p=0.19). The indigenous population experienced higher late mortality. This apparent relationship is explained by increased patient complexity, which may reflect negative social and environmental factors.

  7. Experiencing and Writing Indigeneity, Rurality and Gender: Australian Reflections

    ERIC Educational Resources Information Center

    Ramzan, Bebe; Pini, Barbara; Bryant, Lia

    2009-01-01

    This paper has two interrelated aims. The first is to contribute to knowledge about rurality, gender and Indigeneity. This is undertaken by the first author, Bebe Ramzan, an Indigenous woman living in the Anangu Pitjantjatjara Yankunytjatjara (APY) Lands. Bebe shows similarities across rural and remote areas in Australia and details her knowledge…

  8. Oral health literacy comparisons between Indigenous Australians and American Indians.

    PubMed

    Jamieson, L M; Divaris, K; Parker, E J; Lee, J Y

    2013-03-01

    To compare oral health literacy (OHL) levels between two profoundly disadvantaged groups, Indigenous Australians and American Indians, and to explore differences in socio-demographic, dental service utilisation, self-reported oral health indicators, and oral health-related quality of life (OHRQoL) correlates of OHL among the above. OHL was measured using REALD-30 among convenience samples of 468 Indigenous Australians (aged 17-72 years, 63% female) and 254 female American Indians (aged 18-57 years). Covariates included socio-demography, dental utilisation, self-reported oral health status (OHS), perceived treatment needs and OHRQoL (prevalence, severity and extent of OHIP-14 'impacts'). Descriptive and bivariate methods were used for data presentation and analysis, and between-sample comparisons relied upon empirical contrasts of sample-specific estimates and correlation coefficients. OHL scores were: Indigenous Australians - 15.0 (95% CL=14.2, 15.8) and American Indians--13.7 (95% CL=13.1, 14.4). In both populations, OHL strongly correlated with educational attainment, and was lower among participants with infrequent dental attendance and perceived restorative treatment needs. A significant inverse association between OHL and prevalence of OHRQoL impacts was found among American Indians (rho=-0.23; 95% CL = -0.34, -0.12) but not among Indigenous Australians. Our findings indicate that OHL levels were comparable between the two groups and lower compared to previously reported estimates among diverse populations. Although the patterns of association of OHL with most examined domains of correlates were similar between the two groups, this study found evidence of heterogeneity in the domains of self-reported OHS and OHRQoL.

  9. Social and emotional wellbeing assessment instruments for use with Indigenous Australians: A critical review.

    PubMed

    Le Grande, M; Ski, C F; Thompson, D R; Scuffham, P; Kularatna, S; Jackson, A C; Brown, A

    2017-08-01

    There is growing recognition that in addition to universally recognised domains and indicators of wellbeing (such as population health and life expectancy), additional frameworks are required to fully explain and measure Indigenous wellbeing. In particular, Indigenous Australian wellbeing is largely determined by colonisation, historical trauma, grief, loss, and ongoing social marginalisation. Dominant mainstream indicators of wellbeing based on the biomedical model may therefore be inadequate and not entirely relevant in the Indigenous context. It is possible that "standard" wellbeing instruments fail to adequately assess indicators of health and wellbeing within societies that have a more holistic view of health. The aim of this critical review was to identify, document, and evaluate the use of social and emotional wellbeing measures within the Australian Indigenous community. The instruments were systematically described regarding their intrinsic properties (e.g., generic v. disease-specific, domains assessed, extent of cross-cultural adaptation and psychometric characteristics) and their purpose of utilisation in studies (e.g., study setting, intervention, clinical purpose or survey). We included 33 studies, in which 22 distinct instruments were used. Three major categories of social and emotional wellbeing instruments were identified: unmodified standard instruments (10), cross-culturally adapted standard instruments (6), and Indigenous developed measures (6). Recommendations are made for researchers and practitioners who assess social and emotional wellbeing in Indigenous Australians, which may also be applicable to other minority groups where a more holistic framework of wellbeing is applied. It is advised that standard instruments only be used if they have been subject to a formal cross-cultural adaptation process, and Indigenous developed measures continue to be developed, refined, and validated within a diverse range of research and clinical settings

  10. Academic Staff Perceptions of Factors Underlying Program Completion by Australian Indigenous Nursing Students

    ERIC Educational Resources Information Center

    West, Roianne; Usher, Kim; Foster, Kim; Stewart, Lee

    2014-01-01

    An increase in the number of Indigenous health professionals is one way to help reduce the poor health outcomes of Australia's Indigenous people. However, while Indigenous students are enrolling in Australian tertiary undergraduate nursing courses in increasing numbers, their completion rates remain lower than non-Indigenous students and many…

  11. Reporting rates of child sexual abuse in Indigenous communities in two Australian jurisdictions.

    PubMed

    Bailey, Cate; Powell, Martine; Brubacher, Sonja

    2017-06-01

    Child sexual abuse is a significant problem in many Indigenous communities; there is also evidence of chronic under-reporting of this crime. This study aimed to compare reporting rates between Indigenous and non-Indigenous cases of child sexual abuse across two Australian jurisdictions. Datasets comprising child sexual abuse reports from the Police Information Management Systems of the two jurisdictions were used to calculate reporting rates, and to compare case characteristics and case progression. Results indicated that the reporting rate for child sexual abuse of Indigenous children was between two and four times that of non-Indigenous children. In the Indigenous cases, the second jurisdiction had lower reporting rates than the first jurisdiction. Further analysis of the Indigenous cases only found that cases in the second jurisdiction were more severe, more likely to have a forensic interview, and more likely for the suspect to be charged, than in the first jurisdiction. However, there were no significant differences in conviction rates between the two jurisdictions. Differences observed in severity and case progression suggest that the lower reporting rates observed in the second jurisdiction may be due to comparatively high levels of under-reporting, rather than lower actual levels of child sexual abuse. In conclusion, reporting rates of child sexual abuse can be better understood when further information, such as case characteristics and case progression rates, is available. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Bridging the survival gap between Indigenous and non-Indigenous Australians: priorities for the road ahead.

    PubMed

    Brown, Alex

    2009-04-01

    The life-expectancy gap between Indigenous and non-Indigenous Australians remains one of contemporary Australia's most enduring health divides. The reduction of observed health outcome disparity between population groups based on measures of socioeconomic status, geography, or ethnicity stands as a key target of coordinated societal and health system reform. CVD remains the principal cause of death among all Australian population groups, including Aboriginal males and females, and is the primary contributor to the 17-year life-expectancy gap between Aboriginal and non-Aboriginal Australians. This paper discusses the challenges inherent, from the perspective of broader policy frameworks and health system reform, to reducing disparity between population groups within Australia, and outlines the opportunities for change that could contribute benefit to Aboriginal and mainstream Australians in regards to reducing the burden of CVD and related conditions. Further, through mapping adverse outcomes to acute cardiac events it seeks to discuss several key targets for reform that may serve to reduce health disparity between Aboriginal and non-Aboriginal Australians.

  13. Cancer survival in Indigenous and non-Indigenous Australian children: what is the difference?

    PubMed

    Valery, Patricia C; Youlden, Danny R; Baade, Peter D; Ward, Leisa J; Green, Adele C; Aitken, Joanne F

    2013-12-01

    This study assessed variation in childhood cancer survival by Indigenous status in Australia, and explored the effect of place of residence and socio-economic disadvantage on survival. All children diagnosed with cancer during 1997-2007 were identified through the Australian Pediatric Cancer Registry. Cox regression analysis was used to assess the adjusted differences in survival. Overall, 5-years survival was 75.0 % for Indigenous children (n = 196) and 82.3 % for non-Indigenous children (n = 6,376, p = 0.008). Compared to other children, Indigenous cases had 1.36 times the risk of dying within 5 years of diagnosis after adjustments for rurality of residence, socio-economic disadvantage, cancer diagnostic group, and year of diagnosis (95 % CI 1.01-1.82). No significant survival differential was found for leukemias or tumors of the central nervous system; Indigenous children were 1.83 times more likely (95 % CI 1.22-2.74) than other children to die within 5 years from 'other tumors' (e.g., lymphomas, neuroblastoma). Among children who lived in 'remote/very remote/outer regional' areas, and among children with a subgroup of 'other tumors' that were staged, being Indigenous significantly increased the likelihood of death (HR = 1.69, 95 % CI 1.10-2.59 and HR = 2.99, 95 % CI 1.35-6.62, respectively); no significant differences by Indigenous status were seen among children with stage data missing. Differences in place of residence, socio-economic disadvantage, and cancer diagnostic group only partially explain the survival disadvantage of Indigenous children. Other reasons underlying the disparities in childhood cancer outcomes by Indigenous status are yet to be determined, but may involve factors such as differences in treatment.

  14. Social Media and Mobile Apps for Health Promotion in Australian Indigenous Populations: Scoping Review

    PubMed Central

    Brusse, Carl; McAullay, Daniel; Dowden, Michelle

    2014-01-01

    Background Health promotion organizations are increasingly embracing social media technologies to engage end users in a more interactive way and to widely disseminate their messages with the aim of improving health outcomes. However, such technologies are still in their early stages of development and, thus, evidence of their efficacy is limited. Objective The study aimed to provide a current overview of the evidence surrounding consumer-use social media and mobile software apps for health promotion interventions, with a particular focus on the Australian context and on health promotion targeted toward an Indigenous audience. Specifically, our research questions were: (1) What is the peer-reviewed evidence of benefit for social media and mobile technologies used in health promotion, intervention, self-management, and health service delivery, with regard to smoking cessation, sexual health, and otitis media? and (2) What social media and mobile software have been used in Indigenous-focused health promotion interventions in Australia with respect to smoking cessation, sexual health, or otitis media, and what is the evidence of their effectiveness and benefit? Methods We conducted a scoping study of peer-reviewed evidence for the effectiveness of social media and mobile technologies in health promotion (globally) with respect to smoking cessation, sexual health, and otitis media. A scoping review was also conducted for Australian uses of social media to reach Indigenous Australians and mobile apps produced by Australian health bodies, again with respect to these three areas. Results The review identified 17 intervention studies and seven systematic reviews that met inclusion criteria, which showed limited evidence of benefit from these interventions. We also found five Australian projects with significant social media health components targeting the Indigenous Australian population for health promotion purposes, and four mobile software apps that met inclusion

  15. Social media and mobile apps for health promotion in Australian Indigenous populations: scoping review.

    PubMed

    Brusse, Carl; Gardner, Karen; McAullay, Daniel; Dowden, Michelle

    2014-12-10

    Health promotion organizations are increasingly embracing social media technologies to engage end users in a more interactive way and to widely disseminate their messages with the aim of improving health outcomes. However, such technologies are still in their early stages of development and, thus, evidence of their efficacy is limited. The study aimed to provide a current overview of the evidence surrounding consumer-use social media and mobile software apps for health promotion interventions, with a particular focus on the Australian context and on health promotion targeted toward an Indigenous audience. Specifically, our research questions were: (1) What is the peer-reviewed evidence of benefit for social media and mobile technologies used in health promotion, intervention, self-management, and health service delivery, with regard to smoking cessation, sexual health, and otitis media? and (2) What social media and mobile software have been used in Indigenous-focused health promotion interventions in Australia with respect to smoking cessation, sexual health, or otitis media, and what is the evidence of their effectiveness and benefit? We conducted a scoping study of peer-reviewed evidence for the effectiveness of social media and mobile technologies in health promotion (globally) with respect to smoking cessation, sexual health, and otitis media. A scoping review was also conducted for Australian uses of social media to reach Indigenous Australians and mobile apps produced by Australian health bodies, again with respect to these three areas. The review identified 17 intervention studies and seven systematic reviews that met inclusion criteria, which showed limited evidence of benefit from these interventions. We also found five Australian projects with significant social media health components targeting the Indigenous Australian population for health promotion purposes, and four mobile software apps that met inclusion criteria. No evidence of benefit was found

  16. Optimising meropenem dosing in critically ill Australian Indigenous patients with severe sepsis.

    PubMed

    Tsai, Danny; Stewart, Penelope; Goud, Rajendra; Gourley, Stephen; Hewagama, Saliya; Krishnaswamy, Sushena; Wallis, Steven C; Lipman, Jeffrey; Roberts, Jason A

    2016-11-01

    Currently there are no pharmacokinetic (PK) data to guide antibiotic dosing in critically ill Australian Indigenous patients with severe sepsis. This study aimed to determine whether the population pharmacokinetics of meropenem were different between critically ill Australian Indigenous and critically ill Caucasian patients. Serial plasma and urine samples as well as clinical and demographic data were collected over two dosing intervals from critically ill Australian Indigenous patients. Plasma meropenem concentrations were assayed by validated chromatography. Concentration-time data were analysed with data from a previous PK study in critically ill Caucasian patients using Pmetrics. The population PK model was subsequently used for Monte Carlo dosing simulations to describe optimal doses for these patients. Six Indigenous and five Caucasian subjects were included. A two-compartment model described the data adequately, with meropenem clearance and volume of distribution of the central compartment described by creatinine clearance (CLCr) and patient weight, respectively. Patient ethnicity was not supported as a covariate in the final model. Significant differences were observed for meropenem clearance between the Indigenous and Caucasian groups [median 11.0 (range 3.0-14.1) L/h vs. 17.4 (4.3-30.3) L/h, respectively; P <0.01]. Standard dosing regimens (1 g intravenous every 8 h as a 30-min infusion) consistently achieved target exposures at the minimum inhibitory concentration breakpoint in the absence of augmented renal clearance. No significant interethnic differences in meropenem pharmacokinetics between the Indigenous and Caucasian groups were detected and CLCr was found to be the strongest determinant of appropriate dosing regimens.

  17. Indigenous Australians' understandings regarding mental health and disorders.

    PubMed

    Ypinazar, Valmae A; Margolis, Stephen A; Haswell-Elkins, Melissa; Tsey, Komla

    2007-06-01

    The purpose of the present paper was to determine what is currently documented about Indigenous Australians' understandings of mental health and mental disorders through a meta-synthesis of peer-reviewed qualitative empirical research. The following databases were electronically searched (1995-April 2006): AOA-FT and AIATSIS, Blackwell Synergy, CINAHL and Pre CINHAL, Health source: nursing/academic edition, Medline, Proquest health and medical complete, PsycInfo, Science Direct, Synergy and HealthInfoNet. Eligible studies were those written in English and published in peer-reviewed journals, empirical studies that considered Indigenous people's understandings of mental health and provided details on methodology. Five articles from four qualitative studies met these criteria. Meta-ethnography was used to identify common themes emerging from the original studies. Reciprocal translation was used to synthesize the findings to provide new interpretations extending beyond those presented in the original studies. An overarching theme emerged from the synthesis: the dynamic interconnectedness between the multi-factorial components of life circumstances. Reciprocal translations and synthesis regarding Indigenous understandings of mental health and illness resulted in five themes: (i) culture and spirituality; (ii) family and community kinships; (iii) historical, social and economic factors; (iv) fear and education; and (v) loss. The application of a meta-synthesis to these qualitative studies provided a deeper insight into Indigenous people's understandings of mental health and illness. The importance of understanding Indigenous descriptions and perceptions of mental health issues is crucial to enable two-way understandings between Indigenous people's constructs of wellness and Western biomedical diagnostic labels and treatment pathways for mental disorders and mental health problems.

  18. Nursing students' perspectives of the health and healthcare issues of Australian Indigenous people.

    PubMed

    Hunt, Leanne; Ramjan, Lucie; McDonald, Glenda; Koch, Jane; Baird, David; Salamonson, Yenna

    2015-03-01

    Indigenous people are the most disadvantaged population within Australia with living conditions comparable to developing countries. The Bachelor of Nursing programme at the University of Western Sydney has embedded Indigenous health into the undergraduate teaching programme, with an expectation that students develop an awareness of Indigenous health and healthcare issues. To gain insight into students' perceptions of Indigenous people and whether the course learning and teaching strategies implemented improved students' learning outcomes and attitude towards Indigenous people and Indigenous health in Australia. A mixed methods prospective survey design was chosen. Students enrolled in the Indigenous health subject in 2013 were invited to complete pre- and post-subject surveys that contained closed- and open-ended questions. Students' socio-demographic data was collected at baseline, but the 'Attitude Toward Indigenous Australians' (ATIA) scale, and the 3-item Knowledge, Interest and Confidence to nursing Australian Indigenous peoples scale were administered at both pre- and post-subject surveys. 502 students completed the baseline survey and 249 students completed the follow-up survey. There was a statistically significant attitudinal change towards Indigenous Australians, measured by the ATIA scale, and participants' knowledge, intent to work with Indigenous Australians and confidence in caring for them increased significantly at follow-up. Based on the participants' responses to open-ended questions, four key themes emerged: a) understanding Indigenous history, culture and healthcare; b) development of cultural competence; c) enhanced respect for Indigenous Australians' culture and traditional practices; and d) enhanced awareness of the inherent disadvantages for Indigenous Australians in education and healthcare. There were no statistically significant socio-demographic group differences among those who commented on key themes. Addressing health inequalities for

  19. Lifetime influences for cannabis cessation in male incarcerated indigenous australians.

    PubMed

    Jacups, Susan; Rogerson, Bernadette

    2015-01-01

    Urban non-indigenous populations report life events (marriages, employment) as influences for self-initiated cannabis cessation. However, this hasn't been investigated in remote indigenous populations with different social paradigms. We investigate cannabis use, harms, and poly-substance misuse in 101 consenting male incarcerated indigenous Australians. Interviews applied quantitative and qualitative questions assessing demographic characteristics, criminal history, drug use, the Marijuana Problems Inventory (MPI), and cannabis-cessation influences. Comparisons used Chi Square, Analysis of Variance, and Nvivo software. Cannabis use groups (current users, ex-users, and never users) were demographically similar except that current users reported more juvenile legal problems, younger school departure, and lower school achievement (p < 0.05). Mean cannabis consumption was 12.3 cones/day. Incarceration and family responsibilities were the strongest cessation influences. Employment responsibilities and negative self-image were rarely cited as influences. High cannabis use, with its associated problems, is concerning. These identified influences indicate incarceration should be used for substance reduction programs, plus post-release follow-up. Community-based programs focusing on positive influences, such as family responsibilities and social cohesion, may be successful within indigenous populations with strong kinship responsibilities, rather than programs that focus solely on substance harms.

  20. Microbiology of otitis media in Indigenous Australian children: review.

    PubMed

    Jervis-Bardy, J; Carney, A S; Duguid, R; Leach, A J

    2017-07-01

    To review research addressing the polymicrobial aetiology of otitis media in Indigenous Australian children in order to identify research gaps and inform best practice in effective prevention strategies and therapeutic interventions. Literature review. Studies of aspirated middle-ear fluid represented a minor component of the literature reviewed. Most studies relied upon specimens from middle-ear discharge or the nasopharynx. Culture-based middle-ear discharge studies have found that non-typeable Haemophilus influenzae and Streptococcus pneumoniae predominate, with Moraxella catarrhalis, Staphylococcus aureus and Streptococcus pyogenes isolated in a lower proportion of samples. Alloiococcus otitidis was detected in a number of studies; however, its role in otitis media pathogenesis remains controversial. Nasopharyngeal colonisation is a risk factor for otitis media in Indigenous infants, and bacterial load of otopathogens in the nasopharynx can predict the ear state of Indigenous children. Most studies have used culture-based methods and specimens from middle-ear discharge or the nasopharynx. Findings from these studies are consistent with international literature, but reliance on culture may incorrectly characterise the microbiology of this condition. Advances in genomic technologies are now providing microbiologists with the ability to analyse the entire mixed bacterial communities ('microbiomes') of samples obtained from Indigenous children with otitis media.

  1. Unknown and Unknowing Possibilities: Transformative Learning, Social Justice, and Decolonising Pedagogy in Indigenous Australian Studies

    ERIC Educational Resources Information Center

    Mackinlay, Elizabeth; Barney, Katelyn

    2014-01-01

    For tertiary educators in Indigenous Australian Studies, decolonising discourse in education has held much promise to make space for the diversity of Indigenous Australian peoples to be included, accessed, understood, discussed, and engaged with in meaningful ways. However, Tuck and Yang provide us with the stark reminder that decolonisation…

  2. The Subjective Wellbeing of Indigenous Australian Adolescents: Validating the Personal Wellbeing Index-School Children

    ERIC Educational Resources Information Center

    Tomyn, Adrian J.; Norrish, Jacolyn M.; Cummins, Robert A.

    2013-01-01

    By almost all measures of objective life quality, Indigenous Australians are disadvantaged relative to the general population. However, no measures of their Subjective Wellbeing (SWB) have been published. This paper presents the first such data, norm-referenced to the general Australian population. A total of 519 Indigenous adolescents, aged…

  3. The Subjective Wellbeing of Indigenous Australian Adolescents: Validating the Personal Wellbeing Index-School Children

    ERIC Educational Resources Information Center

    Tomyn, Adrian J.; Norrish, Jacolyn M.; Cummins, Robert A.

    2013-01-01

    By almost all measures of objective life quality, Indigenous Australians are disadvantaged relative to the general population. However, no measures of their Subjective Wellbeing (SWB) have been published. This paper presents the first such data, norm-referenced to the general Australian population. A total of 519 Indigenous adolescents, aged…

  4. Unknown and Unknowing Possibilities: Transformative Learning, Social Justice, and Decolonising Pedagogy in Indigenous Australian Studies

    ERIC Educational Resources Information Center

    Mackinlay, Elizabeth; Barney, Katelyn

    2014-01-01

    For tertiary educators in Indigenous Australian Studies, decolonising discourse in education has held much promise to make space for the diversity of Indigenous Australian peoples to be included, accessed, understood, discussed, and engaged with in meaningful ways. However, Tuck and Yang provide us with the stark reminder that decolonisation…

  5. The Dissertation Examination: Identifying Critical Factors in the Success of Indigenous Australian Doctoral Students

    ERIC Educational Resources Information Center

    Harrison, Neil; Trudgett, Michelle; Page, Susan

    2017-01-01

    Indigenous Australians represent 2.2% of the working age population, yet account for only 1.4% of all university enrolments. In relation to higher degree research students, Indigenous Australians account for 1.1% of enrolments, but only 0.8% of all higher degree research completions. This paper reports on findings that emerged from an Australian…

  6. Effect of Dialect on Identification and Severity of Speech Impairment in Indigenous Australian Children

    ERIC Educational Resources Information Center

    Toohill, Bethany J.; Mcleod, Sharynne; Mccormack, Jane

    2012-01-01

    This study investigated the effect of dialectal difference on identification and rating of severity of speech impairment in children from Indigenous Australian backgrounds. The speech of 15 Indigenous Australian children identified by their parents/caregivers and teachers as having "difficulty talking and making speech sounds" was…

  7. Effect of Dialect on Identification and Severity of Speech Impairment in Indigenous Australian Children

    ERIC Educational Resources Information Center

    Toohill, Bethany J.; Mcleod, Sharynne; Mccormack, Jane

    2012-01-01

    This study investigated the effect of dialectal difference on identification and rating of severity of speech impairment in children from Indigenous Australian backgrounds. The speech of 15 Indigenous Australian children identified by their parents/caregivers and teachers as having "difficulty talking and making speech sounds" was…

  8. Performing Race, Culture, and Gender in an Indigenous Australian Women's Music and Dance Classroom

    ERIC Educational Resources Information Center

    Mackinlay, Elizabeth

    2003-01-01

    One perpetual concern among Indigenous Australian peoples is authenticity of voice. Who has the right to speak for, and to make representations about, the knowledges and cultures of Indigenous Australian peoples? Whose voice is more authentic, and what happens to these ways of knowing when they make the journey into mainstream Western academic…

  9. The Dissertation Examination: Identifying Critical Factors in the Success of Indigenous Australian Doctoral Students

    ERIC Educational Resources Information Center

    Harrison, Neil; Trudgett, Michelle; Page, Susan

    2017-01-01

    Indigenous Australians represent 2.2% of the working age population, yet account for only 1.4% of all university enrolments. In relation to higher degree research students, Indigenous Australians account for 1.1% of enrolments, but only 0.8% of all higher degree research completions. This paper reports on findings that emerged from an Australian…

  10. Seeing white: a critical exploration of occupational therapy with Indigenous Australian people.

    PubMed

    Nelson, Alison

    2007-01-01

    This paper aims to critique current occupational therapy practice and theory using Indigenous Australian people as a case example. Critical race theory will be used to help question the privileged position of an occupational therapist from a dominant Westernized culture. In-depth interviews were conducted with 15 (eight female and seven male) Indigenous Australian young people about their perspectives of health and physical activity. In addition, the Kawa model was used as an alternative data-collection tool and detailed field notes and researcher reflections were used as data sources. Preliminary analysis of data is used to illustrate the ways in which critical race theory can inform occupational therapy practitioners and researchers about the ways Indigenous Australian young people view their health. Methodological dilemmas are also discussed. The paper is based on preliminary findings and further analysis needs to continue. Cross-cultural research is inherently complex but can offer those from the dominant culture valuable insights into their taken-for-granted assumptions. Further use of critical race theory may prove useful as the occupational therapy profession continues to evolve its understanding of cultural safety.

  11. One to One and Face to Face: A Community Based Higher Education Support Strategy Retaining Indigenous Australian University Students

    ERIC Educational Resources Information Center

    Sharrock, Peta; Lockyer, Helen

    2008-01-01

    Literature relating to Indigenous Australian students in higher education highlights the need for improving the retention rates of Indigenous students in Australian universities. A cause for concern has been the increasing numbers of Indigenous Australian people experiencing lower progress and completion rates in comparison to non-Indigenous…

  12. 'I sang Amazing Grace for about 3 hours that day': understanding Indigenous Australians' experience of seclusion.

    PubMed

    Sambrano, Rachel; Cox, Leonie

    2013-12-01

    Research shows that Indigenous Australians' suspicion and fear of being 'locked up' may influence mental health service avoidance. Given this, the aim of this study was to explore, by qualitative analysis of in-depth interviews (n = 3), how three Indigenous people experienced the controversial practice of seclusion. Hans-Georg Gadamer's phenomenology guided analysis of the material, and allowed narrated experiences to be understood within their cultural and historical context. Participants viewed seclusion negatively: police involvement in psychiatric care; perceptions of being punished and powerless; occasions of extreme use of force; and lack of care were prominent themes throughout the interviews. While power imbalances inherent in seclusion are problematic for all mental health clients, the distinguishing factor in the Indigenous clients' experience is that seclusion is continuous with the discriminatory and degrading treatment by governments, police, and health services that many Indigenous people have experienced since colonization. The participants' experiences echoed Goffman's findings that institutional practices act to degrade and dehumanize clients whose resulting conformity eases the work of nursing staff. While some nurses perceive that seclusion reduces clients' agitation, one must ask at what cost to clients' dignity, humanity, and basic human rights. © 2013 The Authors; International Journal of Mental Health Nursing © 2013 Australian College of Mental Health Nurses Inc.

  13. Media Influences on Body Image and Disordered Eating among Indigenous Adolescent Australians

    ERIC Educational Resources Information Center

    McCabe, Marita P.; Ricciardelli, Lina; Mellor, David; Ball, Kylie

    2005-01-01

    There has been no previous investigation of body image concerns and body change strategies among indigenous Australians. This study was designed to investigate the level of body satisfaction, body change strategies, and perceived media messages about body change strategies among 50 indigenous (25 males, 25 females) and 50 non-indigenous (25 males,…

  14. Risk and Protective Factors Associated with Gambling Consequences for Indigenous Australians in North Queensland

    ERIC Educational Resources Information Center

    Breen, Helen M.

    2012-01-01

    The purpose of this paper was to examine risk and protective factors associated with the consequences of card gambling and commercial gambling for Indigenous Australians in north Queensland. With Indigenous Elders' approval and using qualitative methodology, semi-structured interviews were conducted with 60 Indigenous and 48 non-Indigenous…

  15. Risk and Protective Factors Associated with Gambling Consequences for Indigenous Australians in North Queensland

    ERIC Educational Resources Information Center

    Breen, Helen M.

    2012-01-01

    The purpose of this paper was to examine risk and protective factors associated with the consequences of card gambling and commercial gambling for Indigenous Australians in north Queensland. With Indigenous Elders' approval and using qualitative methodology, semi-structured interviews were conducted with 60 Indigenous and 48 non-Indigenous…

  16. Self-Concepts and Educational Outcomes of Indigenous Australian Students in Urban and Rural School Settings

    ERIC Educational Resources Information Center

    Yeung, Alexander Seeshing; Craven, Rhonda G.; Ali, Jinnat

    2013-01-01

    Indigenous Australians have been known to be disadvantaged in many ways although higher art and physical self-concepts have been reported with Indigenous samples. Given recent research demonstrating the reciprocal effects of achievement and self-concept in academic domains, Indigenous students may experience further disadvantages in both academic…

  17. Supervision Provided to Indigenous Australian Doctoral Students: A Black and White Issue

    ERIC Educational Resources Information Center

    Trudgett, Michelle

    2014-01-01

    The number of Indigenous Australians completing doctoral qualifications is disparately below their non-Indigenous contemporaries. Whilst there has been a steady increase in Indigenous completions in recent years, significant work remains to redress the imbalance. Supervision has been identified as a primary influencer of the likely success of…

  18. Supervision Provided to Indigenous Australian Doctoral Students: A Black and White Issue

    ERIC Educational Resources Information Center

    Trudgett, Michelle

    2014-01-01

    The number of Indigenous Australians completing doctoral qualifications is disparately below their non-Indigenous contemporaries. Whilst there has been a steady increase in Indigenous completions in recent years, significant work remains to redress the imbalance. Supervision has been identified as a primary influencer of the likely success of…

  19. Indigenous Australian Women's Leadership: Stayin' Strong against the Post-Colonial Tide

    ERIC Educational Resources Information Center

    White, Nereda

    2010-01-01

    In this article, I reflect on my experiences as an Indigenous woman researcher coming to grips with colonialism through a post-colonialism lens. I also discuss a study which examines the leadership journey of a group of Indigenous Australian women. The research, which includes an auto-ethnographic approach, was guided by an Indigenous worldview…

  20. Haemophilus influenzae serotype a septic arthritis in an immunized central Australian indigenous child.

    PubMed

    Fischer, Nicholas J

    2014-04-01

    This article describes a notable case of Haemophilus influenzae serotype a (Hia) septic arthritis in an immunized central Australian indigenous child. Since the widespread immunization for H. influenzae serotype b (Hib) in many indigenous peoples worldwide, there has been an increase in reported cases of Hia, postulating that this serotype is taking over the niche that Hib once occupied in indigenous populations.

  1. Reflections on Teaching a First-Year Indigenous Australian Studies Subject

    ERIC Educational Resources Information Center

    Heckenberg, Robyn; Gunstone, Andrew

    2013-01-01

    Robyn Heckenberg and Andrew Gunstone team taught a first-year subject in Indigenous Australian Studies at Monash University for eight years. The significant majority of students undertaking this subject are non-Indigenous students who are studying the subject as an elective rather than as part of an Indigenous Studies course. In this paper, we…

  2. Media Influences on Body Image and Disordered Eating among Indigenous Adolescent Australians

    ERIC Educational Resources Information Center

    McCabe, Marita P.; Ricciardelli, Lina; Mellor, David; Ball, Kylie

    2005-01-01

    There has been no previous investigation of body image concerns and body change strategies among indigenous Australians. This study was designed to investigate the level of body satisfaction, body change strategies, and perceived media messages about body change strategies among 50 indigenous (25 males, 25 females) and 50 non-indigenous (25 males,…

  3. Self-Concepts and Educational Outcomes of Indigenous Australian Students in Urban and Rural School Settings

    ERIC Educational Resources Information Center

    Yeung, Alexander Seeshing; Craven, Rhonda G.; Ali, Jinnat

    2013-01-01

    Indigenous Australians have been known to be disadvantaged in many ways although higher art and physical self-concepts have been reported with Indigenous samples. Given recent research demonstrating the reciprocal effects of achievement and self-concept in academic domains, Indigenous students may experience further disadvantages in both academic…

  4. Indigenous Australian Women's Leadership: Stayin' Strong against the Post-Colonial Tide

    ERIC Educational Resources Information Center

    White, Nereda

    2010-01-01

    In this article, I reflect on my experiences as an Indigenous woman researcher coming to grips with colonialism through a post-colonialism lens. I also discuss a study which examines the leadership journey of a group of Indigenous Australian women. The research, which includes an auto-ethnographic approach, was guided by an Indigenous worldview…

  5. Priority setting in Indigenous health: assessing priority setting process and criteria that should guide the health system to improve Indigenous Australian health

    PubMed Central

    2014-01-01

    Introduction The health of Indigenous Australians is worse than that of other Australians. Most of the determinants of health are preventable and the poor health outcomes are inequitable. The Australian Government recently pledged to close that health gap. One possible way is to improve the priority setting process to ensure transparency and the use of evidence such as epidemiology, equity and economic evaluation. The purpose of this research was to elicit the perceptions of Indigenous and non-Indigenous decision-makers on several issues related to priority setting in Indigenous-specific health care services. Specifically, we aimed to: 1. identify the criteria used to set priorities in Indigenous-specific health care services; 2. determine the level of uptake of economic evaluation evidence by decision-makers and how to improve its uptake; and 3. identify how the priority setting process can be improved from the perspective of decision-makers. Methods We used a paper survey instrument, adapted from Mitton and colleagues’ work, and a face-to-face interview approach to elicit decision-makers’ perceptions in Indigenous-specific health care in Victoria, Australia. We used mixed methods to analyse data from the survey. Responses were summarised using descriptive statistics and content analysis. Results were reported as numbers and percentages. Results The size of the health burden; sustainability and acceptability of interventions; historical trends/patterns; and efficiency are key criteria for making choices in Indigenous health in Victoria. There is a need for an explicit priority setting approach, which is systematic, and is able to use available data/evidence, such as economic evaluation evidence. The involvement of Indigenous Australians in the process would potentially make the process acceptable. Conclusions An economic approach to priority setting is a potentially acceptable and useful tool for Aboriginal Community Controlled Health Services (ACCHS). It has

  6. Developing Tests for the Assessment of Traditional Language Skill: A Case Study in an Indigenous Australian Community

    ERIC Educational Resources Information Center

    Loakes, Deborah; Moses, Karin; Simpson, Jane; Wigglesworth, Gillian

    2012-01-01

    This article reports on the development and piloting of a vocabulary recognition test designed for Indigenous Australian children. The research is both application oriented and development oriented. The aims of the article are to determine how well the test is used as a test instrument and the extent to which children recognize vocabulary items in…

  7. Developing Tests for the Assessment of Traditional Language Skill: A Case Study in an Indigenous Australian Community

    ERIC Educational Resources Information Center

    Loakes, Deborah; Moses, Karin; Simpson, Jane; Wigglesworth, Gillian

    2012-01-01

    This article reports on the development and piloting of a vocabulary recognition test designed for Indigenous Australian children. The research is both application oriented and development oriented. The aims of the article are to determine how well the test is used as a test instrument and the extent to which children recognize vocabulary items in…

  8. Starting to smoke: a qualitative study of the experiences of Australian indigenous youth.

    PubMed

    Johnston, Vanessa; Westphal, Darren W; Earnshaw, Cyan; Thomas, David P

    2012-11-10

    Adult smoking has its roots in adolescence. If individuals do not initiate smoking during this period it is unlikely they ever will. In high income countries, smoking rates among Indigenous youth are disproportionately high. However, despite a wealth of literature in other populations, there is less evidence on the determinants of smoking initiation among Indigenous youth. The aim of this study was to explore the determinants of smoking among Australian Indigenous young people with a particular emphasis on the social and cultural processes that underlie tobacco use patterns among this group. This project was undertaken in northern Australia. We undertook group interviews with 65 participants and individual in-depth interviews with 11 youth aged 13-20 years led by trained youth 'peer researchers.' We also used visual methods (photo-elicitation) with individual interviewees to investigate the social context in which young people do or do not smoke. Included in the sample were a smaller number of non-Indigenous youth to explore any significant differences between ethnic groups in determinants of early smoking experiences. The theory of triadic influence, an ecological model of health behaviour, was used as an organising theory for analysis. Family and peer influences play a central role in smoking uptake among Indigenous youth. Social influences to smoke are similar between Indigenous and non-Indigenous youth but are more pervasive (especially in the family domain) among Indigenous youth. While Indigenous youth report high levels of exposure to smoking role models and smoking socialisation practices among their family and social networks, this study provides some indication of a progressive denormalisation of smoking among some Indigenous youth. Future initiatives aimed at preventing smoking uptake in this population need to focus on changing social normative beliefs around smoking, both at a population level and within young peoples' immediate social environment

  9. Colorectal cancer screening knowledge, attitudes and behavioural intention among Indigenous Western Australians

    PubMed Central

    2012-01-01

    Background Indigenous Australians are significantly less likely to participate in colorectal cancer (CRC) screening compared to non-Indigenous people. This study aimed to identify important factors influencing the decision to undertake screening using Faecal Occult Blood Testing (FOBT) among Indigenous Australians. Very little evidence exists to guide interventions and programmatic approaches for facilitating screening uptake in this population in order to reduce the disparity in colorectal cancer outcomes. Methods Interviewer-administered surveys were carried out with a convenience sample (n = 93) of Indigenous Western Australians between November 2009-March 2010 to assess knowledge, awareness, attitudes and behavioural intent in regard to CRC and CRC screening. Results Awareness and knowledge of CRC and screening were low, although both were significantly associated with exposure to media advertising (p = 0.008; p < 0.0001). Nearly two-thirds (63%; 58/92) of respondents reported intending to participate in screening, while a greater proportion (84%; 77/92) said they would participate on a doctor’s recommendation. Multivariate analysis with logistic regression demonstrated that independent predictors of screening intention were, greater perceived self-efficacy (OR = 19.8, 95% CI = 5.5-71.8), a history of cancer screening participation (OR = 6.8, 95% CI = 2.0-23.3) and being aged 45 years or more (OR = 4.5, 95% CI = 1.2-16.5). A higher CRC knowledge score (medium vs. low: OR = 9.9, 95% CI = 2.4-41.3; high vs. low: 13.6, 95% CI = 3.4-54.0) and being married or in a de-facto relationship (OR = 6.9, 95% CI = 2.1-22.5) were also identified as predictors of intention to screen with FOBT. Conclusions Improving CRC related knowledge and confidence to carry out the FOBT self-screening test through education and greater promotion of screening has the potential to enhance Indigenous participation in CRC screening

  10. Better Indigenous Risk stratification for Cardiac Health study (BIRCH) protocol: rationale and design of a cross-sectional and prospective cohort study to identify novel cardiovascular risk indicators in Aboriginal Australian and Torres Strait Islander adults.

    PubMed

    Rémond, Marc G W; Stewart, Simon; Carrington, Melinda J; Marwick, Thomas H; Kingwell, Bronwyn A; Meikle, Peter; O'Brien, Darren; Marshall, Nathaniel S; Maguire, Graeme P

    2017-08-23

    Of the estimated 10-11 year life expectancy gap between Indigenous (Aboriginal and Torres Strait Islander people) and non-Indigenous Australians, approximately one quarter is attributable to cardiovascular disease (CVD). Risk prediction of CVD is imperfect, but particularly limited for Indigenous Australians. The BIRCH (Better Indigenous Risk stratification for Cardiac Health) project aims to identify and assess existing and novel markers of early disease and risk in Indigenous Australians to optimise health outcomes in this disadvantaged population. It further aims to determine whether these markers are relevant in non-Indigenous Australians. BIRCH is a cross-sectional and prospective cohort study of Indigenous and non-Indigenous Australian adults (≥ 18 years) living in remote, regional and urban locations. Participants will be assessed for CVD risk factors, left ventricular mass and strain via echocardiography, sleep disordered breathing and quality via home-based polysomnography or actigraphy respectively, and plasma lipidomic profiles via mass spectrometry. Outcome data will comprise CVD events and death over a period of five years. Results of BIRCH may increase understanding regarding the factors underlying the increased burden of CVD in Indigenous Australians in this setting. Further, it may identify novel markers of early disease and risk to inform the development of more accurate prediction equations. Better identification of at-risk individuals will promote more effective primary and secondary preventive initiatives to reduce Indigenous Australian health disadvantage.

  11. Drug and alcohol use and treatment for Australian Indigenous and non-Indigenous prisoners: demand reduction strategies.

    PubMed

    Dolan, Kate; Rodas, Ana; Bode, Adam

    2015-01-01

    The purpose of this paper is to compare the use of drugs and alcohol by Indigenous and non-Indigenous prisoners and examine relevant treatment in Australian prisons. Prison authorities were surveyed about alcohol and drug use by prisoners prior to and during imprisonment and drug and alcohol treatment programs in prison. The literature was review for information on alcohol and drug use and treatment in Australian prisons. In 2009, over 80 percent of Indigenous and non-Indigenous inmates smoked. Prior to imprisonment, many Indigenous and non-Indigenous inmates drank alcohol at risky levels (65 vs 47 percent) and used illicit drugs (over 70 percent for both groups). Reports of using heroin (15 vs 21 percent), ATS (21 vs 33 percent), cannabis (59 vs 50 percent) and injecting (61 vs 53 percent) were similarly high for both groups. Prison-based programs included detoxification, Opioid Substitution Treatment, counselling and drug free units, but access was limited especially among Indigenous prisoners. Drug and alcohol use was a significant issue in Australian prisons. Prisoners were over five times more likely than the general population to have a substance use disorder. Imprisonment provides an important opportunity for rehabilitation for offenders. This opportunity is especially relevant to Indigenous prisoners who were more likely to use health services when in prison than in the community and given their vast over representations in prison populations. Given the effectiveness of treatment in reducing re-offending rates, it is important to expand drug treatment and especially culturally appropriate treatment programs for Indigenous inmates. Very little is known about Indigenous specific drug and alcohol programs in Australian prisons.

  12. Pharmacokinetics of Piperacillin in Critically Ill Australian Indigenous Patients with Severe Sepsis.

    PubMed

    Tsai, Danny; Stewart, Penelope; Goud, Rajendra; Gourley, Stephen; Hewagama, Saliya; Krishnaswamy, Sushena; Wallis, Steven C; Lipman, Jeffrey; Roberts, Jason A

    2016-12-01

    There are no available pharmacokinetic data to guide piperacillin dosing in critically ill Australian Indigenous patients despite numerous reported physiological differences. This study aimed to describe the population pharmacokinetics of piperacillin in critically ill Australian Indigenous patients with severe sepsis. A population pharmacokinetic study of Indigenous patients with severe sepsis was conducted in a remote hospital intensive care unit. Plasma samples were collected over two dosing intervals and assayed by validated chromatography. Population pharmacokinetic modeling was conducted using Pmetrics. Nine patients were recruited, and a two-compartment model adequately described the data. The piperacillin clearance (CL), volume of distribution of the central compartment (Vc), and distribution rate constants from the central to the peripheral compartment and from the peripheral to the central compartment were 5.6 ± 3.2 liters/h, 14.5 ± 6.6 liters, 1.5 ± 0.4 h(-1), and 1.8 ± 0.9 h(-1), respectively, where CL and Vc were found to be described by creatinine clearance (CLCR) and total body weight, respectively. In this patient population, piperacillin demonstrated high interindividual pharmacokinetic variability. CLCR was found to be the most important determinant of piperacillin pharmacokinetics.

  13. Potential effectiveness of specific anti-smoking mass media advertisements among Australian Indigenous smokers.

    PubMed

    Stewart, Harold S; Bowden, Jacqueline A; Bayly, Megan C; Sharplin, Greg R; Durkin, Sarah J; Miller, Caroline L; Givans, Sharon E; Warne, Charles D; Wakefield, Melanie A

    2011-12-01

    Aboriginal and Torres Strait Islander Australians (Indigenous Australians) have more than twice the smoking prevalence of non-Indigenous Australians. Anti-smoking campaigns have demonstrated success in the general population but little is known about their impact among Indigenous people. A total of 143 Indigenous and a comparison group of 156 non-Indigenous smokers from South Australia were shown 10 anti-smoking advertisements representing a range of advertisements typically aired in Australia. Participants rated advertisements on a five-point Likert scale assessing factors including message acceptance and personalized effectiveness. On average, Indigenous people rated the mainstream advertisements higher than non-Indigenous people and were more likely to report that they provided new information. Advertisements with strong graphic imagery depicting the health effects of smoking were rated highest by Indigenous smokers. Advertisements featuring real people describing the serious health consequences of smoking received mixed responses. Those featuring an ill person were rated higher by Indigenous people than those featuring the family of the person affected by a smoking-related disease. With limited Indigenous-specific messages available and given the finite resources of most public health campaigns, exposure to mainstream strong graphic and emotive first-person narratives about the health effects of smoking are likely to be highly motivating for Indigenous smokers.

  14. Inequalities in Tooth Decay in Australian Children by Neighbourhood Characteristics and Indigenous Status.

    PubMed

    Lalloo, Ratilal; Jamieson, Lisa M; Ha, Diep; Luzzi, Liana

    2016-02-01

    Tooth decay is related to poverty, measured at individual and neighbourhood levels. It is however uncertain if living in an advantaged neighbourhood reduces tooth decay similarly in Australian Indigenous and non-Indigenous children. This study describes tooth decay by neighbourhood characteristics and Indigenous status, and examines inequalities by Indigenous status. In deciduous dentition the percentage of children with tooth decay and untreated decay decreased on average 26% and 20% respectively in the non-Indigenous sample from poor to affluent neighbourhoods. In Indigenous children tooth decay and untreated decay decreased on average 6% and 8%, respectively, from poor to affluent neighbourhoods. While all children from affluent areas had less tooth decay, the gap between non-Indigenous and Indigenous children remained significant across neighbourhood characteristics. This suggests that both universal and targeted prevention programs should be considered for all Indigenous children irrespective of where they live.

  15. Inequalities in Tooth Decay in Australian Children by Neighbourhood Characteristics and Indigenous Status.

    PubMed

    Lalloo, Ratilal; Jamieson, Lisa M; Ha, Diep; Luzzi, Liana

    2016-01-01

    Tooth decay is related to poverty, measured at individual and neighbourhood levels. It is however uncertain if living in an advantaged neighbourhood reduces tooth decay similarly in Australian Indigenous and non-Indigenous children. This study describes tooth decay by neighbourhood characteristics and Indigenous status, and examines inequalities by Indigenous status. In deciduous dentition the percentage of children with tooth decay and untreated decay decreased on average 26% and 20% respectively in the non-Indigenous sample from poor to affluent neighbourhoods. In Indigenous children tooth decay and untreated decay decreased on average 6% and 8%, respectively, from poor to affluent neighbourhoods. While all children from affluent areas had less tooth decay, the gap between non-Indigenous and Indigenous children remained significant across neighbourhood characteristics. This suggests that both universal and targeted prevention programs should be considered for all Indigenous children irrespective of where they live.

  16. Sleep and academic performance in Indigenous Australian children from a remote community: an exploratory study.

    PubMed

    Cooper, Patrick; Kohler, Mark; Blunden, Sarah

    2012-02-01

    Disruptions to sleep in childhood are associated with poor behaviour and deficits in academic performance and executive function. Although academic performance of indigenous children from remote communities in Australia is documented as well below that of non-indigenous children, the extent of sleep disruption and its contribution to academic performance among this population has not been assessed. This pilot study aimed to objectively assess the sleep of remote indigenous children and the association between sleep disruption and both academic performance and executive function. Twenty-one children from a remote Australian indigenous community aged 6-13 years wore actigraphy for two consecutive nights, reported subjective sleepiness, and were objectively assessed for academic performance (Wechsler Individual Achievement Test, 2nd Edition) and executive function (NEuroloPSYcological Assessment-II). Results show marked reduction in sleep time, sleep fragmentation, academic performance and auditory attention compared with non-indigenous norms. Sleep duration was not associated with performance, possibly because of reduced sleep and performance observed across the entire group. Sleep fragmentation was associated with reduced reading and numerical skills (P < 0.05). The sleep of indigenous children in remote communities is an important area of future inquiry, and our initial findings of poor sleep and an association between sleep disruption and academic performance may have important implications for intervention strategies aimed at 'closing the gap'. Further studies should assess a broader range of demographic, social and economic factors to better understand the associations reported here and guide future intervention. © 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  17. Engaging Indigenous Students in the Australian SKA Project

    NASA Astrophysics Data System (ADS)

    Hollow, Robert; Harvey-Smith, Lisa; Brooks, Kate; Boddington, Leonie

    2015-08-01

    The Murchison region of Western Australia is the site of the Murchison Radio-astronomy Observatory (MRO) that includes the Australian SKA Pathfinder (ASKAP) and the Murchison Widefield Array (MWA) and soon the SKA. This is also traditional land of the Wajarri Yamatji people. As part of its development in the region CSIRO has extensive engagement with the Wajarri Yamatji people. This includes educational, cultural, training and commercial opportunities. We outline the Indigenous Land Use Agreement (ILUA) between the Wajarri Yamatji and CSIRO, focusing on the educational and training aspects. Starting with "Wildflowers in the Sky" program in 2006 we have made extensive tours to all schools in the region providing teacher training and student engagement. More recently we have implemented a program where CSIRO Astronomy and Space Science staff visit the Pia Wadjarri Remote Community School, the closest school to the MRO, to mentor students. Students and staff from the school visit the MRO annually to explore the ASKAP telescope and see what is involved in its operation. An educational resource about ASKAP and astronomy that also incorporates traditional sky stories and local ecology is being trialled and developed. A cadetship and trainee program supporting Indigenous students has been implemented with the goal of providing employment opportunities and work skills in a diverse range of areas.

  18. Indigenous Australian dental health: a brief review of caries experience.

    PubMed

    Martin-Iverson, N; Pacza, T; Phatouros, A; Tennant, M

    2000-03-01

    The indigenous community in Australia is an at risk population for oral diseases such as dental caries. The majority of communities are isolated and dental services in these areas are limited. Oral hygiene standards are poor and this combined with a diet rich in refined carbohydrates has led to high incidences of dental caries. In addition, diabetes, which is related to obesity (and a diet high in sugar and fat) has been linked to increases in oral disease. Caries prevalence was found to be low in areas where fluoridation levels in the water were high. The fact that the fluoride supplementation appears to improve oral health to a significant degree suggests that implementation of fluoride treatment programmes for school children and, where viable, fluoridation of water sources would be appropriate. In addition, dental education programmes should receive high priority. As with the rest of the community, these preventive measures will result in less need for emergency dental treatment in the future, better oral health for the community and reduced financial burden on the State. It is under these circumstances that oral health planners and providers must, in consultation with the relevant community representatives, develop appropriate mechanisms to address the needs of this group. The development of strategies that integrate with the plethora of general health strategies currently being implemented is just one means of achieving improved oral health outcomes for indigenous Australians.

  19. What Indigenous Australian clients value about primary health care: a systematic review of qualitative evidence.

    PubMed

    Gomersall, Judith Streak; Gibson, Odette; Dwyer, Judith; O'Donnell, Kim; Stephenson, Matthew; Carter, Drew; Canuto, Kootsy; Munn, Zachary; Aromataris, Edoardo; Brown, Alex

    2017-08-01

    To synthesise client perceptions of the unique characteristics and value of care provided in Aboriginal Community Controlled Health Organisations (ACCHOs) compared to mainstream/general practitioner services, and implications for improving access to quality, appropriate primary health care for Indigenous Australians. Standardised systematic review methods with modification informed by ethical and methodological considerations in research involving Indigenous Australians. Perceived unique valued characteristics of ACCHOs were: 1) accessibility, facilitated by ACCHOs welcoming social spaces and additional services; 2) culturally safe care; and 3) appropriate care, responsive to holistic needs. Provider-client relationships characterised by shared understanding of clients' needs, Indigenous staff, and relationships between clients who share the same culture, are central to ACCHO clients' perceptions of ACCHOs' unique value. The client perceptions provide insights about how ACCHOs address socio-economic factors that contribute to high levels of chronic disease in Indigenous communities, why mainstream PHC provider care cannot substitute for ACCHO care, and how to improve accessibility and quality of care in mainstream providers. Implications for public health: To increase utilisation of PHC services in Indigenous Australian communities, and help close the gaps between the health status of Indigenous and non-Indigenous Australians, Indigenous community leaders and Australian governments should prioritise implementing effective initiatives to support quality health care provision by ACCHOs. © 2017 The Authors.

  20. Study of intra-racial exclusion within Australian Indigenous communities using eco-maps.

    PubMed

    Doyle, Kerrie; Hungerford, Catherine; Cleary, Michelle

    2017-04-01

    In Australia, 'indigeneity' is not determined by skin colour, but rather by a person's heritage, acceptance by an indigenous community, and active participation in the affairs of that indigenous community. Some people who identify as indigenous, however, have experienced 'colourism' - that is, experiences of social exclusion because of the colour of their skin - from non-Indigenous and also Indigenous Australians. This paper describes research that explored the effect of intra-racial exclusion on the mental health and wellbeing of Indigenous Australians, with a particular focus on skin colour or 'manifest indigeneity'. Framed within a qualitative design, an eco-map was used to guide in-depth interviews with 32 participants that gave rise to personal stories that described the distress of experiencing intra-racial colourism. Findings were derived from a thematic analysis that identified four major themes: 'Growing up black', 'Living on black country', 'Looking black', and 'Fitting in black'. These findings are important because they suggest a way forward for mental health nurses to better understand and support the mental health and wellbeing of Indigenous Australians who have experienced social exclusion as a result of colourism. © 2016 Australian College of Mental Health Nurses Inc.

  1. Cohort Profile: Footprints in Time, the Australian Longitudinal Study of Indigenous Children

    PubMed Central

    Thurber, Katherine A; Banks, Emily; Banwell, Cathy

    2015-01-01

    Indigenous Australians experience profound levels of disadvantage in health, living standards, life expectancy, education and employment, particularly in comparison with non-Indigenous Australians. Very little information is available about the healthy development of Australian Indigenous children; the Longitudinal Study of Indigenous Children (LSIC) is designed to fill this knowledge gap. This dataset provides an opportunity to follow the development of up to 1759 Indigenous children. LSIC conducts annual face-to-face interviews with children (aged 0.5–2 and 3.5–5 years at baseline in 2008) and their caregivers. This represents between 5% and 10% of the total population of Indigenous children in these age groups, including families of varied socioeconomic and cultural backgrounds. Study topics include: the physical, social and emotional well-being of children and their caregivers; language; culture; parenting; and early childhood education. LSIC is a shared resource, formed in partnership with communities; its data are readily accessible through the Australian Government Department of Social Services (see http://dss.gov.au/lsic for data and access arrangements). As one of very few longitudinal studies of Indigenous children, and the only national one, LSIC will enable an understanding of Indigenous children from a wide range of environments and cultures. Findings from LSIC form part of a growing infrastructure from which to understand Indigenous child health. PMID:25011454

  2. Cohort Profile: Footprints in Time, the Australian Longitudinal Study of Indigenous Children.

    PubMed

    Thurber, Katherine A; Banks, Emily; Banwell, Cathy

    2015-06-01

    Indigenous Australians experience profound levels of disadvantage in health, living standards, life expectancy, education and employment, particularly in comparison with non-Indigenous Australians. Very little information is available about the healthy development of Australian Indigenous children; the Longitudinal Study of Indigenous Children (LSIC) is designed to fill this knowledge gap.This dataset provides an opportunity to follow the development of up to 1759 Indigenous children. LSIC conducts annual face-to-face interviews with children (aged 0.5-2 and 3.5-5 years at baseline in 2008) and their caregivers. This represents between 5% and 10% of the total population of Indigenous children in these age groups, including families of varied socioeconomic and cultural backgrounds. Study topics include: the physical, social and emotional well-being of children and their caregivers; language; culture; parenting; and early childhood education.LSIC is a shared resource, formed in partnership with communities; its data are readily accessible through the Australian Government Department of Social Services (see http://dss.gov.au/lsic for data and access arrangements). As one of very few longitudinal studies of Indigenous children, and the only national one, LSIC will enable an understanding of Indigenous children from a wide range of environments and cultures. Findings from LSIC form part of a growing infrastructure from which to understand Indigenous child health. © The Author 2014. Published by Oxford University Press on behalf of the International Epidemiological Association.

  3. "It Becomes Almost an Act of Defiance": Indigenous Australian Transformational Resistance as a Driver of Academic Achievement

    ERIC Educational Resources Information Center

    Pechenkina, Ekaterina

    2017-01-01

    Indigenous Australian underrepresentation in higher education remains a topical issue for social scientists, educationalists and policymakers alike, with the concept of indigenous academic success highly contested. This article is based on findings of a doctoral study investigating the drivers of indigenous Australian academic success in a large,…

  4. Antibacterial compounds from the root of the indigenous Australian medicinal plant Carissa lanceolata R.Br.

    PubMed

    Hettiarachchi, Dhanushka S; Locher, Cornelia; Longmore, Robert B

    2011-09-01

    The conkerberry, Carissa lanceolata R.Br. (Apocynaceae), is commonly used by many indigenous Australian communities across Northern Australia for the treatment of a variety of conditions such as chest pain, toothache, colds and flu. Indigenous uses of this plant strongly argue for an antibacterial bioactivity. The aim is to identify antibacterial compounds from root material of C. lanceolata, therefore confirming the indigenous use of the plant. Antibacterial activity was examined against Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus and Bacillus subtilis using a micro broth dilution technique. Three compounds demonstrating considerable activity were isolated. The volatile phenolic compound 2'-hydroxyacetophenone and the lignan carinol both were reported for the first time from C. lanceolata, whereas this is the second account of the occurrence of carissone. All three compounds showed activity, with 2'-hydroxyacetophenone and carinol having a minimum inhibitory concentration of <1.25 mg mL⁻¹ against all four bacteria. Extracts and compounds isolated from C. lanceolata roots were found to possess a significant antibacterial activity, confirming the indigenous use of this plant.

  5. Epidemiology of alcohol-related burden of disease among Indigenous Australians.

    PubMed

    Calabria, Bianca; Doran, Chris M; Vos, Theo; Shakeshaft, Anthony P; Hall, Wayne

    2010-07-01

    To compare the burden of alcohol-related harm and underlying factors of this harm, by age and sex, for Indigenous and general population Australians. Population attributable fractions are used to estimate the disability adjusted life years (DALYs) for alcohol-related disease and injury. The DALYs were converted to rates per 1,000 by age and sex for the Indigenous and general populations. Homicide and violence rates were much higher for Indigenous males: greatest population difference was for 30-44 years, Indigenous rate 8.9 times higher. Rates of suicide were also greater: the largest population difference was for 15-29 years, Indigenous rate 3.9 times higher. Similarly, for Indigenous females, homicide and violence rates were much higher: greatest population difference was for 30-44 years, Indigenous rate 18.1 times higher. Rates of suicide were also greater: the largest population difference was for 15-29 years, Indigenous rate 5.0 times higher. Alcohol consumption and associated harms are of great concern for Indigenous Australians across all ages. Violent alcohol-related harms have been highlighted as a major concern. To reduce the disproportionate burden of alcohol-related harm experienced by Indigenous Australians, targeted interventions should include the impact on families and communities and not just the individual.

  6. Examining the potential contribution of social theory to developing and supporting Australian Indigenous-mainstream health service partnerships.

    PubMed

    Haynes, Emma; Taylor, Kate P; Durey, Angela; Bessarab, Dawn; Thompson, Sandra C

    2014-09-20

    subject to changes in power relations. Theoretical models aiming to understand and improve partnerships indicate the complexity of building and maintaining such partnerships and stress the importance of understanding factors that can strengthen or derail their effectiveness. While the theories presented here are by no means exhaustive, they nonetheless provide a series of entry points through which to engage with the issue and expand the discourse. This approach allows the transformative nature of Australian Indigenous-mainstream 'culture' to be explored and understood in its lived expression; rather than relegated to prescriptive categories.

  7. Culture Matters. Factors Affecting the Outcomes of Participation in Vocational Education and Training by Australian Indigenous Peoples.

    ERIC Educational Resources Information Center

    McIntyre, John; Ardler, William; Morley-Warner, Terri; Solomon, Nicky; Spindler, Laraine

    The factors affecting the outcomes of indigenous Australians' participation in vocational education and training (VET) were examined in a study in which 7 Aboriginal researchers in 5 Australian states and territories interviewed 70 indigenous Australians enrolled in VET and 48 coordinators and teachers in technical and further education (TAFE)…

  8. PEARL: A Reflective Story about Decolonising Pedagogy in Indigenous Australian Studies

    ERIC Educational Resources Information Center

    Mackinlay, Elizabeth

    2012-01-01

    In this article, I take a creative and autoethnographic approach to reflect upon processes of decolonisation in Indigenous Australian studies classrooms. Positioning myself as a non-Indigenous educator, I take the reader on a journey through my search for pedagogy which makes space for the colonial, difficult and messy politics of race, whiteness…

  9. Troubling Cultural Fault Lines: Some Indigenous Australian Families' Perspectives on the Landscape of Early Childhood Education

    ERIC Educational Resources Information Center

    Fleer, Marilyn

    2006-01-01

    Drawing on Vygotsky's (1997a) concept of "fossilized behavior", this study examines the cultural fault lines between the imagined community (Anderson, 1991) of early childhood education and some Australian Indigenous families. Through creating a social space within which Indigenous families could examine dominant and taken-for-granted…

  10. PEARL: A Reflective Story about Decolonising Pedagogy in Indigenous Australian Studies

    ERIC Educational Resources Information Center

    Mackinlay, Elizabeth

    2012-01-01

    In this article, I take a creative and autoethnographic approach to reflect upon processes of decolonisation in Indigenous Australian studies classrooms. Positioning myself as a non-Indigenous educator, I take the reader on a journey through my search for pedagogy which makes space for the colonial, difficult and messy politics of race, whiteness…

  11. Young Australian Indigenous Students' Engagement with Numeracy: Actions that Assist to Bridge the Gap

    ERIC Educational Resources Information Center

    Warren, Elizabeth; deVries, Eva

    2009-01-01

    Many young Indigenous Australian students continue to underachieve in Western mathematics. National test results indicate that they are two years behind their peers. Success in mathematics is important to Indigenous students as it leads to employment opportunities and can assist in identifying power differences among socio-economic classes…

  12. Pre-Service Teachers' Pedagogical Relationships and Experiences of Embedding Indigenous Australian Knowledge in Teaching Practicum

    ERIC Educational Resources Information Center

    Hart, Victor; Whatman, Susan; McLaughlin, Juliana; Sharma-Brymer, Vinathe

    2012-01-01

    This paper argues from the standpoint that embedding Indigenous knowledge and perspectives in Australian curricula occurs within a space of tension, "the cultural interface", in negotiation and contestation with other dominant knowledge systems. In this interface, Indigenous knowledge is in a state of constancy and flux, invisible and…

  13. Re-Reading Representations of Indigenality in Australian Children's Literature: A History

    ERIC Educational Resources Information Center

    Collins-Gearing, Brooke

    2006-01-01

    Australian children's literature has a history of excluding Indigenous child readers and positioning non-Indigenous readers as the subject. Rather than portray such literature, particularly before the 1950s, as simply racist or stereotypical, I argue that it is important for teachers, of all students, to help readers understand how nationalist or…

  14. Performance of comorbidity indices in measuring outcomes after acute myocardial infarction in Australian indigenous and non-indigenous patients.

    PubMed

    Condon, J R; You, J; McDonnell, J

    2012-07-01

    Indigenous Australians have higher prevalence of chronic diseases and worse acute care outcomes than other Australians. The extent to which higher chronic disease comorbidity levels are responsible for their worse outcomes is not clear, and the performance of comorbidity indices has not been assessed for this population with very high comorbidity levels. Using hospital separations data, the Charlson and Elixhauser comorbidity indices were used to measure chronic disease prevalence in 2035 indigenous and non-indigenous patients hospitalised after their first acute myocardial infarction (AMI) in the Northern Territory of Australia between 1992 and 2004, and to adjust for comorbidity in multivariate analysis of mortality outcomes (in-hospital and long-term deaths from coronary heart disease and all causes). Index performance was assessed by the difference between C statistic, Akaike information criterion statistic and estimate of excess indigenous mortality in models with and without comorbidity adjustment. Comorbidity index scores were higher for indigenous than non-indigenous patients and increased considerably over time, at least partly because of information bias. Indigenous patients' higher risk of in-hospital all-cause death was almost fully explained by their higher comorbidity levels. Their higher risk of long-term coronary heart disease and all-cause death was partially explained by higher comorbidity levels. Charlson and Elixhauser indices performed satisfactorily and similarly in this population. Comorbidity indices performed well in a population with very high chronic disease prevalence. After adjusting for comorbidity, short-term outcomes were similar for indigenous and non-indigenous AMI patients, but comorbidity at the time of the acute episode only partly explained the worse long-term outcomes for indigenous patients. © 2011 The Authors. Internal Medicine Journal © 2011 Royal Australasian College of Physicians.

  15. Rocking the Foundations: The Struggle for Effective Indigenous Studies in Australian Higher Education

    ERIC Educational Resources Information Center

    Aberdeen, Lucinda; Carter, Jennifer; Grogan, Justine; Hollinsworth, David

    2013-01-01

    Foundation courses that provide knowledge and understanding about the social, cultural and historical factors shaping Indigenous Australians' lives since colonial settlement and their effects are endorsed in Australian higher education policy. Literature highlights the complexity of changing student views and the need for sustained, comprehensive…

  16. Socialisation, Culture and the Foundations of Expertise in Elite Level Indigenous Australian Sportsmen

    ERIC Educational Resources Information Center

    Light, Richard L.; Evans, John R.

    2017-01-01

    This article reports on an ongoing study that investigates the development of expertise in rugby league and Australian football by Indigenous Australians as a socially and culturally situated process of learning. Focused on the sampling phase of the Development Model of Participation in Sport (6-12 years of age), it combines narrative inquiry and…

  17. The effectiveness of implementation in Indigenous Australian healthcare: an overview of literature reviews.

    PubMed

    McCalman, Janya; Bainbridge, Roxanne; Percival, Nikki; Tsey, Komla

    2016-03-10

    Effective implementation can maximise the beneficial impacts of health services. It is therefore important to review implementation in the context of Indigenous populations, who suffer some of the greatest disadvantage within developed countries. This paper analyses Aboriginal and Torres Strait Islander (hereafter Indigenous) Australian health implementation reviews to examine the research question: What is the effectiveness of implementation, as reported in the Indigenous Australian health implementation literature? Eight databases were systematically searched to find reviews of Indigenous Australian health services and/or programs where implementation was the focus. Search terms included Aborigin* OR Indigen* OR Torres AND health AND service OR program* OR intervention AND implementation (or like terms) AND Australia AND review. Review findings were analysed through the lens of the PARiHS framework which theorises that successful implementation occurs through the interplay of evidence, context and facilitation. The review followed Cochrane methods but was not registered. Six reviews were found; these encompassed 107 studies that considered health service/program implementation. Included studies described many health services implemented across Australia as not underpinned by rigorous impact evaluation; nevertheless implementers tended to prefer evidence-based interventions. Effective implementation was supported by clearly defined management systems, employment of Indigenous health workers as leaders, community control, partnerships, tailoring for diverse places and settings; and active facilitation methods. Short-term funding meant most studies focused on implementation in one site through pilot initiatives. Only two mentioned cost effectiveness. Indigenous Australian studies incorporated two elements not included in the PARiHS reference guide: the value of community control and equity of service provision across sites. Comparison of the Indigenous Australian

  18. Designing an Australian Indigenous Studies Curriculum for the Twenty-First Century: Nakata's "Cultural Interface", Standpoints and Working beyond Binaries

    ERIC Educational Resources Information Center

    Carey, Michelle; Prince, Michael

    2015-01-01

    We discuss the recent reworking of Murdoch University's Australian Indigenous Studies major. For the discipline to realise its charter of decolonising knowledges about Indigenous peoples, it is necessary to move Indigenous Studies beyond the standard reversalist and unsustainable tropes that valorise romanticised notions of Indigeneity and…

  19. Designing an Australian Indigenous Studies Curriculum for the Twenty-First Century: Nakata's "Cultural Interface", Standpoints and Working beyond Binaries

    ERIC Educational Resources Information Center

    Carey, Michelle; Prince, Michael

    2015-01-01

    We discuss the recent reworking of Murdoch University's Australian Indigenous Studies major. For the discipline to realise its charter of decolonising knowledges about Indigenous peoples, it is necessary to move Indigenous Studies beyond the standard reversalist and unsustainable tropes that valorise romanticised notions of Indigeneity and…

  20. The Indigenous Australian Malnutrition Project: the burden and impact of malnutrition in Aboriginal Australian and Torres Strait Islander hospital inpatients, and validation of a malnutrition screening tool for use in hospitals-study rationale and protocol.

    PubMed

    Morris, Natasha F; Stewart, Simon; Riley, Malcolm D; Maguire, Graeme P

    2016-01-01

    Malnutrition is associated with adverse outcomes for hospital inpatients and is a significant economic burden on hospitals. Malnutrition is frequently under-recognised in this setting and valid screening and early diagnosis are important for timely nutritional management. Aboriginal Australian and/or Torres Strait Islander peoples (Indigenous Australians) are likely to be at increased risk of malnutrition due to their disproportionate burden, pattern and age-distribution of chronic diseases. Despite this increased risk, the burden and impact of malnutrition in Indigenous Australians is poorly understood. Furthermore, a suitable screening tool has not been validated for this vulnerable patient group. The aim of this study is to determine the burden of malnutrition, understand its impact, and validate a malnutrition screening tool for Indigenous Australian inpatients. This project involves cross-sectional, prospective cohort and diagnostic validation methodologies to assess the burden and impact of malnutrition and to validate a malnutrition screening tool. A target of 752 adult Indigenous and non-Indigenous Australian inpatients will be recruited across three different public hospitals in the Northern Territory and far north Queensland of Australia. Cross-sectional data collection will be used to determine the prevalence of malnutrition using the Subjective Global Assessment and to stratify participants based on the International Consensus Guideline Committee malnutrition aetiology-diagnostic framework. Subjects will then be followed prospectively to measure short and long-term health outcomes such as length of hospital stay, in-hospital mortality, 30-day and 6-month readmission rates. Finally, the utility of a new screening tool, the Australian Nutrition Tool, will be assessed against an existing screening tool, the malnutrition screening tool, used in these settings and the malnutrition reference standard, the Subjective Global Assessment. Indigenous Australians

  1. Management of diabetes in Indigenous communities: lessons from the Australian Aboriginal population.

    PubMed

    Nguyen, H D; Chitturi, S; Maple-Brown, L J

    2016-11-01

    Type 2 diabetes mellitus and other chronic cardio-metabolic conditions are significant contributors to the large disparities in life expectancy between Indigenous and non-Indigenous Australians. Type 2 diabetes is more prevalent from a young age among Indigenous Australians and is often preceded by a cluster of risk factors, including central obesity, dyslipidaemia, albuminuria and socio-economic disadvantage. Management of type 2 diabetes in Australian Indigenous peoples can be challenging in the setting of limited resources and socio-economic disadvantage. Key strategies to address these challenges include working in partnership with patients, communities and primary healthcare services (PHC, Aboriginal community controlled and government services) and working in a multidisciplinary team. Population prevention measures are required within and beyond the health system, commencing as early as possible in the life course. © 2016 Royal Australasian College of Physicians.

  2. Ten-year all-cause mortality and its association with vision among Indigenous Australians within Central Australia: the Central Australian Ocular Health Study.

    PubMed

    Liu, Ebony; Ng, Soo K; Kahawita, Shyalle; Andrew, Nicholas H; Henderson, Tim; Craig, Jamie E; Landers, John

    2017-05-01

    No studies to date have explored the association of vision with mortality in Indigenous Australians. We aimed to determine the 10-year all-cause mortality and its associations among Indigenous Australians living in Central Australia. Prospective observational cohort study. A total of 1257 (93.0%) of 1347 patients from The Central Australian Ocular Health Study, over the age of 40 years, were available for follow-up during a 10-year period. All-cause mortality and its associations with visual acuity, age and gender were analysed. All-cause mortality. All-cause mortality was 29.3% at the end of 10 years. Mortality increased as age of recruitment increased: 14.2% (40-49 years), 22.6% (50-59 years), 50.3% (60 years or older) (χ = 59.15; P < 0.00001). Gender was not associated with mortality as an unadjusted variable, but after adjustment with age and visual acuity, women were 17.0% less likely to die (t = 2.09; P = 0.037). Reduced visual acuity was associated with increased mortality rate (5% increased mortality per one line of reduced visual acuity; t = 4.74; P < 0.0001) after adjustment for age, sex, diabetes and hypertension. The 10-year all-cause mortality rate of Indigenous Australians over the age of 40 years and living in remote communities of Central Australia was 29.3%. This is more than double that of the Australian population as a whole. Mortality was significantly associated with visual acuity at recruitment. Further work designed to better understand this association is warranted and may help to reduce this disparity in the future. © 2016 Royal Australian and New Zealand College of Ophthalmologists.

  3. Menopause and the influence of culture: another gap for Indigenous Australian women?

    PubMed

    Jones, Emma K; Jurgenson, Janelle R; Katzenellenbogen, Judith M; Thompson, Sandra C

    2012-12-12

    There is great variation in experience of menopause in women around the world. The purpose of this study was to review current understanding of Australian Aboriginal and Torres Strait Islander (Indigenous) women's experiences of menopause. The literature pertaining to the perception, significance and experience of menopause from a number of cultural groups around the world has been included to provide context for why Indigenous women's experience might be important for their health and differ from that reported in other studies of Australian women and menopause. A search of databases including Ovid Medline, Pubmed, Web of Science, AUSThealth, AMED, EMBASE, Global Health and PsychINFO was undertaken from January 2011 to April 2011 using the search terms menopause, Indigenous, Aboriginal, attitudes, and perceptions and repeated in September 2012. Considerable research shows significant variation across cultures in the menopausal experience. Biological, psychological, social and cultural factors are associated with either positive or negative attitudes, perceptions or experiences of menopause in various cultures. Comparative international literature shows that neither biological nor social factors alone are sufficient to explain the variation in experiences of the menopausal transition. However, a strong influence of culture on the menopause experience can be found. The variation in women's experience of menopause indicates that different cultural groups of women may have different understandings and needs during the menopausal transition. While considerable literature exists for Australian women as a whole, there has been little investigation of Australian Indigenous women, with only two research studies related to Indigenous women's experiences of menopause identified. Differences in biocultural experience of menopause around the world suggest the importance of biocultural research. For the Indigenous women of Australia, the relative contribution of culture, social

  4. Media influences on body image and disordered eating among indigenous adolescent Australians.

    PubMed

    McCabe, Marita P; Ricciardelli, Lina; Mellor, David; Ball, Kylie

    2005-01-01

    There has been no previous investigation of body image concerns and body change strategies among indigenous Australians. This study was designed to investigate the level of body satisfaction, body change strategies, and perceived media messages about body change strategies among 50 indigenous (25 males, 25 females) and 50 non-indigenous (25 males, 25 females) Australian adolescents (mean age 14.05, SD = 1.05). Consistent with past studies, girls were more likely to be dissatisfied with their weight and engage in strategies to lose weight. However, contrary to expectations, indigenous adolescents engaged in more strategies to lose weight, increase weight, and increase muscles than did non-indigenous adolescents, despite perceiving fewer media messages about losing weight. Additional factors that may explain the findings and the need for further research with different cultural groups are highlighted.

  5. Australian indigenous children with low cognitive ability: Family and cultural participation.

    PubMed

    Gilroy, John; Emerson, Eric

    2016-09-01

    Family and cultural inclusion are essential for the healthy development of young Australian Indigenous peoples with low cognitive ability. To date, this issue has received limited research attention. A secondary analysis of data collected in Wave 4 of Footprints in Time, Australia's Longitudinal Study of Indigenous Children, was conducted to help address this research gap. The study results indicated that in some areas, Indigenous children with low cognitive ability are at a higher risk of social exclusion than their peers. We discuss the policy implications of these findings with regards to addressing Indigenous disadvantage. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Personalised Medicine: A New Approach to Improving Health in Indigenous Australian Populations.

    PubMed

    Rae, Kym M; Grimson, Steve; Pringle, Kirsty G

    2017-01-01

    Personalised medicine is a newly emerging field with much to offer to all populations in improved clinical treatment options. Since the 1970s, clinicians and researchers have all been working towards improving the health of Indigenous Australians. However, there has been little research on the impact of genetics on Indigenous health, how genetic and environmental factors interact to contribute to poor health in Indigenous people, and how genetic factors specific to Indigenous people affect their responses to particular treatments. This short review highlights the urgent need for more genetic studies specific to Indigenous people in order to provide more appropriate care and to improve health outcomes. This paper explores why genetic work with Indigenous communities has been limited, how personalised medicine could benefit Indigenous communities, and highlights a number of specific instances in which personalised medicine has been critical for improving morbidity and mortality in other high-risk groups. In order to take the next step in advancing the health of Indigenous peoples, targeted research into the genetic factors behind chronic diseases is critically needed. This research may allow clinicians a better understanding of how genetic factors interact with environmental factors to influence an Indigenous Australian's individual risk of disease, prognosis, and response to therapies. It is hoped that this knowledge will produce clinical interventions that will help deliver clearly targeted, more appropriate care to this at-risk population. © 2017 S. Karger AG, Basel.

  7. Life, lifestyle and location: examining the complexities of psychological distress in young adult Indigenous and non-Indigenous Australians.

    PubMed

    Davison, B; Nagel, T; Singh, G R

    2017-03-27

    Mental health is fundamental to an individual's health and well-being. Mental health disorders affect a substantial portion of the Australian population, with the most vulnerable time in adolescence and young adulthood. Indigenous Australians fare worse than other Australians on almost every measure of physical and mental health. Cross-sectional data from young adults (21-27 years) participating in the Life Course Program, Northern Territory, Australia, is presented. Rates of psychological distress were high in remote and urban residing Indigenous and urban non-Indigenous young adults. This rate was more pronounced in young women, particularly in Indigenous remote and urban residing women. Young adults with high psychological distress also had lower levels of positive well-being, higher perceived stress levels, experienced a higher number of major life events and were at an increased risk of suicidal ideation and/or self-harm. This study supports the need for a continued focus on early screening and treatment at this vulnerable age. The significant association seen between psychological distress and other markers of emotional well-being, particularly risk of suicidal ideation and/or self-harm, highlights the need for a holistic approach to mental health assessment and treatment. A concerted focus on improving the environs of young adults by lowering levels of stress, improving access to adequate housing, educational and employment opportunity, will assist in improving the emotional health of young adults.

  8. Dialectal grammatical differences in oral narratives of school-aged Indigenous Australian children.

    PubMed

    Pearce, Wendy Maureen; Williams, Cori; Steed, William

    2015-01-01

    Children's oral language samples are regularly analysed in order to describe levels of language development and develop learning goals. However, diagnostic interpretation of language samples from Indigenous Australian children is problematic due to overlap between features of Aboriginal English and features of language impairment in the mainstream non-Indigenous population. Limited studies explore the use of Aboriginal English and its diagnostic impact. This research, therefore, describes the grammatical features of language samples from one group of Indigenous Australian children. Participants were 19 children aged 8;1-13;4 from the same school in a regional city with 100% Indigenous enrolment. The Test of Narrative Language was administered, eliciting three oral narratives, and features of Aboriginal English grammar were coded. Dialect density was highly variable and greater in the Verb Phrase than in the Noun Phrase or Clause Structure. High teacher ratings of oral language ability aligned with lower measures of dialect density and higher grammatical accuracy for Standard Australian English. Grammatical accuracy was frequently higher for Aboriginal English than Standard Australian English. Over-identification of language impairment was identified as a risk when evaluating the language ability of Indigenous Australian children.

  9. Association between short sleep duration and body mass index in Australian Indigenous children.

    PubMed

    Deacon-Crouch, Melissa; Skinner, Isabelle; Tucci, Joseph; Skinner, Timothy

    2017-08-16

    Associations between short sleep duration and obesity and the relationship between obesity and chronic illness are well documented. Obese children are likely to become obese adults. To date, there is a paucity of information regarding sleep duration and quality for Indigenous Australian people. It may be that poor-quality, short sleep is contributing to the gap in health outcomes for Indigenous people compared with non-Indigenous adults and children. This study sought to investigate the possibility that poor sleep quality may be contributing to health outcomes for Indigenous children by exploring associations between sleep duration and body mass index (BMI). Participants included 1253 children aged 7-12 years in Wave 7 of the national Longitudinal Study of Indigenous Children survey. Interviewers asked primary carers about children's sleep times. BMI was derived from measurements of children made by researchers. Regardless of age, relative socio-economic disadvantage and level of remoteness, unhealthy weight was associated with less sleep duration than healthy weight for Indigenous children. The relationship between short sleep duration and BMI in Indigenous children has important implications for their future health outcomes. Both overweight conditions and short sleep are established modifiable risk factors for metabolic dysfunction and other chronic illnesses prominent in the Indigenous population. It is important to consider strategies to optimise both for Indigenous children in an attempt to help 'close the gap' in health outcomes and life expectancy between Indigenous and non-Indigenous people. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  10. Child-caregiver interaction in two remote Indigenous Australian communities

    PubMed Central

    Vaughan, Jill; Wigglesworth, Gillian; Loakes, Deborah; Disbray, Samantha; Moses, Karin

    2015-01-01

    This paper reports on a study in two remote multilingual Indigenous Australian communities: Yakanarra in the Kimberley region of Western Australia and Tennant Creek in the Barkly region of the Northern Territory. In both communities, processes of language shift are underway from a traditional language (Walmajarri and Warumungu, respectively) to a local creole variety (Fitzroy Valley Kriol and Wumpurrarni English, respectively). The study focuses on language input from primary caregivers to a group of preschool children, and on the children's productive language. The study further highlights child-caregiver interactions as a site of importance in understanding the broader processes of language shift. We use longitudinal data from two time-points, approximately 2 years apart, to explore changes in adult input over time and developmental patterns in the children's speech. At both time points, the local creole varieties are the preferred codes of communication for the dyads in this study, although there is some use of the traditional language in both communities. Results show that for measures of turn length (MLT), there are notable differences between the two communities for both the focus children and their caregivers. In Tennant Creek, children and caregivers use longer turns at Time 2, while in Yakanarra the picture is more variable. The two communities also show differing trends in terms of conversational load (MLT ratio). For measures of morphosyntactic complexity (MLU), children and caregivers in Tennant Creek use more complex utterances at Time 2, while caregivers in Yakanarra show less complexity in their language at that time point. The study's findings contribute to providing a more detailed picture of the multilingual practices at Yakanarra and Tennant Creek, with implications for understanding broader processes of language shift. They also elucidate how children's language and linguistic input varies diachronically across time. As such, we contribute to

  11. Child-caregiver interaction in two remote Indigenous Australian communities.

    PubMed

    Vaughan, Jill; Wigglesworth, Gillian; Loakes, Deborah; Disbray, Samantha; Moses, Karin

    2015-01-01

    This paper reports on a study in two remote multilingual Indigenous Australian communities: Yakanarra in the Kimberley region of Western Australia and Tennant Creek in the Barkly region of the Northern Territory. In both communities, processes of language shift are underway from a traditional language (Walmajarri and Warumungu, respectively) to a local creole variety (Fitzroy Valley Kriol and Wumpurrarni English, respectively). The study focuses on language input from primary caregivers to a group of preschool children, and on the children's productive language. The study further highlights child-caregiver interactions as a site of importance in understanding the broader processes of language shift. We use longitudinal data from two time-points, approximately 2 years apart, to explore changes in adult input over time and developmental patterns in the children's speech. At both time points, the local creole varieties are the preferred codes of communication for the dyads in this study, although there is some use of the traditional language in both communities. Results show that for measures of turn length (MLT), there are notable differences between the two communities for both the focus children and their caregivers. In Tennant Creek, children and caregivers use longer turns at Time 2, while in Yakanarra the picture is more variable. The two communities also show differing trends in terms of conversational load (MLT ratio). For measures of morphosyntactic complexity (MLU), children and caregivers in Tennant Creek use more complex utterances at Time 2, while caregivers in Yakanarra show less complexity in their language at that time point. The study's findings contribute to providing a more detailed picture of the multilingual practices at Yakanarra and Tennant Creek, with implications for understanding broader processes of language shift. They also elucidate how children's language and linguistic input varies diachronically across time. As such, we contribute to

  12. Primary health-care responses to methamphetamine use in Australian Indigenous communities.

    PubMed

    MacLean, Sarah; Harney, Angela; Arabena, Kerry

    2015-01-01

    Crystal methamphetamine (commonly known as 'ice') use is currently a deeply concerning problem for some Australian Indigenous peoples and can cause serious harms to individual, families and communities. This paper is intended to support best practice responses by primary health-care staff working with Australian Indigenous people who use methamphetamine. It draws on a systematic search of relevant databases to identify literature from January 1999 to February 2014, providing an overview of prevalence, treatment, education and harm reduction, and community responses. The prevalence of methamphetamine use is higher in Indigenous than non-Indigenous communities, particularly in urban and regional settings. No evidence was identified that specifically related to effective treatment and treatment outcomes for Indigenous Australians experiencing methamphetamine dependence or problematic use. While studies involving methamphetamine users in the mainstream population suggest that psychological and residential treatments show short-term promise, longer-term outcomes are less clear. Community-driven interventions involving Indigenous populations in Australia and internationally appear to have a high level of community acceptability; however, outcomes in terms of methamphetamine use are rarely evaluated. Improved national data on prevalence of methamphetamine use among Indigenous people and levels of treatment access would support service planning. We argue for the importance of a strength-based approach to addressing methamphetamine use, to counteract the stigma and despair that frequently accompanies it.

  13. 'Yarning up with Koori kids' - hearing the voices of Australian urban Indigenous children about their health and well-being.

    PubMed

    Priest, Naomi; Thompson, Laura; Mackean, Tamara; Baker, Alison; Waters, Elizabeth

    2017-12-01

    Australian Indigenous children experience some of the most substantial health inequalities globally. In this context, research regarding their health and well-being has overemphasised physical illnesses with limited exploration of a diverse range of dimensions and determinants, particularly those based on Indigenous holistic understandings of health and well-being. This deficit-based approach has thus missed many strengths and assets of Indigenous children. This research aimed to gain insight into the perspectives of Indigenous children about their health and well-being in an urban setting in Australia. It joins a limited international literature examining views and experiences of non-majority children. Participatory and qualitative child-friendly research methods were utilised. The project was developed in partnership with Indigenous community organisations and members. Photo-elicitation activities and focus groups were conducted with 31 Indigenous children aged 8-12 years. Qualitative data were analysed thematically, combining focus group and interview data. It was evident an urban Indigenous child perspective of health and well-being includes rich understandings of the interconnectedness of physical, social-emotional and cultural dimensions of holism, as well as the integral importance of family and community relationships. The study also found that specific worries regarding loss of loved ones and racism were highly salient in Indigenous children's lives. The overwhelming conclusion to be drawn from this research is that Indigenous children in urban areas need ongoing recognition of both their agency and resilience in the face of adversity, within a wider context of historical and contemporary racialisation and racism.

  14. Race Based Inequalities for Indigenous Australians' Participation and Engagement in VET: A Targeted Review of the Research

    ERIC Educational Resources Information Center

    Cameron, Roslyn; Stuart, Lynne; Bell, Terry

    2017-01-01

    The poor outcomes in education, training and employment achieved by Aboriginal and Torres Strait Islander people in Australia have been well documented. The transition from a traditional Indigenous society to the statuses of mainstream Australian society has been, and continues to be problematic for Indigenous Australians. The participation in…

  15. Reducing the health disparities of Indigenous Australians: time to change focus

    PubMed Central

    2012-01-01

    Background Indigenous peoples have worse health than non-Indigenous, are over-represented amongst the poor and disadvantaged, have lower life expectancies, and success in improving disparities is limited. To address this, research usually focuses on disadvantaged and marginalised groups, offering only partial understanding of influences underpinning slow progress. Critical analysis is also required of those with the power to perpetuate or improve health inequities. In this paper, using Australia as a case example, we explore the effects of ‘White’, Anglo-Australian cultural dominance in health service delivery to Indigenous Australians. We address the issue using race as an organising principle, underpinned by relations of power. Methods Interviews with non-Indigenous medical practitioners in Western Australia with extensive experience in Indigenous health encouraged reflection and articulation of their insights into factors promoting or impeding quality health care to Indigenous Australians. Interviews were audio-taped and transcribed. An inductive, exploratory analysis identified key themes that were reviewed and interrogated in light of existing literature on health care to Indigenous people, race and disadvantage. The researchers’ past experience, knowledge and understanding of health care and Indigenous health assisted with data interpretation. Informal discussions were also held with colleagues working professionally in Indigenous policy, practice and community settings. Results Racism emerged as a key issue, leading us to more deeply interrogate the role ‘Whiteness’ plays in Indigenous health care. While Whiteness can refer to skin colour, it also represents a racialized social structure where Indigenous knowledge, beliefs and values are subjugated to the dominant western biomedical model in policy and practice. Racism towards Indigenous patients in health services was institutional and interpersonal. Internalised racism was manifest when

  16. Promoting fit bodies, healthy eating and physical activity among Indigenous Australian men: a study protocol

    PubMed Central

    2012-01-01

    Background Overall the physical health of Indigenous men is among the worst in Australia. Research has indicated that modifiable lifestyle factors, such as poor nutrition and physical inactivity, appear to contribute strongly to these poor health conditions. To effectively develop and implement strategies to improve the health of Australia's Indigenous peoples, a greater understanding is needed of how Indigenous men perceive health, and how they view and care for their bodies. Further, a more systematic understanding of how sociocultural factors affect their health attitudes and behaviours is needed. This article presents the study protocol of a community-based investigation into the factors surrounding the health and body image of Indigenous Australian men. Methods and design The study will be conducted in a collaborative manner with Indigenous Australian men using a participatory action research framework. Men will be recruited from three locations around Australia (metropolitan, regional, and rural) and interviewed to understand their experiences and perspectives on a number of issues related to health and health behaviour. The information that is collected will be analysed using modified grounded theory and thematic analysis. The results will then be used to develop and implement community events in each location to provide feedback on the findings to the community, promote health enhancing strategies, and determine future action and collaboration. Discussion This study will explore both risk and protective factors that affect the health of Indigenous Australian men. This knowledge will be disseminated to the wider Indigenous community and can be used to inform future health promotion strategies. The expected outcome of this study is therefore an increased understanding of health and health change in Indigenous Australian men, the development of strategies that promote healthy eating and positive patterns of physical activity and, in the longer term, more

  17. Body mass index trajectories of Indigenous Australian children and relation to screen time, diet, and demographic factors.

    PubMed

    Thurber, Katherine Ann; Dobbins, Timothy; Neeman, Teresa; Banwell, Cathy; Banks, Emily

    2017-04-01

    Limited cross-sectional data indicate elevated overweight/obesity prevalence among Indigenous versus non-Indigenous Australian children. This study aims to quantify body mass index (BMI) trajectories among Indigenous Australian children aged 3-6 and 6-9 years and to identify factors associated with the development of overweight/obesity. Three-year BMI change was examined in up to 1,157 children in the national Longitudinal Study of Indigenous Children. BMI trajectories among children with normal baseline BMI (n = 907/1,157) were quantified using growth curve models. Baseline prevalences of overweight/obesity were 12.1% and 25.4% among children of mean age 3 and 6 years, respectively. Of children with normal baseline BMI, 31.9% had overweight/obesity 3 years later; BMI increased more rapidly for younger versus older (difference: 0.59 kg/m(2) /year; 95% CI: 0.50-0.69), female versus male (difference: 0.15 kg/m(2) /year; 95% CI: 0.07-0.23), and Torres Strait Islander versus Aboriginal (difference: 0.36 kg/m(2) /year; 95% CI: 0.17-0.55) children. Results were consistent with less rapid rates of BMI increase for children with lower sugar-sweetened beverage (including fruit juice) and high-fat food consumption. Children's BMI was lower in more disadvantaged areas. Overweight/obesity is common, and increases rapidly, in early childhood. Interventions are required to reduce the overweight/obesity prevalence among Indigenous Australian children in the first 3 years of life and to slow the rapid overweight/obesity onset from age 3 to 9 years. © 2017 The Authors. Obesity published by Wiley Periodicals, Inc. on behalf of The Obesity Society (TOS).

  18. Deadly Choices empowering Indigenous Australians through social networking sites.

    PubMed

    McPhail-Bell, Karen; Appo, Nathan; Haymes, Alana; Bond, Chelsea; Brough, Mark; Fredericks, Bronwyn

    2017-04-05

    The potential for health promotion through social networking sites (SNSs) is widely recognized. However, while health promotion prides itself in focusing on the social determinants of health, its partiality for persuading individuals to comply with health behaviours dominates the way health promotion utilizes SNSs. This paper contributes to an understanding of collaborative ways SNSs can work for health promotion agendas of self-determination and empowerment in an Indigenous Australia context. An ethnographic study was undertaken with Deadly Choices, an Indigenous-led health promotion initiative. The study involved participant observation of interactions on Deadly Choices SNSs between Deadly Choices and its online community members. Deadly Choices provides an example of SNSs providing a powerful tool to create a safe, inclusive and positive space for Indigenous people and communities to profile their healthy choices, according to Indigenous notions of health and identity. The study found five principles that underpin Deadly Choices' use of SNSs for health promotion. These are: create a dialogue; build community online and offline; incentivise healthy online engagement; celebrate Indigenous identity and culture; and prioritize partnerships. Deadly Choices SNSs empowers Indigenous people and communities to be health promoters themselves, which represents a power shift from health promotion practitioner to Indigenous people and communities and more broadly, an enactment of Indigenous self-determination on SNSs. Mainstream health promotion can learn from Indigenous health promotion practice regarding the use of SNSs for health promotion agendas.

  19. The cultural appropriateness and diagnostic usefulness of standardized language assessments for Indigenous Australian children.

    PubMed

    Pearce, Wendy M; Williams, Cori

    2013-08-01

    Speech-language pathologists experience uncertainty about how to interpret standardized assessment results for Indigenous Australian children. There are risks for inappropriate diagnosis: both over- and under-diagnosis of language impairment may occur due to a convergence of linguistic features which causes difficulty in distinguishing between impairment and difference. While the literature suggests that standardized assessments are inappropriate for Indigenous Australian children, there is an absence of empirical documentation to show how Indigenous children perform on standardized tests of language ability. This study examined the performance of 19 Indigenous Australian children, aged 8;01-13;08, from one school on the Clinical Evaluation of Language Fundamentals, Fourth Edition, Australian Standardized Edition. Standardized scores were compared with teacher ratings of children's oral language skills. Analysis showed poor alignment between teacher ratings and language assessment, and assessment scores were negatively influenced by features of Aboriginal English. Children rated with above average language skills presented with different linguistic profiles from the children rated with average and below average language abilities. The inappropriateness of current standardized language assessments for Indigenous children and the need for further research to guide appropriate assessment are discussed.

  20. The effect of social support on the health of Indigenous Australians in a metropolitan community.

    PubMed

    Waterworth, Pippa; Rosenberg, Michael; Braham, Rebecca; Pescud, Melanie; Dimmock, James

    2014-10-01

    The factors driving the disparity in health outcomes between Indigenous and non-Indigenous Australians continue to be poorly understood. Despite this, studies confirm that social connections are a very important part of Indigenous life, and it is likely these connections play an important role in influencing health outcomes among this population. Examining the support provided by social connections in relation to health behaviour may assist our understanding of health outcomes among Indigenous Australians. The current study is focused on exploring Indigenous participants' impressions of their social network and social support using Participatory Action Research methodology and qualitative methods. The objective was to identify the influence of social support on the health outcomes of Indigenous people within a Western Australian metropolitan community. Seventeen members of the community were interviewed during the study. The participants had extensive social networks that mainly comprised members of their kinship group. The consequences of this social network included: (1) the positive effects of social support from bonded relationships; (2) the negative effects of social support produced by over-obligation and unidirectional support involving bonded relationships; (3) limited or inadequate social support caused by withdrawal from bonded relationships; (4) lack of social support from bridging relationships; and (5) a strong desire for connection and a sense of belonging. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Katu Kalpa: Report on the Inquiry into the Effectiveness of Education and Training Programs for Indigenous Australians.

    ERIC Educational Resources Information Center

    Australia Parliament, Canberra. Senate Employment, Workplace Relations, Small Business and Education References Committee.

    An inquiry into Indigenous education by an Australian Senate committee examined government reports produced in 1989-99 and conducted school site visits and public hearings. During the inquiry, it became clear that educational equity for Indigenous people had not been achieved, and Indigenous participation and achievement rates lagged behind those…

  2. The Impact of Professional Development and Indigenous Education Officers on Australian Teachers' Indigenous Teaching and Learning

    ERIC Educational Resources Information Center

    Craven, Rhonda G.; Yeung, Alexander Seeshing; Han, Feifei

    2014-01-01

    The study investigated the impact of professional development (PD) in Indigenous teaching on teachers' psychological and behavioural aspects, and Indigenous students' learning engagement. Adopting a multiple-indicator-multiple-indicator-cause model, frequency of PD was found to have positive paths to teachers' self-concept in Indigenous teaching…

  3. Independent Correlates of Reported Gambling Problems amongst Indigenous Australians

    ERIC Educational Resources Information Center

    Stevens, Matthew; Young, Martin

    2010-01-01

    To identify independent correlates of reported gambling problems amongst the Indigenous population of Australia. A cross-sectional design was applied to a nationally representative sample of the Indigenous population. Estimates of reported gambling problems are presented by remoteness and jurisdiction. Multivariable logistic regression was used to…

  4. A Motivational Psychology for the Education of Indigenous Australian Students

    ERIC Educational Resources Information Center

    Martin, Andrew J.

    2006-01-01

    This article explores an integrative framework for a motivational psychology for the education of Indigenous students. Drawing on and adapting Graham's (1994) taxonomy for motivational psychology, it is suggested that enhancing the educational outcomes of Indigenous students involves addressing factors relevant to the self (positive identity,…

  5. Independent Correlates of Reported Gambling Problems amongst Indigenous Australians

    ERIC Educational Resources Information Center

    Stevens, Matthew; Young, Martin

    2010-01-01

    To identify independent correlates of reported gambling problems amongst the Indigenous population of Australia. A cross-sectional design was applied to a nationally representative sample of the Indigenous population. Estimates of reported gambling problems are presented by remoteness and jurisdiction. Multivariable logistic regression was used to…

  6. Growth and Empowerment for Indigenous Australians in Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Berry, Stacey L.; Crowe, T. P.; Deane, F. P.; Billingham, M.; Bhagerutty, Y.

    2012-01-01

    This paper describes psychosocial outcomes of an Indigenous residential substance abuse rehabilitation centre in Australia, examines the sensitivity to change of the new Growth and Empowerment Measure (GEM), and explores the degree to which service users value cultural components of the treatment program. Participants were 57 Indigenous and 46…

  7. Indigenous Employment and Enterprise Agreements in Australian Universities

    ERIC Educational Resources Information Center

    Brown, Cath

    2014-01-01

    Considering the benefits that enterprise agreements (EAs) can bring to Indigenous employees, this paper considers the question of whether respectful cultural policies that are aligned with reconciliation and included in EAs can be achieved to Close the Gap on reducing Indigenous disadvantage. A document analysis of EAs at eight Australian…

  8. Culture and Wellbeing: The Case of Indigenous Australians

    ERIC Educational Resources Information Center

    Dockery, Alfred Michael

    2010-01-01

    A recurring theme in Indigenous affairs in Australia is a tension between maintenance of Indigenous culture and achievement of socio-economic "equity": essentially "self-determination" versus "assimilation". Implicit in this tension is the view that attachment to traditional cultures and lifestyles is a hindrance to…

  9. New Digital Technologies: Educational Opportunities for Australian Indigenous Learners

    ERIC Educational Resources Information Center

    Watson, Shalini

    2013-01-01

    This article presents a number of possibilities that digital technologies can offer to increase access for Indigenous people to higher education in Australia. Such technologies can assist Indigenous high school students acquire the knowledge and skills they require to be accepted into higher education courses. They can also assist Indigenous…

  10. An Exploration into Growing Patterns with Young Australian Indigenous Students

    ERIC Educational Resources Information Center

    Miller, Jodie; Warren, Elizabeth

    2012-01-01

    This paper presents the results from an initial lesson in a series of design experiments focusing on young Indigenous students' understandings of growing patterns. Indigenous students in Year 2 and 3 (n = 16) participated in pre lesson activities and a 45 minute lesson on growing patterns. Tentative findings from this study suggest that; (a) Year…

  11. A Motivational Psychology for the Education of Indigenous Australian Students

    ERIC Educational Resources Information Center

    Martin, Andrew J.

    2006-01-01

    This article explores an integrative framework for a motivational psychology for the education of Indigenous students. Drawing on and adapting Graham's (1994) taxonomy for motivational psychology, it is suggested that enhancing the educational outcomes of Indigenous students involves addressing factors relevant to the self (positive identity,…

  12. Indigenous Australians' Access to Higher Education: A Catholic University's Response

    ERIC Educational Resources Information Center

    Carpenter, Peter G.; McMullen, Gabrielle L.

    2006-01-01

    Australia's Indigenous peoples represent 2.5% of the national population but this number is increasing at a faster rate than the national average of other demographic groups. The history of the Indigenous peoples is one of dispossession and displacement, and a loss of cultures and languages. Access to and participation in education at all levels,…

  13. Growth and Empowerment for Indigenous Australians in Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Berry, Stacey L.; Crowe, T. P.; Deane, F. P.; Billingham, M.; Bhagerutty, Y.

    2012-01-01

    This paper describes psychosocial outcomes of an Indigenous residential substance abuse rehabilitation centre in Australia, examines the sensitivity to change of the new Growth and Empowerment Measure (GEM), and explores the degree to which service users value cultural components of the treatment program. Participants were 57 Indigenous and 46…

  14. New Digital Technologies: Educational Opportunities for Australian Indigenous Learners

    ERIC Educational Resources Information Center

    Watson, Shalini

    2013-01-01

    This article presents a number of possibilities that digital technologies can offer to increase access for Indigenous people to higher education in Australia. Such technologies can assist Indigenous high school students acquire the knowledge and skills they require to be accepted into higher education courses. They can also assist Indigenous…

  15. Developing a Collaborative Approach to Standpoint in Indigenous Australian Research

    ERIC Educational Resources Information Center

    Tur, Simone Ulalka; Blanch, Faye Rosas; Wilson, Christopher

    2010-01-01

    The notion of Indigenous epistemologies and "ways of knowing" continues to be undervalued within various academic disciplines, particularly those who continue to draw upon "scientific" approaches that colonise Indigenous peoples today. This paper will examine the politics of contested knowledge from the perspective of three…

  16. Delivering culturally appropriate residential rehabilitation for urban Indigenous Australians: a review of the challenges and opportunities.

    PubMed

    Taylor, Kate; Thompson, Sandra; Davis, Robyn

    2010-07-01

    To review the challenges facing Indigenous and mainstream services in delivering residential rehabilitation services to Indigenous Australians, and explore opportunities to enhance outcomes. A literature review was conducted using keyword searches of databases, on-line journals, articles, national papers, conference proceedings and reports from different organisations, with snowball follow-up of relevant citations. Each article was assessed for quality using recognised criteria. Despite debate about the effectiveness of mainstream residential alcohol rehabilitation treatment, most Indigenous Australians with harmful alcohol consumption who seek help have a strong preference for residential treatment. While there is a significant gap in the cultural appropriateness of mainstream services for Indigenous clients, Indigenous-controlled residential organisations also face issues in service delivery. Limitations and inherent difficulties in rigorous evaluation processes further plague both areas of service provision. With inadequate evidence surrounding what constitutes 'best practice' for Indigenous clients in residential settings, more research is needed to investigate, evaluate and contribute to the further development of culturally appropriate models of best practice. In urban settings, a key area for innovation involves improving the capacity and quality of service delivery through effective inter-agency partnerships between Indigenous and mainstream service providers.

  17. Literacy skills of Australian Indigenous school children with and without otitis media and hearing loss.

    PubMed

    Timms, Lydia; Williams, Cori; Stokes, Stephanie F; Kane, Robert

    2014-06-01

    This study examined the relationship between reading, spelling, and the presence of otitis media (OM) and co-occurring hearing loss (HL) in metropolitan Indigenous Australian children, and compared their reading and spelling outcomes with those of their non-Indigenous peers. OM and HL may hinder language development and phonological awareness skills, but there is little empirical evidence to link OM/HL and literacy in this population. Eighty-six Indigenous and non-Indigenous children attending pre-primary, year one and year two at primary schools in the Perth metropolitan area participated in the study. The ear health of the participants was screened by Telethon Speech and Hearing Centre EarBus in 2011/2012. Participants' reading and spelling skills were tested with culturally modified sub-tests of the Queensland University Inventory of Literacy. Of the 46 Indigenous children, 18 presented with at least one episode of OM and one episode of HL. Results indicated that Indigenous participants had significantly poorer non-word and real word reading and spelling skills than their non-Indigenous peers. There was no significant difference between the groups of Indigenous participants with OM and HL and those with normal ear health on either measure. This research provides evidence to suggest that Indigenous children have ongoing literacy development difficulties and discusses the possibility of OM as one of many impacting factors.

  18. Prevalence of stroke and coexistent conditions: disparities between indigenous and nonindigenous Western Australians.

    PubMed

    Katzenellenbogen, Judith M; Knuiman, Matthew W; Sanfilippo, Frank M; Hobbs, Michael S T; Thompson, Sandra C

    2014-10-01

    Worldwide, the prevalence of stroke is poorly described in indigenous populations, despite high stroke burden. This paper reports the average point prevalence of hospitalized stroke and coexistent conditions (2007-2011) in indigenous and nonindigenous people in Western Australia, the largest and most sparsely populated Australian jurisdiction. Using state-wide linked hospital and mortality data, indigenous and nonindigenous prevalent stroke cases (aged 25-84 years) were identified after reviewing stroke admissions over a fixed 20-year look-back period. Prevalent cases were those alive at midyear of each study year. The 2007-2011 period prevalence was a weighted average of annual prevalence. Histories of 11 comorbidities were identified using the 20-year look-back period. Indigenous cases comprised 5% of the average 13 591 annual prevalent cases. Indigenous patients were more likely to be younger, female, and have unknown stroke type. Indigenous prevalence was higher at every age. The age-standardized prevalence in indigenous men (33·7 per 1000; 95% confidence interval 31·9-35·4) was 3.7 times greater than in nonindigenous men (9·1 per 1000; 95% confidence interval 9·0-9·2). The corresponding estimates for women were 27·1 per 1000 (25·7-28·4) and 6·1 per 1000 (6·0-6·2) (ratio = 4·4). The percentage with selected comorbid conditions was substantially higher for indigenous patients. The high stroke prevalence in indigenous Western Australians, coupled with clinical complexity from comorbid conditions, requires access to culturally appropriate medical, rehabilitation, and logistical support. Intensified primary and secondary prevention is needed to reduce the impact of stroke on indigenous people. © 2014 The Authors. International Journal of Stroke © 2014 World Stroke Organization.

  19. Exploring the reliability and acceptability of cognitive tests for Indigenous Australians: a pilot study.

    PubMed

    Dingwall, Kylie M; Gray, Allison O; McCarthy, Annette R; Delima, Jennifer F; Bowden, Stephen C

    2017-08-02

    Reliable cognitive assessment for Indigenous Australians is difficult given that mainstream tests typically rely on Western concepts, content and values. A test's psychometric properties should therefore be assessed prior to use in other cultures. The aim of this pilot study was to examine the reliability and acceptability of four cognitive tests for Australian Aboriginal people. Participants were 40 male and 44 female (N = 84) Aboriginal patients from Alice Springs Hospital. Four tests were assessed for reliability and acceptability - Rowland Universal Dementia Assessment Screen (RUDAS) (n = 19), PEBL Corsi Blocks (Corsi) (n = 19), Story Memory Recall Test (SMRT) (n = 17) and a CogState battery (n = 18). Participants performed one to three of the tests with repeated assessment to determine test-retest reliability. Qualitative interviews were conducted and analysed based on an adapted phenomenological approach to explore test acceptability. An Indigenous Reference Group gave advice and guidance. Intra-class correlations (ICC) for test retest reliability ranged from r = 0.58 (CogState One Back accuracy) to 0.86 (RUDAS). Themes emerged relating to general impressions, impacts on understanding and performance, appropriateness, task preferences and suggested improvements. RUDAS, CogState Identification task, and SMRT showed the highest reliabilities. Overall the tests were viewed as a positive challenge and an opportunity to learn about the brain despite provoking some anxiety in the patients. Caveats for test acceptability included issues related to language, impacts of convalescence and cultural relevance.

  20. Total and unbound ceftriaxone pharmacokinetics in critically ill Australian Indigenous patients with severe sepsis.

    PubMed

    Tsai, Danny; Stewart, Penelope; Goud, Rajendra; Gourley, Stephen; Hewagama, Saliya; Krishnaswamy, Sushena; Wallis, Steven C; Lipman, Jeffrey; Roberts, Jason A

    2016-12-01

    In the absence of specific data to guide optimal dosing, this study aimed to describe the pharmacokinetics of ceftriaxone in severely septic Australian Indigenous patients and to assess achievement of the pharmacodynamic target of the regimens prescribed. A pharmacokinetic study was conducted in a remote hospital intensive care unit in patients receiving ceftriaxone dosing of 1 g every 12 h (q12h). Serial blood and urine samples were collected over one dosing interval on two consecutive days. Samples were assayed using a validated chromatography method for total and unbound concentrations. Concentration-time data collected were analysed with a non-compartmental approach. A total of 100 plasma samples were collected from five subjects. Ceftriaxone clearance, volume of distribution at steady-state, elimination half-life and elimination rate constant estimates were 0.9 (0.6-1.5) L/h, 11.2 (7.6-13.4) L, 9.5 (3.2-10.2) h and 0.07 (0.07-0.21) h(-1), respectively. The unbound fraction of ceftriaxone ranged between 14% and 43%, with a higher unbound fraction present at higher total concentrations. The unbound concentrations at 720 min from the initiation of infusion for the first and second dosing intervals were 7.2 (4.8-10.7) mg/L and 7.8 (4.7-12.1) mg/L respectively, which exceeds the minimum inhibitory concentration of all typical target pathogens. In conclusion, the regimen of ceftriaxone 1 g q12h is adequate for critically ill Australian Indigenous patients with severe sepsis caused by non-resistant pathogens.

  1. Towards a Decolonising Pedagogy: Understanding Australian Indigenous Studies through Critical Whiteness Theory and Film Pedagogy

    ERIC Educational Resources Information Center

    Hook, Genine

    2012-01-01

    This article explores student and teacher engagement with Australian Indigenous Studies. In this article I identify key themes in the film "September" (2007) that demonstrate how the film can be used as a catalyst for student learning and discussion. Critical whiteness theory provides a framework to explore three themes, the invisibility…

  2. Between Duty Statement and Reality--The "Linguist/Coordinator" at an Australian Indigenous Language Centre

    ERIC Educational Resources Information Center

    Olawsky, Knut J.

    2014-01-01

    The size of Australian Indigenous language centres varies from small programs with a single employment position up to large organisations which may involve several linguists, a manager and a range of support staff. This article is based on the linguist's work at an organisation at the smaller end of the scale--"Mirima Dawang…

  3. The School to Work Transition of Indigenous Australians: A Review of the Literature and Statistical Analysis.

    ERIC Educational Resources Information Center

    Long, Mike; Frigo, Tracey; Batten, Margaret

    This report describes the current educational and employment situation of Australian Indigenous youth in terms of their pathways from school to work. A literature review and analysis of statistical data identify barriers to successful transition from school to work, including forms of teaching, curriculum, and assessment that pose greater…

  4. Recolonising an Ethics of Life: Repositioning Indigeneity in Australian "Gap Talk"

    ERIC Educational Resources Information Center

    Harrison, Neil

    2012-01-01

    Soon after it came to power in 2008, the Australian Government adopted six key targets relating to life expectancy, infant mortality, education and employment in its policy "Closing the Gap on Indigenous disadvantage". As it became apparent in 2011 that these targets were not being met, the Prime Minister, Julia Gillard, in her annual…

  5. Between Duty Statement and Reality--The "Linguist/Coordinator" at an Australian Indigenous Language Centre

    ERIC Educational Resources Information Center

    Olawsky, Knut J.

    2014-01-01

    The size of Australian Indigenous language centres varies from small programs with a single employment position up to large organisations which may involve several linguists, a manager and a range of support staff. This article is based on the linguist's work at an organisation at the smaller end of the scale--"Mirima Dawang…

  6. Social and emotional outcomes of Australian children from Indigenous and culturally and linguistically diverse backgrounds.

    PubMed

    Priest, Naomi; Baxter, Jennifer; Hayes, Linda

    2012-04-01

    1) profile the living environments and 2) examine the social and emotional outcomes of Australian children from Indigenous and cultural and linguistically diverse (CALD) backgrounds at school entry. Secondary analysis of cross-sectional data collected in Wave 1 of the Longitudinal Study of Australian Children (n=4,735). Child mental-health outcomes were measured using parent report of the Strengths and Difficulties Questionnaire (SDQ). Significant differences in family and neighbourhood characteristics, including parental income, maternal education, maternal parenting quality and neighbourhood safety, were found in children of Indigenous and CALD backgrounds compared to the reference group of Australian-born, English-speaking children. After controlling for family and neighbourhood characteristics, significant differences in parent-reported SDQ total difficulties were found for Indigenous children. Significant differences in emotional difficulties and peer problems subscales were found for children with overseas-born mothers regardless of English proficiency. Children from Indigenous and CALD backgrounds experience poorer mental health outcomes at school entry than their Australian-born English-speaking peers. They are also more likely to be exposed to risk factors for poor child mental-health outcomes within their family and neighbourhood environments. © 2012 The Authors. ANZJPH © 2012 Public Health Association of Australia.

  7. "Tone It down a Bit!": Euphemism as a Colonial Device in Australian Indigenous Studies

    ERIC Educational Resources Information Center

    McGloin, Colleen

    2014-01-01

    In a previous article discussing the politics of language in Australian Indigenous Studies teaching and learning contexts, the author and her colleague stated their objective in writing that article was to ''instill'' a sense of the importance of the political nature of language to their student body (McGloin and Carlson 2013). They wanted to…

  8. Teachers' Attitudes to Including Indigenous Knowledges in the Australian Science Curriculum

    ERIC Educational Resources Information Center

    Baynes, Renee

    2016-01-01

    With the introduction of the Australian National Curriculum containing the "Aboriginal and Torres Strait Islander Histories and Cultures" Cross-Curriculum Priority (CCP) and "Intercultural Understanding" General Capability, there has been a renewed push to embed Indigenous content into secondary school subjects. This paper…

  9. Towards a Decolonising Pedagogy: Understanding Australian Indigenous Studies through Critical Whiteness Theory and Film Pedagogy

    ERIC Educational Resources Information Center

    Hook, Genine

    2012-01-01

    This article explores student and teacher engagement with Australian Indigenous Studies. In this article I identify key themes in the film "September" (2007) that demonstrate how the film can be used as a catalyst for student learning and discussion. Critical whiteness theory provides a framework to explore three themes, the invisibility…

  10. "Tone It down a Bit!": Euphemism as a Colonial Device in Australian Indigenous Studies

    ERIC Educational Resources Information Center

    McGloin, Colleen

    2014-01-01

    In a previous article discussing the politics of language in Australian Indigenous Studies teaching and learning contexts, the author and her colleague stated their objective in writing that article was to ''instill'' a sense of the importance of the political nature of language to their student body (McGloin and Carlson 2013). They wanted to…

  11. Children's Language Input: A Study of a Remote Multilingual Indigenous Australian Community

    ERIC Educational Resources Information Center

    Loakes, Deborah; Moses, Karin; Wigglesworth, Gillian; Simpson, Jane; Billington, Rosey

    2013-01-01

    Indigenous children growing up in the remote regions of Australia live in multilingual communities which are often undergoing rapid language shift. In these communities, children are exposed to a range of language input, including the traditional language of the area, a local creole and Standard Australian English. The extent to which the…

  12. Where Do We Look Now? The Future of Research in Indigenous Australian Education

    ERIC Educational Resources Information Center

    Harrison, Neil

    2007-01-01

    Research in Indigenous Australian education is at a dead-end. Researchers are still heading out into the field to look for new knowledge to answer old questions. The same epistemology dominates how we look, and where, while the methodology provides the researcher with a forced choice, one where either the student or the teacher is blamed for the…

  13. Teachers' Attitudes to Including Indigenous Knowledges in the Australian Science Curriculum

    ERIC Educational Resources Information Center

    Baynes, Renee

    2016-01-01

    With the introduction of the Australian National Curriculum containing the "Aboriginal and Torres Strait Islander Histories and Cultures" Cross-Curriculum Priority (CCP) and "Intercultural Understanding" General Capability, there has been a renewed push to embed Indigenous content into secondary school subjects. This paper…

  14. Increased numbers of Australian Indigenous nurses would make a significant contribution to 'closing the gap' in Indigenous health: what is getting in the way?

    PubMed

    West, Roianne; Usher, Kim; Foster, Kim

    2010-01-01

    The provision of a well trained and culturally safe health workforce is critical to the alleviation of health inequities for Australian Indigenous peoples. Educating and graduating significant numbers of Indigenous registered nurses is one way the 'Close the Gap' initiative succeeds. Indigenous nurses bring a set of unique skills, knowledge and understanding to health service delivery. Their contribution has the potential to enhance future outcomes for Indigenous people by improving access to health services, ensure services are culturally appropriate and respectful, and assist non-Indigenous nurses to deliver culturally appropriate care. This paper discusses the background to the current numbers of Indigenous undergraduate nursing students enrolled in and completing tertiary nursing courses, with a focus on Queensland nursing programs. A range of identified barriers impede Indigenous nursing students' successful completion of their studies. We propose recommendations for education, research and employment to help overcome these problems, and ensure greater Indigenous participation in the nursing workforce.

  15. The hookworm Ancylostoma ceylanicum: An emerging public health risk in Australian tropical rainforests and Indigenous communities.

    PubMed

    Smout, Felicity A; Skerratt, Lee F; Butler, James R A; Johnson, Christopher N; Congdon, Bradley C; Thompson, R C Andrew

    2017-06-01

    Ancylostoma ceylanicum is the common hookworm of domestic dogs and cats throughout Asia, and is an emerging but little understood public health risk in tropical northern Australia. We investigated the prevalence of A. ceylanicum in soil and free-ranging domestic dogs at six rainforest locations in Far North Queensland that are Indigenous Australian communities and popular tourist attractions within the Wet Tropics World Heritage Area. By combining PCR-based techniques with traditional methods of hookworm species identification, we found the prevalence of hookworm in Indigenous community dogs was high (96.3% and 91.9% from necropsy and faecal samples, respectively). The majority of these infections were A. caninum. We also observed, for the first time, the presence of A. ceylanicum infection in domestic dogs (21.7%) and soil (55.6%) in an Indigenous community. A. ceylanicum was present in soil samples from two out of the three popular tourist locations sampled. Our results contribute to the understanding of dogs as a public health risk to Indigenous communities and tourists in the Wet Tropics. Dog health needs to be more fully addressed as part of the Australian Government's commitments to "closing the gap" in chronic disease between Indigenous and other Australians, and encouraging tourism in similar locations.

  16. Empowerment and Indigenous Australian health: a synthesis of findings from Family Wellbeing formative research.

    PubMed

    Tsey, Komla; Whiteside, Mary; Haswell-Elkins, Melissa; Bainbridge, Roxanne; Cadet-James, Yvonne; Wilson, Andrew

    2010-03-01

    This paper employs a thematic qualitative analysis to synthesise seven discrete formative evaluation reports of an Indigenous Australian family empowerment programme across four study settings in Australia's Northern Territory and Queensland between 1998 and 2005. The aim of the study, which involved a total of 148 adult and 70 school children participants, is to develop a deeper understanding of the contribution of community empowerment education programmes to improving Indigenous health, beyond the evidence derived from the original discrete micro evaluative studies. Within a context beset by trans-generational grief and despair resulting from colonisation and other discriminatory government policies, across the study sites, the participants demonstrated enhanced capacity to exert greater control over factors shaping their health and wellbeing. Evident in the participants' narratives was a heightened sense of Indigenous and spiritual identity, respect for self and others, enhanced parenting and capacity to deal with substance abuse and violence. Changes at the personal level influenced other individuals and systems over time, highlighting the ecological or multilevel dimensions of empowerment. The study reveals the role of psychosocial empowerment attributes as important foundational resources in helping people engage and benefit from health and other behaviour modification programmes, and take advantage of any reforms made within macro policy environments. A key limitation or challenge in the use of psychosocial empowerment programmes relates to the time and resources required to achieve change at population level. A long-term partnership approach to empowerment research that creatively integrates micro community empowerment initiatives with macro policies and programmes is vital if health gains are to be maximised.

  17. Menopause and the influence of culture: another gap for Indigenous Australian women?

    PubMed Central

    2012-01-01

    Background There is great variation in experience of menopause in women around the world. The purpose of this study was to review current understanding of Australian Aboriginal and Torres Strait Islander (Indigenous) women’s experiences of menopause. The literature pertaining to the perception, significance and experience of menopause from a number of cultural groups around the world has been included to provide context for why Indigenous women’s experience might be important for their health and differ from that reported in other studies of Australian women and menopause. Methods A search of databases including Ovid Medline, Pubmed, Web of Science, AUSThealth, AMED, EMBASE, Global Health and PsychINFO was undertaken from January 2011 to April 2011 using the search terms menopause, Indigenous, Aboriginal, attitudes, and perceptions and repeated in September 2012. Results Considerable research shows significant variation across cultures in the menopausal experience. Biological, psychological, social and cultural factors are associated with either positive or negative attitudes, perceptions or experiences of menopause in various cultures. Comparative international literature shows that neither biological nor social factors alone are sufficient to explain the variation in experiences of the menopausal transition. However, a strong influence of culture on the menopause experience can be found. The variation in women’s experience of menopause indicates that different cultural groups of women may have different understandings and needs during the menopausal transition. While considerable literature exists for Australian women as a whole, there has been little investigation of Australian Indigenous women, with only two research studies related to Indigenous women’s experiences of menopause identified. Conclusions Differences in biocultural experience of menopause around the world suggest the importance of biocultural research. For the Indigenous women of Australia

  18. Towards identification of immune and genetic correlates of severe influenza disease in Indigenous Australians.

    PubMed

    Clemens, E Bridie; Grant, Emma J; Wang, Zhongfang; Gras, Stephanie; Tipping, Peta; Rossjohn, Jamie; Miller, Adrian; Tong, Steven Y C; Kedzierska, Katherine

    2016-04-01

    Indigenous populations, including Indigenous Australians, are highly susceptible to severe influenza disease and the underlying mechanisms are unknown. We studied immune and genetic factors that could predicate severe influenza disease in Indigenous Australians enrolled in the LIFT study: looking into influenza T-cell immunity. To examine CD8(+) T-cell immunity, we characterised human leukocyte antigen (HLA) profiles. HLA typing confirmed previous studies showing predominant usage of HLA-A*02:01, 11:01, 24:02, 34:01 and HLA-B*13:01, 15:21, 40:01/02, 56:01/02 in Indigenous Australians. We identified two new HLA alleles (HLA-A*02:new and HLA-B*56:new). Modelling suggests that variations within HLA-A*02:new (but not HLA-B56:new) could affect peptide binding. There is a relative lack of known influenza epitopes for the majority of these HLAs, with the exception of a universal HLA-A*02:01-M158 epitope and proposed epitopes presented by HLA-A*11:01/HLA-A*24:02. To dissect universal CD8(+) T-cell responses, we analysed the magnitude, function and T-cell receptor (TCR) clonality of HLA-A*02:01-M158(+)CD8(+) T cells. We found comparable IFN-γ, TNF and CD107a and TCRαβ characteristics in Indigenous and non-Indigenous Australians, suggesting that the ~15% of Indigenous people that express HLA-A*02:01 have universal influenza-specific CD8(+) T-cell immunity. Furthermore, the frequency of an influenza host risk factor, IFITM3-C/C, was comparable between Indigenous Australians and Europeans, suggesting that expression of this allele does not explain increased disease severity at a population level. Our study indicates a need to identify novel influenza-specific CD8(+) T-cell epitopes restricted by HLA-A and HLA-B alleles prevalent in Indigenous populations for the rational design of universal T-cell vaccines.

  19. Towards identification of immune and genetic correlates of severe influenza disease in Indigenous Australians

    PubMed Central

    Clemens, E Bridie; Grant, Emma J; Wang, Zhongfang; Gras, Stephanie; Tipping, Peta; Rossjohn, Jamie; Miller, Adrian; Tong, Steven YC; Kedzierska, Katherine

    2016-01-01

    Indigenous populations, including Indigenous Australians, are highly susceptible to severe influenza disease and the underlying mechanisms are unknown. We studied immune and genetic factors that could predicate severe influenza disease in Indigenous Australians enrolled in the LIFT study: looking into influenza T-cell immunity. To examine CD8+ T-cell immunity, we characterised human leukocyte antigen (HLA) profiles. HLA typing confirmed previous studies showing predominant usage of HLA-A*02:01, 11:01, 24:02, 34:01 and HLA-B*13:01, 15:21, 40:01/02, 56:01/02 in Indigenous Australians. We identified two new HLA alleles (HLA-A*02:new and HLA-B*56:new). Modelling suggests that variations within HLA-A*02:new (but not HLA-B56:new) could affect peptide binding. There is a relative lack of known influenza epitopes for the majority of these HLAs, with the exception of a universal HLA-A*02:01-M158 epitope and proposed epitopes presented by HLA-A*11:01/HLA-A*24:02. To dissect universal CD8+ T-cell responses, we analysed the magnitude, function and T-cell receptor (TCR) clonality of HLA-A*02:01-M158+CD8+ T cells. We found comparable IFN-γ, TNF and CD107a and TCRαβ characteristics in Indigenous and non-Indigenous Australians, suggesting that the ~15% of Indigenous people that express HLA-A*02:01 have universal influenza-specific CD8+ T-cell immunity. Furthermore, the frequency of an influenza host risk factor, IFITM3-C/C, was comparable between Indigenous Australians and Europeans, suggesting that expression of this allele does not explain increased disease severity at a population level. Our study indicates a need to identify novel influenza-specific CD8+ T-cell epitopes restricted by HLA-A and HLA-B alleles prevalent in Indigenous populations for the rational design of universal T-cell vaccines. PMID:26493179

  20. Spirituality and religion in response to substance misuse among indigenous Australians.

    PubMed

    d'Abbs, Peter; Chenhall, Richard

    2013-09-01

    The ongoing quest for effective ways of preventing and managing alcohol and other drug use-related problems among Indigenous Australians has spawned a variety of approaches, including AA-based treatment, population health-based preventive approaches, and various forms of cultural healing. This paper examines two inter-related sources of ideas and strategies: firstly, the emergence since the 1970s of evangelical Christianity in some Aboriginal communities as a response to profound changes, including increased access to alcohol. The second is the attempt to invoke Indigenous spirituality as an alternative to both western Christianity and western biomedical intervention models. We also discuss the representation of Australian Indigenous spirituality within New Age and related discourses.

  1. Using Indigenous Australian drama to break cultural barriers in healthcare relationships.

    PubMed

    Matharu, K

    2009-06-01

    Since colonisation, the marginalisation of Indigenous Australians has adversely affected their language, culture and health. Mainstream society has failed to address social differences and establish culturally-appropriate health programmes for these groups. This paper extracts important humanistic themes within the context of health from four Indigenous Australian plays written during a period of social unrest in response to past oppression: (1) The dreamers, by Jack David; (2) Murras, by Eva Johnson; (3) Coordah, by Richard Walley; and (4) The keepers, by Bob Maza. These plays will be analysed to (a) illuminate human suffering from an indigenous perspective, based upon social and cultural planes of analysis; (b) understand the socio-cultural basis of poor health; and (c) instruct healthcare professionals that health is a social construct that can be interpreted as the product of select plays that are not solely based upon an illness narrative.

  2. Risk factors for problem gambling among indigenous Australians: an empirical study.

    PubMed

    Hing, Nerilee; Breen, Helen; Gordon, Ashley; Russell, Alex

    2014-06-01

    Despite a long history of gambling amongst many Indigenous peoples, knowledge about contemporary Indigenous gambling is sparse. In Australia, previous studies of Indigenous gambling have been severely limited in number, scope and rigour. The research reported in this paper is based on the first Indigenous-specific quantitative gambling research undertaken in Australia since 1996 and draws on the largest sample to date. This study examined numerous aspects of gambling among Indigenous Australians. After appropriate consultations and permission, the study collected surveys from 1,259 self-selected Indigenous adults in 2011 at three Indigenous festivals, online and in several Indigenous communities. This paper draws on these data to identify problem gambling risk factors by comparing selected socio-demographic characteristics, early exposure to gambling, gambling motivations, gambling behaviour, gambling cognitions, and substance use while gambling, amongst non-problem, low risk, moderate risk and problem gamblers. A logistic regression investigated the difference between problem gamblers and all other PGSI groups. Risk factors associated with being a problem gambler were: being older, commencing gambling when under 10 years old, always being exposed to adults gambling as a child, using alcohol and/or drugs while gambling, having family and friends who gamble, having an addiction to gambling and not gambling to socialise, having a high expenditure on commercial gambling, and living in a state or territory other than NSW or QLD. Public health measures to address these risk factors are identified.

  3. Psychometric properties of an Australian supportive care needs assessment tool for Indigenous patients with cancer.

    PubMed

    Garvey, Gail; Beesley, Vanessa L; Janda, Monika; O'Rourke, Peter K; He, Vincent Y F; Hawkes, Anna L; Elston, Jacinta K; Green, Adele C; Cunningham, Joan; Valery, Patricia C

    2015-09-01

    There are significant disparities in cancer outcomes between Indigenous and non-Indigenous Australians. Identifying the unmet supportive care needs of Indigenous Australians with cancer is imperative to improve their cancer care. The purpose of the current study was to test the psychometric properties of a supportive cancer care needs assessment tool for Indigenous people (SCNAT-IP) with cancer. The SCNAT-IP was administered to 248 Indigenous Australians diagnosed with a range of cancer types and stages, and who received treatment in 1 of 4 Queensland hospitals. All 39 items were assessed for ceiling and floor effects and were analyzed using exploratory factor analysis to determine construct validity. Identified factors were assessed for internal consistency and convergent validity to validated psychosocial tools. Exploratory factor analysis revealed a 4-factor structure (physical and psychological, hospital care, information and communication, and practical and cultural needs) explaining 51% of the variance. Internal consistency of the 4 subscales was good, with Cronbach alpha reliability coefficients ranging from .70 to .89. Convergent validity was supported by significant correlations between the SCNAT-IP with the National Comprehensive Cancer Network Distress Thermometer (correlation coefficient [r] = 0.60; P<.001) and the Cancer Worry Chart (r = 0.58; P<.001) and a moderately strong negative correlation with the Assessment of Quality of Life questionnaire (r = -0.56; P<.001). These data provide initial support for the SCNAT-IP, a measure of multiple supportive care needs domains specific to Indigenous Australian patients with cancer undergoing treatment. © 2015 American Cancer Society.

  4. Australian urban Indigenous smokers' perspectives on nicotine products and tobacco harm reduction.

    PubMed

    Yuke, Kym; Ford, Pauline; Foley, Wendy; Mutch, Allyson; Fitzgerald, Lisa; Gartner, Coral

    2017-05-10

    Indigenous Australians experience a significant gap in life expectancy compared with non-Indigenous Australians. Indigenous communities have high-smoking prevalence and low engagement with cessation therapies. This qualitative research, conducted in an urban Australian Indigenous community, explored smokers' views on smoking, quitting and engagement with current nicotine replacement therapies. Opinions on acceptability of tobacco harm reduction were sought. We explored the acceptability of novel nicotine products, that is, new or unfamiliar products, including non-therapeutic options, such as e-cigarettes. Focus groups and individual interviews with adult Indigenous daily smokers (n = 27) were used. Current and novel nicotine products were displayed and demonstrated. Discussions were audio-recorded, transcribed and analysed thematically. Participants expressed interest in trying existing and novel nicotine products. Short-to-medium term use of nicotine replacement therapy for quitting was generally acceptable; views on long-term use were mixed. Interest in use of tobacco substitutes depended on their perceived effectiveness, providing a 'kick' and 'relieving stress'. Desirable qualities for tobacco substitutes were identified with gender differences and product preferences noted. The unpleasant taste of existing products is a barrier to both short-term and long-term use. We found substantial interest in trying some existing and novel nicotine products, mostly for short-term use. A number of attributes were identified that would make nicotine products potentially acceptable as a long-term substitute. Some participants were interested in long-term substitution if acceptable products were available. Improvements in current products and access to novel products are needed if tobacco harm reduction is to be acceptable. [Yuke K, Ford P, Foley W, Mutch A, Fitzgerald L, Gartner C. Australian urban Indigenous smokers' perspectives on nicotine products and tobacco harm

  5. Renal transplantation in indigenous Australians of the Northern Territory: closing the gap.

    PubMed

    Majoni, S W; Abeyaratne, A

    2013-10-01

    Chronic kidney disease causes high morbidity and mortality among Indigenous Australians of the Northern Territory (NT). Studies have shown chronic kidney disease rates of 4-10 times higher in indigenous than non-indigenous Australians and prevalent dialysis rates of 700-1200 per million population. For most patients with end-stage renal failure, renal transplantation provides the optimal treatment for people with end-stage renal disease. It reduces morbidity and mortality, and improves survival and quality of life. Graft and patient survival rates of over 80% at 5 years depending on the donor source (deceased vs living donor) are expected worldwide. However, this is not the case in Indigenous Australians of the NT where graft and patient survival are both around 50% at 5 years suggesting death with functioning graft as the most common cause of graft loss. It would provide the best treatment option for indigenous people most of who live in remote (18%) and very remote communities (63%). Many have to relocate from their communities to urban or regional centres for dialysis. Available options to avoid relocation include peritoneal dialysis, home haemodialysis and community health centre dialysis, but the acceptance rates for these are low, hence renal transplantation would provide the best option. There is evidence of identified barriers to renal transplantation for indigenous people of the NT. This review explores published data on why rates of renal transplantation in indigenous people of the NT are low and the reasons for poor outcomes highlighting possible areas of improvement. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

  6. Ibobbly mobile health intervention for suicide prevention in Australian Indigenous youth: a pilot randomised controlled trial

    PubMed Central

    Shand, Fiona; Ridani, Rebecca; Mackinnon, Andrew; De La Mata, Nicole; Christensen, Helen

    2017-01-01

    Objectives Rates of youth suicide in Australian Indigenous communities are 4 times the national youth average and demand innovative interventions. Historical and persistent disadvantage is coupled with multiple barriers to help seeking. Mobile phone applications offer the opportunity to deliver therapeutic interventions directly to individuals in remote communities. The pilot study aimed to evaluate the effectiveness of a self-help mobile app (ibobbly) targeting suicidal ideation, depression, psychological distress and impulsivity among Indigenous youth in remote Australia. Setting Remote and very remote communities in the Kimberley region of North Western Australia. Participants Indigenous Australians aged 18–35 years. Interventions 61 participants were recruited and randomised to receive either an app (ibobbly) which delivered acceptance-based therapy over 6 weeks or were waitlisted for 6 weeks and then received the app for the following 6 weeks. Primary and secondary outcome measures The primary outcome was the Depressive Symptom Inventory—Suicidality Subscale (DSI-SS) to identify the frequency and intensity of suicidal ideation in the previous weeks. Secondary outcomes were the Patient Health Questionnaire 9 (PHQ-9), The Kessler Psychological Distress Scale (K10) and the Barratt Impulsivity Scale (BIS-11). Results Although preintervention and postintervention changes on the (DSI-SS) were significant in the ibobbly arm (t=2.40; df=58.1; p=0.0195), these differences were not significant compared with the waitlist arm (t=1.05; df=57.8; p=0.2962). However, participants in the ibobbly group showed substantial and statistically significant reductions in PHQ-9 and K10 scores compared with waitlist. No differences were observed in impulsivity. Waitlist participants improved after 6 weeks of app use. Conclusions Apps for suicide prevention reduce distress and depression but do not show significant reductions on suicide ideation or impulsivity. A feasible

  7. Australia's National Bowel Cancer Screening Program: does it work for Indigenous Australians?

    PubMed Central

    2010-01-01

    Background Despite a lower incidence of bowel cancer overall, Indigenous Australians are more likely to be diagnosed at an advanced stage when prognosis is poor. Bowel cancer screening is an effective means of reducing incidence and mortality from bowel cancer through early identification and prompt treatment. In 2006, Australia began rolling out a population-based National Bowel Cancer Screening Program (NBCSP) using the Faecal Occult Blood Test. Initial evaluation of the program revealed substantial disparities in bowel cancer screening uptake with Indigenous Australians significantly less likely to participate in screening than the non-Indigenous population. This paper critically reviews characteristics of the program which may contribute to the discrepancy in screening uptake, and includes an analysis of organisational, structural, and socio-cultural barriers that play a part in the poorer participation of Indigenous and other disadvantaged and minority groups. Methods A search was undertaken of peer-reviewed journal articles, government reports, and other grey literature using electronic databases and citation snowballing. Articles were critically evaluated for relevance to themes that addressed the research questions. Results The NBCSP is not reaching many Indigenous Australians in the target group, with factors contributing to sub-optimal participation including how participants are selected, the way the screening kit is distributed, the nature of the test and comprehensiveness of its contents, cultural perceptions of cancer and prevailing low levels of knowledge and awareness of bowel cancer and the importance of screening. Conclusions Our findings suggest that the population-based approach to implementing bowel cancer screening to the Australian population unintentionally excludes vulnerable minorities, particularly Indigenous and other culturally and linguistically diverse groups. This potentially contributes to exacerbating the already widening

  8. Perinatal outcomes among young Indigenous Australian mothers: A cross-sectional study and comparison with adult Indigenous mothers.

    PubMed

    Steenkamp, Malinda; Boyle, Jacqueline; Kildea, Sue; Moore, Vivienne; Davies, Michael; Rumbold, Alice

    2017-09-01

    The teenage pregnancy rate is high among Indigenous Australian women, yet little is known about their pregnancy outcomes. Moreover, against a background of extreme social disadvantage, the relative importance of age as a risk factor for adverse outcomes among Indigenous pregnancies is unclear. We compared perinatal outcomes for Indigenous teenagers (<20 years) with adult Indigenous women (20-34 years), and described outcomes in subgroups of teenagers. Data were analyzed for 2421 singleton births to Indigenous women aged <35 years in Australia's Northern Territory from 2003 to 2005. Regression was used to assess the effect of young maternal age on normal birth, healthy baby, preterm birth, low birthweight, special care admission, and mean birthweight, adjusting for covariates. Three-quarters of teenagers and 62% of adult mothers lived in remote areas. Smoking rates were around 50% in both groups. Teenagers were more likely to have a normal birth than adults (adjusted odds ratio 1.78 [95% CI 1.35-2.34]). The groups did not differ for healthy baby, preterm birth, or low birthweight. Babies of teenagers weighed 135 g less than those of adults; however, adjustment for covariates eliminated this difference. Examination of teenage subgroups (≤16 years and 17-19 years) revealed risk behaviors being higher for 17-19 years olds than for the younger group, and more prevalent among urban-based mothers. Young maternal age is not a risk factor for adverse perinatal outcomes among Indigenous women. Rather, they are having babies in disadvantaged circumstances within a system challenged to support them socially and clinically. © 2017 Wiley Periodicals, Inc.

  9. Oral health behaviours and perceptions reported by Indigenous Australians living in Darwin, Northern Territory.

    PubMed

    Amarasena, N; Kapellas, K; Skilton, M; Maple-Brown, L; Brown, A; Bartold, P M; O'Dea, K; Celermajer, D; Slade, G; Jamieson, L M

    2014-03-01

    To describe the reported oral health behaviours and perceptions of Indigenous Australians living in Darwin, Northern Territory and to compare those with estimates for Darwin and Australia derived from the National Survey of Adult Oral Health (NSAOH). A total of 181 Indigenous Australians aged 22 years and over living in Darwin, participating in screening for a wider randomised clinical trial, were included. Information on socio-demographic characteristics, oral health status including oral health behaviours and perceptions was collected using a questionnaire. Differences between the Darwin study (DS) participants and Australians in NSAOH were made based on non-overlapping 95% confidence intervals. Almost 72% of DS participants had last seen a dentist over a year earlier, compared to 47% and 39% of NSAOH Darwin and Australian participants, respectively. A higher proportion of DS participants usually visited a dentist because of a problem than NSAOH Darwin and NSAOH Australian participants. A higher proportion of DS participants had avoided or delayed a dental visit because of cost than NSAOH participants. Over three times as many DS participants rated their oral health as fair/poor compared to NSAOH participants. A higher proportion of DS participants had perceived gum disease and one or more symptoms of gum disease than NSAOH participants. A higher proportion of DS participants experienced toothache, felt uncomfortable about appearance of their mouth and avoided eating because of oral problems than NSAOH participants. A higher proportion of Indigenous Australians living in Darwin presented with non-optimal oral health behaviours and perceptions compared with both the Darwin and Australian general populations.

  10. Isolation of Alloiococcus otitidis from Indigenous and non-Indigenous Australian children with chronic otitis media with effusion.

    PubMed

    Ashhurst-Smith, Christopher; Hall, Sharron T; Walker, Paul; Stuart, John; Hansbro, Philip M; Blackwell, C Caroline

    2007-10-01

    During the last decade Alloiococcus otitidis has been identified in specimens from patients with chronic otitis media with effusion. Whereas most of those studies employed molecular techniques, we used minor modifications of conventional microbiological methods to isolate and identify A. otitidis in samples obtained from 20/50 (40%) children referred for myringotomy. Alloiococcus otitidis was isolated from 10/22 (45%) Indigenous and 10/28 (36%) non-Indigenous children. This is the first report of isolation of A. otitidis from Australian children with chronic otitis media. All isolates were sensitive to penicillin, but 14/20 (70%) of the isolates were resistant or partially resistant to erythromycin as assessed by the E-test.

  11. Bridging the Gap? A Comparative, Retrospective Analysis of Science Literacy and Interest in Science for Indigenous and Non-Indigenous Australian Students

    NASA Astrophysics Data System (ADS)

    McConney, Andrew; Oliver, Mary; Woods-McConney, Amanda; Schibeci, Renato

    2011-09-01

    Previous research has shown that indigenous students in Australia do not enjoy equal educational outcomes with other Australians. This secondary analysis of PISA 2006 confirmed that this continues to be the case in science literacy for secondary students. However, the analysis also revealed that indigenous Australian students held interest in science equal to that of their non-indigenous peers, and that observed variations in science literacy performance were most strongly explained by variations in reading literacy. These findings hold important implications for teachers, teacher educators, policy-makers, and researchers. Firstly, acknowledging and publicly valuing indigenous Australian science knowledge through rethinking school science curriculum seems an important approach to engaging indigenous students and improving their literacy in science. Secondly, appropriate professional learning for practising teachers and the incorporation of indigenous knowing in science methods training in teacher preparation seems warranted. Additionally, we offer a number of questions for further reflection and research that would benefit our understanding of ways forward in closing the science literacy gap for indigenous students. Whilst this research remains firmly situated within the Australian educational context, we at the same time believe that the findings and implications offered here hold value for science education practitioners and researchers in other countries with similar populations striving to achieve science literacy for all.

  12. Prevalence and characteristics of overweight and obesity in indigenous Australian children: A systematic review.

    PubMed

    Dyer, Suzanne Marie; Gomersall, Judith Streak; Smithers, Lisa Gaye; Davy, Carol; Coleman, Dylan T; Street, Jackie Mary

    2017-05-03

    Evidence-based profiling of obesity and overweight in Indigenous Australian children has been poor. This study systematically reviewed evidence of the prevalence and patterns of obesity/overweight, with respect to gender, age, remoteness, and birth weight, in Indigenous Australian children, 0-18 years (PROSPERO CRD42014007626). Study quality and risk of bias were assessed. Twenty-five publications (21 studies) met inclusion criteria, with large variations in prevalence for obesity or overweight (11 to 54%) reported. A high degree of heterogeneity in study design was observed, few studies (6/21) were representative of the target population, and few appropriately recruited Indigenous children (8/21). Variability in study design, conduct, and small sample sizes mean that it is not possible to derive a single estimate for prevalence although two high-quality studies indicate at least one in four Indigenous Australian children are overweight or obese. Four of six studies reporting on gender, found overweight/obesity higher in girls and eight studies reporting on overweight/obesity by age suggest prevalence increases with age with one high quality large national study reporting total overweight/obesity as 22.4% of children aged 2-4 years, 27.5% of those aged 5-9, 38.5% aged 10-14, and 36.3% aged 15-17. Three of four studies, reporting obesity/overweight by region, found lower rates for children living in more remote areas than urban areas.

  13. The relationship between maternal smoking during pregnancy and parental-reported experience of dental caries in Indigenous Australian children.

    PubMed

    Claudia, C; Ju, X; Mejia, G; Jamieson, L

    2016-12-01

    This study aimed to test the association between maternal smoking during pregnancy and parental-reported experience of dental caries in Indigenous Australian children. Data were from the Longitudinal Study of Indigenous Children (LSIC); a population-based cohort study in Australia. Participants were 1,687 Indigenous Australian children aged 5 or less. Biological, social and behavioural variables were tested using log-linear modelling with binomial regression to determine the association with parental-reported experience of dental caries. Markov Chain Monte Carlo methods were used for multiple imputation of missing data. Overall 25.8% of Indigenous Australian children had dental caries as reported by a carer. In the multivariable model, increased prevalence of parental-reported caries was significantly associated with low maternal education levels (RR=1.60, 95%CI 1.17,2.20) and high sugar consumption (RR= 1.60, 95%CI 1.26,2.02). In the group of children whose mothers smoked tobacco during pregnancy, the association with parent-reported dental caries approached the threshold of significance, but was not significantly associated with caries status in children (RR=1.19, 95%CI 0.99,1.43). After multiple imputation, the most significant association was evident in children of the least educated mothers (RR=1.57, 95%CI 1.25,1.95), breastfeeding more than 12 months (RR=1.26, 95%CI 1.01,1.56), sweet intake more than 30% (RR=1.42, 95%CI 1.15,1.74) and 20-30% (RR=1.29 95%CI 1.04,1.59) and residing in outer regional (RR=1.56, 95%CI 1.19,2.05) or inner regional locations (RR=1.50, 95%CI 1.19,1.88). Mothers' tobacco smoking status showed a weak association with parent-reported dental decay (RR=1.42, 95%CI 1.20,1.68). This study suggests there is a weak association between maternal smoking during pregnancy and prevalence of parentally-reported dental caries in Indigenous Australian children.

  14. Access to eye health services among indigenous Australians: an area level analysis

    PubMed Central

    2012-01-01

    Background This project is a community-level study of equity of access to eye health services for Indigenous Australians. Methods The project used data on eye health services from multiple sources including Medicare Australia, inpatient and outpatient data and the National Indigenous Eye Health Survey. The analysis focused on the extent to which access to eye health services varied at an area level according to the proportion of the population that was Indigenous (very low = 0-1.0%, low = 1.1-3.0%, low medium = 3.1-6.0%, high medium = 6.1-10.0%, high = 10.1-20.0%, very high = 20 + %). The analysis of health service utilisation also took into account age, remoteness and the Socioeconomic Indices for Areas (SEIFA). Results The rate of eye exams provided in areas with very high Indigenous populations was two-thirds of the rate of eye exams for areas with very low indigenous populations. The cataract surgery rates in areas with high medium to very high Indigenous populations were less than half that reference areas. In over a third of communities with very high Indigenous populations the cataract surgery rate fell below the World Health Organization (WHO) guidelines compared to a cataract surgery rate of 3% in areas with very low Indigenous populations. Conclusions There remain serious disparities in access to eye health service in areas with high Indigenous populations. Addressing disparities requires a co-ordinated approach to improving Indigenous people’s access to eye health services. More extensive take-up of existing Medicare provisions is an important step in this process. Along with improving access to health services, community education concerning the importance of eye health and the effectiveness of treatment might reduce reluctance to seek help. PMID:22998612

  15. Indigenous Australian Education: A New Millennium, a More Focused Approach.

    ERIC Educational Resources Information Center

    Tripcony, Penny

    Considerable progress has been made in Australia toward the attainment of equitable educational outcomes by Aboriginal people during the past 30 years, and by people of the Torres Strait Islands during the past 15 years. Although parity of outcomes has not yet been achieved, Indigenous education is now positioned within the core business of both…

  16. The Education of Indigenous Australian Students: Same Story, Different Hemisphere

    ERIC Educational Resources Information Center

    Reynolds, Richard J.

    2005-01-01

    Australia's indigenous population is made up of Aboriginal and Torres Strait Islander people, who each have distinctly different cultures. The former can be found in cities and towns and across the vast reaches of rural and remote Australia. The latter generally inhabit the coastal islands off the northeast coast and adjacent mainland areas.…

  17. Story Telling: Australian Indigenous Women's Means of Health Promotion.

    ERIC Educational Resources Information Center

    Brock, Kaye; Acklin, F.; Newman, J.; Arbon, V.; Trindal, A.; Bermingham, M.; Thompson, B.

    Story-telling, an oral tradition of the indigenous peoples of Australia, was recorded on video as a vehicle for conveying health promotion messages in several urban Aboriginal (Koori) communities in Sydney, Australia. The video was made by a group of Koori women Elders and two female Aboriginal academics. The Elders integrated their personal…

  18. The Education of Indigenous Australian Students: Same Story, Different Hemisphere

    ERIC Educational Resources Information Center

    Reynolds, Richard J.

    2005-01-01

    Australia's indigenous population is made up of Aboriginal and Torres Strait Islander people, who each have distinctly different cultures. The former can be found in cities and towns and across the vast reaches of rural and remote Australia. The latter generally inhabit the coastal islands off the northeast coast and adjacent mainland areas.…

  19. The Legacy of Racism and Indigenous Australian Identity within Education

    ERIC Educational Resources Information Center

    Bodkin-Andrews, Gawaian; Carlson, Bronwyn

    2016-01-01

    It may be argued that the emerging discourses focusing on the social, emotional, educational, and economic disadvantages identified for Australia's First Peoples (when compared to their non-Indigenous counterparts) are becoming increasingly dissociated with an understanding of the interplay between historical and current trends in racism.…

  20. The Legacy of Racism and Indigenous Australian Identity within Education

    ERIC Educational Resources Information Center

    Bodkin-Andrews, Gawaian; Carlson, Bronwyn

    2016-01-01

    It may be argued that the emerging discourses focusing on the social, emotional, educational, and economic disadvantages identified for Australia's First Peoples (when compared to their non-Indigenous counterparts) are becoming increasingly dissociated with an understanding of the interplay between historical and current trends in racism.…

  1. The quality of health research for young Indigenous Australians: systematic review.

    PubMed

    Azzopardi, Peter S; Kennedy, Elissa C; Patton, George C; Power, Robert; Roseby, Robert D; Sawyer, Susan M; Brown, Alex D

    2013-07-08

    To assess the extent and quality of the evidence base related to the health and wellbeing of young Indigenous Australians. Systematic review of peer-reviewed literature; grading of quality of literature; mapping of sample characteristics and study foci. English language publications, 1 Jan 1994 - 1 Jan 2011 in MEDLINE, ERIC, CINAHL, EMBASE, ATSIhealth, PsycINFO, the Cochrane Library and the Australian Indigenous HealthInfoNet. Inclusion criteria were: published 1 Jan 1994 - 1 Jan 2011; original peer-reviewed research; reported data for Australian Aboriginal and Torres Strait Islanders aged 10-24 2013s; focused on health and wellbeing. Grading for quality included ascertainment of Indigenous status, representativeness of the sample for the target population, and quality of measures of exposure and outcome. 360 peer-reviewed publications met inclusion criteria; 90 (25%) exclusively sampled Indigenous young people. 250 studies (69%) were of good-quality design; 124 of these focused on health outcomes (15 of these evaluated an intervention) and 116 focused on health-risk exposure (26 evaluative). The methodological quality of data improved during 1994-2010; however, only 17% of studies focused on urban populations. A third of good-quality studies of health outcome focused on communicable diseases such as sexually transmitted infections and tuberculosis. There was good-quality data for oral health and substance use, and some data for adolescent pregnancy. Data on mental disorders, injury and cause-specific mortality were limited. Despite improvements, there are important gaps in the evidence base for the health of young Indigenous Australians. Our study points to the need for greater research investment in urban settings and with regard to mental disorders and injury, with a further emphasis on trials of preventive and clinical intervention.

  2. Stages of Change, Smoking Behaviour and Readiness to Quit in a Large Sample of Indigenous Australians Living in Eight Remote North Queensland Communities

    PubMed Central

    Campbell, Sandra; Bohanna, India; Swinbourne, Anne; Cadet-James, Yvonne; McKeown, Dallas; McDermott, Robyn

    2013-01-01

    Tobacco smoking is a major health issue for Indigenous Australians, however there are few interventions with demonstrated efficacy in this population. The Transtheoretical Model may provide a useful framework for describing smoking behaviour and assessing readiness to quit, with the aim of developing better interventions. Interviews were conducted with 593 Indigenous Australians in eight rural and remote communities in north Queensland, to examine stages of change and smoking behaviour. Among current smokers, 39.6% and 43.4% were in Precontemplation and Contemplation stages respectively. A further 13.9% were making preparations to quit (Preparation) whilst only 3.2% said they were actively trying to quit (Action). When analysed by stage of change, the pattern of smoking-related behaviours conformed to the results of past research using the model. Importantly however, distribution of individuals across the stages opposes those observed in investigations of smoking behaviour in non-Indigenous Australian populations. The Transtheoretical Model can be used to meaningfully classify Indigenous smokers in remote north Queensland according to stages along the behaviour change continuum. Importantly, in this large sample across eight communities, most Indigenous smokers were not making preparations to change their smoking behaviour. This suggests that interventions should focus on promoting movement toward the Preparation and Action stages of change. PMID:23591787

  3. Study protocol - Indigenous Australian social networks and the impact on smoking policy and programs in Australia: protocol for a mixed-method prospective study

    PubMed Central

    2013-01-01

    Background Tobacco use is the most preventable cause of morbidity and mortality in Australia. Comprehensive tobacco control has reduced smoking rates in Australia from approximately 34 per cent in 1980 to 15 per cent in 2010. However, 46 per cent of Aboriginal and Torres Strait Islander people (Indigenous Australians) smoke on a daily basis, more than double the rate of non-Indigenous Australians. The evidence of effective tobacco control strategies for Indigenous Australians is relatively scarce. The aim of this study is to (i) explore the influences of smoking in Indigenous Australian people and to (ii) help inform and evaluate a multi-component tobacco control strategy. The study aims to answer the following questions: - do individuals' social networks influence smoking behaviours; - is there an association between various social and cultural factors and being a smoker or non-smoker; and - does a multi-component tobacco control program impact positively on tobacco behaviours, attitudes and beliefs in Indigenous Australians. Methods and design Our prospective study will use a mixed-method approach (qualitative and quantitative), including a pre- and post-test evaluation of a tobacco control initiative. The study will explore the social and cultural context underlying Indigenous Australian tobacco use and associated factors which influence smoking behaviour. Primary data will be collected via a panel survey, interviews and focus groups. Secondary data will include de-identified PBS items related to smoking and also data collected from the Quitlines call service. Network analysis will be used to assess whether social networks influence smoking behaviours. For the survey, baseline differences will be tested using chi2 statistics for the categorical and dichotomous variables and t-tests for the continuous variables, where appropriate. Grounded theory will be used to analyse the interviews and focus groups. Local Aboriginal community controlled organisations will

  4. Study protocol--Indigenous Australian social networks and the impact on smoking policy and programs in Australia: protocol for a mixed-method prospective study.

    PubMed

    Maddox, Raglan; Davey, Rachel; Cochrane, Tom; Lovett, Ray; van der Sterren, Anke

    2013-09-24

    Tobacco use is the most preventable cause of morbidity and mortality in Australia. Comprehensive tobacco control has reduced smoking rates in Australia from approximately 34 per cent in 1980 to 15 per cent in 2010. However, 46 per cent of Aboriginal and Torres Strait Islander people (Indigenous Australians) smoke on a daily basis, more than double the rate of non-Indigenous Australians. The evidence of effective tobacco control strategies for Indigenous Australians is relatively scarce. The aim of this study is to (i) explore the influences of smoking in Indigenous Australian people and to (ii) help inform and evaluate a multi-component tobacco control strategy. The study aims to answer the following questions:--do individuals' social networks influence smoking behaviours;--is there an association between various social and cultural factors and being a smoker or non-smoker; and--does a multi-component tobacco control program impact positively on tobacco behaviours, attitudes and beliefs in Indigenous Australians. Our prospective study will use a mixed-method approach (qualitative and quantitative), including a pre- and post-test evaluation of a tobacco control initiative. The study will explore the social and cultural context underlying Indigenous Australian tobacco use and associated factors which influence smoking behaviour. Primary data will be collected via a panel survey, interviews and focus groups. Secondary data will include de-identified PBS items related to smoking and also data collected from the Quitlines call service. Network analysis will be used to assess whether social networks influence smoking behaviours. For the survey, baseline differences will be tested using chi(2) statistics for the categorical and dichotomous variables and t-tests for the continuous variables, where appropriate. Grounded theory will be used to analyse the interviews and focus groups. Local Aboriginal community controlled organisations will partner in the study. Our study

  5. The experiences of remote and rural Aboriginal Health Workers and registered nurses who undertook a postgraduate diabetes course to improve the health of Indigenous Australians.

    PubMed

    King, Meri; King, Lindy; Willis, Eileen; Munt, Rebecca; Semmens, Frith

    2012-08-01

    This paper reports on an evaluation of an educational initiative that seeks to improve the diabetes health outcomes of a vulnerable group, Indigenous Australians residing in remote and rural New South Wales. In this context seven Aboriginal Health Workers (AHWs) and ten registered nurses (RNs) undertook an accredited Australian Diabetes Educators Association (ADEA) course. The aims of this study were to identify the beliefs, attitudes and experiences of this group concerning specialist diabetes training, strategies already used by managers and those that could be used to help consolidate the diabetes expertise of AHWs and RNs. The findings indicate specialist diabetes training and constructive support is required if AHWs and RNs are to develop from a novice to an expert. We concluded that the ADEA diabetes course is highly relevant to the needs of Indigenous Australians and that constructive support from managers and the university is most important in the development of diabetes expertise.

  6. The effect of a periodontal intervention on cardiovascular risk markers in Indigenous Australians with periodontal disease: the PerioCardio study

    PubMed Central

    2011-01-01

    Background Indigenous Australians experience an overwhelming burden of chronic disease, including cardiovascular diseases. Periodontal disease (inflammation of the tissues surrounding teeth) is also widespread, and may contribute to the risk of cardiovascular diseases via pathogenic inflammatory pathways. This study will assess measures of vascular health and inflammation in Indigenous Australian adults with periodontal disease, and determine if intensive periodontal therapy improves these measures over a 12 month follow-up. The aims of the study are: (i) to determine whether there is a dose response relationship between extent and severity of periodontal disease and measures of vascular health and inflammation among Indigenous Australian adults with moderate to severe periodontal disease; and (ii) to determine the effects of periodontal treatment on changes in measures of vascular health and inflammation in a cohort of Indigenous Australians. Methods/Design This study will be a randomised, controlled trial, with predominantly blinded assessment of outcome measures and blinded statistical analysis. All participants will receive the periodontal intervention benefits (with the intervention delayed 12 months in participants who are randomised to the control arm). Participants will be Indigenous adults aged ≥25 years from urban centres within the Top End of the Northern Territory, Australia. Participants assessed to have moderate or severe periodontal disease will be randomised to the study's intervention or control arm. The intervention involves intensive removal of subgingival and supragingival calculus and plaque biofilm by scaling and root-planing. Study visits at baseline, 3 and 12 months, will incorporate questionnaires, non-fasting blood and urine samples, body measurements, blood pressure, periodontal assessment and non-invasive measures of vascular health (pulse wave velocity and carotid intima-media thickness). Primary outcome measures are pulse wave

  7. Need for an Australian Indigenous disability workforce strategy: review of the literature.

    PubMed

    Gilroy, John; Dew, Angela; Lincoln, Michelle; Hines, Monique

    2017-08-01

    To identify approaches for developing workforce capacity to deliver the National Disability Insurance Scheme (NDIS) to Indigenous people with disability in Australian rural and remote communities. A narrative review of peer-reviewed and gray literature was undertaken. Searches of electronic databases and websites of key government and non-government organizations were used to supplement the authors' knowledge of literature that (a) focused on Indigenous peoples in Australia or other countries; (b) referred to people with disability; (c) considered rural/remote settings; (d) recommended workforce strategies; and (e) was published in English between 2004 and 2014. Recommended workforce strategies in each publication were summarized in a narrative synthesis. Six peer-reviewed articles and 12 gray publications met inclusion criteria. Three broad categories of workforce strategies were identified: (a) community-based rehabilitation (CBR) and community-centered approaches; (b) cultural training for all workers; and (c) development of an Indigenous disability workforce. An Indigenous disability workforce strategy based on community-centered principles and incorporating cultural training and Indigenous disability workforce development may help to ensure that Indigenous people with a disability in rural and remote communities benefit from current disability sector reforms. Indigenous workforce development requires strategies to attract and retain Aboriginal workers. Implications for Rehabilitation Indigenous people with disability living in rural and remote areas experience significant access and equity barriers to culturally appropriate supports and services that enable them to live independent, socially inclusive lives. A workforce strategy based on community-centered principles has potential for ensuring that the disability services sector meets the rehabilitation needs of Aboriginal people with disability living in rural and remote areas. Cultural training and

  8. Repeat pneumococcal polysaccharide vaccine in Indigenous Australian adults is associated with decreased immune responsiveness.

    PubMed

    Moberley, Sarah; Licciardi, Paul V; Balloch, Anne; Andrews, Ross; Leach, Amanda J; Kirkwood, Marie; Binks, Paula; Mulholland, Kim; Carapetis, Jonathan; Tang, Mimi L K; Skull, Sue

    2017-05-19

    poorer response to a first dose 23vPPV compared to their non-Indigenous counterparts, with lower IgG following a second 23vPPV dose. These findings highlight the critical need to evaluate the efficacy of future pneumococcal vaccine programs in the Australian Indigenous populations that recommend repeated doses of 23vPPV. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. A qualitative study of a social and emotional well-being service for a remote Indigenous Australian community: implications for access, effectiveness, and sustainability.

    PubMed

    Carey, Timothy A

    2013-03-04

    People living in rural and remote Australia experience increased mental health problems compared with metropolitan Australians. Moreover, Indigenous Australians are twice as likely as non Indigenous Australians to report high or very high levels of mental health problems. It is imperative, therefore, that effective and sustainable social and emotional wellbeing services (Indigenous Australians prefer the term "social and emotional wellbeing" to "mental health") are developed for Indigenous Australians living in remote communities. In response to significant and serious events such as suicides and relationship violence in a remote Indigenous community, a social and emotional wellbeing service (SEWBS) was developed. After the service had been running for over three years, an independent evaluation was initiated by the local health board. The aim of the evaluation was to explore the impact of SEWBS, including issues of effectiveness and sustainability, from the experiences of people involved in the development and delivery of the service. Purposive sampling was used to recruit 21 people with different involvement in the service such as service providers, service participants, and referrers. These people were interviewed and their interviews were transcribed. Interpretative Phenomenological Analysis (IPA) was used to analyse the interview transcripts to identify superordinate themes and subthemes in the data. Two superordinate themes and nine subthemes were developed from the interview transcripts. The first superordinate theme was called "The Big Picture" and it had the sub themes: getting started; organizational factors; funding; the future, and; operational problems. The second superordinate theme was called "On the Ground" and it had the subthemes: personal struggles; program activities; measuring outcomes, and; results. While the evaluation indicated that the service had been experienced as an effective local response to serious problems, recommendations and

  10. Factors Influencing the Health Behaviour of Indigenous Australians: Perspectives from Support People

    PubMed Central

    Waterworth, Pippa; Pescud, Melanie; Braham, Rebecca; Dimmock, James; Rosenberg, Michael

    2015-01-01

    Disparities between the health of Indigenous and non-Indigenous populations continue to be prevalent within Australia. Research suggests that Indigenous people participate in health risk behaviour more often than their non-Indigenous counterparts, and that such behaviour has a substantial impact on health outcomes. Although this would indicate that reducing health risk behaviour may have positive effects on health outcomes, the factors that influence Indigenous health behaviour are still poorly understood. This study aimed to interview people who support Indigenous groups to gain an understanding of their views on the factors influencing health behaviour within Indigenous groups in Western Australia. Twenty nine people participated in the study. The emergent themes were mapped against the social ecological model. The results indicated that: (1) culture, social networks, history, racism, socioeconomic disadvantage, and the psychological distress associated with some of these factors interact to affect health behaviour in a complex manner; (2) the desire to retain cultural identity and distinctiveness may have both positive and negative influence on health risk behaviour; (3) strong social connections to family and kin that is intensified by cultural obligations, appears to affirm and disrupt positive health behaviour; (4) the separation between Indigenous and non-Indigenous social connection/networks that appeared to be fostered by marginalisation and racism may influence the effect of social networks on health behaviour; and (5) communication between Indigenous and non-Indigenous people may be interrupted by distrust between the groups, which reduces the influence of some non-Indigenous sources on the health behaviour of Indigenous people. PMID:26599437

  11. The effectiveness of a suicide prevention app for indigenous Australian youths: study protocol for a randomized controlled trial.

    PubMed

    Shand, Fiona L; Ridani, Rebecca; Tighe, Joe; Christensen, Helen

    2013-11-20

    Indigenous Australian youth (aged 15 to 34) have up to four times the risk of suicide compared with their non-Indigenous counterparts. Barriers to help-seeking include shame, feared loss of autonomy and negative attitudes towards healthcare providers. The use of mobile devices and apps continues to rise amongst young people, thus presenting opportunities to utilize these aids in overcoming help-seeking barriers. Apps have been shown to assist in several health-related areas, including weight loss and smoking cessation, although no apps have as yet been evaluated for suicide prevention. Moreover, there is a lack of research that scientifically evaluates suicide prevention interventions within Indigenous communities. In this study, a recently developed self-help app will be evaluated in a randomized controlled trial. The intervention is based on acceptance and commitment therapy and mindfulness-based cognitive behavioural therapy. It is aimed at participants who have suicidal thoughts but who are not actively suicidal. In total, 150 participants will be randomly allocated to the intervention-condition (N = 75) or to the wait-list control condition (N = 75). Questionnaires will be completed at baseline, post-test and 6 weeks follow-up. The primary outcome measure is a reduction in frequency and intensity of suicidal thoughts. Secondary outcome measures are the reduction of depression, anxiety and impulsivity. This study is the first to evaluate the effectiveness of a self-help app for suicidal thoughts amongst young Indigenous people. Several limitations and strengths of the design are discussed. Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12613000104752.

  12. Differential Effects of Temperature Extremes on Hospital Admission Rates for Respiratory Disease between Indigenous and Non-Indigenous Australians in the Northern Territory.

    PubMed

    Green, Donna; Bambrick, Hilary; Tait, Peter; Goldie, James; Schultz, Rosalie; Webb, Leanne; Alexander, Lisa; Pitman, Andrew

    2015-12-03

    The health gap between Indigenous and non-Indigenous Australians may be exacerbated by climate change if temperature extremes have disproportionate adverse effects on Indigenous people. To explore this issue, we analysed the effect of temperature extremes on hospital admissions for respiratory diseases, stratified by age, Indigenous status and sex, for people living in two different climates zones in the Northern Territory during the period 1993-2011. We examined admissions for both acute and chronic respiratory diagnoses, controlling for day of the week and seasonality variables. Our analysis showed that: (1) overall, Indigenous hospital admission rates far exceeded non-Indigenous admission rates for acute and chronic diagnoses, and Top End climate zone admission rates exceeded Central Australia climate zone admission rates; (2) extreme cold and hot temperatures were associated with inconsistent changes in admission rates for acute respiratory disease in Indigenous and non-Indigenous children and older adults; and (3) no response to cold or hot temperature extremes was found for chronic respiratory diagnoses. These findings support our two hypotheses, that extreme hot and cold temperatures have a different effect on hospitalisations for respiratory disease between Indigenous and non-Indigenous people, and that these health risks vary between the different climate zones. We did not, however, find that there were differing responses to temperature extremes in the two populations, suggesting that any increased vulnerability to climate change in the Indigenous population of the Northern Territory arises from an increased underlying risk to respiratory disease and an already greater existing health burden.

  13. A Discussion with Sandy O'Sullivan about Key Issues for the Australian Indigenous Studies Learning and Teaching Network

    ERIC Educational Resources Information Center

    Barney, Katelyn

    2014-01-01

    This article takes the form of an interview with Sandy O'Sullivan, who is a partner on the Australian Indigenous Studies Learning and Teaching Network, about key issues that have arisen through Network discussions. She is a Wiradjuri woman and a Senior Aboriginal researcher at the Batchelor Institute of Indigenous Tertiary Education. O'Sullivan…

  14. Burdens Too Difficult to Carry? A Case Study of Three Academically Able Indigenous Australian Masters Students Who Had to Withdraw

    ERIC Educational Resources Information Center

    Chirgwin, Sharon Kaye

    2015-01-01

    Previous research into attrition rates of Indigenous Australian Higher Degree by Research (HDR) candidates has focused on institutional barriers, highlighting cultural disparities. This case study of three academically able candidates who withdrew before completion from an institution designed to meet the needs of Indigenous students describes…

  15. A Discussion with Sandy O'Sullivan about Key Issues for the Australian Indigenous Studies Learning and Teaching Network

    ERIC Educational Resources Information Center

    Barney, Katelyn

    2014-01-01

    This article takes the form of an interview with Sandy O'Sullivan, who is a partner on the Australian Indigenous Studies Learning and Teaching Network, about key issues that have arisen through Network discussions. She is a Wiradjuri woman and a Senior Aboriginal researcher at the Batchelor Institute of Indigenous Tertiary Education. O'Sullivan…

  16. Burdens Too Difficult to Carry? A Case Study of Three Academically Able Indigenous Australian Masters Students Who Had to Withdraw

    ERIC Educational Resources Information Center

    Chirgwin, Sharon Kaye

    2015-01-01

    Previous research into attrition rates of Indigenous Australian Higher Degree by Research (HDR) candidates has focused on institutional barriers, highlighting cultural disparities. This case study of three academically able candidates who withdrew before completion from an institution designed to meet the needs of Indigenous students describes…

  17. Speech-language pathology practices with Indigenous Australians with acquired communication disorders.

    PubMed

    Hersh, Deborah; Armstrong, Elizabeth; Panak, Vanessa; Coombes, Jacqui

    2015-02-01

    Little is known about the needs of Indigenous Australian adults with acquired communication disorders (ACD) following stroke or brain injury and how these needs are met by speech-language pathology (SLP) services. In order for the profession to respond to the challenges of providing culturally appropriate, well-tailored and accessible services, more information on current practice and SLPs' concerns and attitudes is required. This paper reports on a national survey with completed responses from 112 SLPs, who worked with adult neurological populations, about their levels of contact with Indigenous clients, cultural competency training and potential sources of support. RESULT. Of the total respondents, 63 SLPs reported clinical contact with Indigenous clients and :they also answered questions on their assessment, intervention and discharge practices; liaison with family; and involvement with Aboriginal Health Professionals and interpreters. This group reported insufficient knowledge about Indigenous culture, lack of support and lower levels of confidence overall in working with these clients as compared to non-Indigenous clients. They wanted more flexible services for their Indigenous clients, good access to interpreters and culturally appropriate assessments and treatments delivered in culturally appropriate settings. This research provides a useful starting point towards understanding SLPs' perspectives and practice at a national level.

  18. Exploring productivity and collaboration in Australian Indigenous health research, 1995–2008

    PubMed Central

    2013-01-01

    Background Building research capacity in Indigenous health has been recognised as integral in efforts to reduce the significant health disparities between Indigenous and other Australian populations. The past few decades have seen substantial changes in funding policy for Australian Indigenous health research, including increases in overall expenditure and a greater focus on collaborative and priority-driven research. However, whether these policy shifts have resulted in any change to the structure of the research workforce in this field is unclear. We examine research publications in Australian Indigenous health from 1995–2008 to explore trends in publication output, key themes investigated, and research collaborations. Methods A comprehensive literature search was undertaken to identify research publications about Australian Indigenous health from 1995–2008. Abstracts of all publications identified were reviewed by two investigators for relevance. Eligible publications were classified according to key themes. Social network analyses of co-authorship patterns were used to examine collaboration in the periods 1995–1999, 2000–2004 and 2005–2008. Results Nine hundred and fifty three publications were identified. Over time, the number of publications per year increased, particularly after 2005, and there was a substantial increase in assessment of health service-related issues. Network analyses revealed a highly collaborative core group of authors responsible for the majority of outputs, in addition to a series of smaller separate groups. In the first two periods there was a small increase in the overall network size (from n = 583 to n = 642 authors) due to growth in collaborations around the core. In the last period, the network size increased considerably (n = 1,083), largely due to an increase in the number and size of separate groups. The general size of collaborations also increased in this period. Conclusions In the past few decades there

  19. Molecular virology of hepatitis B virus, sub-genotype C4 in northern Australian Indigenous populations.

    PubMed

    Littlejohn, M; Davies, J; Yuen, L; Edwards, R; Sozzi, T; Jackson, K; Cowie, B; Tong, S; Davis, J; Locarnini, S

    2014-04-01

    Indigenous Australians experience a significant health burden from chronic hepatitis B infection; however, the strain of hepatitis B virus (HBV) found among Indigenous Australians has not been well characterized. Blood samples were collected from 65 Indigenous Australians with chronic HBV infection from across the Top End of Australia's Northern Territory. Phylogenetic analysis of HBV from these samples revealed that 100% of the isolates were genotype C, sub-genotype C4, expressing the serotype ayw3. This strain is a divergent group within the HBV/C genotype, and has only been described in Indigenous Australians. Evidence of recombination was suggested by discordant phylogenetic clustering of the C4 sequences when comparing the full genome to the surface region and confirmed by recombination analysis which showed the surface gene region to be most closely related to genotype J, while the remaining regions of the genome were most similar to genotype C sequences. Mutational analysis revealed the presence of multiple mutations that have been linked with more rapid liver disease progression and an increased risk of hepatocellular carcinoma. These mutations were detected in the majority of sequences examined. Variants associated with vaccine failure were detected as the predominant viral quasi-species in 3/35 samples. In summary, the HBV C4 variant found in this population has a high potential to cause advanced liver disease and to escape vaccination programs. Further in vitro functional and natural history studies are warranted in order to determine the clinical and public health consequences of infection with the HBV C4 variant in these communities.

  20. Culture and PCR detection of Haemophilus influenzae and Haemophilus haemolyticus in Australian Indigenous children with bronchiectasis.

    PubMed

    Hare, K M; Binks, M J; Grimwood, K; Chang, A B; Leach, A J; Smith-Vaughan, H

    2012-07-01

    A PCR for protein D (hpd#3) was used to differentiate nontypeable Haemophilus influenzae (NTHI) from Haemophilus haemolyticus. While 90% of nasopharyngeal specimens and 100% of lower-airway specimens from 84 Indigenous Australian children with bronchiectasis had phenotypic NTHI isolates confirmed as H. influenzae, only 39% of oropharyngeal specimens with phenotypic NTHI had H. influenzae. The nasopharynx is therefore the preferred site for NTHI colonization studies, and NTHI is confirmed as an important lower-airway pathogen.

  1. Fluctuations in money availability within an income cycle impacts diet quality of remote Indigenous Australians.

    PubMed

    Wycherley, Thomas P; Pekarsky, Brita Ak; Ferguson, Megan M; O'Dea, Kerin; Brimblecombe, Julie K

    2017-06-01

    To consider the plausible nutritional impacts of fluctuations in money availability within an income cycle for remote Indigenous Australians. Community-level dietary intake (energy, micro/macronutrients) and expenditure on foods and beverages (F&B) were estimated over one year for three remote Indigenous Australian communities (Northern Territory, Australia) using monthly F&B transaction data. F&B that were likely to be consumed during a period within an income cycle when money was relatively limited (low money period (LMP) foods) were identified by panel consensus and scenario modelling was conducted to simulate the nutritional outcomes of a range of F&B selection responses to having an LMP. All scenarios resulted in reduced diet quality during the LMP relative to overall average diet values. Protein and fat energy percentages were reduced and carbohydrate energy percentage increased. Despite reduced expenditure, declines in energy intake were typically buffered due to the reduced energy cost ($AU/MJ) of the LMP diet. The micronutrient profile of the LMP diet was substantially poorer, such that additional key micronutrients dropped below population-weighted Estimated Average Requirements/Adequate Intakes. The modelling undertaken herein suggests that even a short period of low money within an income cycle may noticeably contribute to the reduced diet quality of remote Indigenous Australians and exacerbate lifestyle disease risk. Dietary strategies that are designed to respond to diets and expenditure during different income cycle periods, rather than the overall average diet and expenditure, should be considered for improving diet quality and reducing cardiometabolic disease risk in remote Indigenous Australians.

  2. Culture and PCR Detection of Haemophilus influenzae and Haemophilus haemolyticus in Australian Indigenous Children with Bronchiectasis

    PubMed Central

    Binks, M. J.; Grimwood, K.; Chang, A. B.; Leach, A. J.; Smith-Vaughan, H.

    2012-01-01

    A PCR for protein D (hpd#3) was used to differentiate nontypeable Haemophilus influenzae (NTHI) from Haemophilus haemolyticus. While 90% of nasopharyngeal specimens and 100% of lower-airway specimens from 84 Indigenous Australian children with bronchiectasis had phenotypic NTHI isolates confirmed as H. influenzae, only 39% of oropharyngeal specimens with phenotypic NTHI had H. influenzae. The nasopharynx is therefore the preferred site for NTHI colonization studies, and NTHI is confirmed as an important lower-airway pathogen. PMID:22553240

  3. Health literacy and Australian Indigenous peoples: an analysis of the role of language and worldview.

    PubMed

    Vass, Alyssa; Mitchell, Alice; Dhurrkay, Yurranydjil

    2011-04-01

    This article delineates specific issues relating to health literacy for Indigenous Australians. Drawing on the extensive experience of the authors' work with Yolnu people (of north-east Arnhem Land) and using one model for health literacy described in the international literature, various components of health literacy are explored, including fundamental literacy, scientific literacy, community literacy and cultural literacy. By matching these components to the characteristics of Yolnu people, the authors argue that language and worldview form an integral part of health education methodology when working with Indigenous people whose first language is not English and who do not have a biomedical worldview in their history. Only through acknowledging and actively engaging with these characteristics of Indigenous people can all aspects of health literacy be addressed and health empowerment be attained.

  4. Young Australian Indigenous students' effective engagement in mathematics: the role of language, patterns, and structure

    NASA Astrophysics Data System (ADS)

    Warren, Elizabeth; Miller, Jodie

    2013-03-01

    This paper explores the outcomes of the first year of the implementation of a mathematics program ( Representations, oral language and engagement in Mathematics: RoleM) which is framed upon research relating to effectively supporting young Indigenous students' learning. The sample comprised 230 Indigenous students (average age 5.76 years) from 15 schools located across Queensland. The pre-test and post-test results from purposely developed language and mathematics tests indicate that young Indigenous Australian students are very capable learners of mathematics. The results of a multiple regression analysis denoted that their ability to ascertain the structure of patterns and to understand mathematical language were both strong predictors of their success in mathematics, with the latter making the larger contribution.

  5. Indigenous health and environmental risk factors: an Australian problem with global analogues?

    PubMed

    Knibbs, Luke D; Sly, Peter D

    2014-01-01

    Indigenous people experience poorer health than non-Indigenous people, and this well-described inequality has been observed in many countries. The contribution of different risk factors to the health 'gap' has understandably focussed on those factors for which there are sufficient data. However, this has precluded environmental risk factors - those present in air, water, food, and soil - due to a lack of data describing exposures and outcomes. These risk factors are demonstrably important at the global scale, as highlighted by the 2010 Global Burden of Disease study. Here, we describe how a greater focus on environmental risk factors is required in order to define their role in the Indigenous health gap. We use the Australian context as a case study of an issue we feel has global analogues and relevance. Suggestions for how and why this situation should be remedied are presented and discussed.

  6. Approaches to dog health education programs in Australian rural and remote Indigenous communities: four case studies.

    PubMed

    Constable, S E; Dixon, R M; Dixon, R J; Toribio, J-A

    2013-09-01

    Dog health in rural and remote Australian Indigenous communities is below urban averages in numerous respects. Many Indigenous communities have called for knowledge sharing in this area. However, dog health education programs are in their infancy, and lack data on effective practices. Without this core knowledge, health promotion efforts cannot progress effectively. This paper discusses a strategy that draws from successful approaches in human health and indigenous education, such as dadirri, and culturally respectful community engagement and development. Negotiating an appropriate education program is explored in its practical application through four case studies. Though each case was unique, the comparison of the four illustrated the importance of listening (community consultation), developing and maintaining relationships, community involvement and employment. The most successful case studies were those that could fully implement all four areas. Outcomes included improved local dog health capacity, local employment and engagement with the program and significantly improved dog health.

  7. Indigenous health and environmental risk factors: an Australian problem with global analogues?

    PubMed Central

    Knibbs, Luke D.; Sly, Peter D.

    2014-01-01

    Indigenous people experience poorer health than non-Indigenous people, and this well-described inequality has been observed in many countries. The contribution of different risk factors to the health ‘gap’ has understandably focussed on those factors for which there are sufficient data. However, this has precluded environmental risk factors – those present in air, water, food, and soil – due to a lack of data describing exposures and outcomes. These risk factors are demonstrably important at the global scale, as highlighted by the 2010 Global Burden of Disease study. Here, we describe how a greater focus on environmental risk factors is required in order to define their role in the Indigenous health gap. We use the Australian context as a case study of an issue we feel has global analogues and relevance. Suggestions for how and why this situation should be remedied are presented and discussed. PMID:24802385

  8. Pattern and Outcome of Heart Failure-Related Hospitalization Over 5 Years in a Remote Australian Population: A Retrospective Administrative Data Cohort of 617 Indigenous and non-Indigenous Cases.

    PubMed

    Tuttle, Camilla; Reeves, Matthew; Zhong Hu, Ta-Chi; Keates, Ashley K; Brady, Stephen; Maguire, Graeme; Stewart, Simon

    2017-10-01

    The aim of this work was to understand the pattern and outcomes for heart failure (HF)-related hospitalization among Indigenous and non-Indigenous patients living in Central Australia. A retrospective analysis of administrative data for patients presenting with a primary or secondary diagnosis of HF to Central Australia's Alice Springs Hospital during 2008-2012 was performed. The population rate of admission and subsequent outcomes (including mortality and readmission) during the 5-year study period were examined. A total of 617 patients, aged 55.8 ± 17.5 years and 302 (49%) female constituted the study cohort. The 446 Indigenous patients (72%) were significantly younger (50.8 ± 15.9 vs 68.7 ± 14.9; P < .001) and clinically more complex compared with the non-Indigenous patients. Annual prevalence of any HF hospitalization was markedly higher in the Indigenous population (1.9%, 95% CI 1.7-2.1) compared with the non-Indigenous population (0.5%, 95% CI 0.4-0.6); the greatest difference being for women. Overall, non-Indigenous patients had poorer outcomes and were significantly more likely to die (P < .0001), but this was largely driven by age differences. Alternatively, Indigenous patients were significantly more likely to have a higher number of hospitalizations, although indigeneity was not a predictor for 30- or 365-day rehospitalization from the index admission. The pattern of HF among Indigenous Australians in Central Australia is characterized by a younger population with more clinically complex cases and greater health care utilization. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Effect of dialect on identification and severity of speech impairment in Indigenous Australian children.

    PubMed

    Toohill, Bethany J; Mcleod, Sharynne; McCormack, Jane

    2012-02-01

    This study investigated the effect of dialectal difference on identification and rating of severity of speech impairment in children from Indigenous Australian backgrounds. The speech of 15 Indigenous Australian children identified by their parents/caregivers and teachers as having 'difficulty talking and making speech sounds' was assessed using the Diagnostic Evaluation of Articulation and Phonology. Fourteen children were identified with speech impairment on the Diagnostic Evaluation of Articulation and Phonology using Standard Australian English (AusE) as the target pronunciation; whereas 13 were identified using Australian Aboriginal English (AAE) as the target. There was a statistically significant decrease in seven children's severity classification and a statistically significant increase in all children's percentage of consonants, vowels and phonemes correct when comparing AAE with AusE. Features of AAE used by the children included /h/ insertion and deletion, primary stress on the first syllable and diphthongs alternating with short clear vowels. It is important that speech-language pathologists consider children's dialect as one component of culturally and linguistically appropriate services.

  10. Correlations suggest low magnesium may lead to higher rates of type 2 diabetes in Indigenous Australians.

    PubMed

    Longstreet, D A; Heath, D L; Panaretto, K S; Vink, R

    2007-01-01

    Diabetes accounts for a significant part of the morbidity and mortality experienced by Australian Aboriginal and Torres Strait Islander populations. Research over the past two decades has provided evidence of a clinical correlation between diabetes and low magnesium intake. Hypomagnesaemia is the most common electrolyte abnormality in diabetic outpatients and may be linked to the development of both macrovascular and microvascular diabetic complications. A diabetes risk reduction of 33%-34% has been found among those with diets highest in magnesium. This study examines the case for magnesium as a potential contributor to diabetes in Australia, especially among Aboriginal and Torres Strait Islander peoples. Specifically explored are associations between diabetes and the magnesium content of drinking water and diet, as well as climatic and socioeconomic factors that may impact on magnesium status including temperature, rainfall, education, employment and income. Queensland age-standardized death rates due to diabetes were correlated with the magnesium content of drinking water, maximum average temperature, rainfall, unemployment rate, proportion of population with post-school qualification, weekly income, and the percentage population identified as Indigenous. Multiple-pass 24-hour recalls from a convenience sample of 100 Indigenous patients at a regional centre were also analyzed to estimate dietary magnesium intake. The Indigenous nutrient intake was then compared with the Australian National Nutrition Survey estimates. Diabetes related mortality was significantly correlated to the percentage of the population identified as Indigenous (r = 0.675), to water magnesium levels (r = -.414), and to average maximum daily temperature (r = 0.579). The average daily magnesium intake in an Indigenous cohort from a regional centre was 248 mg (men: 267 mg +/- 17; women: 245 mg +/- 6 mg), significantly less than intakes observed in the 1995 National Nutrition Survey (p<.001

  11. Allostatic load mediates the impact of stress and trauma on physical and mental health in Indigenous Australians.

    PubMed

    Sarnyai, Zoltán; Berger, Maximus; Jawan, Isabella

    2016-02-01

    A considerable gap exists in health and social emotional well-being between Indigenous people and non-Indigenous Australians. Recent research in stress neurobiology highlights biological pathways that link early adversity and traumas as well as life stresses to ill health. We argue that the neurobiological stress response and its maladaptive changes, termed allostatic load, provide a useful framework to understand how adversity leads to physical and mental illness in Indigenous people. In this paper we review the biology of allostatic load and make links between stress-induced systemic hormonal, metabolic and immunological changes and physical and mental illnesses. Exposure to chronic stress throughout life results in an increased allostatic load that may contribute to a number of metabolic, cardiovascular and mental disorders that shorten life expectancy in Indigenous Australians. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  12. Translation of tobacco policy into practice in disadvantaged and marginalized subpopulations: a study of challenges and opportunities in remote Australian Indigenous communities

    PubMed Central

    2012-01-01

    Background In Australia generally, smoking prevalence more than halved after 1980 and recently commenced to decline among Australia's disadvantaged Indigenous peoples. However, in some remote Indigenous Australian communities in the Northern Territory (NT), extremely high rates of up to 83% have not changed over the past 25 years. The World Health Organisation has called for public health and political leadership to address a global tobacco epidemic. For Indigenous Australians, unprecedented policies aim to overcome disadvantage and close the 'health gap' with reducing tobacco use the top priority. This study identifies challenges and opportunities to implementing these important new tobacco initiatives in remote Indigenous communities. Methods: With little empirical evidence available, we interviewed 82 key stakeholders across the NT representing operational- and management-level service providers, local Indigenous and non-Indigenous participants to identify challenges and opportunities for translating new policies into successful tobacco interventions. Data were analysed using qualitative approaches to identify emergent themes. Results The 20 emergent themes were classified using counts of occasions each theme occurred in the transcribed data as challenge or opportunity. The 'smoke-free policies' theme occurred most frequently as opportunity but infrequently as challenge while 'health workforce capacity' occurred most frequently as challenge but less frequently as opportunity, suggesting that policy implementation is constrained by lack of a skilled workforce. 'Smoking cessation support' occurred frequently as opportunity but also frequently as challenge suggesting that support for individuals requires additional input and attention. Conclusions These results from interviews with local and operational-level participants indicate that current tobacco policies in Australia targeting Indigenous smoking are sound and comprehensive. However, for remote Indigenous

  13. A narrative analysis of a speech pathologist's work with Indigenous Australians with acquired communication disorders.

    PubMed

    Hersh, Deborah; Armstrong, Elizabeth; Bourke, Noni

    2015-01-01

    To explore in detail the narrative of a speech pathologist (SP) working with Indigenous Australian clients with acquired communication disorders following stroke or brain injury. There is some evidence that Indigenous clients do not find speech pathology rehabilitation to be culturally appropriate but, currently, there is very little published on the nature of this service or the experiences of SPs who provide this rehabilitation. This research uses both thematic and structural narrative analysis of data from a semi-structured, in-depth interview with a SP to examine the adaptations that she made to address the needs of her adult neurological caseload of (mainly) Indigenous Australians from both urban and remote regions. The thematic analysis resulted in a core theme of flexibility and four other sub-themes: awareness of cultural context, client focus/person-centredness, being practical and working ethically. The structural narrative analysis allowed insight into the nature of clinical reasoning in a context lacking predictability and where previous clinical certainties required adaptation. Individual, detailed narratives are useful in exposing the challenges and clinical reasoning behind culturally sensitive practice. Implications for Rehabilitation Speech pathologists (SPs) can learn from hearing the clinical stories of colleagues with experience of providing rehabilitation in culturally diverse contexts, as well as from ongoing training in culturally competent and safe practices. Such stories help bridge understanding from the general to the particular. SPs working with Indigenous Australians with acquired communication disorders post-stroke and brain injury may find it helpful to consider how the themes, drawn from an interview with the clinician in this study - flexibility, awareness of cultural context, person-centredness, being practical and working ethically - might apply to their practice. Narratives may be helpful in staff training and form an important

  14. Health-related quality of life among Indigenous Australians diagnosed with cancer.

    PubMed

    Garvey, G; Cunningham, J; He, V Yf; Janda, M; Baade, P; Sabesan, S; Martin, J H; Fay, M; Adams, J; Kondalsamy-Chennakesavan, S; Valery, P C

    2016-08-01

    Health-related quality of life (HRQoL) and associated factors were assessed among 155 Indigenous Australian adult cancer patients 6 months post-diagnosis. The Assessment of Quality of Life-4D Questionnaire was used to assess HRQoL. Differences in the median utility score among subgroups of interest were examined using nonparametric tests. Factors associated with excellent HRQoL were assessed through logistic regression. Participants' mean age was 52 years (range 20-78), and the majority were female (60 %), unemployed (72 %), and recruited from outpatients clinics (64 %). Breast cancer (27 %) was the most common diagnosis. The median HRQoL score was 0.62; 14 % of participants reported excellent HRQoL (>0.90). After adjusting for age, admission status, and treatment, excellent HRQoL was more likely among participants of Torres Strait Islander origin [adjusted odds ratio (AOR) 3.68; 95 % CI 1.23-11.01], those living in regional areas (AOR 5.59; 95 % CI 1.42-22.06), and those whose main language spoken at home was not English (AOR 3.60; 95 % CI 1.08-11.99) and less likely among those reporting less contact with Indigenous people (AOR 0.23; 95 % CI 0.68-0.81). Assessing HRQoL is important to identifying and improving the length and quality of cancer survivorship, especially in groups that have significantly poorer cancer outcomes, such as Indigenous Australians. Acknowledging the study's observational nature, we found HRQoL was lower than reported for other Australians, and we identified some socio-demographic factors that were associated with excellent HRQoL. Such assessments are an important component of identifying and evaluating appropriate interventions to improve the health and well-being of Indigenous cancer patients.

  15. Nutrition and older indigenous australians: service delivery implications in remote communities. A narrative review.

    PubMed

    Schouten, Kellie; Lindeman, Melissa A; Reid, John Binda

    2013-12-01

    To describe the nutritional status of older Indigenous people, barriers to achieving optimal nutrition, and the effectiveness of programs aimed at improving nutrition in older Indigenous people in remote communities. A comprehensive literature review was undertaken utilising electronic databases Scopus, CINAHL, Informit, Ovid MEDLINE, ProQuest, Web of Knowledge, PsycINFO, ATSI HealthInfoNet and Google Scholar. Grey literature was also accessed. Findings indicated there is a scarcity of representative data on nutritional status and risk in older Indigenous people, and nutrition support programs have not been evaluated. Older Indigenous people suffer from poorer overall health and higher levels of overweight and obesity, and are at increased risk of poor nutritional status and malnutrition than the general population. This risk may be higher in remote areas. More representative data are needed to determine the nutritional status of older Indigenous people, including levels of malnutrition. Support programs also need to be evaluated. © 2013 ACOTA.

  16. An online spatial database of Australian Indigenous Biocultural Knowledge for contemporary natural and cultural resource management.

    PubMed

    Pert, Petina L; Ens, Emilie J; Locke, John; Clarke, Philip A; Packer, Joanne M; Turpin, Gerry

    2015-11-15

    With growing international calls for the enhanced involvement of Indigenous peoples and their biocultural knowledge in managing conservation and the sustainable use of physical environment, it is timely to review the available literature and develop cross-cultural approaches to the management of biocultural resources. Online spatial databases are becoming common tools for educating land managers about Indigenous Biocultural Knowledge (IBK), specifically to raise a broad awareness of issues, identify knowledge gaps and opportunities, and to promote collaboration. Here we describe a novel approach to the application of internet and spatial analysis tools that provide an overview of publically available documented Australian IBK (AIBK) and outline the processes used to develop the online resource. By funding an AIBK working group, the Australian Centre for Ecological Analysis and Synthesis (ACEAS) provided a unique opportunity to bring together cross-cultural, cross-disciplinary and trans-organizational contributors who developed these resources. Without such an intentionally collaborative process, this unique tool would not have been developed. The tool developed through this process is derived from a spatial and temporal literature review, case studies and a compilation of methods, as well as other relevant AIBK papers. The online resource illustrates the depth and breadth of documented IBK and identifies opportunities for further work, partnerships and investment for the benefit of not only Indigenous Australians, but all Australians. The database currently includes links to over 1500 publically available IBK documents, of which 568 are geo-referenced and were mapped. It is anticipated that as awareness of the online resource grows, more documents will be provided through the website to build the database. It is envisaged that this will become a well-used tool, integral to future natural and cultural resource management and maintenance. Copyright © 2015. Published

  17. Early Life Predictors of Increased Body Mass Index among Indigenous Australian Children

    PubMed Central

    Thurber, Katherine A.; Dobbins, Timothy

    2015-01-01

    Aboriginal and Torres Strait Islander Australians are more likely than non-Indigenous Australians to be obese and experience chronic disease in adulthood—conditions linked to being overweight in childhood. Birthweight and prenatal exposures are associated with increased Body Mass Index (BMI) in other populations, but the relationship is unclear for Indigenous children. The Longitudinal Study of Indigenous Children is an ongoing cohort study of up to 1,759 children across Australia. We used a multilevel model to examine the association between children’s birthweight and BMI z-score in 2011, at age 3-9 years, adjusted for sociodemographic and maternal factors. Complete data were available for 682 of the 1,264 children participating in the 2011 survey; we repeated the analyses in the full sample with BMI recorded (n=1,152) after multilevel multiple imputation. One in ten children were born large for gestational age, and 17% were born small for gestational age. Increasing birthweight predicted increasing BMI; a 1-unit increase in birthweight z-score was associated with a 0.22-unit (95% CI:0.13, 0.31) increase in childhood BMI z-score. Maternal smoking during pregnancy was associated with a significant increase (0.25; 95% CI:0.05, 0.45) in BMI z-score. The multiple imputation analysis indicated that our findings were not distorted by biases in the missing data. High birthweight may be a risk indicator for overweight and obesity among Indigenous children. National targets to reduce the incidence of low birthweight which measure progress by an increase in the population’s average birthweight may be ignoring a significant health risk; both ends of the spectrum must be considered. Interventions to improve maternal health during pregnancy are the first step to decreasing the prevalence of high BMI among the next generation of Indigenous children. PMID:26075400

  18. Cultural challenges when developing anti-tobacco messages for Indigenous Australians.

    PubMed

    Gould, Gillian Sandra; Stevenson, Leah C; Cadet-James, Yvonne; Clough, Alan R

    2016-08-22

    Recently, many programs have been funded to tackle Indigenous Australian smoking. This study assessed what challenges and unexpected responses could occur when developing anti-tobacco messages for Indigenous communities. A cross-sectional telephone survey of organizations involved in making anti-tobacco messages for the target population was conducted in 2012-2013. Open-ended questions explored cultural challenges to message development and unexpected outcomes. Responses were noted and these qualitative data were independently coded by two researchers using an inductive analysis. Non-parametric tests explored associations between organization orientation, whether target group feedback about messages was sought (pre-tests) and the presence of the above factors. The 47 organizations represented included: 22 Aboriginal Medical Services (AMS), 13 government organizations (GO), eight non-government organizations (NGO) and four universities. The response rate was 83%. Cultural challenges were reported equally by organizations oriented towards Aboriginal communities and those oriented towards the general population. Organizations conducting target group pre-tests of the messages were more likely to report cultural challenges (p = 0.002). Four main themes were revealed: the diversity of Aboriginal and Torres Strait Islander cultures; the selection of role models; conflicts and delays; and unexpected outcomes. Nearly 60% of organizations reported better-than-expected outcomes e.g. community appreciation and pride. A further 40% reported negative responses, e.g. messages being misunderstood or confronting. Cultural challenges and unexpected outcomes are reported by Australian organizations when developing anti-tobacco messages for Indigenous Australians warranting attention to improve the salience of anti-tobacco messages for Indigenous peoples.NB. In this paper, Indigenous Australians is a term used to refer to Aboriginal and Torres Strait Islander peoples, the first

  19. Socio-demographic factors and psychological distress in Indigenous and non-Indigenous Australian adults aged 18-64 years: analysis of national survey data.

    PubMed

    Cunningham, Joan; Paradies, Yin C

    2012-02-01

    Indigenous Australians are known to be at greater risk of morbidity and mortality from mental health related conditions, but most available data relate to the use of mental health services, and little is known about other aspects of social and emotional wellbeing. Using the first available nationally representative data, we examined the prevalence and patterning of psychological distress among Indigenous Australian adults and compared these with corresponding data from the non-Indigenous population. The analysis used weighted data on psychological distress, as measured by a modified Kessler Psychological Distress score (K5), and a range of socio-demographic measures for 5,417 Indigenous and 15,432 non-Indigenous adults aged 18-64 years from two nationally representative surveys. Very high psychological distress (VHPD) was defined as a K5 score ≥ 15 (possible range = 5-25). Indigenous adults were about three times more likely than non-Indigenous adults to be classified with VHPD: 14.5% (95% confidence interval (CI) 12.9-16.0%) versus 5.5% (95% CI 5.0-5.9%). After adjusting for age, most socio-demographic variables were significantly associated with VHPD in both populations, although the relative odds were generally larger among non-Indigenous people. Indigenous people in remote areas had a lower prevalence of VHPD than their non-remote counterparts, and only marital status, main language, and food insecurity were significantly associated with VHPD in remote areas. Higher absolute levels of VHPD combined with smaller socio-demographic gradients in the Indigenous population suggest the importance of risk factors such as interpersonal racism, marginalization and dispossession, chronic stress and exposure to violence that are experienced by Indigenous Australians with common and/or cross-cutting effects across the socioeconomic spectrum. The lower prevalence of VHPD and lack of association with many socio-demographic variables in remote areas suggests either that the

  20. Socio-demographic factors and psychological distress in Indigenous and non-Indigenous Australian adults aged 18-64 years: analysis of national survey data

    PubMed Central

    2012-01-01

    Background Indigenous Australians are known to be at greater risk of morbidity and mortality from mental health related conditions, but most available data relate to the use of mental health services, and little is known about other aspects of social and emotional wellbeing. Using the first available nationally representative data, we examined the prevalence and patterning of psychological distress among Indigenous Australian adults and compared these with corresponding data from the non-Indigenous population. Methods The analysis used weighted data on psychological distress, as measured by a modified Kessler Psychological Distress score (K5), and a range of socio-demographic measures for 5,417 Indigenous and 15,432 non-Indigenous adults aged 18-64 years from two nationally representative surveys. Very high psychological distress (VHPD) was defined as a K5 score ≥ 15 (possible range = 5-25). Results Indigenous adults were about three times more likely than non-Indigenous adults to be classified with VHPD: 14.5% (95% confidence interval (CI) 12.9-16.0%) versus 5.5% (95% CI 5.0-5.9%). After adjusting for age, most socio-demographic variables were significantly associated with VHPD in both populations, although the relative odds were generally larger among non-Indigenous people. Indigenous people in remote areas had a lower prevalence of VHPD than their non-remote counterparts, and only marital status, main language, and food insecurity were significantly associated with VHPD in remote areas. Conclusions Higher absolute levels of VHPD combined with smaller socio-demographic gradients in the Indigenous population suggest the importance of risk factors such as interpersonal racism, marginalization and dispossession, chronic stress and exposure to violence that are experienced by Indigenous Australians with common and/or cross-cutting effects across the socioeconomic spectrum. The lower prevalence of VHPD and lack of association with many socio-demographic variables in

  1. Community health workers improve diabetes care in remote Australian Indigenous communities: results of a pragmatic cluster randomized controlled trial.

    PubMed

    McDermott, Robyn A; Schmidt, Barbara; Preece, Cilla; Owens, Vickie; Taylor, Sean; Li, Ming; Esterman, Adrian

    2015-02-19

    Health outcomes for Indigenous Australians with diabetes in remote areas remain poor, including high rates of avoidable complications which could be reduced with better primary level care. We aimed to evaluate the effectiveness of a community-based health-worker led case management approach to the care of Indigenous adults with poorly controlled type 2 diabetes in primary care services in remote northern Australia. Two hundred and thirteen adults with poorly controlled diabetes (HbA1c > 8.5%) and significant comorbidities in 12 remote communities were randomly assigned by service cluster to receive chronic care co-ordination from a community-based health worker supported by a clinical outreach team, or to a waitlist control group which received usual care. At baseline, mean age of participants was 47.9 years, 62.4% were female, half were Aboriginal and half identified as Torres Strait Islander, 67% had less than 12 years of education, 39% were smokers, median income was $18,200 and 47% were unemployed. Mean HbA1c was 10.7% (93 mmol/mol) and BMI 32.5. At follow-up after 18 months, HbA1c reduction was significantly greater in the intervention group (-1.0% vs -0.2%, SE (diff) = 0.2, p = 0.02). There were no significant differences between the groups for blood pressure, lipid profile, BMI or renal function. Intervention group participants were more likely to receive nutrition and dental services according to scheduled care plans. Smoking rates were unchanged. A culturally safe, community level health-worker led model of diabetes care for high risk patients can be effective in improving diabetes control in remote Indigenous Australian communities where there is poor access to mainstream services. This approach can be effective in other remote settings, but requires longer term evaluation to capture accrued benefits. ANZCTR 12610000812099, Registered 29 September 2010.

  2. Culture and healthy lifestyles: a qualitative exploration of the role of food and physical activity in three urban Australian Indigenous communities.

    PubMed

    Crowe, Ruth; Stanley, Rebecca; Probst, Yasmine; McMahon, Anne

    2017-08-01

    1) To explore the links between Indigenous Australian children's perspectives on culture, and healthy lifestyle behaviours. 2) To provide insight into how to approach the development of a health intervention targeting lifestyle behaviours in Australian Indigenous children. Seven semi-structured focus groups sessions were conducted with Australian Indigenous children aged 5-12 years living on the South Coast of New South Wales. Audio-recordings were transcribed and thematic analyses were conducted and related to principles of grounded theory. Participants had connections to aspects of Australian Indigenous culture that were embedded in their everyday lives. Healthy lifestyle behaviours (such as healthy eating and physical activity) were found to be interconnected with Australian Indigenous culture and positive emotional wellbeing was identified as an important outcome of connecting Australian Indigenous children to cultural practices. Understanding the importance of culture and its role in healthy lifestyles is critical in the development of health interventions for Indigenous populations. Health interventions embedded with Australian Indigenous culture may have potential to improve physical and emotional health within Australian Indigenous communities. However, it is unlikely that a 'one size fits all' approach to health interventions can be taken. © 2017 The Authors.

  3. Development and preliminary validation of the 'Caring for Country' questionnaire: measurement of an Indigenous Australian health determinant

    PubMed Central

    Burgess, Christopher P; Berry, Helen L; Gunthorpe, Wendy; Bailie, Ross S

    2008-01-01

    Background 'Caring for Country' is defined as Indigenous participation in interrelated activities with the objective of promoting ecological and human health. Ecological services on Indigenous-owned lands are belatedly attracting some institutional investment. However, the health outcomes associated with Indigenous participation in 'caring for country' activities have never been investigated. The aims of this study were to pilot and validate a questionnaire measuring caring for country as an Indigenous health determinant and to relate it to an external reference, obesity. Methods Purposively sampled participants were 301 Indigenous adults aged 15 to 54 years, recruited during a cross-sectional program of preventive health checks in a remote Australian community. Questionnaire validation was undertaken with psychometric tests of internal consistency, reliability, exploratory factor analysis and confirmatory one-factor congeneric modelling. Accurate item weightings were derived from the model and used to create a single weighted composite score for caring for country. Multiple linear regression modelling was used to test associations between the caring for country score and body mass index adjusting for socio-demographic factors and health behaviours. Results The questionnaire demonstrated adequate internal consistency, test-retest validity and proxy-respondent validity. Exploratory factor analysis of the 'caring for country' items produced a single factor solution that was confirmed via one-factor congeneric modelling. A significant and substantial association between greater participation in caring for country activities and lower body mass index was demonstrated. Adjusting for socio-demographic factors and health behaviours, an inter-quartile range rise in caring for country scores was associated with 6.1 Kg and 5.3 Kg less body weight for non-pregnant women and men respectively. Conclusion This study indicates preliminary support for the validity of the caring

  4. The Impact of Prior Flavivirus Infections on the Development of Type 2 Diabetes Among the Indigenous Australians.

    PubMed

    Sorenson, Alanna; Owens, Leigh; Caltabiano, Marie; Cadet-James, Yvonne; Hall, Roy; Govan, Brenda; Clancy, Paula

    2016-08-03

    It is estimated that 5% of Australians over the age of 18 have diabetes, with the number of new cases increasing every year. Type 2 diabetes (T2D) also represents a significant disease burden in the Australian indigenous population, where prevalence is three times greater than that of non-indigenous Australians. Prevalence of T2D has been found to be higher in rural and remote indigenous Australian populations compared with urban indigenous Australian populations. Several studies have also found that body mass index and waist circumference are not appropriate for the prediction of T2D risk in indigenous Australians. Regional and remote areas of Australia are endemic for a variety of mosquito-borne flaviviruses. Studies that have investigated seroprevalence of flaviviruses in remote aboriginal communities have found high proportions of seroconversion. The family Flaviviridae comprises several genera of viruses with non-segmented single-stranded positive sense RNA genomes, and includes the flaviviruses and hepaciviruses. Hepatitis C virus (HCV) has been shown to be associated with insulin resistance and subsequent development of T2D. Flaviviruses and HCV possess conserved proteins and subgenomic RNA structures that may play similar roles in the development of insulin resistance. Although dietary and lifestyle factors are associated with increased risk of developing T2D, the impact of infectious diseases such as arboviruses has not been assessed. Flaviviruses circulating in indigenous Australian communities may play a significant role in inducing glucose intolerance and exacerbating T2D. © The American Society of Tropical Medicine and Hygiene.

  5. 'A politics of what': the enactment of peritoneal dialysis in indigenous Australians.

    PubMed

    McCarthy, Alexandra; Martin-McDonald, Kristine

    2007-01-01

    This paper explores, on the one hand, the requirements of the technologies and practices that have been developed for a particular type of renal patient and health network in Australia. On the other, we examine the cultural and practical specificities entailed in the performance of these technologies and practices in the Indigenous Australian context. The praxiographic orientation of the actor-network approach - which has been called 'the politics of what' (Mol 2002) - enabled us to understand the difficulties involved in translating renal healthcare networks across cultural contexts in Australia; to understand the dynamic and contested nature of these networks; and to suggest possible strategies that make use of the tensions between these two disparate networks in ways that might ensure better healthcare for Indigenous renal patients.

  6. New Visions: Exploring Australian Identity through Films Highlighting Experiences of Indigenous Australians: Year 8 Film Unit

    ERIC Educational Resources Information Center

    Wagner, Monika; Wenlock, Jennifer

    2012-01-01

    Prior to 2011, Year 8 students studied a single film as text, "Yolngu Boy." This had been on the syllabus for several years, and the consensus was that it was time to review the unit, refresh the text and introduce multiple film texts that would present varying visions and perspectives of notions of what it is to be "Australian". The authors aimed…

  7. New Visions: Exploring Australian Identity through Films Highlighting Experiences of Indigenous Australians: Year 8 Film Unit

    ERIC Educational Resources Information Center

    Wagner, Monika; Wenlock, Jennifer

    2012-01-01

    Prior to 2011, Year 8 students studied a single film as text, "Yolngu Boy." This had been on the syllabus for several years, and the consensus was that it was time to review the unit, refresh the text and introduce multiple film texts that would present varying visions and perspectives of notions of what it is to be "Australian". The authors aimed…

  8. Cardiovascular disease risk in young Indigenous Australians: a snapshot of current preventive health care.

    PubMed

    Crinall, Bethany; Boyle, Jacqueline; Gibson-Helm, Melanie; Esler, Danielle; Larkins, Sarah; Bailie, Ross

    2017-10-01

    To examine preventive health attendance and recording of type 2 diabetes and cardiovascular disease risk factors and their management in young Aboriginal peoples and Torres Strait Islanders (Indigenous Australians) at primary health care centres (PHCs). This descriptive cross-sectional study audited medical records of 1,986 Indigenous people aged 15-34 years attending 93 Australian PHCs. Measurements included blood pressure (BP), blood glucose level (BGL), smoking status, body mass index (BMI) and lipid profile. Last attendance was most commonly for acute care (46%); 12% attended for preventive assessment. BP was recorded in 85% (1,686/1,986), BGL 63% (1,244/1,986), smoking status 52% (1,033/1,986), BMI 37% (743/1,986) and lipids 31% (625/1,986). Of those with a recorded assessment, elevated BGL (39%, 479/1,244), smoking (63%, 649/1,033), overweight/obesity (51%, 381/743) and dyslipidaemia (73%, 458/625) were common. Follow-up of abnormal results was documented for elevated BP 28% (34/120), elevated BGL 17% (79/479), smoking 65% (421/649), overweight/obesity 11% (40/381) and abnormal lipids 16% (75/458). These findings highlight the importance of raising awareness and assessment of chronic disease risk factors in young Indigenous people and implementing preventive health care strategies. Strengthening the capacity of PHCs to provide preventive health care may contribute to reducing the chronic disease burden experienced by young Indigenous people. © 2016 Public Health Association of Australia.

  9. Petrol sniffing interventions among Australian indigenous communities through product substitution: from skunk juice to opal.

    PubMed

    d'Abbs, Peter; MacLean, Sarah

    2011-01-01

    Inhalation of petrol (gasoline) fumes has been prevalent in some Australian Indigenous communities since World War II, and has led to a continuing quest for an effective method of preventing the practice either by modifying the substance or by substituting nonharmful alternatives. This article traces the results of this search, beginning with the addition of ethyl mercaptan, then describing the substitution of aviation fuel for conventional vehicle fuel, and concluding with the staged introduction of Opal--a vehicle fuel containing low levels of aromatic hydrocarbons--throughout many communities from 2005. The article assesses the benefits and limitations of supply reduction methods.

  10. Evidence for low high-density lipoprotein cholesterol levels in Australian indigenous peoples: a systematic review

    PubMed Central

    2014-01-01

    Background Low plasma high-density lipoprotein cholesterol (HDL-C) levels are a strong, independent, but poorly understood risk factor for cardiovascular disease (CVD). Although this atherogenic lipid abnormality has been widely reported in Australia’s Indigenous peoples, Aboriginal and Torres Strait Islanders, the evidence has not come under systematic review. This review therefore examines published data for Indigenous Australians reporting 1) mean HDL-C levels for both sexes and 2) factors associated with low HDL-C. Methods PubMed, Medline and Informit ATSI Health databases were systematically searched between 1950 and 2012 for studies on Indigenous Australians reporting mean HDL-C levels in both sexes. Retrieved studies were evaluated by standard criteria. Low HDL-C was defined as: <1.0 mmol/L. Analyses of primary data associating measures of HDL-C with other CVD risk factors were also performed. Results Fifteen of 93 retrieved studies were identified for inclusion. These provided 58 mean HDL-C levels; 29 for each sex, most obtained in rural/regional (20%) or remote settings (60%) and including 51–1641 participants. For Australian Aborigines, mean HDL-C values ranged between 0.81-1.50 mmol/L in females and 0.76-1.60 mmol/L in males. Two of 15 studies reported HDL-C levels for Torres Strait Islander populations, mean HDL-C: 1.00 or 1.11 mmol/L for females and 1.01 or 1.13 mmol/L for males. Low HDL-C was observed only in rural/regional and remote settings - not in national or urban studies (n = 3) in either gender. Diabetes prevalence, mean/median waist-to-hip ratio and circulating C-reactive protein levels were negatively associated with HDL-C levels (all P < 0.05). Thirty-four per cent of studies reported lower mean HDL-C levels in females than in males. Conclusions Very low mean HDL-C levels are common in Australian Indigenous populations living in rural and remote communities. Inverse associations between HDL-C and central obesity, diabetes

  11. Socio-Economic Status and Peritonitis in Australian Non-Indigenous Peritoneal Dialysis Patients.

    PubMed

    Tang, Wen; Grace, Blair; McDonald, Stephen P; Hawley, Carmel M; Badve, Sunil V; Boudville, Neil C; Brown, Fiona G; Clayton, Philip A; Johnson, David W

    2015-01-01

    ♦ The aim of the present study was to investigate the relationship between socio-economic status (SES) and peritoneal dialysis (PD)-related peritonitis. ♦ Associations between area SES and peritonitis risk and outcomes were examined in all non-indigenous patients who received PD in Australia between 1 October 2003 and 31 December 2010 (peritonitis outcomes). SES was assessed by deciles of postcode-based Australian Socio-Economic Indexes for Areas (SEIFA), including Index of Relative Socio-economic Disadvantage (IRSD), Index of Relative Socio-economic Advantage and Disadvantage (IRSAD), Index of Economic Resources (IER) and Index of Education and Occupation (IEO). ♦ 7,417 patients were included in the present study. Mixed-effects Poisson regression demonstrated that incident rate ratios for peritonitis were generally lower in the higher SEIFA-based deciles compared with the reference (decile 1), although the reductions were only statistically significant in some deciles (IRSAD deciles 2 and 4 - 9; IRSD deciles 4 - 6; IER deciles 4 and 6; IEO deciles 3 and 6). Mixed-effects logistic regression showed that lower probabilities of hospitalization were predicted by relatively higher SES, and lower probabilities of peritonitis-associated death were predicted by less SES disadvantage status and greater access to economic resources. No association was observed between SES and the risks of peritonitis cure, catheter removal and permanent hemodialysis (HD) transfer. ♦ In Australia, where there is universal free healthcare, higher SES was associated with lower risks of peritonitis-associated hospitalization and death, and a lower risk of peritonitis in some categories. Copyright © 2015 International Society for Peritoneal Dialysis.

  12. Socio-Economic Status and Peritonitis in Australian Non-Indigenous Peritoneal Dialysis Patients

    PubMed Central

    Tang, Wen; Grace, Blair; McDonald, Stephen P.; Hawley, Carmel M.; Badve, Sunil V.; Boudville, Neil C.; Brown, Fiona G.; Clayton, Philip A.; Johnson, David W.

    2015-01-01

    ♦ Background: The aim of the present study was to investigate the relationship between socio-economic status (SES) and peritoneal dialysis (PD)-related peritonitis. ♦ Methods: Associations between area SES and peritonitis risk and outcomes were examined in all non-indigenous patients who received PD in Australia between 1 October 2003 and 31 December 2010 (peritonitis outcomes). SES was assessed by deciles of postcode-based Australian Socio-Economic Indexes for Areas (SEIFA), including Index of Relative Socio-economic Disadvantage (IRSD), Index of Relative Socio-economic Advantage and Disadvantage (IRSAD), Index of Economic Resources (IER) and Index of Education and Occupation (IEO). ♦ Results: 7,417 patients were included in the present study. Mixed-effects Poisson regression demonstrated that incident rate ratios for peritonitis were generally lower in the higher SEIFA-based deciles compared with the reference (decile 1), although the reductions were only statistically significant in some deciles (IRSAD deciles 2 and 4 – 9; IRSD deciles 4 – 6; IER deciles 4 and 6; IEO deciles 3 and 6). Mixed-effects logistic regression showed that lower probabilities of hospitalization were predicted by relatively higher SES, and lower probabilities of peritonitis-associated death were predicted by less SES disadvantage status and greater access to economic resources. No association was observed between SES and the risks of peritonitis cure, catheter removal and permanent hemodialysis (HD) transfer. ♦ Conclusions: In Australia, where there is universal free healthcare, higher SES was associated with lower risks of peritonitis-associated hospitalization and death, and a lower risk of peritonitis in some categories. PMID:24497587

  13. It's Special and It's Specific: Understanding the Early Childhood Education Experiences and Expectations of Young Indigenous Australian Children and Their Parents

    ERIC Educational Resources Information Center

    Martin, Karen L.

    2017-01-01

    Whilst early childhood education is regarded as important for young Indigenous Australians and it has been a feature of policy since the 1960s, it does not receive the same attention as compulsory schooling for Indigenous Australian students. A serious lack of large-scale research contributes to the devaluing of early childhood education for young…

  14. It's Special and It's Specific: Understanding the Early Childhood Education Experiences and Expectations of Young Indigenous Australian Children and Their Parents

    ERIC Educational Resources Information Center

    Martin, Karen L.

    2017-01-01

    Whilst early childhood education is regarded as important for young Indigenous Australians and it has been a feature of policy since the 1960s, it does not receive the same attention as compulsory schooling for Indigenous Australian students. A serious lack of large-scale research contributes to the devaluing of early childhood education for young…

  15. Differential Effects of Temperature Extremes on Hospital Admission Rates for Respiratory Disease between Indigenous and Non-Indigenous Australians in the Northern Territory

    PubMed Central

    Green, Donna; Bambrick, Hilary; Tait, Peter; Goldie, James; Schultz, Rosalie; Webb, Leanne; Alexander, Lisa; Pitman, Andrew

    2015-01-01

    The health gap between Indigenous and non-Indigenous Australians may be exacerbated by climate change if temperature extremes have disproportionate adverse effects on Indigenous people. To explore this issue, we analysed the effect of temperature extremes on hospital admissions for respiratory diseases, stratified by age, Indigenous status and sex, for people living in two different climates zones in the Northern Territory during the period 1993–2011. We examined admissions for both acute and chronic respiratory diagnoses, controlling for day of the week and seasonality variables. Our analysis showed that: (1) overall, Indigenous hospital admission rates far exceeded non-Indigenous admission rates for acute and chronic diagnoses, and Top End climate zone admission rates exceeded Central Australia climate zone admission rates; (2) extreme cold and hot temperatures were associated with inconsistent changes in admission rates for acute respiratory disease in Indigenous and non-Indigenous children and older adults; and (3) no response to cold or hot temperature extremes was found for chronic respiratory diagnoses. These findings support our two hypotheses, that extreme hot and cold temperatures have a different effect on hospitalisations for respiratory disease between Indigenous and non-Indigenous people, and that these health risks vary between the different climate zones. We did not, however, find that there were differing responses to temperature extremes in the two populations, suggesting that any increased vulnerability to climate change in the Indigenous population of the Northern Territory arises from an increased underlying risk to respiratory disease and an already greater existing health burden. PMID:26633456

  16. Australian Dialects and Indigenous Creoles: Is There a Place for Non-Standard Australian English in the Lower Secondary English Classroom in Australia?

    ERIC Educational Resources Information Center

    Williams, Lucy J.

    2011-01-01

    There are increasing numbers of students entering Australian secondary schools whose first language is not English. Compound this with the numbers of Indigenous students who speak Creoles or who have distinct dialects, and teachers in secondary English classrooms are facing a struggle to implement the syllabus and engage students. The issue of how…

  17. Cervical Abnormalities Are More Common among Indigenous than Other Australian Women: A Retrospective Record-Linkage Study, 2000-2011.

    PubMed

    Whop, Lisa J; Baade, Peter; Garvey, Gail; Cunningham, Joan; Brotherton, Julia M L; Lokuge, Kamalini; Valery, Patricia C; O'Connell, Dianne L; Canfell, Karen; Diaz, Abbey; Roder, David; Gertig, Dorota M; Moore, Suzanne P; Condon, John R

    2016-01-01

    Indigenous Australian women have much higher incidence of cervical cancer compared to non-Indigenous women. Despite an organised cervical screening program introduced 25 years ago, a paucity of Indigenous-identified data in Pap Smear Registers remains. Prevalence of cervical abnormalities detected among the screened Indigenous population has not previously been reported. We conducted a retrospective cohort study of population-based linked health records for 1,334,795 female Queensland residents aged 20-69 years who had one or more Pap smears during 2000-2011; from linked hospital records 23,483 were identified as Indigenous. Prevalence was calculated separately for Indigenous and non-Indigenous women, for cytology-detected low-grade (cLGA) and high-grade abnormalities (cHGA), and histologically confirmed high-grade abnormalities (hHGA). Odds ratios (OR) were estimated from logistic regression analysis. In 2010-2011 the prevalence of hHGA among Indigenous women (16.6 per 1000 women screened, 95% confidence interval [CI] 14.6-18.9) was twice that of non-Indigenous women (7.5 per 1000 women screened, CI 7.3-7.7). Adjusted for age, area-level disadvantage and place of residence, Indigenous women had higher prevalence of cLGA (OR 1.4, CI 1.3-1.4), cHGA (OR 2.2, CI 2.1-2.3) and hHGA (OR 2.0, CI 1.9-2.1). Our findings show that Indigenous women recorded on the Pap Smear Register have much higher prevalence for cLGA, cHGA and hHGA compared to non-Indigenous women. The renewed cervical screening program, to be implemented in 2017, offers opportunities to reduce the burden of abnormalities and invasive cancer among Indigenous women and address long-standing data deficiencies.

  18. Population movement can sustain STI prevalence in remote Australian indigenous communities.

    PubMed

    Hui, Ben B; Gray, Richard T; Wilson, David P; Ward, James S; Smith, Anthony M A; Philip, David J; Law, Matthew G; Hocking, Jane S; Regan, David G

    2013-04-25

    For almost two decades, chlamydia and gonorrhoea diagnosis rates in remote Indigenous communities have been up to 30 times higher than for non-Indigenous Australians. The high levels of population movement known to occur between remote communities may contribute to these high rates. We developed an individual-based computer simulation model to study the relationship between population movement and the persistence of gonorrhoea and chlamydia transmission within hypothetical remote communities. Results from our model suggest that short-term population movement can facilitate gonorrhoea and chlamydia persistence in small populations. By fixing the number of short-term travellers in accordance with census data, we found that these STIs can persist if at least 20% of individuals in the population seek additional partners while away from home and if the time away from home is less than 21 days. Periodic variations in travel patterns can contribute to increased sustainable levels of infection. Expanding existing STI testing and treatment programs to cater for short-term travellers is shown to be ineffective due to their short duration of stay. Testing and treatment strategies tailored to movement patterns, such as encouraging travellers to seek testing and treatment upon return from travel, will likely be more effective. High population mobility is likely to contribute to the high levels of STIs observed in remote Indigenous communities of Australia. More detailed data on mobility patterns and sexual behaviour of travellers will be invaluable for designing and assessing STI control programs in highly mobile communities.

  19. An Early Mathematical Patterning Assessment: identifying young Australian Indigenous children's patterning skills

    NASA Astrophysics Data System (ADS)

    Papic, Marina

    2015-12-01

    This paper presents an Early Mathematical Patterning Assessment (EMPA) tool that provides early childhood educators with a valuable opportunity to identify young children's mathematical thinking and patterning skills through a series of hands-on and drawing tasks. EMPA was administered through one-to-one assessment interviews to children aged 4 to 5 years in the year prior to formal school. Two hundred and seventeen assessments indicated that the young low socioeconomic and predominantly Australian Indigenous children in the study group had varied patterning and counting skills. Three percent of the study group was able to consistently copy and draw an ABABAB pattern made with coloured blocks. Fifty percent could count to six by ones and count out six items with 4 % of the total group able to identify six items presented in regular formations without counting. The integration of patterning into early mathematics learning is critical to the abstraction of mathematical ideas and relationships and to the development of mathematical reasoning in young children. By using the insights into the children's thinking that the EMPA tool provides, early childhood educators can better inform mathematics teaching and learning and so help close the persistent gap in numeracy between Indigenous and non-Indigenous children.

  20. Meeting Indigenous peoples' objectives in environmental flow assessments: Case studies from an Australian multi-jurisdictional water sharing initiative

    NASA Astrophysics Data System (ADS)

    Jackson, Sue; Pollino, Carmel; Maclean, Kirsten; Bark, Rosalind; Moggridge, Bradley

    2015-03-01

    The multi-dimensional relationships that Indigenous peoples have with water are only recently gaining recognition in water policy and management activities. Although Australian water policy stipulates that the native title interests of Indigenous peoples and their social, cultural and spiritual objectives be included in water plans, improved rates of Indigenous access to water have been slow to eventuate, particularly in those regions where the water resource is fully developed or allocated. Experimentation in techniques and approaches to both identify and determine Indigenous water requirements will be needed if environmental assessment processes and water sharing plans are to explicitly account for Indigenous water values. Drawing on two multidisciplinary case studies conducted in Australia's Murray-Darling Basin, we engage Indigenous communities to (i) understand their values and explore the application of methods to derive water requirements to meet those values; (ii) assess the impact of alternative water planning scenarios designed to address over-allocation to irrigation; and (iii) define additional volumes of water and potential works needed to meet identified Indigenous requirements. We provide a framework where Indigenous values can be identified and certain water needs quantified and advance a methodology to integrate Indigenous social, cultural and environmental objectives into environmental flow assessments.

  1. Predictors of negative attitudes toward Indigenous Australians and a unit of study among undergraduate nursing students: A mixed-methods study.

    PubMed

    Ramjan, Lucie; Hunt, Leanne; Salamonson, Yenna

    2016-03-01

    Indigenous people are the most disadvantaged population within Australia. The Bachelor of Nursing program at a large university in Western Sydney embedded Indigenous health into the undergraduate teaching program. This paper reviews the negative responses received towards course content on evaluation of the Indigenous health unit and explores the predictors for the negative attitudes towards Indigenous Australians. Two surveys were used (baseline and follow-up) to: 1. Determine the main predictors for negative attitudes towards Indigenous people and; 2. Explore students' perceptions of the educational quality of the Indigenous health unit. The surveys allowed collection of socio-demographic, academic data and included the 18 item 'Attitude Toward Indigenous Australians' (ATIA) scale and open-ended responses. Students who were: 1. Overseas born, 2. Enrolment category: International student and; 3. Whose primary source of information about Indigenous Australians were the media and school were significantly more likely to have higher negative attitudes towards Indigenous Australians. Qualitative data revealed some unfavourable comments dismissing the value and educational quality of the content within the Indigenous health unit. Community engagement is paramount to enhancing the student experience. Movement away from media driven 'hype' to an educated perspective is necessary to create an accurate portrayal of the Indigenous community. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  2. Factors Relating to Access to Dental Care for Indigenous South Australians.

    PubMed

    Jones, Kelly; Keeler, Ngara; Morris, Chris; Brennan, David; Roberts-Thompson, Kaye; Jamieson, Lisa

    2016-02-01

    To explore and document self-reported factors contributing to Indigenous Australians' attendance and non-attendance at South Australian public dental clinics. Semi-structured interviews were conducted with people (18 males and 26 females) referred for oral care through the Aboriginal Liaison Program of the South Australian Dental Service. Thematic analysis was performed on 44 transcribed conversations and a conceptual model developed. Persons completing all recommended treatment reported high self-efficacy, health literacy, social cohesion and previous use of dental services and presence of a health advocate. Those completing some recommended treatment reported achieving desired oral health outcome of relief of pain or system-level barriers to completion. Those reporting accessing no dental treatment in contrast reported varied and complex barriers to dental care. Differences in both individual and health service-related factors were evident. Individual-level factors related to health literacy, self-efficacy, and social control. Service factors related to availability of an advocate, service delivery, and culture. Practical service-level changes may alleviate the effects of individual-level factors.

  3. Indigenous Training and Employment. Policy Snapshot

    ERIC Educational Resources Information Center

    National Centre for Vocational Education Research (NCVER), 2017

    2017-01-01

    National Indigenous training and employment policy falls under the auspices of the Indigenous Advancement Strategy (IAS), an initiative which covers all facets of Indigenous social, economic, health and well-being across multiple Australian Government departments. Two of the main aims of the Jobs, Land and Economy component of the IAS are to…

  4. A qualitative study of a social and emotional well-being service for a remote Indigenous Australian community: implications for access, effectiveness, and sustainability

    PubMed Central

    2013-01-01

    Background People living in rural and remote Australia experience increased mental health problems compared with metropolitan Australians. Moreover, Indigenous Australians are twice as likely as non Indigenous Australians to report high or very high levels of mental health problems. It is imperative, therefore, that effective and sustainable social and emotional wellbeing services (Indigenous Australians prefer the term “social and emotional wellbeing” to “mental health”) are developed for Indigenous Australians living in remote communities. In response to significant and serious events such as suicides and relationship violence in a remote Indigenous community, a social and emotional wellbeing service (SEWBS) was developed. After the service had been running for over three years, an independent evaluation was initiated by the local health board. The aim of the evaluation was to explore the impact of SEWBS, including issues of effectiveness and sustainability, from the experiences of people involved in the development and delivery of the service. Methods Purposive sampling was used to recruit 21 people with different involvement in the service such as service providers, service participants, and referrers. These people were interviewed and their interviews were transcribed. Interpretative Phenomenological Analysis (IPA) was used to analyse the interview transcripts to identify superordinate themes and subthemes in the data. Results Two superordinate themes and nine subthemes were developed from the interview transcripts. The first superordinate theme was called “The Big Picture” and it had the sub themes: getting started; organizational factors; funding; the future, and; operational problems. The second superordinate theme was called “On the Ground” and it had the subthemes: personal struggles; program activities; measuring outcomes, and; results. Conclusions While the evaluation indicated that the service had been experienced as an effective local

  5. Challenges and strategies for cohort retention and data collection in an indigenous population: Australian Aboriginal Birth Cohort

    PubMed Central

    2014-01-01

    Background Longitudinal prospective birth cohort studies are pivotal to identifying fundamental causes and determinants of disease and health over the life course. There is limited information about the challenges, retention, and collection strategies in the study of Indigenous populations. The aim is to describe the follow-up rates of an Australian Aboriginal Birth Cohort study and how they were achieved. Methods Participants were 686 babies enrolled between January 1987 and March 1990, born to a mother recorded in the Delivery Suite Register of the Royal Darwin Hospital (RDH) as a self-identified Aboriginal. The majority of the participants (70%) resided in Northern Territory within rural, remote and very remote Aboriginal communities that maintain traditional connections to their land and culture. The Aboriginal communities are within a sparsely populated (0.2 people/ km2) area of approximately 900,000 km2 (347sq miles), with poor communication and transport infrastructures. Follow-ups collecting biomedical and lifestyle data directly from participants in over 40 locations were conducted at 11.4 years (Wave-2) and 18.2 years (Wave-3), with Wave-4 follow-up currently underway. Results Follow-ups at 11 and 18 years of age successfully examined 86% and 72% of living participants respectively. Strategies addressing logistic, cultural and ethical challenges are documented. Conclusions Satisfactory follow-up rates of a prospective longitudinal Indigenous birth cohort with traditional characteristics are possible while maintaining scientific rigor in a challenging setting. Approaches included flexibility, respect, and transparent communication along with the adoption of culturally sensitive behaviours. This work should inform and assist researchers undertaking or planning similar studies in Indigenous and developing populations. PMID:24568142

  6. A systematic review of studies evaluating Australian indigenous community development projects: the extent of community participation, their methodological quality and their outcomes.

    PubMed

    Snijder, Mieke; Shakeshaft, Anthony; Wagemakers, Annemarie; Stephens, Anne; Calabria, Bianca

    2015-11-21

    Community development is a health promotion approach identified as having great potential to improve Indigenous health, because of its potential for extensive community participation. There has been no systematic examination of the extent of community participation in community development projects and little analysis of their effectiveness. This systematic review aims to identify the extent of community participation in community development projects implemented in Australian Indigenous communities, critically appraise the qualitative and quantitative methods used in their evaluation, and summarise their outcomes. Ten electronic peer-reviewed databases and two electronic grey literature databases were searched for relevant studies published between 1990 and 2015. The level of community participation and the methodological quality of the qualitative and quantitative components of the studies were assessed against standardised criteria. Thirty one evaluation studies of community development projects were identified. Community participation varied between different phases of project development, generally high during project implementation, but low during the evaluation phase. For the majority of studies, methodological quality was low and the methods were poorly described. Although positive qualitative or quantitative outcomes were reported in all studies, only two studies reported statistically significant outcomes. Partnerships between researchers, community members and service providers have great potential to improve methodological quality and community participation when research skills and community knowledge are integrated to design, implement and evaluate community development projects. The methodological quality of studies evaluating Australian Indigenous community development projects is currently too weak to confidently determine the cost-effectiveness of community development projects in improving the health and wellbeing of Indigenous Australians

  7. Exploring the meaning of, the barriers to and potential strategies for promoting physical activity among urban Indigenous Australians.

    PubMed

    Hunt, Julian; Marshall, Alison L; Jenkins, David

    2008-08-01

    There is evidence that many of the chronic lifestyle-related problems faced by Australia's Indigenous population are related to physical inactivity. However, little is known as to how to introduce physical activity programs that will be meaningful, relevant and acceptable to Australia's Indigenous people. Seventeen focus groups involving 96 Indigenous adult participants, explored the meaning of, the barriers to, and potential strategies for promoting physical activity among urban Indigenous Australians. Indigenous researchers moderated the groups and data were transcribed verbatim and analysed independently. The relationship between physical activity and health was well understood by participants. Commonly reported activities undertaken by participants included walking, domestic chores and specific sports. Barriers to activity included being judged by others when in public spaces, cost and accessibility. Family engagement and group-based activities were strong motivators for participation. Attempts to increase physical activity among urban Indigenous Australians must engage the community from the outset, and focus on increased opportunities for family-orientated activities, and/or group walking programs; cost and safety must also be addressed.

  8. Study Protocol: establishing good relationships between patients and health care providers while providing cardiac care. Exploring how patient-clinician engagement contributes to health disparities between indigenous and non-indigenous Australians in South Australia

    PubMed Central

    2012-01-01

    Background Studies that compare Indigenous Australian and non-Indigenous patients who experience a cardiac event or chest pain are inconclusive about the reasons for the differences in-hospital and survival rates. The advances in diagnostic accuracy, medication and specialised workforce has contributed to a lower case fatality and lengthen survival rates however this is not evident in the Indigenous Australian population. A possible driver contributing to this disparity may be the impact of patient-clinician interface during key interactions during the health care process. Methods/Design This study will apply an Indigenous framework to describe the interaction between Indigenous patients and clinicians during the continuum of cardiac health care, i.e. from acute admission, secondary and rehabilitative care. Adopting an Indigenous framework is more aligned with Indigenous realities, knowledge, intellects, histories and experiences. A triple layered designed focus group will be employed to discuss patient-clinician engagement. Focus groups will be arranged by geographic clusters i.e. metropolitan and a regional centre. Patient informants will be identified by Indigenous status (i.e. Indigenous and non-Indigenous) and the focus groups will be convened separately. The health care provider focus groups will be convened on an organisational basis i.e. state health providers and Aboriginal Community Controlled Health Services. Yarning will be used as a research method to facilitate discussion. Yarning is in congruence with the oral traditions that are still a reality in day-to-day Indigenous lives. Discussion This study is nestled in a larger research program that explores the drivers to the disparity of care and health outcomes for Indigenous and non-Indigenous Australians who experience an acute cardiac admission. A focus on health status, risk factors and clinical interventions may camouflage critical issues within a patient-clinician exchange. This approach may

  9. Measuring short-term population mobility among indigenous Australians: options and implications.

    PubMed

    Taylor, J

    1998-03-01

    "Despite the fact that indigenous Australians are known to be frequently mobile over the short term, statistical information regarding this population movement is grossly deficient.... This paper examines various means by which short-term population movement can be quantified to yield aggregate indicators of demographic impact. First, census data are used to establish the rate and pattern of inter-regional, short-term displacement. This reveals regional urban centres as net recipients of temporary residents while most rural areas experience temporary absenteeism. Secondly, results from household surveys are reported stressing the importance of including visitors to households in the estimation of service populations. Thirdly, administrative data on occupancy in urban hostels are used to derive indicators of the duration of movement." excerpt

  10. Living on climate-changed country: indigenous health, well-being and climate change in remote Australian communities.

    PubMed

    Green, Donna; Minchin, Liz

    2014-06-01

    Closing the gap between the health and well-being status of Indigenous people living in remote areas of northern Australia and non-Indigenous Australians has long been a major target of federal health policy. With climate projections suggesting large increases in hot spells in desert regions and more extremes in rainfall in other areas of the north, direct and indirect impacts resulting from these changes are likely to further entrench this health and well-being disparity. This paper argues that it is time to explicitly draw on Indigenous definitions of health, which directly address the need to connect individual and community health to the health of their country, in order to develop effective climate adaptation and health strategies. We detail how current health policies overlook this 'missing' dimension of Indigenous connection to country, and why that is likely to be detrimental to the health and well-being of people living in remote communities in a climate-changed future.

  11. Using Mobile Phones as Placed Resources for Literacy Learning in a Remote Indigenous Community in Australia

    ERIC Educational Resources Information Center

    Auld, Glenn; Snyder, Ilana; Henderson, Michael

    2012-01-01

    Despite massive funding from the Australian government, the literacy achievement of Australian Indigenous children remains significantly lower than for non-Indigenous. With the aim of identifying innovative ways to improve Indigenous children's literacy achievement, this study explored the social practices surrounding everyday mobile phone use by…

  12. Using Mobile Phones as Placed Resources for Literacy Learning in a Remote Indigenous Community in Australia

    ERIC Educational Resources Information Center

    Auld, Glenn; Snyder, Ilana; Henderson, Michael

    2012-01-01

    Despite massive funding from the Australian government, the literacy achievement of Australian Indigenous children remains significantly lower than for non-Indigenous. With the aim of identifying innovative ways to improve Indigenous children's literacy achievement, this study explored the social practices surrounding everyday mobile phone use by…

  13. An innovation in Australian dental education: rural, remote and Indigenous pre-graduation placements.

    PubMed

    Bazen, Jennifer J; Kruger, Estie; Dyson, Kate; Tennant, Marc

    2007-01-01

    Anticipating the looming crisis in access to dental services in rural and remote areas, the Western Australian Centre for Rural and Remote Oral Health developed an undergraduate rural placement program to provide dental students of The University of Western Australia opportunities for direct experience of rural and remote practice during the final year of the undergraduate curriculum. The Rural, Remote and Indigenous Placement program started in 2002 and, to the end of 2005, had placed 78 final year dental students in supervised clinical practice in rural, remote or Indigenous practice. In this study, the evolution of the program (2002-2005) is described and student evaluation of the program is reported. While involved in the rural placement program, students were assessed by experienced dental practitioners and provided program evaluation. This structured feedback allowed continuous improvement of the program. Data from each year's graduates was also analysed to examine the question of influence of placements on practice location during the first 6 months after graduation. Although it will be many years before the effects of outplacement programs can be specifically attained, the evidence to date indicates that the program may be a valuable tool among the plethora of strategies being investigated to augment Australia's rural oral health workforce.

  14. Identification of antibacterial constituents from the indigenous Australian medicinal plant Eremophila duttonii F. Muell. (Myoporaceae).

    PubMed

    Smith, Joshua E; Tucker, David; Watson, Kenneth; Jones, Graham Lloyd

    2007-06-13

    This paper reports on the isolation and identification of antibacterial constituents from the indigenous Australian medicinal plant Eremophila duttonii F. Muell. (Myoporaceae). Preparations derived from this plant are used by indigenous populations in the topical treatment of minor wounds, otitis and ocular complaints, and as a gargle for sore throat. Several authors have reported extracts of this plant to effect rapid bacteriolysis and inhibit growth of a wide range of Gram-positive micro-organisms. In other studies involving screening of native medicinal plants for antibacterial activity, extracts of Eremophila duttonii have been reported to consistently exhibit the highest potency amongst all species included. From a hexane extract, we identified two diterpenes of the serrulatane class, the principal constituents responsible for antibacterial activity and present as major constituents of the resinous leaf cuticle: serrulat-14-en-7,8,20-triol (1) and serrulat-14-en-3,7,8,20-tetraol (2). In addition, a hydroxylated furanosesquiterpene with mild antibacterial activity which appeared to be a novel compound was isolated from the extract and tentatively identified as 4-hydroxy-4-methyl-1-(2,3,4,5-tetrahydro-5-methyl[2,3'-bifuran]-5-yl) pentan-2-one. Minimum inhibitory concentrations for each of the compounds against three Gram-positive bacteria: Staphylococcus aureus (ATCC 29213), Staphylococcus epidermidis (ATCC 12228) and Streptococcus pneumoniae (ARL 10582), were determined using a micro-titre plate broth dilution assay.

  15. Using probabilistic record linkage methods to identify Australian Indigenous women on the Queensland Pap Smear Register: the National Indigenous Cervical Screening Project

    PubMed Central

    Diaz, Abbey; Baade, Peter; Garvey, Gail; Cunningham, Joan; Brotherton, Julia M L; Canfell, Karen; Valery, Patricia C; O'Connell, Dianne L; Taylor, Catherine; Moore, Suzanne P; Condon, John R

    2016-01-01

    Objective To evaluate the feasibility and reliability of record linkage of existing population-based data sets to determine Indigenous status among women receiving Pap smears. This method may allow for the first ever population measure of Australian Indigenous women's cervical screening participation rates. Setting/participants A linked data set of women aged 20–69 in the Queensland Pap Smear Register (PSR; 1999–2011) and Queensland Cancer Registry (QCR; 1997–2010) formed the Initial Study Cohort. Two extracts (1995–2011) were taken from Queensland public hospitals data (Queensland Hospital Admitted Patient Data Collection, QHAPDC) for women, aged 20–69, who had ever been identified as Indigenous (extract 1) and had a diagnosis or procedure code relating to cervical cancer (extract 2). The Initial Study Cohort was linked to extract 1, and women with cervical cancer in the initial cohort were linked to extract 2. Outcome measures The proportion of women in the Initial Cohort who linked with the extracts (true -pairs) is reported, as well as the proportion of potential pairs that required clerical review. After assigning Indigenous status from QHAPDC to the PSR, the proportion of women identified as Indigenous was calculated using 4 algorithms, and compared. Results There were 28 872 women (2.1%) from the Initial Study Cohort who matched to an ever Indigenous record in extract 1 (n=76 831). Women with cervical cancer in the Initial Study Cohort linked to 1385 (71%) records in extract 2. The proportion of Indigenous women ranged from 2.00% to 2.08% when using different algorithms to define Indigenous status. The Final Study Cohort included 1 372 823 women (PSR n=1 374 401; QCR n=1955), and 5 062 118 records. Conclusions Indigenous status in Queensland cervical screening data was successfully ascertained through record linkage, allowing for the crucial assessment of the current cervical screening programme for Indigenous women. Our study

  16. Pregnancy and neonatal characteristics of opioid-dependent Indigenous Australians: a rural and metropolitan comparison.

    PubMed

    Tetstall, Emma; Liu, Anthony Jun Wing; An, Ethan Ikhyun; Canalese, Joe; Nanan, Ralph

    2009-06-01

    To identify maternal, obstetric and neonatal characteristics of opioid-dependent Indigenous Australians in rural and metropolitan settings. Retrospective cohort study of 232 metropolitan and 67 rural infants born to mothers maintained on methadone throughout pregnancy for the treatment of opiate dependency, between January 2000 and December 2006. Medical records of identified mother/infant dyads were reviewed by evaluating 20 different maternal, obstetric and neonatal parameters. The number of infants of opiate-dependent mothers (IODMs) identified to be of Aboriginal ethnicity was 47 in the rural and 50 in the metropolitan setting. This reflected a significantly higher proportion in the rural versus metropolitan areas (70.1% vs 21.6%, P < 0.05). The effect of rurality was independent of ethnicity with significantly lower rates of neonatal withdrawal requiring treatment (P < 0.001), antenatal consultations (P < 0.01), department of community services (DoCS) involvement (P < 0.001) and shorter infant lengths of stay (P < 0.001). There was a non-significant trend towards more intrauterine growth restriction in Aboriginal infants. There were no significant differences in parameters in rural Indigenous versus rural non-Indigenous infants. Significant differences exist between rural and metropolitan IODMs in terms of less attendance at antenatal consultations, less neonatal withdrawal requiring treatment, shorter average length of hospital stay for the infant and less documented DoCS involvement. These differences maybe a reflection of a different diagnostic and management approach. Ethnicity had no major clinical impact in either the rural or the metropolitan settings. Future research comparing the long-term outcomes would be of interest.

  17. Population movement can sustain STI prevalence in remote Australian indigenous communities

    PubMed Central

    2013-01-01

    Background For almost two decades, chlamydia and gonorrhoea diagnosis rates in remote Indigenous communities have been up to 30 times higher than for non-Indigenous Australians. The high levels of population movement known to occur between remote communities may contribute to these high rates. Methods We developed an individual-based computer simulation model to study the relationship between population movement and the persistence of gonorrhoea and chlamydia transmission within hypothetical remote communities. Results Results from our model suggest that short-term population movement can facilitate gonorrhoea and chlamydia persistence in small populations. By fixing the number of short-term travellers in accordance with census data, we found that these STIs can persist if at least 20% of individuals in the population seek additional partners while away from home and if the time away from home is less than 21 days. Periodic variations in travel patterns can contribute to increased sustainable levels of infection. Expanding existing STI testing and treatment programs to cater for short-term travellers is shown to be ineffective due to their short duration of stay. Testing and treatment strategies tailored to movement patterns, such as encouraging travellers to seek testing and treatment upon return from travel, will likely be more effective. Conclusion High population mobility is likely to contribute to the high levels of STIs observed in remote Indigenous communities of Australia. More detailed data on mobility patterns and sexual behaviour of travellers will be invaluable for designing and assessing STI control programs in highly mobile communities. PMID:23618061

  18. The health and well-being of Indigenous drug and alcohol workers: results from a national Australian survey.

    PubMed

    Roche, Ann M; Duraisingam, Vinita; Trifonoff, Allan; Tovell, Amanda

    2013-01-01

    The increasing demand for alcohol and other drug (AOD) treatment services among the Australian Indigenous population, complex organisational challenges and limitations, and high unemployment rates are likely to negatively impact Indigenous AOD workers' health and well-being. Building the capacity of Indigenous AOD workers is vital, as they play a crucial role in the delivery of treatment services and offer essential support to their communities. A national online survey was conducted to examine organisational, workplace and individual factors that might contribute to levels of stress and well-being among workers who provide services to Indigenous clients. A total of 294 eligible surveys were completed; 184 (63%) from Indigenous and 108 (37%) from non-Indigenous AOD workers. Multiple regression models were conducted to assess the significant predictors of mental health and well-being, job satisfaction, emotional exhaustion, and turnover intention. Indigenous AOD workers typically experienced above average levels of job satisfaction and relatively low levels of emotional exhaustion. However, 1 in 10 reported high levels of emotional exhaustion, a key predictor of turnover intention. Indigenous workers also experienced significantly lower levels of mental health and well-being and greater work/family imbalance, which was a significant contributor to emotional exhaustion. The findings highlight the importance of implementing workforce development strategies that focus on achieving culturally appropriate, equitable and supportive organisational conditions for Indigenous AOD workers. Preventing or managing levels of stress, ensuring adequate and equitable salaries and benefits, and providing more opportunities for career and personal growth may increase job satisfaction and reduce turnover intention among Indigenous workers in the drug and alcohol field. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

  19. Risk indicators for severe impaired oral health among indigenous Australian young adults

    PubMed Central

    2010-01-01

    Background Oral health impairment comprises three conceptual domains; pain, appearance and function. This study sought to: (1) estimate the prevalence of severe oral health impairment as assessed by a summary oral health impairment measure, including aspects of dental pain, dissatisfaction with dental appearance and difficulty eating, among a birth cohort of Indigenous Australian young adults (n = 442, age range 16-20 years); (2) compare prevalence according to demographic, socio-economic, behavioural, dental service utilisation and oral health outcome risk indicators; and (3) ascertain the independent contribution of those risk indicators to severe oral health impairment in this population. Methods Data were from the Aboriginal Birth Cohort (ABC) study, a prospective longitudinal investigation of Aboriginal individuals born 1987-1990 at an Australian regional hospital. Data for this analysis pertained to Wave-3 of the study only. Severe oral health impairment was defined as reported experience of toothache, poor dental appearance and food avoidance in the last 12 months. Logistic regression models were used to evaluate effects of demographic, socio-economic, behavioural, dental service utilisation and clinical oral disease indicators on severe oral health impairment. Effects were quantified as odds ratios (OR). Results The percent of participants with severe oral health impairment was 16.3 (95% CI 12.9-19.7). In the multivariate model, severe oral health impairment was associated with untreated dental decay (OR 4.0, 95% CI 1.6-9.6). In addition to that clinical indicator, greater odds of severe oral health impairment were associated with being female (OR 2.0, 95% CI 1.2-3.6), being aged 19-20 years (OR 2.1, 95% CI 1.2-3.6), soft drink consumption every day or a few days a week (OR 2.6, 95% 1.2-5.6) and non-ownership of a toothbrush (OR 1.9, 95% CI 1.1-3.4). Conclusions Severe oral health impairment was prevalent among this population. The findings suggest that

  20. Risk indicators for severe impaired oral health among indigenous Australian young adults.

    PubMed

    Jamieson, Lisa M; Roberts-Thomson, Kaye F; Sayers, Susan M

    2010-01-27

    Oral health impairment comprises three conceptual domains; pain, appearance and function. This study sought to: (1) estimate the prevalence of severe oral health impairment as assessed by a summary oral health impairment measure, including aspects of dental pain, dissatisfaction with dental appearance and difficulty eating, among a birth cohort of Indigenous Australian young adults (n = 442, age range 16-20 years); (2) compare prevalence according to demographic, socio-economic, behavioural, dental service utilisation and oral health outcome risk indicators; and (3) ascertain the independent contribution of those risk indicators to severe oral health impairment in this population. Data were from the Aboriginal Birth Cohort (ABC) study, a prospective longitudinal investigation of Aboriginal individuals born 1987-1990 at an Australian regional hospital. Data for this analysis pertained to Wave-3 of the study only. Severe oral health impairment was defined as reported experience of toothache, poor dental appearance and food avoidance in the last 12 months. Logistic regression models were used to evaluate effects of demographic, socio-economic, behavioural, dental service utilisation and clinical oral disease indicators on severe oral health impairment. Effects were quantified as odds ratios (OR). The percent of participants with severe oral health impairment was 16.3 (95% CI 12.9-19.7). In the multivariate model, severe oral health impairment was associated with untreated dental decay (OR 4.0, 95% CI 1.6-9.6). In addition to that clinical indicator, greater odds of severe oral health impairment were associated with being female (OR 2.0, 95% CI 1.2-3.6), being aged 19-20 years (OR 2.1, 95% CI 1.2-3.6), soft drink consumption every day or a few days a week (OR 2.6, 95% 1.2-5.6) and non-ownership of a toothbrush (OR 1.9, 95% CI 1.1-3.4). Severe oral health impairment was prevalent among this population. The findings suggest that public health strategies that address

  1. Lessons from the AIME Approach to the Teaching Relationship: Valuing Biepistemic Practice

    ERIC Educational Resources Information Center

    McMahon, Samantha; Harwood, Valerie; Bodkin-Andrews, Gawaian; O'Shea, Sarah; McKnight, Anthony; Chandler, Paul; Priestly, Amy

    2017-01-01

    The Australian Indigenous Mentoring Experience (AIME) is a national, extra-curricular mentoring programme that is closing the educational gap for young Indigenous Australians. So what is AIME doing that is working so well? This article draws on a large-scale classroom ethnography to describe the pedagogies that facilitate the teacher-student…

  2. Lessons from the AIME Approach to the Teaching Relationship: Valuing Biepistemic Practice

    ERIC Educational Resources Information Center

    McMahon, Samantha; Harwood, Valerie; Bodkin-Andrews, Gawaian; O'Shea, Sarah; McKnight, Anthony; Chandler, Paul; Priestly, Amy

    2017-01-01

    The Australian Indigenous Mentoring Experience (AIME) is a national, extra-curricular mentoring programme that is closing the educational gap for young Indigenous Australians. So what is AIME doing that is working so well? This article draws on a large-scale classroom ethnography to describe the pedagogies that facilitate the teacher-student…

  3. Study Protocol – Diabetes and related conditions in urban Indigenous people in the Darwin, Australia region: aims, methods and participation in the DRUID Study

    PubMed Central

    Cunningham, Joan; O'Dea, Kerin; Dunbar, Terry; Weeramanthri, Tarun; Zimmet, Paul; Shaw, Jonathan

    2006-01-01

    Background Diabetes mellitus is a serious and increasing health problem in Australia and is a designated national health priority. Diabetes and related conditions represent an even greater health burden among Indigenous Australians (Aborigines and Torres Strait Islanders), but there are critical gaps in knowledge relating to the incidence and prevalence, aetiology, and prevention of diabetes in this group, including a lack of information on the burden of disease among Indigenous people in urban areas. The DRUID Study (Diabetes and Related conditions in Urban Indigenous people in the Darwin region) was designed to address this knowledge gap. Methods/design The study was conducted in a specified geographic area in and around Darwin, Australia. Eligible participants underwent a health examination, including collection of blood and urine samples, clinical and anthropometric measurements, and administration of questionnaires, with an additional assessment for people with diabetes. The study was designed to incorporate local Indigenous leadership, facilitate community engagement, and provide employment and training opportunities for local Indigenous people. A variety of recruitment methods were used. A total of 1,004 eligible people gave consent and provided at least one measurement. When compared with census data for the Indigenous population living in the study area, there was a marked under-representation of males, but no substantial differences in age, place of residence, Indigenous group, or household income. Early participants were more likely than later participants to have previously diagnosed diabetes. Discussion Despite lower than anticipated recruitment, this is, to our knowledge, the largest study ever conducted on the health of Indigenous Australians living in urban areas, a group which comprises the majority of Australia's Indigenous population but about whose health and wellbeing relatively little is known. The study is well-placed to provide new

  4. The Kimberley assessment of depression of older Indigenous Australians: prevalence of depressive disorders, risk factors and validation of the KICA-dep scale.

    PubMed

    Almeida, Osvaldo P; Flicker, Leon; Fenner, Stephen; Smith, Kate; Hyde, Zoe; Atkinson, David; Skeaf, Linda; Malay, Roslyn; LoGiudice, Dina

    2014-01-01

    This study aimed to develop a culturally acceptable and valid scale to assess depressive symptoms in older Indigenous Australians, to determine the prevalence of depressive disorders in the older Kimberley community, and to investigate the sociodemographic, lifestyle and clinical factors associated with depression in this population. Cross-sectional survey of adults aged 45 years or over from six remote Indigenous communities in the Kimberley and 30% of those living in Derby, Western Australia. The 11 linguistic and culturally sensitive items of the Kimberley Indigenous Cognitive Assessment of Depression (KICA-dep) scale were derived from the signs and symptoms required to establish the diagnosis of a depressive episode according to the DSM-IV-TR and ICD-10 criteria, and their frequency was rated on a 4-point scale ranging from 'never' to 'all the time' (range of scores: 0 to 33). The diagnosis of depressive disorder was established after a face-to-face assessment with a consultant psychiatrist. Other measures included sociodemographic and lifestyle factors, and clinical history. The study included 250 participants aged 46 to 89 years (mean±SD = 60.9±10.7), of whom 143 (57.2%) were women. The internal reliability of the KICA-dep was 0.88 and the cut-point 7/8 (non-case/case) was associated with 78% sensitivity and 82% specificity for the diagnosis of a depressive disorder. The point-prevalence of a depressive disorder in this population was 7.7%; 4.0% for men and 10.4% for women. Heart problems were associated with increased odds of depression (odds ratio = 3.3, 95% confidence interval = 1.2,8.8). The KICA-dep has robust psychometric properties and can be used with confidence as a screening tool for depression among older Indigenous Australians. Depressive disorders are common in this population, possibly because of increased stressors and health morbidities.

  5. The Role of Cultural and Spiritual Expressions in Affirming a Sense of Self, Place, and Purpose among Young Urban, Indigenous Australians

    ERIC Educational Resources Information Center

    de Souza, Marian; Rymarz, Richard

    2007-01-01

    This article sets out to discuss the impact that urban living has had on the lives of young Indigenous people. It will seek to discover some of the problems that occur when there is a meeting of two cultures, in this case the Indigenous culture of Australian Aboriginal people and the mainstream culture that has been derived largely from west…

  6. The impact of racial discrimination on the health of Australian Indigenous children aged 5-10 years: analysis of national longitudinal data.

    PubMed

    Shepherd, Carrington C J; Li, Jianghong; Cooper, Matthew N; Hopkins, Katrina D; Farrant, Brad M

    2017-07-03

    . Tackling and reducing racism should be an integral part of policy and intervention aimed at improving the health of Australian Indigenous children and thereby reducing health disparities between Indigenous and non-Indigenous children.

  7. When There Is Not Enough Evidence and When Evidence Is Not Enough: An Australian Indigenous Smoking Policy Study.

    PubMed

    Vujcich, Daniel; Rayner, Mike; Allender, Steven; Fitzpatrick, Ray

    2016-01-01

    The Indigenous Tobacco Control Initiative and Tackling Indigenous Smoking Measure were both announced by the Australian Government at a time when its rhetoric around the importance of evidence-based policy making was strong. This article will (1) examine how the Rudd Government used evidence in Indigenous tobacco control policy making and (2) explore the facilitators of and barriers to the use of evidence. Data were collected through (1) a review of primary documents largely obtained under the Freedom of Information Act 1982 (Commonwealth of Australia) and (2) interviews with senior politicians, senior bureaucrats, government advisors, Indigenous health advocates, and academics. Through the Freedom of Information Act process, 24 previously undisclosed government documents relevant to the making of Indigenous tobacco control policies were identified. Interviewees (n = 31, response rate 62%) were identified through both purposive and snowball recruitment strategies. The Framework Analysis method was used to analyze documentary and interview data. Government policy design was heavily influenced by the recommendations presented in government authored/commissioned literature reviews. Resulting policies were led by equivocal evidence for improved tobacco control outcomes among Indigenous Australians. Many of the cited studies had methodological limitations. In the absence of high-quality evidence, some policy makers supported policy recommendations that were perceived to be popular among the Indigenous community. Other policy makers recognized that there were barriers to accumulating rigorous, generalizable evidence; in the absence of such evidence, the policy makers considered that the "need for action" could be combined with the "need for research" by introducing innovative strategies and evaluating them. Despite the absence of high-quality evidence, the formulation and adoption of Indigenous tobacco policy was neither irrational nor reckless. The decision to adopt

  8. Knowledge of and preferred sources of assistance for physical activity in a sample of urban Indigenous Australians

    PubMed Central

    Marshall, Alison L; Hunt, Julian; Jenkins, David

    2008-01-01

    Background To examine urban Indigenous Australians' knowledge of the current Physical Activity Guidelines (PAG) and identify their preferred sources of assistance or advice regarding physical activity. Method Self-completed questionnaire data were collected from 194 participants; the questionnaires sought information on standard demographics including an assessment of their perceived physical activity level relative to peers. Outcome measures were agreement with five statements from the current PAG and indicators of preferred sources of assistance or advice regarding physical activity. Results Most participants demonstrated excellent knowledge of the current PAG, with 92% to 88% of participants agreeing with the statements. Significantly more older participants (> 44 years) identified that 'blocks of 10 minutes of activity are OK' compared to younger participants (aged 18–44 years: 60%; X2 = 6.23; p = .04). Significantly more higher educated participants agreed (96%) that 'brisk walking for half an hour most days was good for health' compared to the less educated participants (85%; X2 = 8.08; p = .02). The most preferred source of physical activity advice identified by men was the GP/health professional (62% vs. 53%; men and women respectively, NS), while for women it was a group to be active with (60% vs. 42%; women and men respectively; X2 = 6.09; p = .01). Conclusion Urban Indigenous Australians have similar levels of knowledge regarding the PAG to non-Indigenous Australians. However, the option of accumulating 10-minute activity bouts needs to be better communicated to younger Indigenous people. Most participants expressed a preference for advice about physical activity to be delivered via health professionals, and groups to be active with. Indigenous and age-specific resources that promote the unique aspects of the current PAG (e.g., that vigorous exercise is not essential for health and blocks of 10 minutes of activity are OK) should be developed and

  9. Performance of formulas for estimating glomerular filtration rate in Indigenous Australians with and without Type 2 diabetes: the eGFR Study.

    PubMed

    Maple-Brown, L J; Ekinci, E I; Hughes, J T; Chatfield, M; Lawton, P D; Jones, G R D; Ellis, A G; Sinha, A; Cass, A; Hoy, W E; O'Dea, K; Jerums, G; MacIsaac, R J

    2014-07-01

    It has been proposed that the Chronic Kidney Disease Epidemiology Collaboration formula estimates glomerular filtration rate more accurately than the Modification of Diet in Renal Disease formula. With the very high incidence of diabetes and end-stage kidney disease in Indigenous Australians, accurate estimation of glomerular filtration rate is vital in early detection of kidney disease. We aimed to assess the performance of the Chronic Kidney Disease Epidemiology Collaboration, Modification of Diet in Renal Disease and Cockcroft-Gault formulas in Indigenous Australians with and without diabetes. Indigenous Australians with (n = 224) or without (n = 340) Type 2 diabetes had a reference glomerular filtration rate measure using plasma disappearance of iohexol (measured glomerular filtration rate) over 4 h. Serum creatinine was measured by an enzymatic method. Performance was assessed by bias (measured glomerular filtration rate - estimated glomerular filtration rate) and accuracy (percentage of estimated glomerular filtration rate within 30% of measured glomerular filtration rate). The median measured glomerular filtration rate (interquartile range) in participants with or without diabetes was 97 (68-119) and 108 (90-122) ml min(-1)  1.73 m(-2) , respectively. The Chronic Kidney Disease Epidemiology Collaboration formula had smaller bias and greater accuracy than the Modification of Diet in Renal Disease and Cockcroft-Gault formulas overall, for participants both with and without diabetes. However, for estimated glomerular filtration rate > 90 ml min(-1)  1.73 m(-2) , the Chronic Kidney Disease Epidemiology Collaboration formula had greater bias in participants with diabetes, underestimating measured glomerular filtration rate by 7.4 vs. 1.0 ml min(-1)  1.73 m(-2) in those without diabetes. The Chronic Kidney Disease Epidemiology Collaboration formula was less accurate across the whole range of estimated glomerular filtration rates in participants

  10. Association of disease-specific causes of visual impairment and 10-year mortality amongst Indigenous Australians: the Central Australian Ocular Health Study.

    PubMed

    Estevez, José; Kaidonis, Georgia; Henderson, Tim; Craig, Jamie E; Landers, John

    2017-06-16

    Visual impairment significantly impairs the length and quality of life, but little is known of its impact in Indigenous Australians. To investigate the association of disease-specific causes of visual impairment with all-cause mortality. A retrospective cohort analysis. A total of 1347 Indigenous Australians aged over 40 years. Participants visiting remote medical clinics underwent clinical examinations including visual acuity, subjective refraction and slit-lamp examination of the anterior and posterior segments. The major ocular cause of visual impairment was determined. Patients were assessed periodically in these remote clinics for the succeeding 10 years after recruitment. Mortality rates were obtained from relevant departments. All-cause 10-year mortality and its association with disease-specific causes of visual impairment. The all-cause mortality rate for the entire cohort was 29.3% at the 10-year completion of follow-up. Of those with visual impairment, the overall mortality rate was 44.9%. The mortality rates differed for those with visual impairment due to cataract (59.8%), diabetic retinopathy (48.4%), trachoma (46.6%), 'other' (36.2%) and refractive error (33.4%) (P < 0.0001). Only those with visual impairment from diabetic retinopathy were any more likely to die during the 10 years of follow-up when compared with those without visual impairment (HR 1.70; 95% CI, 1.00-2.87; P = 0.049). Visual impairment was associated with all-cause mortality in a cohort of Indigenous Australians. However, diabetic retinopathy was the only ocular disease that significantly increased the risk of mortality. Visual impairment secondary to diabetic retinopathy may be an important predictor of mortality. © 2017 Royal Australian and New Zealand College of Ophthalmologists.

  11. Efficacy of an oral health literacy intervention among Indigenous Australian adults.

    PubMed

    Ju, Xiangqun; Brennan, David; Parker, Eleanor; Mills, Helen; Kapellas, Kostas; Jamieson, Lisa

    2017-10-01

    To determine the effect of an oral health literacy intervention on oral health literacy-related outcomes among rural-dwelling Indigenous Australian adults. A total of 400 Indigenous adults (203 intervention and 197 control participants) were recruited into a randomized controlled trial; a functional, context-specific oral health literacy interventions were developed and implemented by Indigenous staff. The intervention comprised five sessions, each lasting 1.5 hours, across a 1-year period. The primary outcome was oral health literacy as assessed by the HeLD-14 instrument, with secondary outcomes including the social impact of oral disease, and psychosocial and knowledge-related factors. Three scenarios were used in data analysis: (I) intention to treat; (II) as treated and; (III) adherence only. Multiple imputation (MI) was used to replace missing data. The proportion reporting that "water with fluoride" was good increased in the intervention group within both crude and MI data analyses under the three scenarios. Other crude data analysis yielded no significant differences for either primary or secondary outcomes between intervention and control groups under the three scenarios. After MI, oral health literacy improved when assessed under scenario II (mean change=1.3, 95% CI: 1.1, 1.6). Improvements under three scenarios were also observed for the Oral Health Impact Profile (OHIP-14; mean change ranged from -0.7 to -3.8), sense of control (mean change ranged from 0.4 to 1.1), oral health-related fatalism (mean change ranged from -0.7 to -0.4) and perceived stress (mean change ranged from -2.1 to -1.1). The proportion reporting that "cordial was good" decreased in the intervention group from MI analysis under scenarios II and III. A context-specific oral health literacy intervention was partially successful in improving oral health literacy and oral health literacy-related outcomes in this vulnerable population, but only after MI. © 2017 John Wiley & Sons A

  12. Social inequality in dental caries and changes over time among Indigenous and non-Indigenous Australian children.

    PubMed

    Ha, Diep Hong; Xiangqun, Ju; Cecilia, Mejia Gloria; Jason, Armfield; Do, Loc G; Jamieson, Lisa M

    2016-12-01

    This paper describes and compares magnitudes of socioeconomic (SES) inequalities in oral health among Indigenous and non-Indigenous children over a 10-year period. We analysed annual oral health survey data from NSW, NT and SA. Data were extracted for time period 1 (2000-2002, N=215,317) and time period 2 (2007-2010, N=34,495). Oral health outcomes were untreated decayed deciduous teeth (dt) and cumulative dental caries experience (dmft). Postcode-level Socioeconomic Index for Areas was used to assess SES. Age standardisation and complex survey weights were used. Indices of socioeconomic inequality in health (Slope Index of Inequality, Relative Index of Inequality, Absolute and Relative Concentration Index) were used to quantify inequality in dental caries and its changes over time. Oral health outcomes deteriorated in both Indigenous and non-Indigenous populations over time. Indigenous children experienced higher levels of disease at both times. Untreated dt increased in both populations. The cummulative disease (dmft) increased at higher rate among children in low-SES areas in both populations. Over time, there was an increase in socioecononomic inequalities in dmft in all children and in dt in non-Indigenous children. Area-level socioeconomic inequality in child oral health has widened due to deterioration in low-SES children. © 2016 Public Health Association of Australia.

  13. Psycho-social resilience, vulnerability and suicide prevention: impact evaluation of a mentoring approach to modify suicide risk for remote Indigenous Australian students at boarding school.

    PubMed

    McCalman, Janya; Bainbridge, Roxanne; Russo, Sandra; Rutherford, Katrina; Tsey, Komla; Wenitong, Mark; Shakeshaft, Anthony; Doran, Chris; Jacups, Susan

    2016-02-01

    The proposed study was developed in response to increased suicide risk identified in Aboriginal and Torres Strait Islander students who are compelled to attend boarding schools across Queensland when there is no secondary schooling provision in their remote home communities. It will investigate the impact of a multicomponent mentoring intervention to increase levels of psychosocial resilience. We aim to test the null hypothesis that students' resilience is not positively influenced by the intervention. The 5-year project was funded by the Australian National Health and Medical Research Council from December 2014. An integrated mixed methods approach will be adopted; each component iteratively informing the other. Using an interrupted time series design, the primary research methods are quantitative: 1) assessment of change in students' resilience, educational outcomes and suicide risk; and 2) calculation of costs of the intervention. Secondary methods are qualitative: 3) a grounded theoretical model of the process of enhancing students' psychosocial resilience to protect against suicide. Additionally, there is a tertiary focus on capacity development: more experienced researchers in the team will provide research mentorship to less experienced researchers through regular meetings; while Indigenous team members provide cultural mentorship in research practices to non-Indigenous members. Australia's suicide prevention policy is progressive but a strong service delivery model is lacking, particularly for Indigenous peoples. The proposed research will potentially improve students' levels of resilience to mitigate against suicide risk. Additionally, it could reduce the economic and social costs of Indigenous youth suicide by obtaining agreement on what is good suicide prevention practice for remote Indigenous students who transition to boarding schools for education, and identifying the benefits-costs of an evidence-based multi-component mentoring intervention to

  14. Improving Health Promotion Using Quality Improvement Techniques in Australian Indigenous Primary Health Care

    PubMed Central

    Percival, Nikki; O’Donoghue, Lynette; Lin, Vivian; Tsey, Komla; Bailie, Ross Stewart

    2016-01-01

    Although some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI) projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centers. Our study objectives were to (a) describe the scope and quality of health promotion activities, (b) describe the status of health center system support for health promotion activities, and (c) introduce a CQI intervention and examine the impact on health promotion activities and health centers systems over 2 years. Baseline assessments showed suboptimal health center systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health center systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence-based health promotion by engaging front line health practitioners in decision-making processes about the design/redesign of health center systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff, and members of the local community to address organizational and policy level barriers. PMID:27066470

  15. Improving Health Promotion Using Quality Improvement Techniques in Australian Indigenous Primary Health Care.

    PubMed

    Percival, Nikki; O'Donoghue, Lynette; Lin, Vivian; Tsey, Komla; Bailie, Ross Stewart

    2016-01-01

    Although some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI) projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centers. Our study objectives were to (a) describe the scope and quality of health promotion activities, (b) describe the status of health center system support for health promotion activities, and (c) introduce a CQI intervention and examine the impact on health promotion activities and health centers systems over 2 years. Baseline assessments showed suboptimal health center systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice health promotion, such as community engagement and intersectoral partnerships, were inhibited by the way health center systems were organized, predominately to support clinical and curative services. These findings suggest that CQI can improve the delivery of evidence-based health promotion by engaging front line health practitioners in decision-making processes about the design/redesign of health center systems to support the delivery of best practice health promotion. However, further and sustained improvements in health promotion will require broader engagement of management, senior staff, and members of the local community to address organizational and policy level barriers.

  16. Interventions Aimed at the Prevention of Childhood Injuries in the Indigenous Populations in Canada, Australia and New Zealand in the Last 20 Years: A Systematic Review.

    PubMed

    Margeson, Alyssa; Gray, Selena

    2017-06-02

    Globally, Indigenous children are found to be at a significantly higher risk of injury compared to non-Indigenous children. It has been suggested that mainstream injury prevention strategies are ineffective within Indigenous communities. The aim of this review is to identify existing interventions aimed at preventing injury in Indigenous children in the hope that it guides future strategies. To the best of the authors' knowledge, no prior systematic reviews exist looking at interventions specifically aimed at preventing injury in Indigenous child populations in the three chosen countries. Electronic databases were systematically searched for relevant childhood interventions aimed at the prevention of injuries in Indigenous populations based in Canada, Australia and New Zealand from 1996 to 2016. A manual search of the reference lists of relevant articles and a manual search of relevant websites were also completed. After 191 records were screened, six interventions were identified meeting the criteria for inclusion. Eligible papers underwent a quality appraisal using adapted assessment checklists and key information was extracted. Findings were then synthesized using a narrative approach. The interventions mainly promoted child safety through activities focusing on education and awareness. Only three of the six studies measured changes in injury hospitalization rates, all but one evaluation reporting a significant decrease. Studies which measured awareness all demonstrated positive changes. Results suggest that interventions delivered in a culturally appropriate manner acted as a main success factor. Barriers identified as hindering intervention success included lack of cohesion within the intervention due to staff turnover and lack of experienced staff with Indigenous knowledge. This review revealed a limited amount of evaluated interventions for the prevention of Indigenous childhood injuries. Conclusive evidence of the effectiveness of existing interventions is

  17. Short-term predictive validity of the static-99 and static-99-R for indigenous and nonindigenous Australian sexual offenders.

    PubMed

    Smallbone, Stephen; Rallings, Mark

    2013-06-01

    Actuarial risk assessment (Static-99 and Static-99-R) scores were obtained for 399 Australian adult sexual offenders who were subsequently released from prison and followed up with searches of police arrest records (mean follow-up period = 29 months; range = 15-53 months). Indigenous offenders (n = 67; 16.8%) scored significantly higher on both the Static-99 (M = 4.04 vs. 2.89, p < .001) and Static-99-R (M = 3.72 vs. 2.22, p < .001), were more than twice as likely to be arrested for sexual offenses (9.0% vs. 4.1%, ns), and were significantly more likely to be arrested for nonsexual violent (28.4% vs. 1.9%, p < .001), any violent (including sexual; 37% vs. 5.9%, p < .001), and any offenses (58.2% vs. 21.6%, p < .001). For the combined groups, predictive accuracy of both instruments was comparable to results reported elsewhere. Predictive accuracy of the Static-99 was similar for indigenous and nonindigenous offenders. The Static-99-R was only marginally predictive of any violent recidivism (AUC = .65, 95% CI = [.52, .79]), and did not predict sexual (AUC = .61, 95% CI = [.45, .77]) or nonsexual violent recidivism (AUC = .65, 95% CI = [.48, .78]), for indigenous offenders. Higher risk scores, indigenous race, and unsupervised release all contributed unique variance to any violent recidivism. Results suggest that the Static-99 may be appropriate for assessing Australian indigenous sexual offenders, but more research is needed to test the validity of the Static-99-R for this population. We conclude that practitioners should consider the potential effects of racial differences and postrelease factors, as well as static risk factors, in their assessments.

  18. If you can't comply with dialysis, how do you expect me to trust you with transplantation? Australian nephrologists' views on indigenous Australians' 'non-compliance' and their suitability for kidney transplantation

    PubMed Central

    2012-01-01

    Introduction Indigenous Australians suffer markedly higher rates of end-stage kidney disease (ESKD) but are less likely than their non-Indigenous counterparts to receive a transplant. This difference is not fully explained by measurable clinical differences. Previous work suggests that Indigenous Australian patients may be regarded by treating specialists as 'non-compliers', which may negatively impact on referral for a transplant. However, this decision-making is not well understood. The objectives of this study were to investigate: whether Indigenous patients are commonly characterised as 'non-compliers'; how estimations of patient compliance factor into Australian nephrologists' decision-making about transplant referral; and whether this may pose a particular barrier for Indigenous patients accessing transplants. Methods Nineteen nephrologists, from eight renal units treating the majority of Indigenous Australian renal patients, were interviewed in 2005-06 as part of a larger study. Thematic analysis was undertaken to investigate how compliance factors in specialists' decision-making, and its implications for Indigenous patients' likelihood of obtaining transplants. Results Specialists commonly identified Indigenous patients as both non-compliers and high-risk transplant candidates. Definition and assessment of 'compliance' was neither formal nor systematic. There was uncertainty about the value of compliance status in predicting post-transplant outcomes and the issue of organ scarcity permeated participants' responses. Overall, there was marked variation in how specialists weighed perceptions of compliance and risk in their decision-making. Conclusion Reliance on notions of patient 'compliance' in decision-making for transplant referral is likely to result in continuing disadvantage for Indigenous Australian ESKD patients. In the absence of robust evidence on predictors of post-transplant outcomes, referral decision-making processes require attention and debate

  19. Determinants of access to chronic illness care: a mixed-methods evaluation of a national multifaceted chronic disease package for Indigenous Australians

    PubMed Central

    Bailie, Jodie; Schierhout, Gill; Laycock, Alison; Kelaher, Margaret; Percival, Nikki; O'Donoghue, Lynette; McNeair, Tracy; Bailie, Ross

    2015-01-01

    Objectives Indigenous Australians have a disproportionately high burden of chronic illness, and relatively poor access to healthcare. This paper examines how a national multicomponent programme aimed at improving prevention and management of chronic disease among Australian Indigenous people addressed various dimensions of access. Design Data from a place-based, mixed-methods formative evaluation were analysed against a framework that defines supply and demand-side dimensions to access. The evaluation included 24 geographically bounded ‘sentinel sites’ that included a range of primary care service organisations. It drew on administrative data on service utilisation, focus group and interview data on community members’ and service providers’ perceptions of chronic illness care between 2010 and 2013. Setting Urban, regional and remote areas of Australia that have relatively large Indigenous populations. Participants 670 community members participated in focus groups; 374 practitioners and representatives of regional primary care support organisations participated in in-depth interviews. Results The programme largely addressed supply-side dimensions of access with less focus or impact on demand-side dimensions. Application of the access framework highlighted the complex inter-relationships between dimensions of access. Key ongoing challenges are achieving population coverage through a national programme, reaching high-need groups and ensuring provision of ongoing care. Conclusions Strategies to improve access to chronic illness care for this population need to be tailored to local circumstances and address the range of dimensions of access on both the demand and supply sides. These findings highlight the importance of flexibility in national programme guidelines to support locally determined strategies. PMID:26614617

  20. Mental health at the intersections: the impact of complex needs on police contact and custody for Indigenous Australian men.

    PubMed

    Trofimovs, Julian; Dowse, Leanne

    2014-01-01

    Indigenous Australians experience significant social risk, vulnerability and disadvantage. Nowhere is this more starkly demonstrated than in the levels of contact that Indigenous Australians have with the criminal justice system, particularly the police. Utilizing a linked dataset of extant criminal justice, human and health service administrative data in New South Wales (NSW) Australia, this paper explores patterns of police contact and custody for a cohort of Indigenous males with complex needs. Four significant factors are identified that alone or in combination appear to impact on the frequency with which these men experience police contact and custody, including young age at first police contact, experiencing out of home care as a child, alcohol misuse, and limited locational mobility. Whilst it might be expected that the presence of mental ill-health and/or cognitive disability would be a key predictor of the frequency and intensity of police contact and custody, the findings suggest rather that the presence of multiple disadvantages beginning in the early years and compounding throughout individuals' lives, in which mental illness may or may not be a factor, is more significant than the presence of any one diagnosis in precipitating police contact and custody for this group. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Colorectal cancer among Indigenous and non-Indigenous people in Queensland, Australia: Toward survival equality.

    PubMed

    Moore, Suzanne P; Green, Adèle C; Bray, Freddie; Coory, Michael; Garvey, Gail; Sabesan, Sabe; Valery, Patricia C

    2016-06-01

    While Indigenous people in Queensland have lower colorectal cancer (CRC) incidence and mortality than the rest of the population, CRC remains the third most frequent cancer among Australian Indigenous people overall. This study aimed to investigate patterns of care and survival between Indigenous and non-Indigenous Australians with CRC. Through a matched-cohort design we compared 80 Indigenous and 85 non-Indigenous people all diagnosed with CRC and treated in Queensland public hospitals during 1998-2004 (frequency matched on age, sex, geographical remoteness). We compared clinical and treatment data (Pearson's chi-square) and all-cause and cancer survival (Cox regression analysis). Indigenous patients with CRC were not significantly more likely to have comorbidity, advanced disease at diagnosis or less treatment than non-Indigenous people. There was also no statistically significant difference in all-cause survival (HR 1.14, 95% CI 0.69, 1.89) or cancer survival (HR 1.01, 95% CI 0.60, 1.69) between the two groups. Similar CRC mortality among Indigenous and other Australians may reflect both the lower incidence and adequate management. Increasing life expectancy and exposures to risk factors suggests that Indigenous people are vulnerable to a growing burden of CRC. Primary prevention and early detection will be of paramount importance to future CRC control among Indigenous Australians. Current CRC management must be maintained and include prevention measures to ensure that predicted increases in CRC burden are minimized. © 2014 Wiley Publishing Asia Pty Ltd.

  2. The first comprehensive report on Indigenous Australian women's inequalities in cervical screening: A retrospective registry cohort study in Queensland, Australia (2000‐2011)

    PubMed Central

    Garvey, Gail; Baade, Peter; Cunningham, Joan; Lokuge, Kamalini; Brotherton, Julia M. L.; Valery, Patricia C.; O'Connell, Dianne L.; Canfell, Karen; Diaz, Abbey; Roder, David; Gertig, Dorota; Moore, Suzanne P.; Condon, John R.

    2016-01-01

    BACKGROUND The Australian National Cervical Screening Program, introduced more than 20 years ago, does not record the Indigenous status of screening participants. This article reports the first population‐based estimates of participation in cervical screening for Indigenous and non‐Indigenous Australian women. METHODS This was a retrospective, population‐based study of 1,334,795 female Queensland residents, aged 20 to 69 years, who participated in cervical screening from 2000 to 2011; 26,829 were identified as Indigenous through linkage to hospitalization records. Participation rates were calculated as the number of women screened divided by the average estimated resident population, with adjustments made for hysterectomies, for each 2‐, 3‐, and 5‐year screening period. Multivariate logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs), which were adjusted for age group, place of residence, and socioeconomic disadvantage. RESULTS In 2010‐2011, the 2‐year participation rate was 55.7% (95% CI, 55.6%‐55.9%) for non‐Indigenous women and 33.5% (95% CI, 32.9%‐34.1%) for Indigenous women; this represented a decrease from 2000‐2001 (57.7% [95% CI, 57.6%‐57.9%] and 35.3% [95% CI, 34.5%‐36.1%], respectively). The difference between Indigenous and non‐Indigenous women was greatest for those aged 45 to 49 years. The 3‐ and 5‐year participation rates were higher within both groups, and the absolute differences between the 2 groups were larger. Significant interactions between the Indigenous status and the place of residence and socioeconomic disadvantage highlight that the Indigenous/non‐Indigenous differential was evident in all places of residence except for very remote areas (OR, 0.99; 95% CI, 0.95‐1.02) and was greatest in the most affluent areas (OR, 0.26; 95% CI, 0.24‐0.27). CONCLUSIONS Indigenous Australian women participate less than non‐Indigenous women, and this gap has not closed. These

  3. Applying what works: a systematic search of the transfer and implementation of promising Indigenous Australian health services and programs

    PubMed Central

    2012-01-01

    Background The transfer and implementation of acceptable and effective health services, programs and innovations across settings provides an important and potentially cost-effective strategy for reducing Indigenous Australians' high burden of disease. This study reports a systematic review of Indigenous health services, programs and innovations to examine the extent to which studies considered processes of transfer and implementation within and across Indigenous communities and healthcare settings. Methods Medline, Informit, Infotrac, Blackwells Publishing, Proquest, Taylor and Francis, JStor, and the Indigenous HealthInfoNet were searched using terms: Aborigin* OR Indigen* OR Torres AND health AND service OR program* OR intervention AND Australia to locate publications from 1992–2011. The reference lists of 19 reviews were also checked. Data from peer reviewed journals, reports, and websites were included. The 95% confidence intervals (95% CI) for proportions that referred to and focussed on transfer were calculated as exact binomial confidence intervals. Test comparisons between proportions were calculated using Fisher's exact test with an alpha level of 5%. Results Of 1311 publications identified, 119 (9.1%; 95% CI: 7.6% - 10.8%) referred to the transfer and implementation of Indigenous Australian health services or programs, but only 21 studies (1.6%; 95% CI: 1.0% - 2.4%) actually focused on transfer and implementation. Of the 119 transfer studies, 37 (31.1%; 95% CI: 22.9 - 40.2%) evaluated the impact of a service or program, 28 (23.5%; 95% CI: 16.2% - 32.2%) reported only process measures and 54 were descriptive. Of the 37 impact evaluation studies, 28 (75.7%; 95% CI: 58.8% - 88.2%) appeared in peer reviewed journals but none included experimental designs. Conclusion While services and programs are being transferred and implemented, few studies focus on the process by which this occurred or the effectiveness of the service or program in the new setting

  4. Applying what works: a systematic search of the transfer and implementation of promising Indigenous Australian health services and programs.

    PubMed

    McCalman, Janya; Tsey, Komla; Clifford, Anton; Earles, Wendy; Shakeshaft, Anthony; Bainbridge, Roxanne

    2012-08-03

    The transfer and implementation of acceptable and effective health services, programs and innovations across settings provides an important and potentially cost-effective strategy for reducing Indigenous Australians' high burden of disease. This study reports a systematic review of Indigenous health services, programs and innovations to examine the extent to which studies considered processes of transfer and implementation within and across Indigenous communities and healthcare settings. Medline, Informit, Infotrac, Blackwells Publishing, Proquest, Taylor and Francis, JStor, and the Indigenous HealthInfoNet were searched using terms: Aborigin* OR Indigen* OR Torres AND health AND service OR program* OR intervention AND Australia to locate publications from 1992-2011. The reference lists of 19 reviews were also checked. Data from peer reviewed journals, reports, and websites were included. The 95% confidence intervals (95% CI) for proportions that referred to and focussed on transfer were calculated as exact binomial confidence intervals. Test comparisons between proportions were calculated using Fisher's exact test with an alpha level of 5%. Of 1311 publications identified, 119 (9.1%; 95% CI: 7.6%-10.8%) referred to the transfer and implementation of Indigenous Australian health services or programs, but only 21 studies (1.6%; 95% CI: 1.0%-2.4%) actually focused on transfer and implementation. Of the 119 transfer studies, 37 (31.1%; 95% CI: 22.9-40.2%) evaluated the impact of a service or program, 28 (23.5%; 95% CI: 16.2%-32.2%) reported only process measures and 54 were descriptive. Of the 37 impact evaluation studies, 28 (75.7%; 95% CI: 58.8%-88.2%) appeared in peer reviewed journals but none included experimental designs. While services and programs are being transferred and implemented, few studies focus on the process by which this occurred or the effectiveness of the service or program in the new setting. Findings highlight a need for partnerships between

  5. An Australian Indigenous community-led suicide intervention skills training program: community consultation findings.

    PubMed

    Nasir, Bushra; Kisely, Steve; Hides, Leanne; Ranmuthugala, Geetha; Brennan-Olsen, Sharon; Nicholson, Geoffrey C; Gill, Neeraj S; Hayman, Noel; Kondalsamy-Chennakesavan, Srinivas; Toombs, Maree

    2017-06-13

    Little is known of the appropriateness of existing gatekeeper suicide prevention programs for Indigenous communities. Despite the high rates of Indigenous suicide in Australia, especially among Indigenous youth, it is unclear how effective existing suicide prevention programs are in providing appropriate management of Indigenous people at risk of suicide. In-depth, semi-structured interviews and focus groups were conducted with Indigenous communities in rural and regional areas of Southern Queensland. Thematic analysis was performed on the gathered information. Existing programs were time-intensive and included content irrelevant to Indigenous people. There was inconsistency in the content and delivery of gatekeeper training. Programs were also not sustainable for rural and regional Indigenous communities. Appropriate programs should be practical, relevant, and sustainable across all Indigenous communities, with a focus on the social, emotional, cultural and spiritual underpinnings of community wellbeing. Programs need to be developed in thorough consultation with Indigenous communities. Indigenous-led suicide intervention training programs are needed to mitigate the increasing rates of suicide experienced by Indigenous peoples living in rural and remote locations.

  6. Lectins from indigenous Australian wildflowers--detection of lectins from Bauhinia carronii, Hardenbergia comptoniana, Ptilotis obovatus and Rhadogia crassifolia.

    PubMed

    Flower, R L; Wilcox, G E; Chugg, V; Neal, J R

    1984-12-01

    Extracts from 21 indigenous Australian plant species, representing eight genera, were tested for haemagglutinating activity to human and animal erythrocytes. Extracts from Bauhinia carronii, Hardenbergia comptoniana, Ptilotis obovatus and Rhadogia crassifolia agglutinated at least one of the erythrocyte types tested. The extracts from B. carronii and R. crassifolia contained mitogens for human lymphocytes. Both the haemagglutinating and mitogenic activity of the B. carronii extract were inhibited by lactose. Both the haemagglutinating and mitogenic activity of R. crassifolia were inhibited by maltose and alpha-methyl-glucoside. The haemagglutinating activity of H. comptoniana was inhibited by raffinose and the haemagglutinating activity of P. obovatus by maltose and alpha-methylglucoside.

  7. Development of a Culturally Appropriate Bilingual Electronic App About Hepatitis B for Indigenous Australians: Towards Shared Understandings.

    PubMed

    Davies, Jane; Bukulatjpi, Sarah; Sharma, Suresh; Caldwell, Luci; Johnston, Vanessa; Davis, Joshua Saul

    2015-06-10

    Hepatitis B is endemic in Indigenous communities in Northern Australia; however, there is a lack of culturally appropriate educational tools. Health care workers and educators in this setting have voiced a desire for visual, interactive tools in local languages. Mobile phones are increasingly used and available in remote Indigenous communities. In this context, we identified the need for a tablet-based health education app about hepatitis B, developed in partnership with an Australian remote Indigenous community. To develop a culturally appropriate bilingual app about hepatitis B for Indigenous Australians in Arnhem Land using a participatory action research (PAR) framework. This project was a partnership between the Menzies School of Health Research, Miwatj Aboriginal Health Corporation, Royal Darwin Hospital Liver Clinic, and Dreamedia Darwin. We have previously published a qualitative study that identified major knowledge gaps about hepatitis B in this community, and suggested that a tablet-based app would be an appropriate and popular tool to improve this knowledge. The process of developing the app was based on PAR principles, particularly ongoing consultation, evaluation, and discussion with the community throughout each iterative cycle. Stages included development of the storyboard, the translation process (forward translation and backtranslation), prelaunch community review, launch and initial community evaluation, and finally, wider launch and evaluation at a viral hepatitis conference. We produced an app called "Hep B Story" for use with iPad, iPhone, Android tablets, and mobile phones or personal computers. The app is culturally appropriate, audiovisual, interactive, and users can choose either English or Yolŋu Matha (the most common language in East Arnhem Land) as their preferred language. The initial evaluation demonstrated a statistically significant improvement in Hep B-related knowledge for 2 of 3 questions (P=.01 and .02, respectively) and

  8. Development of a Culturally Appropriate Bilingual Electronic App About Hepatitis B for Indigenous Australians: Towards Shared Understandings

    PubMed Central

    Bukulatjpi, Sarah; Sharma, Suresh; Caldwell, Luci; Johnston, Vanessa; Davis, Joshua Saul

    2015-01-01

    Background Hepatitis B is endemic in Indigenous communities in Northern Australia; however, there is a lack of culturally appropriate educational tools. Health care workers and educators in this setting have voiced a desire for visual, interactive tools in local languages. Mobile phones are increasingly used and available in remote Indigenous communities. In this context, we identified the need for a tablet-based health education app about hepatitis B, developed in partnership with an Australian remote Indigenous community. Objective To develop a culturally appropriate bilingual app about hepatitis B for Indigenous Australians in Arnhem Land using a participatory action research (PAR) framework. Methods This project was a partnership between the Menzies School of Health Research, Miwatj Aboriginal Health Corporation, Royal Darwin Hospital Liver Clinic, and Dreamedia Darwin. We have previously published a qualitative study that identified major knowledge gaps about hepatitis B in this community, and suggested that a tablet-based app would be an appropriate and popular tool to improve this knowledge. The process of developing the app was based on PAR principles, particularly ongoing consultation, evaluation, and discussion with the community throughout each iterative cycle. Stages included development of the storyboard, the translation process (forward translation and backtranslation), prelaunch community review, launch and initial community evaluation, and finally, wider launch and evaluation at a viral hepatitis conference. Results We produced an app called “Hep B Story” for use with iPad, iPhone, Android tablets, and mobile phones or personal computers. The app is culturally appropriate, audiovisual, interactive, and users can choose either English or Yolŋu Matha (the most common language in East Arnhem Land) as their preferred language. The initial evaluation demonstrated a statistically significant improvement in Hep B-related knowledge for 2 of 3 questions

  9. Mapping Indigenous land management for threatened species conservation: An Australian case-study

    PubMed Central

    Renwick, Anna R.; Robinson, Catherine J.; Garnett, Stephen T.; Leiper, Ian; Possingham, Hugh P.; Carwardine, Josie

    2017-01-01

    Much biodiversity lives on lands to which Indigenous people retain strong legal and management rights. However this is rarely quantified. Here we provide the first quantitative overview of the importance of Indigenous land for a critical and vulnerable part of biodiversity, threatened species, using the continent of Australia as a case study. We find that three quarters of Australia’s 272 terrestrial or freshwater vertebrate species listed as threatened under national legislation have projected ranges that overlap Indigenous lands. On average this overlap represents 45% of the range of each threatened species while Indigenous land is 52% of the country. Hotspots where multiple threatened species ranges overlap occur predominantly in coastal Northern Australia. Our analysis quantifies the vast potential of Indigenous land in Australia for contributing to national level conservation goals, and identifies the main land management arrangements available to Indigenous people which may enable them to deliver those goals should they choose to do so. PMID:28291797

  10. Different survival analysis methods for measuring long-term outcomes of Indigenous and non-Indigenous Australian cancer patients in the presence and absence of competing risks.

    PubMed

    He, Vincent Y F; Condon, John R; Baade, Peter D; Zhang, Xiaohua; Zhao, Yuejen

    2017-01-17

    Net survival is the most common measure of cancer prognosis and has been used to study differentials in cancer survival between ethnic or racial population subgroups. However, net survival ignores competing risks of deaths and so provides incomplete prognostic information for cancer patients, and when comparing survival between populations with different all-cause mortality. Another prognosis measure, "crude probability of death", which takes competing risk of death into account, overcomes this limitation. Similar to net survival, it can be calculated using either life tables (using Cronin-Feuer method) or cause of death data (using Fine-Gray method). The aim of this study is two-fold: (1) to compare the multivariable results produced by different survival analysis methods; and (2) to compare the Cronin-Feuer with the Fine-Gray methods, in estimating the cancer and non-cancer death probability of both Indigenous and non-Indigenous cancer patients and the Indigenous cancer disparities. Cancer survival was investigated for 9,595 people (18.5% Indigenous) diagnosed with cancer in the Northern Territory of Australia between 1991 and 2009. The Cox proportional hazard model along with Poisson and Fine-Gray regression were used in the multivariable analysis. The crude probabilities of cancer and non-cancer methods were estimated in two ways: first, using cause of death data with the Fine-Gray method, and second, using life tables with the Cronin-Feuer method. Multivariable regression using the relative survival, cause-specific survival, and competing risk analysis produced similar results. In the presence of competing risks, the Cronin-Feuer method produced similar results to Fine-Gray in the estimation of cancer death probability (higher Indigenous cancer death probabilities for all cancers) and non-cancer death probabilities (higher Indigenous non-cancer death probabilities for all cancers except lung cancer and head and neck cancers). Cronin-Feuer estimated much lower

  11. The Kimberley Assessment of Depression of Older Indigenous Australians: Prevalence of Depressive Disorders, Risk Factors and Validation of the KICA-dep Scale

    PubMed Central

    Almeida, Osvaldo P.; Flicker, Leon; Fenner, Stephen; Smith, Kate; Hyde, Zoe; Atkinson, David; Skeaf, Linda; Malay, Roslyn; LoGiudice, Dina

    2014-01-01

    Objective This study aimed to develop a culturally acceptable and valid scale to assess depressive symptoms in older Indigenous Australians, to determine the prevalence of depressive disorders in the older Kimberley community, and to investigate the sociodemographic, lifestyle and clinical factors associated with depression in this population. Methods Cross-sectional survey of adults aged 45 years or over from six remote Indigenous communities in the Kimberley and 30% of those living in Derby, Western Australia. The 11 linguistic and culturally sensitive items of the Kimberley Indigenous Cognitive Assessment of Depression (KICA-dep) scale were derived from the signs and symptoms required to establish the diagnosis of a depressive episode according to the DSM-IV-TR and ICD-10 criteria, and their frequency was rated on a 4-point scale ranging from ‘never’ to ‘all the time’ (range of scores: 0 to 33). The diagnosis of depressive disorder was established after a face-to-face assessment with a consultant psychiatrist. Other measures included sociodemographic and lifestyle factors, and clinical history. Results The study included 250 participants aged 46 to 89 years (mean±SD = 60.9±10.7), of whom 143 (57.2%) were women. The internal reliability of the KICA-dep was 0.88 and the cut-point 7/8 (non-case/case) was associated with 78% sensitivity and 82% specificity for the diagnosis of a depressive disorder. The point-prevalence of a depressive disorder in this population was 7.7%; 4.0% for men and 10.4% for women. Heart problems were associated with increased odds of depression (odds ratio = 3.3, 95% confidence interval = 1.2,8.8). Conclusions The KICA-dep has robust psychometric properties and can be used with confidence as a screening tool for depression among older Indigenous Australians. Depressive disorders are common in this population, possibly because of increased stressors and health morbidities. PMID:24740098

  12. Education resources in remote Australian Indigenous community dog health programs: a comparison of community and extra-community-produced resources.

    PubMed

    Constable, Sophie Elizabeth; Dixon, Roselyn May; Dixon, Robert John

    2013-09-01

    Commercial dog health programs in Australian Indigenous communities are a relatively recent occurrence. Health promotion for these programs is an even more recent development, and lacks data on effective practices. This paper analyses 38 resources created by veterinary-community partnerships in Indigenous communities, to 71 resources available through local veterinary service providers. On average, community-produced resources used significantly more of the resource area as image, more imagery as communicative rather than decorative images, larger fonts and smaller segments of text and used images of people with a range of skin tones. As well as informal registers of Standard Australian English, community-produced resources used Aboriginal English and/or Creole languages in their text, while extra-community (EC)-produced resources did not. The text of EC resources had Flesh-Kincaid reading grade levels that excluded a large proportion of community recipients. Also, they did not cover some topics of importance in communities, used academic, formal and technical language, and did not depict people of a representative range of skin tones. As such, community-produced resources were more relevant to the unique situations in remote communities, while EC resources were often inappropriate and in some cases could even distance recipients by using inappropriate language, formats and imagery.

  13. Development of a single-frequency bioimpedance prediction equation for fat-free mass in an adult Indigenous Australian population.

    PubMed

    Hughes, J T; Maple-Brown, L J; Piers, L S; Meerkin, J; O'Dea, K; Ward, L C

    2015-01-01

    To describe the development of a single-frequency bioimpedance prediction equation for fat-free mass (FFM) suitable for adult Aboriginal and Torres Strait Islander peoples with and without diabetes or indicators of chronic kidney disease (CKD). FFM was measured by whole-body dual-energy X-ray absorptiometry in 147 adult Indigenous Australians. Height, weight, body circumference and resistance were also measured. Adults with and without diabetes and indicators of CKD were examined. A random split sample with internal cross-validation approach was used to predict and subsequently validate FFM using resistance, height, weight, age and gender against measured FFM. Among 147 adults with a median body mass index of 31 kg/m(2), the final model of FFM was FFM (kg)=0.432 (height, cm(2)/resistance, ohm)-0.086 (age, years)+0.269 (weight, kg)-6.422 (if female)+16.429. Adjusted R(2) was 0.94 and the root mean square error was 3.33 kg. The concordance was high (rc=0.97) between measured and predicted FFM across a wide range of FFM (31-85 kg). In the context of the high burden of diabetes and CKD among adult Indigenous Australians, this new equation for FFM was both accurate and precise and based on easily acquired variables (height, weight, age, gender and resistance) among a heterogeneous adult cohort.

  14. Indigenous Peoples and Indicators of Well-Being: Australian Perspectives on United Nations Global Frameworks

    ERIC Educational Resources Information Center

    Taylor, John

    2008-01-01

    One of the major tasks of the United Nations Permanent Forum on Indigenous Issues (UNPFII) following its establishment in 2000 has been to establish statistical profiles of the world's Indigenous peoples. As part of this broad task, it has recommended that the Millennium Development Goals and other global reporting frameworks should be assessed…

  15. Seeds of Myth: Exotic Disease Theory and Deconstructing the Australian Narrative of Indigenous Depopulation

    ERIC Educational Resources Information Center

    Blyton, Greg

    2009-01-01

    The theory that the rapid depopulation of Indigenous people post-colonisation was largely caused by European introduced or exotic disease to which Indigenous people had no immunity resonates through most narratives of the early years of colonisation. The question of whether this narrative is based on sound medical evidence or is better placed in…

  16. Exploring Anomalies in Indigenous Student Engagement: Findings from a National Australian Survey of Undergraduates

    ERIC Educational Resources Information Center

    Asmar, Christine; Page, Susan; Radloff, Ali

    2015-01-01

    Increases in participation by Aboriginal and Torres Strait Islander students in higher education across Australia continue to be promising. However, it is also known that Indigenous students' attrition, retention and completion rates remain areas of concern. In this paper, we report our findings from an analysis of Indigenous student responses to…

  17. Exploring Anomalies in Indigenous Student Engagement: Findings from a National Australian Survey of Undergraduates

    ERIC Educational Resources Information Center

    Asmar, Christine; Page, Susan; Radloff, Ali

    2015-01-01

    Increases in participation by Aboriginal and Torres Strait Islander students in higher education across Australia continue to be promising. However, it is also known that Indigenous students' attrition, retention and completion rates remain areas of concern. In this paper, we report our findings from an analysis of Indigenous student responses to…

  18. Addressing the Foundations for Improved Indigenous Secondary Student Outcomes: A South Australian Qualitative Study

    ERIC Educational Resources Information Center

    Rahman, Kiara

    2010-01-01

    It is well documented, that Indigenous students, compared with their non-Indigenous counterparts, attend school less frequently, and are more likely to develop anti-schooling attitudes leading to their early exit from school (Hayes et al., 2009; Gray & Partington, 2003; Hunter & Schwad, 2003). Although research does suggest that there has…

  19. Changing the Teaching of Mathematics for Improved Indigenous Education in a Rural Australian City

    ERIC Educational Resources Information Center

    Owens, Kay

    2015-01-01

    Transforming teachers and their approach to teaching Indigenous students requires partnerships with the Indigenous community, planning, small steps, and funds. This article illustrates how teachers can change when funds are available to assist schools and communities to implement appropriate and effective professional development, to establish…

  20. Young Australian Indigenous Students' Effective Engagement in Mathematics: The Role of Language, Patterns, and Structure

    ERIC Educational Resources Information Center

    Warren, Elizabeth; Miller, Jodie

    2013-01-01

    This paper explores the outcomes of the first year of the implementation of a mathematics program ("Representations, oral language and engagement in Mathematics": RoleM) which is framed upon research relating to effectively supporting young Indigenous students' learning. The sample comprised 230 Indigenous students (average age 5.76…

  1. Seeds of Myth: Exotic Disease Theory and Deconstructing the Australian Narrative of Indigenous Depopulation

    ERIC Educational Resources Information Center

    Blyton, Greg

    2009-01-01

    The theory that the rapid depopulation of Indigenous people post-colonisation was largely caused by European introduced or exotic disease to which Indigenous people had no immunity resonates through most narratives of the early years of colonisation. The question of whether this narrative is based on sound medical evidence or is better placed in…

  2. Retaining Indigenous Students in Tertiary Education: Lessons from the Griffith School of Environment

    ERIC Educational Resources Information Center

    Howlett, Catherine; Seini, Monica; Matthews, Chris; Dillon, Bronwyn; Hauser, Vivian

    2008-01-01

    Low retention of Indigenous peoples in all Australian universities has been identified as a problematic issue by the Australian Federal government. Griffith University (GU), Queensland, Australia, provided funding to examine the factors affecting Indigenous retention in higher education, with the aim of developing innovative participation and…

  3. Retaining Indigenous Students in Tertiary Education: Lessons from the Griffith School of Environment

    ERIC Educational Resources Information Center

    Howlett, Catherine; Seini, Monica; Matthews, Chris; Dillon, Bronwyn; Hauser, Vivian

    2008-01-01

    Low retention of Indigenous peoples in all Australian universities has been identified as a problematic issue by the Australian Federal government. Griffith University (GU), Queensland, Australia, provided funding to examine the factors affecting Indigenous retention in higher education, with the aim of developing innovative participation and…

  4. Improving forensic mental health care to Indigenous Australians: theorizing the intercultural space.

    PubMed

    Durey, A; Wynaden, D; O'Kane, M

    2014-05-01

    This paper uses the 'intercultural space' as an educational strategy to prepare nurses to work respectfully with Indigenous patients in a forensic mental health context; offers an educational approach that introduces nurses to Indigenous knowledge, beliefs and values, examines power relations in colonized countries between the dominant white cultural group and the Indigenous population and encourages nurses to critically reflect on their health care practice; and explores the intercultural space as a shared space between cultures fostering open and robust inquiry where neither culture dominates and new positions, representations and understandings can emerge. Given the disproportionately high number of Indigenous people imprisoned in colonized countries, this paper responds to research from Western Australia on the need to prepare forensic mental health nurses to deliver care to Indigenous patients with mental health disorders. The paper highlights the nexus between theory, research and education that can inform the design and implementation of programmes to help nurses navigate the complex, layered and contested 'intercultural space' and deliver culturally safe care to Indigenous patients. Nurses are encouraged to critically reflect on how beliefs and values underpinning their cultural positioning impact on health care to Indigenous patients. The paper draws on intercultural theory to offer a pedagogical framework that acknowledges the negative impacts of colonization on Indigenous health and well-being, repositions and revalues Indigenous cultures and knowledges and fosters open and robust inquiry. This approach is seen as a step towards working more effectively in the intercultural space where ultimately binary oppositions that privilege one culture over another and inhibit robust inquiry are avoided, paving the way for new, more inclusive positions, representations and understandings to emerge. While the intercultural space can be a place of struggle, tension

  5. Differences in post-exercise inflammatory and glucose regulatory response between sedentary indigenous Australian and Caucasian men completing a single bout of cycling.

    PubMed

    Mendham, Amy E; Duffield, Rob; Marino, Frank; Coutts, Aaron J

    2014-01-01

    This study compared the acute inflammatory and glucose responses following aerobic exercise in sedentary Indigenous Australian and Caucasian men, matched for fitness and body composition. Sedentary Indigenous (n = 10) and Caucasian (n = 9) Australian men who were free from chronic disease volunteered to participate. Following baseline testing, participants completed a 40 min cycling bout at ∼80% maximal heart rate. Fasting venous blood was collected pre, 0, 30, 60, and 240 min post-exercise for analysis of glucose, insulin, cortisol, tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, IL-1 receptor agonist (ra), and C-reactive protein (CRP). Resting TNF-α and glucose concentrations were significantly higher in the Indigenous group (P < 0.05). IL-6 and IL-1ra were elevated for longer in Caucasian (P < 0.05), compared with the Indigenous group (P > 0.05). The post-exercise (0 min) increase in cortisol and glucose for the Caucasians was higher (P < 0.05) than the attenuated responses within the Indigenous group (P > 0.05). Despite being matched for fitness and body composition the Indigenous men had elevated resting TNF-α and glucose compared with the Caucasian men, which may have contributed to the suppressed post-exercise anti-inflammatory response of the Indigenous men; however, glucose normalized between groups post-exercise. As such, it is recommended for acute moderate-intensity exercise to be completed daily for long-term improvements in glucose regulation, irrespective of ancestry. Of note, results suggest it to be even more pertinent for exercise to be encouraged for Indigenous Australian men due to their elevated resting glucose levels at a younger age, when compared to the respective Caucasian group. Copyright © 2013 Wiley Periodicals, Inc.

  6. Indigenizing Teacher Professional Development: Anticipating the Australian Professional Standards for Teachers in Australia

    ERIC Educational Resources Information Center

    Rhea, Zane Ma

    2012-01-01

    It is the Australian Government's intention that all teachers will have, as a minimum, a proficient level of demonstrable professional expertise in both Aboriginal and Torres Strait Islander Education and Australian Aboriginal and Torres Strait Islander Studies. A raft of government policies are giving shape to the engagement of the Australian…

  7. Interrogating Social Justice in Early Years Education: How Effectively Do Contemporary Policies and Practices Create Equitable Learning Environments for Indigenous Australian Children?

    ERIC Educational Resources Information Center

    Herbert, Jeannie

    2013-01-01

    This article examines some of the contemporary policies and practices in Australian early years education to provide an insight into why social justice is such a critical element in preparing Australia's Indigenous children to engage in learning experiences in ways that will enable them to establish sound foundations for their future learning…

  8. Screen Worlds, Sound Worlds and School: A Consideration of the Potential of the Ethnomusicology of Australian Indigenous Film for Music Education

    ERIC Educational Resources Information Center

    Webb, Michael; Fienberg, Thomas

    2011-01-01

    This article arises from the authors' belief that there is a need to develop motivating ways for students across Australia to meaningfully encounter Australian indigenous music, the breadth and richness of which is beginning to be conveyed via a diverse range of mainstream media texts. Engaging with theoretical insights from the ethnomusicology of…

  9. Fibrinogen and associated risk factors in a high-risk population: urban Indigenous Australians, the DRUID Study.

    PubMed

    Maple-Brown, Louise J; Cunningham, Joan; Nandi, Nirjhar; Hodge, Allison; O'Dea, Kerin

    2010-10-29

    Epidemiological evidence suggests that fibrinogen and CRP are associated with coronary heart disease risk. High CRP in Indigenous Australians has been reported in previous studies including our 'Diabetes and Related diseases in Urban Indigenous population in Darwin region' (DRUID) Study. We studied levels of fibrinogen and its cross-sectional relationship with traditional and non-traditional cardiovascular risk factors in an urban Indigenous Australian cohort. Fibrinogen data were available from 287 males and 628 females (aged ≥ 15 years) from the DRUID study. Analysis was performed for associations with the following risk factors: diabetes, HbA1c, age, BMI, waist circumference, waist-hip ratio, total cholesterol, triglyceride, HDL cholesterol, C-reactive protein, homocysteine, blood pressure, heart rate, urine ACR, smoking status, alcohol abstinence. Fibrinogen generally increased with age in both genders; levels by age group were higher than those previously reported in other populations, including Native Americans. Fibrinogen was higher in those with than without diabetes (4.24 vs 3.56 g/L, p < 0.001). After adjusting for age and sex, the following were significantly associated with fibrinogen: BMI, waist, waist-hip ratio, systolic blood pressure, heart rate, fasting triglycerides, HDL cholesterol, HbA1c, CRP, ACR and alcohol abstinence. On multivariate regression (age and sex-adjusted) CRP and HbA1c were significant independent predictors of fibrinogen, explaining 27% of its variance; CRP alone explained 25% of fibrinogen variance. On factor analysis, both CRP and fibrinogen clustered with obesity in women (this factor explained 20% of variance); but in men, CRP clustered with obesity (factor explained 18% of variance) whilst fibrinogen clustered with HbA1c and urine ACR (factor explained 13% of variance). Fibrinogen is associated with traditional and non-traditional cardiovascular risk factors in this urban Indigenous cohort and may be a useful biomarker of

  10. Post-traumatic stress disorder symptoms in pregnant Australian Indigenous women residing in rural and remote New South Wales: A cross-sectional descriptive study.

    PubMed

    Mah, Beth; Weatherall, Loretta; Burrows, Julie; Blackwell, Caroline C; Gwynn, Josephine; Wadhwa, Pathik; Lumbers, Eugenie R; Smith, Roger; Rae, Kym M

    2017-10-01

    Pregnancy can be a stressful time for many women. There is ample evidence of numerous physical and mental health inequities for Indigenous Australians. For those Indigenous women who are pregnant, it is established that there is a higher incidence of poor physical perinatal outcomes when compared with non-Indigenous Australians. However, little evidence exists that examines stressful events and post-traumatic stress disorder (PTSD) symptoms in pregnant women who are members of this community. To quantify the rates of stressful events and PTSD symptoms in pregnant Indigenous women. One hundred and fifty rural and remote Indigenous women were invited to complete a survey during each trimester of their pregnancy. The survey measures were the stressful life events and the Impact of Events Scale. Extremely high rates of PTSD symptoms were reported by participants. Approximately 40% of this group exhibited PTSD symptoms during their pregnancy with mean score 33.38 (SD = 14.37) significantly higher than a study of European victims of crisis, including terrorism attacks (20.6, SD = 18.5). The extreme levels of PTSD symptoms found in the women participating in this study are likely to result in negative implications for both mother and infant. An urgent response must be mounted at government, health, community development and research levels to address these findings. Immediate attention needs to focus on the development of interventions to address the high levels of PTSD symptoms that pregnant Australian Indigenous women experience. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  11. Longitudinal Nasopharyngeal Carriage and Antibiotic Resistance of Respiratory Bacteria in Indigenous Australian and Alaska Native Children with Bronchiectasis

    PubMed Central

    Hare, Kim M.; Singleton, Rosalyn J.; Grimwood, Keith; Valery, Patricia C.; Cheng, Allen C.; Morris, Peter S.; Leach, Amanda J.; Smith-Vaughan, Heidi C.; Chatfield, Mark; Redding, Greg; Reasonover, Alisa L.; McCallum, Gabrielle B.; Chikoyak, Lori; McDonald, Malcolm I.; Brown, Ngiare; Torzillo, Paul J.; Chang, Anne B.

    2013-01-01

    Background Indigenous children in Australia and Alaska have very high rates of chronic suppurative lung disease (CSLD)/bronchiectasis. Antibiotics, including frequent or long-term azithromycin in Australia and short-term beta-lactam therapy in both countries, are often prescribed to treat these patients. In the Bronchiectasis Observational Study we examined over several years the nasopharyngeal carriage and antibiotic resistance of respiratory bacteria in these two PCV7-vaccinated populations. Methods Indigenous children aged 0.5–8.9 years with CSLD/bronchiectasis from remote Australia (n = 79) and Alaska (n = 41) were enrolled in a prospective cohort study during 2004–8. At scheduled study visits until 2010 antibiotic use in the preceding 2-weeks was recorded and nasopharyngeal swabs collected for culture and antimicrobial susceptibility testing. Analysis of respiratory bacterial carriage and antibiotic resistance was by baseline and final swabs, and total swabs by year. Results Streptococcus pneumoniae carriage changed little over time. In contrast, carriage of Haemophilus influenzae declined and Staphylococcus aureus increased (from 0% in 2005–6 to 23% in 2010 in Alaskan children); these changes were associated with increasing age. Moraxella catarrhalis carriage declined significantly in Australian, but not Alaskan, children (from 64% in 2004–6 to 11% in 2010). While beta-lactam antibiotic use was similar in the two cohorts, Australian children received more azithromycin. Macrolide resistance was significantly higher in Australian compared to Alaskan children, while H. influenzae beta-lactam resistance was higher in Alaskan children. Azithromycin use coincided significantly with reduced carriage of S. pneumoniae, H. influenzae and M. catarrhalis, but increased carriage of S. aureus and macrolide-resistant strains of S. pneumoniae and S. aureus (proportion of carriers and all swabs), in a ‘cumulative dose-response’ relationship. Conclusions

  12. Homicide among Indigenous South Australians: a forty-year study (1969-2008).

    PubMed

    Temlett, Julia; Byard, Roger W

    2012-11-01

    A retrospective review of homicide cases among Aboriginal people in South Australia examined at Forensic Science SA was undertaken over a 40-year period from 1969 to 2008. A total of 90 Indigenous homicide victims were identified compared to 599 non-Indigenous victims over the same time period. Although homicide rates have fallen, the Indigenous homicide rate (ranging from 73.5 to 223.97 per 100,000) significantly exceeded the non-Indigenous rate (ranging from 8.16 to 12.6 per 100,000) for all decades (p<0.001). The most common methods of homicide in the Indigenous population involved blunt force and sharp force trauma, with gunshot, strangulation and other forms of homicides being encountered less often. While lack of access to firearms may explain the lower numbers of gunshot deaths it would not explain the low numbers of deaths due to strangulation. Considerable variability may, therefore, exist in the types of unnatural deaths that may be found in different cultural and ethnic groups, even within the same community.

  13. Mental health first aid for Indigenous Australians: using Delphi consensus studies to develop guidelines for culturally appropriate responses to mental health problems

    PubMed Central

    Hart, Laura M; Jorm, Anthony F; Kanowski, Leonard G; Kelly, Claire M; Langlands, Robyn L

    2009-01-01

    Background Ethnic minority groups are under-represented in mental health care services because of barriers such as poor mental health literacy. In 2007, the Mental Health First Aid (MHFA) program implemented a cultural adaptation of its first aid course to improve the capacity of Indigenous Australians to recognise and respond to mental health issues within their own communities. It became apparent that the content of this training would be improved by the development of best practice guidelines. This research aimed to develop culturally appropriate guidelines for providing first aid to an Australian Aboriginal or Torres Strait Islander person who is experiencing a mental health crisis or developing a mental illness. Methods A panel of Australian Aboriginal people who are experts in Aboriginal mental health, participated in six independent Delphi studies investigating depression, psychosis, suicidal thoughts and behaviours, deliberate self-injury, trauma and loss, and cultural considerations. The panel varied in size across the studies, from 20-24 participants. Panellists were presented with statements about possible first aid actions via online questionnaires and were encouraged to suggest additional actions not covered by the survey content. Statements were accepted for inclusion in a guideline if they were endorsed by ≥ 90% of panellists as essential or important. Each study developed one guideline from the outcomes of three Delphi questionnaire rounds. At the end of the six Delphi studies, participants were asked to give feedback on the value of the project and their participation experience. Results From a total of 1,016 statements shown to the panel of experts, 536 statements were endorsed (94 for depression, 151 for psychosis, 52 for suicidal thoughts and behaviours, 53 for deliberate self-injury, 155 for trauma and loss, and 31 for cultural considerations). The methodology and the guidelines themselves were found to be useful and appropriate by the

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

    PubMed Central

    Sayers, Susan M; Mackerras, Dorothy; Singh, Gurmeet; Bucens, Ingrid; Flynn, Kathryn; Reid, Alison

    2003-01-01

    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. PMID:12659639

  15. Invented Tradition and How Physical Education Curricula in the Australian Capital Territory Has Resisted Indigenous Mention

    ERIC Educational Resources Information Center

    Williams, John

    2016-01-01

    This article reports how "invented tradition" [Hobsbawm, E. (2012), "Introduction: Inventing traditions." In E. Hobsbawm & T. Ranger (Eds.), "The invention of tradition" (pp. 1-14). New York, NY: Cambridge University Press] as a long-term process has contributed to Indigenous students experiencing physical…

  16. Young Australian Indigenous Students' Growing Pattern Generalisations: The Role of Gesture When Generalising

    ERIC Educational Resources Information Center

    Miller, Jodie

    2014-01-01

    This paper explores how young Indigenous students' (Year 2 and 3) generalise growing patterns. Piagetian clinical interviews were conducted to determine how students articulated growing pattern generalisations. Two case studies are presented displaying how students used gesture to support and articulate their generalisations of growing patterns.…

  17. Invented Tradition and How Physical Education Curricula in the Australian Capital Territory Has Resisted Indigenous Mention

    ERIC Educational Resources Information Center

    Williams, John

    2016-01-01

    This article reports how "invented tradition" [Hobsbawm, E. (2012), "Introduction: Inventing traditions." In E. Hobsbawm & T. Ranger (Eds.), "The invention of tradition" (pp. 1-14). New York, NY: Cambridge University Press] as a long-term process has contributed to Indigenous students experiencing physical…

  18. The Mathematical Needs of Urban Indigenous Primary Children: A Western Australian Snapshot

    ERIC Educational Resources Information Center

    Hurst, Chris; Sparrow, Len

    2010-01-01

    This study considered ways of improving mathematical outcomes for urban Indigenous students. It focused on three primary schools in Western Australia and identified factors that were perceived to be having an impact on student learning. These included expectations for students, attendance rates, parent involvement, student literacy levels, student…

  19. Indigenous Language Learning and Maintenance among Young Australian Aboriginal and Torres Strait Islander Children

    ERIC Educational Resources Information Center

    Verdon, Sarah; McLeod, Sharynne

    2015-01-01

    Internationally, cultural renewal and language revitalisation are occurring among Indigenous people whose lands were colonised by foreign nations. In Australia, the Aboriginal and Torres Strait Islander people are striving for the re-voicing of their mother tongue and the re-practicing of their mother culture to achieve cultural renewal in the…

  20. Indigenous Australians' Information Behaviour and Internet Use in Everyday Life: An Exploratory Study

    ERIC Educational Resources Information Center

    Du, Jia Tina; Haines, Jelina

    2017-01-01

    Introduction: This paper reports the first stage of an ongoing information behaviour research project undertaken with a rural Indigenous community in South Australia. Method: Twenty-one Ngarrindjeri volunteers participated in the field study. Permission was granted and extensive community consultations were conducted. Analysis: Questionnaires and…

  1. Indigenous Language Learning and Maintenance among Young Australian Aboriginal and Torres Strait Islander Children

    ERIC Educational Resources Information Center

    Verdon, Sarah; McLeod, Sharynne

    2015-01-01

    Internationally, cultural renewal and language revitalisation are occurring among Indigenous people whose lands were colonised by foreign nations. In Australia, the Aboriginal and Torres Strait Islander people are striving for the re-voicing of their mother tongue and the re-practicing of their mother culture to achieve cultural renewal in the…

  2. Great expectations: An analysis of researchers' and policy makers' perceptions of the potential value of the Australian indigenous burden of disease study for policy.

    PubMed

    Katz, Aaron; Gajjar, Deepa; Zwi, Anthony B; Hill, Peter S

    2017-07-30

    The "Burden of disease and injury in Aboriginal and Torres Strait Islander Peoples" was commissioned by the Australian government as part of the Australian Burden of Disease study. This paper explores the extent to which key actors in the research and policy communities expected the Indigenous Burden of Disease study's findings to inform, influence, or drive federal decisions concerning Indigenous health in Australia. This qualitative research undertook interviews with 13 key informants with significant involvement in the Indigenous Burden of Disease study: six researchers, five policy makers, and two knowledge brokers. Interviews were recorded, transcribed, and analyzed, and the findings were triangulated with a review of the literature. Policy makers and researchers anticipated that the Indigenous Burden of Disease study would improve the available information for policy deliberations about Indigenous health. Beyond that, their expectations about its policy influence differed substantially, with researchers more confident of the study's capacity to guide health priorities, and policy makers situating findings in the context of other critical inputs. Expectations of policy influence are shaped by the disciplinary perspectives of actors, and their relationship to policy outcomes and cannot be examined without also considering the policy, political, and financing context of the study being analyzed. Copyright © 2017 John Wiley & Sons, Ltd.

  3. The Effect of Weight Loss on Indigenous Australians with Diabetes: a study of Feasibility, Acceptability and Effectiveness of Laparoscopic Adjustable Gastric Banding.

    PubMed

    O'Brien, Paul E; DeWitt, Dawn E; Laurie, Cheryl; Brennan, Leah; Wentworth, John M; Anderson, Margaret; O'Dea, Kerin; Dean, Felicia; Smith, Andrew; Dalton, David P

    2016-01-01

    Diabetes and obesity are common and serious health challenges for indigenous people worldwide. The feasibility of achieving substantial weight loss, leading to remission of diabetes, was evaluated in a regional indigenous Australian community. A prospective cohort study of 30 obese indigenous adults from the Rumbalara Aboriginal Co-operative in Central Victoria was performed. Inclusion criteria included aboriginality, BMI > 30 kg/m(2) and diabetes diagnosed within the last 10 years. Weight loss was achieved using laparoscopic adjustable gastric banding (LAGB). Participants were treated in their community and followed for 2 years. Outcomes were compared with those of non-indigenous Australians from an earlier randomized controlled trial (RCT) using a similar protocol. 30 participants (26 females, mean age 44.6 years; mean BMI 44.3) had LAGB at the regional hospital. Twenty-six participants completed diabetes assessment at 2 years follow-up. They showed diabetes remission (fasting blood glucose < 7.0 mmol/L and haemoglobin A1c (HbA1c) < 6.2 % while off all therapy except metformin) in 20 of the 26 and a mean weight loss (SD) of 26.0 (14) kilograms. Based on intention-to-treat, remission rate was 66 %. Quality of life improved. There was one early event and 12 late adverse events. The outcomes for weight loss and diabetes remission were not different from the LAGB group of the RCT. For obese indigenous people with diabetes, a regionalized model of care centred on the LAGB is an effective approach to a serious health problem. The model proved feasible and acceptable to the indigenous people. Australian New Zealand Clinical Trials Registry (ACTRN 12609000319279).

  4. Long-term trends in invasive Haemophilus influenzae type B disease among indigenous Australian children following use of PRP-OMP and PRP-T vaccines.

    PubMed

    Menzies, Robert Ian; Bremner, Kyla Margaret; Wang, Han; Beard, Frank Hudson; McIntyre, Peter Bruce

    2015-06-01

    Among indigenous populations with high incidence and early onset of invasive Haemophilus influenzae type b (Hib) disease, PRP-OMP vaccines are used in the United States and PRP-T vaccines in Canada. In Australia, PRP-OMP vaccines were exclusively used in indigenous children from 1993 until they were replaced by PRP-T between late 2005 and 2009. Analytic descriptive study of 20 years of enhanced surveillance data (1993-2013) for invasive Hib disease in Australian children <10 years of age was conducted. Of 579 Hib cases under 10 years of age reported from vaccine introduction in 1993 to 2013, 78 (13%) were in indigenous children, 47 (60%) of whom lived in regions with high prevaccine incidence. In this population, incidence per 100,000 declined from 18.1 (95% confidence interval [CI]: 10.4, 29.4) in the early PRP-OMP period (1993-1996) to 6.2 (95% CI: 4.0, 9.2) and 4.7 (95% CI: 1.7, 10.3) in the later PRP-OMP (1996-2009) and PRP-T periods (2009-2013), respectively. The indigenous:nonindigenous incidence rate ratio increased to 43 (95% CI: 16, 145) and 58 (95% CI: 7, 2660) in the later PRP-OMP and PRP-T periods, respectively, more than 10-fold higher than in lesser-incidence Australian regions. We found no change in Hib incidence among indigenous Australian children living in high-incidence regions in the first 4 years following a change to PRP-T-containing combination vaccines. This may be of relevance to North American indigenous populations characterized by suboptimal living conditions and young age of onset for whom PRP-OMP continues to be recommended, such as Alaska Natives.

  5. "White", "Ethnic" and "Indigenous": Pre-Service Teachers Reflect on Discourses of Ethnicity in Australian Culture

    ERIC Educational Resources Information Center

    Hickling-Hudson, Anne

    2005-01-01

    A cornerstone of the author's pedagogy as a teacher educator is to help students analyse how their culture and socialisation influence their role as teachers. In this article she shares the reflections of her Australian students on their culture. As part of their coursework in an elective subject, "Cultural Diversity and Education",…

  6. "White", "Ethnic" and "Indigenous": Pre-Service Teachers Reflect on Discourses of Ethnicity in Australian Culture

    ERIC Educational Resources Information Center

    Hickling-Hudson, Anne

    2005-01-01

    A cornerstone of the author's pedagogy as a teacher educator is to help students analyse how their culture and socialisation influence their role as teachers. In this article she shares the reflections of her Australian students on their culture. As part of their coursework in an elective subject, "Cultural Diversity and Education",…

  7. Working together as a catalyst for change: the development of a peer mentoring model for the prevention of chronic disease in Australian Indigenous communities.

    PubMed

    Paasse, Gail; Adams, Karen

    2011-01-01

    This paper outlines the development of a model for an Indigenous peer mentoring program. The aim of this program is to improve the health of Indigenous people living in the western suburbs of Melbourne, Australia. Although the benefits of peer mentoring are well documented, particularly in relation to disease prevention, little has been written about the specific benefits for Indigenous people. While developing this model, it became apparent that to be successful, peer mentoring programs for Indigenous people need to be flexible, informal and draw on the knowledge and skills of the local community in partnership with local services.

  8. A Visual Profile of Queensland Indigenous Children.

    PubMed

    Hopkins, Shelley; Sampson, Geoff P; Hendicott, Peter L; Wood, Joanne M

    2016-03-01

    Little is known about the prevalence of refractive error, binocular vision, and other visual conditions in Australian Indigenous children. This is important given the association of these visual conditions with reduced reading performance in the wider population, which may also contribute to the suboptimal reading performance reported in this population. The aim of this study was to develop a visual profile of Queensland Indigenous children. Vision testing was performed on 595 primary schoolchildren in Queensland, Australia. Vision parameters measured included visual acuity, refractive error, color vision, nearpoint of convergence, horizontal heterophoria, fusional vergence range, accommodative facility, AC/A ratio, visual motor integration, and rapid automatized naming. Near heterophoria, nearpoint of convergence, and near fusional vergence range were used to classify convergence insufficiency (CI). Although refractive error (Indigenous, 10%; non-Indigenous, 16%; p = 0.04) and strabismus (Indigenous, 0%; non-Indigenous, 3%; p = 0.03) were significantly less common in Indigenous children, CI was twice as prevalent (Indigenous, 10%; non-Indigenous, 5%; p = 0.04). Reduced visual information processing skills were more common in Indigenous children (reduced visual motor integration [Indigenous, 28%; non-Indigenous, 16%; p < 0.01] and slower rapid automatized naming [Indigenous, 67%; non-Indigenous, 59%; p = 0.04]). The prevalence of visual impairment (reduced visual acuity) and color vision deficiency was similar between groups. Indigenous children have less refractive error and strabismus than their non-Indigenous peers. However, CI and reduced visual information processing skills were more common in this group. Given that vision screenings primarily target visual acuity assessment and strabismus detection, this is an important finding as many Indigenous children with CI and reduced visual information processing may be missed. Emphasis should be placed on identifying

  9. Higher HTLV-1c proviral loads are associated with blood stream infections in an Indigenous Australian population.

    PubMed

    Einsiedel, Lloyd; Cassar, Olivier; Spelman, Tim; Joseph, Sheela; Gessain, Antoine

    2016-05-01

    An association between blood stream infections (BSI) and HTLV-1 seropositivity in Indigenous Australians might result from HTLV-1 mediated inflammation and parasite coinfections that provide portals of entry for bacteria. To determine whether BSI risk increases with HTLV-1c proviral load (PVL) and to identify the pathogens responsible in the context of HTLV-1 related conditions. Indigenous adults admitted to Alice Springs Hospital, central Australia, were recruited as cases or controls according to whether they had a BSI. Clinical data were extracted from case notes and the hospital pathology database. HTLV-1 serology and PVL assays were then performed and risk factors for BSI were determined for HTLV-1 infected subjects. Risk factors were compared between 44 cases and 30 controls who were HTLV-1 Western blot positive. In a multivariable model, high HTLV-1c PVL was predictive of BSI during the study period (OR, 9.10; 95% CI, 2.40-34.4). Median (IQR) HTLV-1c PVL (copies per 100 PBL) was 39-fold higher for patients recording any BSI (0.116 (0.009, 0.277)) relative to those who had no BSI (0.003 (0.000, 0.067))(p=0.0007). Mean (SD) PVL for subjects with no BSI (n=27), 1 BSI (n=37) and ≥2 BSI (n=10) during the study period were 0.120 (0.301), 0.271 (0.622) and 0.500 (0.654) copies per 100 PBL, respectively (p=0.0007). Five BSI were associated with possible complications of HTLV-1; strongyloidiasis (3), infective dermatitis (1), HTLV-1 associated bronchiectasis (1). Higher HTLV-1c PVL predicts BSI risk; however; most BSI were not associated with recognised complications of HTLV-1 infection. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

  10. Clinical associations of Human T-Lymphotropic Virus type 1 infection in an indigenous Australian population.

    PubMed

    Einsiedel, Lloyd; Spelman, Tim; Goeman, Emma; Cassar, Olivier; Arundell, Mick; Gessain, Antoine

    2014-01-01

    In resource-poor areas, infectious diseases may be important causes of morbidity among individuals infected with the Human T-Lymphotropic Virus type 1 (HTLV-1). We report the clinical associations of HTLV-1 infection among socially disadvantaged Indigenous adults in central Australia. HTLV-1 serological results for Indigenous adults admitted 1(st) January 2000 to 31(st) December 2010 were obtained from the Alice Springs Hospital pathology database. Infections, comorbid conditions and HTLV-1 related diseases were identified using ICD-10 AM discharge morbidity codes. Relevant pathology and imaging results were reviewed. Disease associations, admission rates and risk factors for death were compared according to HTLV-1 serostatus. HTLV-1 western blots were positive for 531 (33.3%) of 1595 Indigenous adults tested. Clinical associations of HTLV-1 infection included bronchiectasis (adjusted Risk Ratio, 1.35; 95% CI, 1.14-1.60), blood stream infections (BSI) with enteric organisms (aRR, 1.36; 95% CI, 1.05-1.77) and admission with strongyloidiasis (aRR 1.38; 95% CI, 1.16-1.64). After adjusting for covariates, HTLV-1 infection remained associated with increased numbers of BSI episodes (adjusted negative binomial regression, coefficient, 0.21; 95% CI, 0.02-0.41) and increased admission numbers with strongyloidiasis (coefficient, 0.563; 95% CI, 0.17-0.95) and respiratory conditions including asthma (coefficient, 0.99; 95% CI, 0.27-1.7), lower respiratory tract infections (coefficient, 0.19; 95% CI, 0.04-0.34) and bronchiectasis (coefficient, 0.60; 95% CI, 0.02-1.18). Two patients were admitted with adult T-cell Leukemia/Lymphoma, four with probable HTLV-1 associated myelopathy and another with infective dermatitis. Independent predictors of mortality included BSI with enteric organisms (aRR 1.78; 95% CI, 1.15-2.74) and bronchiectasis (aRR 2.07; 95% CI, 1.45-2.98). HTLV-1 infection contributes to morbidity among socially disadvantaged Indigenous adults in central Australia

  11. The pharmacokinetics of metformin and concentrations of haemoglobin A1C and lactate in Indigenous and non-Indigenous Australians with type 2 diabetes mellitus.

    PubMed

    Duong, Janna K; Kumar, Shaun S; Furlong, Timothy J; Kirkpatrick, Carl M; Graham, Garry G; Greenfield, Jerry R; Williams, Ken M; Day, Richard O

    2015-04-01

    To compare the pharmacokinetics of metformin between diabetic Indigenous (Aboriginal and Torres Strait Islander) and non-Indigenous patients. An observational, cross-sectional study was conducted on type 2 diabetic Indigenous and non-Indigenous patients treated with metformin. Blood samples were collected to determine metformin, lactate, creatinine and vitamin B12 concentrations and glycosylated haemoglobin levels. A population model was used to determine the pharmacokinetic parameters. The Indigenous patients (median age 55 years) were younger than the non-Indigenous patients (65 years), with a difference of 10 years (95% confidence interval 6-14 years, P < 0.001). The median glycosylated haemoglobin was higher in the Indigenous patients (8.5%) than in the non-Indigenous patients (7.2%), with a difference of 1.4% (0.8-2.2%, P < 0.001). Indigenous patients had a higher creatinine clearance (4.3 l h(-1) ) than the non-Indigenous patients (4.0 l h(-1) ), with a median difference of 0.3 l h(-1) (0.07-1.17 l h(-1) ; P < 0.05). The ratio of the apparent clearance of metformin to the creatinine clearance in Indigenous patients (13.1, 10.2-15.2; median, interquartile range) was comparable to that in non-Indigenous patients (12.6, 9.9-14.9). Median lactate concentrations were also similar [1.55 (1.20-1.88) vs. 1.60 (1.35-2.10) mmol l(-1) ] for Indigenous and non-Indigenous patients, respectively. The median vitamin B12 was 306 pmol l(-1) (range 105-920 pmol l(-1) ) for the Indigenous patients. There were no significant differences in the pharmacokinetics of metformin or plasma concentrations of lactate between Indigenous and non-Indigenous patients with type 2 diabetes mellitus. Further studies are required in Indigenous patients with creatinine clearance <30 ml min(-1) . © 2014 The British Pharmacological Society.

  12. Detection of 12.5% and 25% Salt Reduction in Bread in a Remote Indigenous Australian Community.

    PubMed

    McMahon, Emma; Clarke, Rozlynne; Jaenke, Rachael; Brimblecombe, Julie

    2016-03-16

    Food reformulation is an important strategy to reduce the excess salt intake observed in remote Indigenous Australia. We aimed to examine whether 12.5% and 25% salt reduction in bread is detectable, and, if so, whether acceptability is changed, in a sample of adults living in a remote Indigenous community in the Northern Territory of Australia. Convenience samples were recruited for testing of reduced-salt (300 and 350 mg Na/100 g) versus Standard (~400 mg Na/100 g) white and wholemeal breads (n = 62 for white; n = 72 for wholemeal). Triangle testing was used to examine whether participants could detect a difference between the breads. Liking of each bread was also measured; standard consumer acceptability questionnaires were modified to maximise cultural appropriateness and understanding. Participants were unable to detect a difference between Standard and reduced-salt breads (all p values > 0.05 when analysed using binomial probability). Further, as expected, liking of the breads was not changed with salt reduction (all p values > 0.05 when analysed using ANOVA). Reducing salt in products commonly purchased in remote Indigenous communities has potential as an equitable, cost-effective and sustainable strategy to reduce population salt intake and reduce risk of chronic disease, without the barriers associated with strategies that require individual behaviour change.

  13. Detection of 12.5% and 25% Salt Reduction in Bread in a Remote Indigenous Australian Community

    PubMed Central

    McMahon, Emma; Clarke, Rozlynne; Jaenke, Rachael; Brimblecombe, Julie

    2016-01-01

    Food reformulation is an important strategy to reduce the excess salt intake observed in remote Indigenous Australia. We aimed to examine whether 12.5% and 25% salt reduction in bread is detectable, and, if so, whether acceptability is changed, in a sample of adults living in a remote Indigenous community in the Northern Territory of Australia. Convenience samples were recruited for testing of reduced-salt (300 and 350 mg Na/100 g) versus Standard (~400 mg Na/100 g) white and wholemeal breads (n = 62 for white; n = 72 for wholemeal). Triangle testing was used to examine whether participants could detect a difference between the breads. Liking of each bread was also measured; standard consumer acceptability questionnaires were modified to maximise cultural appropriateness and understanding. Participants were unable to detect a difference between Standard and reduced-salt breads (all p values > 0.05 when analysed using binomial probability). Further, as expected, liking of the breads was not changed with salt reduction (all p values > 0.05 when analysed using ANOVA). Reducing salt in products commonly purchased in remote Indigenous communities has potential as an equitable, cost-effective and sustainable strategy to reduce population salt intake and reduce risk of chronic disease, without the barriers associated with strategies that require individual behaviour change. PMID:26999196

  14. 'It's very difficult to get respite out here at the moment': Australian findings on end-of-life care for Indigenous people.

    PubMed

    McGrath, Pam; Patton, Mary Anne; McGrath, Zoë; Olgivie, Katherine; Rayner, Robert; Holewa, Hamish

    2006-03-01

    Whilst access to respite care has been found to represent an important source of support for terminally ill patients and their families, the availability of these services to Indigenous Australians has to date remained undocumented. This potential need for respite in Indigenous communities was explored as part of a National Health and Medical Research Council (NH&MRC) funded study designed to develop an innovative model for Indigenous palliative care. The data needed for model development were collected through a series of open-ended, qualitative interviews conducted with a cross-section of consumers and health professionals within the Northern Territory, Australia. The findings reflected a serious need for Indigenous respite services, coupled with a severe deficiency in the present availability of these services, especially within rural and regional areas. This lack of local respite services was documented to be negatively impacting upon the ability of carers to fulfil their caring duties and was found placing undue physical, emotional and economic stress upon carers, patients and their families. Furthermore, the lack of access to local respite services documented was found to be forcing rural and regional patients to relocate to metropolitan areas away from the family, community and land to which strong ties are held. The lack of Indigenous respite services was also found to obstruct patients' and carers' wishes for death to occur in the local community, rather than in far away cities. Significant obstacles were found to be hindering the provision of respite care to Indigenous Australians, namely beliefs about families looking after their own, resource restrictions, limited staff availability in local areas, as well as problems associated with hostel use in metropolitan areas. The conclusions drawn from this study suggest the importance of tackling the obstacles preventing local respite services being established in areas close to where patients and carers live.

  15. Care for chronic conditions for indigenous Australians: key informants' perspectives on policy.

    PubMed

    Baeza, Juan; Bailie, Ross; Lewis, Jenny M

    2009-10-01

    The WHO's 2002 global report, Innovative Care for Chronic Conditions proposes a comprehensive framework for health systems to meet the challenges posed by chronic conditions. This paper uses the policy environment component of the WHO framework as a lens through which to examine key informants' perspectives on the management and prevention of chronic conditions in rural and remote Aboriginal communities in Australia. Twenty one semi-structured telephone interviews were conducted with a purposive sample of stakeholders, including senior commonwealth, state/territory and regional public servants and health service staff. All of the interviews were audio recorded, from which written summaries were produced. These summaries were then content analysed to build a composite picture of this area. The results indicate substantial success in developing national and sub-national strategies and refining funding and reporting arrangements. But much work remains to be done in strengthening partnerships, developing and retaining the workforce, and further shifting the focus from acute to chronic conditions. This paper provides a snapshot of the main policy issues, as identified by key informants, facing chronic disease management in rural and remote Indigenous communities in Australia. It has the potential to contribute to new national policy directions in Indigenous health.

  16. Effect of Ambient Temperature on Australian Northern Territory Public Hospital Admissions for Cardiovascular Disease among Indigenous and Non-Indigenous Populations

    PubMed Central

    Webb, Leanne; Bambrick, Hilary; Tait, Peter; Green, Donna; Alexander, Lisa

    2014-01-01

    Hospitalisations are associated with ambient temperature, but little is known about responses in population sub-groups. In this study, heat responses for Indigenous and non-Indigenous people in two age groups were examined for two categories of cardiac diseases using daily hospital admissions from five Northern Territory hospitals (1992–2011). Admission rates during the hottest five per cent of days and the coolest five per cent of days were compared with rates at other times. Among 25–64 year olds, the Indigenous female population was more adversely affected by very hot days than the non-Indigenous female population, with admission rates for ischaemic heart disease (IHD) increasing by 32%. People older than 65 were more sensitive to cold, with non-Indigenous male admissions for heart failure increasing by 64%, and for IHD by 29%. For older Indigenous males, IHD admissions increased by 52% during cold conditions. For older non-Indigenous females, increases in admissions for heart failure were around 50% on these cold days, and 64% for older Indigenous females. We conclude that under projected climate change conditions, admissions for IHD amongst younger Indigenous people would increase in hot conditions, while admissions among elderly people during cold weather may be reduced. The responses to temperature, while showing significant relationships across the Northern Territory, may vary by region. These variations were not explored in this assessment. PMID:24531121

  17. Effect of ambient temperature on Australian northern territory public hospital admissions for cardiovascular disease among indigenous and non-indigenous populations.

    PubMed

    Webb, Leanne; Bambrick, Hilary; Tait, Peter; Green, Donna; Alexander, Lisa

    2014-02-13

    Hospitalisations are associated with ambient temperature, but little is known about responses in population sub-groups. In this study, heat responses for Indigenous and non-Indigenous people in two age groups were examined for two categories of cardiac diseases using daily hospital admissions from five Northern Territory hospitals (1992-2011). Admission rates during the hottest five per cent of days and the coolest five per cent of days were compared with rates at other times. Among 25-64 year olds, the Indigenous female population was more adversely affected by very hot days than the non-Indigenous female population, with admission rates for ischaemic heart disease (IHD) increasing by 32%. People older than 65 were more sensitive to cold, with non-Indigenous male admissions for heart failure increasing by 64%, and for IHD by 29%. For older Indigenous males, IHD admissions increased by 52% during cold conditions. For older non-Indigenous females, increases in admissions for heart failure were around 50% on these cold days, and 64% for older Indigenous females. We conclude that under projected climate change conditions, admissions for IHD amongst younger Indigenous people would increase in hot conditions, while admissions among elderly people during cold weather may be reduced. The responses to temperature, while showing significant relationships across the Northern Territory, may vary by region. These variations were not explored in this assessment.

  18. Chiropractors` experience and readiness to work in Indigenous Australian Communities: a preliminary cross-sectional survey to explore preparedness, perceived barriers and facilitators for chiropractors practising cross-culturally.

    PubMed

    Vindigni, Dein; Polus, Barbara I; Cleary, Sonja; Doyle, Aunty Kerrie

    2017-01-01

    Indigenous people make up approximately 3% of the total Australian population and score poorer on all health indices, including back pain. Chiropractors are well placed to alleviate back pain, yet there is no research that considers chiropractors' readiness to treat Indigenous patients. This study explores chiropractors` experience working with Indigenous Australians, describes perceived barriers and facilitators to chiropractors' participation in Indigenous Healthcare and their willingness to engage in cultural competency training. This study used a non-representative cross-sectional design and a convenience sample. Participants were recruited via email invitation to complete an online survey and encouraged to send the invitation on to colleagues. A 17-item online-survey measured demographic data, perceived barriers and facilitators related to caring for Indigenous Australians, participants` level of comfort when working in Indigenous health, and their willingness to participate in cultural competency programs to enhance their skills, knowledge and cultural capacity when engaging with Indigenous Australians. Analysis of the data included descriptive statistics as well as thematic analysis of qualitative free text. One hundred and twenty-five chiropractors participated in the survey. The majority of participants (86%, n = 108) were employed in private practice. 62% of respondents were members of the Chiropractors' Association of Australia, 41% were Chiropractic and Osteopathic College of Australasia members. 60% of chiropractors considered that they had, or do treat Indigenous patients yet only 4% of respondents asked their patients if they identified as Indigenous. A majority of participants expressed a high level of 'comfort' or confidence in working with Indigenous people while only 17% of respondents had undertaken some form of cultural proficiency training. A majority of respondents (62.7%, n = 74) expressed an interest in working with Indigenous

  19. Human T-Lymphotropic Virus type 1 infection in an Indigenous Australian population: epidemiological insights from a hospital-based cohort study.

    PubMed

    Einsiedel, Lloyd; Woodman, Richard J; Flynn, Maria; Wilson, Kim; Cassar, Olivier; Gessain, Antoine

    2016-08-15

    The Human T Lymphotropic Virus type 1 (HTLV-1) subtype C is endemic to central Australia where each of the major sequelae of HTLV-1 infection has been documented in the socially disadvantaged Indigenous population. Nevertheless, available epidemiological information relating to HTLV-1c infection is very limited, risk factors for transmission are unknown and no coordinated program has been implemented to reduce transmission among Indigenous Australians. Identifying risk factors for HTLV-1 infection is essential to direct strategies that could control HTLV-1 transmission. Risk factors for HTLV-1 infection were retrospectively determined for a cohort of Indigenous Australians who were tested for HTLV-1 at Alice Springs Hospital (ASH), 1st January 2000 to 30th June 2013. Demographic details were obtained from the ASH patient management database and the results of tests for sexually transmitted infections (STI) were obtained from the ASH pathology database. Among 1889 Indigenous patients whose HTLV-1 serostatus was known, 635 (33.6 %) were HTLV-1 Western blot positive. Only one of 77 (1.3 %) children tested was HTLV-1 infected. Thereafter, rates progressively increased with age (15-29 years, 17.3 %; 30-49 years, 36.2 %; 50-64 years, 41.7 %) reaching 48.5 % among men aged 50-64 years. In a multivariable model, increasing age (OR, 1.04; 95 % CI, 1.03-1.04), male gender (OR, 1.41; 95 % CI, 1.08-1.85), residence in the south (OR, 10.7; 95 % CI, 7.4-15.6) or west (OR, 4.4; 95 % CI, 3.1-6.3) of central Australia and previous STI (OR, 1.42; 95 % CI, 1.04-1.95) were associated with HTLV-1 infection. Infection was acquired by three of 351 adults who were tested more than once during the study period (seroconversion rate, 0.24 (95 % CI = 0.18-2.48) per 100 person-years). This study confirms that HTLV-1 is highly endemic to central Australia. Although childhood infection was documented, HTLV-1 infection in adults was closely associated with increasing age, male

  20. Meeting the challenges of recruitment and retention of Indigenous people into nursing: outcomes of the Indigenous Nurse Education Working Group.

    PubMed

    Usher, Kim; Miller, Maria; Turale, Sue; Goold, Sally

    2005-07-01

    It has been recognised internationally that increasing the number of Indigenous people working as health professionals is linked to the improved health status of Indigenous people. When comparing Australian Indigenous and non-Indigenous populations, Indigenous people continue to have poorer health standards and are much less likely to be involved in employment in health professions than other Australians. In 2000, the Indigenous Nurse Education Working Group (INEWG) was formed by government with the mandate to work collaboratively with universities and important professional nursing bodies across the nation in an attempt to increase the number of Indigenous registered nurses and to prepare nursing graduates with better understanding of, and skills to assist with, Indigenous health issues. This paper describes the work of the INEWG from 2000 to mid-2003; firstly in developing and implementing strategies aimed at increasing the recruitment and retention of Indigenous people into undergraduate nursing programs; and secondly by helping university schools of nursing increase faculty and student understanding of Indigenous culture, history and health issues through educational processes. Lastly, it summarises the INEWG's 2002 recommendations to achieve a higher rate of Indigenous participation in nursing. The results of research into the success of these recommendations will be the subject of a later paper.

  1. An evaluation of the telehealth facilitation of diabetes and cardiovascular care in remote Australian Indigenous communities: - protocol for the telehealth eye and associated medical services network [TEAMSnet] project, a pre-post study design.

    PubMed

    Brazionis, Laima; Jenkins, Alicia; Keech, Anthony; Ryan, Chris; Bursell, Sven-Erik

    2017-01-05

    Despite substantial investment in detection, early intervention and evidence-based treatments, current management strategies for diabetes-associated retinopathy and cardiovascular disease are largely based on real-time and face-to-face approaches. There are limited data re telehealth facilitation in type 2 diabetes management. Therefore, we aim to investigate efficacy of telehealth facilitation of diabetes and cardiovascular disease care in high-risk vulnerable Aboriginal and Torres Strait Islanders in remote/very remote Australia. Using a pre-post intervention design, 600 Indigenous Australians with type 2 diabetes will be recruited from three primary-care health-services in the Northern Territory. Diabetes status will be based on clinical records. There will be four technological interventions: 1. Baseline retinal imaging [as a real-time patient education/engagement tool and telehealth screening strategy]. 2. A lifestyle survey tool administered at ≈ 6-months. 3. At ≈ 6- and 18-months, an electronic cardiovascular disease and diabetes decision-support tool based on current guidelines in the Standard Treatment Manual of the Central Australian Rural Practitioner's Association to generate clinical recommendations. 4. Mobile tablet technology developed to enhance participant engagement in self-management. Data will include: Pre-intervention clinical and encounter-history data, baseline retinopathy status, decision-support and survey data/opportunistic mobile tablet encounter data. The primary outcome is increased participant adherence to clinical appointments, a marker of engagement and self-management. A cost-benefit analysis will be performed. Remoteness is a major barrier to provision and uptake of best-practice chronic disease management. Telehealth, beyond videoconferencing of consultations, could facilitate evidence-based management of diabetes and cardiovascular disease in Indigenous Australians and serve as a model for other conditions. Australia

  2. "From your own thinking you can't help us": intercultural collaboration to address inequities in services for Indigenous Australians in response to the World Report on Disability.

    PubMed

    Lowell, Anne

    2013-02-01

    Inequity in service provision for Indigenous Australians with communication disability is an issue requiring urgent attention. In the lead article, Wylie, McAllister, Davidson, and Marshall (2013) note that, even in the relatively affluent Minority World, including Australia, equity in service provision for people with communication disability has not been achieved. In remote communities in the Northern Territory (NT) almost all residents speak a language other than English as their primary language. However, there are no speech-language pathologists (SLPs) in the NT who speak an Indigenous language or who share their cultural background. Specific data on the prevalence of communication disability in this population are unavailable due to a range of factors. The disability data that are available, for example, demonstrating the high level of conductive hearing loss, indicates that the risk of communication disability in this population is particularly high. Change is urgently needed to address current inequities in both availability of, and access to, culturally responsive services for Indigenous people with communication disability. Such change must engage Indigenous people in a collaborative process that recognizes their expertise in identifying both their needs and the most effective form of response to these needs.

  3. Human T-cell lymphotropic virus type 1 subtype C molecular variants among indigenous australians: new insights into the molecular epidemiology of HTLV-1 in Australo-Melanesia.

    PubMed

    Cassar, Olivier; Einsiedel, Lloyd; Afonso, Philippe V; Gessain, Antoine

    2013-01-01

    HTLV-1 infection is endemic among people of Melanesian descent in Papua New Guinea, the Solomon Islands and Vanuatu. Molecular studies reveal that these Melanesian strains belong to the highly divergent HTLV-1c subtype. In Australia, HTLV-1 is also endemic among the Indigenous people of central Australia; however, the molecular epidemiology of HTLV-1 infection in this population remains poorly documented. Studying a series of 23 HTLV-1 strains from Indigenous residents of central Australia, we analyzed coding (gag, pol, env, tax) and non-coding (LTR) genomic proviral regions. Four complete HTLV-1 proviral sequences were also characterized. Phylogenetic analyses implemented with both Neighbor-Joining and Maximum Likelihood methods revealed that all proviral strains belong to the HTLV-1c subtype with a high genetic diversity, which varied with the geographic origin of the infected individuals. Two distinct Australians clades were found, the first including strains derived from most patients whose origins are in the North, and the second comprising a majority of those from the South of central Australia. Time divergence estimation suggests that the speciation of these two Australian clades probably occurred 9,120 years ago (38,000-4,500). The HTLV-1c subtype is endemic to central Australia where the Indigenous population is infected with diverse subtype c variants. At least two Australian clades exist, which cluster according to the geographic origin of the human hosts. These molecular variants are probably of very ancient origin. Further studies could provide new insights into the evolution and modes of dissemination of these retrovirus variants and the associated ancient migration events through which early human settlement of Australia and Melanesia was achieved.

  4. Human T-Cell Lymphotropic Virus Type 1 Subtype C Molecular Variants among Indigenous Australians: New Insights into the Molecular Epidemiology of HTLV-1 in Australo-Melanesia

    PubMed Central

    Afonso, Philippe V.; Gessain, Antoine

    2013-01-01

    Background HTLV-1 infection is endemic among people of Melanesian descent in Papua New Guinea, the Solomon Islands and Vanuatu. Molecular studies reveal that these Melanesian strains belong to the highly divergent HTLV-1c subtype. In Australia, HTLV-1 is also endemic among the Indigenous people of central Australia; however, the molecular epidemiology of HTLV-1 infection in this population remains poorly documented. Findings Studying a series of 23 HTLV-1 strains from Indigenous residents of central Australia, we analyzed coding (gag, pol, env, tax) and non-coding (LTR) genomic proviral regions. Four complete HTLV-1 proviral sequences were also characterized. Phylogenetic analyses implemented with both Neighbor-Joining and Maximum Likelihood methods revealed that all proviral strains belong to the HTLV-1c subtype with a high genetic diversity, which varied with the geographic origin of the infected individuals. Two distinct Australians clades were found, the first including strains derived from most patients whose origins are in the North, and the second comprising a majority of those from the South of central Australia. Time divergence estimation suggests that the speciation of these two Australian clades probably occurred 9,120 years ago (38,000–4,500). Conclusions The HTLV-1c subtype is endemic to central Australia where the Indigenous population is infected with diverse subtype c variants. At least two Australian clades exist, which cluster according to the geographic origin of the human hosts. These molecular variants are probably of very ancient origin. Further studies could provide new insights into the evolution and modes of dissemination of these retrovirus variants and the associated ancient migration events through which early human settlement of Australia and Melanesia was achieved. PMID:24086779

  5. A 12-week sports-based exercise programme for inactive Indigenous Australian men improved clinical risk factors associated with type 2 diabetes mellitus.

    PubMed

    Mendham, Amy E; Duffield, Rob; Marino, Frank; Coutts, Aaron J

    2015-07-01

    This study assessed the effect of a 12-week sports-based exercise intervention on glucose regulation, anthropometry and inflammatory markers associated with the prevalence of type 2 diabetes mellitus (T2DM) in Indigenous Australian men. Twenty-six inactive Indigenous Australian men (48.6±6.6 years) were randomized into exercise (n=16) or control (n=10)conditions. Training included ∼2-3 days/week for 12 weeks of sports and gym exercises in a group environment, whilst control participants maintained normal activity and dietary patterns. Pre- and post-intervention testing included: anthropometry, peak aerobic capacity, fasting blood chemistry of inflammatory cytokines, adiponectin, leptin, cholesterol, glucose, insulin and C-peptide. An oral glucose tolerance test measured glucose, insulin and C-peptide 30, 60, 90 and 120min post 75g glucose ingestion. The exercise condition decreased insulin area under the curve (25±22%), increased estimated insulin sensitivity (35±62%) and decreased insulin resistance (9±35%; p<0.05), compared with control (p>0.05). The exercise condition decreased in body mass index, waist circumference and waist to hip ratio (p<0.05), compared to control (p>0.05). Leptin decreased in the exercise group, with no changes for adiponectin (p>0.05) or inflammatory markers (p>0.05) in either condition. Aerobic fitness variables showed significant increases in peak oxygen consumption for the exercise condition compared to no change in control (p>0.05). Findings indicate positive clinical outcomes in metabolic, anthropometric and aerobic fitness variables. This study provides evidence for sport and group-based activities leading to improved clinical risk factors associated with T2DM development in clinically obese Indigenous Australian men. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  6. AUStralian Indigenous Chronic Disease Optimisation Study (AUSI-CDS) prospective observational cohort study to determine if an established chronic disease health care model can be used to deliver better heart failure care among remote Indigenous Australians: Proof of concept-study rationale and protocol.

    PubMed

    Iyngkaran, P; Majoni, V; Nadarajan, K; Haste, M; Battersby, M; Ilton, Marcus; Harris, M

    2013-11-01

    The congestive heart failure syndrome has increased to epidemic proportions and is cause for significant morbidity and mortality. Indigenous patients suffer a greater prevalence with greater severity. Upon diagnosis patients require regular follow-up with medical and allied health services. Patients are prescribed life saving, disease modifying and symptom relieving therapies. This can be an overwhelming experience for patients. To compound this, remoteness, differentials in conventional health care and services pose special problems for Indigenous clients in accessing care. Additional barriers of language, culture, socio-economic disadvantage, negative attitudes towards establishment, social stereotyping, stigma and discrimination act as barriers to improved care. Recent focus supported by clinical evidence support the role of chronic disease self-management programs. A patient focused, problem identification, goal setting and psychosocial modification based program should in principal highlight these issues and help tailor a patient focused comprehensive care plan to complement guideline based care. At present there are no Indigenous focused chronic disease self-management programs. There is a need for research on ways to provide chronic disease management to this group. We therefore designed a study to assess a model of patient focussed comprehensive care for Indigenous Australians with heart failure. AUSI-CDS is a prospective, cohort, observational study to evaluate the efficacy of the standard "Flinders Program of Chronic Condition Management" for Indigenous patients with chronic heart failure. Eligible patients will be Indigenous, suffering from chronic heart failure, in the Northern Territory. The primary end-point is the satisfaction score based on the PACIC. The study will recruit 20 patients and is expected to last 12 months. The rationale and design of the AUSI-CDS using the Flinders Model is described. Copyright © 2013 Australian and New Zealand

  7. Communication: Are Australians Different?

    ERIC Educational Resources Information Center

    Hansford, B. C.

    1992-01-01

    Examines the question of the distinctive nature of communication in Australia. Discusses nonverbal messages, gender concerns, historical influences on communication, the Australian accent, communication with indigenous persons, communication apprehension, and classroom communication. Argues that Australians' communication is relatively similar to…

  8. What Predicts Health Students' Self-Reported Preparedness to Work in Indigenous Health Settings?

    ERIC Educational Resources Information Center

    Bullen, Jonathan; Roberts, Lynne; Hoffman, Julie

    2017-01-01

    Australian undergraduate programs are implementing curriculum aimed at better preparing graduates to work in culturally diverse settings, but there remains uncertainty over the role of extant student attitudes towards Indigenous Australians. To begin to address this, we obtained baseline data on student attitudes upon entry to tertiary education.…

  9. What Predicts Health Students' Self-Reported Preparedness to Work in Indigenous Health Settings?

    ERIC Educational Resources Information Center

    Bullen, Jonathan; Roberts, Lynne; Hoffman, Julie

    2017-01-01

    Australian undergraduate programs are implementing curriculum aimed at better preparing graduates to work in culturally diverse settings, but there remains uncertainty over the role of extant student attitudes towards Indigenous Australians. To begin to address this, we obtained baseline data on student attitudes upon entry to tertiary education.…

  10. A Survey of Dog Owners in Remote Northern Australian Indigenous Communities to Inform Rabies Incursion Planning

    PubMed Central

    Hudson, Emily G.; Dhand, Navneet; Dürr, Salome; Ward, Michael P.

    2016-01-01

    Australia is underprepared for a rabies incursion due to a lack of information about how a rabies outbreak would spread within the susceptible canine populations and which control strategies would be best to control it. The aim of this study was to collect information to parameterize a recently developed dog rabies spread model as well as use this information to gauge how the community would accept potential control strategies. Such information–together with model outputs–would be used to inform decision makers on the best control strategies and improve Australia’s preparedness against a canine rabies incursion. The parameters this study focussed on were detection time, vaccination rates and dog-culling and dog movement restriction compliance. A cross-sectional survey of 31 dog-owners, using a questionnaire, was undertaken in the five communities of the Northern Peninsular Area (NPA) in northern Australia regarding community dog movements, veterinary visits, reporting systems, perceptions of sick dogs and potential human behaviours during hypothetical rabies outbreaks. It highlighted the significant shortfalls in veterinary care that would need to be vastly improved during an outbreak, who educational programs should be targeted towards and which dog movements should be restricted. The results indicate that men were significantly more likely than women to allow their dogs to roam and to move their dogs. The current low vaccination rate of 12% highlighted the limited veterinary services that would need to be substantially increased to achieve effective rabies control. Participation in mass vaccination was accepted by 100% of the respondents. There was lower acceptance for other possible rabies control strategies with 10–20% of the respondents stating a resistance to both a mass culling program and a ban on dog movements. Consequently, movement bans and mass dog culling would have limited effectiveness as a control strategy in the NPA community. More than

  11. A Survey of Dog Owners in Remote Northern Australian Indigenous Communities to Inform Rabies Incursion Planning.

    PubMed

    Hudson, Emily G; Dhand, Navneet; Dürr, Salome; Ward, Michael P

    2016-04-01

    Australia is underprepared for a rabies incursion due to a lack of information about how a rabies outbreak would spread within the susceptible canine populations and which control strategies would be best to control it. The aim of this study was to collect information to parameterize a recently developed dog rabies spread model as well as use this information to gauge how the community would accept potential control strategies. Such information-together with model outputs-would be used to inform decision makers on the best control strategies and improve Australia's preparedness against a canine rabies incursion. The parameters this study focussed on were detection time, vaccination rates and dog-culling and dog movement restriction compliance. A cross-sectional survey of 31 dog-owners, using a questionnaire, was undertaken in the five communities of the Northern Peninsular Area (NPA) in northern Australia regarding community dog movements, veterinary visits, reporting systems, perceptions of sick dogs and potential human behaviours during hypothetical rabies outbreaks. It highlighted the significant shortfalls in veterinary care that would need to be vastly improved during an outbreak, who educational programs should be targeted towards and which dog movements should be restricted. The results indicate that men were significantly more likely than women to allow their dogs to roam and to move their dogs. The current low vaccination rate of 12% highlighted the limited veterinary services that would need to be substantially increased to achieve effective rabies control. Participation in mass vaccination was accepted by 100% of the respondents. There was lower acceptance for other possible rabies control strategies with 10-20% of the respondents stating a resistance to both a mass culling program and a ban on dog movements. Consequently, movement bans and mass dog culling would have limited effectiveness as a control strategy in the NPA community. More than half of the

  12. Effect of 25% Sodium Reduction on Sales of a Top-Selling Bread in Remote Indigenous Australian Community Stores: A Controlled Intervention Trial

    PubMed Central

    McMahon, Emma; Webster, Jacqui; Brimblecombe, Julie

    2017-01-01

    Reducing sodium in the food supply is key to achieving population salt targets, but maintaining sales is important to ensuring commercial viability and maximising clinical impact. We investigated whether 25% sodium reduction in a top-selling bread affected sales in 26 remote Indigenous community stores. After a 23-week baseline period, 11 control stores received the regular-salt bread (400 mg Na/100 g) and 15 intervention stores received the reduced-salt version (300 mg Na/100 g) for 12-weeks. Sales data were collected to examine difference between groups in change from baseline to follow-up (effect size) in sales (primary outcome) or sodium density, analysed using a mixed model. There was no significant effect on market share (−0.31%; 95% CI −0.68, 0.07; p = 0.11) or weekly dollars ($58; −149, 266; p = 0.58). Sodium density of all purchases was not significantly reduced (−8 mg Na/MJ; −18, 2; p = 0.14), but 25% reduction across all bread could significantly reduce sodium (−12; −23, −1; p = 0.03). We found 25% salt reduction in a top-selling bread did not affect sales in remote Indigenous community stores. If achieved across all breads, estimated salt intake in remote Indigenous Australian communities would be reduced by approximately 15% of the magnitude needed to achieve population salt targets, which could lead to significant health gains at the population-level. PMID:28264485

  13. Obesity, albuminuria, and gamma-glutamyl transferase predict incidence of hypertension in indigenous Australians in rural and remote communities in northern Australia.

    PubMed

    Li, Ming; McDermott, Robyn

    2015-04-01

    To describe the incidence of hypertension in a cohort of Australian Aboriginal and Torres Strait Islanders. A follow-up study conducted among 1831 indigenous population aged 15 years and over without hypertension at baseline from 19 communities in North Queensland during 1997-2008. Main measurements included baseline and follow-up weight, waist circumference, blood pressure, fasting glucose, lipids (triglycerides and cholesterol), gamma-glutamyl transferase, urinary albumin creatinine ratio, self-reported tobacco smoking, alcohol intake and physical activity. Hundred cases of hypertension developed over 2633.4 person-years giving a crude incidence of hypertension of 22.6 (16.2-31.4) per 1000 person-years in females and 60.0 (47.1-76.6) per 1000 person-years for males. Age standardized overall incidence was 51.9 per 1000 person-years. Aboriginal participants were twice as likely as Torres Strait Islanders to develop hypertension, which increased with age. Obesity (BMI >30) strongly predicted incident hypertension independently of age or sex (adjusted hazard ratio 2.9, 95% confidence interval 1.9-4.8). Albuminuria and elevated gamma-glutamyl transferase increased the risk of hypertension (adjusted hazard ratio 1.4-1.7) in this population. Incidence of hypertension in indigenous Australian adults is nearly double than that of the general Australian population. High background prevalence of obesity, diabetes and albuminuria contributes to this excess. As well as early detection and management of high blood pressure, albuminuria and diabetes in primary care settings, attention should be equally focused on community-level prevention and management of obesity.

  14. Prevalence and validity of self-reported smoking in Indigenous and non-Indigenous young adults in the Australian Northern Territory.

    PubMed

    Pearce, Mark S; Mann, Kay D; Singh, Gurmeet; Davison, Belinda; Sayers, Susan M

    2014-08-21

    In this study, we used data from Australia's Northern Territory to assess differences in self-reported smoking prevalence between the Indigenous and non-Indigenous populations. We also used urinary cotinine data to assess the validity of using self-reported smoking data in these populations. The Aboriginal Birth Cohort (ABC) is a prospective study of 686 Aboriginal babies born in Darwin 1987-90. The Top End Cohort (TEC) is a study of non-Indigenous adolescents, all born in Darwin 1987-91. In both studies, participants aged between 16 and 21 years, were asked whether they smoked. Urinary cotinine measurements were made from samples taken at the same visits. Self-reported smoking prevalence was 68% in the ABC and 14% in the TEC. Among the self-reported non-smokers, the median cotinine levels were higher in the ABC (33 ng/ml) than in the TEC (5 ng/ml), with greater percentages of reported non-smokers in the under 50 ng/ml group in the TEC than in the ABC CONCLUSIONS: Prevalence of smoking was much higher in the ABC than in the TEC. The higher cotinine levels in ABC non-smokers may reflect an underestimated prevalence, but is also likely to reflect higher levels of passive smoking. A broader approach encompassing social, cultural and language factors with increased attention to smoking socialisation factors is required.

  15. Assessing the Association between Serum Ferritin, Transferrin Saturation, and C-Reactive Protein in Northern Territory Indigenous Australian Patients with High Serum Ferritin on Maintenance Haemodialysis

    PubMed Central

    Lawton, Paul D.; Barzi, Federica; Cass, Alan; Hughes, Jaquelyne T.

    2017-01-01

    Objective. To determine the significance of high serum ferritin observed in Indigenous Australian patients on maintenance haemodialysis in the Northern Territory, we assessed the relationship between ferritin and transferrin saturation (TSAT) as measures of iron status and ferritin and C-reactive protein (CRP) as markers of inflammation. Methods. We performed a retrospective cohort analysis of data from adult patients (≥18 years) on maintenance haemodialysis (>3 months) from 2004 to 2011. Results. There were 1568 patients. The mean age was 53.9 (11.9) years. 1244 (79.3%) were Indigenous. 44.2% (n = 693) were male. Indigenous patients were younger (mean age [52.3 (11.1) versus 57.4 (15.2), p < 0.001]) and had higher CRP [14.7 mg/l (7–35) versus 5.9 mg/l (1.9–17.5), p < 0.001], higher median serum ferritin [1069 µg/l (668–1522) versus 794.9 µg/l (558.5–1252.0), p < 0.001], but similar transferrin saturation [26% (19–37) versus 28% (20–38), p = 0.516]. We observed a small positive correlation between ferritin and TSAT (r2 = 0.11, p < 0.001), no correlation between ferritin and CRP (r2 = 0.001, p < 0.001), and positive association between high serum ferritin and TSAT (p < 0.001), Indigenous ethnicity (p < 0.001), urea reduction ratio (p = 0.001), and gender (p < 0.001) after adjustment in mixed regression analysis. Conclusion. Serum ferritin and TSAT may inadequately reflect iron status in this population. The high ferritin was poorly explained by inflammation. PMID:28243472

  16. Study Protocol--Improving Access to Kidney Transplants (IMPAKT): a detailed account of a qualitative study investigating barriers to transplant for Australian Indigenous people with end-stage kidney disease.

    PubMed

    Devitt, Jeannie; Cass, Alan; Cunningham, Joan; Preece, Cilla; Anderson, Kate; Snelling, Paul

    2008-02-04

    Indigenous Australians are slightly more than 2% of the total Australian population however, in recent years they have comprised between 6 and 10% of new patients beginning treatment for end-stage kidney disease (ESKD). Although transplant is considered the optimal form of treatment for many ESKD patients there is a pronounced disparity between the rates at which Indigenous ESKD patients receive transplants compared with their non-Indigenous counterparts. The IMPAKT (Improving Access to Kidney Transplants) Interview study investigated reasons for this disparity through a large scale, in-depth interview study involving patients, nephrologists and key decision-making staff at selected Australian transplant and dialysis sites. The design and conduct of the study reflected the multi-disciplinary membership of the core IMPAKT team. Promoting a participatory ethos, IMPAKT established partnerships with a network of hospital transplant units and hospital dialysis treatment centres that provide treatment to the vast majority of Indigenous patients across Australia. Under their auspices, the IMPAKT team conducted in-depth interviews in 26 treatment/service centres located in metropolitan, regional and remote Australia. Peer interviewing supported the engagement of Indigenous patients (146), and nephrologists (19). In total IMPAKT spoke with Indigenous and non-Indigenous patients (241), key renal nursing and other (non-specialist) staff (95) and a small number of relevant others (28). Data analysis was supported by QSR software. At each site, IMPAKT also documented educational programs and resources, mapped an hypothetical 'patient journey' to transplant through the local system and observed patient care and treatment routines. The national scope, inter-disciplinary approach and use of qualitative methods in an investigation of a significant health inequality affecting Indigenous people is, we believe, an Australian first. An exceptionally large cohort of Indigenous

  17. Study Protocol – Improving Access to Kidney Transplants (IMPAKT): A detailed account of a qualitative study investigating barriers to transplant for Australian Indigenous people with end-stage kidney disease

    PubMed Central

    Devitt, Jeannie; Cass, Alan; Cunningham, Joan; Preece, Cilla; Anderson, Kate; Snelling, Paul

    2008-01-01

    Background Indigenous Australians are slightly more than 2% of the total Australian population however, in recent years they have comprised between 6 and 10% of new patients beginning treatment for end-stage kidney disease (ESKD). Although transplant is considered the optimal form of treatment for many ESKD patients there is a pronounced disparity between the rates at which Indigenous ESKD patients receive transplants compared with their non-Indigenous counterparts. The IMPAKT (Improving Access to Kidney Transplants) Interview study investigated reasons for this disparity through a large scale, in-depth interview study involving patients, nephrologists and key decision-making staff at selected Australian transplant and dialysis sites. Methods The design and conduct of the study reflected the multi-disciplinary membership of the core IMPAKT team. Promoting a participatory ethos, IMPAKT established partnerships with a network of hospital transplant units and hospital dialysis treatment centres that provide treatment to the vast majority of Indigenous patients across Australia. Under their auspices, the IMPAKT team conducted in-depth interviews in 26 treatment/service centres located in metropolitan, regional and remote Australia. Peer interviewing supported the engagement of Indigenous patients (146), and nephrologists (19). In total IMPAKT spoke with Indigenous and non-Indigenous patients (241), key renal nursing and other (non-specialist) staff (95) and a small number of relevant others (28). Data analysis was supported by QSR software. At each site, IMPAKT also documented educational programs and resources, mapped an hypothetical ‘patient journey’ to transplant through the local system and observed patient care and treatment routines. Discussion The national scope, inter-disciplinary approach and use of qualitative methods in an investigation of a significant health inequality affecting Indigenous people is, we believe, an Australian first. An exceptionally

  18. Dietary sodium and iodine in remote Indigenous Australian communities: will salt-reduction strategies increase risk of iodine deficiency? A cross-sectional analysis and simulation study.

    PubMed

    McMahon, Emma; Webster, Jacqui; O'Dea, Kerin; Brimblecombe, Julie

    2015-12-30

    Excess salt intake is a global issue. Effective salt-reduction strategies are needed, however, as salt is a vehicle for iodine fortification, these strategies may also reduce iodine intake. This study examines the case of the remote Indigenous Australian population; we employed an innovative, objective method to assess sodium and iodine intakes against requirements and modelled the potential effects of salt-reduction strategies on estimated sodium and iodine intakes. Store-sales data were collected from 20 remote Indigenous community stores in 2012-14 representing the main source of food for 2 years for ~8300 individuals. Estimated average sodium and iodine intakes were compared against recommendations (nutrient reference values weighted to age and gender distribution). Linear programming was employed to simulate potential effects of salt-reduction strategies on estimated sodium and iodine intakes. Estimated average sodium intake was 2770 (range within communities 2410-3450) mg/day, far exceeding the population-weighted upper limit (2060 mg/day). Discretionary (added) salt, bread and processed meat were the biggest contributors providing 46% of all sodium. Estimated average iodine intake was within recommendations at 206 (186-246) μg/day. The following scenarios enabled modelling of estimated average salt intake to within recommendations: 1) 67% reduction in sodium content of bread and discretionary salt intake, 2) 38% reduction in sodium content of all processed foods, 3) 30% reduction in sodium content of all processed foods and discretionary salt intake. In all scenarios, simulated average iodine intakes remained within recommendations. Salt intakes of the remote Indigenous Australian population are far above recommendations, likely contributing to the high prevalence of hypertension and cardiovascular mortality experienced by this population. Salt-reduction strategies could considerably reduce salt intake in this population without increasing risk of iodine

  19. Closing the Gap: cultural safety in Indigenous health education.

    PubMed

    Rigby, Wayne; Duffy, Elaine; Manners, Jan; Latham, Heather; Lyons, Lorraine; Crawford, Laurie; Eldridge, Ray

    The challenge for the future is to embrace a new partnership aimed at closing the gap between Indigenous and non-Indigenous Australians on life expectancy, educational achievement and employment opportunities. Significant improvements in contemporary Indigenous health care can be achieved through culturally safe health education programs for Indigenous students. However, while participation rates of Australian Indigenous students in the higher education sector are increasing, attrition rates are markedly higher than those of the general student population. This paper focuses on a unique degree program that is offered exclusively to Indigenous students in the field of mental health in the School of Nursing, Midwifery and Indigenous Health, Charles Sturt University. This qualitative exploratory study aimed to identify strategies that were especially helpful in sustaining students in the program and to identify and address barriers to the retention of students, to empower students to better prepare for the university environment and to inform academics within the course about areas that could be improved to provide a more culturally safe learning environment. The first stage of the study utilised focus group interviews with 36 Indigenous students across all three years of the program. The findings of the study addressing the issues of culturally appropriate pedagogy, curricula and cultural safety in the mental health degree program are discussed.

  20. How well is the National Cervical Screening Program performing for Indigenous Australian women? Why we don't really know, and what we can and should do about it.

    PubMed

    Whop, L J; Cunningham, J; Condon, J R

    2014-11-01

    Since its inception in 1991, Australia's organised approach to cervical screening, the National Cervical Screening Program (NCSP), has seen a 50% reduction in both incidence and mortality from cervical cancer in Australia. However, Indigenous Australian women continue to experience a disproportionately higher burden of cervical cancer. No national data on screening participation of Indigenous women currently exist, in large part because pathology forms, the primary source of data for Pap Test Registers (PTR), do not record Indigenous status. While including Indigenous status on pathology forms is the obvious solution for producing essential information about cervical screening of Indigenous women, this will require an appropriate consultative process and it will be many years before reliable data are available. One interim option being explored is the feasibility of linking the PTR to another data source which includes Indigenous status, such as hospital data. However, despite its promise, there remain major impediments to obtaining useful linked data in Australia, and it continues to be unclear whether such an approach is viable for routine reporting. If we are to understand and improve cervical screening participation and outcomes for Indigenous women in the foreseeable future, Australia needs to act now to include Indigenous status in pathology forms and (subsequently) PTRs.

  1. Community Involvement and Education in the 1991-2000 Australian Reconciliation Process

    ERIC Educational Resources Information Center

    Gunstone, Andrew

    2007-01-01

    In 1991, the Australian Parliament implemented a formal 10-year process of reconciliation. The aim of the process was to reconcile Indigenous and non-Indigenous people by the end of 2000. The Council for Aboriginal Reconciliation (CAR) was established to promote the process. The process had three broad goals: improving education, addressing…

  2. Developing a best practice pathway to support improvements in Indigenous Australians' mental health and well-being: a qualitative study.

    PubMed

    Hinton, Rachael; Kavanagh, David J; Barclay, Lesley; Chenhall, Richard; Nagel, Tricia

    2015-08-27

    There is a need to adapt pathways to care to promote access to mental health services for Indigenous people in Australia. This study explored Indigenous community and service provider perspectives of well-being and ways to promote access to care for Indigenous people at risk of depressive illness. A participatory action research framework was used to inform the development of an agreed early intervention pathway; thematic analysis 2 remote communities in the Northern Territory. Using snowball and purposive sampling, 27 service providers and community members with knowledge of the local context and the diverse needs of those at risk of depression were interviewed. 30% of participants were Indigenous. The proposed pathway to care was adapted in response to participant feedback. The study found that Indigenous mental health and well-being is perceived as multifaceted and strongly linked to cultural identity. It also confirms that there is broad support for promotion of a clear pathway to early intervention. Key identified components of this pathway were the health centre, visiting and community-based services, and local community resources including elders, cultural activities and families. Enablers to early intervention were reported. Significant barriers to the detection and treatment of those at risk of depression were identified, including insufficient resources, negative attitudes and stigma, and limited awareness of support options. Successful early intervention for well-being concerns requires improved understanding of Indigenous well-being perspectives and a systematic change in service delivery that promotes integration, flexibility and collaboration between services and the community, and recognises the importance of social determinants in health promotion and the healing process. Such changes require policy support, targeted training and education, and ongoing promotion. Published by the BMJ Publishing Group Limited. For permission to use (where not already

  3. Impact of policy support on uptake of evidence-based continuous quality improvement activities and the quality of care for Indigenous Australians: a comparative case study.

    PubMed

    Bailie, Ross; Matthews, Veronica; Larkins, Sarah; Thompson, Sandra; Burgess, Paul; Weeramanthri, Tarun; Bailie, Jodie; Cunningham, Frances; Kwedza, Ru; Clark, Louise

    2017-10-05

    To examine the impact of state/territory policy support on (1) uptake of evidence-based continuous quality improvement (CQI) activities and (2) quality of care for Indigenous Australians. Mixed-method comparative case study methodology, drawing on quality-of-care audit data, documentary evidence of policies and strategies and the experience and insights of stakeholders involved in relevant CQI programmes. We use multilevel linear regression to analyse jurisdictional differences in quality of care. Indigenous primary healthcare services across five states/territories of Australia. 175 Indigenous primary healthcare services. A range of national and state/territory policy and infrastructure initiatives to support CQI, including support for applied research. PRIMARY AND SECONDARY OUTCOME MEASURES: (i) Trends in the consistent uptake of evidence-based CQI tools available through a research-based CQI initiative (the Audit and Best Practice in Chronic Disease programme) and (ii) quality of care (as reflected in adherence to best practice guidelines). Progressive uptake of evidence-based CQI activities and steady improvements or maintenance of high-quality care occurred where there was long-term policy and infrastructure support for CQI. Where support was provided but not sustained there was a rapid rise and subsequent fall in relevant CQI activities. Health authorities should ensure consistent and sustained policy and infrastructure support for CQI to enable wide-scale and ongoing improvement in quality of care and, subsequently, health outcomes. It is not sufficient for improvement initiatives to rely on local service managers and clinicians, as their efforts are strongly mediated by higher system-level influences. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. Learning Preferences and Impacts of Education Programs in Dog Health Programs in Five Rural and Remote Australian Indigenous Communities

    ERIC Educational Resources Information Center

    Constable, Sophie; Dixon, Roselyn; Dixon, Robert

    2011-01-01

    As part of strategies to improve dog and community health in rural and remote Indigenous communities, this study investigated preferences and impacts of dog health education programs. Semistructured interviews with 63 residents from five communities explored learning preferences. Though each community differed, on average yarning was preferred by…

  5. Review of Indigenous Health Curriculum in Nutrition and Dietetics at One Australian University: An Action Research Study

    ERIC Educational Resources Information Center

    Wilson, Annabelle M.; Mehta, Kaye; Miller, Jacqueline; Yaxley, Alison; Thomas, Jolene; Jackson, Kathryn; Wray, Amanda; Miller, Michelle D.

    2015-01-01

    This article describes a review undertaken in 2012-2013 by Nutrition and Dietetics, Flinders University, to assess the Indigenous health curriculum of the Bachelor of Nutrition and Dietetics (BND) and Masters of Nutrition and Dietetics (MND). An action research framework was used to guide and inform inquiry. This involved four stages, each of…

  6. Review of Indigenous Health Curriculum in Nutrition and Dietetics at One Australian University: An Action Research Study

    ERIC Educational Resources Information Center

    Wilson, Annabelle M.; Mehta, Kaye; Miller, Jacqueline; Yaxley, Alison; Thomas, Jolene; Jackson, Kathryn; Wray, Amanda; Miller, Michelle D.

    2015-01-01

    This article describes a review undertaken in 2012-2013 by Nutrition and Dietetics, Flinders University, to assess the Indigenous health curriculum of the Bachelor of Nutrition and Dietetics (BND) and Masters of Nutrition and Dietetics (MND). An action research framework was used to guide and inform inquiry. This involved four stages, each of…

  7. Learning Preferences and Impacts of Education Programs in Dog Health Programs in Five Rural and Remote Australian Indigenous Communities

    ERIC Educational Resources Information Center

    Constable, Sophie; Dixon, Roselyn; Dixon, Robert

    2011-01-01

    As part of strategies to improve dog and community health in rural and remote Indigenous communities, this study investigated preferences and impacts of dog health education programs. Semistructured interviews with 63 residents from five communities explored learning preferences. Though each community differed, on average yarning was preferred by…

  8. Estimating the effects of maternal education on child dental caries using marginal structural models: The Longitudinal Study of Indigenous Australian Children.

    PubMed

    Ju, Xiangqun; Jamieson, Lisa M; Mejia, Gloria C

    2016-12-01

    To estimate the effect of mothers' education on Indigenous Australian children's dental caries experience while controlling for the mediating effect of children's sweet food intake. The Longitudinal Study of Indigenous Children is a study of two representative cohorts of Indigenous Australian children, aged from 6 months to 2 years (baby cohort) and from 3.5 to 5 years (child cohort) at baseline. The children's primary caregiver undertook a face-to-face interview in 2008 and repeated annually for the next 4 years. Data included household demographics, child health (nutrition information and dental health), maternal conditions and highest qualification levels. Mother's educational level was classified into four categories: 0-9 years, 10 years, 11-12 years and >12 years. Children's mean sweet food intake was categorized as <20%, 20-30%, and >30%. After multiple imputation of missing values, a marginal structural model with stabilized inverse probability weights was used to estimate the direct effect of mothers' education level on children's dental decay experience. From 2008 to 2012, complete data on 1720 mother-child dyads were available. Dental caries experience for children was 42.3% over the 5-year period. The controlled direct effect estimates of mother's education on child dental caries were 1.21 (95% CI: 1.01-1.45), 1.03 (95% CI: 0.91-1.18) and 1.07 (95% CI: 0.93-1.22); after multiple imputation of missing values, the effects were 1.21 (95% CI: 1.05-1.39), 1.06 (95% CI: 0.94-1.19) and 1.06 (95% CI: 0.95-1.19), comparing '0-9', '10' and '11-12' years to > 12 years of education. Mothers' education level had a direct effect on children's dental decay experience that was not mediated by sweet food intake and other risk factors when estimated using a marginal structural model. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Double Power: English Literacy and Indigenous Education.

    ERIC Educational Resources Information Center

    Wignell, Peter, Ed.

    The collection of essays on the relationship between English literacy and indigenous education, particularly in the Australian context, includes: "Double Power" (Mandawuy Yunupingu); "History, Cultural Diversity & English Language Teaching" (Martin Nakata); "Scaffolding Reading and Writing for Indigenous Children in…

  10. Recognising Aspiration: The AIME Program's Effectiveness in Inspiring Indigenous Young People's Participation in Schooling and Opportunities for Further Education and Employment

    ERIC Educational Resources Information Center

    Harwood, Valerie; McMahon, Samantha; O'Shea, Sarah; Bodkin-Andrews, Gawaian; Priestly, Amy

    2015-01-01

    A strong feature of the widening participation agenda is improving the aspirations of groups that are underrepresented in higher education. This paper seeks to reposition the utility of this as a focal point of educational interventions by showcasing the success of a mentoring program that takes a different approach. The Australian Indigenous…

  11. Plasma carotenoids are associated with socioeconomic status in an urban Indigenous population: an observational study.

    PubMed

    Hodge, Allison; Cunningham, Joan; Maple-Brown, Louise; Dunbar, Terry; O'Dea, Kerin

    2011-02-02

    Indigenous Australians experience poorer health than other Australians. Poor diet may contribute to this, and be related to their generally lower socioeconomic status (SES). Even within Indigenous populations, SES may be important. Our aim was to identify factors associated with plasma carotenoids as a marker of fruit and vegetable intake among urban dwelling Indigenous Australians, with a particular focus on SES. Cross sectional study in urban dwelling Indigenous Australians participating in the DRUID (Darwin Region Urban Indigenous Diabetes) Study. An SES score, based on education, employment, household size, home ownership and income was computed and plasma carotenoids measured by high performance liquid chromatography in 897 men and women aged 15-81 years (mean 36, standard deviation 15). Linear regression analysis was used to determine the relationship between SES and plasma carotenoids, adjusting for demographic, health and lifestyle variables, including frequency of intakes of food groups (fruit, vegetables, takeaway foods, snacks and fruit/vegetable juice). SES was positively associated with plasma concentrations of lutein/zeaxanthin (p trend <0.001), lycopene (p trend = 0.001), α- and ß-carotene (p trend = 0.019 and 0.026 respectively), after adjusting for age, sex, glucose tolerance status, smoking, alcohol use, hypercholesterolemia, dyslipidemia, self-reported health, waist to hip ratio and body mass index. These associations remained after adjustment for self-reported frequency of intake of fruit, vegetables, takeaway foods and fruit juice, which all showed some association with plasma carotenoids. Even in the highest SES quintile, concentrations of all carotenoids (except lycopene) were lower than the mean concentrations in a non-Indigenous population. Even within urban Indigenous Australians, higher SES was associated with higher concentrations of plasma carotenoids. Low plasma carotenoids have been linked with poor health outcomes; increasing

  12. Body Image and Obesity among Australian Adolescents from Indigenous and Anglo-European Backgrounds: Implications for Health Promotion and Obesity Prevention among Aboriginal Youth

    ERIC Educational Resources Information Center

    Cinelli, Renata Leah; O'Dea, Jennifer A.

    2009-01-01

    This study examines the relationship between body image and obesity, among 4367 indigenous and Anglo-European adolescents in Australia in 2006. It shows that indigenous adolescents, male and female, were more likely than their non-indigenous counterparts to desire and pursue weight gain. Indigenous males showed the greatest tendencies to gain…

  13. Body Image and Obesity among Australian Adolescents from Indigenous and Anglo-European Backgrounds: Implications for Health Promotion and Obesity Prevention among Aboriginal Youth

    ERIC Educational Resources Information Center

    Cinelli, Renata Leah; O'Dea, Jennifer A.

    2009-01-01

    This study examines the relationship between body image and obesity, among 4367 indigenous and Anglo-European adolescents in Australia in 2006. It shows that indigenous adolescents, male and female, were more likely than their non-indigenous counterparts to desire and pursue weight gain. Indigenous males showed the greatest tendencies to gain…

  14. A cost-based equity weight for use in the economic evaluation of primary health care interventions: case study of the Australian Indigenous population

    PubMed Central

    Ong, Katherine S; Kelaher, Margaret; Anderson, Ian; Carter, Rob

    2009-01-01

    Background Efficiency and equity are both important policy objectives in resource allocation. The discipline of health economics has traditionally focused on maximising efficiency, however addressing inequities in health also requires consideration. Methods to incorporate equity within economic evaluation techniques range from qualitative judgements to quantitative outcomes-based equity weights. Yet, due to definitional uncertainties and other inherent limitations, no method has been universally adopted to date. This paper proposes an alternative cost-based equity weight for use in the economic evaluation of interventions delivered from primary health care services. Methods Equity is defined in terms of 'access' to health services, with the vertical equity objective to achieve 'equitable access for unequal need'. Using the Australian Indigenous population as an illustrative case study, the magnitude of the equity weight is constructed using the ratio of the costs of providing specific interventions via Indigenous primary health care services compared with the costs of the same interventions delivered via mainstream services. Applying this weight to the costs of subsequent interventions deflates the costs of provision via Indigenous health services, and thus makes comparisons with mainstream more equitable when applied during economic evaluation. Results Based on achieving 'equitable access', existing measures of health inequity are suitable for establishing 'need', however the magnitude of health inequity is not necessarily proportional to the magnitude of resources required to redress it. Rather, equitable access may be better measured using appropriate methods of health service delivery for the target group. 'Equity of access' also suggests a focus on the processes of providing equitable health care rather than on outcomes, and therefore supports application of equity weights to the cost side rather than the outcomes side of the economic equation. Conclusion Cost

  15. Indigenous Partner Violence, Indigenous Sentencing Courts, and Pathways to Desistance.

    PubMed

    Marchetti, Elena; Daly, Kathleen

    2016-09-13

    Mainstream sentencing courts do little to change the behavior of partner violence offenders, let alone members of more socially marginal groups. Indigenous offenders face a court system that has little relevance to the complexity of their relations and lived experiences. Assisted by respected Elders and Community Representatives, Australian Indigenous sentencing courts seek to create a more meaningful sentencing process that has a deeper impact on Indigenous offenders' attitudes and, ultimately, their behavior. Drawing from interviews with 30 Indigenous offenders, we explore the ways in which the courts can motivate Indigenous partner violence offenders on pathways to desistence. © The Author(s) 2016.

  16. Improving maternity services for Indigenous women in Australia: moving from policy to practice.

    PubMed

    Kildea, Sue; Tracy, Sally; Sherwood, Juanita; Magick-Dennis, Fleur; Barclay, Lesley

    2016-10-17

    The well established disparities in health outcomes between Indigenous and non-Indigenous Australians include a significant and concerning higher incidence of preterm birth, low birth weight and newborn mortality. Chronic diseases (eg, diabetes, hypertension, cardiovascular and renal disease) that are prevalent in Indigenous Australian adults have their genesis in utero and in early life. Applying interventions during pregnancy and early life that aim to improve maternal and infant health is likely to have long lasting consequences, as recognised by Australia's National Maternity Services Plan (NMSP), which set out a 5-year vision for 2010-2015 that was endorsed by all governments (federal and state and territory). We report on the actions targeting Indigenous women, and the progress that has been achieved in three priority areas: The Indigenous maternity workforce; Culturally competent maternity care; and; Developing dedicated programs for "Birthing on Country". The timeframe for the NMSP has expired without notable results in these priority areas. More urgent leadership is required from the Australian government. Funding needs to be allocated to the priority areas, including for scholarships and support to train and retain Indigenous midwives, greater commitment to culturally competent maternity care and the development and evaluation of Birthing on Country sites in urban, rural and particularly in remote and very remote communities. Tools such as the Australian Rural Birth Index and the National Maternity Services Capability Framework can help guide this work.

  17. Partnership for Improving Outcomes in Indigenous Education: Relationship or Business?

    ERIC Educational Resources Information Center

    Ma Rhea, Zane

    2012-01-01

    This paper examines the Australian government's Indigenous policy by interrogating the concept of partnership between governments and Indigenous communities through three examples. Increasingly, the Australian federal government is focusing attention on the poor literacy and numeracy outcomes for Indigenous children in remote and very remote…

  18. Indigenous health program evaluation design and methods in Australia: a systematic review of the evidence.

    PubMed

    Lokuge, Kamalini; Thurber, Katherine; Calabria, Bianca; Davis, Meg; McMahon, Kathryn; Sartor, Lauren; Lovett, Raymond; Guthrie, Jill; Banks, Emily

    2017-10-01

    Indigenous Australians experience a disproportionately higher burden of disease compared to non-Indigenous Australians. High-quality evaluation of Indigenous health programs is required to inform health and health services improvement. We aimed to quantify methodological and other characteristics of Australian Indigenous health program evaluations published in the peer-reviewed literature. Systematic review of peer-reviewed literature (November 2009-2014) on Indigenous health program evaluation. We identified 118 papers describing evaluations of 109 interventions; 72.0% were university/research institution-led. 82.2% of evaluations included a quantitative component; 49.2% utilised quantitative data only and 33.1% used both quantitative and qualitative data. The most common design was a before/after comparison (30.5%, n=36/118). 7.6% of studies (n=9/118) used an experimental design: six individual-level and three cluster-randomised controlled trials. 56.8% (67/118) reported on service delivery/process outcomes (versus health or health risk factor outcomes) only. Given the number of Indigenous health programs that are implemented, few evaluations overall are published in the peer-reviewed literature and, of these, few use optimal methodologies such as mixed methods and experimental design. Implications for public health: Multiple strategies are required to increase high-quality, accessible evaluation in Indigenous health, including supporting stronger research-policy-practice partnerships and capacity building for evaluation by health services and government. © 2017 The Authors.

  19. Oral health investigations of indigenous participants in remote settings: a methods paper describing the dental component of wave III of an Australian Aboriginal birth cohort study

    PubMed Central

    Jamieson, Lisa M; Sayers, Susan M

    2008-01-01

    Background A prospective Aboriginal Birth Cohort (ABC) study has been underway in Australia's Northern Territory since 1987. Inclusion of oral epidemiological information in a follow-up study required flexible and novel approaches with unconventional techniques. Documenting these procedures may be of value to researchers interested in including oral health components in remotely-located studies. The objectives are to compare and describe dental data collection methods in wave III of the ABC study with a more conventional oral health investigation. Methods The Australian National Survey of Adult Oral Health (NSAOH) was considered the 'conventional' study. Differences between this investigation and the dental component of the ABC study were assessed in terms of ethics, location, recruitment, consent, privacy, equipment, examination, clinical data collection and replication. In the ABC study, recording of clinical data by different voice recording techniques were described and assessed for ease-of-use portability, reliability, time-efficiency and cost-effectiveness. Results Conventional investigation recruitment was by post and telephone. Participants self presented. Examinations took place in dental clinics, using customised dental chairs with standard dental lights attached. For all examinations, a dental assistant recorded dental data directly onto a laptop computer. By contrast, follow-up of ABC study participants involved a multi-phase protocol with reliance on locally-employed Indigenous advocates bringing participants to the examination point. Dental examinations occurred in settings ranging from health centre clinic rooms to improvised spaces outdoors. The dental chair was a lightweight, portable reclining camp chair and the dental light a fire-fighter's head torch with rechargeable batteries. The digital voice recorder was considered the most suitable instrument for clinical dental data collection in the ABC study in comparison with computer-based voice

  20. Strengthening the link between policy formulation and implementation of Indigenous health policy directions.

    PubMed

    Matthews, Anna; Jackson Pulver, Lisa R; Ring, Ian T

    2008-11-01

    This study aimed to understand the problems within the Indigenous health policy process in Australia and how weaknesses in the process impact on policy implementation. Using semi-structured questions, 23 key stakeholders in the policy-making process were interviewed. Three main themes dominated; a need for increased Indigenous involvement in policy formulation at the senior Australian Government level, increased participation of Indigenous community-controlled health organisations in the policy-making process and, most importantly, ensuring that policies have the necessary resources for their implementation. The emergence of these specific themes demonstrated weaknesses in policy process from the formulation stage onward. Tackling these would, according to our informants, significantly enhance the effectiveness of the policy process and contribute to further improvement of the health of Indigenous Australians.

  1. Culture at the centre of community based aged care in a remote Australian Indigenous setting: a case study of the development of Yuendumu Old People's Programme.

    PubMed

    Smith, Kay; Grundy, John J; Nelson, Harry J

    2010-01-01

    Yuendumu is a Warlpiri Aboriginal community 300 km north west of Alice Springs in Central Australia. Since emerging from the welfare period in the early 1970s, a range of services have evolved with the aim of developing a comprehensive community based aged care service. In 2000 Mampu Maninja-kurlangu Jarlu Patu-ku Aboriginal Corporation (Yuendumu Old Peoples Programme; YOPP) commenced operation to manage the developing services. This case study aims to describe, from the analytic standpoint of community control and cultural comfort, the main features of the 'Family Model of Care', which underpins the operations of the service and YOPP management processes. Data were mostly generated from participant observation by the authors in the development and management of YOPP between 1993 and 2009. A literature review of Indigenous history and public health in Central Australia was also undertaken, which was supplemented by a review of Programme documentation, including evaluations, needs assessments and annual reports. The design and operations of YOPP are embodied in a documented 'Family Model of Care' which provides important lessons for the provision of aged care in a cross-cultural context. According to the concepts 'community control' and 'cultural comfort' outlined in this article, mainstream services can function in a complementary and supportive manner with professional services being accountable and responsive to a local management system that is governed by the structures and norms of community tradition. The notions of 'cultural comfort' and 'community control' as operating principles have enabled YOPP to continue under the management of local people, sustain core cultural strengths and values, and meet the needs for increased quality of care for the aged in Yuendumu. This model of care emphasizes and recognizes paradigms of mutual competence between traditional and mainstream human service culture, and offers important lessons for improvement to the quality of

  2. Motivation Matters: Profiling Indigenous and Non-Indigenous Students' Motivational Goals

    ERIC Educational Resources Information Center

    Magson, Natasha R.; Craven, Rhonda G.; Nelson, Genevieve F.; Yeung, Alexander S.; Bodkin-Andrews, Gawaian H.; McInerney, Dennis M.

    2014-01-01

    This research explored gender and cross-cultural similarities and differences in the motivational profiles of Indigenous Papua New Guinean (PNG) and Indigenous and non-Indigenous Australians. Secondary students (N = 1,792) completed self-report motivational measures. Invariance testing demonstrated that the Inventory of School Motivation…

  3. Motivation Matters: Profiling Indigenous and Non-Indigenous Students' Motivational Goals

    ERIC Educational Resources Information Center

    Magson, Natasha R.; Craven, Rhonda G.; Nelson, Genevieve F.; Yeung, Alexander S.; Bodkin-Andrews, Gawaian H.; McInerney, Dennis M.

    2014-01-01

    This research explored gender and cross-cultural similarities and differences in the motivational profiles of Indigenous Papua New Guinean (PNG) and Indigenous and non-Indigenous Australians. Secondary students (N = 1,792) completed self-report motivational measures. Invariance testing demonstrated that the Inventory of School Motivation…

  4. PEARLs, Problems and Politics: Exploring Findings from Two Teaching and Learning Projects in Indigenous Australian Studies at the University of Queensland

    ERIC Educational Resources Information Center

    Mackinlay, Elizabeth; Barney, Katelyn

    2014-01-01

    This article explores the implementation of PEARL (Political, Embodied, Active, and Reflective Learning) in two courses at The University of Queensland: a first-year introductory Indigenous Studies course and a second year Indigenous Education course. We draw on findings from a 2-year (2010-2011) Office for Learning and Teaching (then ALTC) funded…

  5. Remote school gardens: exploring a cost-effective and novel way to engage Australian Indigenous students in nutrition and health.

    PubMed

    Hume, Andrew; Wetten, Alexander; Feeney, Camilla; Taylor, Sally; O'Dea, Kerin; Brimblecombe, Julie

    2014-06-01

    This pilot study aimed to determine the feasibility of a novel, low-cost program to get remote schools started in gardening and nutrition activities, for a lower cost than existing models, and without on-the-ground horticultural support. A multi-site, mixed methods case study was undertaken, in which four remote schools were shipped gardening materials and a nutrition and cooking resource, and provided with horticultural support by phone and email. A support register and teacher surveys were used for four months of evaluation. The study demonstrated that the program is feasible, and may be associated with an increase from baseline in student's time spent cooking, gardening and on related classroom activities. The program was delivered economically without the need for on-the-ground staff, in a manner that was acceptable to teachers. This model may have application in remote schools throughout Australia, where there is a need to alter health impacting behaviours in high-risk populations. Lengthier program evaluation times and further resource development may be worth investigating in the future. © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia.

  6. Culturally capable and culturally safe: Caseload care for Indigenous women by Indigenous midwifery students.

    PubMed

    West, R; Gamble, J; Kelly, J; Milne, T; Duffy, E; Sidebotham, M

    2016-12-01

    Evidence is emerging of the benefits to students of providing continuity of midwifery care as a learning strategy in midwifery education, however little is known about the value of this strategy for midwifery students. To explore Indigenous students' perceptions of providing continuity of midwifery care to Indigenous women whilst undertaking a Bachelor of Midwifery. Indigenous Bachelor of Midwifery students' experiences of providing continuity of midwifery care to Indigenous childbearing women were explored within an Indigenous research approach using a narrative inquiry framework. Participants were three Indigenous midwifery students who provided continuity of care to Indigenous women. Three interconnected themes; facilitating connection, being connected, and journeying with the woman. These themes contribute to the overarching finding that the experience of providing continuity of care for Indigenous women creates a sense of personal affirmation, purpose and a validation of cultural identity in Indigenous students. Midwifery philosophy aligns strongly with the Indigenous health philosophy and this provides a learning platform for Indigenous student midwives. Privileging Indigenous culture within midwifery education programs assists students develop a sense of purpose and affirms them in their emerging professional role and within their community. The findings from this study illustrate the demand for, and pertinence of, continuity of care midwifery experiences with Indigenous women as fundamental to increasing the Indigenous midwifery workforce in Australia. Australian universities should provide this experience for Indigenous student midwives. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  7. "Move over and Make Room for Meeka": The Representation of Race, Otherness and Indigeneity on the Australian Children's Television Programme "Play School"

    ERIC Educational Resources Information Center

    Mackinlay, Elizabeth; Barney, Katelyn

    2008-01-01

    "Play school" is an icon of Australian children's television and an important part of Australian life--this programme, perhaps more than any other, has taken and continues to take centre stage in our living rooms and social worlds as young children. "Play school" is invested with an enormous amount of cultural capital and hence…

  8. Hepatitis B immunization for indigenous adults, Australia

    PubMed Central

    Yin, J Kevin; Beard, Frank; Wesselingh, Steve; Cowie, Benjamin; Ward, James; Macartney, Kristine

    2016-01-01

    Abstract Objective To quantify the disparity in incidence of hepatitis B between indigenous and non-indigenous people in Australia, and to estimate the potential impact of a hepatitis B immunization programme targeting non-immune indigenous adults. Methods Using national data on persons with newly acquired hepatitis B disease notified between 2005 and 2012, we estimated incident infection rates and rate ratios comparing indigenous and non-indigenous people, with adjustments for underreporting. The potential impact of a hepatitis B immunization programme targeting non-immune indigenous adults was projected using a Markov chain Monte Carlo simulation model. Findings Of the 54 522 persons with hepatitis B disease notified between 1 January 2005 and 31 December 2012, 1953  infections were newly acquired. Acute hepatitis B infection notification rates were significantly higher for indigenous than non-indigenous Australians. The rates per 100 000 population for all ages were 3.6 (156/4 368 511) and 1.1 (1797/168 449 302) for indigenous and non-indigenous people respectively. The rate ratio of age-standardized notifications was 4.0 (95% confidence interval: 3.7–4.3). If 50% of non-immune indigenous adults (20% of all indigenous adults) were vaccinated over a 10-year programme a projected 527–549 new cases of acute hepatitis B would be prevented. Conclusion There continues to be significant health inequity between indigenous and non-indigenous Australians in relation to vaccine-preventable hepatitis B disease. An immunization programme targeting indigenous Australian adults could have considerable impact in terms of cases of acute hepatitis B prevented, with a relatively low number needed to vaccinate to prevent each case. PMID:27821885

  9. The Limits of Cultural Competence: An Indigenous Studies Perspective

    ERIC Educational Resources Information Center

    Carey, Michelle

    2015-01-01

    Taking the Universities Australia report, "National best practice framework for Indigenous cultural competency in Australian universities" (2011) as the starting point for its discussion, this paper examines the applicability of cultural competence in the design and delivery of Australian Indigenous Studies. It argues that both the…

  10. Utilising PEARL to Teach Indigenous Art History: A Canadian Example

    ERIC Educational Resources Information Center

    Robertson, Carmen

    2012-01-01

    This article explores the concepts advanced from the Australian Learning and Teaching Council (ALTC)-funded project, "Exploring Problem-Based Learning pedagogy as transformative education in Indigenous Australian Studies". As an Indigenous art historian teaching at a mainstream university in Canada, I am constantly reflecting on how to…

  11. The Limits of Cultural Competence: An Indigenous Studies Perspective

    ERIC Educational Resources Information Center

    Carey, Michelle

    2015-01-01

    Taking the Universities Australia report, "National best practice framework for Indigenous cultural competency in Australian universities" (2011) as the starting point for its discussion, this paper examines the applicability of cultural competence in the design and delivery of Australian Indigenous Studies. It argues that both the…

  12. Exploring Multiple Pathways for Indigenous Students. Discussion Paper.

    ERIC Educational Resources Information Center

    Ministerial Council on Education, Employment, Training and Youth Affairs, Carlton South (Australia).

    An Australian national task force examined a number of areas related to achieving educational equality for Australia's Indigenous peoples. Young Indigenous Australians are disproportionately represented among young people who do not successfully negotiate the transition from school to independence and employment. This paper focuses on issues of…

  13. Utilising PEARL to Teach Indigenous Art History: A Canadian Example

    ERIC Educational Resources Information Center

    Robertson, Carmen

    2012-01-01

    This article explores the concepts advanced from the Australian Learning and Teaching Council (ALTC)-funded project, "Exploring Problem-Based Learning pedagogy as transformative education in Indigenous Australian Studies". As an Indigenous art historian teaching at a mainstream university in Canada, I am constantly reflecting on how to…

  14. Report of MCEETYA Taskforce on Indigenous Education.

    ERIC Educational Resources Information Center

    Ministerial Council on Education, Employment, Training and Youth Affairs, Carlton South (Australia).

    In April 1999, the (Australian) Ministerial Council on Education, Employment, Training and Youth Affairs established a taskforce on making educational equality for Indigenous peoples a national priority; enhancing the performance and monitoring framework for the National Indigenous Education Strategic Initiatives Programme (IESIP); and developing…

  15. National Indigenous English Literacy and Numeracy Strategy, 2000-2004.

    ERIC Educational Resources Information Center

    Australian Dept. of Employment, Education, Training and Youth Affairs, Canberra.

    Australia's National Indigenous Literacy and Numeracy Strategy acknowledges that extra effort and resources will be required for Indigenous Australian children to achieve the recently enacted national educational goals. The principal objective of the strategy is to achieve English literacy and numeracy for Indigenous students at levels comparable…

  16. National Indigenous English Literacy and Numeracy Strategy, 2000-2004.

    ERIC Educational Resources Information Center

    Australian Dept. of Employment, Education, Training and Youth Affairs, Canberra.

    Australia's National Indigenous Literacy and Numeracy Strategy acknowledges that extra effort and resources will be required for Indigenous Australian children to achieve the recently enacted national educational goals. The principal objective of the strategy is to achieve English literacy and numeracy for Indigenous students at levels comparable…

  17. Teaching Indigenous Geography in a Neo-Colonial World

    ERIC Educational Resources Information Center

    Carter, Jennifer; Hollinsworth, David

    2017-01-01

    Australian universities are increasingly embedding Indigenous content and perspectives within curriculum to promote Indigenous cultural competency. We present teaching challenges in an Indigenous geography course designed to present an engaged, intercultural learning experience. We critically reflect on student evaluations, informal discussions…

  18. A service-level action research intervention to improve identification and treatment of cannabis and related mental health issues in young Indigenous Australians: a study protocol.

    PubMed

    Bohanna, India; Bird, Katrina; Copeland, Jan; Roberts, Nicholas; Clough, Alan

    2014-07-31

    Regular cannabis use is associated with negative mental health impacts including psychosis, depression and anxiety. Rates of cannabis use have increased in Aboriginal and Torres Strait Islander communities in northern Australia within the last two decades, presenting a significant increased risk to young people's mental health in these regions. Improved screening, early detection and treatment for cannabis-related mental health issues are urgently required. This paper describes a service-level action research intervention and evaluation protocol for use in the few services where it is possible to engage young Aboriginal and Torres Strait Islander Australians. The protocol is being developed in two services where youth mental health is core business: a primary healthcare centre and a youth service in the Cairns and hinterland region, far north Queensland. The protocol calls first for baseline data to be collected using staff and client surveys; network mapping; and analysis of screening, treatment and referral rates. The protocol's intervention phase is driven by service needs identified from baseline data. Intervention strategies focus on implementing/enhancing cannabis screening instruments and processes in line with current best practice; enhancing networks with external drug and mental health services; developing culturally acceptable training and resources; developing activities aiming to reduce cannabis use in young Aboriginal and Torres Strait Islander clients using the services. The protocol requires implementation of the multilevel intervention within each service for 1 year, with follow-up data then collected and compared to baseline. Process evaluation identifies the more effective intervention strategies and documents the challenges to be overcome for full implementation. Ethics approval was provided by The James Cook University, Human Research Ethics Committee. Ethics Approval Number H5322. Peer-reviewed publications will also be used to disseminate

  19. A service-level action research intervention to improve identification and treatment of cannabis and related mental health issues in young Indigenous Australians: a study protocol

    PubMed Central

    Bohanna, India; Bird, Katrina; Copeland, Jan; Roberts, Nicholas; Clough, Alan

    2014-01-01

    Introduction Regular cannabis use is associated with negative mental health impacts including psychosis, depression and anxiety. Rates of cannabis use have increased in Aboriginal and Torres Strait Islander communities in northern Australia within the last two decades, presenting a significant increased risk to young people's mental health in these regions. Improved screening, early detection and treatment for cannabis-related mental health issues are urgently required. This paper describes a service-level action research intervention and evaluation protocol for use in the few services where it is possible to engage young Aboriginal and Torres Strait Islander Australians. Methods/Design The protocol is being developed in two services where youth mental health is core business: a primary healthcare centre and a youth service in the Cairns and hinterland region, far north Queensland. The protocol calls first for baseline data to be collected using staff and client surveys; network mapping; and analysis of screening, treatment and referral rates. The protocol's intervention phase is driven by service needs identified from baseline data. Intervention strategies focus on implementing/enhancing cannabis screening instruments and processes in line with current best practice; enhancing networks with external drug and mental health services; developing culturally acceptable training and resources; developing activities aiming to reduce cannabis use in young Aboriginal and Torres Strait Islander clients using the services. The protocol requires implementation of the multilevel intervention within each service for 1 year, with follow-up data then collected and compared to baseline. Process evaluation identifies the more effective intervention strategies and documents the challenges to be overcome for full implementation. Ethics and dissemination Ethics approval was provided by The James Cook University, Human Research Ethics Committee. Ethics Approval Number H5322. Peer

  20. Supporting the Learning of Nomadic Communities across Transnational Contexts: Exploring Parallels in the Education of UK Roma Gypsies and Indigenous Australians

    ERIC Educational Resources Information Center

    Levinson, Martin; Hooley, Neil

    2014-01-01

    Deriving from the authors' respective ethnographic fieldwork (around two decades in each context), this position paper considers experiences of education across two communities: Gypsy/Roma in the UK and Indigenous in Australia. The article brings together understandings across these traditionally nomadic communities, with no shared history or…

  1. Supporting the Learning of Nomadic Communities across Transnational Contexts: Exploring Parallels in the Education of UK Roma Gypsies and Indigenous Australians

    ERIC Educational Resources Information Center

    Levinson, Martin; Hooley, Neil

    2014-01-01

    Deriving from the authors' respective ethnographic fieldwork (around two decades in each context), this position paper considers experiences of education across two communities: Gypsy/Roma in the UK and Indigenous in Australia. The article brings together understandings across these traditionally nomadic communities, with no shared history or…

  2. Decolonizing Indigenous Archaeology: Developments from Down Under

    ERIC Educational Resources Information Center

    Smith, Claire; Jackson, Gary

    2006-01-01

    In this article the authors discuss recent developments in the decolonization of Australian archaeology. From the viewpoint of Indigenous Australians, much archaeological and anthropological research has been nothing more than a tool of colonial exploitation. For the last twenty years, many have argued for greater control over research and for a…

  3. Decolonizing Indigenous Archaeology: Developments from Down Under

    ERIC Educational Resources Information Center

    Smith, Claire; Jackson, Gary

    2006-01-01

    In this article the authors discuss recent developments in the decolonization of Australian archaeology. From the viewpoint of Indigenous Australians, much archaeological and anthropological research has been nothing more than a tool of colonial exploitation. For the last twenty years, many have argued for greater control over research and for a…

  4. Learning through Indigenous Business: The Role of Vocational Education and Training in Indigenous Enterprise and Community Development

    ERIC Educational Resources Information Center

    Flamsteed, Kate; Golding, Barry

    2005-01-01

    This report explores the ways in which Indigenous Australians are learning through enterprise and small business development. It reveals that this learning will be more effective if it takes into account that Indigenous experience differs by location, with remote areas offering a significant challenge. Learning through Indigenous business is most…

  5. Working Together: Strategies That Support Cross-Cultural Engagement of Indigenous Teacher Assistants Working in Indigenous Contexts

    ERIC Educational Resources Information Center

    Armour, Danielle; Warren, Elizabeth; Miller, Jodie

    2016-01-01

    Indigenous teacher assistants (ITAs) are often employed in schools to assist in addressing educational issues relating to Indigenous students. While, this practice has occurred for over 40 years in most Australian states, little has been written about their contribution in assisting Indigenous students to learn. This paper explores the influence…

  6. Working Together: Strategies That Support Cross-Cultural Engagement of Indigenous Teacher Assistants Working in Indigenous Contexts

    ERIC Educational Resources Information Center

    Armour, Danielle; Warren, Elizabeth; Miller, Jodie

    2016-01-01

    Indigenous teacher assistants (ITAs) are often employed in schools to assist in addressing educational issues relating to Indigenous students. While, this practice has occurred for over 40 years in most Australian states, little has been written about their contribution in assisting Indigenous students to learn. This paper explores the influence…

  7. Australian Film Studies.

    ERIC Educational Resources Information Center

    Breen, Myles P.

    Although Australia had a vigorous film industry in the silent film era, it was stifled in the 1930s when United States and British interests bought up the Australian distribution channels and closed down the indigenous industry. However, the industry and film study have undergone a renaissance since the advent of the Labor government in 1972,…

  8. Australian Film Studies.

    ERIC Educational Resources Information Center

    Breen, Myles P.

    Although Australia had a vigorous film industry in the silent film era, it was stifled in the 1930s when United States and British interests bought up the Australian distribution channels and closed down the indigenous industry. However, the industry and film study have undergone a renaissance since the advent of the Labor government in 1972,…

  9. Cultural Dimensions of Indigenous Participation in Education and Training. NCVER Monograph Series 02/2009

    ERIC Educational Resources Information Center

    Dockery, Alfred Michael

    2009-01-01

    The preservation of Indigenous cultures is a controversial issue in Australia. On the one hand, the maintenance of traditional Indigenous culture has been viewed as a barrier to integration with mainstream society and the achievement of socio-economic equality between Indigenous and non-Indigenous Australians. An alternative view sees maintenance…

  10. How Do Pre-Service Teachers Cope with a Literacy Intervention Program in a Remote Indigenous Community? The Community Action Support Program in the Northern Territory, Australia

    ERIC Educational Resources Information Center

    Naidoo, Loshini

    2012-01-01

    This paper examines a new community education initiative, Community Action Support (CAS) that helps facilitate learning in Indigenous young people from Tennant Creek in the Northern Territory. CAS is an innovative partnership program between the Australian Literacy and Numeracy Foundation and the University of Western Sydney. The core aim of the…

  11. Making progress: the role of cancer councils in Australia in indigenous cancer control

    PubMed Central

    2014-01-01

    Background Indigenous Australians have poorer outcomes from cancer for a variety of reasons including poorer participation in screening programs, later diagnosis, higher rates of cancer with poor prognosis and poorer uptake and completion of treatment. Cancer prevention and support for people with cancer is part of the core business of the State and Territory Cancer Councils. To support sharing of lessons learned, this paper reports an environmental scan undertaken in 2010 in cancer councils (CCs) nationwide that aimed to support Indigenous cancer control. Methods The methods replicated the approach used in a 2006 environmental scan of Indigenous related activity in CCs. The Chief Executive Officer of each CC nominated individuals for interview. Interviews explored staffing, projects, programs and activities to progress cancer control issues for Indigenous Australians, through phone or face-to-face interviews. Reported initiatives were tabulated using predetermined categories of activity and summaries were returned to interviewees, the Aboriginal and Torres Strait Islander Subcommittee and Chief Executive Officers for verification. Results All CCs participated and modest increases in activity had occurred in most states since 2006 through different means. Indigenous staff numbers were low and no Indigenous person had yet been employed in smaller CCs; no CC had an Indigenous Board member and efforts at capacity building were often directed outside of the organisation. Developing partnerships with Indigenous organisations were ongoing. Acknowledgement and specific mention of Indigenous people in policy was increasing. Momentum increased following the establishment of a national subcommittee which increased the profile of Indigenous issues and provided collegial and practical support for those committed to reducing Indigenous cancer disparities. Government funding of “Closing the Gap” and research in the larger CCs have been other avenues for increasing knowledge

  12. "Only your blood can tell the story"--a qualitative research study using semi-structured interviews to explore the hepatitis B related knowledge, perceptions and experiences of remote dwelling Indigenous Australians and their health care providers in northern Australia.

    PubMed

    Davies, Jane; Bukulatjpi, Sarah; Sharma, Suresh; Davis, Joshua; Johnston, Vanessa

    2014-11-28

    Hepatitis B is endemic in the Indigenous communities of the Northern Territory of Australia and significantly contributes to liver-related morbidity and mortality. It is recognised that low health literacy levels, different worldviews and English as a second language all contribute to the difficulties health workers often have in explaining biomedical health concepts, relevant to hepatitis B infection, to patients. The aim of this research project was to explore the knowledge, perceptions and experiences of remote dwelling Indigenous adults and their health care providers relating to hepatitis B infection with a view to using this as the evidence base to develop a culturally appropriate educational tool. The impetus for this project came from health clinic staff at a remote community in Arnhem Land in the Northern Territory, in partnership with a visiting specialist liver clinic from the Royal Darwin Hospital. Participants were clinic patients with hepatitis B (n = 12), community members (n = 9) and key informants (n = 13); 25 were Indigenous individuals.A participatory action research project design was used with purposive sampling to identify participants. Semi-structured interviews were undertaken to explore: current understanding of hepatitis B, desire for knowledge, and perspectives on how people could acquire the information needed. All individuals were offered the use of an interpreter. The data were examined using deductive and inductive thematic analysis. Low levels of biomedical knowledge about Hepatitis B, negative perceptions of Hepatitis B, communication (particularly language) and culture were the major themes that emerged from the data. Accurate concepts grounded in Indigenous culture such as "only your blood can tell the story" were present but accompanied by a feeling of disempowerment due to perceived lack of "medical" understanding, and informed partnerships between caregiver and patient. Culturally appropriate discussions in a

  13. The development of a supportive care needs assessment tool for Indigenous people with cancer.

    PubMed

    Garvey, Gail; Beesley, Vanessa L; Janda, Monika; Jacka, Catherine; Green, Adèle C; O'Rourke, Peter; Valery, Patricia C

    2012-07-20

    Little is known about the supportive care needs of Indigenous people with cancer and to date, existing needs assessment tools have not considered cultural issues for this population. We aimed to adapt an existing supportive care needs assessment tool for use with Indigenous Australians with cancer. Face-to-face interviews with Indigenous cancer patients (n = 29) and five focus groups with Indigenous key-informants (n = 23) were conducted to assess the face and content validity, cultural acceptability, utility and relevance of the Supportive Care Needs Survey - Short Form 34 (SCNS-SF34) for use with Indigenous patients with cancer. All items from the SCNS-SF34 were shortened and changed to use more appropriate language (e.g. the word 'anxiety' was substituted with 'worry'). Seven questions were omitted (e.g. items on death and future considerations) as they were deemed culturally inappropriate or irrelevant and 12 items were added (e.g. accessible transport). Optional instructions were added before the sexual items. The design and response format of the SCNS-SF34 was modified to make it easier to use for Indigenous cancer patients. Given the extensive modifications to the SCNS-SF34 and the liklihood of a different factor structure we consider this tool to be a new tool rather than a modification. The Supportive care needs assessment tool for Indigenous people (SCNAT-IP) shows promising face and content validity and will be useful in informing services where they need to direct their attention for these patients. Indigenous people with cancer have language, customs and specific needs that are not accommodated within the standard SCNS-SF34. Our SCNAT-IP improves acceptability, relevance and face validity for Indigenous-specific concerns. Our SCNAT-IP will allow screening for supportive care needs that are specific to Indigenous cancer patients' and greatly inform targeted policy development and practice.

  14. The development of a supportive care needs assessment tool for Indigenous people with cancer

    PubMed Central

    2012-01-01

    Background Little is known about the supportive care needs of Indigenous people with cancer and to date, existing needs assessment tools have not considered cultural issues for this population. We aimed to adapt an existing supportive care needs assessment tool for use with Indigenous Australians with cancer. Methods Face-to-face interviews with Indigenous cancer patients (n = 29) and five focus groups with Indigenous key-informants (n = 23) were conducted to assess the face and content validity, cultural acceptability, utility and relevance of the Supportive Care Needs Survey - Short Form 34 (SCNS-SF34) for use with Indigenous patients with cancer. Results All items from the SCNS-SF34 were shortened and changed to use more appropriate language (e.g. the word 'anxiety' was substituted with 'worry'). Seven questions were omitted (e.g. items on death and future considerations) as they were deemed culturally inappropriate or irrelevant and 12 items were added (e.g. accessible transport). Optional instructions were added before the sexual items. The design and response format of the SCNS-SF34 was modified to make it easier to use for Indigenous cancer patients. Given the extensive modifications to the SCNS-SF34 and the liklihood of a different factor structure we consider this tool to be a new tool rather than a modification. The Supportive care needs assessment tool for Indigenous people (SCNAT-IP) shows promising face and content validity and will be useful in informing services where they need to direct their attention for these patients. Conclusions Indigenous people with cancer have language, customs and specific needs that are not accommodated within the standard SCNS-SF34. Our SCNAT-IP improves acceptability, relevance and face validity for Indigenous-specific concerns. Our SCNAT-IP will allow screening for supportive care needs that are specific to Indigenous cancer patients' and greatly inform targeted policy development and practice. PMID:22817614

  15. Positioning the School in the Landscape: Exploring Black History with a Regional Australian Primary School

    ERIC Educational Resources Information Center

    Zeegers, Margaret

    2011-01-01

    This paper deals with a project establishing an Indigenous Australian artists-in-residence program at a regional Australian primary school to foreground its Black History. Primary school students worked with Indigenous Australian story tellers, artists, dancers and musicians to explore ways in which they could examine print and non-print texts for…

  16. REM: A Collaborative Framework for Building Indigenous Cultural Competence.

    PubMed

    Power, Tamara; Virdun, Claudia; Sherwood, Juanita; Parker, Nicola; Van Balen, Jane; Gray, Joanne; Jackson, Debra

    2016-09-01

    The well-documented health disparities between the Australian Indigenous and non-Indigenous population mandates a comprehensive response from health professionals. This article outlines the approach taken by one faculty of health in a large urban Australian university to enhance cultural competence in students from a variety of fields. Here we outline a collaborative and deeply respectful process of Indigenous and non-Indigenous university staff collectively developing a model that has framed the embedding of a common faculty Indigenous graduate attribute across the curriculum. Through collaborative committee processes, the development of the principles of "Respect; Engagement and sharing; Moving forward" (REM) has provided both a framework and way of "being and doing" our work. By drawing together the recurring principles and qualities that characterize Indigenous cultural competence the result will be students and staff learning and bringing into their lives and practice, important Indigenous cultural understanding.

  17. The Utility of General Self-Esteem and Domain-Specific Self-Concepts: Their Influence on Indigenous and Non-Indigenous Students' Educational Outcomes

    ERIC Educational Resources Information Center

    Bodkin-Andrews, Gawaian; O'Rourke, Virginia; Craven, Rhonda G.

    2010-01-01

    It is only relatively recently that empirical research has begun to emerge that has sought to further understand the factors that may contribute to the educational inequities between Indigenous Australian and non-Indigenous Australian students. Although it has been argued that research has typically employed small, unrepresentative case studies…

  18. The Utility of General Self-Esteem and Domain-Specific Self-Concepts: Their Influence on Indigenous and Non-Indigenous Students' Educational Outcomes

    ERIC Educational Resources Information Center

    Bodkin-Andrews, Gawaian; O'Rourke, Virginia; Craven, Rhonda G.

    2010-01-01

    It is only relatively recently that empirical research has begun to emerge that has sought to further understand the factors that may contribute to the educational inequities between Indigenous Australian and non-Indigenous Australian students. Although it has been argued that research has typically employed small, unrepresentative case studies…

  19. Evidence for a comprehensive approach to Aboriginal tobacco control to maintain the decline in smoking: an overview of reviews among Indigenous peoples.

    PubMed

    Chamberlain, Catherine; Perlen, Susan; Brennan, Sue; Rychetnik, Lucie; Thomas, David; Maddox, Raglan; Alam, Noore; Banks, Emily; Wilson, Andrew; Eades, Sandra

    2017-07-10

    Tobacco smoking is a leading cause of disease and premature mortality among Aboriginal and Torres Strait Islander (Indigenous) Australians. While the daily smoking prevalence among Indigenous Australians has declined significantly from 49% in 2001, it remains about three times higher than that of non-Indigenous Australians (39 and 14%, respectively, for age ≥15 years in 2014-15). This overview of systematic reviews aimed to synthesise evidence about reducing tobacco consumption among Indigenous peoples using a comprehensive framework for Indigenous tobacco control in Australia comprised of the National Tobacco Strategy (NTS) and National Aboriginal and Torres Strait Islander Health Plan (NATSIHP) principles and priorities. MEDLINE, EMBASE, systematic review and Indigenous health databases were searched (2000 to Jan 2016) for reviews examining the effects of tobacco control interventions among Indigenous peoples. Two reviewers independently screened reviews, extracted data, and assessed review quality using Assessing the Methodological Quality of Systematic Reviews. Data were synthesised narratively by framework domain. Reporting followed the PRISMA statement. Twenty-one reviews of varying quality were included. There was generally limited Indigenous-specific evidence of effective interventions for reducing smoking; however, many reviewers recommended multifaceted interventions which incorporate Indigenous leadership, partnership and engagement and cultural tailoring. Under the NTS priority areas, reviewers reported evidence for brief smoking cessation interventions and pharmacological support, mass media campaigns (on knowledge and attitudes) and reducing affordability and regulation of tobacco sales. Aspects of intervention implementation related to the NATSIHP domains were less well described and evidence was limited; however, reviewers suggested that cultural tailoring, holistic approaches and building workforce capacity were important strategies to address

  20. The Prevalence of Self-Reported Diabetes in the Australian National Eye Health Survey

    PubMed Central

    Keel, Stuart; Xie, Jing; van Wijngaarden, Peter; Taylor, Hugh R.; Dirani, Mohamed

    2017-01-01

    Objective To present the prevalence of self-reported diabetes in Indigenous and non-Indigenous participants in the National Eye Health Survey. Research Design and Methods 3098 non-Indigenous Australians aged 50–98 years and 1738 Indigenous Australians aged 40–92 years were examined in 30 randomly selected sites, stratified by remoteness. A history of diabetes was obtained using an interviewer-administered questionnaire. Results 13.91% (431/3098) of non-Indigenous Australians and 37.11% (645/1738) of Indigenous Australians had self-reported diabetes. The age-adjusted prevalence of self-reported diabetes for non-Indigenous and Indigenous Australians was 11.49% and 43.77%, respectively (p <0.001). The prevalence of self-reported diabetes increased markedly with age (OR = 1.04 per year, p = 0.017). Indigenous Australians living in very remote areas were more likely to have self-reported diabetes than those in major city areas (OR = 1.61, p = 0.038). Conclusions The prevalence of self-reported diabetes in Australia was high, with the prevalence being almost 4 times higher in Indigenous Australians compared with non-Indigenous Australians. With the prevalence of diabetes likely to increase, the results of this national survey may inform future policy, planning and funding allocation to assist in controlling the diabetes epidemic. PMID:28045990

  1. From targets to ripples: tracing the process of developing a community capacity building appraisal tool with remote Australian Indigenous communities to tackle food security.

    PubMed

    Brimblecombe, Julie; van den Boogaard, Christel; Ritchie, Jan; Bailie, Ross; Coveney, John; Liberato, Selma

    2014-09-04

    The issue of food security is complex and requires capacity for often-unrelated groups to work together. We sought to assess the relevance and meaning of a commonly used set of community capacity development constructs in the context of remote Indigenous Australia and through this propose a model to support capacity. The assessment was conducted with four communities and took place over five steps that involved: (i) test of clarity of construct meaning; (ii) inductive derivation of community capacity constructs; (iii) application of these constructs to the capacity of community multi-sector food-interest groups; (iv) a cross-check of these constructs and their meanings to literature-derived constructs, and; (v) achieving consensus on tool constructs. Data were collected over a three-year period (2010-2012) that involved two on-site visits to one community, and two urban-based workshops. These data were augmented by food-interest group meeting minutes and reports. Eleven community capacity development constructs were included in the proposed model: community ownership, building on strengths, strong leadership and voice, making decisions together, strong partnerships, opportunities for learning and skill development, way of working, getting together the things you need, good strong communication, sharing the true story, and continuing the process and passing on to the next generation. The constructs derived from the literature and commonly used to appraise community capacity development were well accepted and could be used to identify areas needing strengthening. The specifics of each construct however differed from those derived from the literature yet were similar across the four communities and had particular meaning for those involved. The involvement of elders and communication with the wider community seemed paramount to forming a solid foundation on which capacity could be further developed. This study explored an approach for ascribing context specific

  2. Assessing the port to port risk of vessel movements vectoring non-indigenous marine species within and across domestic Australian borders.

    PubMed

    Campbell, Marnie L; Hewitt, Chad L

    2011-07-01

    Biofouling of vessels is implicated as a high risk transfer mechanism of non-indigenous marine species (NIMS). Biofouling on international vessels is managed through stringent border control policies, however, domestic biofouling transfers are managed under different policies and legislative arrangements as they cross internal borders. As comprehensive guidelines are developed and increased compliance of international vessels with 'clean hull' expectations increase, vessel movements from port to port will become the focus of biosecurity management. A semi-quantitative port to port biofouling risk assessment is presented that evaluates the presence of known NIMS in the source port and determines the likelihood of transfer based on the NIMS association with biofouling and environmental match between source and receiving ports. This risk assessment method was used to assess the risk profile of a single dredge vessel during three anticipated voyages within Australia, resulting in negligible to low risk outcomes. This finding is contrasted with expectations in the literature, specifically those that suggest slow moving vessels pose a high to extreme risk of transferring NIMS species.

  3. Effects of fish oil supplementation on learning and behaviour of children from Australian Indigenous remote community schools: a randomised controlled trial.

    PubMed

    Parletta, Natalie; Cooper, Patrick; Gent, Debra N; Petkov, John; O'Dea, Kerin

    2013-08-01

    Omega-3 fatty acids are essential for brain function. We recruited 409 children aged 3-13 years (M=8.27, SD=2.17) for a randomised controlled trial supplementing with placebo or fish oil capsules (providing 750mg docosahexaenoic plus eicosapentaenoic acids, and 60mg gamma linolenic acid/school day) for 20 school weeks (Phase 1) followed by one-way crossover to fish oil (Phase 2). Children undertook assessments of reading, spelling and non-verbal cognitive development (Draw-A-Person) at baseline, 20 and 40 weeks. Teachers completed Conners Behaviour Rating Scales (CBRS). The treatment group showed improvements in Draw-A-Person compared with the placebo during Phase 1 (p=0.029), with strongest effects in Indigenous 7-12 year olds (p=0.008). The placebo group showed significant within-group improvements after switching to treatment (p<0.001). There was no treatment effect for reading or spelling, and CBRS data were unable to be analysed. These findings may be understood in the context that sustained school attendance and nutrition interact to produce school-related achievement.

  4. Australian Aboriginal Language Early Childhood Education Programmes.

    ERIC Educational Resources Information Center

    Holmes, Tony

    This report discusses the provision of culturally appropriate early childhood programs in Australian Aboriginal language in Australia, and the education of teachers for these programs. The first section of the report examines the education of indigenous peoples in the context of the current Australian education system. Evidence in support of the…

  5. Indigenous Gambling Motivations, Behaviour and Consequences in Northern New South Wales, Australia

    ERIC Educational Resources Information Center

    Breen, Helen M.; Hing, Nerilee; Gordon, Ashley

    2011-01-01

    Against a background of public health, we sought to examine and explain gambling behaviours, motivations and consequences of Indigenous Australians in northern New South Wales. Adhering to national Aboriginal and ethical guidelines and using qualitative methods, 169 Indigenous Australians were interviewed individually and in small groups using…

  6. Indigenous Gambling Motivations, Behaviour and Consequences in Northern New South Wales, Australia

    ERIC Educational Resources Information Center

    Breen, Helen M.; Hing, Nerilee; Gordon, Ashley

    2011-01-01

    Against a background of public health, we sought to examine and explain gambling behaviours, motivations and consequences of Indigenous Australians in northern New South Wales. Adhering to national Aboriginal and ethical guidelines and using qualitative methods, 169 Indigenous Australians were interviewed individually and in small groups using…

  7. Indigenous Tutorial Assistance Scheme. Tertiary Tuition and Beyond: Transitioning with Strengths and Promoting Opportunities

    ERIC Educational Resources Information Center

    Wilks, Judith; Fleeton, Ellen Radnidge; Wilson, Katie

    2017-01-01

    The Indigenous Tutorial Assistance Scheme-Tertiary Tuition (ITAS-TT) has provided Australian government funding for one-to-one and group tutorial study support for Aboriginal and Torres Strait Islander students attending Australian universities since 1989. It has been a central plank supporting Indigenous university students in their studies.…

  8. Policies on and Practices of Cultural Inclusivity in Learning Management Systems: Perspectives of Indigenous Holistic Pedagogies

    ERIC Educational Resources Information Center

    Dreamson, Neal; Thomas, Gary; Lee Hong, Anita; Kim, Soyoung

    2017-01-01

    Online learning has become a conventional term and practice in Australian higher education, yet cultural inclusivity for Indigenous (Indigenous for the purposes of this paper refers to Australian Aboriginal and Torres Strait Islander peoples) students is insufficiently reflected in learning management system (LMS) policies and design. This study…

  9. Information Technology and Indigenous People

    ERIC Educational Resources Information Center

    Dyson, Laurel, Ed.; Hendriks, Max, Ed.; Grant, Stephen, Ed.

    2007-01-01

    Information Technology and Indigenous People provides theoretical and empirical information related to the planning and execution of IT projects aimed at serving indigenous people. It explores many cultural concerns with IT implementation, including language issues and questions of cultural appropriateness, and brings together cutting-edge…

  10. Information Technology and Indigenous People

    ERIC Educational Resources Information Center

    Dyson, Laurel, Ed.; Hendriks, Max, Ed.; Grant, Stephen, Ed.

    2007-01-01

    Information Technology and Indigenous People provides theoretical and empirical information related to the planning and execution of IT projects aimed at serving indigenous people. It explores many cultural concerns with IT implementation, including language issues and questions of cultural appropriateness, and brings together cutting-edge…

  11. Indigenous Vocational Education and Training. At a Glance

    ERIC Educational Resources Information Center

    O'Callaghan, Katy

    2005-01-01

    This publication presents the results of a comprehensive research program on Indigenous Australians in vocational education and training (VET), along with feedback from over 200 people who attended the National Centre for Vocational Education Research (NCVER) Research Forum on Indigenous VET in August 2005. The planning and implementation of the…

  12. Indigenous Wellbeing Frameworks in Australia and the Quest for Quantification

    ERIC Educational Resources Information Center

    Prout, Sarah

    2012-01-01

    There is an emerging global recognition of the inadequacies of conventional socio-economic and demographic data in being able to reflect the relative wellbeing of Indigenous peoples. This paper emerges out of a recent desktop study commissioned by an Australian Indigenous organization who identified a need to enhance local literacies in data…

  13. Walking in Both Worlds: Rethinking Indigenous Knowledge in the Academy

    ERIC Educational Resources Information Center

    Arnold, Josie

    2017-01-01

    Six generations ago, my Celtic forebears came to Australia as convicts and invaders displacing Indigenous peoples. As a scholar today, I am interested in how Indigenous knowledge remains a challenge in Australian Universities even in this postmodern and postcolonial moment. This paper recognises the need to extend discussion about how Indigenous…

  14. Indigenous Studies: Tool of Empowerment within the Academe

    ERIC Educational Resources Information Center

    Herbert, Jeannie

    2010-01-01

    In this paper, I consider the importance of Indigenous studies programs, at both undergraduate and postgraduate levels, as critical elements in enabling Indigenous Australian students to engage in the academe in ways that not only allow them to empower themselves, but, ultimately, to become effective change agents within both their own and the…

  15. Experiencing Indigenous Knowledge Online as a Community Narrative

    ERIC Educational Resources Information Center

    Kutay, Cat; Mooney, Janet; Riley, Lynette; Howard-Wagner, Deirdre

    2012-01-01

    This article explores a project at the Koori Centre, University of Sydney, funded by the Australian Learning and Teaching Council (ALTC) in 2011, titled "Indigenous On-Line Cultural Teaching and Sharing". One of the team members (Kutay) was also a project team member on the ALTC-funded project "Exploring PBL in Indigenous Australian…

  16. Experiencing Indigenous Knowledge Online as a Community Narrative

    ERIC Educational Resources Information Center

    Kutay, Cat; Mooney, Janet; Riley, Lynette; Howard-Wagner, Deirdre

    2012-01-01

    This article explores a project at the Koori Centre, University of Sydney, funded by the Australian Learning and Teaching Council (ALTC) in 2011, titled "Indigenous On-Line Cultural Teaching and Sharing". One of the team members (Kutay) was also a project team member on the ALTC-funded project "Exploring PBL in Indigenous Australian…

  17. Alternative VET Pathways to Indigenous Development. Review of Research.

    ERIC Educational Resources Information Center

    Boughton, Bob

    Recent research and policy documents on indigenous Australians' development needs and aspirations were reviewed to determine their impact on current developments in vocational education and training (VET) research and policy. Special attention was paid to the work of indigenous community-controlled organizations in areas such the following: land;…

  18. Indigenous Health and Socioeconomic Status in India

    PubMed Central

    Subramanian, S. V; Smith, George Davey; Subramanyam, Malavika

    2006-01-01

    Background Systematic evidence on the patterns of health deprivation among indigenous peoples remains scant in developing countries. We investigate the inequalities in mortality and substance use between indigenous and non-indigenous, and within indigenous, groups in India, with an aim to establishing the relative contribution of socioeconomic status in generating health inequalities. Methods and Findings Cross-sectional population-based data were obtained from the 1998–1999 Indian National Family Health Survey. Mortality, smoking, chewing tobacco use, and alcohol use were four separate binary outcomes in our analysis. Indigenous status in the context of India was operationalized through the Indian government category of scheduled tribes, or Adivasis, which refers to people living in tribal communities characterized by distinctive social, cultural, historical, and geographical circumstances. Indigenous groups experience excess mortality compared to non-indigenous groups, even after adjusting for economic standard of living (odds ratio 1.22; 95% confidence interval 1.13–1.30). They are also more likely to smoke and (especially) drink alcohol, but the prevalence of chewing tobacco is not substantially different between indigenous and non-indigenous groups. There are substantial health variations within indigenous groups, such that indigenous peoples in the bottom quintile of the indigenous-peoples-specific standard of living index have an odds ratio for mortality of 1.61 (95% confidence interval 1.33–1.95) compared to indigenous peoples in the top fifth of the wealth distribution. Smoking, drinking alcohol, and chewing tobacco also show graded associations with socioeconomic status within indigenous groups. Conclusions Socioeconomic status differentials substantially account for the health inequalities between indigenous and non-indigenous groups in India. However, a strong socioeconomic gradient in health is also evident within indigenous populations

  19. Indigenous child health: are we making progress?

    PubMed

    Brewster, David R; Morris, Peter S

    2015-01-01

    We identified 244 relevant articles pertinent to indigenous health (4% of the total) with a steady increase in number since 1995. Most Australian publications in the journal (with a small Indigenous population) have focussed on conditions such as malnutrition, diarrhoeal disease, iron deficiency, rheumatic fever, acute glomerulonephritis and respiratory and ear infections, and in settings where nearly all affected children are Indigenous. In contrast, New Zealand publications (with a large Maori and Pacific Islander population) have addressed important health issues affecting all children but emphasised the over-representation of Maori and Pacific Islanders. Publications in the journal are largely descriptive studies with relatively few systematic reviews and randomised trials. Our review attempts to cover the important Indigenous health issues in our region as represented by articles published in the Journal. The studies do document definite improvements in indigenous child health over the last 50 years.

  20. Risk and Protective Factors Associated with Gambling Products and Services: Indigenous Gamblers in North Queensland

    ERIC Educational Resources Information Center

    Breen, Helen

    2012-01-01

    As part of a larger study, this paper reports on findings into risk and protective factors associated with gambling products and services by Indigenous Australians. Both Indigenous card gambling (traditional or unregulated) and commercial gambling (regulated) were investigated. Permission was granted by Indigenous Elders and by a university ethics…

  1. Risk and Protective Factors Associated with Gambling Products and Services: Indigenous Gamblers in North Queensland

    ERIC Educational Resources Information Center

    Breen, Helen

    2012-01-01

    As part of a larger study, this paper reports on findings into risk and protective factors associated with gambling products and services by Indigenous Australians. Both Indigenous card gambling (traditional or unregulated) and commercial gambling (regulated) were investigated. Permission was granted by Indigenous Elders and by a university ethics…

  2. Indigenous Students' Wellbeing and the Mobilisation of Ethics of Care in the Contact Zone

    ERIC Educational Resources Information Center

    MacGill, Bindi Mary; Blanch, Faye

    2013-01-01

    Schools have historically been a location of oppression for Indigenous students in Australian schools. This paper explores the processes of democratising (Giroux, 1992, p. 24) the school space by Aboriginal Community Education Officers (henceforward ACEOs) through an Indigenous ethics of care framework. The enactment of Indigenous ethics of care…

  3. Spaces for Learning: Policy and Practice for Indigenous Languages in a Remote Context

    ERIC Educational Resources Information Center

    Disbray, Samantha

    2016-01-01

    Bilingual and Indigenous language and culture programmes have run in remote Australian schools with significant and continuing local support. Developments such as the new national Indigenous languages curriculum offer a further opportunity to broaden and sustain Indigenous language teaching and learning activities in these schools. However, over…

  4. Murra: Guidelines for the Evaluation of Indigenous Content on the WWW.

    ERIC Educational Resources Information Center

    Victorian Aboriginal Education Association, Fitzroy (Australia).

    There are over 600 sites on the World Wide Web with substantial Australian Indigenous content. This guide provides strategies for determining which Indigenous sites may be useful in an educational context. Section 1 deals with finding Indigenous content on the World Wide Web. The three main types of search engines are keyword, directory, and…

  5. Spaces for Learning: Policy and Practice for Indigenous Languages in a Remote Context

    ERIC Educational Resources Information Center

    Disbray, Samantha

    2016-01-01

    Bilingual and Indigenous language and culture programmes have run in remote Australian schools with significant and continuing local support. Developments such as the new national Indigenous languages curriculum offer a further opportunity to broaden and sustain Indigenous language teaching and learning activities in these schools. However, over…

  6. Literacy Practitioners' Perspectives on Adult Learning Needs and Technology Approaches in Indigenous Communities

    ERIC Educational Resources Information Center

    Eady, Michelle; Herrington, Anthony; Jones, Caroline

    2010-01-01

    Current reports of literacy rates in Australia indicate an ongoing gap in literacy skills between Indigenous and non-Indigenous Australian adults, at a time when the literacy demands of work and life are increasing. There are many perspectives on what are the literacy needs of Indigenous adults, from the perspectives of community members…

  7. A matched pair cluster randomized implementation trail to measure the effectiveness of an intervention package aiming to decrease perinatal mortality and increase institution-based obstetric care among indigenous women in Guatemala: study protocol.

    PubMed

    Kestler, Edgar; Walker, Dilys; Bonvecchio, Anabelle; de Tejada, Sandra Sáenz; Donner, Allan

    2013-03-21

    Maternal and perinatal mortality continue to be a high priority problem on the health agendas of less developed countries. Despite the progress made in the last decade to quantify the magnitude of maternal mortality, few interventions have been implemented with the intent to measure impact directly on maternal or perinatal deaths. The success of interventions implemented in less developed countries to reduce mortality has been questioned, in terms of the tendency to maintain a clinical perspective with a focus on purely medical care separate from community-based approaches that take cultural and social aspects of maternal and perinatal deaths into account. Our innovative approach utilizes both the clinical and community perspectives; moreover, our study will report the weight that each of these components may have had on reducing perinatal mortality and increasing institution-based deliveries. A matched pair cluster-randomized trial will be conducted in clinics in four rural indigenous districts with the highest maternal mortality ratios in Guatemala. The individual clinic will serve as the unit of randomization, with 15 matched pairs of control and intervention clinics composing the final sample. Three interventions will be implemented in indigenous, rural and poor populations: a simulation training program for emergency obstetric and perinatal care, increased participation of the professional midwife in strengthening the link between traditional birth attendants (TBA) and the formal health care system, and a social marketing campaign to promote institution-based deliveries. No external intervention is planned for control clinics, although enhanced monitoring, surveillance and data collection will occur throughout the study in all clinics throughout the four districts. All obstetric events occurring in any of the participating health facilities and districts during the 18 months implementation period will be included in the analysis, controlling for the cluster

  8. A matched pair cluster randomized implementation trail to measure the effectiveness of an intervention package aiming to decrease perinatal mortality and increase institution-based obstetric care among indigenous women in Guatemala: study protocol

    PubMed Central

    2013-01-01

    Background Maternal and perinatal mortality continue to be a high priority problem on the health agendas of less developed countries. Despite the progress made in the last decade to quantify the magnitude of maternal mortality, few interventions have been implemented with the intent to measure impact directly on maternal or perinatal deaths. The success of interventions implemented in less developed countries to reduce mortality has been questioned, in terms of the tendency to maintain a clinical perspective with a focus on purely medical care separate from community-based approaches that take cultural and social aspects of maternal and perinatal deaths into account. Our innovative approach utilizes both the clinical and community perspectives; moreover, our study will report the weight that each of these components may have had on reducing perinatal mortality and increasing institution-based deliveries. Methods/Design A matched pair cluster-randomized trial will be conducted in clinics in four rural indigenous districts with the highest maternal mortality ratios in Guatemala. The individual clinic will serve as the unit of randomization, with 15 matched pairs of control and intervention clinics composing the final sample. Three interventions will be implemented in indigenous, rural and poor populations: a simulation training program for emergency obstetric and perinatal care, increased participation of the professional midwife in strengthening the link between traditional birth attendants (TBA) and the formal health care system, and a social marketing campaign to promote institution-based deliveries. No external intervention is planned for control clinics, although enhanced monitoring, surveillance and data collection will occur throughout the study in all clinics throughout the four districts. All obstetric events occurring in any of the participating health facilities and districts during the 18 months implementation period will be included in the analysis

  9. Cost-Effectiveness Analysis of a Mobile Ear Screening and Surveillance Service versus an Outreach Screening, Surveillance and Surgical Service for Indigenous Children in Australia.

    PubMed

    Nguyen, Kim-Huong; Smith, Anthony C; Armfield, Nigel R; Bensink, Mark; Scuffham, Paul A

    2015-01-01

    Indigenous Australians experience a high rate of ear disease and hearing loss, yet they have a lower rate of service access and utilisation compared to their non-Indigenous counterparts. Screening, surveillance and timely access to specialist ear, nose and throat (ENT) services are key components in detecting and preventing the recurrence of ear diseases. To address the low access and utilisation rate by Indigenous Australians, a collaborative, community-based mobile telemedicine-enabled screening and surveillance (MTESS) service was trialled in Cherbourg, the third largest Indigenous community in Queensland, Australia. This paper aims to evaluate the cost-effectiveness of the MTESS service using a lifetime Markov model that compares two options: (i) the Deadly Ears Program alone (current practice involving an outreach ENT surgical service and screening program), and (ii) the Deadly Ears Program supplemented with the MTESS service. Data were obtained from the Deadly Ears Program, a feasibility study of the MTESS service and the literature. Incremental cost-utility ratios were calculated from a societal perspective with both costs (in 2013-14 Australian dollars) and quality-adjusted life years (QALYs) discounted at 5% annually. The model showed that compared with the Deadly Ears Program, the probability of an acceptable cost-utility ratio at a willingness-to-pay threshold of $50,000/QALY was 98% for the MTESS service. This cost effectiveness arises from preventing hearing loss in the Indigenous population and the subsequent reduction in associated costs. Deterministic and probability sensitivity analyses indicated that the model was robust to parameter changes. We concluded that the MTESS service is a cost-effective strategy. It presents an opportunity to resolve major issues confronting Australia's health system such as the inequitable provision and access to quality healthcare for rural and remotes communities, and for Indigenous Australians. Additionally, it may

  10. Cost-Effectiveness Analysis of a Mobile Ear Screening and Surveillance Service versus an Outreach Screening, Surveillance and Surgical Service for Indigenous Children in Australia

    PubMed Central

    Nguyen, Kim-Huong; Smith, Anthony C.; Armfield, Nigel R.; Bensink, Mark; Scuffham, Paul A.

    2015-01-01

    Indigenous Australians experience a high rate of ear disease and hearing loss, yet they have a lower rate of service access and utilisation compared to their non-Indigenous counterparts. Screening, surveillance and timely access to specialist ear, nose and throat (ENT) services are key components in detecting and preventing the recurrence of ear diseases. To address the low access and utilisation rate by Indigenous Australians, a collaborative, community-based mobile telemedicine-enabled screening and surveillance (MTESS) service was trialled in Cherbourg, the third largest Indigenous community in Queensland, Australia. This paper aims to evaluate the cost-effectiveness of the MTESS service using a lifetime Markov model that compares two options: (i) the Deadly Ears Program alone (current practice involving an outreach ENT surgical service and screening program), and (ii) the Deadly Ears Program supplemented with the MTESS service. Data were obtained from the Deadly Ears Program, a feasibility study of the MTESS service and the literature. Incremental cost-utility ratios were calculated from a societal perspective with both costs (in 2013–14 Australian dollars) and quality-adjusted life years (QALYs) discounted at 5% annually. The model showed that compared with the Deadly Ears Program, the probability of an acceptable cost-utility ratio at a willingness-to-pay threshold of $50,000/QALY was 98% for the MTESS service. This cost effectiveness arises from preventing hearing loss in the Indigenous population and the subsequent reduction in associated costs. Deterministic and probability sensitivity analyses indicated that the model was robust to parameter changes. We concluded that the MTESS service is a cost-effective strategy. It presents an opportunity to resolve major issues confronting Australia’s health system such as the inequitable provision and access to quality healthcare for rural and remotes communities, and for Indigenous Australians. Additionally, it

  11. The magnitude of Indigenous and non-Indigenous oral health inequalities in Brazil, New Zealand and Australia.

    PubMed

    Schuch, Helena S; Haag, Dandara G; Kapellas, Kostas; Arantes, Rui; Peres, Marco A; Thomson, W M; Jamieson, Lisa M

    2017-10-01

    To compare the magnitude of relative oral health inequalities between Indigenous and non-Indigenous persons from Brazil, New Zealand and Australia. Data were from surveys in Brazil (2010), New Zealand (2009) and Australia (2004-06 and 2012). Participants were aged 35-44 years and 65-74 years. Indigenous and non-Indigenous inequalities were estimated by prevalence ratios (PR) and their corresponding 95% confidence intervals (CI), adjusting for sex, age and income. Outcomes included inadequate dentition, untreated dental caries, periodontal disease and the prevalence of "fair" or "poor" self-rated oral health in Australia and New Zealand, and satisfaction with mouth/teeth in Brazil (SROH). Irrespective of country, Indigenous persons had worse oral health than their non-Indigenous counterparts in all indicators. The magnitude of these ratios was greatest among Indigenous and non-Indigenous Australians, who, after adjustments, had 2.77 times the prevalence of untreated dental caries (95% CI 1.76, 4.37), 5.14 times the prevalence of fair/poor SROH (95% CI 2.53, 10.43). Indigenous people had poorer oral health than their non-Indigenous counterparts, regardless of setting. The magnitude of the relative inequalities was greatest among Indigenous Australians for untreated dental decay and poor SROH. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Establishing contemporary trends in hepatitis B sero-epidemiology in an Indigenous population.

    PubMed

    Davies, Jane; Li, Shu Qin; Tong, Steven Y; Baird, Rob W; Beaman, Miles; Higgins, Geoff; Cowie, Benjamin C; Condon, John R; Davis, Joshua S

    2017-01-01

    Indigenous populations globally are disproportionately affected by chronic hepatitis B virus (HBV) infection however contemporary sero-prevalence data are often absent. In the Indigenous population of the Northern Territory (NT) of Australia the unique C4 sub-genotype of HBV universally circulates. There are no studies of the sero-prevalence, nor the impact of the vaccination program (which has a serotype mismatch compared to C4), at a population-wide level. We examined all available HBV serology results obtained from the three main laboratories serving NT residents between 1991 and 2011. Data were linked with a NT government database to determine Indigenous status and the most recent test results for each individual were extracted as a cross-sectional database including 88,112 unique individuals. The primary aim was to obtain a contemporary estimate of HBsAg positivity for the NT by Indigenous status. Based on all tests from 2007-2011 (35,633 individuals), hepatitis B surface antigen (HBsAg) positivity was 3·40% (95%CI 3·19-3·61), being higher in Indigenous (6·08%[5·65%-6·53%]) than non-Indigenous (1·56%[1·38%-1·76%]) Australians, p<0·0001. Birth cohort analysis showed HBsAg positivity fell over time for Indigenous people, with this decrease commencing prior to universal infant vaccination (which commenced in 1990), with an ongoing but slower rate of decline since 1990, (0·23% decrease per year versus 0·17%). HBsAg positivity is high in the NT, particularly in the Indigenous population. HBsAg positivity has fallen over time but a substantial part of this decrease is due to factors other than the universal vaccination program.

  13. Establishing contemporary trends in hepatitis B sero-epidemiology in an Indigenous population

    PubMed Central

    Li, Shu Qin; Tong, Steven Y.; Baird, Rob W.; Beaman, Miles; Higgins, Geoff; Cowie, Benjamin C.; Condon, John R.; Davis, Joshua S.

    2017-01-01

    Background Indigenous populations globally are disproportionately affected by chronic hepatitis B virus (HBV) infection however contemporary sero-prevalence data are often absent. In the Indigenous population of the Northern Territory (NT) of Australia the unique C4 sub-genotype of HBV universally circulates. There are no studies of the sero-prevalence, nor the impact of the vaccination program (which has a serotype mismatch compared to C4), at a population-wide level. Methods We examined all available HBV serology results obtained from the three main laboratories serving NT residents between 1991 and 2011. Data were linked with a NT government database to determine Indigenous status and the most recent test results for each individual were extracted as a cross-sectional database including 88,112 unique individuals. The primary aim was to obtain a contemporary estimate of HBsAg positivity for the NT by Indigenous status. Results Based on all tests from 2007–2011 (35,633 individuals), hepatitis B surface antigen (HBsAg) positivity was 3·40% (95%CI 3·19–3·61), being higher in Indigenous (6·08%[5·65%-6·53%]) than non-Indigenous (1·56%[1·38%-1·76%]) Australians, p<0·0001. Birth cohort analysis showed HBsAg positivity fell over time for Indigenous people, with this decrease commencing prior to universal infant vaccination (which commenced in 1990), with an ongoing but slower rate of decline since 1990, (0·23% decrease per year versus 0·17%). Conclusions HBsAg positivity is high in the NT, particularly in the Indigenous population. HBsAg positivity has fallen over time but a substantial part of this decrease is due to factors other than the universal vaccination program. PMID:28886050

  14. Trends in cancer incidence and survival for Indigenous and non-Indigenous people in the Northern Territory.