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.

Suicidal behaviour in Indigenous compared to non-Indigenous males in urban and regional Australia: Prevalence data suggest disparities increase across age groups.

PubMed

Armstrong, Gregory; Pirkis, Jane; Arabena, Kerry; Currier, Dianne; Spittal, Matthew J; Jorm, Anthony F

2017-12-01

We compare the prevalence of suicidal thoughts and attempts between Indigenous and non-Indigenous males in urban and regional Australia, and examine the extent to which any disparity between Indigenous and non-Indigenous males varies across age groups. We used data from the baseline wave of The Australian Longitudinal Study on Male Health (Ten to Men), a large-scale cohort study of Australian males aged 10-55 years residing in urban and regional areas. Indigenous identification was determined through participants self-reporting as Aboriginal, Torres Strait Islander or both. The survey collected data on suicidal thoughts in the preceding 2 weeks and lifetime suicide attempts. A total of 432 participants (2.7%) identified as Indigenous and 15,425 as non-Indigenous (97.3%). Indigenous males were twice as likely as non-Indigenous males to report recent suicidal thoughts (17.6% vs 9.4%; odds ratio = 2.1, p < 0.001) and more than three times as likely to report a suicide attempt in their lifetime (17.0% vs 5.1%; odds ratio = 3.6; p < 0.001). The prevalence of recent suicidal thoughts did not differ between Indigenous and non-Indigenous males in younger age groups, but a significant gap emerged among men aged 30-39 years and was largest among men aged 40-55 years. Similarly, the prevalence of lifetime suicide attempts did not differ between Indigenous and non-Indigenous males in the 14- to 17-years age group, but a disparity emerged in the 18- to 24-years age group and was even larger among males aged 25 years and older. Our paper presents unique data on suicidal thoughts and attempts among a broad age range of Indigenous and non-Indigenous males. The disparity in the prevalence of suicidal thoughts increased across age groups, which is in contrast to the large disparity between the Indigenous and non-Indigenous suicide rates in younger age groups.

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 CVD in this high-risk population. The apparent different associations of fibrinogen with cardiovascular disease risk markers in men and women should be explored further.

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…

Making an APPropriate Care Program for Indigenous Cardiac Disease: Customization of an Existing Cardiac Rehabilitation Program.

PubMed

Bradford, DanaKai; Hansen, David; Karunanithi, Mohan

2015-01-01

Cardiovascular disease is a major health problem for all Australians and is the leading cause of death in Aboriginal and Torres Strait Islanders. In 2010, more then 50% of all heart attack deaths were due to repeated events. Cardiac rehabilitation programs have been proven to be effective in preventing the recurrence of cardiac events and readmission to hospitals. There are however, many barriers to the use of these programs. To address these barriers, CSIRO developed an IT enabled cardiac rehabilitation program delivered by mobile phone through a smartphone app and succesfully trialed it in an urban general population. If these results can be replicated in Indigenous populations, the program has the potential to significantly improve life expectancy and help close the gap in health outcomes. The challenge described in this paper is customizing the existing cardiac health program to make it culturally relevant and suitable for Indigenous Australians living in urban and remote communities.

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.

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.

Presentation and outcomes of indigenous Australians with peripheral artery disease.

PubMed

Singh, Tejas P; Moxon, Joseph V; Healy, Genevieve N; Cadet-James, Yvonne; Golledge, Jonathan

2018-05-16

The risk factors for peripheral artery disease (PAD) are more common in Indigenous than non-Indigenous Australians, however the presentation and outcome of PAD in Indigenous Australians has not been previously investigated. The aim of this prospective cohort study was to compare the presenting characteristics and clinical outcome of Indigenous and non-Indigenous Australians with PAD. PAD patients were prospectively recruited and followed-up since 2003 from an outpatient vascular clinic in Townsville, Australia. Presenting symptoms and risk factors in Indigenous and non-Indigenous patients were compared using Pearson's χ2 test and Mann Whitney U test. Kaplan Meier survival analysis and Cox proportional hazard analysis were used to compare the incidence of myocardial infarction (MI), stroke or death (major cardiovascular events) among Indigenous and non-Indigenous patients. Four hundred and one PAD patients were recruited, of which 16 were Indigenous and 385 were non-Indigenous Australians. Indigenous Australians were younger at entry (median age 63.3 [54.7-67.8] vs 69.6 [63.3-75.4]), more commonly current smokers (56.3% vs 31.4%), and more frequently had insulin-treated diabetes (18.8% vs 5.2%). During a median follow-up of 2.5 years, five and 45 major cardiovascular events were recorded amongst Indigenous and non-Indigenous Australians, respectively. Indigenous Australians were at ~ 5-fold greater risk of major cardiovascular events (adjusted hazard ratio 4.72 [95% confidence intervals 1.41-15.78], p = 0.012) compared to non-Indigenous Australians. These findings suggest that Indigenous Australians with PAD present at a younger age, have higher rates of smoking and insulin-treated diabetes, and poorer clinical outcomes compared to non-Indigenous Australians.

The quality of Indigenous identification in administrative health data in Australia: insights from studies using data linkage

PubMed Central

2012-01-01

Background Missing or incorrect Indigenous status in health records hinders monitoring of Indigenous health indicators. Linkage of administrative data has been used to improve the ascertainment of Indigenous status. Data linkage was pioneered in Western Australia (WA) and is now being used in other Australian states. This systematic review appraises peer-reviewed Australian studies that used data linkage to elucidate the impact of under-ascertainment of Indigenous status on health indicators. Methods A PubMed search identified eligible studies that used Australian linked data to interrogate Indigenous identification using more than one identifier and interrogated the impact of the different identifiers on estimation of Indigenous health indicators. Results Eight papers were included, five from WA and three from New South Wales (NSW). The WA papers included a self-identified Indigenous community cohort and showed improved identification in hospital separation data after 2000. In CVD hospitalised patients (2000–05), under-identification was greater in urban residents, older people and socially more advantaged Indigenous people, with varying algorithms giving different estimates of under-count. Age-standardised myocardial infarction incidence rates (2000–2004) increased by about 10%-15% with improved identification. Under-ascertainment of Indigenous identification overestimated secular improvements in life expectancy and mortality whereas correcting infectious disease notifications resulted in lower Indigenous/ non-Indigenous rate ratios. NSW has a history of poor Indigenous identification in administrative data systems, but the NSW papers confirmed the usefulness of data linkage for improving Indigenous identification and the potential for very different estimates of Indigenous disease indicators depending upon the algorithm used for identification. Conclusions Under-identification of Indigenous status must be addressed in health analyses concerning Indigenous health differentials – they cannot be ignored or wished away. This problem can be substantially diminished through data linkage. Under-identification of Indigenous status impacts differently in different disease contexts, generally resulting in under-estimation of absolute and relative Indigenous health indicators, but may perversely overestimate Indigenous rates and differentials in the setting of stigma-associated conditions such as sexually-transmitted and blood-borne virus infections. Under-numeration in Census surveys also needs consideration to address the added problem of denominator undercounts. PMID:23157943

Caries and periodontal disease in Indigenous adults in Australia: a case of limited and non-contemporary data.

PubMed

de Silva, Andrea M; Martin-Kerry, Jacqueline M; McKee, Katherine; Cole, Deborah

2017-08-01

Objective The aim of the present study was to identify all evidence about the prevalence and severity of clinically measured caries and periodontal disease in Indigenous adults in Australia published in peer-reviewed journals and to summarise trends over time. In addition, we examined whether the studies investigated associations between putative risk factors and levels of caries and periodontal disease. Methods PubMed was searched in September 2014, with no date limitations, for published peer-reviewed articles reporting the prevalence rates and/or severity of caries and periodontal disease in Indigenous adults living in Australia. Articles were excluded if measurement was not based on clinical assessment and if oral disease was reported only in a specific or targeted sample, and not the general population. Results The search identified 18 papers (reporting on 10 primary studies) that met the inclusion criteria. The studies published clinical data about dental caries and/or periodontal disease in Australian Indigenous adults. The studies reported on oral health for Indigenous adults living in rural (40%), urban (10%) and both urban and rural (50%) locations. Included studies showed that virtually all Indigenous adults living in rural locations had periodontal disease. The data also showed caries prevalence ranged from 46% to 93%. Although 10 studies were identified, the peer-reviewed literature was extremely limited and no published studies were identified that provided statistics for a significant proportion of Australia (Victoria, Tasmania, Queensland or the Australian Capital Territory). There were also inconsistencies in how the data were reported between studies, making comparisons difficult. Conclusions This review highlights a lack of robust and contemporary data to inform the development of policies and programs to address the disparities in oral health in Indigenous populations living in many parts of Australia. What is known about the topic? Many studies report that Indigenous people in Australia have poorer general health compared with non-Indigenous people. What does this paper add? This paper documents the available caries and periodontal disease prevalence and experience for Indigenous adults in Australia published in peer-reviewed journals. It demonstrates significant limitations in the data, including no data in several large Australian jurisdictions, inconsistency with reporting methods and most data available being for Indigenous adults living in rural locations. Therefore, the oral health data available in the peer-reviewed literature do not reflect the situation of all Indigenous people living in Australia. What are the implications for practitioners? It is important for oral health practitioners to have access to current and relevant statistics on the oral health of Indigenous Australians. However, we have highlighted significant evidence gaps for this population group within the peer-reviewed literature and identified the limitations of the available data upon which decisions are currently being made. This paper also identifies ways to capture and report oral health data in the future to enable more meaningful comparisons and relevance for use in policy development.

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

2017-12-01

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, 0.60 for men), and diabetes in combination with never having had an eye examination (OR, 14.47). Vision loss is more prevalent in Indigenous Australians than in non-Indigenous Australians, highlighting that improvements in eye healthcare in Indigenous communities are required. The leading causes of vision loss were uncorrected refractive error and cataract, which are readily treatable. Other countries with Indigenous communities may benefit from conducting similar surveys of Indigenous and non-Indigenous populations. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Immunisation timeliness in a cohort of urban Aboriginal and Torres Strait Islander children.

PubMed

Lovie-Toon, Yolanda G; Hall, Kerry K; Chang, Anne B; Anderson, Jennie; O'Grady, Kerry-Ann F

2016-11-14

To evaluate immunisation coverage, timeliness and predictors of delayed receipt in urban Australian Indigenous children during the first 18 months of life. Cross-sectional retrospective analysis of data collected from 140 Australian Indigenous children aged < 5 years at the time of enrolment in a prospective cohort study on respiratory illness between 14 February 2013 and 28 January 2015. Children were recruited through an urban community primary health care centre in the Northern suburbs of Brisbane, Queensland. The proportion of children with completed immunisation schedules was 50 of 105 (47.6%) at 7 months, 30 of 85 (35.3%) at 13 months and 12 of 65 (18.5%) at 19 months. Timely receipt of diphtheria-tetanus-pertussis decreased from 78.4% at 2 months of age to 63.7 and 59.3% at 4 and 6 months respectively. Amongst the 105 parents/guardians with children ≥7 months at enrolment, 71 (67.6%) incorrectly reported their child's immunisation status. Delayed vaccine receipt was significantly associated (p ≤0.05) with having multiple children in the household, mother's unemployment and premature birth. Coverage and timeliness among this population is suboptimal and decreases as children age. Parent/guardian reporting of vaccination status was unreliable. Children of unemployed mothers and those with multiple siblings should be targeted to improve community immunisation timeliness due to a greater risk of vaccination delay. High quality trials, conducted in several settings to account for the diversity of Australian Indigenous communities are urgently needed to identify culturally appropriate, effective and sustainable strategies to improve immunisation targets in children.

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…

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.

Illicit and injecting drug use among Indigenous young people in urban, regional and remote Australia.

PubMed

Bryant, Joanne; Ward, James; Wand, Handan; Byron, Kat; Bamblett, Andrew; Waples-Crowe, Peter; Betts, Sarah; Coburn, Tony; Delaney-Thiele, Dea; Worth, Heather; Kaldor, John; Pitts, Marian

2016-07-01

To examine patterns of illicit drug use among Australian Indigenous young people, identify correlates of frequent use separately in urban, regional and remote settings and characterise those who inject. Cross-sectional design at 40 Indigenous events. Self-complete surveys were administered to Indigenous people aged 16-29 years using mobile devices. 2,877 participants completed the survey. One in five reported using cannabis at least weekly in the previous year, but the use of other drugs was less prevalent. Patterns of drug use were largely similar across regions, although more participants in urban and regional areas reported using ecstasy (12% vs 11% vs 5%) and cocaine (6% vs 3% vs 1%) and more reported weekly cannabis use (18% vs 22% vs 14%). Injecting was rare (3%) but those who did inject reported a high incidence of needle sharing (37%). Methamphetamine (37%), heroin (36%) and methadone (26%) were the most commonly injected drugs, and injecting was related to prison experience (AOR 5.3 95% CI 2.8-10.0). Attention is needed in relation to cannabis use, particularly among those Indigenous young people living in regional and urban settings. Also, although injecting is uncommon, it is associated with prison involvement. Priority must be given to reducing the numbers of Indigenous youth entering justice settings, delaying the age at first entry to justice settings, and reducing the risk of BBV acquisition while in custody through, for example, prison-based NSP, BBV education, and Indigenous-specific treatment that emphasises connection to country and culture. [Bryant J, Ward J, Wand H, Byron K, Bamblett A, Waples-Crowe P, Betts S, Coburn T, Delaney-Thiele D, Worth H, Kaldor J, Pitts M. Illicit and injecting drug use among Indigenous young people in urban, regional and remote Australia. Drug Alcohol Rev 2016;35:447-455]. © 2015 Australasian Professional Society on Alcohol and other Drugs.

Elevated reporting of unprotected anal intercourse and injecting drug use but no difference in HIV prevalence among Indigenous Australian men who have sex with men compared with their Anglo-Australian peers.

PubMed

Lea, Toby; Costello, Michael; Mao, Limin; Prestage, Garrett; Zablotska, Iryna; Ward, James; Kaldor, John; de Wit, John; Holt, Martin

2013-05-01

Although half of the HIV notifications among Aboriginal and Torres Strait Islander people ('Indigenous Australians') are attributed to homosexual transmission, there has been little research examining sexual and drug use risk practices among Indigenous Australian men who have sex with men (MSM). Respondents were Indigenous Australian (n=1278) and Anglo-Australian men (n=24002) participating in the routine cross-sectional Gay Community Periodic Surveys conducted in Australia from 2007 to 2011. Sociodemographic characteristics, sexual risk practices, drug use, HIV testing and HIV status of Indigenous and Anglo-Australian men were compared and evaluated to discover whether Indigenous status was independently associated with HIV risk practices. Although an equivalent proportion of Indigenous and Anglo-Australian men reported being HIV-positive (9.6%), Indigenous MSM were more likely to report unprotected anal intercourse with casual partners in the previous 6 months (27.9% v. 21.5%; Adjusted odds ratio (AOR)=1.29, 95% confidence interval (CI): 1.11-1.49). Indigenous men were more likely than Anglo-Australian men to report use of several specific drugs and twice as likely to report injecting drug use in the previous 6 months (8.8% v. 4.5%; AOR=1.43, 95% CI: 1.11-1.86). Despite a higher proportion of Indigenous men reporting sexual and drug use practices that increase the risk of HIV transmission, there were no differences in the HIV status of Indigenous and Anglo-Australian men. However, the elevated rates of risk practices suggest that Indigenous MSM should remain a focus for HIV prevention, care and support.

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

PubMed

Sullivan, Corrinne Tayce

2018-04-01

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.

The facilitators and barriers of physical activity among Aboriginal and Torres Strait Islander regional sport participants.

PubMed

Péloquin, Claudie; Doering, Thomas; Alley, Stephanie; Rebar, Amanda

2017-10-01

Disparities in health perspectives between Indigenous and non-Indigenous populations are major concerns in many of the world's well-developed nations. Indigenous populations are largely less healthy, more prone to chronic diseases, and have an earlier overall mortality than non-Indigenous populations. Low levels of physical activity (PA) contribute to the high levels of disease in Indigenous Australians. Qualitative analysis of structured one-on-one interviews discussing PA in a regional setting. Participants were 12 Indigenous Australian adults, and 12 non-Indigenous Australian adults matched on age, sex, and basketball division. Most participants reported engaging in regular exercise; however, the Indigenous group reported more barriers to PA. These factors included cost, time management and environmental constraints. The physical facilitators identified by our Indigenous sample included social support, intrinsic motivation and role modelling. Findings describe individual and external factors that promote or constraint PA as reported by Indigenous Australian adults. Results indicate that Indigenous people face specific barriers to PA when compared to a non-Indigenous sample. Implications for public health: This study is the first to compare the perspective of Indigenous Australians to a matched group of non-Indigenous Australians and provides useful knowledge to develop public health programs based on culturally sensitive data. © 2017 The Authors.

The Age at Which Indigenous Australians Undertake Qualifications: A Descriptive Analysis

ERIC Educational Resources Information Center

Biddle, Nicholas

2006-01-01

Reducing disparities in education outcomes between Indigenous and non-Indigenous Australians is one of the main ways in which the relative disadvantage Indigenous Australians face will be overcome. Relative and absolute participation rates in all forms of education have improved, however they are still unacceptably low. Those Indigenous…

Suicides in Aboriginal and Torres Strait Islander children: analysis of Queensland Suicide Register.

PubMed

Soole, Rebecca; Kõlves, Kairi; De Leo, Diego

2014-12-01

Suicide rates among Indigenous Australian children are higher than for other Australian children. The current study aimed to identify factors associated with Indigenous child suicide when compared to other Australian children. Using the Queensland Suicide Register, suicides in Indigenous children (10-14 years) and other Australian children in the same age band were compared. Between 2000 and 2010, 45 child suicides were recorded: 21 of Indigenous children and 24 of other Australian children. This corresponded to a suicide rate of 10.15 suicides per 100,000 for Indigenous children - 12.63 times higher than the suicide rate for other Australian children (0.80 per 100,000). Hanging was the predominant method used by all children. Indigenous children were significantly more likely to suicide outside the home, to be living outside the parental home at time of death, and be living in remote or very remote areas. Indigenous children were found to consume alcohol more frequently before suicide, compared to other Australian children. Current and past treatments of psychiatric disorders were significantly less common among Indigenous children compared to other Australian children. Western conceptualisation of mental illness may not adequately embody Indigenous people's holistic perspective regarding mental health. Further development of culturally appropriate suicide prevention activities for Aboriginal and Torres Strait Islander children is required. © 2014 Public Health Association of Australia.

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…

Thirty-day Outcomes in Indigenous Australians Following Coronary Artery Bypass Grafting.

PubMed

O'Brien, Jessica; Saxena, Akshat; Reid, Christopher M; Tran, Lavinia; Baker, Robert; Newcomb, Andrew; Smith, Julian; Huq, Molla M; Duffy, Stephen J

2018-03-07

Indigenous Australians have higher rates of cardiovascular disease and co-morbidities compared to their non-Indigenous counterparts. We sought to evaluate whether Indigenous status per se portends a worse prognosis following isolated coronary artery bypass grafting (CABG). The outcomes of 778 Indigenous Australians (55±10 years; 32% female) enrolled in the Australian and New Zealand Society of Cardiac and Thoracic Surgeons registry were compared to 36,124 non-Indigenous Australians (66±10 years; 21% female) following isolated CABG. In a secondary analysis, patients were propensity-matched by age, gender, renal function, diabetes, and ejection fraction (778 individuals in each group). Indigenous Australians were younger and more likely to be female, current smokers, to have diabetes, hypertension, renal impairment, heart failure, and previous CABG (all p<0.04). Indigenous patients had fewer bypasses with arterial conduits (including less internal mammary artery use), and a higher number of distal vein anastomoses (p<0.001). Post-operative bleeding rates were higher in indigenous patients (p=0.001). However, in-hospital and 30-day all-cause mortality, and rates of 30-day readmission were similar between both groups, though cardiac mortality was higher in the Indigenous cohort (1.5% vs. 0.8%, p=0.02). With propensity-matching, rates of post-operative complications were similar amongst the two groups, with the exception of bleeding, which remained higher in Indigenous Australians (p=0.03). Despite procedural differences and higher rates of baseline co-morbidities, Indigenous Australians do not have worse short-term outcomes following isolated CABG. Given the higher rates of baseline co-morbidities and lower rates of arterial conduit use, it will be essential to determine long-term outcomes. This article is protected by copyright. All rights reserved.

Improving Labour Market Outcomes through Education and Training. Issues Paper No. 9. Produced for the Closing the Gap Clearinghouse

ERIC Educational Resources Information Center

Karmel, Tom; Misko, Josie; Blomberg, Davinia; Bednarz, Alice; Atkinson, Georgina

2014-01-01

In recent years, the level of participation and attainment by Indigenous Australians in education and training has improved, yet substantial gaps still exist between Indigenous Australians and non-Indigenous Australians. Education has to be a key focus if the gap between Indigenous and non-Indigenous employment rates is to be closed. This report…

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 cases may be common in this population. In order to optimise management and to inform policy, high quality research on heart failure in Indigenous Australians is required to delineate accurate epidemiological indicators and to appraise health service provision. PMID:23116367

Leadership as a Personal Journey: An Indigenous Perspective.

PubMed

Doyle, Kerrie; Hungerford, Catherine

2015-05-01

Indigenous Australians have higher levels of mental illness, self-harm, suicide and substance abuse than non-Indigenous Australians, as well as more frequent contact with the criminal justice system. These indices point to the need for strong leadership to support Close the Gap programmes that have now been implemented across Australia. This article considers leadership as a journey of learning for Australian Indigenous leaders. Through the use of story, it is suggested that a situational leadership approach, incorporating the principles of mindfulness, provides the most appropriate framework for Indigenous leaders who work with Indigenous communities. Flexible approaches are needed to meet the needs of diverse Indigenous populations, and address the complex challenges involved, including lateral violence. Such flexibility will enable Indigenous leaders and communities to work together to achieve improvements in the health outcomes, not only for Indigenous Australians, but also for Indigenous populations worldwide.

"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,…

Sources of Satisfaction and Stress among Indigenous Academic Teachers: Findings from a National Australian Study

ERIC Educational Resources Information Center

Asmar, Christine; Page, Susan

2009-01-01

Academics of Aboriginal and/or Torres Strait Islander descent are few in number but play a vital role in Australian university teaching. In addition to teaching both Indigenous and non-Indigenous students, they interact with academic colleagues in a context where pressures to "Indigenize" Australian curricula and increase Indigenous…

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

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)…

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

PubMed

Lyons, Jasmine G; O'Dea, Kerin; Walker, Karen Z

2014-06-02

Low plasma high-density lipoprotein cholesterol (HDL-C) levels are a strong, independent, but poorly understood risk factor for cardiovascular disease (CVD). Although this atherogenic lipid abnormality has been widely reported in Australia's Indigenous peoples, Aboriginal and Torres Strait Islanders, the evidence has not come under systematic review. This review therefore examines published data for Indigenous Australians reporting 1) mean HDL-C levels for both sexes and 2) factors associated with low HDL-C. PubMed, Medline and Informit ATSI Health databases were systematically searched between 1950 and 2012 for studies on Indigenous Australians reporting mean HDL-C levels in both sexes. Retrieved studies were evaluated by standard criteria. Low HDL-C was defined as: <1.0 mmol/L. Analyses of primary data associating measures of HDL-C with other CVD risk factors were also performed. 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. 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 prevalence and inflammatory markers suggest a particularly adverse CVD risk factor profile. An absence of sex dichotomy in HDL-C levels warrants further investigation.

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.

The Participation of Australian Indigenous Students in Higher Education: A Scoping Review of Empirical Research, 2000-2016

ERIC Educational Resources Information Center

Gore, Jennifer; Patfield, Sally; Fray, Leanne; Holmes, Kathryn; Gruppetta, Maree; Lloyd, Adam; Smith, Maxwell; Heath, Treesa

2017-01-01

While access to higher education has increased for Indigenous Australians, participation and completion rates remain lower than those of non-Indigenous Australians. A sound evidence base is needed to ground equity initiatives if they are to address the specific needs of Indigenous students. This paper presents the results of a scoping review of…

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.

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.

Indigenous Australians and Preschool Education: Who Is Attending?

ERIC Educational Resources Information Center

Biddle, Nicholas

2007-01-01

This paper discusses the individual, family, household and area level characteristics associated with preschool attendance for Indigenous and non-Indigenous Australians (aged three to five years who are not at school). Controlling for these factors explains all of the difference between Indigenous and non-Indigenous attendance rates for…

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.

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.

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.

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…

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. PMID:22513223

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

Anderson, Kate; Devitt, Jeannie; Cunningham, Joan; Preece, Cilla; Jardine, Meg; Cass, Alan

2012-04-18

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. 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. 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. 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.

A systematic review of adherence in Indigenous Australians: an opportunity to improve chronic condition management.

PubMed

de Dassel, Jessica Langloh; Ralph, Anna P; Cass, Alan

2017-12-27

Indigenous Australians experience high rates of chronic conditions. It is often asserted Indigenous Australians have low adherence to medication; however there has not been a comprehensive examination of the evidence. This systematic literature review presents data from studies of Indigenous Australians on adherence rates and identifies supporting factors and impediments from the perspective of health professionals and patients. Search strategies were used to identify literature in electronic databases and websites. The following databases were searched: Scopus, Medline, CINAHL Plus, PsycINFO, Academic Search Premier, Cochrane Library, Trove, Indigenous Health infonet and Grey Lit.org . Articles in English, reporting original data on adherence to long-term, self-administered medicines in Australia's Indigenous populations were included. Data were extracted into a standard template and a quality assessment was undertaken. Forty-seven articles met inclusion criteria. Varied study methodologies prevented the use of meta-analysis. health professionals believe adherence is a significant problem for Indigenous Australians; however, adherence rates are rarely measured. Health professionals and patients often reported the same barriers and facilitators, providing a framework for improvement. There is no evidence that medication adherence amongst Indigenous Australians is lower than for the general population. Nevertheless, the heavy burden of morbidity and mortality faced by Indigenous Australians with chronic conditions could be alleviated by enhancing medication adherence. Some evidence supports strategies to improve adherence, including the use of dose administration aids. This evidence should be used by clinicians when prescribing, and to implement and evaluate programs using standard measures to quantify adherence, to drive improvement in health outcomes.

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…

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…

Beyond the Biomedical Paradigm: The Formation and Development of Indigenous Community-Controlled Health Organizations in Australia.

PubMed

Khoury, Peter

2015-01-01

This article describes the formation and development of Aboriginal Community-Controlled Health Services in Australia, with emphasis on the Redfern Aboriginal Medical Service in Sydney. These organizations were established in the 1970s by Indigenous Australians who were excluded from and denied access to mainstream health services. The aim of this research was to explore notions of Indigenous agency against a historical backdrop of dispossession, colonialism, and racism. Aboriginal Community-Controlled Health Services act as a primary source of healthcare for many Indigenous communities in rural and urban areas. This study examined their philosophy of healthcare, the range of services provided, their problems with state bureaucracies and government funding bodies, and the imposition of managerialist techniques and strategies on their governance. Essentially, these organizations transcend individualistic, biomedical, and bureaucratic paradigms of health services by conceptualizing and responding to Indigenous health needs at a grassroots level and in a broad social and political context. They are based on a social model of health. © SAGE Publications 2015.

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…

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…

"Re-Casting Terra Nullius Design-Blindness": Better Teaching of Indigenous Knowledge and Protocols in Australian Architecture Education

ERIC Educational Resources Information Center

Tucker, Richard; Choy, Darryl Low; Heyes, Scott; Revell, Grant; Jones, David

2018-01-01

This paper reviews the current status and focus of Australian Architecture programs with respect to Indigenous Knowledge and the extent to which these tertiary programs currently address reconciliation and respect to Indigenous Australians in relation to their professional institutions and accreditation policies. The paper draws upon the findings…

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…

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…

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.

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

Retinal photography screening programs to prevent vision loss from diabetic retinopathy in rural and urban Australia: a review.

PubMed

Tapp, Robyn J; Svoboda, Jean; Fredericks, Bronwyn; Jackson, A Jonathan; Taylor, Hugh R

2015-02-01

This review assessed the effectiveness of diabetic retinopathy (DR) screening programs, using retinal photography in Australian urban and rural settings, and considered implications for public health strategy and policy. An electronic search of MEDLINE, PubMed, and Embase for studies published between 1 January 1996 and the 30 June 2013 was undertaken. Key search terms were "diabetic retinopathy," "screening," "retinal photography" and "Australia." Twelve peer-reviewed publications were identified. The 14 DR screening programs identified from the 12 publications were successfully undertaken in urban, rural and remote communities across Australia. Locations included a pathology collection center, and Indigenous primary health care and Aboriginal community controlled organizations. Each intervention using retinal photography was highly effective at increasing the number of people who underwent screening for DR. The review identified that prior to commencement of the screening programs a median of 48% (range 16-85%) of those screened had not undergone a retinal examination within the recommended time frame (every year for Indigenous people and every 2 years for non-Indigenous people in Australia). A median of 16% (range 0-45%) of study participants had evidence of DR. This review has shown there have been many pilot and demonstration projects in rural and urban Australia that confirm the effectiveness of retinal photography-based screening for DR.

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…

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…

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.

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…

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.

Strategies for Improving Indigenous Financial Literacy in Schools

ERIC Educational Resources Information Center

Bin-Sallik, MaryAnn; Adams, Isabella; Vemuri, Siva Ram

2004-01-01

The Indigenous Australian population is not only considerably younger than the non-Indigenous population but is also on the rise. The challenge for many is to provide the kind of education that equips young Indigenous Australians with the necessary skills for managing their money. This challenge is further compounded, as the adult Indigenous…

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…

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…

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…

Visual outcomes following vitrectomy for diabetic retinopathy amongst Indigenous and non-Indigenous Australians in South Australia and the Northern Territory.

PubMed

Kaidonis, Georgia; Hassall, Mark M; Phillips, Russell; Raymond, Grant; Saha, Niladri; Wong, George Hc; Gilhotra, Jagjit S; Liu, Ebony; Burdon, Kathryn P; Henderson, Tim; Newland, Henry; Lake, Stewart R; Craig, Jamie E

2018-05-01

Visual outcomes following diabetic vitrectomy have not previously been studied in an Australian population. This analysis aimed to determine the rate of, and factors associated with visual success following diabetic vitrectomy performed for Indigenous and non-Indigenous Australians, and investigate factors predisposing to early progression to diabetic retinopathy (DR) requiring vitrectomy. Retrospective, population-based audit. All patients undergoing vitrectomy for the complications of DR in South Australia (SA) and the Northern Territory (NT) between 2007 and 2011. Medical records were audited and data collected, including demographics, diabetic history, past treatment for DR, indication for vitrectomy and visual acuity pre and postoperatively. Visual success (gain of ≥15 ETDRS letters) at 6 and 12 months, postoperatively. A total of 495 diabetic vitrectomies, for 404 eyes of 335 patients were performed in SA and NT between 2007 and 2011. 77 (23%) patients requiring diabetic vitrectomy were Indigenous Australians. 87% of patients undergoing diabetic vitrectomy had stable or improved vision at 1 year, postoperatively. There was no significant difference between indigenous and non-indigenous eyes achieving visual success (P = 0.929). Timely preoperative laser treatment (P = 0.03) and preoperative visual acuity (P = 0.01) were the predominant factors associated with visual success. Indigenous patients are just as likely to have improved vision following diabetic vitrectomy as non-Indigenous Australians. However, the small subset of indigenous patients with blind eyes prior to vitrectomy are significantly less likely to improve from surgery. The underlying factors associated with poor outcomes in this group requires further exploration. © 2017 Royal Australian and New Zealand College of Ophthalmologists.

Comorbidities and Ventricular Dysfunction Drive Excess Mid-Term Morbidity in an Indigenous Australian Coronary Revascularisation Cohort.

PubMed

Wiemers, Paul D; Marney, Lucy; White, Nicole; Bough, Georgina; Hustig, Alistair; Tan, Wei; Cheng, Ching-Siang; Kang, Dong; Yadav, Sumit; Tam, Robert; Fraser, John F

2018-04-24

There is a paucity of data in regards to longer term morbidity outcomes in Indigenous Australian patients undergoing coronary artery bypass grafting (CABG). No comparative data on re-infarction, stroke or reintervention rates exist. Outcome data following percutaneous coronary intervention (PCI) is also extremely limited. Addressing this gap in knowledge forms the major aim of our study. This was a single centre cohort study conducted at the Townsville Hospital, Australia which provides tertiary adult cardiac surgical services to the northern parts of the state of Queensland. It incorporated consecutive patients (n=350) undergoing isolated CABG procedures, 2008-2010, 20.9% (73/350) of whom were Indigenous Australians. The main outcome measures were major adverse cardiac or cerebrovascular events (MACCE) at mid-term follow-up (mean 38.9 months). The incidence of MACCE among Indigenous Australian patients was approximately twice that of non-Indigenous patients at mid-term follow-up (36.7% vs. 18.6%; p=0.005; OR 2.525 (1.291-4.880)). Following adjustment for preoperative and operative variables, Indigenous Australian status itself was not significantly associated with MACCE (AOR 1.578 (0.637-3.910)). Significant associations with MACCE included renal impairment (AOR 2.198 (1.010-4.783)) and moderate-severe left ventricular impairment (AOR 3.697 (1.820-7.508)). An association between diabetes and MACCE failed to reach statistical significance (AOR 1.812 (0.941-3.490)). Indigenous Australians undergoing CABG suffer an excess of MACCE when followed-up in the longer term. High rates of comorbidities in the Indigenous Australian population likely play an aetiological role. Copyright © 2018. Published by Elsevier B.V.

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.

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,…

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…

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…

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…

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.

Mood and anxiety disorders in Australia and New Zealand's indigenous populations: A systematic review and meta-analysis.

PubMed

Black, Emma; Kisely, Steve; Alichniewicz, Karolina; Toombs, Maree

2017-09-01

The Indigenous populations of Australia and New Zealand are considered at higher risk of mood and anxiety disorders but many studies do not include direct comparisons with similar non-Indigenous controls. We conducted a systematic search of relevant electronic databases, as well as snowballing and targeted searches of the grey literature. Studies were included for meta-analysis if they compared rates of mood and anxiety disorders between Indigenous and non-Indigenous Australians or Maori. Seven Australian and 10 NZ studies were included. Overall, Indigenous people in both countries did not have significantly higher rates of disorder. However, in terms of specific disorders, there were differences in risk by gender, country (Australia or NZ), disorder type, and prevalence (current, 12-month or lifetime). For instance, Indigenous Australians and Maori both had significantly lower rates of simple phobias (current prevalence) and Maori participants had significantly lower rates of both lifetime simple phobia and generalised anxiety disorders. By contrast, Indigenous Australians had significantly higher rates of bipolar affective disorder and social phobia (current prevalence). Generalisations regarding the risk of psychiatric disorders in Indigenous people cannot therefore be made as this varies by several factors. These include disorder type, sociodemographic factors, Indigenous origin and study method. Copyright © 2017. Published by Elsevier B.V.

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.

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…

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.

Assessing cognition following petrol sniffing for Indigenous Australians.

PubMed

Dingwall, Kylie M; Lewis, Matthew S; Maruff, Paul; Cairney, Sheree

2010-07-01

Chronic petrol inhalation can be associated with significant cognitive impairment. While rehabilitation programs can rely on such skills to educate clients and achieve treatment outcomes, cognitive function is rarely assessed on admission. This is particularly true for Indigenous populations where standard assessments are not appropriate. This paper describes a process for assessing cognition in Indigenous Australians. Two studies investigate firstly the demographic factors impacting on cognition for healthy Indigenous Australians and secondly the utility of the assessment process for detecting petrol sniffing related cognitive impairments. Study One assessed a naturalistic sample of healthy Indigenous Australians from the Northern Territory (N = 206; mean age = 28.03) on computerised tests of psychomotor speed, visual attention, memory, learning, spatial awareness and executive functions. Multiple regression analyses determined the unique contributions of six factors (age, education, gender, familiarity with computers, regular long term cannabis use and locality) to the variance in performance for this group. Study Two examined group differences in cognitive performance on the same tests between healthy Indigenous Australians (N = 96) and Indigenous petrol sniffers (N = 50; both age restricted to < 26 years) while controlling those factors found to impact on performance from Study One. Age, computer familiarity, and education significantly contributed to the variance in performance measures. While controlling these factors, petrol abuse was associated with poorer performance on complex tasks of psychomotor, visual attention, memory, learning, spatial awareness and executive function. This assessment process is useful for detecting substance abuse related impairments in Indigenous Australians and when using this assessment process, age and computer familiarity in particular should be controlled for.

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…

Group-based guilt as a predictor of commitment to apology.

PubMed

McGarty, Craig; Pedersen, Anne; Leach, Colin Wayne; Mansell, Tamarra; Waller, Julie; Bliuc, Ana-Maria

2005-12-01

Whether the Australian government should officially apologize to Indigenous Australians for past wrongs is hotly debated in Australia. The predictors of support amongst non-Indigenous Australians for such an apology were examined in two studies. The first study (N=164) showed that group-based guilt was a good predictor of support for a government apology, as was the perception that non-Indigenous Australians were relatively advantaged. In the second study (N=116) it was found that group-based guilt was an excellent predictor of support for apology and was itself predicted by perceived non-Indigenous responsibility for harsh treatment of Indigenous people, and an absence of doubts about the legitimacy of group-based guilt. National identification was not a predictor of group-based guilt. The results of the two studies suggest that, just as individual emotions predict individual action tendencies, so group-based guilt predicts support for actions or decisions to be taken at the collective level.

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.

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…

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 Australians and a majority (91%, n  = 104) were willing to participate in training to develop Indigenous cultural competency. The study points to a need for chiropractors to have access to cultural proficiency training in order to develop the capability and confidence to engage respectfully with their Indigenous patients. This preliminary study has provided the researchers with valuable insights aiding the development and implementation of an Indigenous cultural proficiency program for chiropractors.

Assessment of Fetal Kidney Growth and Birth Weight in an Indigenous Australian Cohort.

PubMed

Diehm, Christopher J; Lumbers, Eugenie R; Weatherall, Loretta; Keogh, Lyniece; Eades, Sandra; Brown, Alex; Smith, Roger; Johnson, Vanessa; Pringle, Kirsty G; Rae, Kym M

2017-01-01

Introduction: Indigenous Australians experience higher rates of renal disease and hypertension than non-Indigenous Australians. Low birth weight is recognized as a contributing factor in chronic disease and has been shown to increase the risk of renal failure in adulthood. A smaller kidney volume with fewer nephrons places an individual at risk of hypertension and renal failure. Indigenous Australians have fewer nephrons than non-Indigenous Australians. In this study, intrauterine fetal and kidney growth were evaluated in 174 Indigenous Australian babies throughout gestation in order to record and evaluate fetal growth and kidney size, within a population that is at high risk for chronic illness. Methods: Pregnant women that identified as Indigenous, or non-Indigenous women that were pregnant with a partner who identified as an Indigenous Australian were eligible to participate. Maternal history, smoking status, blood and urine samples and fetal ultrasounds were collected throughout pregnancy. Fetal kidney measurements were collected using ultrasound. Statistical analysis was performed using the Stata 14.1 software package. Results: 15.2% of babies were born prematurely. 44% of the mothers reported smoking in pregnancy. The median birth weight of this cohort was 3,240 g. Male fetuses had higher kidney to body weight ratios than female fetuses ( P = 0.02). The birth weights of term neonates whose mothers smoked during pregnancy were lower (327 g, P < 0.001) than the birth weights of term babies from non-smoking mothers. The kidney volumes of babies whose mothers smoked were also smaller ( P = 0.02), but were in proportion to body weight. Conclusion: In this cohort of Indigenous women smoking was associated with both increased number of preterm births and with a reduction in birth weights, even of term infants. Since kidney volume is a surrogate measure of nephron number and nephrogenesis is complete at birth, babies whose mothers smoked during pregnancy must have fewer nephrons than those from non-smoking mothers. Previous studies have shown that glomerular filtration rate is not related to birth weight, thus infants with smaller kidney volumes are hyperfiltering from birth and therefore are likely to be more susceptible to early onset renal disease in later life.

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 the ability to use evidence and ensure due process at the same time. The use of evidence can ensure that health outcomes for Indigenous peoples can be maximised – hence, increase the potential for ‘closing the gap’ between Indigenous and other Australians. PMID:24906391

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…

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…

Making Sense of "Their" Sense of Place: Australian Children's Literature Landscape on Indigenous Land

ERIC Educational Resources Information Center

Collins-Gearing, Brooke

2007-01-01

Australian children's literature has traditionally provided a space for colonial Australia to perpetuate ideas about segregation, assimilation, and reconciliation. Children's literature offers a complex medium for readers, Indigenous and non-Indigenous, to question and challenge prevalent attitudes, in particular, the notion of…

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.

Heart Failure in Minority Populations - Impediments to Optimal Treatment in Australian Aborigines

PubMed Central

Iyngkaran, Pupalan; Kangaharan, Nadarajan; Zimmet, Hendrik; Arstall, Margaret; Minson, Rob; Thomas, Merlin C.; Bergin, Peter; Atherton, John; MacDonald, Peter; Hare, David L.; Horowitz, John D.; Ilton, Marcus

2016-01-01

Chronic heart failure (CHF) among Aboriginal/Indigenous Australians is endemic. There are also grave concerns for outcomes once acquired. This point is compounded by a lack of prospective and objective studies to plan care. To capture the essence of the presented topic it is essential to broadly understand Indigenous health. Key words such as ‘worsening’, ‘gaps’, ‘need to do more’, ‘poorly studied’, or ‘future studies should inform’ occur frequently in contrast to CHF research for almost all other groups. This narrative styled opinion piece attempts to discuss future directions for CHF care for Indigenous Australians. We provide a synopsis of the problem, highlight the treatment gaps, and define the impediments that present hurdles in optimising CHF care for Indigenous Australians. PMID:27280307

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…

Settler Grammars and the Australian Professional Standards for Teachers

ERIC Educational Resources Information Center

Moodie, Nikki; Patrick, Rachel

2017-01-01

In 2011, the Australian Institute for Teaching and School Leadership introduced new Professional Standards for Teachers, which require that graduate teachers possess knowledge and understanding of Indigenous students and cultures. The authors conducted interviews with 12 non-Indigenous teacher educators at one Australian university in order to…

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…

Potential Factors Influencing Indigenous Education Participation and Achievement. Research Report

ERIC Educational Resources Information Center

Biddle, Nicholas; Cameron, Timothy

2012-01-01

This report examines two sets of issues, the first being whether Indigenous Australians obtain a lower return on investment in education and training than other Australians. If they do, then this would partly explain why, in general, Indigenous participation in education and training is relatively low. The second issue is whether Indigenous…

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…

Closing the Gap Clearinghouse: Annual Report, 2009-10

ERIC Educational Resources Information Center

Australian Institute of Health and Welfare, 2011

2011-01-01

The Council of Australian Governments (COAG) has made a range of commitments to improve the lives of Indigenous Australians and in particular provide for a better future for Indigenous children. These commitments have re-focused the efforts of everyone working for a better future for Australia's Indigenous people. The Closing the Gap Clearinghouse…

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.…

Factors Affecting the Retention of Indigenous Australians in the Health Workforce: A Systematic Review

PubMed Central

Lai, Genevieve C.; Haigh, Margaret M.

2018-01-01

Indigenous Australians are under-represented in the health workforce. The shortfall in the Indigenous health workforce compounds the health disparities experienced by Indigenous Australians and places pressure on Indigenous health professionals. This systematic review aims to identify enablers and barriers to the retention of Indigenous Australians within the health workforce and to describe strategies to assist with development and retention of Indigenous health professionals after qualification. Four electronic databases were systematically searched in August 2017. Supplementary searches of relevant websites were also undertaken. Articles were screened for inclusion using pre-defined criteria and assessed for quality using the Mixed Methods Assessment Tool. Fifteen articles met the criteria for inclusion. Important factors affecting the retention of Indigenous health professionals included work environment, heavy workloads, poorly documented/understood roles and responsibilities, low salary and a perception of salary disparity, and the influence of community as both a strong personal motivator and source of stress when work/life boundaries could not be maintained. Evidence suggests that retention of Indigenous health professionals will be improved through building supportive and culturally safe workplaces; clearly documenting and communicating roles, scope of practice and responsibilities; and ensuring that employees are appropriately supported and remunerated. The absence of intervention studies highlights the need for deliberative interventions that rigorously evaluate all aspects of implementation of relevant workforce, health service policy, and practice change. PMID:29734679

Factors Affecting the Retention of Indigenous Australians in the Health Workforce: A Systematic Review.

PubMed

Lai, Genevieve C; Taylor, Emma V; Haigh, Margaret M; Thompson, Sandra C

2018-05-04

Indigenous Australians are under-represented in the health workforce. The shortfall in the Indigenous health workforce compounds the health disparities experienced by Indigenous Australians and places pressure on Indigenous health professionals. This systematic review aims to identify enablers and barriers to the retention of Indigenous Australians within the health workforce and to describe strategies to assist with development and retention of Indigenous health professionals after qualification. Four electronic databases were systematically searched in August 2017. Supplementary searches of relevant websites were also undertaken. Articles were screened for inclusion using pre-defined criteria and assessed for quality using the Mixed Methods Assessment Tool. Fifteen articles met the criteria for inclusion. Important factors affecting the retention of Indigenous health professionals included work environment, heavy workloads, poorly documented/understood roles and responsibilities, low salary and a perception of salary disparity, and the influence of community as both a strong personal motivator and source of stress when work/life boundaries could not be maintained. Evidence suggests that retention of Indigenous health professionals will be improved through building supportive and culturally safe workplaces; clearly documenting and communicating roles, scope of practice and responsibilities; and ensuring that employees are appropriately supported and remunerated. The absence of intervention studies highlights the need for deliberative interventions that rigorously evaluate all aspects of implementation of relevant workforce, health service policy, and practice change.

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

The substantial gap in life expectancy between Indigenous and non-Indigenous Australians has been slow to improve, despite increased dedicated funding. Partnerships between Australian Indigenous and mainstream Western biomedical organisations are recognised as crucial to improved Indigenous health outcomes. However, these partnerships often experience challenges, particularly in the context of Australia's race and political relations. We examined the relevant literature in order to identify the potential role for social theory and theoretical models in developing and maintaining intercultural partnerships. Having identified relevant theoretical models, terms and possible key words, a range of databases were searched and relevant articles selected for inclusion. An integrative approach brought together theoretical models and practical considerations about working in partnership, to inform our analysis of the literature. Considering partnerships between Australian Indigenous and mainstream health organisations as 'bi-cultural' is simplistic: rather they are culturally diverse across social and professional levels. As such, partnerships between Australian Indigenous and mainstream health organisations may be better conceptualised as 'intercultural', operating across diverse and shifting cultural frames of reference. Theories identified by this review as useful to guide partnerships include power relations, reflexivity and dialogue, borders and strangeness and the intercultural or third space. This paper examines how these theoretical approaches can develop understanding and improve intercultural engagement between mainstream and Australian Indigenous partners in healthcare. Rather than viewing partnerships merely as arrangements between disembodied entities, sometimes contractual in nature, they are better seen as activities between people and organisations and essentially dependent on relationships, occurring in an intercultural space that is complex, dynamic and 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.

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

PubMed

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

2012-01-11

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. 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. 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 effective and culturally-appropriate interventions to improve health.

Increased bone mineral density in Aboriginal and Torres Strait Islander Australians: impact of body composition differences.

PubMed

Maple-Brown, L J; Hughes, J; Piers, L S; Ward, L C; Meerkin, J; Eisman, J A; Center, J R; Pocock, N A; Jerums, G; O'Dea, K

2012-07-01

Bone mineral density (BMD) has been reported to be both higher and lower in Indigenous women from different populations. Body composition data have been reported for Indigenous Australians, but there are few published BMD data in this population. We assessed BMD in 161 Indigenous Australians, identified as Aboriginal (n=70), Torres Strait Islander (n=68) or both (n=23). BMD measurements were made on Norland-XR46 (n=107) and Hologic (n=90) dual-energy X-ray absorptiometry (DXA) machines. Norland BMD and body composition measurements in these individuals, and also in 36 Caucasian Australians, were converted to equivalent Hologic BMD (BMD(H)) and body composition measurements for comparison. Femoral neck (FN) and lumbar spine Z-scores were high in Indigenous participants (mean FN Z-score: Indigenous men +0.98, p<0.0001 vs. mean zero; Indigenous women +0.82, p<0.0001 vs. mean zero). FN BMD(H) was higher in Aboriginal and/or Torres Strait Islander than Caucasian participants, after adjusting for age, gender, diabetes and height and remained higher in men after addition of lean mass to the model. We conclude that FN BMD is higher in Aboriginal and/or Torres Strait Islander Australians than Caucasian Australian reference ranges and these differences still remained significant in men after adjustment for lean mass. It remains to be seen whether these BMD differences translate to differences in fracture rates. Copyright © 2012 Elsevier Inc. All rights reserved.

Comparison of Three Cognitive Screening Tools in Older Urban and Regional Aboriginal Australians.

PubMed

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

2015-01-01

Validated cognitive screening tools for use in urban and regional Aboriginal populations in Australia are lacking. In a cross-sectional community-based study, 235 participants were assessed on the Mini-Mental State Examination (MMSE), the Rowland Universal Dementia Assessment Scale (RUDAS) and an urban modification of the Kimberley Indigenous Cognitive Assessment (mKICA). Performance on these cognitive screening tools was compared to dementia diagnosis by clinical consensus. All tests were culturally acceptable with good psychometric properties. Receiver operating characteristic curve analyses revealed that the MMSE and mKICA were the most accurate. The MMSE is an effective cognitive screening tool in urban Aboriginal populations. The mKICA is a good alternative when illiteracy, language or cultural considerations deem it appropriate. The RUDAS also has adequate validity in this population. © 2015 S. Karger AG, Basel.

"Working Together": An Intercultural Academic Leadership Programme to Build Health Science Educators' Capacity to Teach Indigenous Health and Culture

ERIC Educational Resources Information Center

Durey, Angela; Taylor, Kate; Bessarab, Dawn; Kickett, Marion; Jones, Sue; Hoffman, Julie; Flavell, Helen; Scott, Kim

2017-01-01

Progress has been slow in improving health disparities between Aboriginal and Torres Strait Islander (Indigenous) Australians and other Australians. While reasons for this are complex, delivering healthcare respectful of cultural differences is one approach to improving Indigenous health outcomes. This paper presents and evaluates an intercultural…

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…

When a Dream Becomes a Nightmare: Why Do Indigenous Australian Medical Students Withdraw from Their Courses?

ERIC Educational Resources Information Center

Ellender, Isabel; Drysdale, Marlene; Chesters, Janice; Faulkner, Susan; Kelly, Heather; Turnbull, Leanne

2008-01-01

This paper investigates reasons Indigenous Australian medical students gave for leaving their courses prior to graduation. Indigenous students who had withdrawn or deferred from their medical courses were asked about the barriers and disincentives that had dissuaded them from graduating. Although the response rate to the questionnaire was very…

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, the relative contribution of culture, social disadvantage and poor general health compared with non-Indigenous women to the experience of menopause is unknown. As such, further research and understanding of the experience of Indigenous women around Australia is needed. This information could assist individuals, families, cultural groups and healthcare providers to enhance management and support for Indigenous Australian women. PMID:23234340

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 disadvantage and poor general health compared with non-Indigenous women to the experience of menopause is unknown. As such, further research and understanding of the experience of Indigenous women around Australia is needed. This information could assist individuals, families, cultural groups and healthcare providers to enhance management and support for Indigenous Australian women.

Systematic review to inform prevention and management of chronic disease for Indigenous Australians: overview and priorities.

PubMed

Gomersall, Judith Streak; Canuto, Karla; Aromataris, Edoardo; Braunack-Mayer, Annette; Brown, Alex

2016-02-01

To describe the main characteristics of systematic reviews addressing questions of chronic disease and related risk factors for Indigenous Australians. We searched databases for systematic reviews meeting inclusion criteria. Two reviewers assessed quality and extracted characteristics using pre-defined tools. We identified 14 systematic reviews. Seven synthesised evidence about health intervention effectiveness; four addressed chronic disease or risk factor prevalence; and six conducted critical appraisal as per current best practice. Only three reported steps to align the review with standards for ethical research with Indigenous Australians and/or capture Indigenous-specific knowledge. Most called for more high-quality research. Systematic review is an under-utilised method for gathering evidence to inform chronic disease prevention and management for Indigenous Australians. Relevance of future systematic reviews could be improved by: 1) aligning questions with community priorities as well as decision maker needs; 2) involvement of, and leadership by, Indigenous researchers with relevant cultural and contextual knowledge; iii) use of critical appraisal tools that include traditional risk of bias assessment criteria and criteria that reflect Indigenous standards of appropriate research. Systematic review method guidance, tools and reporting standards are required to ensure alignment with ethical obligations and promote rigor and relevance. © 2015 Public Health Association of Australia.

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…

Urinary angiotensinogen excretion in Australian Indigenous and non-Indigenous pregnant women.

PubMed

Pringle, Kirsty G; de Meaultsart, Celine Corbisier; Sykes, Shane D; Weatherall, Loretta J; Keogh, Lyniece; Clausen, Don C; Dekker, Gus A; Smith, Roger; Roberts, Claire T; Rae, Kym M; Lumbers, Eugenie R

2018-04-01

The intrarenal renin-angiotensin system (iRAS) is implicated in the pathogenesis of hypertension, chronic kidney disease and diabetic nephropathy. Urinary angiotensinogen (uAGT) levels reflect the activity of the iRAS and are altered in women with preeclampsia. Since Indigenous Australians suffer high rates and early onset of renal disease, we hypothesised that Indigenous Australian pregnant women, like non-Indigenous women with pregnancy complications, would have altered uAGT levels. The excretion of RAS proteins was measured in non-Indigenous and Indigenous Australian women with uncomplicated or complicated pregnancies (preeclampsia, diabetes/gestational diabetes, proteinuria/albuminuria, hypertension, small/large for gestational age, preterm birth), and in non-pregnant non-Indigenous women. Non-Indigenous pregnant women with uncomplicated pregnancies, had higher uAGT/creatinine levels than non-Indigenous non-pregnant women (P < 0.01), and levels increased as pregnancy progressed (P < 0.001). In non-Indigenous pregnant women with pregnancy complications, uAGT/creatinine was suppressed in the third trimester (P < 0.01). In Indigenous pregnant women with uncomplicated pregnancies, there was no change in uAGT/creatinine with gestational age and uAGT/creatinine was lower in the 2nd and 3rd trimesters than in non-Indigenous pregnant women with uncomplicated pregnancies (P < 0.03, P < 0.007, respectively). The uAGT/creatinine ratios of Indigenous women with uncomplicated or complicated pregnancies were the same. A decrease in uAGT/creatinine with advancing gestational age was associated with increased urinary albumin/creatinine, as is seen in preeclampsia, but it was not specific for this disorder. The reduced uAGT/creatinine in Indigenous pregnant women may reflect subclinical renal dysfunction which limits the ability of the kidney to maintain sodium balance and could indicate an increased risk of pregnancy complications and/or future renal disease. Copyright © 2018 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.

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

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 126080005833347.

Association of Visual Impairment and All-Cause 10-Year Mortality Among Indigenous Australian Individuals Within Central Australia: The Central Australian Ocular Health Study.

PubMed

Ng, Soo Khai; Kahawita, Shyalle; Andrew, Nicholas Howard; Henderson, Tim; Craig, Jamie Evan; Landers, John

2018-05-01

It is well established from different population-based studies that visual impairment is associated with increased mortality rate. However, to our knowledge, the association of visual impairment with increased mortality rate has not been reported among indigenous Australian individuals. To assess the association between visual impairment and 10-year mortality risk among the remote indigenous Australian population. Prospective cohort study recruiting indigenous Australian individuals from 30 remote communities located within the central Australian statistical local area over a 36-month period between July 2005 and June 2008. The data were analyzed in January 2017. Visual acuity, slitlamp biomicroscopy, and fundus examination were performed on all patients at recruitment. Visual impairment was defined as a visual acuity of less than 6/12 in the better eye. Mortality rate and mortality cause were obtained at 10 years, and statistical analyses were performed. Hazard ratios for 10-year mortality with 95% confidence intervals are presented. One thousand three hundred forty-seven patients were recruited from a total target population number of 2014. The mean (SD) age was 56 (11) years, and 62% were women. The total all-cause mortality was found to be 29.3% at 10 years. This varied from 21.1% among those without visual impairment to 48.5% among those with visual impairment. After adjustment for age, sex, and the presence of diabetes and hypertension, those with visual impairment were 40% more likely to die (hazard ratio, 1.40; 95% CI, 1.16-1.70; P = .001) during the 10-year follow-up period compared with those with normal vision. Bilateral visual impairment among remote indigenous Australian individuals was associated with 40% higher 10-year mortality risk compared with those who were not visually impaired. Resource allocation toward improving visual acuity may therefore aid in closing the gap in mortality outcomes between indigenous and nonindigenous Australian individuals.

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 will explore the key factors, including the influence of social networks, that impact on tobacco use and the extent to which smoking behaviours transcend networks within the Indigenous Australian community in the ACT. This will add to the evidence-base, identifying influential factors to tobacco use and the effectiveness and influence of a multi-component tobacco control strategy.

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 partner in the study. Discussion Our study will explore the key factors, including the influence of social networks, that impact on tobacco use and the extent to which smoking behaviours transcend networks within the Indigenous Australian community in the ACT. This will add to the evidence-base, identifying influential factors to tobacco use and the effectiveness and influence of a multi-component tobacco control strategy. PMID:24060337

Teaching the Teachers To Understand and Teach Indigenous Australian Studies: New Models, Teaching Strategies and Resources To Empower and Educate a Nation.

ERIC Educational Resources Information Center

Craven, Rhonda G.; Mooney, Janet

This review presents a rationale for teaching Australian teachers to understand and teach Aboriginal Studies, describing the structure and development of the Teaching the Teachers: Indigenous Australian Studies Project of National Significance. The project was designed in response to a government recommendation that all teacher training programs…

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

PubMed

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

2017-01-01

The Aboriginal and Torres Strait Islander community has an increased risk of developing chronic illnesses including diabetes. Among people with diabetes, foot complications are common and make a significant contribution to the morbidity and mortality associated with this disease. The aim of this review was to systematically evaluate the literature comparing the rates of diabetes related foot complications in Aboriginal and Torres Strait Islander Australians to non-Indigenous Australians. MEDLINE, EMBASE, The Cochrane Library; PUBMED and CINAHL were searched from inception until August 2016. Inclusion criteria were: published cross-sectional or longitudinal studies reporting the prevalence of diabetes related foot complications in both a cohort of Aboriginal and Torres Strait Islander Australians and a cohort of one other Australian population of any age with diabetes. Risk of bias was assessed using the STROBE tool. Eleven studies including a total of 157,892 participants were included. Studies were set in Queensland, the Northern Territory and Western Australia, primarily in rural and remote areas. Aboriginal and Torres Strait Islander Australians experienced substantially more diabetes related foot complications with the mean age up to 14 years younger than non-Indigenous Australians. Aboriginality was associated with increased risk of peripheral neuropathy, foot ulceration and amputation. In several studies, Aboriginal and Torres Strait Islander Australians accounted for the vast majority of diabetes related foot complications (up to 91%) while comprising only a small proportion of the regional population. Reporting quality as assessed with the STROBE tool showed underreporting of: methods, sample description and potential sources of bias. There are no data available for some Australian states and for specific types of diabetes related foot complications. Aboriginal and Torres Strait Islander Australians have a 3-6 fold increased likelihood of experiencing a diabetes related foot complication compared to non-Indigenous Australians. Evidence-based, culturally appropriate screening and intervention programs and improved access to effective health care services are required to prevent a widening of the gap in diabetes related foot complications between Aboriginal and Torres Strait Islander and non-Indigenous Australians.

Comorbidity and cervical cancer survival of Indigenous and non-Indigenous Australian women: A semi-national registry-based cohort study (2003-2012)

PubMed Central

Baade, Peter D.; Valery, Patricia C.; Whop, Lisa J.; Moore, Suzanne P.; Cunningham, Joan; Garvey, Gail; Brotherton, Julia M. L.; O’Connell, Dianne L.; Canfell, Karen; Sarfati, Diana; Roder, David; Buckley, Elizabeth; Condon, John R.

2018-01-01

Background Little is known about the impact of comorbidity on cervical cancer survival in Australian women, including whether Indigenous women’s higher prevalence of comorbidity contributes to their lower survival compared to non-Indigenous women. Methods Data for cervical cancers diagnosed in 2003–2012 were extracted from six Australian state-based cancer registries and linked to hospital inpatient records to identify comorbidity diagnoses. Five-year cause-specific and all-cause survival probabilities were estimated using the Kaplan-Meier method. Flexible parametric models were used to estimate excess cause-specific mortality by Charlson comorbidity index score (0,1,2+), for Indigenous women compared to non-Indigenous women. Results Of 4,467 women, Indigenous women (4.4%) compared to non-Indigenous women had more comorbidity at diagnosis (score ≥1: 24.2% vs. 10.0%) and lower five-year cause-specific survival (60.2% vs. 76.6%). Comorbidity was associated with increased cervical cancer mortality for non-Indigenous women, but there was no evidence of such a relationship for Indigenous women. There was an 18% reduction in the Indigenous: non-Indigenous hazard ratio (excess mortality) when comorbidity was included in the model, yet this reduction was not statistically significant. The excess mortality for Indigenous women was only evident among those without comorbidity (Indigenous: non-Indigenous HR 2.5, 95%CI 1.9–3.4), indicating that factors other than those measured in this study are contributing to the differential. In a subgroup of New South Wales women, comorbidity was associated with advanced-stage cancer, which in turn was associated with elevated cervical cancer mortality. Conclusions Survival was lowest for women with comorbidity. However, there wasn’t a clear comorbidity-survival gradient for Indigenous women. Further investigation of potential drivers of the cervical cancer survival differentials is warranted. Impact The results highlight the need for cancer care guidelines and multidisciplinary care that can meet the needs of complex patients. Also, primary and acute care services may need to pay more attention to Indigenous Australian women who may not obviously need it (i.e. those without comorbidity). PMID:29738533

Comorbidity and cervical cancer survival of Indigenous and non-Indigenous Australian women: A semi-national registry-based cohort study (2003-2012).

PubMed

Diaz, Abbey; Baade, Peter D; Valery, Patricia C; Whop, Lisa J; Moore, Suzanne P; Cunningham, Joan; Garvey, Gail; Brotherton, Julia M L; O'Connell, Dianne L; Canfell, Karen; Sarfati, Diana; Roder, David; Buckley, Elizabeth; Condon, John R

2018-01-01

Little is known about the impact of comorbidity on cervical cancer survival in Australian women, including whether Indigenous women's higher prevalence of comorbidity contributes to their lower survival compared to non-Indigenous women. Data for cervical cancers diagnosed in 2003-2012 were extracted from six Australian state-based cancer registries and linked to hospital inpatient records to identify comorbidity diagnoses. Five-year cause-specific and all-cause survival probabilities were estimated using the Kaplan-Meier method. Flexible parametric models were used to estimate excess cause-specific mortality by Charlson comorbidity index score (0,1,2+), for Indigenous women compared to non-Indigenous women. Of 4,467 women, Indigenous women (4.4%) compared to non-Indigenous women had more comorbidity at diagnosis (score ≥1: 24.2% vs. 10.0%) and lower five-year cause-specific survival (60.2% vs. 76.6%). Comorbidity was associated with increased cervical cancer mortality for non-Indigenous women, but there was no evidence of such a relationship for Indigenous women. There was an 18% reduction in the Indigenous: non-Indigenous hazard ratio (excess mortality) when comorbidity was included in the model, yet this reduction was not statistically significant. The excess mortality for Indigenous women was only evident among those without comorbidity (Indigenous: non-Indigenous HR 2.5, 95%CI 1.9-3.4), indicating that factors other than those measured in this study are contributing to the differential. In a subgroup of New South Wales women, comorbidity was associated with advanced-stage cancer, which in turn was associated with elevated cervical cancer mortality. Survival was lowest for women with comorbidity. However, there wasn't a clear comorbidity-survival gradient for Indigenous women. Further investigation of potential drivers of the cervical cancer survival differentials is warranted. The results highlight the need for cancer care guidelines and multidisciplinary care that can meet the needs of complex patients. Also, primary and acute care services may need to pay more attention to Indigenous Australian women who may not obviously need it (i.e. those without comorbidity).

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…

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.

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.

An expanded nationwide view of chronic kidney disease in Aboriginal Australians.

PubMed

Hoy, Wendy E; Mott, Susan A; Mc Donald, Stephen P

2016-11-01

We summarize new knowledge that has accrued in recent years on chronic kidney disease (CKD) in Indigenous Australians. CKD refers to all stages of preterminal kidney disease, including end-stage kidney failure (ESKF), whether or not a person receives renal replacement therapy (RRT). Recently recorded rates of ESKF, RRT, non-dialysis CKD hospitalizations and CKD attributed deaths were, respectively, more than sixfold, eightfold, eightfold and threefold those of non-Indigenous Australians, with age adjustment, although all except the RRT rates are still under-enumerated. However, the nationwide average Indigenous incidence rate of RRT appears to have stabilized. The median age of Indigenous people with ESKF was about 30 years less than for non-Indigenous people, and 84% of them received RTT, while only half of non-Indigenous people with ESKF did so. The first-ever (2012) nationwide health survey data showed elevated levels of CKD markers in Indigenous people at the community level. For all CKD parameters, rates among Indigenous people themselves were strikingly correlated with increasing remoteness of residence and socio-economic disadvantage, and there was a female predominance in remote areas. The burden of renal disease in Australian Indigenous people is seriously understated by Global Burden of Disease Mortality methodology, because it employs underlying cause of death only, and because deaths of people on RRT are frequently attributed to non-renal causes. These data give a much expanded view of CKD in Aboriginal people. Methodologic approaches must be remedied for a full appreciation of the burden, costs and outcomes of the disease, to direct appropriate policy development. © 2016 Asian Pacific Society of Nephrology.

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

PubMed

Durey, Angela; Thompson, Sandra C

2012-06-10

Indigenous peoples have worse health than non-Indigenous, are over-represented amongst the poor and disadvantaged, have lower life expectancies, and success in improving disparities is limited. To address this, research usually focuses on disadvantaged and marginalised groups, offering only partial understanding of influences underpinning slow progress. Critical analysis is also required of those with the power to perpetuate or improve health inequities. In this paper, using Australia as a case example, we explore the effects of 'White', Anglo-Australian cultural dominance in health service delivery to Indigenous Australians. We address the issue using race as an organising principle, underpinned by relations of power. Interviews with non-Indigenous medical practitioners in Western Australia with extensive experience in Indigenous health encouraged reflection and articulation of their insights into factors promoting or impeding quality health care to Indigenous Australians. Interviews were audio-taped and transcribed. An inductive, exploratory analysis identified key themes that were reviewed and interrogated in light of existing literature on health care to Indigenous people, race and disadvantage. The researchers' past experience, knowledge and understanding of health care and Indigenous health assisted with data interpretation. Informal discussions were also held with colleagues working professionally in Indigenous policy, practice and community settings. Racism emerged as a key issue, leading us to more deeply interrogate the role 'Whiteness' plays in Indigenous health care. While Whiteness can refer to skin colour, it also represents a racialized social structure where Indigenous knowledge, beliefs and values are subjugated to the dominant western biomedical model in policy and practice. Racism towards Indigenous patients in health services was institutional and interpersonal. Internalised racism was manifest when Indigenous patients incorporated racist attitudes and beliefs into their lived experience, lowering expectations and their sense of self-worth. Current health policies and practices favour standardised care where the voice of those who are marginalised is often absent. Examining the effectiveness of such models in reducing health disparities requires health providers to critically reflect on whether policies and practices promote or compromise Indigenous health and wellbeing--an important step in changing the discourse that places Indigenous people at the centre of the problem.

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 Indigenous patients incorporated racist attitudes and beliefs into their lived experience, lowering expectations and their sense of self-worth. Conclusions Current health policies and practices favour standardised care where the voice of those who are marginalised is often absent. Examining the effectiveness of such models in reducing health disparities requires health providers to critically reflect on whether policies and practices promote or compromise Indigenous health and wellbeing - an important step in changing the discourse that places Indigenous people at the centre of the problem. PMID:22682494

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 effective and culturally-appropriate interventions to improve health. PMID:22236166

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 participants provided evaluative comment on their health services in relation to dialysis and transplant. Additionally, the data includes extensive parallel commentary from a cohort of specialists, nurses and other staff. The study considers a 'patient journey' to transplant within a diverse range of Australian treatment centre/workplace settings. The IMPAKT Interview study protocol may contribute to improvements in multi-disciplinary, flexible design health services research with hard to reach or vulnerable populations in Australia and elsewhere.

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 large cohort of Indigenous participants provided evaluative comment on their health services in relation to dialysis and transplant. Additionally, the data includes extensive parallel commentary from a cohort of specialists, nurses and other staff. The study considers a ‘patient journey’ to transplant within a diverse range of Australian treatment centre/workplace settings. The IMPAKT Interview study protocol may contribute to improvements in multi-disciplinary, flexible design health services research with hard to reach or vulnerable populations in Australia and elsewhere. PMID:18248667

Indigenous Students and Completion of Year 12. Education and Training in an Era of Economic Uncertainty: CEET 13th Annual National Conference

ERIC Educational Resources Information Center

Long, Michael

2009-01-01

The Council of Australian Governments (COAG) has endorsed a "Closing the Gap" agenda designed to improve the lives of Indigenous Australians. The agenda is distilled in a series of targets, one of which is the goal of halving the gap for Indigenous students in Year 12 attainment or equivalent (Certificate II or above) attainment rates by…

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.

Paths to improving care of Australian Aboriginal and Torres Strait Islander women following gestational diabetes.

PubMed

Campbell, Sandra; Roux, Nicolette; Preece, Cilla; Rafter, Eileen; Davis, Bronwyn; Mein, Jackie; Boyle, Jacqueline; Fredericks, Bronwyn; Chamberlain, Catherine

2017-11-01

Aim To understand enablers and barriers influencing postpartum screening for type 2 diabetes following gestational diabetes in Australian Indigenous women and how screening might be improved. Australian Indigenous women with gestational diabetes mellitus (GDM) are less likely than other Australian women to receive postpartum diabetes screening. This is despite a fourfold higher risk of developing type 2 diabetes within eight years postpartum. We conducted interviews with seven Indigenous women with previous GDM, focus groups with 20 Indigenous health workers and workshops with 24 other health professionals. Data collection included brainstorming, visualisation, sorting and prioritising activities. Data were analysed thematically using the Theoretical Domains Framework. Barriers are presented under the headings of 'capability', 'motivation' and 'opportunity'. Enabling strategies are presented under 'intervention' and 'policy' headings. Findings Participants generated 28 enabling environmental, educational and incentive interventions, and service provision, communication, guideline, persuasive and fiscal policies to address barriers to screening and improve postpartum support for women. The highest priorities included providing holistic social support, culturally appropriate resources, improving Indigenous workforce involvement and establishing structured follow-up systems. Understanding Indigenous women's perspectives, developing strategies with health workers and action planning with other health professionals can generate context-relevant feasible strategies to improve postpartum care after GDM. Importantly, we need evidence which can demonstrate whether the strategies are effective.

The morbidity and mortality outcomes of indigenous Australian peoples after isolated coronary artery bypass graft surgery: the influence of geographic remoteness.

PubMed

Prabhu, Anil; Tully, Phillip J; Bennetts, Jayme S; Tuble, Sigrid C; Baker, Robert A

2013-08-01

Though Indigenous Australian peoples reportedly have poorer survival outcome after cardiac surgery, few studies have jointly documented the experience of major morbidity, and considered the influence of patient geographic remoteness. From January 1998 to September 2008, major morbidity events and survival were recorded for 2748 consecutive patients undergoing coronary artery bypass graft surgery. Morbidity and survival analyses adjusted for propensity deciles based on patient ethnicity and age, sex, left ventricular ejection fraction, recent myocardial infarction, tobacco smoking, diabetes, renal disease and history of stroke. Sensitivity analyses controlled for the patient accessibility/remoteness index of Australia (ARIA). The 297 Indigenous Australian patients (10.8% of total) had greater odds for total morbidity (adjusted odds ratio = 1.55; 95% confidence interval [CI] 1.04-2.30) and prolonged ventilation (adjusted odds ratio = 2.08; 95% confidence interval [CI] 1.25-3.44) in analyses adjusted for propensity deciles and geographic remoteness. With a median follow-up of 7.5 years (interquartile range 5.2-10.2), Indigenous Australian patients were found to experience 30% greater mortality risk (unadjusted hazard ratio = 1.30; 95% CI: 1.03-1.64, p = 0.03). The effect size strengthened after adjustment for propensity score (adjusted hazard ratio = 1.49; 95% CI: 1.13-1.96, p = .004). Adjustment for ARIA categorisation strengthened the effect size (adjusted HR = 1.54 (95% CI: 1.11-2.13, p = .009). Indigenous Australian peoples were at greater risk for prolonged ventilation and combined morbidity outcome, and experienced poorer survival in the longer term. Higher mortality risk among Indigenous Australians was evident even after controlling for remoteness and accessibility to services. Crown Copyright © 2013. Published by Elsevier B.V. All rights reserved.

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 instrument may be less valid for Indigenous people living in remote areas or that living in an Indigenous majority environment (such as exists in most remote communities) may mitigate the risk of psychological distress to some degree.

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 remote areas suggests either that the instrument may be less valid for Indigenous people living in remote areas or that living in an Indigenous majority environment (such as exists in most remote communities) may mitigate the risk of psychological distress to some degree. PMID:22296820

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…

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

Why it's time to recognise Indigenous peoples in the Constitution.

PubMed

Williams, George

2015-06-01

This article provides an overview of why it is proposed that the Australian Constitution be changed to recognise Aboriginal and Torres Strait Islander peoples. It then establishes what changes are needed to the Constitution. The Australian Constitution fails to recognise Indigenous peoples, and still enables discrimination against them. This provides a sound case for changing the document. © The Royal Australian and New Zealand College of Psychiatrists 2015.

The maternal and neonatal outcomes for an urban Indigenous population compared with their non-Indigenous counterparts and a trend analysis over four triennia.

PubMed

Kildea, Sue; Stapleton, Helen; Murphy, Rebecca; Kosiak, Machellee; Gibbons, Kristen

2013-08-30

Indigenous Australians experience significantly disproportionate poorer health outcomes compared to their non-Indigenous counterparts. Despite the recognised importance of maternal infant health (MIH), there is surprisingly little empirical research to guide service redesign that successfully addresses the disparities. This paper reports on a service evaluation that also compared key MIH indicators for Indigenous and non-Indigenous mothers and babies over a 12-year period 1998-2009. Trend analysis with logistic regression, using the independent variables of ethnicity and triennia, explored changes over time (1998-2009) between two cohorts: 1,523 births to Indigenous mothers and 43,693 births to non-Indigenous mothers. We included bivariate and multivariate analysis on key indicators (e.g. teenage births, preterm birth, low birth weight, smoking) and report odds ratios (ORs), 95% CIs and logistic regression adjusting for important confounders. We excluded transfers in from other areas which are identified within the database. Bivariate analysis revealed Indigenous women were statistically more likely to have spontaneous onset of labour and a non-instrumental vaginal birth. They were less likely to take epidurals for pain relief in labour, have assisted births, caesarean sections or perineal trauma. Despite better labour outcomes, Indigenous babies were more likely to be born preterm (< 37 weeks) and be low birth weight (< 2500 g); these differences remained significant in multivariate analysis. The trend analysis revealed relatively stable rates for teenage pregnancy, small for gestational age, low birth weight babies, and perinatal mortality for both cohorts, with the gap between cohorts consistent over time. A statistical widening of the gap in preterm birth and smoking rates was found with preterm birth demonstrating a relative increase of 51% over this period. The comprehensive database from a large urban hospital allowed a thorough examination of outcomes and contributing factors. The gap between both cohorts remains static in several areas but in some cases worsened. Alternative models for delivering care to Indigenous women and their babies have shown improved outcomes, including preterm birth, though not all have been sustained over time and none are available Australia-wide. New models of care, which recognise the heterogeneity of Indigenous communities, incorporate a multiagency approach, and are set within a research framework, are urgently needed.

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 Australian communities, local and operational-level participants' views point to an 'implementation gap'. Their views should be heard because they are in a position to provide practical recommendations for effective policy implementation faithful to its design, thereby translating sound policy into meaningful action. Some recommendations may also find a place in culturally diverse low- and middle-income countries. Key words: tobacco policy implementation, challenges, opportunities, remote Indigenous Australian communities. PMID:22839197

Changes in exposure to ‘life stressors’ in the Aboriginal and Torres Strait Islander population, 2002 to 2008

PubMed Central

2014-01-01

Background The Negative Life Events Scale (NLES) has been included in nationally representative surveys of the Indigenous and Australian population since 2002 as a measure of exposure to a range of ‘life stressors’. There has been limited reporting or analysis of estimates of the NLES from these surveys. This paper reports changes in exposure to stressors from 2002 to 2008 for the Indigenous population, and examines inter-relationships between eleven NLES items. Data for the 2006 Australian population is also included for comparative purposes. Methods Data from the 2002 and 2008 National Aboriginal and Torres Strait Islander Social Surveys (NATSISS) and the 2006 General Social Survey (GSS) were accessed from the Australia Bureau of Statistics in order to determine significant changes in exposure to stressors for the 2002 and 2008 Indigenous population by remoteness and to compare this with the 2006 Australian population. Factor analysis was used to assess the inter-relationships between stressors for the Indigenous and Australian population by remoteness. Results In remote locations, between 2002 and 2008, exposure to life stressors decreased significantly for the Indigenous population across seven of the eleven stressors. In non-remote locations, exposure to four of the stressors increased significantly. Exposure to stressors in the 2002 and 2008 non-remote Indigenous population were significantly higher than those for the 2006 Australian population for all items, except ‘alcohol and/or drug problems’ and ‘trouble with the police’, which showed no evidence of a difference. The factor analysis of the NLES for the 2002 and 2008 remote and non-remote Indigenous populations and the 2006 Australian population showed a consistent clustering of items into three groups: social transgressions; grief and trauma; and labour market stressors. Conclusions The reduction in exposure to life stressors for the remote Indigenous population may be related to policy and practice changes (e.g. more police, income quarantining, housing construction). The differential change in exposure to life stressors between remote and non-remote locations highlights the importance of presenting data for these geographic locations separately. PMID:24512200

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

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…

An Assessment of Intellectual Disability Among Aboriginal Australians

ERIC Educational Resources Information Center

Glasson, E. J.; Sullivan, S. G.; Hussain, R.; Bittles, A. H.

2005-01-01

Background: The health and well-being of Indigenous people is a significant global problem, and Aboriginal Australians suffer from a considerably higher burden of disease and lower life expectancy than the non-Indigenous population. Intellectual disability (ID) can further compromise health, but there is little information that documents the…

Disturbances and Dislocations: Understanding Teaching and Learning Experiences in Australian Aboriginal Music.

ERIC Educational Resources Information Center

Mackinlay, Elizabeth

2001-01-01

A White Australian professor of a class on Indigenous women's dance has her Aboriginal sister-in-law conduct workshops on Indigenous dance. The classroom dynamics resulting from the complex power relationships (teacher as White woman, Aboriginal family member, and students) disturbs Western paradigms. The responsibility of "safely…

Ensuring Indigenous Cultural Respect in Australian Undergraduate Nursing Students

ERIC Educational Resources Information Center

Power, Tamara; Virdun, Claudia; Gorman, Edward; Doab, Anna; Smith, Rachel; Phillips, Angela; Gray, Joanne

2018-01-01

Like other Westernised countries, Australia's history of colonisation, racism and oppression has impacted upon Indigenous Peoples' health and well-being. It is also evident that institutional racism and ongoing colonisation are present in the Australian health system. Better preparation of health professionals to work in a culturally respectful…

Cancer Services and Their Initiatives to Improve the Care of Indigenous Australians.

PubMed

Taylor, Emma V; Haigh, Margaret M; Shahid, Shaouli; Garvey, Gail; Cunningham, Joan; Thompson, Sandra C

2018-04-11

Indigenous Australians continue to experience significantly poorer outcomes from cancer than non-Indigenous Australians. Despite the importance of culturally appropriate cancer services in improving outcomes, there is a lack of awareness of current programs and initiatives that are aimed at meeting the needs of Indigenous patients. Telephone interviews were used to identify and describe the Indigenous-specific programs and initiatives that are implemented in a subset of the services that participated in a larger national online survey of cancer treatment services. Fourteen services located across Australia participated in the interviews. Participants identified a number of factors that were seen as critical to delivering culturally appropriate treatment and support, including having a trained workforce with effective cross-cultural communication skills, providing best practice care, and improving the knowledge, attitudes, and understanding of cancer by Indigenous people. However, over a third of participants were not sure how their service compared with others, indicating that they were not aware of how other services are doing in this field. There are currently many Indigenous-specific programs and initiatives that are aimed at providing culturally appropriate treatment and supporting Indigenous people affected by cancer across Australia. However, details of these initiatives are not widely known and barriers to information sharing exist. Further research in this area is needed to evaluate programs and initiatives and showcase the effective approaches to Indigenous cancer care.

Exploring Positive Survivorship Experiences of Indigenous Australian Cancer Patients

PubMed Central

Tam, Laura; Garvey, Gail; Meiklejohn, Judith; Martin, Jennifer; Adams, Jon; Walpole, Euan; Fay, Michael; Valery, Patricia

2018-01-01

Amongst Indigenous Australians, “cancer” has negative connotations that detrimentally impact upon access to cancer care services. Barriers to accessing cancer services amongst Indigenous Australians are widely reported. In contrast, factors that facilitate this cohort to successfully navigate cancer care services (“enablers”) are scarcely reported in the literature. Through qualitative interviews, this article examines factors that assist Indigenous Australians to have positive cancer experiences. Semi-structured interviews were conducted with twelve adult Indigenous oncology patients recruited from a tertiary hospital in Queensland, Australia during 2012–2014. Data generated from the interviews were independently reviewed by two researchers via inductive thematic analytical processes. Discussions followed by consensus on the major categories allowed conclusions to be drawn on potential enablers. Two major categories of enablers were identified by the researchers: resilience and communication. Individual’s intrinsic strength, their coping strategies, and receipt of support improved participant’s resilience and consequently supported a positive experience. Communication methods and an effective patient-provider relationship facilitated positive experiences for participants. Despite potential barriers to access of care for Indigenous cancer patients, participants in the study demonstrated that it was still possible to focus on the positive aspects of their cancer experiences. Many participants explained how cancer changed their outlook on life, often for the better, with many feeling empowered as they progressed through their cancer diagnosis and treatment processes. PMID:29342934

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…

Childhood disability in Aboriginal and Torres Strait Islander peoples: a literature review

PubMed Central

2013-01-01

Introduction Aboriginal and Torres Strait Islander children have higher rates of disability than non-Indigenous children and are considered doubly disadvantaged, yet there is very little data reflecting prevalence and service access to inform design and delivery of services. Failing to address physical, social, and psychological factors can have life-long consequences and perpetuate longstanding health disparities. Methods A narrative literature review was undertaken to identify peer reviewed literature describing factors impacting on the prevention, recognition, and access to support and management of disability in Indigenous Australian children. Results Twenty-seven peer-reviewed journal articles met inclusion criteria. The majority of articles focused on the hearing loss and learning disabilities consequent of otitis media. Few articles reported data on urban or metropolitan Indigenous populations or described interventions. Individual/community-, provider-, and systems level factors were identified as impacting on recognition and management of disability in young Indigenous children. Conclusions Given the burden of childhood disability, the limited literature retrieved is concerning as this is a barometer of activity and investment. Solutions addressing childhood disability will require collaboration between health, social and educational disciplines as well as an increased investment in prevention, identification and promotion of access. PMID:23327694

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

PubMed

Adegbija, Odewumi Oluwarotimi; Wang, Zhiqiang

2014-01-01

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

Human papillomavirus vaccination and genital warts in young Indigenous Australians: national sentinel surveillance data.

PubMed

Ali, Hammad; McManus, Hamish; O'Connor, Catherine C; Callander, Denton; Kong, Marlene; Graham, Simon; Saulo, Dina; Fairley, Christopher K; Regan, David G; Grulich, Andrew; Low, Nicola; Guy, Rebecca J; Donovan, Basil

2017-03-20

To examine the impact of the national human papillomavirus (HPV) vaccination program (available to girls and women [12-26 years] since 2007 and to boys [12-15 years] since 2013) on the number of diagnoses of genital warts in Australian Aboriginal and Torres Strait Islander (Indigenous) people. Analysis of routinely collected data from patients attending 39 sexual health clinics (SHCs) in the Genital Warts Surveillance Network for the first time.Major outcome: The average annual proportion of Indigenous and non-Indigenous SHC patients diagnosed with genital warts during the pre-vaccination (2004-2007) and vaccination periods (2008-2014), stratified by age group and sex. 7.3% of the 215 599 Australian-born patients with known Indigenous status and seen for the first time at participating SHCs during 2004-2014 were Indigenous Australians. The average proportion of female Indigenous patients diagnosed with warts was lower during the vaccination period than during the pre-vaccination period (in those under 21, summary rate ratio [SRR], 0.12; 95% CI, 0.07-0.21; P < 0.001); in 21-30-year olds: SRR, 0.41; 95% CI, 0.27-0.61; P < 0.001); there was no significant difference for women over 30 (SRR, 0.84; 95% CI, 0.51-1.36; P = 0.47). The proportion of male Indigenous heterosexual SHC patients under 21 diagnosed with warts was also lower during the vaccination period (SRR, 0.25; 95% CI, 0.12-0.49; P < 0.001), with no significant changes among older Indigenous men over 30. There were marked declines in the proportions of diagnoses of genital warts in young Indigenous women and men attending SHCs after the introduction of the HPV vaccination program. If high levels of HPV vaccine coverage are sustained, HPV-related cancer rates should also decline.

Indigenous Australians with non-small cell lung cancer or cervical cancer receive suboptimal treatment.

PubMed

Whop, Lisa J; Bernardes, Christina M; Kondalsamy-Chennakesavan, Srinivas; Darshan, Deepak; Chetty, Naven; Moore, Suzanne P; Garvey, Gail; Walpole, Euan; Baade, Peter; Valery, Patricia C

2017-10-01

Lung cancer and cervical cancer are higher in incidence for Indigenous Australians and survival is worse compared with non-Indigenous Australians. Here we aim to determine if being Indigenous and/or other factors are associated with patients receiving "suboptimal treatment" compared to "optimal treatment" according to clinical guidelines for two cancer types. Data were collected from hospital medical records for Indigenous adults diagnosed with cervical cancer and non-small cell lung cancer (NSCLC) and a frequency-matched comparison group of non-Indigenous patients in the Queensland Cancer Registry between January 1998 and December 2004. The two cancer types were analyzed separately. A total of 105 women with cervical cancer were included in the study, 56 of whom were Indigenous. Indigenous women had higher odds of not receiving optimal treatment according to clinical guidelines (unadjusted OR 7.1; 95% CI, 1.5-33.3), even after adjusting for stage (OR 5.7; 95% CI, 1.2-27.3). Of 225 patients with NSCLC, 198 patients (56% Indigenous) had sufficient information available to be analyzed. The odds of receiving suboptimal treatment were significantly higher for Indigenous compared to non-Indigenous NSCLC patients (unadjusted OR 1.9; 95% CI, 1.0-3.6) and remained significant after adjusting for stage, comorbidity and age (adjusted OR 2.1; 95% CI, 1.1-4.1). The monitoring of treatment patterns and appraisal against guidelines can provide valuable evidence of inequity in cancer treatment. We found that Indigenous people with lung cancer or cervical cancer received suboptimal treatment, reinforcing the need for urgent action to reduce the impact of these two cancer types on Indigenous people. © 2016 John Wiley & Sons Australia, Ltd.

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…

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. Copyright © 2017 Elsevier Ltd. All rights reserved.

Genetic Diversity and Differentiation in Urban and Indigenous Populations of Mexico: Patterns of Mitochondrial DNA and Y-Chromosome Lineages.

PubMed

González-Sobrino, Blanca Z; Pintado-Cortina, Ana P; Sebastián-Medina, Leticia; Morales-Mandujano, Fabiola; Contreras, Alejandra V; Aguilar, Yasnaya E; Chávez-Benavides, Juan; Carrillo-Rodríguez, Aurelio; Silva-Zolezzi, Irma; Medrano-González, Luis

2016-01-01

Aside from the admixture between indigenous people and people from overseas, populations in Mexico changed drastically after the Spanish conquest of the sixteenth century, forming an intricate history that has been underutilized in understanding the genetic population structure of Mexicans. To infer historical processes of isolation, dispersal, and assimilation, we examined the phylogeography of mitochondrial (mt) DNA and Y-chromosome lineages in 3,026 individuals from 10 urban and nine indigenous populations by identifying single nucleotide polymorphisms. A geographic array with a predominance of Amerindian lineages was observed for mtDNA, with northern indigenous populations being divergent from the central and southern indigenous populations; urban populations showed low differentiation with isolation by distance. Y-chromosome variation distinguished urban and indigenous populations through the Amerindian haplogroup Q frequency. The MtDNA and the Y-chromosome together primarily distinguished urban and indigenous populations, with different geographic arrays for both. Gene flow across geographical distance and between the urban and indigenous realms appears to have altered the pre-Hispanic phylogeography in central and southern Mexico, mainly by displacement of women, while maintaining the indigenous isolation in the north, southeast, and Zapotec regions. Most Amerindian mtDNA diversity currently occurs in urban populations and appears to be reduced among indigenous people.

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

ERIC Educational Resources Information Center

McCollow, John

2012-01-01

This article examines a controversial initiative in Indigenous education: the establishment of the Cape York Aboriginal Australian Academy (CYAAA). The article provides a brief description of the Academy's three campuses and their communities and considers: the circumstances of its creation, including the role of Noel Pearson and Cape York…

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…

The Cape York Aboriginal Australian Academy Three Years On: What Is the Evidence? What Does It Indicate?

ERIC Educational Resources Information Center

McCollow, John

2012-01-01

The Cape York Aboriginal Australian Academy (CYAAA), which began operation as part of the government schooling system in 2010, incorporates activities across three overlapping "domains": Class--the formal schooling component; Culture--Indigenous and non-Indigenous cultural knowledge; and Club--sporting, cultural, music and physical…

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…

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.…

Dreamtime astronomy: development of a new indigenous program at Sydney Observatory

NASA Astrophysics Data System (ADS)

Wyatt, Geoffrey; Stephenson, Toner; Hamacher, Duane W.

2014-07-01

The Australian National Curriculum promotes Indigenous culture in school education programs. To foster a broader appreciation of cultural astronomy, to utilise the unique astronomical heritage of the site, and to develop an educational program within the framework of the National Curriculum, Sydney Observatory launched Dreamtime Astronomy - a program incorporating Australian Indigenous culture, astronomy, and Sydney's astronomical history and heritage. This paper reviews the development and implementation of this program and discusses modifications following an evaluation that was conducted by schools.

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.

Applying a Midwifery Lens to Indigenous Health Care Delivery: The Contribution of Campus Learning and Rural Placements to Effecting Systemic Change.

PubMed

Thackrah, Rosalie D; Thompson, Sandra C

2018-01-01

Study background Increasing cultural safety in health settings is essential to address stark health disparities between Indigenous and non-Indigenous Australians. Respect for cultural knowledge, better communication, and recognition of racism as a determinant of health are required for improved service delivery. How this knowledge is acquired in health professional training and translated to clinical settings is poorly understood. Purpose Impacts of an innovative Indigenous health unit and remote clinical placements on knowledge acquisition and attitude change were explored among midwifery students to inform cultural competency initiatives in health professional training. Methods A multiphased, mixed methods research design used surveys, observations, and interviews. Qualitative analysis was strengthened through triangulation with quantitative data. Results A unit conceived with substantial Indigenous Australian input and which privileged these voices enhanced knowledge and shifted attitudes in a positive direction; however, immediate gains diminished over time. Remote placements had a profound effect on student learning. Exposure to Indigenous Australians in classrooms and communities, and the self-reflection generated, helped dispel stereotypes and challenge assumptions based on limited cultural knowledge and contact. Conclusion Optimization of receptivity to Indigenous Australian content and opportunities for remote placements contributed to students' developing cultural capabilities with implications for all health professional training. Whether this heightened awareness is enough to address institutional racism identified in health service delivery remains unanswered. The focus must include those established health practitioners and administrators who influence organizational culture if real systemic change is to occur. Given appropriate on-going support, graduates can play a vital role in expediting this process.

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…

Proposing a health promotion framework to address gambling problems in Australian Indigenous communities.

PubMed

Fogarty, Marisa; Coalter, Nicola; Gordon, Ashley; Breen, Helen

2018-02-01

Gambling impacts affect Australian Indigenous families and communities in diverse and complex ways. Indigenous people throughout Australia engage in a broad range of regulated and unregulated gambling activities. Challenges in this area include the complexities that come with delivering services and programmes between the most remote regions, to highly populated towns and cities of Australia. There is little knowledge transfer between states and territories in Australia and no conceptual understanding or analysis of what constitutes 'best practice' in gambling service delivery for Indigenous people, families and communities. This article reviews health promotion approaches used in Australia, with a particular focus on Indigenous and gambling-based initiatives. Contributing to this review is an examination of health promotion strategies used in Indigenous gambling service delivery in the Northern Territory, New South Wales and Western Australia, demonstrating diversity and innovation in approaches. The article concludes by emphasizing the potential value of adopting health promotion strategies to underpin programme and service delivery for addressing gambling problems in Australian Indigenous communities. However, success is contingent on robust, evidence-based programme design, implementation and evaluation that adhere to health promotion principles. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

Development of a National Aboriginal and Torres Strait Islander Cancer Framework: A Shared Process to Guide Effective Policy and Practice

PubMed Central

Brands, Jenny; Garvey, Gail; Anderson, Kate; Cunningham, Joan; Chynoweth, Jennifer; Wallington, Isabella; Morris, Bronwyn; Knott, Vikki; Webster, Samantha; Kinsella, Lauren; Zorbas, Helen

2018-01-01

Indigenous Australians experience a substantially higher cancer mortality rate than non-Indigenous Australians. While cancer outcomes are improving for non-Indigenous Australians, they are worsening for Indigenous Australians. Reducing this disparity requires evidence-based and culturally-appropriate guidance. The purpose of this paper is to describe an initiative by Cancer Australia and Menzies School of Health Research (Menzies) to develop Australia’s first National Aboriginal and Torres Strait Islander Cancer Framework using a process of co-design with relevant stakeholders. The initiative was guided by three core principles: achieving policy-relevant evidence-based outcomes; engaging and maintaining trust with Indigenous Australians at every phase; and employing best-practice and appropriate research methods. Four components of research comprised the Framework development: evidence review; multifaceted stakeholder consultation and input; triangulation of findings; and direct stakeholder input in drafting and refining the Framework. The evidence review confirmed the increasing burden of cancer on Indigenous Australians, while stakeholder consultations facilitated comprehensive input from those with lived experience. The consultations revealed issues not identified in existing literature, and gave different emphases of priority, thus reinforcing the value of including stakeholder perspectives. This paper focuses primarily on documenting the methods used; findings are presented only in order to illustrate the results of the process. The published Framework is available at www.canceraustralia.gov.au; further description and analyses of findings from the consultations will be published elsewhere. The logistics inherent in large-scale consultation are considerable. However, the quality of data and the foundation for sustained partnership with stakeholders and knowledge translation vastly outweighed the challenges. The process of wide-ranging stakeholder consultation described in this paper offers a model for other areas of national and international Indigenous priority setting and policy and practice development that meets the needs of those most affected. The Framework, through the establishment of an agreed, shared and evidence-based agenda, provides guidance for jurisdictional cancer plans, optimal care pathways, and program and service planning for the multiple players across all levels of the health system. PMID:29747405

The validation of a self-report measure and physical activity of Australian Aboriginal and Torres Strait Islander and non-Indigenous rural children.

PubMed

Gwynn, Josephine D; Hardy, Louise L; Wiggers, John H; Smith, Wayne T; D'Este, Catherine A; Turner, Nicole; Cochrane, Janine; Barker, Daniel J; Attia, John R

2010-07-01

To validate a self-report measure of physical activity for both Australian Aboriginal and Torres Strait Islander and non-Indigenous rural children, and to describe their physical activity participation. In this cross-sectional study, 84 Aboriginal and Torres Strait Islander and 146 non-Indigenous children aged 10-12 years old completed the Many Rivers Physical Activity Recall Questionnaire (MRPARQ), a modified version of the Adolescent Physical Activity Recall Questionnaire (APARQ). A sub-group (n=86) wore an accelerometer for seven consecutive days in order to validate the instrument. Pearson and Intra Class Correlation coefficients between the survey and acceleromtery for weekdays only are 0.31 and 0.16, respectively, for Aboriginal and Torres Strait Islander children, and 0.38 and 0.31, respectively, for non-Indigenous children, and demonstrate a modest (p<0.05) correlation. Self-reported MVPA for Aboriginal and Torres Strait Islander children is between 162 and 172 minutes/day, and is 125 minutes by accelerometer; for non-Indigenous children MVPA is between 123 and 149 minutes (survey) and 107 minutes (accelerometer). Australian Aboriginal and Torres Strait Islander children's self-report of physical activity is at least as valid as non-Indigenous children, given culturally appropriate support; they tend to be more active than non-Indigenous children. The MRPARQ can be administered with Aboriginal and Torres Strait Islander and non-Indigenous children.

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.

The International Covenant on Economic, Social and Cultural Rights and the right to health: is Australia meeting its obligations to Aboriginal peoples?

PubMed

Couzos, Sophie; Thiele, Dea Delaney

2007-05-21

There is evidence that Australia is not meeting its obligations to Aboriginal and Torres Strait Islander peoples for their right to the "highest attainable standard" of health, required under the International Covenant on Economic, Social and Cultural Rights (ICESCR). Poor access to primary health care for Aboriginal peoples and substantial shortfalls in government spending to address this are in violation of the ICESCR. Aboriginal and Torres Strait Islander peoples' share of the universal health coverage expenditure offered to all Australians is less per person than for other Australians. The failure to monitor the provision of mainstream health services to Aboriginal peoples and inequitable distribution of health facilities and services compound these violations. Equality in health between Indigenous and non-Indigenous Australians is achievable, but not until the shortfall in health services expenditure for Indigenous Australians is addressed.

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…

Aboriginal Community Education Officers' Border Work: Culturally Safe Practices for Supporting Migrating Indigenous Students from Country into Urban and Semi-Rural Schools

ERIC Educational Resources Information Center

MacGill, Bindi

2012-01-01

Since 2001 there has been an increase in migration patterns by Indigenous families from remote communities to urban and semi-rural locations. Indigenous student emigration from remote Indigenous schools to urban and semi-rural schools is an emerging crisis as there are routinely inadequate service providers for Indigenous emigres. Migration away…

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.

Academic "Place-Making": Fostering Attachment, Belonging and Identity for Indigenous Students in Australian Universities

ERIC Educational Resources Information Center

Carter, Jennifer; Hollinsworth, David; Raciti, Maria; Gilbey, Kathryn

2018-01-01

Place is a concept used to explore how people ascribe meaning to their physical and social surrounds, and their emotional affects. Exploring the university as a place can highlight social relations affecting Australian Indigenous students' sense of belonging and identity. We asked what university factors contribute to the development of a positive…

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…

Refocusing on Oral Language and Rich Representations to Develop the Early Mathematical Understandings of Indigenous Students

ERIC Educational Resources Information Center

McDonald, Susan; Warren, Elizabeth; DeVries, Eva

2011-01-01

This article examines the nature of oral language and representations used by teachers as they instruct young Indigenous Australian students at the beginning of formal schooling during play-based activities in mathematics. In particular, the use of Standard Australian English (SAE), the mathematical register used, and the interplay with…

Difficult conversations: Australian Indigenous patients' views on kidney transplantation.

PubMed

Devitt, Jeannie; Anderson, Kate; Cunningham, Joan; Preece, Cilla; Snelling, Paul; Cass, Alan

2017-10-11

Indigenous Australians suffer a disproportionate burden of end stage kidney disease (ESKD) but are significantly less likely to receive a transplant. This study explores Indigenous ESKD patients' views on transplantation as a treatment option. The Improving Access to Kidney Transplants (IMPAKT) research program investigated barriers to kidney transplantation for Indigenous Australians. An interview study, conducted in 2005-2006, elicited illness experience narratives from 146 Indigenous patients, including views on transplant. Interviews were conducted at 26 sites that collectively treat the majority of Indigenous ESKD patients. Key themes were identified via team consensus meetings, providing a flexible framework and focus for continued coding. Four inter-related themes were identified in patient commentary: a very high level (90% of respondents) of positive interest in transplantation; patients experienced a range of communication difficulties and felt uninformed about transplant; family involvement in decision-making was constrained by inadequate information; and patients needed to negotiate cultural and social sensitivities around transplantation. Indigenous ESKD patients demonstrated an intense interest in transplantation preferring deceased over living kidney donation. Patients believe transplant is the path most likely to support the re-establishment of their 'normal' family life. Patients described themselves as poorly informed; most had only a rudimentary knowledge of the notion of transplant but no understanding of eligibility criteria, the transplant procedure and associated risks. Patients experienced multiple communication barriers that - taken together - undermine their engagement in treatment decision-making. Families and communities are disempowered because they also lack information to reach a shared understanding of transplantation. Cultural sensitivities associated with transplantation were described but these did not appear to constrain patients in making choices about their own health. Transplant units and local treatment providers should collaborate to develop user-friendly, culturally informed and region-specific patient education programs. Quality improvement cycles should underpin the development of national guidelines for patient education. Noting Indigenous patients' intense interest in transplantation, and nephrologists' concerns regarding poor transplant outcomes, research should prioritise exploring the predictors of transplant outcomes for Indigenous Australians.

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 criteria. No evidence of benefit was found for these projects. Conclusions Although social media technologies have the unique capacity to reach Indigenous Australians as well as other underserved populations because of their wide and instant disseminability, evidence of their capacity to do so is limited. Current interventions are neither evidence-based nor widely adopted. Health promotion organizations need to gain a more thorough understanding of their technologies, who engages with them, why they engage with them, and how, in order to be able to create successful social media projects. PMID:25498835

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 for these projects. Although social media technologies have the unique capacity to reach Indigenous Australians as well as other underserved populations because of their wide and instant disseminability, evidence of their capacity to do so is limited. Current interventions are neither evidence-based nor widely adopted. Health promotion organizations need to gain a more thorough understanding of their technologies, who engages with them, why they engage with them, and how, in order to be able to create successful social media projects.

Roles of Urban Indigenous Community Members in Collaborative Field-Based Teacher Preparation

ERIC Educational Resources Information Center

Lees, Anna

2016-01-01

This qualitative case study explored a community-university partnership for teacher preparation with an urban Indigenous community organization. The study examined the roles of Indigenous community partners as co-teacher educators working to better prepare teachers for the needs of urban Indigenous children and communities. The author collected…

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

PubMed

Rumbold, Alice R; Cunningham, Joan; Purbrick, Brydie; Lewis, Jenny M

2013-11-08

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. 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. 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. In the past few decades there has been substantial development of the research workforce in Indigenous health, characterised by an increase in authors and outputs, a greater focus on some identified priority areas and sustained growth in collaborations. This has occurred in conjunction with significant changes to funding policy for Indigenous health research, suggesting that both productivity and collaboration may be sensitive to reform, including the provision of dedicated funding.

Critical Allies and Feminist Praxis: Rethinking Dis-Ease

ERIC Educational Resources Information Center

McGloin, Colleen

2016-01-01

In Australian universities, non-Indigenous educators teaching Indigenous studies and/or Indigenous content must engage critically with anti-colonialism, not simply as lip service to syllabus content, but also, as an ethical consideration whereby consultation and collaboration with Indigenous scholars must necessarily direct praxis. Such an…

Prevalence of augmented renal clearance and performance of glomerular filtration estimates in Indigenous Australian patients requiring intensive care admission.

PubMed

Tsai, D; Udy, A A; Stewart, P C; Gourley, S; Morick, N M; Lipman, J; Roberts, J A

2018-01-01

Augmented renal clearance (ARC) refers to the enhanced renal excretion of circulating solute commonly demonstrated in numerous critically ill subgroups. This study aimed to describe the prevalence of ARC in critically ill Indigenous Australian patients and explore the accuracy of commonly employed mathematical estimates of glomerular filtration. We completed a single-centre, prospective, observational study in the intensive care unit (ICU), Alice Springs Hospital, Central Australia. Participants were critically ill adult Indigenous and non-Indigenous Australian patients with a urinary catheter in situ. Exclusion criteria were anuria, pregnancy or the requirement for renal replacement therapy. Daily eight-hour measured creatinine clearances (CrCL_m) were collected throughout the ICU stay. ARC was defined by a CrCL_m ≥130 ml/min/1.73 m². The Cockcroft-Gault and Chronic Kidney Disease Epidemiology Collaboration equations were also used to calculate mathematical estimates for comparison. In total, 131 patients were recruited (97 Indigenous, 34 non-Indigenous) and 445 samples were collected. The median (range) CrCL_m was 93.0 (5.14 to 205.2) and 90.4 (18.7 to 206.8) ml/min/1.73 m² in Indigenous and non-Indigenous patients, respectively. Thirty-one of 97 (32%) Indigenous patients manifested ARC, compared to 7 of 34 (21%) non-Indigenous patients (P=0.21). Younger age, major surgery, higher baseline renal function and an absence of diabetes were all associated with ARC. Both mathematical estimates manifest limited accuracy. ARC was prevalent in critically ill Indigenous patients, which places them at significant risk of underdosing with renally excreted drugs. CrCL_m should be obtained wherever possible to ensure accurate dosing.

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 barriers. There was limited evidence regarding social media and mobile applications, for Indigenous youth, pregnant women and prisoners, and no evidence regarding interventions to protect communities from industry interference, the use of electronic cigarettes, interventions for people experiencing mental illness, juvenile justice, linguistic diversity or 'pubs, clubs and restaurants'. There is limited Indigenous-specific evidence for most tobacco interventions. A 'comprehensive approach' incorporating NTS and NATSIHP Principles and Priorities of partnership and engagement, evidence from other settings, programme logic and responsive evaluation plans may improve intervention acceptability, effectiveness and implementation and mitigate risks of adapting tobacco evidence for Indigenous Australians.

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…

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…

Does Indigenous health research have impact? A systematic review of reviews.

PubMed

Kinchin, Irina; Mccalman, Janya; Bainbridge, Roxanne; Tsey, Komla; Lui, Felecia Watkin

2017-03-21

Aboriginal and Torres Strait Islander Australians (hereafter respectfully Indigenous Australians) claim that they have been over-researched without corresponding research benefit. This claim raises two questions. The first, which has been covered to some extent in the literature, is about what type(s) of research are likely to achieve benefits for Indigenous people. The second is how researchers report the impact of their research for Indigenous people. This systematic review of Indigenous health reviews addresses the second enquiry. Fourteen electronic databases were systematically searched for Indigenous health reviews which met eligibility criteria. Two reviewers assessed their characteristics and methodological rigour using an a priori protocol. Three research hypotheses were stated and tested: (1) reviews address Indigenous health priority needs; (2) reviews adopt best practice guidelines on research conduct and reporting in respect to methodological transparency and rigour, as well as acceptability and appropriateness of research implementation to Indigenous people; and (3) reviews explicitly report the incremental impacts of the included studies and translation of research. We argue that if review authors explicitly address each of these three hypotheses, then the impact of research for Indigenous peoples' health would be explicated. Seventy-six reviews were included; comprising 55 journal articles and 21 Australian Government commissioned evidence review reports. While reviews are gaining prominence and recognition in Indigenous health research and increasing in number, breadth and complexity, there is little reporting of the impact of health research for Indigenous people. This finding raises questions about the relevance of these reviews for Indigenous people, their impact on policy and practice and how reviews have been commissioned, reported and evaluated. The findings of our study serve two main purposes. First, we have identified knowledge and methodological gaps in documenting Indigenous health research impact that can be addressed by researchers and policy makers. Second, the findings provide the justification for developing a framework allowing researchers and funding bodies to structure future Indigenous health research to improve the reporting and assessment of impact over time.

Guidelines for inclusion: Ensuring Indigenous peoples' involvement in water planning processes across South Eastern Australia

NASA Astrophysics Data System (ADS)

Saenz Quitian, Alejandra; Rodríguez, Gloria Amparo

2016-11-01

Indigenous peoples within the Murray-Darling Basin have traditionally struggled for the recognition of their cultural, social, environmental, spiritual, commercial and economic connection to the waters that they have traditionally used, as well as their right to engage in all stages of water planning processes. Despite Australian national and federal frameworks providing for the inclusion of Indigenous Australians' objectives in planning frameworks, water plans have rarely addressed these objectives in water, or the strategies to achieve them. Indeed, insufficient resources, a lack of institutional capacity in both Indigenous communities and agencies and an inadequate understanding of Indigenous people's objectives in water management have limited the extent to which Indigenous objectives are addressed in water plans within the Murray-Darling Basin. In this context, the adoption of specific guidelines to meet Indigenous requirements in relation to basin water resources is crucial to support Indigenous engagement in water planning processes. Using insights from participatory planning methods and human rights frameworks, this article outlines a set of alternative and collaborative guidelines to improve Indigenous involvement in water planning and to promote sustainable and just water allocations.

Coronial Practice, Indigeneity and Suicide.

PubMed

Tait, Gordon; Carpenter, Belinda; Jowett, Stephanie

2018-04-16

All available data suggest that, like many other Indigenous peoples, Australian Aborigines are significantly more likely to kill themselves than are non-Aboriginal Australians. This statistical disparity is normally positioned an objective, ontological and undeniable social fact, a fact best explained as a function of endemic community disadvantage and disenfranchisement. This research explores the possibility that higher-than-normal Aboriginal suicide rates may also be a function of coronial decision-making practices. Based upon in-depth interviews with 32 coroners from across Australia, the following conclusions emerged from the data. First, coroners have differing perceptions of Indigenous capacity, and are less likely to have concerns about intent when the suicide is committed by an Indigenous person. Second, coroners have identified divergent scripts of Indigenous suicide, particularly its spontaneity and public location, and this supports rather than challenges, a finding of suicide. Third, the coronial perception of Indigenous life is a factor which influences a suicide determination for Indigenous deaths. Finally, the low level of Indigenous engagement with the coronial system, and the unlikelihood of a challenge to the finding of suicide by Indigenous families, means that a coronial determination of suicide is more likely.

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.

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…

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,…

"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…

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.

Australia’s Efforts to Improve Food Security for Aboriginal and Torres Strait Islander Peoples

PubMed Central

2016-01-01

Abstract Australia is a wealthy country; however, available evidence suggests that food security among Aboriginal and Torres Strait Islander peoples has not yet been achieved. Aboriginal and Torres Strait Islander peoples living in remote, regional, and urban parts of Australia experience food insecurity for a number of reasons that usually include low income and a lack of access to affordable and healthy food. The much higher rate of illness and disease that this population experiences compared to non-indigenous Australians is directly related to food insecurity. This paper examines the food insecurity among Aboriginal and Torres Strait Islander peoples and recent Australian government efforts to combat this problem. The paper first considers what constitutes a human rights-based approach to achieving food security. Second, it describes the food insecurity that currently exists among Aboriginal and Torres Strait Islander peoples across the three pillars of food access, food availability, and food use. Third, the paper critically examines recent and current Australian government policy aimed at improving food security. The paper concludes with some reflections regarding how the Australian government can improve its efforts to achieve food security for Aboriginal and Torres Strait Islander peoples. PMID:28559687

Dental hospitalization trends in Western Australian children under the age of 15 years: a decade of population-based study.

PubMed

Alsharif, Alla T; Kruger, Estie; Tennant, Marc

2015-01-01

This study analyzed a decade of dental admission patterns in Western Australian children under the age of 15 years, examining associations with sociodemographic characteristics and with particular focus on dental decay and Indigenous children. This retrospective study analyzed the data obtained for 43,937 child patients under the age of 15 years hospitalized for an oral-health-related condition, as determined by principal diagnosis (ICD-10AM). Primary place of residency, age, gender, insurance status and Indigenous status were also analyzed. 'Dental caries' and 'embedded and impacted teeth' were the most common reasons for hospitalization among children under the age of 15 years. 'Dental caries' were most common in non-Indigenous patients, with 'pulp and periapical' most prevalent in Indigenous patients. The age-standardized rate (ASR) of hospitalization for Indigenous children in the last decade increased to reach that of non-Indigenous children in 2009. Total DRG costs of hospitalization, both public and private, were in excess of AUS $92 million over 10 years. This study indicates the burden of oral-health-related conditions on Western Australian children and the hospital system, in terms of health and economical impact. © 2014 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Biopedagogies and Indigenous Knowledge: Examining Sport for Development and Peace for Urban Indigenous Young Women in Canada and Australia

ERIC Educational Resources Information Center

Hayhurst, Lyndsay M. C.; Giles, Audrey R.; Wright, Jan

2016-01-01

This paper uses transnational postcolonial feminist participatory action research (TPFPAR) to examine two sport for development and peace (SDP) initiatives that focus on Indigenous young women residing in urban areas, one in Vancouver, Canada, and one in Perth, Australia. We examine how SDP programs that target urban Indigenous young women and…

Local co-ordination and case management can enhance Indigenous eye care – a qualitative study

PubMed Central

2013-01-01

Background Indigenous adults suffer six times more blindness than other Australians but 94% of this vision loss is unnecessary being preventable or treatable. We have explored the barriers and solutions to improve Indigenous eye health and proposed significant system changes required to close the gap for Indigenous eye health. This paper aims to identify the local co-ordination and case management requirements necessary to improve eye care for Indigenous Australians. Methods A qualitative study, using semi-structured interviews, focus groups, stakeholder workshops and meetings was conducted in community, private practice, hospital, non-government organisation and government settings. Data were collected at 21 sites across Australia. Semi-structured interviews were conducted with 289 people working in Indigenous health and eye care; focus group discussions with 81 community members; stakeholder workshops involving 86 individuals; and separate meetings with 75 people. 531 people participated in the consultations. Barriers and issues were identified through thematic analysis and policy solutions developed through iterative consultation. Results Poorly co-ordinated eye care services for Indigenous Australians are inefficient and costly and result in poorer outcomes for patients, communities and health care providers. Services are more effective where there is good co-ordination of services and case management of patients along the pathway of care. The establishment of clear pathways of care, development local and regional partnerships to manage services and service providers and the application of sufficient workforce with clear roles and responsibilities have the potential to achieve important improvements in eye care. Conclusions Co-ordination is a key to close the gap in eye care for Indigenous Australians. Properly co-ordinated care and support along the patient pathway through case management will save money by preventing dropout of patients who haven’t received treatment and a successfully functioning system will encourage more people to enter for care. PMID:23822115

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…

Learning in Place, Cultural Mapping and Sustainable Values on the Millawa Billa (Murray River)

ERIC Educational Resources Information Center

Heckenberg, Robyn

2016-01-01

This paper presents an Indigenous perspective on the significance of land, culture and Indigenous rights. The United Nations (UN) Declaration on the Rights of Indigenous Peoples promote the importance of traditional Indigenous societies, such as Aboriginal Australians. Participating in caring for country methods and having a close on-going…

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…

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…

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…

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 directions for future research and development emerged that were more broadly applicable. Issues such as appropriate staffing, localising decision making, identifying priorities and how they will be evaluated, and developing flexibility in terms of job descriptions and qualifications are highlighted.

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.

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. These findings should guide the development of interventions to encourage screening uptake and reduce bowel cancer related deaths among Indigenous Australians. PMID:22809457

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…

Coronial Practice, Indigeneity and Suicide

PubMed Central

Tait, Gordon; Carpenter, Belinda; Jowett, Stephanie

2018-01-01

All available data suggest that, like many other Indigenous peoples, Australian Aborigines are significantly more likely to kill themselves than are non-Aboriginal Australians. This statistical disparity is normally positioned an objective, ontological and undeniable social fact, a fact best explained as a function of endemic community disadvantage and disenfranchisement. This research explores the possibility that higher-than-normal Aboriginal suicide rates may also be a function of coronial decision-making practices. Based upon in-depth interviews with 32 coroners from across Australia, the following conclusions emerged from the data. First, coroners have differing perceptions of Indigenous capacity, and are less likely to have concerns about intent when the suicide is committed by an Indigenous person. Second, coroners have identified divergent scripts of Indigenous suicide, particularly its spontaneity and public location, and this supports rather than challenges, a finding of suicide. Third, the coronial perception of Indigenous life is a factor which influences a suicide determination for Indigenous deaths. Finally, the low level of Indigenous engagement with the coronial system, and the unlikelihood of a challenge to the finding of suicide by Indigenous families, means that a coronial determination of suicide is more likely. PMID:29659514

The "ripple effect": Health and community perceptions of the Indigenous Marathon Program on Thursday Island in the Torres Strait, Australia.

PubMed

Macniven, Rona; Plater, Suzanne; Canuto, Karla; Dickson, Michelle; Gwynn, Josephine; Bauman, Adrian; Richards, Justin

2018-02-19

Physical inactivity is a key health risk among Aboriginal and Torres Strait Islander (Indigenous) Australians. We examined perceptions of the Indigenous Marathon Program (IMP) in a remote Torres Strait island community. Semi-structured interviews with community and program stakeholders (n = 18; 14 Indigenous) examined barriers and enablers to running and the influence of the IMP on the community. A questionnaire asked 104 running event participants (n = 42 Indigenous) about their physical activity behaviours, running motivation and perceptions of program impact. Qualitative data were analysed using thematic content analysis, and quantitative data were analysed using descriptive statistics. Interviews revealed six main themes: community readiness, changing social norms to adopt healthy lifestyles, importance of social support, program appeal to hard-to-reach population groups, program sustainability and initiation of broader healthy lifestyle ripple effects beyond running. Barriers to running in the community were personal (cultural attitudes; shyness) and environmental (infrastructure; weather; dogs). Enablers reflected potential strategies to overcome described barriers. Indigenous questionnaire respondents were more likely to report being inspired to run by IMP runners than non-Indigenous respondents. Positive "ripple" effects of the IMP on running and broader health were described to have occurred through local role modelling of healthy lifestyles by IMP runners that reduced levels of "shame" and embarrassment, a common barrier to physical activity among Indigenous Australians. A high initial level of community readiness for behaviour change was also reported. SO WHAT?: Strategies to overcome this "shame" factor and community readiness measurement should be incorporated into the design of future Indigenous physical activity programs. © 2018 Australian Health Promotion Association.

Establishment of an innovative specialist cardiac indigenous outreach service in rural and remote Queensland.

PubMed

Tibby, David; Corpus, Rohan; Walters, Darren L

2010-01-01

Cardiovascular diseases are the leading cause of mortality in Indigenous Australians. Indigneous Australians present at a younger age and have a greater incidence of cardiac risk including smoking and diabetes than non-Indigenous Australians. Access to specialist health services is an important determinant of health care outcomes for these patients. We describe an innovative and successful for model for providing Outreach Cardiac Specialist services to Indigenous communities in rural and remote locations. The approach involves a step-wise process of a) community engagement, b) delivering recovery interventions to improve health outcomes, c) building community capacity to self manage chronic illness and promoting health and well being with the aim of d) community self governance of chronic disease and health promotion. Key elements to this process are community participation in the program, disease self-management led by local health care workers, open access that is all-inclusive utilising community-generated referral, and the translation of scientific knowledge of disease processes into community understanding and making culturally relevant connections. Specialist cardiac services and point of care diagnostics have been provided to 18 sites across rural and remote Queensland. More than 1400 episodes of care have been provided to Indigenous Australians with rheumatic heart disease, ischaemic heart disease and congenital heart conditions. Traditional values can work harmoniously with an inclusive medical approach in this relational model. Crown Copyright 2010. Published by Elsevier B.V. All rights reserved.

Acute Post-Streptococcal Glomerulonephritis in the Northern Territory of Australia: A Review of 16 Years Data and Comparison with the Literature

PubMed Central

Marshall, Catherine S.; Cheng, Allen C.; Markey, Peter G.; Towers, Rebecca J.; Richardson, Leisha J.; Fagan, Peter K.; Scott, Lesley; Krause, Vicki L.; Currie, Bart J.

2011-01-01

Data relating to acute post-streptococcal glomerulonephritis (APSGN) from the notifiable diseases surveillance system in the Northern Territory of Australia was extracted and analyzed. Isolates of Streptococcus pyogenes from confirmed cases were emm sequence typed. From 1991 to July 2008, there were 415 confirmed cases and 23 probable cases of APSGN notified. Four hundred fifteen (94.7%) of these were Indigenous Australians and 428 (97.7%) were people living in remote or very remote locations. The median age of cases was 7 years (range 0–54). The incidence of confirmed cases was 12.5/100,000 person-years, with an incidence in Indigenous Australian children younger than 15 years of age of 94.3 cases/100,000 person-years. The overall rate ratio of confirmed cases in Indigenous Australians to non-Indigenous Australians was 53.6 (95% confidence interval 32.6–94.8). Outbreaks of disease across multiple communities occurred in 1995 (N = 68), 2000 (N = 55), and 2005 (N = 87 [confirmed cases]). Various emm types of S. pyogenes were isolated from cases of APSGN including some types not previously recognized to be nephritogenic. The widespread outbreak in 2005 was caused by emm55.0 S. pyogenes. Acute post-streptococcal glomerulonephritis continues to occur in remote Indigenous communities in Australia at rates comparable to or higher than those estimated in developing countries. Improvements in preventative and outbreak control strategies are needed. PMID:21976576

Acute post-streptococcal glomerulonephritis in the Northern Territory of Australia: a review of 16 years data and comparison with the literature.

PubMed

Marshall, Catherine S; Cheng, Allen C; Markey, Peter G; Towers, Rebecca J; Richardson, Leisha J; Fagan, Peter K; Scott, Lesley; Krause, Vicki L; Currie, Bart J

2011-10-01

Data relating to acute post-streptococcal glomerulonephritis (APSGN) from the notifiable diseases surveillance system in the Northern Territory of Australia was extracted and analyzed. Isolates of Streptococcus pyogenes from confirmed cases were emm sequence typed. From 1991 to July 2008, there were 415 confirmed cases and 23 probable cases of APSGN notified. Four hundred fifteen (94.7%) of these were Indigenous Australians and 428 (97.7%) were people living in remote or very remote locations. The median age of cases was 7 years (range 0-54). The incidence of confirmed cases was 12.5/100,000 person-years, with an incidence in Indigenous Australian children younger than 15 years of age of 94.3 cases/100,000 person-years. The overall rate ratio of confirmed cases in Indigenous Australians to non-Indigenous Australians was 53.6 (95% confidence interval 32.6-94.8). Outbreaks of disease across multiple communities occurred in 1995 (N = 68), 2000 (N = 55), and 2005 (N = 87 [confirmed cases]). Various emm types of S. pyogenes were isolated from cases of APSGN including some types not previously recognized to be nephritogenic. The widespread outbreak in 2005 was caused by emm55.0 S. pyogenes. Acute post-streptococcal glomerulonephritis continues to occur in remote Indigenous communities in Australia at rates comparable to or higher than those estimated in developing countries. Improvements in preventative and outbreak control strategies are needed.

Content and cultural validity in the development of the Indigenous Play Partner Scale.

PubMed

Dender, Alma M; Stagnitti, Karen E

2017-08-01

Culturally relevant assessments of Australian Indigenous children's social pretend play do not exist. This study investigated the content validity and cultural validity of the Indigenous Play Partner Scale (I-PPS). Six pairs of children (i.e. 12 children) aged four-six years from a remote Australian town were videoed playing in pairs, and 14 community elders and mothers participated across three focus groups. The social interactions between the children were transcribed from the videos. Nineteen verbs, grouped into five categories of social interaction, described the social interactions between the pairs of children. The descriptions of the social interaction verbs were presented to the community elders and mothers in a focus group. The themes from the focus groups were 'background of Indigenous understanding of play' and 'proposed social interaction verbs'. The first theme reflected community collaboration, children playing in multi-aged groups and the role of older children within the play. Guided by the focus group discussion, the videos were re-analysed and 20 social interaction verbs were described that reflected the cultural context of play. The content and cultural validity of the I-PPS was established through community consultation. Twenty social interaction verbs, which form the basis of the items of the I-PPS, reflected Indigenous cultural values of being non-judgemental of Indigenous children's social interactions during pretend play. Culturally relevant assessments for Australian Indigenous children do not disadvantage this population group and are essential for practice in occupational therapy. © 2017 Occupational Therapy Australia.

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…

Place-Consciousness and Bronfenbrenner's "Ecological Systems Model": A Discussion of Recurring Issues That Undermine the Teaching of Indigenous Histories in New Zealand and Australian Schools

ERIC Educational Resources Information Center

Manning, Richard F.

2017-01-01

This article draws upon a "tale from the feld" (Van Maanen, 1988) to encourage New Zealand and Australian teachers of history and social studies to appraise how their own perceptions of place and teaching about Indigenous peoples' histories impact upon their students' learning. Moreover, it explains why Uri Bronfenbrenner's (1979)…

Marginalization and health service coverage among indigenous, rural, and urban populations: a public health problem in Mexico.

PubMed

Roldán, José; Álvarez, Marsela; Carrasco, María; Guarneros, Noé; Ledesma, José; Cuchillo-Hilario, Mario; Chávez, Adolfo

2017-12-01

  Marginalization is a significant issue in Mexico, involving a lack of access to health services with differential impacts on Indigenous, rural and urban populations. The objective of this study was to understand Mexico’s public health problem across three population areas, Indigenous, rural and urban, in relation to degree of marginalization and health service coverage.   The sampling universe of the study consisted of 107 458 geographic locations in the country. The study was retrospective, comparative and confirmatory. The study applied analysis of variance, parametric and non-parametric, correlation and correspondence analyses.   Significant differences were identified between the Indigenous, rural and urban populations with respect to their level of marginalization and access to health services. The most affected area was Indigenous, followed by rural areas. The sector that was least affected was urban.   Although health coverage is highly concentrated in urban areas in Mexico, shortages are mostly concentrated in rural areas where Indigenous groups represent the extreme end of marginalization and access to medical coverage. Inadequate access to health services in the Indigenous and rural populations throws the gravity of the public health problem into relief.

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

PubMed Central

Dobbins, Timothy; Neeman, Teresa; Banwell, Cathy; Banks, Emily

2017-01-01

Objective 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. Methods 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. Results 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/m2/year; 95% CI: 0.50‐0.69), female versus male (difference: 0.15 kg/m2/year; 95% CI: 0.07‐0.23), and Torres Strait Islander versus Aboriginal (difference: 0.36 kg/m2/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. Conclusions 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. PMID:28349661

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).

Depression in Aboriginal men in central Australia: adaptation of the Patient Health Questionnaire 9

PubMed Central

2013-01-01

Background While Indigenous Australians are believed to be at a high risk of psychological illness, few screening instruments have been designed to accurately measure this burden. Rather than simply transposing western labels of symptoms, this paper describes the process by which a screening tool for depression was specifically adapted for use across multiple Indigenous Australian communities. Method Potential depression screening instruments were identified and interrogated according to a set of pre-defined criteria. A structured process was then developed which relied on the expertise of five focus groups comprising of members from primary Indigenous language groups in central Australia. First, focus group participants were asked to review and select a screening measure for adaptation. Bi-lingual experts then translated and back translated the language within the selected measure. Focus group participants re-visited the difficult items, explored their meaning and identified potential ways to achieve equivalence of meaning. Results All five focus groups independently selected the Primary Health Questionnaire 9, several key conceptual differences were exposed, largely related to the construction of hopelessness. Together with translated versions of each instrument for each of the five languages, a single, simplified English version for use across heterogeneous settings was negotiated. Importantly, the ‘code’ and specific conceptually equivalent words that could be used for other Indigenous language groups were also developed. Conclusions The extensive process of adaptation used in this study has demonstrated that within the context of Indigenous Australian communities, across multiple language groups, where English is often a third or fourth language, conceptual and linguistic equivalence of psychological constructs can be negotiated. A validation study is now required to assess the adapted instrument’s potential for measuring the burden of disease across all Indigenous Australian populations. PMID:24139186

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…

Influences of indigenous language on spatial frames of reference in Aboriginal English

NASA Astrophysics Data System (ADS)

Edmonds-Wathen, Cris

2014-06-01

The Aboriginal English spoken by Indigenous children in remote communities in the Northern Territory of Australia is influenced by the home languages spoken by themselves and their families. This affects uses of spatial terms used in mathematics such as `in front' and `behind.' Speakers of the endangered Indigenous Australian language Iwaidja use the intrinsic frame of reference in contexts where speakers of Standard Australian English use the relative frame of reference. Children speaking Aboriginal English show patterns of use that parallel the Iwaidja contexts. This paper presents detailed examples of spatial descriptions in Iwaidja and Aboriginal English that demonstrate the parallel patterns of use. The data comes from a study that investigated how an understanding of spatial frame of reference in Iwaidja could assist teaching mathematics to Indigenous language-speaking students. Implications for teaching mathematics are explored for teachers without previous experience in a remote Indigenous community.

Indigenous Māori perspectives on urban transport patterns linked to health and wellbeing.

PubMed

Raerino Ngāti Awa Te Arawa, K; Macmillan, Alex K; Jones Ngāti Kahungunu, Rhys G

2013-09-01

There is a growing body of research linking urban transport systems to inequities in health. However, there is a lack of research providing evidence of the effect of transport systems on indigenous family wellbeing. We examined the connections between urban transport and the health and wellbeing of Māori, the indigenous people of New Zealand. We provide an indigenous exploration of current urban transport systems, with a particular focus on the impacts of car dependence and the need for culturally relevant travel. We interviewed nineteen Māori participants utilising qualitative research techniques underpinned by an indigenous research methodology (Kaupapa Māori). The data highlighted the importance of accessing cultural activities and sites relevant to 'being Māori', and issues with affordability and safety of public transport. Understanding the relationship between indigenous wellbeing and transport systems that goes further than limited discourses of inequity is essential to improving transport for indigenous wellbeing. Providing an indigenous voice in transport decision-making will make it more likely that indigenous health and wellbeing is prioritised in transport planning. Copyright © 2013. Published by Elsevier Ltd.

A multilevel analysis on the relationship between neighbourhood poverty and public hospital utilization: is the high Indigenous morbidity avoidable?

PubMed Central

2011-01-01

Background The estimated life expectancy at birth for Indigenous Australians is 10-11 years less than the general Australian population. The mean family income for Indigenous people is also significantly lower than for non-Indigenous people. In this paper we examine poverty or socioeconomic disadvantage as an explanation for the Indigenous health gap in hospital morbidity in Australia. Methods We utilised a cross-sectional and ecological design using the Northern Territory public hospitalisation data from 1 July 2004 to 30 June 2008 and socio-economic indexes for areas (SEIFA) from the 2006 census. Multilevel logistic regression models were used to estimate odds ratios and confidence intervals. Both total and potentially avoidable hospitalisations were investigated. Results This study indicated that lifting SEIFA scores for family income and education/occupation by two quintile categories for low socio-economic Indigenous groups was sufficient to overcome the excess hospital utilisation among the Indigenous population compared with the non-Indigenous population. The results support a reframing of the Indigenous health gap as being a consequence of poverty and not simplistically of ethnicity. Conclusions Socio-economic disadvantage is a likely explanation for a substantial proportion of the hospital morbidity gap between Indigenous and non-Indigenous populations. Efforts to improve Indigenous health outcomes should recognise poverty as an underlying determinant of the health gap. PMID:21951514

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.

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

PubMed

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

2013-12-01

There is increasing recognition of Indigenous perspectives from various parts of the world in relation to storytelling, research and its effects on practice. The recent emergence of storytelling or yarning as a research method in Australian Aboriginal and Torres Strait Island studies and other Indigenous peoples of the world is gaining momentum. Narratives, stories, storytelling and yarning are emerging methods in research and has wide ranging potential to shape conventional research discourse making research more meaningful and accessible for researchers. In this paper we argue for the importance of Indigenous research methods and Indigenous method(ology), within collaborative respectful partnerships with non-Indigenous researchers. It is imperative to take these challenging steps together towards better outcomes for Indigenous people and their communities. In the Australian context we as researchers cannot afford to allow the gap between Aboriginal and Torres Strait Islanders and mainstream Australia health outcomes to grow even wider. One such pathway is the inclusion of Aboriginal storytelling or yarning from an Aboriginal and Torres Strait perspective within Indigenous and non-Indigenous research paradigms. Utilising Aboriginal storytelling or yarning will provide deeper understanding; complementing a two-way research paradigm for collaborative research. Furthermore, it has significant social implications for research and clinical practice amongst Indigenous populations; thus complementing the biomedical medical paradigm.

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

PubMed

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

2016-05-24

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

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…

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 may encourage effective health service delivery at a time when the healthcare funding and workforce capacity are limited. PMID:26406592

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 encourage effective health service delivery at a time when the healthcare funding and workforce capacity are limited.

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

2018-01-01

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.

It's Not Rocket Science: The Perspectives of Indigenous Early Childhood Workers on Supporting the Engagement of Indigenous Families in Early Childhood Settings

ERIC Educational Resources Information Center

Grace, Rebekah; Trudgett, Michelle

2012-01-01

This paper presents the findings from semi-structured interviews with six Indigenous Australian early childhood workers who were asked about how Indigenous families might be better supported to engage with early childhood education and care services. The workers identified three key barriers to family participation: transport difficulties, family…

Indigenous Students' Persistence in Higher Education in Australia: Contextualising Models of Change from Psychology to Understand and Aid Students' Practices at a Cultural Interface

ERIC Educational Resources Information Center

Day, Andrew; Nakata, Vicky; Nakata, Martin; Martin, Gregory

2015-01-01

The need to address the substantial inequities that exist between Indigenous and non-Indigenous Australians in higher education is widely recognised. Those factors that affect the performance of Indigenous students in tertiary education have been reasonably well documented across different institutions, disciplines, and programme levels but there…

Are supernovae recorded in indigenous astronomical traditions?

NASA Astrophysics Data System (ADS)

Hamacher, Duane W.

2014-07-01

Novae and supernovae are rare astronomical events that would have had an influence on the skywatching peoples who witnessed them. Although several bright novae/supernovae have been visible during recorded human history, there are many proposed but no confirmed accounts of supernovae in indigenous oral traditions or material culture. Criteria are established for confirming novae/supernovae in oral traditions and material culture, and claims from around the world are discussed to determine if they meet these criteria. Aboriginal Australian traditions are explored for possible descriptions of novae/supernovae. Although representations of supernovae may exist in Aboriginal traditions, there are currently no confirmed accounts of supernovae in Indigenous Australian oral or material traditions.

The Aboriginal Australian cosmic landscape. Part 1: the ethnobotany of the skyworld

NASA Astrophysics Data System (ADS)

Clarke, Philip A.

2014-11-01

In Aboriginal Australia, the corpus of cosmological beliefs was united by the centrality of the Skyworld, which was considered to be the upper part of a total landscape that possessed topography linked with that of Earth and the Underworld. Early historical accounts of classical Australian hunter-gatherer beliefs described the heavens as inhabited by human and spiritual ancestors who interacted with the same species of plants and animals as they had below. This paper is the first of two that describes Indigenous perceptions of the Skyworld flora and draws out major ethnobotanical themes from the corpus of ethnoastronomical records garnered from a diverse range of Australian Aboriginal cultures. It investigates how Indigenous perceptions of the flora are interwoven with Aboriginal traditions concerning the heavens, and provides examples of how the study of ethnoastronomy can provide insights into the Indigenous use and perception of plants.

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.

Immunisation coverage annual report, 2014.

PubMed

Hull, Brynley P; Hendry, Alexandra J; Dey, Aditi; Beard, Frank H; Brotherton, Julia M; McIntyre, Peter B

2017-03-31

This 8th annual immunisation coverage report shows data for 2014 derived from the Australian Childhood Immunisation Register and the National Human Papillomavirus Vaccination Program Register. This report includes coverage data for 'fully immunised' and by individual vaccines at standard age milestones and timeliness of receipt at earlier ages according to Indigenous status. Overall, 'fully immunised' coverage has been mostly stable at the 12- and 24-month age milestones since late 2003, but at 60 months of age, it has increased by more than 10 percentage points since 2009. As in previous years, coverage for 'fully immunised' at 12 months of age among Indigenous children was 3.7% lower than for non-Indigenous children overall, varying from 6.9 percentage points in Western Australia to 0.3 of a percentage point in the Australian Capital Territory. In 2014, 73.4% of Australian females aged 15 years had 3 documented doses of human papillomavirus vaccine (jurisdictional range 67.7% to 77.4%), and 82.7% had at least 1 dose, compared with 71.4% and 81.5%, respectively, in 2013. The disparity in on-time vaccination between Indigenous and non-Indigenous children in 2014 diminished progressively from 20.2% for vaccines due by 12 months to 11.5% for those due by 24 months and 3.0% at 60 months of age.

Measures of indigenous social capital and their relationship with well-being.

PubMed

Biddle, Nicholas

2012-12-01

To provide the first estimates of a comprehensive measure of social capital for the Indigenous population and to link the indicators to well-being. Observational study-based. Household survey. Nationally representative sample of 7823 Indigenous Australians aged 15 years and over who were usual residents of private dwellings. Whether or not the respondent felt happy in the last 4 weeks all or most of the time (happiness), and whether or not they felt so sad that nothing could cheer them up at least a little bit of the time over the same period (sadness). There were no consistent differences in social capital measures between Indigenous men and women, nor were there consistent differences between the remote and non-remote population. High levels of social capital were, however, associated with higher subjective well-being. Social capital is both an indicator and determinant of well-being. It was possible to derive an index of social capital for Indigenous Australians that had a strong positive association with self-reported happiness and a negative association with self-reported sadness. However, the analysis also showed that there are a set of related domains of social capital, rather than there being a single underlying concept. © 2012 The Author. Australian Journal of Rural Health © National Rural Health Alliance Inc.

'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.

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…

An Exploration of the Role of Schema Theory and the (Non-Indigenous) Construction of Indigenous Identity

ERIC Educational Resources Information Center

Lloyd, D.; Boyd, W. E.

2014-01-01

Community engagement is increasingly important in environmental management. While such engagement has tended to comprise only one-way communication, genuine engagement often requires meaningful cross-cultural communication. This paper explores issues surrounding engagement with Australian indigenous communities, suggesting that the construction of…

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,…

The Principals as Literacy Leaders with Indigenous Communities: Professional Learning and Research

ERIC Educational Resources Information Center

Johnson, Greer; Dempster, Neil; McKenzie, Lynanne

2013-01-01

The vast proportion of Australia's Indigenous students are represented persistently as well below the national benchmarks for literacy and numeracy. Recent national school-based research and development projects, funded by the Australian Government's "Closing the Gap" strategy, have again targeted improving Indigenous students' literacy…

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…

Methodology Is Content: Indigenous Approaches to Research and Knowledge

ERIC Educational Resources Information Center

Martin, Brian

2017-01-01

There has been extensive work in the space of Indigenous epistemological approaches to research. Because Australian Indigenous peoples have been researched significantly, there are guidelines around the ethical and cultural conduct of this type of research. Via investigating the Academy's approach to research in general, we can illuminate the vast…

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…

Educator Perspectives on Indigenous Cultural Content in an Occupational Therapy Curriculum

ERIC Educational Resources Information Center

Melchert, Belinda; Gray, Marion; Miller, Adrian

2016-01-01

Health professionals must understand Indigenous perspectives to deliver effective health services. This study set out to determine the amount, type and effectiveness of current Indigenous content in an occupational therapy curriculum at an Australian regional university and the progress in meeting the National Aboriginal Health Strategy (NAHS)…

Aboriginal and Torres Strait Islander Public Health: Online and Integrated into Core Master of Public Health Subjects

PubMed Central

Angus, Lynnell; Ewen, Shaun; Coombe, Leanne

2016-01-01

The Master of Public Health (MPH) is an internationally recognised post-graduate qualification for building the public health workforce. In Australia, MPH graduate attributes include six Indigenous public health (IPH) competencies. The University of Melbourne MPH program includes five core subjects and ten specialisation streams, of which one is Indigenous health. Unless students complete this specialisation or electives in Indigenous health, it is possible for students to graduate without attaining the IPH competencies. To address this issue in a crowded and competitive curriculum an innovative approach to integrating the IPH competencies in core MPH subjects was developed. Five online modules that corresponded with the learning outcomes of the core public health subjects were developed, implemented and evaluated in 2015. This brief report outlines the conceptualisation, development, and description of the curriculum content; it also provides preliminary student evaluation and staff feedback on the integration project. Significance for public health This approach to a comprehensive, online, integrated Indigenous public health (IPH) curriculum is significant, as it ensures that all University of Melbourne Master of Public Health (MPH) graduates will have the competencies to positively contribute to Indigenous health status. A workforce that is attuned not only to the challenges of IPH, but also to the principles of self-determination, Indigenous agency and collaboration is better equipped to be comprised of ethical and judgment-safe practitioners. Additionally, the outlined approach of utilizing IPH content and examples into core MPH subjects ensures both the Australian relevance for an Australian-based health professional course and international appeal through the modules inclusion of International Indigenous case-studies and content. Furthermore, approaches learned in a challenging Indigenous Australian context are transferable and applicable to other IPH challenges in a local, national and global context. PMID:27190981

"Urban-Rural" Dynamics and Indigenous Urbanization: The Case of Inuit Language Use in Ottawa

ERIC Educational Resources Information Center

Patrick, Donna; Budach, Gabriele

2014-01-01

The establishment of cities in Canada has played a pivotal role in the displacement, dispossession, and marginalization of Indigenous peoples. Yet, more than half of the Indigenous population now resides in cities, and urbanization continues to increase. This paper addresses a specific aspect of Inuit mobility--namely, migration and the dynamic…

Associations of mortality and cardiovascular disease risks with diabetes and albuminuria in urban Indigenous Australians: the DRUID follow-up study.

PubMed

Barr, E L M; Cunningham, J; Tatipata, S; Dunbar, T; Kangaharan, N; Guthridge, S; Li, S Q; Condon, J R; Shaw, J E; O'Dea, K; Maple-Brown, L J

2017-07-01

To assess the relationships of diabetes and albuminuria with all-cause mortality and cardiovascular disease outcomes in a population without prior cardiovascular disease using data from the Darwin Region Urban Indigenous Diabetes (DRUID) study. We conducted a prospective cohort study of 706 participants (aged 15-81 years, 68% women) without prior cardiovascular disease who underwent a 75-g oral glucose tolerance test. Deaths and fatal or non-fatal cardiovascular disease were determined over 7 years, and hazard ratios with 95% CIs and population attributable risks were estimated for baseline glycaemia and albuminuria. Compared with normoglycaemia and after adjustment for age, sex, hypertension, dyslipidaemia and smoking, known diabetes was associated with an adjusted hazard ratio of 4.8 (95% CI 1.5-14.7) for all-cause mortality and 5.6 (95% CI 2.1-15.2) for cardiovascular disease. Compared with normoalbuminuria, the respective adjusted risks for macroalbuminuria were 10.9 (95% CI 3.7-32.1) and 3.9 (95% CI 1.4-10.8). The Adjusted all-cause mortality and cardiovascular disease estimated population attributable risks for diabetes were 27% and 32%, and for albuminuria they were 32% and 21%, respectively. In our study population, the burden of mortality and cardiovascular disease was largely driven by diabetes and albuminuria. This finding on the influence of diabetes and albuminuria is consistent with reports in other high-risk Indigenous populations and should be better reflected in risk scores and intervention programmes. © 2017 Diabetes UK.

Falls risk assessment outcomes and factors associated with falls for older Indigenous Australians.

PubMed

Hill, Keith D; Flicker, Leon; LoGiudice, Dina; Smith, Kate; Atkinson, David; Hyde, Zoë; Fenner, Stephen; Skeaf, Linda; Malay, Roslyn; Boyle, Eileen

2016-12-01

To describe the prevalence of falls and associated risk factors in older Indigenous Australians, and compare the accuracy of validated falls risk screening and assessment tools in this population in classifying fall status. Cross-sectional study of 289 Indigenous Australians aged ≥45 years from the Kimberley region of Western Australia who had a detailed assessment including self-reported falls in the past year (n=289), the adapted Elderly Falls Screening Tool (EFST; n=255), and the Falls Risk for Older People-Community (FROP-Com) screening tool (3 items, n=74) and FROP-Com falls assessment tool (n=74). 32% of participants had ≥1 fall in the preceding year, and 37.3% were classified high falls risk using the EFST (cut-off ≥2). In contrast, for the 74 participants assessed with the FROP-Com, only 14.9% were rated high risk, 35.8% moderate risk, and 49.3% low risk. The FROP-Com screen and assessment tools had the highest classification accuracy for identifying fallers in the preceding year (area under curve >0.85), with sensitivity/specificity highest for the FROP-Com assessment (cut-off ≥12), sensitivity=0.84 and specificity=0.73. Falls are common in older Indigenous Australians. The FROP-Com falls risk assessment tool appears useful in this population, and this research suggests changes that may improve its utility further. © 2016 Public Health Association of Australia.

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

PubMed

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

2018-01-01

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).

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. Copyright© 2016 Dennis Barber Ltd

Improving health service delivery for women with diabetes in pregnancy in remote Australia: survey of care in the Northern Territory Diabetes in Pregnancy Partnership.

PubMed

Edwards, Laura; Connors, Christine; Whitbread, Cherie; Brown, Alex; Oats, Jeremy; Maple-Brown, Louise

2014-12-01

In the Northern Territory (NT), 38% of 3500 births each year are to Indigenous women, 80% of whom live in regional and remote areas. Compared with the general Australian population, rates of pre-existing type 2 diabetes in pregnancy are 10-fold higher and rates of gestational diabetes are 1.5-fold higher among Indigenous women. Current practices in screening for diabetes in pregnancy in remote Australia are not known. To assess current health service delivery for NT women with diabetes in pregnancy (DIP) by surveying healthcare professionals' views and practices in DIP screening and management. A cross-sectional survey of NT healthcare professionals providing clinical care for women with DIP was conducted based on pre-identified themes of communication, care-coordination, education, orientation and guidelines, logistics and access, and information technology. Of the 116 responders to the survey, 78% were primary healthcare professionals, 32% midwives and 25% general practitioners. High staff turnover was evident: of Central Australian professionals, only 33% (urban) and 18% (regional/remote) had been in their current position over 5 years. DIP screening was conducted at first antenatal visit by 66% and at 24-28-week gestation by 81%. Only 50% of respondents agreed that most women at their health service received appropriate care for DIP, and 41% of primary care practitioners were neutral or not confident in their skills to manage DIP. It is promising that many healthcare professionals report following new guidelines in conducting early pregnancy screening for DIP in high risk women. Several challenges were identified in healthcare delivery to a high risk population in remote Australia. © 2014 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

PA-EFL: A Phonological Awareness Program For Indigenous EFL Students with Hearing Disabilities.

ERIC Educational Resources Information Center

Yonovitz, L.; Yonovitz, A.; Palmer, Juan C.

2000-01-01

Australia's indigenous populations have endemic levels of otitis media with conductive hearing loss. PA-EFL is a phonological awareness program designed for indigenous Australians who are at high risk for hearing disabilities and who are learning English as a foreign language (EFL). Hearing support services were provided; remarkable literacy gains…

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…

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…

Promoting the Persistence of Indigenous Students through Teaching at the Cultural Interface

ERIC Educational Resources Information Center

Martin, Gregory; Nakata, Vicky; Nakata, Martin; Day, Andrew

2017-01-01

The promise of higher education remains elusive for many Indigenous students in Australia. To date, institutional efforts to improve the persistence and retention of Indigenous students have been largely piecemeal, poorly integrated and designed to remediate skill deficits. Yet, market-led expansion of Australian higher education is driving…

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…

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…

Mapping More than Aboriginal Studies: Pedagogy, Professional Practice and Knowledge

ERIC Educational Resources Information Center

Norman, Heidi

2014-01-01

As undergraduate curriculum is increasingly required to meet a range of intellectual, professional practice and personal learning outcomes, what purpose does Australian Aboriginal Studies have in curriculum? Most Australian universities are currently in the process of developing institution-wide approaches to Indigenous Australian content in…

Nutritional status of indigenous children younger than five years of age in Mexico: results of a national probabilistic survey.

PubMed

Rivera, Juan A; Monterrubio, Eric A; González-Cossío, Teresa; García-Feregrino, Raquel; García-Guerra, Armando; Sepúlveda-Amor, Jaime

2003-01-01

To compare the prevalence of undernutrition and anemia in indigenous and non-indigenous children < 5 years of age at the national level, by region and by urban and rural areas, and to evaluate the degree to which the socioeconomic condition of the family predicts the differences. A national probabilistic survey was conducted in Mexico in 1999. Indigenous families were identified as those in which at least one woman 12-49 years of age in the household spoke a native language. The prevalence of undernutrition (stunting, wasting and underweight) and anemia was compared between indigenous and non-indigenous children. Probability ratios (PR) were used to compare prevalences in indigenous and non-indigenous children adjusting for socioeconomic status (SES) of the family and for other covariates. The prevalences of stunting and underweight were greater in indigenous than in non-indigenous children. At the national level and in urban areas the prevalences were three times greater and in rural areas approximately 2 times greater (p < 0.05). No differences were found in the prevalence of wasting (p > 0.05). The prevalence of anemia in indigenous children was one third greater than in non-indigenous children at the national level (p < 0.05) and was between 30 and 60% greater in urban areas and in the regions studied (p < 0.05) but was not statistically significant (p > 0.05) in rural areas. These differences were reduced to about half when adjusting for SES but remained significantly higher in indigenous children (p < 0.05). Indigenous children have higher probabilities of stunting and underweight than non-indigenous children. The differences are larger in urban areas and in higher socioeconomic geographic regions and are explained mostly by socioeconomic factors. The overall difference in the probability of anemia is small, is higher only in urban relative to rural areas, and is explained to a lesser degree by socioeconomic factors. Policy and programs should be designed and implemented to reduce the dramatic differences in nutritional status between indigenous and non-indigenous children in Mexico. The English version of this paper is available too at: http://www.insp.mx/salud/index.html.

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

Incidence and treatment of ESRD among indigenous peoples of Australasia.

PubMed

McDonald, S

2010-11-01

Indigenous people in Australia and New Zealand experience rates of ESKD several times higher than non-indigenous people. This relative rate is highest among people aged 45 - 54 for Aboriginal Australians, and 65 - 74 years for Maori. The majority of this is driven by diabetic nephropathy. Both groups have lesser utilization of transplantation as a renal replacement therapy than non-indigenous comparators, and lesser utilization of home dialysis modalities.

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

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 an innovate and evaluate strategy was justifiable given (a) the potential for the gap between Indigenous and non-Indigenous health outcomes to worsen in the absence of an imminent policy response; (b) the existence of circumstances, which made it difficult to obtain high-quality evidence to guide policy; and (c) the need for policy solutions to reflect community preferences, given sociohistorical sensitivities.

Barriers to effective perioperative communication in indigenous Australians: an audit of progress since 1996.

PubMed

Cheng, W Y C; Blum, P; Spain, B

2004-08-01

This prospective study was designed to elucidate barriers limiting effective perioperative communication between indigenous Australians and anaesthetists, and to identify strategies for improving communication. A questionnaire was used to collect data on 1040 consecutive patients undergoing anaesthesia at Royal Darwin Hospital between February and March 2003. 27.1% of these patients described themselves as Aboriginal. Aboriginal patients were more likely to undergo emergency surgery and were more likely to be classified as ASA 3, 4 or 5 than non-indigenous patients. Communication difficulties were identified in 28.7% of all Aboriginal patients, which was 31 times higher than those in non-Aboriginal patients. The most common reason identified for this was difficulty in speaking English. Only 17.7% of Aboriginal patients presenting to the operating theatre spoke English as their first language. Unfortunately, the anaesthetic team utilized the Aboriginal interpreter service in only a minority of cases. Communication difficulty in indigenous Australians is pervasive and often goes unrecognized. The results suggest that heath care providers may need staff training in cross-cultural communication and that protocols need to be developed within the health care system so that interpreters are called upon automatically early in the admission process.

Principles and guidelines for good practice in Indigenous engagement in water planning

NASA Astrophysics Data System (ADS)

Jackson, Sue; Tan, Poh-Ling; Mooney, Carla; Hoverman, Suzanne; White, Ian

2012-12-01

SummaryIndigenous rights, values and interests relating to water have been identified by Australia's National Water Commission as a national priority area, requiring greater understanding, research attention and government action. Yet Indigenous water values are rarely addressed in water planning, despite objectives in national policy requiring Indigenous participation and the identification of Indigenous social, spiritual and customary values in water plans. Water planners are presently equipped with a very limited number of engagement tools tailored to the water resource management context to redress the historical neglect of Indigenous interests. In an Australian research project focused on water planning, seven participatory planning tools were employed in three Australian case studies with different social and hydrological characteristics to improve the way in which Indigenous values are elicited and incorporated and to enhance the status of Indigenous knowledge in water planning. The results from the two Murray Darling Basin (MDB) case studies reveal the many ways in which Indigenous values have been adversely affected by recent water resource developments and concomitant water scarcity. In the third case on the Tiwi Islands in the Northern Territory, where land title to the entire water planning area is vested in Indigenous traditional owners, methods were refined to ensure engagement and generate capacity to manage the development of a solely Indigenous-owned, first-generation Water Management Strategy, in collaboration with a range of stakeholders. This paper describes the needs and aspirations of Indigenous people, the engagement strategies employed to elicit Indigenous knowledge, assess Indigenous values, and incorporate the results into three developing water plans. In addition, it outlines a set of general principles to guide water planning in other regions and thereby to improve Indigenous access to water.

Mobile phones support adherence and retention of indigenous participants in a randomised controlled trial: strategies and lessons learnt.

PubMed

McCallum, Gabrielle B; Versteegh, Lesley A; Morris, Peter S; Mckay, Clare C; Jacobsen, Nerida J; White, Andrew V; D'Antoine, Heather A; Chang, Anne B

2014-06-18

Ensuring adherence to treatment and retention is important in clinical trials, particularly in remote areas and minority groups. We describe a novel approach to improve adherence, retention and clinical review rates of Indigenous children. This descriptive study was nested within a placebo-controlled, randomised trial (RCT) on weekly azithromycin (or placebo) for 3-weeks. Indigenous children aged ≤24-months hospitalised with acute bronchiolitis were recruited from two tertiary hospitals in northern Australia (Darwin and Townsville). Using mobile phones embedded within a culturally-sensitive approach and framework, we report our strategies used and results obtained. Our main outcome measure was rates of adherence to medications, retention in the RCT and self-presentation (with child) to clinic for a clinical review on day-21. Of 301 eligible children, 76 (21%) families declined participation and 39 (13%) did not have access to a mobile phone. 186 Indigenous children were randomised and received dose one under supervision in hospital. Subsequently, 182 (99%) children received dose two (day-7), 169 (93%) dose three (day-14) and 180 (97%) attended their clinical review (day-21). A median of 2 calls (IQR 1-3) were needed to verify adherence. Importantly, over 97% of children remained in the RCT until their clinical endpoint at day-21. In our setting, the use of mobile phones within an Indigenous-appropriate framework has been an effective strategy to support a clinical trial involving Australian Indigenous children in urban and remote Australia. Further research is required to explore other applications of this approach, including the impact on clinical outcomes. ACTRN12608000150347 (RCT component).

"It Is Not Natural Anymore": Nutrition, Urbanization, and Indigenous Identity on Bolivia's Andean Plateau.

PubMed

Lipus, Adam C; Leon, Juan S; Calle, Susana C; Andes, Karen L

2018-03-01

The objective of this article was to characterize how urbanization and indigenous identity shape nutrition attitudes and practices in El Alto, a rapidly urbanizing and predominantly indigenous (Aymara) community on Bolivia's Andean plateau. We took a qualitative ethnographic approach, interviewing health care providers ( n = 11) and conducting focus groups with mothers of young children ( n = 4 focus groups with 25 mothers total [age = 18-43 years, 60% Aymara]). Participants generally described their urban environment as being problematic for nutrition, a place where unhealthy "junk foods" and "chemicals" have supplanted healthy, "natural," "indigenous" foods from the countryside. Placing nutrition in El Alto within a broader context of cultural identity and a struggle to harmonize different lifestyles and worldviews, we propose how an intercultural framework for nutrition can harmonize Western scientific perspectives with rural and indigenous food culture.

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

ERIC Educational Resources Information Center

Jorgensen, Robyn

2012-01-01

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

Fall-related hospitalisations of older Aboriginal and Torres Strait Islander people and other Australians.

PubMed

Lukaszyk, Caroline; Harvey, Lara A; Sherrington, Catherine; Close, Jacqueline Ct; Coombes, Julieann; Mitchell, Rebecca J; Moore, Robyn; Ivers, Rebecca

2017-07-03

To compare the socio-demographic characteristics and type of injury sustained, the use of hospital resources and rates of hospitalisation by injury type, and survival following fall injuries to older Aboriginal people and non-Indigenous Australian people hospitalised for fall-related injuries. Population-based retrospective cohort data linkage study. Setting, participants: New South Wales residents aged 50 years or more admitted to a public or private NSW hospital for a fall-related injury during 1 January 2003 - 31 December 2012. Proportions of patients with defined injury types, mean hospital length of stay (LOS), 30-day mortality, age-standardised hospitalisation rates and age-adjusted rate ratios, 28-day re-admission rates. There were 312 758 fall-related injury hospitalisations for 234 979 individuals; 2660 admissions (0.85%) were of Aboriginal people. The proportion of hospitalisations for fall-related fracture injuries was lower for Aboriginal than for non-Indigenous Australians (49% v 60% of fall-related hospitalisations; P < 0.001). The major injury type for Aboriginal patients was non-fracture injury to head or neck (19% of hospitalisations); for non-Indigenous patients it was hip fractures (18%). Age-adjusted LOS was lower for Aboriginal than for non-Indigenous patients (9.1 v 14.0 days; P < 0.001), as was 30-day mortality (2.9% v 4.2%; P < 0.001). For Aboriginal people, fall injury hospitalisations increased at an annual rate of 5.8% (95% CI, 4.0-7.7%; P < 0.001); for non-Indigenous patients, the mean annual increase was 2.5% (95% CI, 2.1-3.0; P < 0.001). The patterns of injury and outcomes of fall injury hospitalisations were different for older Aboriginal people and other older Australians, suggesting that different approaches are required to prevent and treat fall injuries.

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. Higher quality studies evaluating community development projects would strengthen the evidence base.

Spatial analysis of community-onset Staphylococcus aureus bacteremia in Queensland, Australia.

PubMed

Marquess, John; Hu, Wenbiao; Nimmo, Graeme R; Clements, Archie C A

2013-03-01

To investigate and describe the relationship between indigenous Australian populations, residential aged care services, and community-onset Staphylococcus aureus bacteremia (SAB) among patients admitted to public hospitals in Queensland, Australia. Ecological study. We used administrative healthcare data linked to microbiology results from patients with SAB admitted to Queensland public hospitals from 2005 through 2010 to identify community-onset infections. Data about indigenous Australian population and residential aged care services at the local government area level were obtained from the Queensland Office of Economic and Statistical Research. Associations between community-onset SAB and indigenous Australian population and residential aged care services were calculated using Poisson regression models in a Bayesian framework. Choropleth maps were used to describe the spatial patterns of SAB risk. We observed a 21% increase in relative risk (RR) of bacteremia with methicillin-susceptible S. aureus (MSSA; RR, 1.21 [95% credible interval, 1.15-1.26]) and a 24% increase in RR with nonmultiresistant methicillin-resistant S. aureus (nmMRSA; RR, 1.24 [95% credible interval, 1.13-1.34]) with a 10% increase in the indigenous Australian population proportion. There was no significant association between RR of SAB and the number of residential aged care services. Areas with the highest RR for nmMRSA and MSSA bacteremia were identified in the northern and western regions of Queensland. The RR of community-onset SAB varied spatially across Queensland. There was increased RR of community-onset SAB with nmMRSA and MSSA in areas of Queensland with increased indigenous population proportions. Additional research should be undertaken to understand other factors that increase the risk of infection due to this organism.

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,…

School (Non-)Attendance and "Mobile Cultures": Theoretical and Empirical Insights from Indigenous Australia

ERIC Educational Resources Information Center

Prout Quicke, Sarah; Biddle, Nicholas

2017-01-01

Aboriginal and Torres Strait Islander (Indigenous) Australians are significantly and substantially less likely to be attending school on a given day than their non-Indigenous counterparts. This has been shown to have long-term consequences for the development of the mainstream literacy and numeracy skills associated with formal schooling, as well…

Valuing people in the landscape: Re-thinking conservation approaches

Treesearch

Peter Taylor

2015-01-01

When Australian Governments committed to building a National Reserve System (NRS) for Australia in 1991 they didn't anticipate that some of the most important conservation gains were to be made on Indigenous owned land. An innovative Federal Government policy decision in 1996 to support Indigenous landowners to establish Indigenous Protected Areas (IPA# on their...

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…

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…

Mind the gap: What is the difference between alcohol treatment need and access for Aboriginal and Torres Strait Islander Australians?

PubMed

Brett, Jonathan; Lee, K S Kylie; Gray, Dennis; Wilson, Scott; Freeburn, Bradley; Harrison, Kristie; Conigrave, Katherine

2016-07-01

Alcohol-related harms cause great concern to Aboriginal and Torres Strait Islander (Indigenous) communities in Australia as well as challenges to policy makers. Treatment of alcohol use disorders forms one component of an effective public health response. While alcohol dependence typically behaves as a chronic relapsing condition, treatment has been shown to be both effective and cost-effective in improving outcomes. Provision of alcohol treatment services should be based on accurate assessment of treatment need. In this paper, we examine the likely extent of the gap between voluntary alcohol treatment need and accessibility. We also suggest potential approaches to improve the ability to assess unmet need. Existing methods of assessing the treatment needs of Indigenous Australians are limited by incomplete and inaccurate survey data and an over-reliance on existing service use data. In addition to a shortage of services, cultural and logistical barriers may hamper access to alcohol treatment for Indigenous Australians. There is also a lack of services funded to a level that allows them to cope with clients with complex medical and physical comorbidity, and a lack of services for women, families and young people. A lack of voluntary treatment services also raises serious ethical concerns, given the expansion of mandatory treatment programmes and incarceration of Indigenous Australians for continued drinking. The use of modelling approaches, linkage of administrative data sets and strategies to improve data collection are discussed as possible methods to better assess treatment need. [Brett J, Lee K, Gray D, Wilson S, Freeburn B, Harrison K, Conigrave K. Mind the gap: what is the difference between alcohol treatment need and access for Aboriginal and Torres Strait Islander Australians? Drug Alcohol Rev 2016;35:456-460]. © 2015 Australasian Professional Society on Alcohol and other Drugs.

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 by Elsevier B.V.

Mitochondrial DNA diversity of present-day Aboriginal Australians and implications for human evolution in Oceania.

PubMed

Nagle, Nano; Ballantyne, Kaye N; van Oven, Mannis; Tyler-Smith, Chris; Xue, Yali; Wilcox, Stephen; Wilcox, Leah; Turkalov, Rust; van Oorschot, Roland A H; van Holst Pellekaan, Sheila; Schurr, Theodore G; McAllister, Peter; Williams, Lesley; Kayser, Manfred; Mitchell, R John

2017-03-01

Aboriginal Australians are one of the more poorly studied populations from the standpoint of human evolution and genetic diversity. Thus, to investigate their genetic diversity, the possible date of their ancestors' arrival and their relationships with neighboring populations, we analyzed mitochondrial DNA (mtDNA) diversity in a large sample of Aboriginal Australians. Selected mtDNA single-nucleotide polymorphisms and the hypervariable segment haplotypes were analyzed in 594 Aboriginal Australians drawn from locations across the continent, chiefly from regions not previously sampled. Most (~78%) samples could be assigned to mtDNA haplogroups indigenous to Australia. The indigenous haplogroups were all ancient (with estimated ages >40 000 years) and geographically widespread across the continent. The most common haplogroup was P (44%) followed by S (23%) and M42a (9%). There was some geographic structure at the haplotype level. The estimated ages of the indigenous haplogroups range from 39 000 to 55 000 years, dates that fit well with the estimated date of colonization of Australia based on archeological evidence (~47 000 years ago). The distribution of mtDNA haplogroups in Australia and New Guinea supports the hypothesis that the ancestors of Aboriginal Australians entered Sahul through at least two entry points. The mtDNA data give no support to the hypothesis of secondary gene flow into Australia during the Holocene, but instead suggest long-term isolation of the continent.

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

2017-11-01

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.

Patterns of drug dependence in a Queensland (Australia) sample of Indigenous and non-Indigenous people who inject drugs.

PubMed

Smirnov, Andrew; Kemp, Robert; Ward, James; Henderson, Suzanna; Williams, Sidney; Dev, Abhilash; Najman, Jake M

2016-09-01

Despite over-representation of Indigenous Australians in sentinel studies of injecting drug use, little is known about relevant patterns of drug use and dependence. This study compares drug dependence and possible contributing factors in Indigenous and non-Indigenous Australians who inject drugs. Respondent-driven sampling was used in major cities and 'peer recruitment' in regional towns of Queensland to obtain a community sample of Indigenous (n = 282) and non-Indigenous (n = 267) injectors. Data are cross sectional. Multinomial models were developed for each group to examine types of dependence on injected drugs (no dependence, methamphetamine-dependent only, opioid-dependent only, dependent on methamphetamine and opioids). Around one-fifth of Indigenous and non-Indigenous injectors were dependent on both methamphetamine and opioids in the previous 12 months. Psychological distress was associated with dual dependence on these drugs for Indigenous [adjusted relative risk (ARR) 4.86, 95% confidence interval (CI) 2.08-11.34] and non-Indigenous (ARR 4.14, 95% CI 1.59-10.78) participants. Unemployment (ARR 8.98, 95% CI 2.25-35.82) and repeated (> once) incarceration as an adult (ARR 3.78, 95% CI 1.43-9.97) were associated with dual dependence for Indigenous participants only. Indigenous participants had high rates of alcohol dependence, except for those dependent on opioids only. The drug dependence patterns of Indigenous and non-Indigenous people who inject drugs were similar, including the proportions dependent on both methamphetamine and opioids. However, for Indigenous injectors, there was a stronger association between drug dependence and contextual factors such as unemployment and incarceration. Expansion of treatment options and community-level programs may be required. [Smirnov A, Kemp R, Ward J, Henderson S, Williams S, Dev A, Najman J M. Patterns of drug dependence in a Queensland (Australia) sample of Indigenous and non-Indigenous people who inject drugs. Drug Alcohol Rev 2016;35:611-619]. © 2016 Australasian Professional Society on Alcohol and other Drugs.

Hepatitis C virus prevalence and associated risk factors among Indigenous Australians who inject drugs.

PubMed

Doyle, Michael; Maher, Lisa; Graham, Simon; Wand, Handan; Iversen, Jenny

2018-02-01

To examine factors associated with hepatitis C virus (HCV) infection among a national sample of Indigenous and non-Indigenous people who inject drugs (PWID) in Australia. Respondents were recruited from Australia's Needle Syringe Program Survey; an annual bio-behavioural surveillance project that monitors HCV antibody prevalence among PWID. Data from 2006-2015 were de-duplicated to retain only one record where individuals participated in >1 survey round. Univariate and multivariable logistic regression examined demographic characteristics and injection-related behaviours associated with exposure to HCV. Among 17,413 respondents, 2,215 (13%) were Indigenous Australians. Compared to their non-Indigenous counterparts, Indigenous respondents were significantly more likely to be exposed to HCV infection (53% vs. 60% respectively, p<0.001). Among Indigenous respondents, HCV antibody positivity was independently associated with a history of imprisonment (Adjusted Odd Ratio [AOR] 2.13, 95%CI 1.73-2.64), opioid injection (AOR 1.53, 95%CI 11.43-2.16), recruitment in a metropolitan location (AOR 1.27, 95%CI 1.02-1.59), engagement in opioid substitution therapy (AOR 2.83, 95%CI 2.23-3.59) and length of time since first injection (p<0.001). Indigenous PWID are more likely to be exposed to HCV infection than their non-Indigenous counterparts. Implications for public health: Increased access to culturally sensitive harm reduction programs is required to prevent primary HCV infection and reinfection among Indigenous PWID. Given recent advances in HCV treatment, promotion of treatment uptake among Indigenous PWID may reduce future HCV-related morbidity and mortality. © 2017 The Authors.

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…

Incidence of end-stage renal disease in overseas-born, compared with Australian-born, non-indigenous Australians.

PubMed

Stewart, John H; McCredie, Margaret R E; McDonald, Stephen P

2004-08-01

Barriers to immigration from non-European sources were relaxed in the 1970s. As a result, more Australians are now of Middle Eastern, Asian or Pacific Islander origin, rather than British or European. Currently, overseas-born persons comprise one-third of non-indigenous Australians with end-stage renal disease (ESRD). Using data recorded by the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, age-standardized incidence rates were calculated for ESRD due to all causes and to certain primary renal diseases for all non-indigenous Australians who were aged over 15 years when first treated for ESRD between 1993 and 2001. Truncated age-standardized incidence rates were calculated for ESRD due to glomerulonephritis by type. Immigrants from the British Isles and 'rest of Europe' had less, and those from the Pacific Island nations, East/South-East Asia, Indian subcontinent, Middle East and Southern Europe more ESRD from all causes than the Australian-born. Two diseases accounted for most of the excess: Type 2 diabetic nephropathy and glomerulonephritis (the latter not significant for the Indian-born). There was a small excess (not always significant) of hypertensive/arteriopathic renal disease in Asian- and Middle Eastern-born persons. The East/South-East Asian-born had the highest rates of ESRD due to mesangial immunoglobulin A (IgA) disease and lupus nephritis, and the Middle Eastern-born the highest rates from focal sclerosing glomerulonephritis. For Australians born in the Pacific Island nations, Asia, the Middle East or Southern Europe, excess prevalence of, and/or susceptibility to, diseases that cause ESRD has more than offset any 'healthy migrant' effect.

Resting heart rate, physiological stress and disadvantage in Aboriginal and Torres Strait Islander Australians: analysis from a cross-sectional study.

PubMed

Zhang, Alice; Hughes, Jaquelyne T; Brown, Alex; Lawton, Paul D; Cass, Alan; Hoy, Wendy; O'Dea, Kerin; Maple-Brown, Louise J

2016-02-11

Lower socioeconomic status has been linked to long-term stress, which can manifest in individuals as physiological stress. The aim was to explore the relationship between low socioeconomic status and physiological stress in Aboriginal and Torres Strait Islander Australians. Using data from the eGFR Study (a cross-sectional study of 634 Indigenous Australians in urban and remote areas of northern and central Australia), we examined associations between resting heart rate and demographic, socioeconomic, and biomedical factors. An elevated resting heart rate has been proposed as a measure of sustained stress activation and was used as a marker of physiological stress. Relationships were assessed between heart rate and the above variables using univariate and multiple regression analyses. We reported a mean resting heart rate of 74 beats/min in the cohort (mean age 45 years). On multiple regression analysis, higher heart rate was found to be independently associated with Aboriginal ethnicity, being a current smoker, having only primary level schooling, higher HbA1c and higher diastolic blood pressure (model R(2) 0.25). Elevated resting heart rate was associated with lower socioeconomic status and poorer health profile in Aboriginal and Torres Strait Islander Australians. Higher resting heart rate may be an indicator of stress and disadvantage in this population at high risk of chronic diseases.

Exploring Indigenous Identities of Urban American Indian Youth of the Southwest

PubMed Central

Kulis, Stephen; Wagaman, M. Alex; Tso, Crescentia; Brown, Eddie F.

2013-01-01

This study examined the indigenous identities of urban American Indian youth using measures related to three theoretical dimensions of Markstrom's identity model: identification (tribal and ethnic heritage), connection (reservation ties), and involvement in traditional cultural practices and spirituality. Data came from self-administered questionnaires completed by 142 urban American Indian middle school students in a southwestern metropolitan area with the largest urban American Indian population in the United States. Using both quantitative and qualitative measures, descriptive statistics showed most youth were connected to all three dimensions of indigenous identity. Hierarchical regression analyses showed that youth with the strongest sense of American Indian ethnic identity had native fathers and were heavily involved in traditional cultural practices and spirituality. Although urban American Indians may face challenges in maintaining their tribal identities, the youth in this study appeared strongly moored to their native indigenous heritage. Implications for future research are discussed. PMID:23766553

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.

A Smartphone App to Reduce Sugar-Sweetened Beverage Consumption Among Young Adults in Australian Remote Indigenous Communities: Design, Formative Evaluation and User-Testing

PubMed Central

Jeffs, Lauren; Wycherley, Thomas Philip; Maher, Carol; Smith, Ross; Hart, Jonathon; Cubillo, Beau; Brimblecombe, Julie

2017-01-01

Background The disproportionate burden of noncommunicable disease among Indigenous Australians living in remote Indigenous communities (RICs) is a complex and persistent problem. Smartphones are increasingly being used by young Indigenous adults and therefore represent a promising method to engage them in programs seeking to improve nutritional intake. Objective This study aimed to consult RIC members to inform the content of a smartphone app that can be used to monitor and reduce sugar-sweetened beverage intake in RICs. Methods The study was conducted in two phases. The formative phase involved a simulated grocery selection activity with think aloud (“think aloud shop”), a semistructured interview, a questionnaire outlining current smartphone and app use, and a paper prototyping activity. A preliminary end-user testing phase involved a think aloud prototype test and a semistructured interview regarding user satisfaction. Convenience sampling was used to recruit 20 18- to 35-year-old smartphone users for each phase from two RICs in the Northern Territory, Australia. Thematic analysis of transcribed audio recordings was used to identify determinants of food choice from the think aloud shop; themes related to the Theory of Planned Behavior (TPB) from the eating behaviors interview; and usability, comprehension, and satisfaction with the app from the preliminary end-user testing. Results Smartphone use in RICs is currently different to that found in urban environments; in particular, extremely low use of Facebook, restricted variety of phone types, and limited Internet access. Findings regarding promoting app engagement indicate that utilizing an opt-in approach to social features such as leader boards and team challenges is essential. The inclusion of games was also shown to be important for satisfaction, as were the use of audio features, contextually embedded dissemination, and streamlined app design for comprehension in this target group. Conclusions This research provides critical insights and concrete recommendations for the development of lifestyle improvement apps targeted toward disadvantaged young adults in nonurban settings, specifically RICs. It serves as a framework for future app development projects using a consultative user-centered design approach, supporting calls for the increased use of this strategy in app development. PMID:29233803

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…

'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.

A review of outcome following valve surgery for rheumatic heart disease in Australia.

PubMed

Russell, E Anne; Tran, Lavinia; Baker, Robert A; Bennetts, Jayme S; Brown, Alex; Reid, Christopher M; Tam, Robert; Walsh, Warren F; Maguire, Graeme P

2015-09-23

Globally, rheumatic heart disease (RHD) remains an important cause of heart disease. In Australia it particularly affects younger Indigenous and older non-Indigenous Australians. Despite its impact there is limited understanding of the factors influencing outcome following surgery for RHD. The Australian and New Zealand Society of Cardiac and Thoracic Surgeons Cardiac Surgery Database was analysed to assess outcomes following surgical procedures for RHD and non-RHD valvular disease. The association with demographics, co-morbidities, pre-operative status, valve(s) affected and operative procedure was evaluated. Outcome of 1384 RHD and 15843 non-RHD valve procedures was analysed. RHD patients had longer ventilation, experienced fewer strokes and had more readmissions to hospital and anticoagulant complications. Mortality following RHD surgery at 30 days was 3.1% (95% CI 2.2 - 4.3), 5 years 15.3% (11.7 - 19.5) and 10 years 25.0% (10.7 - 44.9). Mortality following non-RHD surgery at 30 days was 4.3% (95% CI 3.9 - 4.6), 5 years 17.6% (16.4 - 18.9) and 10 years 39.4% (33.0 - 46.1). Factors independently associated with poorer longer term survival following RHD surgery included older age (OR1.03/additional year, 95% CI 1.01 - 1.05), concomitant diabetes (OR 1.7, 95% CI 1.1 - 2.5) and chronic kidney disease (1.9, 1.2 - 2.9), longer invasive ventilation time (OR 1.7 if greater than median value, 1.1- 2.9) and prolonged stay in hospital (1.02/additional day, 1.01 - 1.03). Survival in Indigenous Australians was comparable to that seen in non-Indigenous Australians. In a large prospective cohort study we have demonstrated survival following RHD valve surgery in Australia is comparable to earlier studies. Patients with diabetes and chronic kidney disease, were at particular risk of poorer long-term survival. Unlike earlier studies we did not find pre-existing atrial fibrillation, being an Indigenous Australian or the nature of the underlying valve lesion were independent predictors of survival.

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…

The Honey Ant Readers: An Innovative and Bold Approach to Engaging Rural Indigenous Students in Print Literacy through Accessible, Culturally and Linguistically Appropriate Resources

ERIC Educational Resources Information Center

James, Margaret

2014-01-01

On entering school, rural Australian children from Indigenous backgrounds are thrown into an unfamiliar environment, linguistically and culturally, which sets them up for failure. The author, working closely with elders and community in Alice Springs, has drawn on her considerable experience in both Indigenous education and TESOL to address this…

Impact of the national targeted Hepatitis A immunisation program in Australia: 2000-2014.

PubMed

Thompson, Craig; Dey, Aditi; Fearnley, Emily; Polkinghorne, Benjamin; Beard, Frank

2017-01-03

In November 2005, hepatitis A vaccine was funded under the Australian National Immunisation Program for Aboriginal and Torres Strait Islander (Indigenous) children aged 12-24months in the targeted jurisdictions of Queensland, South Australia, Western Australia and the Northern Territory. We reviewed the epidemiology of hepatitis A from 2000 to 2014 using data from the Australian National Notifiable Diseases Surveillance System, the National Hospital Morbidity Database, and Australian Bureau of Statistics causes-of-death data. The impact of the national hepatitis A immunisation program was assessed by comparison of pre-vaccine (2000-2005) and post-vaccine time periods (2006-2014), by age group, Indigenous status and jurisdiction using incidence rate ratios (IRR) per 100,000 population and 95% confidence intervals (CI). The national pre-vaccine notification rate in Indigenous people was four times higher than the non-Indigenous rate, and declined from 8.41 per 100,000 (95% CI 5.03-11.79) pre-vaccine to 0.85 per 100,000 (95% CI 0.00-1.99) post-vaccine, becoming similar to the non-Indigenous rate. Notification and hospitalisation rates in Indigenous children aged <5years from targeted jurisdictions declined in the post-vaccine period when compared to the pre-vaccine period (notifications: IRR=0.07; 95% CI 0.04-0.13; hospitalisations: IRR=0.04; 95% CI 0.01-0.16). As did notification rates in Indigenous people aged 5-19 (IRR=0.08; 95% CI 0.05-0.13) and 20-49years (IRR=0.06; 95% CI 0.02-0.15) in targeted jurisdictions. For non-Indigenous people from targeted jurisdictions, notification rates decreased significantly in children aged <5years (IRR 0.47; 95% CI 0.31-0.71), and significantly more overall (IRR=0.43; 95% CI 0.39-0.47) compared to non-Indigenous people from non-targeted jurisdictions (IRR=0.60; 95% CI 0.56-0.64). The national hepatitis A immunisation program has had a significant impact in the targeted population with relatively modest vaccine coverage, with evidence suggestive of substantial herd protection effects. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

PubMed

Thurber, Katherine A; Dobbins, Timothy; Kirk, Martyn; Dance, Phyll; Banwell, Cathy

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.

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.

Sleep schedules and school performance in Indigenous Australian children.

PubMed

Blunden, Sarah; Magee, Chris; Attard, Kelly; Clarkson, Larissa; Caputi, Peter; Skinner, Timothy

2018-04-01

Sleep duration and sleep schedule variability have been related to negative health and well-being outcomes in children, but little is known about Australian Indigenous children. Data for children aged 7-9 years came from the Australian Longitudinal Study of Indigenous Children and the National Assessment Program-Literacy and Numeracy (NAPLAN). Latent class analysis determined sleep classes taking into account sleep duration, bedtimes, waketimes, and variability in bedtimes from weekdays to weekends. Regression models tested whether the sleep classes were cross-sectionally associated with grade 3 NAPLAN scores. Latent change score modeling then examined whether the sleep classes predicted changes in NAPLAN performance from grades 3 to 5. Five sleep schedule classes were identified: normative sleep, early risers, long sleep, variable sleep, and short sleep. Overall, long sleepers performed best, with those with reduced sleep (short sleepers and early risers) performing the worse on grammar, numeracy, and writing performance. Latent change score results also showed that long sleepers performed best in spelling and writing and short sleepers and typical sleepers performed the worst over time. In this sample of Australian Indigenous children, short sleep was associated with poorer school performance compared with long sleep, with this performance worsening over time for some performance indicators. Other sleep schedules (eg, early wake times and variable sleep) also had some relationships with school performance. As sleep scheduling is modifiable, this offers opportunity for improvement in sleep and thus performance outcomes for these and potentially all children. Copyright © 2018 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

Between Indigenous and Non-Indigenous: Urban/Nature/Child Pedagogies

ERIC Educational Resources Information Center

Somerville, Margaret; Hickey, Sandra

2017-01-01

This co-authored paper offers Aboriginal and non-Aboriginal perspectives on the emergence of urban/nature/child pedagogies in a project to reclaim remnant woodlands. Set in the context of indigenous issues explored in a special edition of the journal on land based education, the paper engages critically with a claim by a group of ecologists, that…

Higher Education and Urban Migration for Community Resilience: Indigenous Amazonian Youth Promoting Place-Based Livelihoods and Identities in Peru

ERIC Educational Resources Information Center

Steele, Diana

2018-01-01

This paper offers an ethnographic analysis of indigenous Peruvian Amazonian youth pursuing higher education through urban migration to contribute to the resilience of their communities, place-based livelihoods, and indigenous Amazonian identities. Youth and their communities promoted education and migration as powerful tools in the context of…

Multiliteracies and Family Language Policy in an Urban Inuit Community

ERIC Educational Resources Information Center

Patrick, Donna; Budach, Gabriele; Muckpaloo, Igah

2013-01-01

This study investigates the intersection of family language policy with Indigenous multiliteracies and urban Indigeneity. It documents a grassroots Inuit literacy initiative in Ottawa, Canada and considers literacy practices among Inuit at a local Inuit educational centre, where maintaining connections between urban Inuit and their homeland…

Drumming up Courage

ERIC Educational Resources Information Center

Faulkner, Simon

2012-01-01

The Holyoake DRUMBEAT (Discovering Relationships Using Music--Beliefs, Emotions, Attitudes, & Thoughts) program was first developed in 2003 as a means of engaging Australian Aboriginal youth who were resistant to talk-based therapeutic approaches. Aboriginal Australians, like indigenous peoples in many other countries, are over-represented in…

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 overwhelmingly positive opinion regarding acceptability and ease of use (median rating of 5, on a 5-point Likert-type scale when users were asked if they would recommend the app to others). We describe the process of development of a bilingual hepatitis B-specific app for Indigenous Australians, using a PAR framework. The approach was found to be successful with positive evaluations.

The characteristics, implementation and effects of Aboriginal and Torres Strait Islander health promotion tools: a systematic literature search

PubMed Central

2014-01-01

Background Health promotion by and with Aboriginal and Torres Strait Islander (hereafter Indigenous) Australians is critically important given a wide gap in health parity compared to other Australians. The development and implementation of step-by-step guides, instruments, packages, frameworks or resources has provided a feasible and low-resource strategy for strengthening evidence-informed health promotion practice. Yet there has been little assessment of where and how these tools are implemented or their effectiveness. This paper reviews the characteristics, implementation and effects of Indigenous health promotion tools. Methods Indigenous health promotion tools were identified through a systematic literature search including a prior scoping study, eight databases, references of other reviews and the authors’ knowledge (n = 1494). Documents in the peer reviewed and grey literature were included if they described or evaluated tools designed, recommended or used for strengthening Indigenous Australian health promotion. Eligible publications were entered into an Excel spreadsheet and documented tools classified according to their characteristics, implementation and effects. Quality was appraised using the Dictionary for Effective Public Health Practice Project (EPHPP) and Critical Appraisal Skills Program (CASP) tools for quantitative and qualitative studies respectively. Results The review found that Indigenous health promotion tools were widely available. Of 74 publications that met inclusion criteria, sixty (81%) documented tools developed specifically for the Indigenous Australian population. All tools had been developed in reference to evidence; but only 22/74 (30%) publications specified intended or actual implementation, and only 11/74 (15%) publications evaluated impacts of the implemented tools. Impacts included health, environmental, community, organisational and health care improvements. The quality of impact evaluations was strong for only five (7%) studies. Conclusions The small number and generally moderate quality of implementation and evaluation studies means that little is known about how tools work to strengthen Indigenous health promotion practice. The findings suggest that rather than continuing to invest in tool development, practitioners, policy makers and researchers could evaluate the implementation and effects of existing tools and publish the results. There is a need for long-term investment in research to review the current use of health promotion tools and the factors that are likely to enhance their implementation. PMID:25012401

Indigenous Youth Peer-Led Health Promotion in Canada, New Zealand, Australia, and the United States: A Systematic Review of the Approaches, Study Designs, and Effectiveness.

PubMed

Vujcich, Daniel; Thomas, Jessica; Crawford, Katy; Ward, James

2018-01-01

Youth peer-led interventions have become a popular way of sharing health information with young people and appear well suited to Indigenous community contexts. However, no systematic reviews focusing on Indigenous youth have been published. We conducted a systematic review to understand the range and characteristics of Indigenous youth-led health promotion projects implemented and their effectiveness. A systematic search of Medline, Embase, and ProQuest Social Sciences databases was conducted, supplemented by gray literature searches. Included studies focused on interventions where young Indigenous people delivered health information to age-matched peers. Twenty-four studies were identified for inclusion, based on 20 interventions (9 Australian, 4 Canadian, and 7 from the United States of America). Only one intervention was evaluated using a randomized controlled study design. The majority of evaluations took the form of pre-post studies. Methodological limitations were identified in a majority of studies. Study outcomes included improved knowledge, attitude, and behaviors. Currently, there is limited high quality evidence for the effectiveness of peer-led health interventions with Indigenous young people, and the literature is dominated by Australian-based sexual health interventions. More systematic research investigating the effectiveness of peer-led inventions is required, specifically with Indigenous populations. To improve health outcomes for Indigenous youth, greater knowledge of the mechanisms and context under which peer-delivered health promotion is effective in comparison to other methods of health promotion is needed.

Brief communication: the Australian Barrineans and their relationship to Southeast Asian negritos: an investigation using mitochondrial genomics.

PubMed

McAllister, Peter; Nagle, Nano; Mitchell, Robert John

2013-01-01

The existence of a short-statured Aboriginal population in the Far North Queensland (FNQ) rainforest zone of Australia's northeast coast and Tasmania has long been an enigma in Australian anthropology. Based on their reduced stature and associated morphological traits such as tightly curled hair, Birdsell and Tindale proposed that these "Barrinean" peoples were closely related to "negrito" peoples of Southeast Asia and that their ancestors had been the original Pleistocene settlers of Sahul, eventually displaced by taller invaders. Subsequent craniometric and blood protein studies, however, have suggested an overall homogeneity of indigenous Australians, including Barrineans. To confirm this finding and determine the degree of relatedness between Barrinean people and Southeast Asian negritos, we compared indigenous Australian mitochondrial DNA (mtDNA) sequences in populations from the FNQ rainforest ecozone and Tasmania with sequences from other Australian Aboriginal populations and from Southeast Asian negrito populations (Philippines Batek and Mamanwa, and mainland Southeast Asian Jahai, Mendriq, and Batak). The results confirm that FNQ and Tasmanian mtDNA haplogroups cluster with those of other Australian Aboriginal populations and are only very distantly related to Southeast Asian negrito haplogroups. Copyright © 2013 Wayne State University Press, Detroit, Michigan 48201-1309.

Exploring barriers to and enablers of adequate healthcare for Indigenous Australian prisoners with cancer: a scoping review drawing on evidence from Australia, Canada and the United States.

PubMed

Olds, Jessica; Reilly, Rachel; Yerrell, Paul; Stajic, Janet; Micklem, Jasmine; Morey, Kim; Brown, Alex

International frameworks supported by national principles in Australia stipulate that prisoners should be provided with health services equivalent to those provided in the general community. However, a number of barriers unique to the prison system may hinder the provision of equitable healthcare for this population. In Australia, Indigenous people carry a greater burden of cancer mortality, which the Cancer Data and Aboriginal Disparities (CanDAD) project is seeking to address. During the course of recruiting participants to the CanDAD study, Indigenous Australian prisoners with cancer emerged as an important, under-researched but difficult to access sub-group. This scoping review sought to identify barriers and facilitators of access to adequate and equitable healthcare for Indigenous Australian prisoners with cancer in Australia. This review demonstrated a lack of research and, as such, the scoping review was extended to prisoners with cancer in Australia, New Zealand, the United States and Canada. This approach was taken in order to summarise the existing body of evidence regarding the barriers and facilitators of access to adequate and equitable healthcare for those who are incarcerated and suffering from cancer, and highlight areas that may require further investigation. Eight studies or commentaries were found to meet the inclusion criteria. This limited set of findings pointed to a range of possible barriers faced by prisoners with cancer, including a tension between the prisons' concern with security versus the need for timely access to medical care. Findings identified here offer potential starting points for research and policy development. Further research is needed to better elucidate how barriers to adequate cancer care for prisoners may be identified and overcome, in Australia and internationally. Furthermore, given Indigenous Australians' over-burden of cancer mortality and over-representation in the prison system, further research is needed to identify whether there are a unique set of barriers for this group.

"A Space for You to Be Who You Are": An Ethnographic Portrait of Reterritorializing Indigenous Student Identities

ERIC Educational Resources Information Center

Anthony-Stevens, Vanessa; Stevens, Philip

2017-01-01

This article explores the discourse practices of an Indigenous, community-based charter school and its efforts to create space for Indigenous both/and identities across rural-urban divides. The ethnographic portrait of Urban Native Middle School (UNMS) analyzes the discourse of making "a space for you", which brings together rural and…

Lessons Worth Remembering: Combat In Urban Areas

DTIC Science & Technology

2016-05-10

areas, realize that indigenous groups are best at resolving local problems, accept operating decentralized, and value the importance of supreme firepower...that foments within urban areas, realize that indigenous groups are best at resolving local problems, accept operating decentralized, and value the...permeated stability throughout Ramadi. Second, 1BCT transitioned areas of responsibility to a competent and capable indigenous force to maintain the

Towards Growing Indigenous Culturally Competent Legal Professionals in Australia

ERIC Educational Resources Information Center

Burns, Marcelle

2013-01-01

The Review of Australian Higher Education (Bradley Review, 2008) and the Review of Higher Education Access and Outcomes for Aboriginal and Torres Strait Islander People (Behrendt Review, 2012) identified the need for tertiary institutions to incorporate Indigenous knowledges into curriculum to improve educational outcomes for Indigenous…

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). Although not representative of all Indigenous people, this study identified low dietary magnesium intake among an Indigenous cohort from a regional centre. We also found a significant correlation between the magnesium content of municipal water supplies and age-standardized deaths due to diabetes. We hypothesise that low magnesium dietary intake, compounded by inadequate magnesium replenishment in drinking water, may increase the risk of hypomagnesaemia in the Indigenous population of Queensland. The associations identified in this study support the hypothesis that magnesium may be a potential contributor to diabetes in Australia, especially among Indigenous people, and confirm the need for further research.

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.

Smoking behaviour and preferences for cessation support among clients of an Indigenous community-controlled health service.

PubMed

Cockburn, Nicole; Gartner, Coral; Ford, Pauline J

2018-03-02

Reducing smoking prevalence among Indigenous Australians is a vital part of closing the health gap between Indigenous and non-Indigenous Australians. Community-controlled health clinics are an important setting for delivering smoking cessation advice and assistance. This study measured tobacco and e-cigarette use, knowledge of smoking-related health effects, motivations to quit and interest in cessation aids. Clients of Aboriginal & Torres Strait Islander Community Health Service dental clinics in Southeast Queensland (n = 421) completed a brief written questionnaire while in the waiting room. Nearly half (n = 184, 47%) of the participants currently smoked daily, of which 9% (n = 7) currently used e-cigarettes. Few smokers (8%, n = 13) had no intention to quit smoking. For current smokers, previously used quit methods were abrupt cessation (42%, n = 78), nicotine replacement therapies (NRT; 25%, n = 45), prescription medications (23%, n = 43), e-cigarettes (9%, n = 17) and other methods (3%, n = 6). Current smokers were most interested in cutting down (85%, n = 110), abrupt cessation (75%, n = 98) and free NRT (72%, n = 101). Fewer (34%, n = 36) were interested in purchasing NRT for smoking cessation. Our study found there was interest in accessing smoking cessation aids among the clients of this community-controlled health clinic, particularly if provided free of charge. Embedding smoking cessation advice and assistance into a range of community-controlled health clinics could provide opportunities for addressing the high smoking prevalence among Indigenous Australians. © 2018 Australasian Professional Society on Alcohol and other Drugs.

Association of the Familial Coexistence of Child Stunting and Maternal Overweight with Indigenous Women in Guatemala.

PubMed

Lee, J; Houser, R; Must, A; Palma, P; Bermudez, O

2017-11-01

Objectives This study investigated the association of the familial coexistence of child stunting and maternal overweight with indigenous women in Guatemala. Methods We selected 2388 child-mother pairs from the data set of the Living Standards Measurement Study conducted in Guatemala in 2000. This study examined the association between maternal and household characteristics and the nutritional status of children aged 6-60 months and mothers aged 18-49 years by using multivariable logistic regression models. Results Compared with non-indigenous households, a significantly higher percentage of indigenous households exhibited stunted child and overweight mother (SCOM) pairs (15.9 vs. 22.2%). Compared with normal-weight mothers, overweight mothers were less likely to have stunted children [adjusted odds ratio (AOR) 0.66, 95% confidence interval (CI) 0.50-0.88]. However, compared with mothers who were not short and overweight, short and overweight mothers were significantly more likely to have stunted children (AOR 1.80, 95% CI 1.19-2.73) and were more likely to be indigenous women living in urban areas (AOR 3.01, 95% CI 1.19-7.60) or rural areas (AOR 3.02, 95% CI 1.28-7.14). The order of observed prevalence of SCOM pairs in different types of households was as follows: urban indigenous (25.0%), rural indigenous (21.2%), rural non-indigenous (19.8%), and urban non-indigenous households (10.7%). Conclusions for Practice Urban indigenous households were more likely to have SCOM pairs. This study provided useful information for identifying the most vulnerable groups and areas with a high prevalence of the familial coexistence of child stunting and maternal overweight.

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 development of an Indigenous disability workforce may help to ensure a culturally safe disability services sector and workforce.

Can we measure daily tobacco consumption in remote indigenous communities? Comparing self-reported tobacco consumption with community-level estimates in an Arnhem Land study.

PubMed

Clough, Alan R; MacLaren, David J; Robertson, Jan A; Ivers, Rowena G; Conigrave, Katherine M

2011-03-01

In remote Indigenous Australian communities measuring individual tobacco use can be confounded by cultural expectations, including sharing. We compared self-reported tobacco consumption with community-level estimates in Arnhem Land (Northern Territory). In a cross-sectional survey in three communities (population 2319 Indigenous residents, aged ≥16 years), 400 Indigenous residents were interviewed (206 men, 194 women). Eight community stores provided information about tobacco sold during the survey. To gauge the impact of 255 non-Indigenous residents on tobacco turnover, 10 were interviewed (five men, five women). Breath carbon monoxide levels confirmed self-reported smoking. Self-reported number of cigarettes smoked per day was compared with daily tobacco consumption per user estimated using amounts of tobacco sold during 12 months before the survey (2007-2008). 'Lighter smokers' (<10 cigarettes per day) and 'heavier smokers' (≥10 cigarettes per day) in men and women were compared. Of 400 Indigenous study participants, 305 (76%) used tobacco; four chewed tobacco. Of 301 Indigenous smokers, 177 (58%) provided self-reported consumption information; a median of 11-11.5 cigarettes per day in men and 5.5-10 cigarettes per day in women. Men were three times (odds ratio=2.9) more likely to be 'heavier smokers'. Store turnover data indicated that Indigenous tobacco users consumed the equivalent of 9.2-13.1 cigarettes per day; very similar to self-reported levels. Sixty per cent (=6/10) of non-Indigenous residents interviewed were smokers, but with little impact on tobacco turnover overall (2-6%). Smoking levels reported by Indigenous Australians in this study, when sharing tobacco was considered, closely reflected quantities of tobacco sold in community stores. © 2010 Australasian Professional Society on Alcohol and other Drugs.

Indigenous cardiac patients' and relatives' experiences of hospitalisation: A narrative inquiry.

PubMed

Mbuzi, Vainess; Fulbrook, Paul; Jessup, Melanie

2017-12-01

To explore Indigenous people's experiences of hospitalisation for acute cardiac care. Indigenous Australians suffer a higher burden of cardiovascular ill health and hospitalisation rates in comparison with other Australians, but there is little research that explores their perspectives of hospitalisation. Narrative inquiry. Interviews were undertaken using storytelling to facilitate participants' descriptions of their hospital experience. Data were collected during 2014-2015. A purposive sample of Indigenous cardiac patients that were admitted to hospital and their relatives participated. The narrative revealed three linked themes that characterised Indigenous people's hospitalisation experiences: The impact of the past; The reality of the present; and Anticipating the future. Hospitalisation was challenging for participants due to their sense of dislocation and disorientation, a lack of cultural and spiritual aspects to care practices, and the poor interpersonal relationships they experienced. Findings revealed that there were many unmet needs during hospitalisation for Indigenous people. Past experiences and future expectations were connected in a way that impacted on participants' current hospitalisation experience. Understanding this context, with incorporation of cultural and spiritual aspects of care may help nurses and other healthcare professionals to provide more positive interactions that in turn may contribute to improved cardiac care experiences of Indigenous people during hospitalisation. Healthcare professionals need to be aware and focused on person-specific and contextualised aspects of Indigenous people's experience of hospitalisation for cardiac care in order to impact outcomes. Healthcare professionals need to understand Indigenous people's perspectives that contribute to improved health outcomes. Stories of participants' experiences may assist in the identification of aspects which might further the development of culturally appropriate continuity models that could effectively provide support throughout Indigenous people's hospital journeys, and beyond the hospital, and help improve associated health outcomes. © 2017 John Wiley & Sons Ltd.

Indigenous cultural competence: A dental faculty curriculum review.

PubMed

Forsyth, C; Irving, M; Tennant, M; Short, S; Gilroy, J

2017-12-30

Indigenous Australians have more than double the rate of poor oral health than their non-Indigenous counterparts. Cultural competence of dental and oral health practitioners is fundamental to health care and quality of life in addressing health disparities in minority cultural groups in Australia. Higher education curricula reviews have identified the need for institutions to incorporate Indigenous culture and knowledge more widely into the curricula to improve educational outcomes for Indigenous Australians and to increase cultural competence for all students. The aim of this research was to provide a baseline analysis of Indigenous cultural competence curricula practices to ascertain changes required within Faculty of Dentistry programmes at the University of Sydney to enable students to become more culturally competent upon graduation. Staff and students of the Doctor of Dental Medicine and Bachelor of Oral Health programmes at the Faculty of Dentistry, University of Sydney participated in an online survey. Quantitative analysis of the survey data was conducted using integrated research electronic data capture survey tools, with open-ended questions being coded to common responses for those questions. A total of 69 staff (71%) and 191 students (51%) participated in the online survey. The majority of participants perceived there was limited Indigenous content in the curriculum. Most participants reported that Indigenous curriculum was integrated into several units of study. The main pedagogical method for curriculum delivery was lectures, followed by case studies and group discussions. Although some Indigenous content exists in dental faculty curriculum, in-depth investigation is required to develop a comprehensive, evidenced-based Indigenous cultural competence teaching framework, for integration into Doctor of Dental Medicine and Bachelor of Oral Health curricula. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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.

Can administrative data provide insights into the mental health of Indigenous Queenslanders?

PubMed

Kisely, Steve; Pais, Joanne

2011-07-01

The Australian Government has provided $20 million to establish the Population Health Research Network (PHRN), with representation from all States and Territories to facilitate population health research through data linkage. Health LinQ is part of the Queensland node involving four Queensland universities, Queensland Health and the Australian e-Health Research Centre. This paper reviews the potential for using administrative databases to study the mental health experience of Indigenous Queenslanders. Researchers can define cohorts for study within the administrative data or link them to their own data. Robust protocols preserve confidentiality so that researchers only receive anonymized data. Indigenous status can be defined either through place of residence or through the recording of Indigenous status in datasets such as the Queensland Hospital Admitted Patient Data Collection. Available data include hospital morbidity, mental health data and mortality. Indigenous status is correctly identified in about 89% of cases with variation by definition used. Administrative data provide researchers and decision makers with accessible, cost-effective information without the intrusion and cost of additional data collection. These techniques are especially useful in studying regional, rural and remote populations where access may be difficult.

Development and validation of the Measure of Indigenous Racism Experiences (MIRE)

PubMed Central

Paradies, Yin C; Cunningham, Joan

2008-01-01

Background In recent decades there has been increasing evidence of a relationship between self-reported racism and health. Although a plethora of instruments to measure racism have been developed, very few have been described conceptually or psychometrically Furthermore, this research field has been limited by a dearth of instruments that examine reactions/responses to racism and by a restricted focus on African American populations. Methods In response to these limitations, the 31-item Measure of Indigenous Racism Experiences (MIRE) was developed to assess self-reported racism for Indigenous Australians. This paper describes the development of the MIRE together with an opportunistic examination of its content, construct and convergent validity in a population health study involving 312 Indigenous Australians. Results Focus group research supported the content validity of the MIRE, and inter-item/scale correlations suggested good construct validity. A good fit with a priori conceptual dimensions was demonstrated in factor analysis, and convergence with a separate item on discrimination was satisfactory. Conclusion The MIRE has considerable utility as an instrument that can assess multiple facets of racism together with responses/reactions to racism among indigenous populations and, potentially, among other ethnic/racial groups. PMID:18426602

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…

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…

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.…

"Too much moving...there's always a reason": Understanding urban Aboriginal peoples' experiences of mobility and its impact on holistic health.

PubMed

Snyder, Marcie; Wilson, Kathi

2015-07-01

Urban Indigenous peoples face a disproportionate burden of ill health compared to non-Indigenous populations, and experience more frequent geographic mobility. However, most of what is known about Indigenous health is limited to rural, northern, or in the case of Canada, reserve-based populations. Little is known about the complexities of urban Indigenous health, and the differential impacts of residential mobility and urban migration remain poorly understood. Drawing upon interviews with Aboriginal movers and service providers in Winnipeg, Canada, we apply a critical population health lens, informed by holistic health, to examine these impacts. The results demonstrate mobility is an intergenerational phenomenon, influenced by colonial practices. While migration can contribute to positive health experiences, residential mobility, which is largely involuntary, and linked to stressors such as neighborhood safety, results in negative health effects. Copyright © 2015 Elsevier Ltd. All rights reserved.

Out of a digital chrysalis: NIHNMF (pronounced nymph--the National Indigenous Health and New Media Forum).

PubMed

Cattoni, Jan; Gamble, Lucinda; Gibson, Julie; Hunter, Ernest; Jones, Anita; Mitchell, Sarah; Pelham, Steven; Smith, Rakana; Travers, Helen

2009-08-01

In conjunction with the Creating Futures conference, the inaugural meeting of the National Indigenous Health and New Media Forum (NIHNMF--pronounced as 'nymph') was held at the Tanks Gallery in Cairns, Queensland, Australia. This paper describes the background to this innovative meeting of media minds. It also explores an emerging vision for addressing Indigenous health disparities through digital inclusion to overcome the 'digital divide' between mainstream and Indigenous Australians that constrains the delivery of appropriate health promotion to this health priority population.

All in the Blood: A Review of Aboriginal Australians' Cultural Beliefs About Blood and Implications for Biospecimen Research.

PubMed

Kowal, Emma; Greenwood, Ashley; McWhirter, Rebekah E

2015-10-01

Public participation in medical research and biobanking is considered key to advances in scientific discovery and translation to improved health care. Cultural concerns relating to blood have been found to affect the participation of indigenous peoples and minorities in research, but such concerns are rarely specified in the literature. This article presents a review of the role of blood in Australian Aboriginal cultures. We discuss the range of meanings and uses of blood in traditional culture, including their use in ceremonies, healing, and sorcery. We draw on more recent literature on Aboriginal Australians and biomedicine to consider how traditional beliefs may be changing over time. These findings provide an empirical basis for researchers and bioethicists to develop culturally grounded strategies to boost the participation of Aboriginal Australians in biomedical research. They also serve as a model for integrating anthropological literature with bioethical concerns that could be applied to other indigenous and minority groups. © The Author(s) 2015.

Canadian Residential Schools and Urban Indigenous Knowledge Production about Diabetes

PubMed Central

Howard, Heather A.

2016-01-01

The construction of illness as an inscription on the body of colonization figures importantly among Indigenous community-based service and health care providers. While residential schools and diabetes have both been characterized as products of colonization, little work has been done to examine how they are connected to and informative for health provider practice. The research data presented in this article come from a collaborative urban Indigenous community-based study examining the legacy of negative relationships with food that was instilled in residential schools and used in diabetes intervention. I illustrate how residential school disciplined eating, providing a context for understanding the contemporary production of Indigenous health knowledge and practice in the urban setting, and the diet-related management of diabetes. PMID:24964719

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.

Yaitya tirka madlanna warratinna: exploring what sexual health nurses need to know and do in order to meet the sexual health needs of young Aboriginal women in Adelaide.

PubMed

Kelly, Janet; Luxford, Yoni

2007-07-01

Young Aboriginal women are consistently identified as having poorer health outcomes and access to sexual health services than non-Indigenous Australians. Yet the literature is particularly silent on what sexual health nurses need to know and do in order to work well with young urban Aboriginal women. This paper reports on a qualitative pilot study undertaken by a non-Indigenous nurse in Adelaide. The participatory action research methods used in this study were sensitive to the history of problems associated with research in Aboriginal communities. A reference group of Elder Aboriginal women and Aboriginal health workers guided all aspects of the study. A partnership approach between the researcher and the Reference Group ensured that the methods, analysis, and final report were culturally safe. Three groups participated in this study: Elders and Aboriginal health workers; young Aboriginal women, and sexual health nurses. All participants acknowledged the importance of nurses being clinically competent. However, the overarching finding was a lack of a clear model of cultural care to guide health service delivery. Three interrelated themes emerged from the data to support this contention. These were: the structural and personal importance of establishing and maintaining trustworthy relationships between nurses, Aboriginal health workers and Elders; the recognition that Aboriginal culture does exist, and is important in urban areas; and the importance of gender considerations to understanding urban women's health business. A partnership approach was recommended as a way to use these findings to develop a transparent cultural model of care. Further research is currently being undertaken to progress this agenda.

Trachoma, cataracts and uncorrected refractive error are still important contributors to visual morbidity in two remote indigenous communities of the Northern Territory, Australia.

PubMed

Wright, Heathcote R; Keeffe, Jill E; Taylor, Hugh R

2009-08-01

To assess the contribution of trachoma, cataract and refractive error to visual morbidity among Indigenous adults living in two remote communities of the Northern Territory. Cross-sectional survey of all adults aged 40 and over within a desert and coastal community. Visual acuity, clinical signs of trachoma using the simplified WHO grading system and assessment of cataract through a non-dilated pupil. Two hundred and sixty individuals over the age of 40 years participated in the study. The prevalence of visual impairment (<6/12) was 17%. The prevalence of blindness (<3/60) was 2%, 40-fold higher than seen in an urban Australian population when adjusted for age. In total, 78% of adults who grew up in a desert community had trachomatous scarring compared with 26% of those who grew up in a coastal community (P < or = 0.001). In the desert community the prevalence of trachomatous trichiasis was 10% and corneal opacity was 6%. No trachomatous trichiasis or corneal opacity was seen in the coastal community. Trachoma, cataract and uncorrected refractive error remain significant contributors to visual morbidity in at least two remote indigenous communities. A wider survey is required to determine if these findings represent a more widespread pattern and existing eye care services may need to be re-assessed to determine the cause of this unmet need.

The DRUID study: racism and self-assessed health status in an indigenous population

PubMed Central

2012-01-01

Background There is now considerable evidence from around the world that racism is associated with both mental and physical ill-health. However, little is known about the mediating factors between racism and ill-health. This paper investigates relationships between racism and self-assessed mental and physical health among Indigenous Australians as well as potential mediators of these relationships. Methods A total of 164 adults in the Darwin Region Urban Indigenous Diabetes (DRUID) study completed a validated instrument assessing interpersonal racism and a separate item on discrimination-related stress. Self-assessed health status was measured using the SF-12. Stress, optimism, lack of control, social connections, cultural identity and reactions/responses to interpersonal racism were considered as mediators and moderators of the relationship between racism/discrimination and self-assessed health status. Results After adjusting for socio-demographic factors, interpersonal racism was significantly associated with the SF-12 mental (but not the physical) health component. Stress, lack of control and feeling powerless as a reaction to racism emerged as significant mediators of the relationship between racism and general mental health. Similar findings emerged for discrimination-related stress. Conclusions Racism/discrimination is significantly associated with poor general mental health among this indigenous population. The mediating factors between racism and mental health identified in this study suggest new approaches to ameliorating the detrimental effects of racism on health. In particular, the importance of reducing racism-related stress, enhancing general levels of mastery, and minimising negative social connections in order to ameliorate the negative consequences of racism. PMID:22333047

Psychometric validation of the Growth and Empowerment Measure (GEM) applied with Indigenous Australians.

PubMed

Haswell, Melissa R; Kavanagh, David; Tsey, Komla; Reilly, Lyndon; Cadet-James, Yvonne; Laliberte, Arlene; Wilson, Andrew; Doran, Chris

2010-09-01

Empowerment is a complex process of psychological, social, organizational and structural change. It allows individuals and groups to achieve positive growth and effectively address the social and psychological impacts of historical oppression, marginalization and disadvantage. The Growth and Empowerment Measure (GEM) was developed to measure change in dimensions of empowerment as defined and described by Aboriginal Australians who participated in the Family Well Being programme. The GEM has two components: a 14-item Emotional Empowerment Scale (EES14) and 12 Scenarios (12S). It is accompanied by the Kessler 6 Psychological Distress Scale (K6), supplemented by two questions assessing frequency of happy and angry feelings. For validation, the measure was applied with 184 Indigenous Australian participants involved in personal and/or organizational social health activities. Psychometric analyses of the new instruments support their validity and reliability and indicate two-component structures for both the EES (Self-capacity; Inner peace) and the 12S (Healing and enabling growth, Connection and purpose). Strong correlations were observed across the scales and subscales. Participants who scored higher on the newly developed scales showed lower distress on the K6, particularly when the two additional questions were included. However, exploratory factor analyses demonstrated that GEM subscales are separable from the Kessler distress measure. The GEM shows promise in enabling measurement and enhancing understanding of both process and outcome of psychological and social empowerment within an Australian Indigenous context.

Observations of red-giant variable stars by Aboriginal Australians

NASA Astrophysics Data System (ADS)

Hamacher, Duane W.

2018-04-01

Aboriginal Australians carefully observe the properties and positions of stars, including both overt and subtle changes in their brightness, for subsistence and social application. These observations are encoded in oral tradition. I examine two Aboriginal oral traditions from South Australia that describe the periodic changing brightness in three pulsating, red-giant variable stars: Betelgeuse (Alpha Orionis), Aldebaran (Alpha Tauri), and Antares (Alpha Scorpii). The Australian Aboriginal accounts stand as the only known descriptions of pulsating variable stars in any Indigenous oral tradition in the world. Researchers examining these oral traditions over the last century, including anthropologists and astronomers, missed the description of these stars as being variable in nature as the ethnographic record contained several misidentifications of stars and celestial objects. Arguably, ethnographers working on Indigenous Knowledge Systems should have academic training in both the natural and social sciences.

Learning from the past, looking to the future: Exploring our place with Indigenous Australians.

PubMed

Nelson, Alison

2009-04-01

This paper aims to explore ways in which we as occupational therapists in Australia can participate in enabling a different and better future for all Australians. In doing so, it is necessary to explore our history and our cultures, both individually and collectively as a profession, and to understand the ways in which these shape who we are and what we do. As occupational therapists, we have valuable knowledge and skills that have the potential to contribute in a positive way to the health and educational outcomes of Indigenous Australians. As a profession operating in Australia, we also have a responsibility to reach this potential. This paper aims to present some of these contributions and to provide examples of practical and culturally safe ways in which we can take action.

[Sanitation and racial inequality conditions in urban Brazil: an analysis focused on the indigenous population based on the 2010 Population Census].

PubMed

Raupp, Ludimila; Fávaro, Thatiana Regina; Cunha, Geraldo Marcelo; Santos, Ricardo Ventura

2017-01-01

The aims of this study were to analyze and describe the presence and infrastructure of basic sanitation in the urban areas of Brazil, contrasting indigenous with non-indigenous households. Methods: A cross-sectional study based on microdata from the 2010 Census was conducted. The analyses were based on descriptive statistics (prevalence) and the construction of multiple logistic regression models (adjusted by socioeconomic and demographic covariates). The odds ratios were estimated for the association between the explanatory variables (covariates) and the outcome variables (water supply, sewage, garbage collection, and adequate sanitation). The statistical significance level established was 5%. Among the analyzed services, sewage proved to be the most precarious. Regarding race or color, indigenous households presented the lowest rate of sanitary infrastructure in Urban Brazil. The adjusted regression showed that, in general, indigenous households were at a disadvantage when compared to other categories of race or color, especially in terms of the presence of garbage collection services. These inequalities were much more pronounced in the South and Southeastern regions. The analyses of this study not only confirm the profile of poor conditions and infrastructure of the basic sanitation of indigenous households in urban areas, but also demonstrate the persistence of inequalities associated with race or color in the country.

Developing a tablet computer-based application ('App') to measure self-reported alcohol consumption in Indigenous Australians.

PubMed

Lee, K S Kylie; Wilson, Scott; Perry, Jimmy; Room, Robin; Callinan, Sarah; Assan, Robert; Hayman, Noel; Chikritzhs, Tanya; Gray, Dennis; Wilkes, Edward; Jack, Peter; Conigrave, Katherine M

2018-01-15

The challenges of assessing alcohol consumption can be greater in Indigenous communities where there may be culturally distinct approaches to communication, sharing of drinking containers and episodic patterns of drinking. This paper discusses the processes used to develop a tablet computer-based application ('App') to collect a detailed assessment of drinking patterns in Indigenous Australians. The key features of the resulting App are described. An iterative consultation process was used (instead of one-off focus groups), with Indigenous cultural experts and clinical experts. Regular (weekly or more) advice was sought over a 12-month period from Indigenous community leaders and from a range of Indigenous and non-Indigenous health professionals and researchers. The underpinning principles, selected survey items, and key technical features of the App are described. Features include culturally appropriate questioning style and gender-specific voice and images; community-recognised events used as reference points to 'anchor' time periods; 'translation' to colloquial English and (for audio) to traditional language; interactive visual approaches to estimate quantity of drinking; images of specific brands of alcohol, rather than abstract description of alcohol type (e.g. 'spirits'); images of make-shift drinking containers; option to estimate consumption based on the individual's share of what the group drank. With any survey platform, helping participants to accurately reflect on and report their drinking presents a challenge. The availability of interactive, tablet-based technologies enables potential bridging of differences in culture and lifestyle and enhanced reporting.

The burden and nature of malnutrition among patients in regional hospital settings: A cross-sectional survey.

PubMed

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

2018-02-01

Indigenous people experience a higher burden of nutrition-related conditions and are more likely to experience food insecurity compared to non-Indigenous people. Consequently, they remain at increased risk of malnutrition; particularly when residing in regional or remote areas. This study aims to compare and characterise the burden and nature of malnutrition among a representative cohort of Indigenous and non-Indigenous Australians admitted to regional hospitals for medical inpatient care. This was a cross-sectional survey conducted in three regional hospitals in the Northern Territory and Far North Queensland of Australia from February 2015 to September 2015. A total of 1606 adult medical inpatients were screened for eligibility. Of these, 608 eligible patients were screened for malnutrition using the validated Malnutrition Screening Tool and assessed for malnutrition using the Subjective Global Assessment. Socio-economic and health-related variables and anthropometric measurements were collected to identify the correlates of malnutrition. Of the 271 Indigenous patients and 337 non-Indigenous patients screened and assessed for malnutrition, 250/608 (41.7%, 95% CI 40.1-52.3%) were found to be malnourished. Significantly higher rates of malnutrition (46.1%, 95% CI 40.1-52.3% versus 37.1%, 95% CI 31.9-42.5%) were found in Indigenous patients compared to non-Indigenous patients (P = 0.024). Higher rates of malnutrition were observed in Indigenous patients residing in Central Australia (56.7%, 95% CI 46.7-66.4%) than in the Top End of the Northern Territory (40.7%, 95% CI 31.7-50.1%) and in Far North Queensland (36.7%, 95% CI 23.4-51.7%). Factors independently predictive of malnutrition for both Indigenous and non-Indigenous participants included residence in Central Australia (OR 4.31, 95% CI 2.63-7.90, P < 0.001); an increased Charlson Comorbidity Index prognostic score (OR 1.37 [per incremental score], 95% CI 1.19-1.59, P < 0.001); and an underweight Body Mass Index (OR 29.97, 95% CI 3.68-244.0, P < 0.001). Of the 250/608 patients who were malnourished, the positive predictor value (PPV) for malnourished patients who were underweight was 96.6% (95% CI 88.3-99.6%); for Indigenous Australians who were malnourished and underweight, the PPV was 100%. A mid-upper arm circumference of less than 23 cm demonstrated a strong PPV for all patients who were malnourished (96.1%, 95% CI 89.0-99.2%). This is the first study to characterise malnutrition in adult Indigenous Australians in a hospital inpatient setting. Compared to non-Indigenous patients the burden and pattern of malnutrition was both higher and markedly different among Indigenous patients. These data highlight the critical importance for actively screening for and responding to malnutrition in this vulnerable patient population in regional and remote settings. Copyright © 2017 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Restorative Justice Conferencing: Not a Panacea for the Overrepresentation of Australia's Indigenous Youth in the Criminal Justice System.

PubMed

Little, Simon; Stewart, Anna; Ryan, Nicole

2018-03-01

Restorative justice conferencing is a police diversionary strategy used extensively in Australian jurisdictions to channel young offenders away from formal court processing. Advocates view conferencing as culturally appropriate and a means to reduce the overrepresentation of Indigenous young people because it is rooted in Indigenous justice traditions. However, whether conferencing is effective at reducing recidivism by Indigenous young people compared with non-Indigenous young people remains unknown. We examine this using a longitudinal cohort of youth offenders from Australia. Propensity score matching was used to match Indigenous and non-Indigenous young people at their first conference and examined reoffending outcomes to explore its efficacy at reducing recidivism ( n = 394). Results indicate that, despite statistically controlling for factors related to reoffending, recidivism levels postconference were significantly higher for Indigenous young people. These results suggest that conferencing is unlikely to address the problem of Indigenous overrepresentation within Australia's youth justice system.

Development of the Indigenous Child-Initiated Pretend Play Assessment: Selection of play materials and administration.

PubMed

Dender, Alma; Stagnitti, Karen

2011-02-01

There is a need for culturally appropriate assessments for Australian Indigenous children. This article reports the selection of culturally appropriate and gender-neutral play materials, and changes in administration identified to develop further the Indigenous Child-Initiated Pretend Play Assessment (I-ChIPPA). Twenty-three typically developing children aged four to six years from the Pilbara region in Western Australia participated in the study. Children were presented with four sets of play materials and frequency counts were recorded for each time the child used one of the play materials in a pretend play action. Twelve of the 23 children came to play in pairs. Both boys and girls used the Pilbara toy set including the dark coloured dolls and Pilbara region animals, more frequently than the standardised play materials from the Child-Initiated Pretend Play Assessment (ChIPPA). This study reports the first steps in the development of the I-ChIPPA. Future development will include the refinement of the administration and scoring with pairs of children, and then validity testing the assessment. © 2010 The Authors. Australian Occupational Therapy Journal © 2010 Australian Association of Occupational Therapists.

The Production and Distribution of Burarra Talking Books

ERIC Educational Resources Information Center

Darcy, Rose; Auld, Glenn

2008-01-01

The use of ICTs to support literacy in a minority Indigenous Australian language is an important domain of pedagogy that is often overlooked by teachers in these contexts. The development of new technological configurations in remote communities can be highly supportive of Indigenous languages spoken by a small number of people. This paper reports…

Working towards the Assurance of Graduate Attributes for Indigenous Cultural Competency: The Case for Alignment between Policy, Professional Development and Curriculum Processes

ERIC Educational Resources Information Center

Goerke, Veronica; Kickett, Marion

2013-01-01

In the Australian higher education environment, often preoccupied with internationalisation of education and associated issues around intercultural competencies, there is an uncomfortable awareness of the commensurate lack of attention on 'Indigenisation of the curriculum" and the interconnected 'Indigenous cultural competencies". This…

Cultural Dimensions of Indigenous Participation in Vocational Education and Training: New Perspectives. Research Report

ERIC Educational Resources Information Center

Dockery, Alfred Michael

2013-01-01

This study provides new evidence on the inter-relationships between Indigenous Australians' association with their traditional culture and their engagement with vocational education and training. It builds on previous work to develop a "richer" measure of the concept of cultural attachment. This report discusses the links between…

Tensions between Policy and Practice: Reconciliation Agendas in the Australian Curriculum English

ERIC Educational Resources Information Center

Exley, Beryl; Chan, Mui Yoke,

2014-01-01

In various parts of the world, Indigenous and non-Indigenous peoples are actively working towards Reconciliation. In Australia, the context in which we each undertake our work as educationalists and researchers, the Reconciliation agenda has been pushed into schools and English teachers have been called on to share responsibility for facilitating…

Recognising Change and Seeking Affirmation: Themes for Embedding Indigenous Knowledges on Teaching Practicum

ERIC Educational Resources Information Center

McLaughlin, Juliana M.; Whatman, Susan L.

2015-01-01

The imperative for Indigenous education in Australia is influenced by national political, social and economic discourses as Australian education systems continue to grapple with an agreed aspiration of full participation for Aboriginal and Torres Strait Islander students. Innovations within and policies guiding our education systems are often…

Listening to Hear: Critical Allies in Indigenous Studies

ERIC Educational Resources Information Center

McGloin, Colleen

2015-01-01

This paper reflects on a particular class in an undergraduate seminar in Australian Indigenous Studies where anecdote played a crucial role and where both the teacher and learners were challenged to consider their implication as racialised subjects in the teaching and learning process. The paper argues that student anecdote can be a vital bridge…

Measuring the "Gift": Epistemological and Ontological Differences between the Academy and Indigenous Australia

ERIC Educational Resources Information Center

Bullen, Jonathan; Flavell, Helen

2017-01-01

This paper is drawn from our collective experience coordinating, and teaching in, a large common inter-professional unit on Indigenous cultures and health at an Australian university. Specifically, we use our lived experiences as Aboriginal and non-Aboriginal academics working interculturally to inform a theoretical discussion about how…

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.…

Increasing access by priority populations to Australian sexual health clinics.

PubMed

Ali, Hammad; Donovan, Basil; Fairley, Christopher K; Chen, Marcus Y; O'Connor, Catherine C; Grulich, Andrew E; McNulty, Anna; Ryder, Nathan; Hellard, Margaret E; Guy, Rebecca J

2013-10-01

Data from a network of 35 Australian sexual health clinics, in geographically diverse locations, showed that the number and proportion of patients from priority populations (ie, young people, men who have sex with men, indigenous people, and female sex workers) increased significantly between 2004 and 2011.

Learning through Standard English: Cognitive Implications for Post-Pidgin/-Creole Speakers

ERIC Educational Resources Information Center

Malcolm, Ian G.

2011-01-01

Despite their (albeit limited) access to Standard Australian English through education, Australian Indigenous communities have maintained their own dialect (Aboriginal English) for intragroup communication and are increasingly using it as a medium of cultural expression in the wider community. Most linguists agree that the most significant early…

"Really Really Different Different": Rurality, Regional Schools and Refugees

ERIC Educational Resources Information Center

Colvin, Neroli

2017-01-01

This article explores the dynamics of difference-making in a regional Australian town. Despite Australia's high levels of cultural diversity, many rural and regional areas remain predominantly "white" spaces, presided over by people of Anglo-Celtic ancestry but with small populations of indigenous Australians. Over the past decade,…

'I could never have learned this in a lecture': transformative learning in rural health education.

PubMed

Prout, Sarah; Lin, Ivan; Nattabi, Barbara; Green, Charmaine

2014-05-01

Health indicators for rural populations in Australia continue to lag behind those of urban populations and particularly for Indigenous populations who make up a large proportion of people living in rural and remote Australia. Preparation of health practitioners who are adequately prepared to face the 'messy swamps' of rural health practice is a growing challenge. This paper examines the process of learning among health science students from several health disciplines from five Western Australian universities during 'Country Week': a one-week intensive experiential interprofessional education program in rural Western Australia. The paper weaves together strands of transformative theory of learning with findings from staff and student reflections from Country Week to explore how facilitated learning in situ can work to produce practitioners better prepared for rural health practice.

Pollen analysis of Australian honey.

PubMed

Sniderman, J M Kale; Matley, Kia A; Haberle, Simon G; Cantrill, David J

2018-01-01

Pollen analysis is widely used to verify the geographic origin of honeys, but has never been employed in Australia. In this study, we analysed the pollen content of 173 unblended honey samples sourced from most of the commercial honey producing regions in southern Australia. Southern Australian vegetation is dominated by Eucalyptus (Myrtaceae) forests and, as expected, most Australian honeys are palynologically dominated by Eucalyptus, while other important components include Myrtaceae taxa such as Corymbia/Angophora and the tribe Leptospermeae; plus Brassicaceae, Echium, Macadamia, and Acacia. An important feature of the honeys is the number of Myrtaceae pollen morphotypes per sample, which is generally high (mean = 4.6) compared to honeys produced outside of Australia, including Eucalyptus honeys produced in the Mediterranean region, and honeys produced in South America, which has its own rich indigenous Myrtaceae flora. In the latter regions, the number of Myrtaceae morphotypes is apparently generally ≤2. A high number of Myrtaceae morphotypes may be a feasible criterion for authenticating the origin of Australian honeys, since most Australian honey is produced by honey bees mainly working indigenous floral resources. Myrtaceae morphotype diversity is a convenient melissopalynological measure that could be applied even where detailed knowledge of the pollen morphology of the many component genera and species is absent. Palynological criteria developed in Europe for authenticating Eucalyptus honeys should not be relied upon for Australian honeys, since those criteria are not based on samples of Australian honey.

Impact of an integrated diabetes service involving specialist outreach and primary health care on risk factors for micro- and macrovascular diabetes complications in remote Indigenous communities in Australia.

PubMed

Hotu, Cheri; Rémond, Marc; Maguire, Graeme; Ekinci, Elif; Cohen, Neale

2018-06-04

To determine the impact of an integrated diabetes service involving specialist outreach and primary health care teams on risk factors for micro- and macrovascular diabetes complications in three remote Indigenous Australian communities over a 12-month period. Quantitative, retrospective evaluation. Primary health care clinics in remote Indigenous communities in Australia. One-hundred-and-twenty-four adults (including 123 Indigenous Australians; 76.6% female) with diabetes living in remote communities. Glycosylated haemoglobin, lipid profile, estimated glomerular filtration rate, urinary albumin : creatinine ratio and blood pressure. Diabetes prevalence in the three communities was high, at 32.8%. A total of 124 patients reviewed by the outreach service had a median consultation rate of 1.0 by an endocrinologist and 0.9 by a diabetes nurse educator over the 12-month period. Diabetes care plans were made in collaboration with local primary health care services, which also provided patients with diabetes care between outreach team visits. A significant reduction was seen in median (interquartile range) glycosylated haemoglobin from baseline to 12 months. Median (interquartile range) total cholesterol was also reduced. The number of patients prescribed glucagon-like peptide-1 analogues and dipeptidyl peptidase-4 inhibitors increased over the 12 months and an increase in the number of patients prescribed insulin trended towards statistical significance. A collaborative health care approach to deliver diabetes care to remote Indigenous Australian communities was associated with an improvement in glycosylated haemoglobin and total cholesterol, both important risk factors, respectively, for micro- and macrovascular diabetes complications. © 2018 National Rural Health Alliance Ltd.

Australian orchids and the doctors they commemorate.

PubMed

Pearn, John H

2013-01-21

Botanical taxonomy is a repository of medical biographical information. Such botanical memorials include the names of some indigenous orchids of Australia. By searching reference texts and journals relating to Australian botany and Australian orchidology, as well as Australian and international medical and botanical biographical texts, I identified 30 orchids indigenous to Australia whose names commemorate doctors and other medical professionals. Of these, 24 have names that commemorate a total of 16 doctors who worked in Australia. The doctors and orchids I identified include: doctor-soldiers Richard Sanders Rogers (1862-1942), after whom the Rogers' Greenhood (Pterostylis rogersii) is named, and Robert Brown (1773-1858), after whom the Purple Enamel Orchid (Elythranthera brunonis) is named; navy surgeon Archibald Menzies (1754-1842), after whom the Hare Orchid (Leptoceras menziesii) is named; radiologist Hugo Flecker (1884-1957) after whom the Slender Sphinx Orchid (Cestichis fleckeri) is named; and general medical practitioner Hereward Leighton Kesteven (1881-1964), after whom the Kesteven's Orchid (Dendrobium kestevenii) is named. Biographic references in scientific names of plants comprise a select but important library of Australian medical history. Such botanical taxonomy commemorates, in an enduring manner, clinicians who have contributed to biology outside clinical practice.

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

Making progress: the role of cancer councils in Australia in indigenous cancer control.

PubMed

Thompson, Sandra C; Shahid, Shaouli; DiGiacomo, Michelle; Pilkington, Leanne; Davidson, Patricia M

2014-04-11

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. 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. 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 and activity in Indigenous cancer control. This environmental scan measured progress, allowed sharing of information and provided critical assessment of progress across areas of importance for increasing Indigenous cancer control. Structured examination of policies, institutional support systems, programs and interventions is a useful means of highlighting opportunities for progress with minority groups relevant for many organisations. Progress has occurred with momentum likely to increase in the future and benefit from commitment to long-term monitoring and sharing of achievements.

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 (P=.01 and .02, respectively) and overwhelmingly positive opinion regarding acceptability and ease of use (median rating of 5, on a 5-point Likert-type scale when users were asked if they would recommend the app to others). Conclusions We describe the process of development of a bilingual hepatitis B-specific app for Indigenous Australians, using a PAR framework. The approach was found to be successful with positive evaluations. PMID:26063474

Improving preventive health care in Aboriginal and Torres Strait Islander primary care settings.

PubMed

Bailie, Jodie; Matthews, Veronica; Laycock, Alison; Schultz, Rosalie; Burgess, Christopher P; Peiris, David; Larkins, Sarah; Bailie, Ross

2017-07-14

Like other colonised populations, Indigenous Australians experience poorer health outcomes than non-Indigenous Australians. Preventable chronic disease is the largest contributor to the health differential between Indigenous and non-Indigenous Australians, but recommended best-practice preventive care is not consistently provided to Indigenous Australians. Significant improvement in health care delivery could be achieved through identifying and minimising evidence-practice gaps. Our objective was to use clinical audit data to create a framework of the priority evidence-practice gaps, strategies to address them, and drivers to support these strategies in the delivery of recommended preventive care. De-identified preventive health clinical audit data from 137 primary health care (PHC) centres in five jurisdictions were analysed (n = 17,108 audited records of well adults with no documented major chronic disease; 367 system assessments; 2005-2014), together with stakeholder survey data relating to interpretation of these data, using a mixed-methods approach (n = 152 responses collated in 2015-16). Stakeholders surveyed included clinicians, managers, policy officers, continuous quality improvement (CQI) facilitators and academics. Priority evidence-practice gaps and associated barriers, enablers and strategies to address the gaps were identified and reported back through two-stages of consultation. Further analysis and interpretation of these data were used to develop a framework of strategies and drivers for health service improvement. Stakeholder identified priorities were: following-up abnormal test results; completing cardiovascular risk assessments; timely recording of results; recording enquiries about living conditions, family relationships and substance use; providing support for clients identified with emotional wellbeing risk; enhancing systems to enable team function and continuity of care. Drivers identified for improving care in these areas included: strong Indigenous participation in the PHC service; appropriate team structure and function to support preventive care; meaningful use of data to support quality of care and CQI; and corporate support functions and structures. The framework should be useful for guiding development and implementation of barrier-driven, tailored interventions for primary health care service delivery and policy contexts, and for guiding further research. While specific strategies to improve the quality of preventive care need to be tailored to local context, these findings reinforce the requirement for multi-level action across the system. The framework and findings may be useful for similar purposes in other parts of the world, with appropriate attention to context in different locations.

Our Health Counts Toronto: using respondent-driven sampling to unmask census undercounts of an urban indigenous population in Toronto, Canada.

PubMed

Rotondi, Michael A; O'Campo, Patricia; O'Brien, Kristen; Firestone, Michelle; Wolfe, Sara H; Bourgeois, Cheryllee; Smylie, Janet K

2017-12-26

To provide evidence of the magnitude of census undercounts of 'hard-to-reach' subpopulations and to improve estimation of the size of the urban indigenous population in Toronto, Canada, using respondent-driven sampling (RDS). Respondent-driven sampling. The study took place in the urban indigenous community in Toronto, Canada. Three locations within the city were used to recruit study participants. 908 adult participants (15+) who self-identified as indigenous (First Nation, Inuit or Métis) and lived in the city of Toronto. Study participants were generally young with over 60% of indigenous adults under the age of 45 years. Household income was low with approximately two-thirds of the sample living in households which earned less than $C20 000 last year. We collected baseline data on demographic characteristics, including indigenous identity, age, gender, income, household type and household size. Our primary outcome asked: 'Did you complete the 2011 Census Canada questionnaire?' Using RDS and our large-scale survey of the urban indigenous population in Toronto, Canada, we have shown that the most recent Canadian census underestimated the size of the indigenous population in Toronto by a factor of 2 to 4. Specifically, under conservative assumptions, there are approximately 55 000 (95% CI 45 000 to 73 000) indigenous people living in Toronto, at least double the current estimate of 19 270. Our indigenous enumeration methods, including RDS and census completion information will have broad impacts across governmental and health policy, potentially improving healthcare access for this community. These novel applications of RDS may be relevant for the enumeration of other 'hard-to-reach' populations, such as illegal immigrants or homeless individuals in Canada and beyond. © 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.

"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.

Gender determinants of smoking practice in Indigenous communities: an exploratory study.

PubMed

Knott, V E; Gilligan, G; Maksimovic, L; Shen, D; Murphy, M

2016-03-01

Despite the need to urgently reduce smoking rates among Indigenous Australians, in order to close-the-gap in life expectancy, little is known regarding how this can be achieved. This study aimed to explore whether a focus on gender specific determinants of smoking among Indigenous Australians could be identified, thus providing a potentially novel approach to underpin future efforts at intervention. A qualitative research design was employed. Eighty-two participants, comprised of 43 Indigenous women (mean age 32.15, SD, 12.47) and 39 Indigenous men (mean age 34.91, SD, 11.26), participated in one of 12 focus groups held in metropolitan, regional and rural locations in South Australia. Facilitators prompted discussion in response to the question: 'What is it like being a smoker these days?' Two experienced coders assessed data for themes using Attride-Stirling's (2002) method of analysis. Two global themes emerged for men and women. The first theme, 'It's Harder to Smoke Nowadays', encompassed sub-themes capturing changed smoking practices in response to tobacco control strategies implemented in Australia. Sub-themes of 'smoking in secrecy' coupled with an 'awareness of the effects of passive smoking' were identified among women. Among men, sub-themes that depicted tension between 'a desire to be a role model' and 'guilt about smoking' emerged. The second theme, 'Push and Pull Factors', identified a range of gender specific determinants of smoking. While similar reasons for smoking ('pull factors') were identified in men and women (e.g. addiction, boredom, stress, pleasure, mood stabiliser), different 'push factors' (reasons for not wanting to smoke) emerged. For men, sport, fitness and children were identified as reasons for not wanting to smoke, whereas women identified factors such as respect for non-smokers, and body image concerns. The current findings suggest that there may be fundamental differences in the determinants of smoking (pull factors) as well as reasons for wanting to quit (push factors) between Indigenous men and women. A focus on interventions that target gender specific determinants, or motivators of smoking, offers a novel, and potentially efficacious approach to reduce smoking rates among Indigenous Australians. © 2016 John Wiley & Sons Ltd.

Supporting Australian Torres Strait Islander and Aboriginal Nursing Students Using Mentoring Circles: An Action Research Study

ERIC Educational Resources Information Center

Mills, Jane; Felton-Busch, Catrina; Park, Tanya; Maza, Karen; Mills, Frances; Ghee, McCauley; Hitchins, Marnie; Chamberlain-Salaun, Jennifer; Neuendorf, Nalisa

2014-01-01

Attempts to recruit Aboriginal and Torres Strait Islander students into nursing degrees have made minimal impact on the number of registered nurses working in Australia's healthcare sector. Yet increasing the number of Indigenous nurses remains one of the most important objectives in strategies to close the health gap between Indigenous and…

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.…

Remote and Invisible: The Voices of Female Indigenous Educational Leaders in Northern Territory Remote Community Schools in Australia

ERIC Educational Resources Information Center

Kamara, Martha

2017-01-01

While the literature on women and educational leadership has been addressed in substantive ways in recent years, the experiences that reflect female Australian educational leaders are rare. This article reports findings from a study of five female Indigenous principals in the Northern Territory utilising biographic narratives and foregrounds their…

Situating the "beyond": Adventure-Learning and Indigenous Cultural Competence

ERIC Educational Resources Information Center

Hill, Barbara; Mills, Jane

2013-01-01

In 2010, an Indigenous Elder from the Wiradjuri nation and a group of academics from Charles Sturt University travelled to Menindee, a small locality on the edge of the Australian outback. They were embarked upon an "adventure-learning" research journey to study ways of learning by creating a community of practice with an Elder from the…

Language, Relationships and Pedagogical Practices: Pre-Service Teachers in an Indigenous Australian Context

ERIC Educational Resources Information Center

Bennet, Maria; Moriarty, Beverley

2015-01-01

This article focuses on the initial stage of a longitudinal study whose eventual aim is to produce educators with the capacity, knowledge and cultural competence to engage effectively with Indigenous students in cross-cultural environments. The initial stage of the study involved 24 second-year pre-service teachers working individually with…

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…

"Kitchen Table Prejudices" in the Diverse Classrooms of Today: Some Research-Based Approaches to Teaching Majority Students about Minority Issues

ERIC Educational Resources Information Center

Asmar, Christine

2017-01-01

Worldwide awareness is slowly growing that Indigenous histories and perspectives are, or should be, integral to the attributes of global citizens graduating from our universities. In this context, an investigation of how Indigenous perspectives are being taught in Australian universities offered a heretofore underutilized avenue toward getting…

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…

Schooling for Self-Determination through a Justice Politics of Indigenous Representation

ERIC Educational Resources Information Center

Keddie, Amanda

2013-01-01

This paper presents data from a study of secondary school for girls, the majority of whom identify as Indigenous Australian. "Gamarada" High School is located in a suburban area of Queensland (Australia) and was established to provide quality education for disadvantaged girls. The paper draws on student and teacher interview data from a…

Exploring Indigenous Identities of Urban American Indian Youth of the Southwest

ERIC Educational Resources Information Center

Kulis, Stephen; Wagaman, M. Alex; Tso, Crescentia; Brown, Eddie F.

2013-01-01

This study examined the indigenous identities of urban American Indian youth using measures related to three theoretical dimensions of Markstrom's identity model: identification (tribal and ethnic heritage), connection (reservation ties), and involvement in traditional cultural practices and spirituality. Data came from self-administered…

A Smartphone App to Reduce Sugar-Sweetened Beverage Consumption Among Young Adults in Australian Remote Indigenous Communities: Design, Formative Evaluation and User-Testing.

PubMed

Tonkin, Emma; Jeffs, Lauren; Wycherley, Thomas Philip; Maher, Carol; Smith, Ross; Hart, Jonathon; Cubillo, Beau; Brimblecombe, Julie

2017-12-12

The disproportionate burden of noncommunicable disease among Indigenous Australians living in remote Indigenous communities (RICs) is a complex and persistent problem. Smartphones are increasingly being used by young Indigenous adults and therefore represent a promising method to engage them in programs seeking to improve nutritional intake. This study aimed to consult RIC members to inform the content of a smartphone app that can be used to monitor and reduce sugar-sweetened beverage intake in RICs. The study was conducted in two phases. The formative phase involved a simulated grocery selection activity with think aloud ("think aloud shop"), a semistructured interview, a questionnaire outlining current smartphone and app use, and a paper prototyping activity. A preliminary end-user testing phase involved a think aloud prototype test and a semistructured interview regarding user satisfaction. Convenience sampling was used to recruit 20 18- to 35-year-old smartphone users for each phase from two RICs in the Northern Territory, Australia. Thematic analysis of transcribed audio recordings was used to identify determinants of food choice from the think aloud shop; themes related to the Theory of Planned Behavior (TPB) from the eating behaviors interview; and usability, comprehension, and satisfaction with the app from the preliminary end-user testing. Smartphone use in RICs is currently different to that found in urban environments; in particular, extremely low use of Facebook, restricted variety of phone types, and limited Internet access. Findings regarding promoting app engagement indicate that utilizing an opt-in approach to social features such as leader boards and team challenges is essential. The inclusion of games was also shown to be important for satisfaction, as were the use of audio features, contextually embedded dissemination, and streamlined app design for comprehension in this target group. This research provides critical insights and concrete recommendations for the development of lifestyle improvement apps targeted toward disadvantaged young adults in nonurban settings, specifically RICs. It serves as a framework for future app development projects using a consultative user-centered design approach, supporting calls for the increased use of this strategy in app development. ©Emma Tonkin, Lauren Jeffs, Thomas Philip Wycherley, Carol Maher, Ross Smith, Jonathon Hart, Beau Cubillo, Julie Brimblecombe. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 12.12.2017.

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 highlights the need to include Indigenous status on Pap smear request and report forms in any renewed and redesigned cervical screening programme in Australia. PMID:26873047

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,…

Encountering Disregard in Australian Academe: The Subjective Perspective of a Disaffiliated Racial "Other"

ERIC Educational Resources Information Center

Coram, Stella

2009-01-01

This article proposes that progressive frameworks underpinned by diversity are contradictory to the inclusion of the "other" in Australian higher education. I integrate the critical race theory constructs of disregard and convergence with white privilege and indigenous lacking to claim that objective processes underpinned by merit embed…

Teaching Australian Aboriginal Higher Education Students: What Should Universities Do?

ERIC Educational Resources Information Center

Rochecouste, Judith; Oliver, Rhonda; Bennell, Debra; Anderson, Roz; Cooper, Inala; Forrest, Simon

2017-01-01

This paper reports findings from a recent study of Australian Aboriginal higher education student experience. Reported here are extracts from a set of case studies of staff, specifically those working in Indigenous Centres, involved with these students in both teaching and support capacities. These participants provided a rich set of qualitative…

Demographic Predictors of Students' Science Participation over the Age of 16: an Australian Case Study

NASA Astrophysics Data System (ADS)

Cooper, Grant; Berry, Amanda; Baglin, James

2018-01-01

Using the Longitudinal Surveys of Australian Youth (LSAY) data, this paper aimed to examine if, and to what extent, demographic factors predict students' participation in science over the age of 16 (post-16). While all the students participating in this study are attending Australian schools, the comprehensiveness of these datasets, together with inclusion of studies from around the world provides a useful reference point for an international audience. Over 7000 students are included in the analysis of this paper. Characteristics of focus in this paper include groups who have been identified as being underrepresented in past studies including Indigenous students, those from lower-socio-economic status (SES) backgrounds, sex differences and immigrants. Among the factors tested, Indigenous status was the strongest negative predictor of post-16 science participation. SES was also a relatively strong predictor of post-16 science participation. Compared to students categorised with an Australian-ancestry, first-generation and foreign-background students were more likely to participate in post-16 science. The findings of this study contribute to existing research on debates about equity and trends in science participation.

'A scandal which must be corrected'. Reconsidering the success of the Australian Tuberculosis Campaign.

PubMed

Stylianou, Marianna

2009-01-01

Operating from 1948 to 1976, the Australian Tuberculosis Campaign was successful in almost eliminating the incidence of tuberculosis in Victoria, which until the late 1940s had been the leading cause of death for the state's young adults. Yet despite claims that the campaign was inclusive of all citizens, this dramatic fall in morbidity and mortality was not replicated in Victoria's Indigenous population. By examining contemporary discourses relating to citizenship and civic responsibility, this article seeks to understand policymakers' rationale and methodology for the public health campaign, and then analyse them to explore the reasons for the striking disparity in outcomes between Victoria's white and Indigenous populations.

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.

Ethnic specific differences in survival of patients with type 2 diabetes: analysis of data collected from an Australian multi-ethnic cohort over a 25 year period.

PubMed

Alharbi, Turki J; Constantino, Maria I; Molyneaux, Lynda; Wu, Ted; Twigg, Stephen M; Yue, Dennis K; Wong, Jencia

2015-01-01

To examine the survival of patients with type 2 diabetes from 7 ethnic groups, living in the shared environment of an Australian city. Hazard ratio of death (HR) after diagnosis of diabetes was compared between Anglo-Celtic (n=5433), Indigenous Australian (n=439), Pacific Islander (n=354), Mediterranean (n=3138), Arabic (n=768), Indian (n=702) and Chinese (n=1632) patients who live in metropolitan Sydney. Mortality was ascertained by data-linkage with the Australian National Death Index. The modulating effects of glycaemic control, diabetes/vascular complications and risk factors, year of diabetes diagnosis and duration of diabetes on ethnic differences were analysed by Cox regression. Socio-economic status and competence in English were also examined. There were significant differences in survival between the ethnic groups; the Indigenous Australians had the highest HR for death (2.3, 95% CI 1.7-3.0) and the Chinese the lowest (0.4, 95% CI 0.4-0.5). The survival of the Anglo-Celtics (HR 1) was surprisingly poorer than for Indian (0.6, 95% CI 0.5-0.8), Arab (0.7, 95% CI 0.6-0.8) and Mediterranean groups (0.8, 95% CI 0.7-0.9). Prevalence of smoking and albuminuria were strongly associated with HR. The better survival of Chinese and Arab and the worse survival of Indigenous Australians remained after adjustment of risk factors. Need for an interpreter was a favourable risk factor for survival. Ethnicity is a significant determinant of survival in type 2 diabetes and this is substantially but not completely mediated by smoking and vascular risk factors. The favourable impact associated with less competence in English may represent a Healthy-migrant effect. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Does rural or urban residence make a difference to neonatal outcome in premature birth? A regional study in Australia.

PubMed

Abdel-Latif, M E; Bajuk, B; Oei, J; Vincent, T; Sutton, L; Lui, K

2006-07-01

Patients living in rural areas may be at a disadvantage in accessing tertiary health care. To test the hypothesis that very premature infants born to mothers residing in rural areas have poorer outcomes than those residing in urban areas in the state of New South Wales (NSW) and the Australian Capital Territory (ACT) despite a coordinated referral and transport system. "Rural" or "urban" status was based on the location of maternal residence. Perinatal characteristics, major morbidity and case mix adjusted mortality were compared between 1879 rural and 6775 urban infants <32 weeks gestational age, born in 1992-2002 and admitted to all 10 neonatal intensive care units in NSW and ACT. Rural mothers were more likely to be teenaged, indigenous, and to have had a previous premature birth, prolonged ruptured membrane, and antenatal corticosteroid. Urban mothers were more likely to have had assisted conception and a caesarean section. More urban (93% v 83%) infants were born in a tertiary obstetric hospital. Infants of rural residence had a higher mortality (adjusted odds ratio (OR) 1.26, 95% confidence interval (CI) 1.07 to 1.48, p = 0.005). This trend was consistently seen in all subgroups and significantly for the tertiary hospital born population and the 30-31 weeks gestation subgroup. Regional birth data in this gestational age range also showed a higher stillbirth rate among rural infants (OR 1.20, 95% CI 1.09 to 1.32, p<0.001). Premature births from rural mothers have a higher risk of stillbirth and mortality in neonatal intensive care than urban infants.

The impact of indigenous cultural identity and cultural engagement on violent offending.

PubMed

Shepherd, Stephane M; Delgado, Rosa Hazel; Sherwood, Juanita; Paradies, Yin

2017-07-24

Possessing a strong cultural identity has been shown to protect against mental health symptoms and buffer distress prompted by discrimination. However, no research to date has explored the protective influences of cultural identity and cultural engagement on violent offending. This paper investigates the relationships between cultural identity/engagement and violent recidivism for a cohort of Australian Indigenous people in custody. A total of 122 adults from 11 prisons in the state of Victoria completed a semi-structured interview comprising cultural identification and cultural engagement material in custody. All official police charges for violent offences were obtained for participants who were released from custody into the community over a period of 2 years. No meaningful relationship between cultural identity and violent recidivism was identified. However a significant association between cultural engagement and violent recidivism was obtained. Further analyses demonstrated that this relationship was significant only for participants with a strong Indigenous cultural identity. Participants with higher levels of cultural engagement took longer to violently re-offend although this association did not reach significance. For Australian Indigenous people in custody, 'cultural engagement' was significantly associated with non-recidivism. The observed protective impact of cultural engagement is a novel finding in a correctional context. Whereas identity alone did not buffer recidivism directly, it may have had an indirect influence given its relationship with cultural engagement. The findings of the study emphasize the importance of culture for Indigenous people in custody and a greater need for correctional institutions to accommodate Indigenous cultural considerations.

Development and validation of the Australian Aboriginal racial identity and self-esteem survey for 8-12 year old children (IRISE_C).

PubMed

Kickett-Tucker, C S; Christensen, D; Lawrence, D; Zubrick, S R; Johnson, D J; Stanley, F

2015-10-24

In Australia, there is little empirical research of the racial identity of Indigenous children and youth as the majority of the current literature focuses on adults. Furthermore, there are no instruments developed with cultural appropriateness when exploring the identity and self-esteem of the Australian Aboriginal population, especially children. The IRISE_C (Racial Identity and Self-Esteem of children) inventory was developed to explore the elements of racial identity and self-esteem of urban, rural and regional Aboriginal children. This paper describes the development and validation of the IRISE_C instrument with over 250 Aboriginal children aged 8 to 12 years. A pilot of the IRISE C instrument was combined with individual interviews and was undertaken with 35 urban Aboriginal children aged 8-12 years. An exploratory factor analysis was performed to refine the survey and reduce redundant items in readiness for the main study. In the main study, the IRISE C was employed to 229 Aboriginal children aged 6-13 years across three sites (rural, regional and urban) in Western Australia. An exploratory factor analysis using Principal axis factoring was used to assess the fit of items and survey structure. A confirmatory factor analysis was then employed using LISREL (diagonally weighted least squares) to assess factor structures across domains. Internal consistency and reliability of subscales were assessed using Cronbach's co-efficient alpha. The pilot testing identified two key concepts - children's knowledge of issues related to their racial identity, and the importance, or salience, that they attach to these issues. In the main study, factor analyses showed two clear factors relating to: Aboriginal culture and traditions; and a sense of belonging to an Aboriginal community. Principal Axis Factoring of the Knowledge items supported a 2-factor solution, which explained 38.7% of variance. Factor One (Aboriginal culture) had a Cronbach's alpha of 0.835; Factor 2 (racial identity) had a Cronbach's alpha of 0.800, thus demonstrating high internal reliability of the scales. The IRISE_C has been shown to be a valid instrument useful of exploring the development of racial identity of Australian Aboriginal children across the 8-12 year old age range and across urban, rural and regional geographical locations.

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

PubMed Central

2012-01-01

Background Adult smoking has its roots in adolescence. If individuals do not initiate smoking during this period it is unlikely they ever will. In high income countries, smoking rates among Indigenous youth are disproportionately high. However, despite a wealth of literature in other populations, there is less evidence on the determinants of smoking initiation among Indigenous youth. The aim of this study was to explore the determinants of smoking among Australian Indigenous young people with a particular emphasis on the social and cultural processes that underlie tobacco use patterns among this group. Methods This project was undertaken in northern Australia. We undertook group interviews with 65 participants and individual in-depth interviews with 11 youth aged 13–20 years led by trained youth ‘peer researchers.’ We also used visual methods (photo-elicitation) with individual interviewees to investigate the social context in which young people do or do not smoke. Included in the sample were a smaller number of non-Indigenous youth to explore any significant differences between ethnic groups in determinants of early smoking experiences. The theory of triadic influence, an ecological model of health behaviour, was used as an organising theory for analysis. Results Family and peer influences play a central role in smoking uptake among Indigenous youth. Social influences to smoke are similar between Indigenous and non-Indigenous youth but are more pervasive (especially in the family domain) among Indigenous youth. While Indigenous youth report high levels of exposure to smoking role models and smoking socialisation practices among their family and social networks, this study provides some indication of a progressive denormalisation of smoking among some Indigenous youth. Conclusions Future initiatives aimed at preventing smoking uptake in this population need to focus on changing social normative beliefs around smoking, both at a population level and within young peoples’ immediate social environment. Such interventions could be effectively delivered in both the school and family environments. Specifically, health practitioners in contact with Indigenous families should be promoting smoke free homes and other anti-smoking socialisation behaviours. PMID:23140529

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.

Peritoneal dialysis in rural Australia.

PubMed

Gray, Nicholas A; Grace, Blair S; McDonald, Stephen P

2013-12-20

Australians living in rural areas have lower incidence rates of renal replacement therapy and poorer dialysis survival compared with urban dwellers. This study compares peritoneal dialysis (PD) patient characteristics and outcomes in rural and urban Australia. Non-indigenous Australian adults who commenced chronic dialysis between 1 January 2000 and 31 December 2010 according to the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) were investigated. Each patient's residence was classified according to the Australian Bureau of Statistics remote area index as major city (MC), inner regional (IR), outer regional (OR), or remote/very remote (REM). A total of 7657 patients underwent PD treatment during the study period. Patient distribution was 69.0% MC, 19.6% IR, 9.5% OR, and 1.8% REM. PD uptake increased with increasing remoteness. Compared with MC, sub-hazard ratios [95% confidence intervals] for commencing PD were 1.70 [1.61-1.79] IR, 2.01 [1.87-2.16] OR, and 2.60 [2.21-3.06] REM. During the first 6 months of PD, technique failure was less likely outside MC (sub-hazard ratio 0.47 [95% CI: 0.35-0.62], P < 0.001), but no difference was seen after 6 months (sub-hazard ratio 1.05 [95% CI: 0.84-1.32], P = 0.6). Technique failure due to technical (sub-hazard ratio 0.57 [95% CI: 0.38-0.84], P = 0.005) and non-medical causes (sub-hazard ratio 0.52 [95% CI: 0.31-0.87], P = 0.01) was less likely outside MC. Time to first peritonitis episode was not associated with remoteness (P = 0.8). Patient survival while on PD or within 90 days of stopping PD did not differ by region (P = 0.2). PD uptake increases with increasing remoteness. In rural areas, PD technique failure is less likely during the first 6 months and time to first peritonitis is comparable to urban areas. Mortality while on PD does not differ by region. PD is therefore a good dialysis modality choice for rural patients in Australia.

Peritoneal dialysis in rural Australia

PubMed Central

2013-01-01

Background Australians living in rural areas have lower incidence rates of renal replacement therapy and poorer dialysis survival compared with urban dwellers. This study compares peritoneal dialysis (PD) patient characteristics and outcomes in rural and urban Australia. Methods Non-indigenous Australian adults who commenced chronic dialysis between 1 January 2000 and 31 December 2010 according to the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) were investigated. Each patient’s residence was classified according to the Australian Bureau of Statistics remote area index as major city (MC), inner regional (IR), outer regional (OR), or remote/very remote (REM). Results A total of 7657 patients underwent PD treatment during the study period. Patient distribution was 69.0% MC, 19.6% IR, 9.5% OR, and 1.8% REM. PD uptake increased with increasing remoteness. Compared with MC, sub-hazard ratios [95% confidence intervals] for commencing PD were 1.70 [1.61-1.79] IR, 2.01 [1.87-2.16] OR, and 2.60 [2.21-3.06] REM. During the first 6 months of PD, technique failure was less likely outside MC (sub-hazard ratio 0.47 [95% CI: 0.35-0.62], P < 0.001), but no difference was seen after 6 months (sub-hazard ratio 1.05 [95% CI: 0.84-1.32], P = 0.6). Technique failure due to technical (sub-hazard ratio 0.57 [95% CI: 0.38-0.84], P = 0.005) and non-medical causes (sub-hazard ratio 0.52 [95% CI: 0.31-0.87], P = 0.01) was less likely outside MC. Time to first peritonitis episode was not associated with remoteness (P = 0.8). Patient survival while on PD or within 90 days of stopping PD did not differ by region (P = 0.2). Conclusions PD uptake increases with increasing remoteness. In rural areas, PD technique failure is less likely during the first 6 months and time to first peritonitis is comparable to urban areas. Mortality while on PD does not differ by region. PD is therefore a good dialysis modality choice for rural patients in Australia. PMID:24359341

Mapping Indigenous land management for threatened species conservation: An Australian case-study.

PubMed

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.

Small Screen Technology Use among Indigenous Boarding School Adolescents from Remote Regions of Western Australia

ERIC Educational Resources Information Center

Johnson, Genevieve Marie; Oliver, Rhonda

2014-01-01

The uptake of small screen technology by adolescents is widespread, particularly in industrial nations. Whether the same is true for Australian Aboriginal youth is less clear as there is a dearth of research in this regard. Therefore, in this exploratory study the use of small screen technology by Indigenous students was examined. Twenty-four…

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…

Solid Foundations: Health and Education Partnership for Indigenous Children Aged 0 to 8 Years. 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. This paper looks at health issues, particularly during ages 0-8, that may affect the educational outcomes of Aboriginal and Torres Strait Islander children. Chapter 1 discusses the importance of the early years…

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.

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.

Putting History in Its Place: Grounding the Australian Curriculum--History in Local Community

ERIC Educational Resources Information Center

Harrison, Neil

2012-01-01

This position paper develops the case for a greater focus on the teaching of local histories in the Australian Curriculum: History. It takes as its starting point an Indigenous epistemology that understands knowledge to be embedded in the land. This connection between knowledge and country is used to examine recent literature on whether the…

Investigating Debates around Racism in Sport to Facilitate Perspective Transformation in the Secondary English Classroom

ERIC Educational Resources Information Center

Merga, Margaret K.; Booth, Sarah

2017-01-01

The English classroom is a space in which issues of social justice can be explored through texts, using a critical literacy approach. Indigenous Australians have been subject to racist policies throughout postcolonial Australian history, and racist attitudes toward Australia's original inhabitants prevail. This article suggests that racism in the…

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.

Engaging Indigenous Urban Youth in Environmental Learning: The Importance of Place Revisited

ERIC Educational Resources Information Center

Swayze, Natalie

2009-01-01

This paper describes the evolution of an environmental learning program for Indigenous, urban youth called Bridging the Gap. A critical pedagogy of place provides a theoretical framework to engage in practitioner-reflection, exploring the decisions made while revising the original program to make it both culturally and ecologically relevant. Using…

Witnessing (Halted) Deconstruction: White Teachers' "Perfect Stranger" Position within Urban Indigenous Education

ERIC Educational Resources Information Center

Higgins, Marc; Madden, Brooke; Korteweg, Lisa

2015-01-01

This article extends upon Susan Dion's theory of the "perfect stranger" by exploring how this position is articulated and embodied by white teachers (N?=?67) involved in urban Indigenous education reform. On the lookout for deconstruction, we think with Derrida around the interrelated self/other and familiar/strange binaries that uphold…

Planning and implementing the first stage of an oral health program for the Pika Wiya Health Service Incorporated Aboriginal community in Port Augusta, South Australia.

PubMed

Parker, Eleanor J; Misan, Gary; Richards, Lindsay C; Russell, Angela

2005-01-01

The oral health of the Indigenous community in South Australia's mid-north has been a concern for some years. There has been a history of under-utilisation of available dental services by the local community. This is in part due to the services not meeting their cultural and holistic health care needs. The Indigenous community resolved to establish a culturally sensitive dental service within the Aboriginal Health Service already operating in Port Augusta in South Australia's mid-north. To achieve this, a partnership between Pika Wiya Health Service Incorporated, the South Australian Dental Service, the University of Adelaide Dental School and the South Australian Centre for Rural and Remote Health was formed. The aim of the project partners was to establish a culturally sensitive, quality dental service that caters to the needs of the Indigenous community serviced by Pika Wiya Health Service Inc. This article describes the process of planning and implementing the first stage of this project.

Relationship of tooth wear to chronological age among indigenous Amazon populations.

PubMed

Vieira, Elma Pinto; Barbosa, Mayara Silva; Quintão, Cátia Cardoso Abdo; Normando, David

2015-01-01

In indigenous populations, age can be estimated based on family structure and physical examination. However, the accuracy of such methods is questionable. The aim of this cross-sectional study was to evaluate occlusal tooth wear related to estimated age in the remote indigenous populations of the Xingu River, Amazon. Two hundred and twenty three semi-isolated indigenous subjects with permanent dentition from the Arara (n = 117), Xicrin-Kayapó (n = 60) and Assurini (n = 46) villages were examined. The control group consisted of 40 non-indigenous individuals living in an urban area in the Amazon basin (Belem). A modified tooth wear index was applied and then associated with chronological age by linear regression analysis. A strong association was found between tooth wear and chronological age in the indigenous populations (p <0.001). Tooth wear measurements were able to explain 86% of the variation in the ages of the Arara sample, 70% of the Xicrin-Kaiapó sample and 65% of the Assurini sample. In the urban control sample, only 12% of ages could be determined by tooth wear. These findings suggest that tooth wear is a poor estimator of chronological age in the urban population; however, it has a strong association with age for the more remote indigenous populations. Consequently, these findings suggest that a simple tooth wear evaluation method, as described and applied in this study, can be used to provide a straightforward and efficient means to assist in age determination of newly contacted indigenous groups.

Relationship of Tooth Wear to Chronological Age among Indigenous Amazon Populations

PubMed Central

Vieira, Elma Pinto; Barbosa, Mayara Silva; Quintão, Cátia Cardoso Abdo; Normando, David

2015-01-01

In indigenous populations, age can be estimated based on family structure and physical examination. However, the accuracy of such methods is questionable. The aim of this cross-sectional study was to evaluate occlusal tooth wear related to estimated age in the remote indigenous populations of the Xingu River, Amazon. Two hundred and twenty three semi-isolated indigenous subjects with permanent dentition from the Arara (n = 117), Xicrin-Kayapó (n = 60) and Assurini (n = 46) villages were examined. The control group consisted of 40 non-indigenous individuals living in an urban area in the Amazon basin (Belem). A modified tooth wear index was applied and then associated with chronological age by linear regression analysis. A strong association was found between tooth wear and chronological age in the indigenous populations (p <0.001). Tooth wear measurements were able to explain 86% of the variation in the ages of the Arara sample, 70% of the Xicrin-Kaiapó sample and 65% of the Assurini sample. In the urban control sample, only 12% of ages could be determined by tooth wear. These findings suggest that tooth wear is a poor estimator of chronological age in the urban population; however, it has a strong association with age for the more remote indigenous populations. Consequently, these findings suggest that a simple tooth wear evaluation method, as described and applied in this study, can be used to provide a straightforward and efficient means to assist in age determination of newly contacted indigenous groups. PMID:25602501

Injury prevention in Australian Indigenous communities.

PubMed

Ivers, Rebecca; Clapham, Kathleen; Senserrick, Teresa; Lyford, Marilyn; Stevenson, Mark

2008-12-01

Injury prevention in Indigenous communities in Australia is a continuing national challenge, with Indigenous fatality rates due to injury three times higher than the general population. Suicide and transport are the leading causes of injury mortality, and assault, transport and falls the primary causes of injury morbidity. Addressing the complex range of injury problems in disadvantaged Indigenous communities requires considerable work in building or enhancing existing capacity of communities to address local safety issues. Poor data, lack of funding and absence of targeted programs are some of the issues that impede injury prevention activities. Traditional approaches to injury prevention can be used to highlight key areas of need, however adaptations are needed in keeping with Indigenous peoples' holistic approach to health, linked to land and linked to community in order to address the complex spiritual, emotional and social determinants of Indigenous injury.

Strength-based well-being indicators for Indigenous children and families: A literature review of Indigenous communities' identified well-being indicators.

PubMed

Rountree, Jennifer; Smith, Addie

2016-01-01

Mainstream child and family well-being indicators frequently are based on measuring health, economic, and social deficits, and do not reflect Indigenous holistic and strength-based definitions of health and well-being. The present article is a review of literature that features Indigenous communities' self-identified strength-based indicators of child and family well-being. The literature search included Indigenous communities from across the world, incorporating findings from American Indians and Alaska Natives, First Nations, Native Hawaiians, Māori, Aboriginal Australians, and Sámi communities. Sorting the identified indicators into the quadrants of the Relational Worldview, an Indigenous framework for well-being based on medicine wheel teachings that views health and well-being as a balance among physical, mental, contextual, and spiritual factors, the authors discuss the findings.

Enhanced primary mental healthcare for Indigenous Australians: service implementation strategies and perspectives of providers.

PubMed

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

2018-01-01

Improving access to culturally appropriate mental healthcare has been recognised as a key strategy to address the often greater burden of mental health issues experienced by Indigenous populations. We present data from the evaluation of a national attempt at improving access to culturally appropriate mental healthcare for Indigenous Australians through a mainstream primary mental healthcare program, the Access to Allied Psychological Services program, whilst specifically focusing on the implementation strategies and perspectives of service providers. We conducted semi-structured interviews with 31 service providers (primary care agency staff, referrers, and mental health professionals) that were analysed thematically and descriptively. Agency-level implementation strategies to enhance service access and cultural appropriateness included: the conduct of local service needs assessments; Indigenous stakeholder consultation and partnership development; establishment of clinical governance frameworks; workforce recruitment, clinical/cultural training and supervision; stakeholder and referrer education; and service co-location at Indigenous health organisations. Dedicated provider-level strategies to ensure the cultural appropriateness of services were primarily aimed at the context and process of delivery (involving, flexible referral pathways, suitable locations, adaptation of client engagement and service feedback processes) and, to a lesser extent, the nature and content of interventions (provision of culturally adapted therapy). This study offers insights into key factors underpinning the successful national service implementation approach. Study findings highlight that concerted national attempts to enhance mainstream primary mental healthcare for Indigenous people are critically dependent on effective local agency- and provider-level strategies to optimise the integration, adaptation and broader utility of these services within local Indigenous community and healthcare service contexts. Despite the explicit provider focus, this study was limited by a lack of Indigenous stakeholder perspectives. Key study findings are of direct relevance to inform the future implementation and delivery of culturally appropriate primary mental healthcare programs for Indigenous populations in Australia and internationally.

Mortality causes and outcomes in Indigenous populations of Canada, the United States, and Australia with rheumatic disease: A systematic review.

PubMed

Hurd, Kelle; Barnabe, Cheryl

2018-02-01

Indigenous populations of Canada, America, Australia, and New Zealand have increased rates and severity of rheumatic disease. Our objective was to summarize mortality outcomes and explore disease and social factors related to mortality. A systematic search was performed in medical (Medline, EMBASE, and CINAHL), Indigenous and conference abstract databases (to June 2015) combining search terms for Indigenous populations and rheumatic diseases. Studies were included if they reported measures of mortality (crude frequency, mortality rate, survival, and potential years of life lost (PYLL)) in Indigenous populations from the four countries. Of 5269 titles and abstracts identified, 504 underwent full-text review and 12 were included. No studies from New Zealand were found. In five Canadian studies of systemic lupus erythematosus (SLE) patients, First Nations ethnicity was associated with lower survival after adjusting for disease and social factors, and an increased frequency of death from lupus and its complications compared to Caucasians was found. All-cause mortality was higher in Native Americans (n = 2 studies) relative to Whites with SLE after adjusting for disease and social factors, but not in those with lupus nephritis alone. Australian Aborigines with SLE frequently developed infection and lupus complications leading to death (n = 3 studies). Mortality rates were increased in Pima Indians in the United States with rheumatoid arthritis (RA) compared to those without RA. One study in Native Americans with scleroderma found nearly all deaths were related to progressive disease. Canadian and American Indigenous populations with SLE have increased mortality rates compared to Caucasian populations. Mortality in Canadian and Australian Indigenous populations with SLE, and in Native American populations with RA and scleroderma, is frequently attributed to disease progression or complications. The proportional attribution of rheumatic disease severity and social factors to mortality and complications leading to death between Indigenous and non-Indigenous populations has not been fully evaluated. Copyright © 2018 Elsevier Inc. All rights reserved.

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 and activity in Indigenous cancer control. Conclusions This environmental scan measured progress, allowed sharing of information and provided critical assessment of progress across areas of importance for increasing Indigenous cancer control. Structured examination of policies, institutional support systems, programs and interventions is a useful means of highlighting opportunities for progress with minority groups relevant for many organisations. Progress has occurred with momentum likely to increase in the future and benefit from commitment to long-term monitoring and sharing of achievements. PMID:24725974

Social and Psychiatric Influences on Urban-Rural Differentials in Australian Suicide

ERIC Educational Resources Information Center

Taylor, Richard; Page, Andrew; Morrell, Stephen; Harrison, James; Carter, Greg

2005-01-01

The purpose of this study was to investigate urban-rural differentials in Australian suicide rates, and to examine influences that previously have remained largely speculative. Suicide rates for males (all ages and young adults) were significantly higher in rural areas compared to urban areas. Urban-rural suicide rate differences in males were…

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.

Institutional (mis)trust in colorectal cancer screening: a qualitative study with Greek, Iranian, Anglo-Australian and Indigenous groups.

PubMed

Ward, Paul R; Coffey, Cushla; Javanparast, Sara; Wilson, Carlene; Meyer, Samantha B

2015-12-01

Colorectal cancer (CRC) has the second highest cancer mortality rate in Australia. The Australian National Bowel Cancer Screening Program (NBCSP) aims to increase early detection of CRC by offering free Faecal Occult Blood Testing (FOBT), although uptake is low for culturally and linguistically diverse (CALD) groups. To present data on trust and mistrust in the NBCSP by population groups with low uptake and thus to highlight areas in need of policy change. A qualitative study was undertaken in South Australia, involving interviews with 94 people from four CALD groups: Greek, Iranian, Anglo-Australian, and Indigenous peoples. Our study highlights the complexities of institutional trust, which involves considerations of trust at interpersonal, local and national levels. In addition, trust and mistrust was found in more abstract systems such as the medical knowledge of doctors to diagnose or treat cancer or the scientific procedures in laboratories to test the FOBTs. The object of institutional (mis)trust differed between cultural groups - Anglo-Australian and Iranian groups indicated a high level of trust in the government, whereas Indigenous participants were much less trusting. The level and nature of trust in the screening process varied between the CALD groups. Addressing program misconceptions, clarifying the FOBT capabilities and involving medical services in collecting and transporting the samples may increase trust in the NBCSP. However, broader and more enduring mistrust in services and institutions may need to be dealt with in order to increase trust and participation. © 2014 John Wiley & Sons Ltd.

Moving toward holistic wellness, empowerment and self-determination for Indigenous peoples in Canada: Can traditional Indigenous health care practices increase ownership over health and health care decisions?

PubMed

Auger, Monique; Howell, Teresa; Gomes, Tonya

2016-12-27

This study aimed to understand the role that traditional Indigenous health care practices can play in increasing individual-level self-determination over health care and improving health outcomes for urban Indigenous peoples in Canada. This project took place in Vancouver, British Columbia and included the creation and delivery of holistic workshops to engage community members (n = 35) in learning about aspects of traditional health care practices. Short-term and intermediate outcomes were discussed through two gatherings involving focus groups and surveys. Data were transcribed, reviewed, thematically analyzed, and presented to the working group for validation. When participants compared their experiences with traditional health care to western health care, they described barriers to care that they had experienced in accessing medical doctors (e.g., racism, mistrust), as well as the benefits of traditional healing (e.g., based on relationships, holistic approach). All participants also noted that they had increased ownership over their choices around, and access to, health care, inclusive of both western and traditional options. They stressed that increased access to traditional health care is crucial within urban settings. Self-determination within Indigenous urban communities, and on a smaller scale, ownership for individuals, is a key determinant of health for Indigenous individuals and communities; this was made clear through the analysis of the research findings and is also supported within the literature. This research also demonstrates that access to traditional healing can enhance ownership for community members. These findings emphasize that there is a continued and growing need for support to aid urban Indigenous peoples in accessing traditional health care supports.

Temporal trends in paediatric bacterial meningitis in a tropical Australian region: 1992-2014.

PubMed

White, Stephanie; Katf, Hala; Baird, Rob; Francis, Joshua

2018-05-13

The epidemiology of community-acquired bacterial meningitis has changed following the introduction of routine immunisation against common causative organisms. Indigenous children living in the Northern Territory, Australia, have high rates of bacterial infections. This study describes changes in the epidemiology of childhood bacterial meningitis and the distribution of the burden of disease in the Top End. A retrospective review of cases derived from hospital medical records and laboratory data was performed. Inclusion criteria were children aged 3 months to 14 years of age, admitted to Royal Darwin Hospital between 1992 and 2014 and diagnosed with bacterial meningitis. Annual incidence of bacterial meningitis and the distribution of causative pathogens are described. Demographic data, investigations, treatment and outcomes were compared between Indigenous and non-Indigenous children. There were 137 cases of childhood bacterial meningitis identified over the 23-year period. The incidence reduced from 21 per 100 000 children per year for 1992-2002 to 11 per 100 000 per year for 2003-2014 (P = 0.0025). Haemophilus influenzae type b, Streptococcus pneumoniae and Neisseria meningitidis were the most common causative organisms, with a reduction in cases for each pathogen observed across the study period. Indigenous children were over-represented (104/137, 76%). Case fatality rate was 8% (11/137); 91% of fatal cases presented to a remote facility. The incidence of childhood bacterial meningitis has declined in the Northern Territory of Australia, but Indigenous children are disproportionately affected. Routine immunisation is beneficial for all, although further efforts to 'Close the Gap' between health outcomes in Indigenous and non-Indigenous Australians is required. © 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Dimensions of belonging as an aspect of racial-ethnic-cultural identity: an exploration of indigenous Australians.

PubMed

Neville, Helen A; Oyama, Kathleen E; Odunewu, Latifat O; Huggins, Jackie G

2014-07-01

Sense of belonging is a key aspect of racial and ethnic identity. Interestingly, there is little exploration of the multiple characteristics of belongingness within the racial and ethnic identity literature. Through individual interviews and a focus group, we explored the sense of racial-ethnic-cultural (REC) belonging among 19 self-identified Black Indigenous Australians (Aborigines and Torres Strait Islanders). Using dimensional analysis, we uncovered 5 core interrelated dimensions of REC belonging: History/Memory, Place, and Peoplehood; Sense of Community; Acceptance and Pride; Shared Language and Culture; and Interconnections. We also uncovered 3 main barriers undermining participants' sense of REC belonging: phenotype, social identity, and history of colonization. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Dublin Core: The Base for an Indigenous Culture Environment?

ERIC Educational Resources Information Center

Nevile, Liddy; Lissonnet, Sophie

A day in Cape York, in the far north east of Australia, can change the life of a modern Australian. In that time, one can see hundreds of examples of rock art that are up to 36,000 years old, sharply contrasting the history of Indigenous people and the immigration of Europeans.One such visit led to a proposed collaboration between the Quinkan…

Extending Business Education beyond Traditional Boundaries: A Case Study in Negotiated Problem Resolution in a Remote Regional Indigenous Community in Australia

ERIC Educational Resources Information Center

Pearson, Cecil A. L.; Chatterjee, Samir Ranjan

2010-01-01

It is widely accepted that the concepts and practices of management can only be of benefit when they are anchored to the contextual architecture of people, processes, structures, and technologies. The challenge of establishing a bridging program for providing managerial competencies to Australian Indigenous people has become a serious one for…

Inducing Empathy: Pondering Students' (In)Ability to Empathize with an Aboriginal Man's Lament and What Might Be Done about It

ERIC Educational Resources Information Center

Gair, Susan

2013-01-01

Empathy is a familiar term in social work education, although how to teach and learn empathy is not well documented. Equally, how non-indigenous Australian practitioners learn empathic regard for indigenous peoples living with the crippling legacies of colonialism is not commonly described in the literature. The primary aim of the classroom-based…

How Working Poor Maya Migrant Families Acculturate to an Urban Setting--Daily Routines and Adaptation Strategies

ERIC Educational Resources Information Center

Tovote, Katrin Erika

2012-01-01

Globally, an increasing number of people migrate from their rural communities to large cities. Despite the pervasive thinking that indigenous communities are solidified in space and strictly conserve cultural traditions, indigenous individuals and families increasingly leave their homelands to set up a new life in an urban environment mostly…

Gateway to Understanding: Indigenous Ecological Activism and Education in Urban, Rural, and Remote Contexts

ERIC Educational Resources Information Center

Lowan-Trudeau, Gregory

2017-01-01

This article is a response to Kassam, Avery, and Ruelle's insights as presented in this forum on rural science education. Topics considered include troubling the urban/rural divide in the context of Indigenous knowledge and expanding to include the common Canadian notion of the "remote," a designation rooted in our national colonial…

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

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.

Equity Groups in Total VET Students and Courses 2014: Australian Vocational Education and Training Statistics

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2015

2015-01-01

This publication provides summary information on equity groups in vocational education and training (VET) delivered by 4601 Australian providers in 2014, under the first collection of "total VET activity" data. In 2014, there were: (1) 146,500 Indigenous students (3.7% of all students); (2) 201,000 students with a disability (5.1% of all…

"Let 'em Be King Pin Out There All on Their Own in the Streets." How Some Koori Boys Responded to Their School and Classroom.

ERIC Educational Resources Information Center

Munns, Geoff

This paper discusses the production, nature, and consequences of oppositional behavior among 102 poor, inner-city Koori (Aboriginal Australian) boys and girls attending Greytown School, Australia. The connection between the local indigenous Australian community's history and culture and the classroom life of its primary school illustrates the…

Reconciliation Agendas in the Australian Curriculum English: Using Postcolonial Theory to Enter the Fray

ERIC Educational Resources Information Center

Wood, Megan; Exley, Beryl; Knight, Linda

2017-01-01

This article begins by discussing the Australian Curriculum: English and its remit to contribute to this nation's reconciliation agenda. Ever cognisant of our individual identities as non-Indigenous teachers and teacher educators and our relations to this topic, we hone in on one Content Description from Year 10, and analyse one stimulus text, an…

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

PubMed

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

2016-02-12

To evaluate the feasibility and reliability of record linkage of existing population-based data sets to determine Indigenous status among women receiving Pap smears. This method may allow for the first ever population measure of Australian Indigenous women's cervical screening participation rates. A linked data set of women aged 20-69 in the Queensland Pap Smear Register (PSR; 1999-2011) and Queensland Cancer Registry (QCR; 1997-2010) formed the Initial Study Cohort. Two extracts (1995-2011) were taken from Queensland public hospitals data (Queensland Hospital Admitted Patient Data Collection, QHAPDC) for women, aged 20-69, who had ever been identified as Indigenous (extract 1) and had a diagnosis or procedure code relating to cervical cancer (extract 2). The Initial Study Cohort was linked to extract 1, and women with cervical cancer in the initial cohort were linked to extract 2. The proportion of women in the Initial Cohort who linked with the extracts (true -pairs) is reported, as well as the proportion of potential pairs that required clerical review. After assigning Indigenous status from QHAPDC to the PSR, the proportion of women identified as Indigenous was calculated using 4 algorithms, and compared. There were 28,872 women (2.1%) from the Initial Study Cohort who matched to an ever Indigenous record in extract 1 (n=76,831). Women with cervical cancer in the Initial Study Cohort linked to 1385 (71%) records in extract 2. The proportion of Indigenous women ranged from 2.00% to 2.08% when using different algorithms to define Indigenous status. The Final Study Cohort included 1,372,823 women (PSR n=1,374,401; QCR n=1955), and 5,062,118 records. Indigenous status in Queensland cervical screening data was successfully ascertained through record linkage, allowing for the crucial assessment of the current cervical screening programme for Indigenous women. Our study highlights the need to include Indigenous status on Pap smear request and report forms in any renewed and redesigned cervical screening programme in Australia. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Sleep Disorders in Aboriginal and Torres Strait Islander People and Residents of Regional and Remote Australia.

PubMed

Woods, Cindy E; McPherson, Karen; Tikoft, Erik; Usher, Kim; Hosseini, Fariborz; Ferns, Janine; Jersmann, Hubertus; Antic, Ral; Maguire, Graeme Paul

2015-11-15

To compare the use of sleep diagnostic tests, the risks, and cofactors, and outcomes of the care of Indigenous and non-indigenous Australian adults in regional and remote Australia in whom sleep related breathing disorders have been diagnosed. A retrospective cohort study of 200 adults; 100 Aboriginal and Torres Strait Islander and 100 non-indigenous adults with a confirmed sleep related breathing disorder diagnosed prior to September 2011 at Alice Springs Hospital and Cairns Hospital, Australia. Results showed overall Indigenous Australians were 1.8 times more likely to have a positive diagnostic sleep study performed compared with non-indigenous patients, 1.6 times less likely in central Australia and 3.4 times more likely in far north Queensland. All regional and remote residents accessed diagnostic sleep studies at a rate less than Australia overall (31/100,000/y (95% confidence interval, 21-44) compared with 575/100,000/y). The barriers to diagnosis and ongoing care are likely to relate to remote residence, lower health self-efficacy, the complex nature of the treatment tool, and environmental factors such as electricity and sleeping area. Indigeneity, remote residence, environmental factors, and low awareness of sleep health are likely to affect service accessibility and rate of use and capacity to enhance patient and family education and support following a diagnosis. A greater understanding of enablers and barriers to care and evaluation of interventions to address these are required. A commentary on this article appears in this issue on page 1255. © 2015 American Academy of Sleep Medicine.

Tobacco use among urban Aboriginal Australian young people: a qualitative study of reasons for smoking, barriers to cessation and motivators for smoking cessation.

PubMed

Cosh, Suzanne; Hawkins, Kimberley; Skaczkowski, Gemma; Copley, David; Bowden, Jacqueline

2015-01-01

Smoking prevalence among Aboriginal Australian young people greatly exceeds the prevalence in the broader population of Australian young people, yet limited research has explored the social context in which young Aboriginal Australians smoke. Four focus groups were conducted in 2009 with South Australian Aboriginal smokers aged 15-29 years residing in urban areas (n = 32) to examine attitudes and experiences surrounding smoking and quitting. The primary reasons for smoking initiation and maintenance among Aboriginal Australian young people were identified as stress, social influence and boredom. Motivators for quitting were identified as pregnancy and/or children, sporting performance (males only), cost issues and, to a lesser extent, health reasons. The barriers to cessation were identified as social influence, the perception of quitting as a distant event and reluctance to access cessation support. However, it appears that social influences and stress were particularly salient contributors to smoking maintenance among Aboriginal Australian young people. Smoking cessation interventions targeted at young urban Aboriginal Australian smokers should aim to build motivation to quit by utilising the motivators of pregnancy and/or children, sporting performance (males only), cost issues and, to a lesser extent, health reasons, while acknowledging the pertinent role of social influence and stress in the lives of young urban Aboriginal Australian smokers.

Implementing Indigenous community control in health care: lessons from Canada.

PubMed

Lavoie, Josée G; Dwyer, Judith

2016-09-01

Objective Over past decades, Australian and Canadian Indigenous primary healthcare policies have focused on supporting community controlled Indigenous health organisations. After more than 20 years of sustained effort, over 89% of eligible communities in Canada are currently engaged in the planning, management and provision of community controlled health services. In Australia, policy commitment to community control has also been in place for more than 25 years, but implementation has been complicated by unrealistic timelines, underdeveloped change management processes, inflexible funding agreements and distrust. This paper discusses the lessons from the Canadian experience to inform the continuing efforts to achieve the implementation of community control in Australia. Methods We reviewed Canadian policy and evaluation grey literature documents, and assessed lessons and recommendations for relevance to the Australian context. Results Our analysis yielded three broad lessons. First, implementing community control takes time. It took Canada 20 years to achieve 89% implementation. To succeed, Australia will need to make a firm long term commitment to this objective. Second, implementing community control is complex. Communities require adequate resources to support change management. And third, accountability frameworks must be tailored to the Indigenous primary health care context to be meaningful. Conclusions We conclude that although the Canadian experience is based on a different context, the processes and tools created to implement community control in Canada can help inform the Australian context. What is known about the topic? Although Australia has promoted Indigenous control over primary healthcare (PHC) services, implementation remains incomplete. Enduring barriers to the transfer of PHC services to community control have not been addressed in the largely sporadic attention to this challenge to date, despite significant recent efforts in some jurisdictions. What does this paper add? The Canadian experience indicates that transferring PHC from government to community ownership requires sustained commitment, adequate resourcing of the change process and the development of a meaningful accountability framework tailored to the sector. What are the implications for practitioners? Policy makers in Australia will need to attend to reform in contractual arrangements (towards pooled or bundled funding), adopt a long-term vision for transfer and find ways to harmonise the roles of federal and state governments. The arrangements achieved in some communities in the Australian Coordinated Care Trials (and still in place) provide a model.

Study protocol: a pragmatic randomised controlled trial of a 12-week physical activity and nutritional education program for overweight Aboriginal and Torres Strait Islander women.

PubMed

Canuto, Karla J; McDermott, Robyn A; Cargo, Margaret; Esterman, Adrian J

2011-08-19

Aboriginal and Torres Strait Islander women have a higher prevalence and incidence of obesity and type 2 diabetes than non-Indigenous Australian women. Physical inactivity is a key modifiable risk factor for obesity and evidence shows that even modest reductions in waist circumference (WC) have significant health benefits. Trialing physical activity programs in difficult-to-reach high risk groups, especially urban Indigenous Australians poses distinct implementation challenges. The trial objective is to evaluate the effectiveness of a structured 12-week physical activity group program with nutritional advice. The design is a pragmatic randomised controlled trial. This study protocol describes the implementation and evaluation of the program. Participants are randomised into either an intervention or waitlisted group. The waitlisted group have a 12 month waiting period before commencing the 12-week program. Participant data is collected at baseline, 12, 24 and 52 weeks. Participants are Aboriginal and Torres Strait Islander women, aged 18-64 years with a waist circumference greater than 80 centimetres residing in Adelaide. The primary outcome measure is WC change immediately post program from baseline. Secondary outcomes include short term and long term changes in WC, weight, blood pressure, fasting blood glucose, insulin, insulin resistance (calculated HOMA), haemoglobin A1C (HbA1C), triglycerides and C-reactive protein (CRP). Behavioural and psychosocial surveys are administered to assess physical activity, dietary intake and the participant's motivation, self-efficacy and perceived social support for physical activity. Qualitative interviews focusing on participants' motivation, enablers and barriers to healthy eating and physical activity will be undertaken. Implementation fidelity and participation are also assessed. The Aboriginal and Torres Strait Islander Women's Fitness Program (WFP) is designed to provide a rigorous physiological and client-based evaluation of a structured 12-week program aimed to increase metabolic fitness and reduce WC in this high risk population. Evaluation results aim to provide the support necessary to design programs that are accessible, affordable and effective at reducing WC, while also improving the metabolic profile of overweight Aboriginal and Torres Strait Islander women. Australian New Zealand Clinical Trials Registry ACTRN12610000224022.

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.

Type 2 diabetes after gestational diabetes: greater than fourfold risk among Indigenous compared with non-Indigenous Australian women.

PubMed

Chamberlain, Catherine R; Oldenburg, Brian; Wilson, Alyce N; Eades, Sandra J; O'Dea, Kerin; Oats, Jeremy J N; Wolfe, Rory

2016-02-01

Gestational diabetes is associated with a high risk of type 2 diabetes. However, progression rates among Indigenous women in Australia who experience high prevalence of gestational diabetes are unknown. This retrospective cohort study includes all births to women at a regional hospital in Far North Queensland, Australia, coded as having 'gestational diabetes' from 1 January 2004 to 31 December 2010 (1098 births) and receiving laboratory postpartum screening from 1 January 2004 to 31 December 2011 (n = 483 births). Women who did not receive postpartum screening were excluded from the denominator. Data were linked between hospital electronic records, routinely collected birth data and laboratories, with sample validation by reviews of medical records. Analysis was conducted using Cox-proportional regression models. Indigenous women had a greater than fourfold risk of developing type 2 diabetes within 8 years of having gestational diabetes, compared with non-Indigenous women (hazards ratio 4.55, 95% confidence interval 2.63-7.88, p < 0.0001). Among women receiving postpartum screening tests, by 3, 5 and 7 years postpartum, 21.9% (15.8-30.0%), 25.5% (18.6-34.3%) and 42.4% (29.6-58.0%) Indigenous women were diagnosed with type 2 diabetes after gestational diabetes, respectively, compared with 4.2% (2.5-7.2%), 5.7% (3.3-9.5%) and 13.5% (7.3-24.2%) non-Indigenous women. Multivariate analysis showed an increased risk of developing type 2 diabetes among women with an early pregnancy body mass index ≥25 kg/m(2) , only partially breastfeeding at hospital discharge and gestational diabetes diagnosis prior to 17 weeks gestation. This study demonstrates that, compared with non-Indigenous women, Indigenous Australian women have a greater than fourfold risk of developing type 2 diabetes after gestational diabetes. Strategies are urgently needed to reduce rates of type 2 diabetes by supporting a healthy weight and breastfeeding and to improve postpartum screening among Indigenous women with gestational diabetes. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

A Case Study on the Spatial Conceptualization Abilities for Sixth Grade Elementary Students from Urban, Suburban and Remote Schools

ERIC Educational Resources Information Center

Chao, Jen Yi; Liu, Chuan Hsi

2017-01-01

The main objective of this study was to investigate and compare the spatial conceptualization performance for sixth grade elementary school students from urban, suburban and remote schools in Taiwan. This study involved 27, 25, and 26 sixth grade students from one remote indigenous school in eastern Taiwan, one suburban indigenous school in…

From Alaska: A 21st Century Story of Indigenous Self-Determination in Urban American Public Education

ERIC Educational Resources Information Center

Weinstein, Gail L. Israel

2014-01-01

For Alaskan Indigenous people, an acute clash of cultures occurs daily in U.S. public school education. The dynamics used to implement and improve the well-being and graduation outcomes for Alaska Native youth in urban public school are presented. A partnership between Cook Inlet Tribal Council, Inc., an Alaska Native social service nonprofit, and…

An empowerment intervention for Indigenous communities: an outcome assessment.

PubMed

Kinchin, Irina; Jacups, Susan; Tsey, Komla; Lines, Katrina

2015-08-21

Empowerment programs have been shown to contribute to increased empowerment of individuals and build capacity within the community or workplace. To-date, the impact of empowerment programs has yet to be quantified in the published literature in this field. This study assessed the Indigenous-developed Family Wellbeing (FWB) program as an empowerment intervention for a child safety workforce in remote Indigenous communities by measuring effect sizes. The study also assessed the value of measurement tools for future impact evaluations. A three-day FWB workshop designed to promote empowerment and workplace engagement among child protection staff was held across five remote north Queensland Indigenous communities. The FWB assessment tool comprised a set of validated surveys including the Growth and Empowerment Measure (GEM), Australian Unity Wellbeing Index, Kessler psychological distress scale (K10) and Workforce engagement survey. The assessment was conducted pre-intervention and three months post-intervention. The analysis of pre-and post-surveys revealed that the GEM appeared to be the most tangible measure for detecting positive changes in communication, conflict resolution, decision making and life skill development. The GEM indicated a 17 % positive change compared to 9 % for the Australian Unity Wellbeing Index, 5 % for the workforce engagement survey and less than 1 % for K10. This study extended qualitative research and identified the best measurement tool for detecting the outcomes of empowerment programs. The GEM was found the most sensitive and the most tangible measure that captures improvements in communication, conflict resolution, decision making and life skill development. The GEM and Australian Unity Wellbeing Index could be recommended as routine measures for empowerment programs assessment among similar remote area workforce.

Indigenous and Western Knowledges in Science Education: An Ethnographic Study of Rural and Urban Secondary Schools and Classrooms in Kenya

ERIC Educational Resources Information Center

O'Hern, Darren M.

2010-01-01

In Kenya, indigenous knowledges related to the natural sciences are not considered in the formal science education of secondary students. Despite the prevalence of studies that examine indigenous knowledges in Kenyan school and community contexts, the perspectives of students and teachers concerning indigenous natural science knowledges and their…

Prevalence of airflow obstruction and reduced forced vital capacity in an Aboriginal Australian population: The cross-sectional BOLD study.

PubMed

Cooksley, Nathania A J B; Atkinson, David; Marks, Guy B; Toelle, Brett G; Reeve, David; Johns, David P; Abramson, Michael J; Burton, Deborah L; James, Alan L; Wood-Baker, Richard; Walters, E Haydn; Buist, A Sonia; Maguire, Graeme P

2015-07-01

Mortality and hospital separation data suggest a higher burden of chronic obstructive pulmonary disease (COPD) in indigenous than non-indigenous subpopulations of high-income countries. This study sought to accurately measure the true prevalence of post-bronchodilator airflow obstruction and forced vital capacity reduction in representative samples of Indigenous and non-Indigenous Australians. This study applies cross-sectional population-based survey of Aboriginal and non-Indigenous residents of the Kimberley region of Western Australia aged 40 years or older, following the international Burden Of Lung Disease (BOLD) protocol. Quality-controlled spirometry was conducted before and after bronchodilator. COPD was defined as Global initiative for chronic Obstructive Lung Disease (GOLD) Stage 2 and above (post-bronchodilator forced expiratory volume in 1 s/forced vital capacity (FEV1 /FVC) ratio <0.7 and FEV1  < 80% predicted). Complete data were available for 704 participants. The prevalence of COPD, adjusted for age, gender and body weight in Aboriginal participants (7.2%, 95% confidence interval (CI) 3.9 to 10.4) was similar to that seen in non-Indigenous Kimberley participants (8.2%, 95% CI 5.7 to 10.7) and non-Indigenous residents of the remainder of Australia (7.1%, 95% CI 6.1 to 8.0). The prevalence of low FVC (<80% predicted) was substantially higher in Aboriginal compared with non-Indigenous participants (74.0%, 95% CI 69.1 to 78.8, vs 9.7%, 95% CI 7.1 to 12.4). Low FVC, rather than airflow obstruction, characterizes the impact of chronic lung disease previously attributed to COPD in this population subject to significant social and economic disadvantage. Environmental risk factors other than smoking as well as developmental factors must be considered. These findings require further investigation and have implications for future prevention of chronic lung disease in similar populations. © 2015 Asian Pacific Society of Respirology.

The Need for New Models for Delivery of Therapy Intervention to People with a Disability in Rural and Remote Areas of Australia

ERIC Educational Resources Information Center

Dew, Angela; Veitch, Craig; Lincoln, Michelle; Brentnall, Jennie; Bulkeley, Kim; Gallego, Gisselle; Bundy, Anita; Griffiths, Scott

2012-01-01

Therapy service delivery models to non-Indigenous and Indigenous people living in outer regional, remote, and very remote areas of Australia have typically involved irregular outreach from larger regional towns and capital cities. New South Wales (NSW) is the most populous Australian state with 7.23 million people of whom 4.58 million live in the…

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

Does fluoride in the water close the dental caries gap between Indigenous and non-Indigenous children?

PubMed

Lalloo, R; Jamieson, L M; Ha, D; Ellershaw, A; Luzzi, L

2015-09-01

Indigenous children experience significantly more dental caries than non-Indigenous children. This study assessed if access to fluoride in the water closed the gap in dental caries between Indigenous and non-Indigenous children. Data from four states and two territories were sourced from the Child Dental Health Survey (CDHS) conducted in 2010. The outcomes were dental caries in the deciduous and permanent dentitions, and the explanatory variables were Indigenous status and access to fluoridated water (≥0.5 mg/L) prior to 2008. Dental caries prevalence and severity for Indigenous and non-Indigenous children, in both dentitions, was lower in fluoridated areas compared to non-fluoridated areas. Among non-Indigenous children, there was a 50.9% difference in mean dmft scores in fluoridated (1.70) compared to non-fluoridated (2.86) areas. The difference between Indigenous children in fluoridated (3.29) compared to non-fluoridated (4.16) areas was 23.4%. Among non-Indigenous children there was a 79.7% difference in the mean DMFT scores in fluoridated (0.68) compared to non-fluoridated (1.58) areas. The difference between Indigenous children in fluoridated (1.59) and non-fluoridated (2.23) areas was 33.5%. Water fluoridation is effective in reducing dental caries, but does not appear to close the gap between non-Indigenous children and Indigenous children. © 2015 Australian Dental Association.

Performance in Basic Mathematics of Indigenous Students

ERIC Educational Resources Information Center

Sicat, Lolita V.; David, Ma. Elena D.

2016-01-01

This analytical study analyzed the performance in Basic Mathematics of the indigenous students, the Aeta students (Grade 6) of Sta. Juliana Elementary School, Capas, Tarlac, and the APC students of Malaybalay City, Bukidnon. Results were compared with regular students in rural, urban, private, and public schools to analyze indigenous students'…

Kimberley Indigenous mental health: An examination of metabolic syndrome risk factors.

PubMed

Stanley, Susanne H; Laugharne, Jonathan D E; Chapman, Murray; Balaratnasingam, Sivasankaran

2016-10-01

There is an increased risk of physical health comorbidities in people with a mental illness. This paper examines the metabolic syndrome parameters for the general population, indigenous Australians and people with a mental illness, and compares them to a sample of predominantly indigenous adults with mental health problems. A longitudinal (24 month) audit of patient medical records was conducted between February 2011 and March 2013. The Kimberley Mental Health and Drug Service in Broome, Western Australia. Largely indigenous adults with a mental illness. Sample numbers increased from 56 at baseline (80% indigenous) to 136 at 18 months (70% indigenous). Waist circumference, blood pressure, fasting lipids, and fasting blood glucose. Preliminary assessment of the data indicates a high percentage of abnormalities at baseline and at the 18 month period on all four parameters, yet not all patients were assessed on a regular basis. Abnormalities in metabolic profiles consistent with the non-Indigenous mental health population were found. There are considerable challenges to implementing regular monitoring of physical and metabolic profiles of indigenous people in rural and remote communities. © 2015 National Rural Health Alliance Inc.

Indigenous migration dynamics in the Ecuadorian Amazon: a longitudinal and hierarchical analysis.

PubMed

Davis, Jason; Sellers, Samuel; Gray, Clark; Bilsborrow, Richard

2017-01-01

Amazonian indigenous populations are approaching a critical stage in their history in which increasing education and market integration, rapid population growth and degradation of natural resources threaten the survival of their traditions and livelihoods. A topic that has hardly been touched upon in this context is migration and population mobility. We address this by analysing a unique longitudinal dataset from the Ecuadorian Amazon on the spatial mobility of five indigenous groups and mestizo co-residents. Analyses reveal traditional and new forms of population mobility and migrant selectivity, including gendered forms of marriage migration and rural-urban moves driven by education. These results illustrate a dynamic present and an uncertain future for indigenous populations in which rural, natural-resource-based lifeways may well be sustained but with increasing links to urban areas.

Comparison of creatinine and cystatin C based eGFR in the estimation of glomerular filtration rate in Indigenous Australians: The eGFR Study.

PubMed

Barr, Elizabeth Lm; Maple-Brown, Louise J; Barzi, Federica; Hughes, Jaquelyne T; Jerums, George; Ekinci, Elif I; Ellis, Andrew G; Jones, Graham Rd; Lawton, Paul D; Sajiv, Cherian; Majoni, Sandawana W; Brown, Alex Dh; Hoy, Wendy E; O'Dea, Kerin; Cass, Alan; MacIsaac, Richard J

2017-04-01

The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation that combines creatinine and cystatin C is superior to equations that include either measure alone in estimating glomerular filtration rate (GFR). However, whether cystatin C can provide any additional benefits in estimating GFR for Indigenous Australians, a population at high risk of end-stage kidney disease (ESKD) is unknown. Using a cross-sectional analysis from the eGFR Study of 654 Indigenous Australians at high risk of ESKD, eGFR was calculated using the CKD-EPI equations for serum creatinine (eGFRcr), cystatin C (eGFRcysC) and combined creatinine and cystatin C (eGFRcysC+cr). Reference GFR (mGFR) was determined using a non-isotopic iohexol plasma disappearance technique over 4h. Performance of each equation to mGFR was assessed by calculating bias, % bias, precision and accuracy for the total population, and according to age, sex, kidney disease, diabetes, obesity and c-reactive protein. Data were available for 542 participants (38% men, mean [sd] age 45 [14] years). Bias was significantly greater for eGFRcysC (15.0mL/min/1.73m 2 ; 95% CI 13.3-16.4, p<0.001) and eGFRcysC+cr (10.3; 8.8-11.5, p<0.001) compared to eGFRcr (5.4; 3.0-7.2). Accuracy was lower for eGFRcysC (80.3%; 76.7-83.5, p<0.001) but not for eGFRcysC+cr (91.9; 89.3-94.0, p=0.29) compared to eGFRcr (90.0; 87.2-92.4). Precision was comparable for all equations. The performance of eGFRcysC deteriorated across increasing levels of c-reactive protein. Cystatin C based eGFR equations may not perform well in populations with high levels of chronic inflammation. CKD-EPI eGFR based on serum creatinine remains the preferred equation in Indigenous Australians. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Red Dirt Thinking on Child Wellbeing in Indigenous, Rural and Remote Australian Communities: The SpICE Model "I Just Don't Want my Kid to Struggle Like I Did at School"

ERIC Educational Resources Information Center

Clarke, Kendall; Denton, Marijke

2013-01-01

Supporting children in their early development and learning has long-term benefits for both them and the broader community. Yet in Australia we still have significant examples of inequality of opportunity (Allan, 2010) and other structural barriers to family wellbeing, particularly in Indigenous and rural and remote communities (Bourke, Humphreys,…

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

A growing body of literature highlights that racial discrimination has negative impacts on child health, although most studies have been limited to an examination of direct forms of racism using cross-sectional data. We aim to provide further insights on the impact of early exposure to racism on child health using longitudinal data among Indigenous children in Australia and multiple indicators of racial discrimination. We used data on 1239 Indigenous children aged 5-10 years from Waves 1-6 (2008-2013) of Footprints in Time, a longitudinal study of Indigenous children across Australia. We examined associations between three dimensions of carer-reported racial discrimination (measuring the direct experiences of children and vicarious exposure by their primary carer and family) and a range of physical and mental health outcomes. Analysis was conducted using multivariate logistic regression within a multilevel framework. Two-fifths (40%) of primary carers, 45% of families and 14% of Indigenous children aged 5-10 years were reported to have experienced racial discrimination at some point in time, with 28-40% of these experiencing it persistently (reported at multiple time points). Primary carer and child experiences of racial discrimination were each associated with poor child mental health status (high risk of clinically significant emotional or behavioural difficulties), sleep difficulties, obesity and asthma, but not with child general health or injury. Children exposed to persistent vicarious racial discrimination were more likely to have sleep difficulties and asthma in multivariate models than those with a time-limited exposure. The findings indicate that direct and persistent vicarious racial discrimination are detrimental to the physical and mental health of Indigenous children in Australia, and suggest that prolonged and more frequent exposure to racial discrimination that starts in the early lifecourse can impact on multiple domains of health in later life. 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.

Trends in hospital admissions involving suicidal behaviour in the Northern Territory, 2001-2013.

PubMed

Leckning, Bernard A; Li, Shu Qin; Cunningham, Teresa; Guthridge, Steven; Robinson, Gary; Nagel, Tricia; Silburn, Sven

2016-06-01

To investigate trends in hospital admissions involving suicidal behaviour in the Northern Territory (NT) resident population over the period 2001-2013. Estimates of age-standardised rates and average changes in the annual rate of hospital admissions involving suicidal behaviour were calculated by socio-demographic characteristics and types of suicidal behaviour. Overall rates for Indigenous admissions were 2.7 times higher than non-Indigenous admissions and had increased by almost twice as much. While male and female rates of admission were similar for both Indigenous and non-Indigenous residents, the average annual change in rates was greater for Indigenous females (13.4%) compared to males (8.8%) and for non-Indigenous males (7.7%) compared to females (5.2%). Younger and middle-aged Indigenous admissions experienced increasing rates of admissions, whilst trends were similar across age groups for non-Indigenous admissions. Admissions with a diagnosis of suicidal ideation increased the most across all groups. Trends in intentional self-harm admissions differed according to Indigenous status and sex. There have been substantial increases in hospital admissions involving suicidal behaviour in the NT, most markedly for Indigenous residents. Indigenous females and youth appear to be at increasing risk. The steep increase in suicidal ideation across all groups warrants further investigation. © The Royal Australian and New Zealand College of Psychiatrists 2016.

Does rural or urban residence make a difference to neonatal outcome in premature birth? A regional study in Australia

PubMed Central

Abdel‐Latif, M E; Bajuk, B; Oei, J; Vincent, T; Sutton, L; Lui, K

2006-01-01

Background Patients living in rural areas may be at a disadvantage in accessing tertiary health care. Aim To test the hypothesis that very premature infants born to mothers residing in rural areas have poorer outcomes than those residing in urban areas in the state of New South Wales (NSW) and the Australian Capital Territory (ACT) despite a coordinated referral and transport system. Methods “Rural” or “urban” status was based on the location of maternal residence. Perinatal characteristics, major morbidity and case mix adjusted mortality were compared between 1879 rural and 6775 urban infants <32 weeks gestational age, born in 1992–2002 and admitted to all 10 neonatal intensive care units in NSW and ACT. Results Rural mothers were more likely to be teenaged, indigenous, and to have had a previous premature birth, prolonged ruptured membrane, and antenatal corticosteroid. Urban mothers were more likely to have had assisted conception and a caesarean section. More urban (93% v 83%) infants were born in a tertiary obstetric hospital. Infants of rural residence had a higher mortality (adjusted odds ratio (OR) 1.26, 95% confidence interval (CI) 1.07 to 1.48, p  =  0.005). This trend was consistently seen in all subgroups and significantly for the tertiary hospital born population and the 30–31 weeks gestation subgroup. Regional birth data in this gestational age range also showed a higher stillbirth rate among rural infants (OR 1.20, 95% CI 1.09 to 1.32, p<0.001). Conclusions Premature births from rural mothers have a higher risk of stillbirth and mortality in neonatal intensive care than urban infants. PMID:16428354

Indigenous Student Success in Public Schools: A "We" Approach for Educators

ERIC Educational Resources Information Center

Moon, Martha; Berger, Paul

2016-01-01

What does Indigenous student success look like in public school boards? Seven urban Indigenous educators' interview responses to this question were interpreted and reported by the lead author, a teacher and researcher of English, Irish, and Scottish heritage--a Settler Canadian. The "Connected Beads Model" is the result of these…

Mental health consequences of stress and trauma: allostatic load markers for practice and policy with a focus on Indigenous health.

PubMed

Berger, Maximus; Juster, Robert-Paul; Sarnyai, Zoltán

2015-12-01

Mental health, well-being, and social life are intimately related as is evident from the higher incidence of psychiatric illness in individuals exposed to social stress and adversity. Several biological pathways linking social adversity to health outcomes are heavily investigated in the aims of facilitating early identification and prevention of adverse health outcomes. We provide a practice-orientated overview of the allostatic load model and how it relates to metabolic and cardiovascular comorbidity in psychiatric disorders. Allostatic load brings together a set of neuroendocrine, metabolic, immune and cardiovascular biomarkers that are elevated in individuals with adverse early life experiences and are predictive of cardiovascular and metabolic risk in psychiatric illness of critical importance for Indigenous Australians. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Factors relating to high psychological distress in Indigenous Australians and their contribution to Indigenous-non-Indigenous disparities.

PubMed

McNamara, Bridgette J; Banks, Emily; Gubhaju, Lina; Joshy, Grace; Williamson, Anna; Raphael, Beverley; Eades, Sandra

2018-04-01

To explore factors associated with high psychological distress among Aboriginal and non-Aboriginal Australians and their contribution to the elevated distress prevalence among Aboriginal people. Questionnaire data from 1,631 Aboriginal and 233,405 non-Aboriginal 45 and Up Study (NSW, Australia) participants aged ≥45 years were used to calculate adjusted prevalence ratios for high psychological distress (Kessler-10 score ≥22) for socio-demographic, health and disability-related factors, and to quantify contributions to differences in distress prevalence. While high-distress prevalence was increased around three-fold in Aboriginal versus non-Aboriginal participants, distress-related risk factors were similar. Morbidity and physical disability had the strongest associations; high distress affected 43.8% of Aboriginal and 20.9% of non-Aboriginal participants with severe physical limitations and 9.5% and 3.9% of those without limitations, respectively. Differences in distress prevalence between Aboriginal and non-Aboriginal participants were essentially attributable to differences in SES, morbidity, disability/functional limitations and social support (fully-adjusted PR 1.19 [95% 1.08, 1.30]); physical morbidity and disability explained the bulk. The markedly elevated prevalence of high distress among older Aboriginal Australians appears largely attributable to greater physical morbidity and disability. Implications for public health: Addressing upstream determinants of physical morbidity and improved integration of social and emotional wellbeing care into primary care and chronic disease management are essential. © 2018 The Authors.

Increasing alcohol restrictions and rates of serious injury in four remote Australian Indigenous communities.

PubMed

Margolis, Stephen A; Ypinazar, Valmae A; Muller, Reinhold; Clough, Alan

2011-05-16

To document rates of serious injuries in relation to government alcohol restrictions in remote Australian Indigenous communities. An ecological study using Royal Flying Doctor Service injury retrieval data, before and after changes in legal access to alcohol in four remote Australian Indigenous communities, Queensland, 1 January 1996-31 July 2010. Changes in rates of aeromedical retrievals for serious injury, and proportion of retrievals for serious injury, before and after alcohol restrictions. After alcohol restrictions were introduced in 2002-2003, retrieval rates for serious injury dropped initially, and then increased in the 2 years before further restrictions in 2008 (average increase, 2.34 per 1000 per year). This trend reversed in the 2 years after the 2008 restrictions (average decrease, 7.97 per 1000 per year). There was a statistically significant decreasing time trend in serious-injury retrieval rates in each of the four communities for the period 2 years before the 2002-2003 restrictions, 2 years before the 2008 restrictions, and the final 2 years of observations (2009-2010) (P < 0.001 for all four communities combined). Overall, serious-injury retrieval rates dropped from 30 per 1000 in 2008 to 14 per 1000 in 2010, and the proportions of serious-injury retrievals decreased significantly for all four communities. The absolute and the proportional rates of serious-injury retrievals fell significantly as government restrictions on legal access to alcohol increased; they are now at their lowest recorded level in 15 years.

Improving organisational systems for diabetes care in Australian Indigenous communities.

PubMed

Bailie, Ross; Si, Damin; Dowden, Michelle; O'Donoghue, Lynette; Connors, Christine; Robinson, Gary; Cunningham, Joan; Weeramanthri, Tarun

2007-05-06

Indigenous Australians experience disproportionately high prevalence of, and morbidity and mortality from diabetes. There is an urgent need to understand how Indigenous primary care systems are organised to deliver diabetes services to those most in need, to monitor the quality of diabetes care received by Indigenous people, and to improve systems for better diabetes care. The intervention featured two annual cycles of assessment, feedback workshops, action planning, and implementation of system changes in 12 Indigenous community health centres. Assessment included a structured review of health service systems and audit of clinical records. Main process of care measures included adherence to guideline-scheduled services and medication adjustment. Main patient outcome measures were HbA1c, blood pressure and total cholesterol levels. There was good engagement of health centre staff, with significant improvements in system development over the study period. Adherence to guideline-scheduled processes improved, including increases in 6 monthly testing of HbA1c from 41% to 74% (Risk ratio 1.93, 95% CI 1.71-2.10), 3 monthly checking of blood pressure from 63% to 76% (1.27, 1.13-1.37), annual testing of total cholesterol from 56% to 74% (1.36, 1.20-1.49), biennial eye checking by a ophthalmologist from 34% to 54% (1.68, 1.39-1.95), and 3 monthly feet checking from 20% to 58% (3.01, 2.52-3.47). Medication adjustment rates following identification of elevated HbA1c and blood pressure were low, increasing from 10% to 24%, and from 13% to 21% respectively at year 1 audit. However, improvements in medication adjustment were not maintained at the year 2 follow-up. Mean HbA1c value improved from 9.3 to 8.9% (mean difference -0.4%, 95% CI -0.7;-0.1), but there was no improvement in blood pressure or cholesterol control. This quality improvement (QI) intervention has proved to be highly acceptable in the Indigenous Australian primary care setting and has been associated with significant improvements in systems and processes of care and some intermediate outcomes. However, improvements appear to be limited by inadequate attention to abnormal clinical findings and medication management. Greater improvement in intermediate outcomes may be achieved by specifically addressing system barriers to therapy intensification through more effective engagement of medical staff in QI activities and/or greater use of nurse-practitioners.

Designing an implementation intervention with the Behaviour Change Wheel for health provider smoking cessation care for Australian Indigenous pregnant women.

PubMed

Gould, Gillian S; Bar-Zeev, Yael; Bovill, Michelle; Atkins, Lou; Gruppetta, Maree; Clarke, Marilyn J; Bonevski, Billie

2017-09-15

Indigenous smoking rates are up to 80% among pregnant women: prevalence among pregnant Australian Indigenous women was 45% in 2014, contributing significantly to the health gap for Indigenous Australians. We aimed to develop an implementation intervention to improve smoking cessation care (SCC) for pregnant Indigenous smokers, an outcome to be achieved by training health providers at Aboriginal Medical Services (AMS) in a culturally competent approach, developed collaboratively with AMS. The Behaviour Change Wheel (BCW), incorporating the COM-B model (capability, opportunity and motivation for behavioural interventions), provided a framework for the development of the Indigenous Counselling and Nicotine (ICAN) QUIT in Pregnancy implementation intervention at provider and patient levels. We identified evidence-practice gaps through (i) systematic literature reviews, (ii) a national survey of clinicians and (iii) a qualitative study of smoking and quitting with Aboriginal mothers. We followed the three stages recommended in Michie et al.'s "Behaviour Change Wheel" guide. Targets identified for health provider behaviour change included the following: capability (psychological capability, knowledge and skills) by training clinicians in pharmacotherapy to assist women to quit; motivation (optimism) by presenting evidence of effectiveness, and positive testimonials from patients and clinicians; and opportunity (environmental context and resources) by promoting a whole-of-service approach and structuring consultations using a flipchart and prompts. Education and training were selected as the main intervention functions. For health providers, the delivery mode was webinar, to accommodate time and location constraints, bringing the training to the services; for patients, face-to-face consultations were supported by a booklet embedded with videos to improve patients' capability, opportunity and motivation. The ICAN QUIT in Pregnancy was an intervention to train health providers at Aboriginal Medical Services in how to implement culturally competent evidence-based practice including counselling and nicotine replacement therapy for pregnant patients who smoke. The BCW aided in scientifically and systematically informing this targeted implementation intervention based on the identified gaps in SCC by health providers. Multiple factors impact at systemic, provider, community and individual levels. This process was therefore important for defining the design and intervention components, prior to a conducting a pilot feasibility trial, then leading on to a full clinical trial.

Bridging the triple divide: performance and innovative multimedia in the service of behavioural health change in remote Indigenous settings.

PubMed

Hunter, Ernest; Travers, Helen; Gibson, Julie; Campion, Jonathan

2007-01-01

The use of innovative information technology is now well established in health. However, while the gap in health status between Indigenous and other Australians is both significant and unchanging, there is limited application of these new approaches to addressing this national health priority. This may in part reflect the 'digital divide', which is another facet of Indigenous disadvantage. This paper describes an approach to address both issues in remote Indigenous settings. The Health Interactive Technology Network began as a proof-of-concept study of touchscreen technology in two Indigenous health settings. It has subsequently expanded to a number of remote Indigenous communities and developed new platforms and applications to respond to emerging health issues. In creating narrative, interactive approaches to address choices in relation to health behaviours, the community development and engagement effects of the creative process have been highlighted. These findings suggest that these approaches will be suited to further expansion in the area of mental health.

Beyond policy and planning to practice: getting sexual health on the agenda in Aboriginal communities in Western Australia.

PubMed

Thompson, Sandra C; Greville, Heath S; Param, Rani

2008-05-19

Indigenous Australians have significantly poorer status on a large range of health, educational and socioeconomic measures and successive Australian governments at state and federal level have committed to redressing these disparities. Despite this, improvements in Aboriginal health status have been modest, and Australia has much greater disparities in the health of its Indigenous people compared to countries that share a history characterised by colonisation and the dispossession of indigenous populations such as New Zealand, Canada and the United States of America. Efforts at policy and planning must ultimately be translated into practical strategies. This article outlines an approach that was effective in Western Australia in increasing the engagement and concern of Aboriginal people about high rates of sexually transmissible infections and sexual health issues. Many aspects of the approach are relevant for other health issues. The complexity of Indigenous sexual health necessitates inter-agency and cross-governmental collaboration, in addition to Aboriginal leadership, accurate data, and community support. A recent approach covering all these areas is described. This has resulted in Aboriginal sexual health being more actively discussed within Aboriginal health settings than it once was and additional resources for Indigenous sexual health being available, with better communication and partnership across different health service providers and sectors. The valuable lessons in capacity building, collaboration and community engagement are readily transferable to other health issues, and may be useful for other health professionals working in the challenging area of Aboriginal health. Health service planners and providers grapple with achieving Aboriginal ownership and leadership regarding their particular health issue, despite sincere concern and commitment to addressing Aboriginal health issues. This highlights the need to secure genuine Aboriginal engagement. Building capacity that enables Indigenous people and communities to fulfill their own goals is a long-term strategy and requires sustained commitment, but we argue is a prerequisite for better Indigenous health outcomes.

Engaging Australian Aboriginal narratives to challenge attitudes and create empathy in health care: a methodological perspective.

PubMed

Wain, Toni; Sim, Moira; Bessarab, Dawn; Mak, Donna; Hayward, Colleen; Rudd, Cobie

2016-06-02

Unconscious bias and negative attitudes towards minority groups have detrimental effects on the way health care is, or is not, provided to these groups. Recognition of racist attitudes and behaviours as well as understanding clients' experiences of health and health care are pivotal to developing better health care strategies to positively impact on the quality and safety of care provided to Indigenous people. Indigenous research demands inclusive research processes and the use of culturally appropriate methodologies. This paper presents a methodological account of collecting narratives which accurately and respectfully reflect Aboriginal Australians' experiences with health care in Western Australia. The purpose of these narratives is to provide health students and professionals with an opportunity to 'walk-in the shoes' of Aboriginal people where face-to-face interaction is not feasible. With the incorporation of Indigenous peoples' voices being an important link in cultural safety, the project was led by an Indigenous Reference group, who encouraged active participation of Aboriginal people in all areas of the project. Using a phenomenological approach and guided by the Indigenous Reference group, yarning data collection was implemented to collect stories focusing on Aboriginal people's experiences with health care services. An open-access, on-line website was established to host education resources developed from these "yarns". Yarning provided a rich source of information on personal experiences and encouraged the story provider to recognise their facilitative role in the research process. While the methodology used in this project was lengthy and labour-intensive it afforded a respectful manner for story collection and highlighted several innate flaws when Western methods are applied to an Indigenous context. Engagement of an Indigenous Reference Group was pivotal to designing an appropriate methodology that incorporated the voices of Aboriginal people in a multimedia resource of Aboriginal narratives. However further research is warranted to understand how the resources are being used and integrated into curricula, and their impact on students and health care outcomes.

Does evidence influence policy? Resource allocation and the Indigenous Burden of Disease study.

PubMed

Doran, Christopher M; Ling, Rod; Searles, Andrew; Hill, Peter

2016-01-01

Objective The Indigenous Burden of Disease (IBoD) report is the most comprehensive assessment of Indigenous disease burden in Australia. The aim of the present study was to investigate the potential effect of the IBoD report on Australian Indigenous health policy, service expenditure and research funding. Findings have significance for understanding factors that may influence Indigenous health policy. Methods The potential effect of the IBoD report was considered by: (1) conducting a text search of pertinent documents published by the federal government, Council of Australian Governments and the National Health and Medical Research Council of Australia (NHMRC) and observing the quantity and quality of references to IBoD; (2) examining data on government Indigenous healthcare expenditure for trends consistent with the findings and policy implications of the IBoD report; and (3) examining NHMRC Indigenous grant allocation trends consistent with the findings and policy implications of the IBoD report. Results Of 110 government and NHMRC documents found, IBoD was cited in 27. Immediately after publication of the IBoD report, federal and state governments increased Indigenous health spending (relative to non-Indigenous), notably for community health and public health at the state level. Expenditure on Indigenous hospital separations for chronic diseases also increased. These changes are broadly consistent with the findings of the IBoD report on the significance of chronic disease and the need to address certain risk factors. However, there is no evidence that such changes had a causal connection with the IBoD study. After publication of the IBoD report, changes in NHMRC Indigenous research funding showed little consistency with the findings of the IBoD report. Conclusions The present study found only indirect and inconsistent correlational evidence of the potential influence of the IBoD report on Indigenous health expenditure and research funding. Further assessment of the potential influence of the IBoD report on Indigenous health policy will require more targeted research, including interviews with key informants involved in developing health policy. What is known about the topic? There are currently no publications that consider the potential effed of the IBoD study on Indigenous health expenditure and research funding. What does this paper add? This paper offers the first consideration of the potential effect of the IBoD report. It contains analyses of data from readily available sources, examining national expenditures on Indigenous health and NHMRC Indigenous research, before and after the publication of the IBoD report. What are the implications for practitioners? The paper is relevant to analysts interested in drivers of Indigenous health policy. Although it finds correlations between the release of the IBoD report and some subsequent health spending decisions, other factors should be investigated to better understand the complexity of processes that drive government efforts to improve Indigenous health.

Developing a postgraduate program in Indigenous mental health and wellbeing at University of Southern Queensland.

PubMed

Hampton, Ron; McCann, William

2007-01-01

The aim of this paper is to explain the development of an innovative postgraduate program in Indigenous Australian Mental Health and Well-Being for non-Indigenous health and allied health practitioners. The historical background is explored, together with details of the approach to, and the management of, the new program. The establishment of the new program has been achieved and the interest level in the new directions being undertaken has been gauged as very high. Judging by the number of enquiries, the enrolments so far achieved and the Department of Education, Science and Training granting of 20 HECS places for the new program, it is clear that the program will be viable and the future development of a Master's in Indigenous Mental Health and Well-Being assured.

Indigenous migration dynamics in the Ecuadorian Amazon: a longitudinal and hierarchical analysis

PubMed Central

Davis, Jason; Sellers, Samuel; Gray, Clark; Bilsborrow, Richard

2017-01-01

Amazonian indigenous populations are approaching a critical stage in their history in which increasing education and market integration, rapid population growth and degradation of natural resources threaten the survival of their traditions and livelihoods. A topic that has hardly been touched upon in this context is migration and population mobility. We address this by analysing a unique longitudinal dataset from the Ecuadorian Amazon on the spatial mobility of five indigenous groups and mestizo co-residents. Analyses reveal traditional and new forms of population mobility and migrant selectivity, including gendered forms of marriage migration and rural-urban moves driven by education. These results illustrate a dynamic present and an uncertain future for indigenous populations in which rural, natural-resource-based lifeways may well be sustained but with increasing links to urban areas. PMID:29129939

Rickettsial seropositivity in the indigenous community and animal farm workers, and vector surveillance in Peninsular Malaysia

PubMed Central

Kho, Kai Ling; Koh, Fui Xian; Hasan, Lailatul Insyirah Mohd; Wong, Li Ping; Kisomi, Masoumeh Ghane; Bulgiba, Awang; Nizam, Quaza Nizamuddin Hassan; Tay, Sun Tee

2017-01-01

Rickettsioses are emerging zoonotic diseases that are often neglected in many countries in Southeast Asia. Rickettsial agents are transmitted to humans through exposure to infected arthropods. Limited data are available on the exposure of indigenous community and animal farm workers to the aetiological agents and arthropod vectors of rickettsioses in Peninsular Malaysia. Serological analysis of Rickettsia conorii and Rickettsia felis was performed for 102 individuals from the indigenous community at six rural villages and 87 workers from eight animal farms in Peninsular Malaysia in a cross-sectional study. The indigenous community had significantly higher seropositivity rates for R. conorii (P<0.001) and R. felis (P<0.001), as compared to blood donors from urban (n=61). Similarly, higher seropositivity rates for R. conorii (P=0.046) and R. felis (P<0.001) were noted for animal farm workers, as compared to urban blood donors. On the basis of the sequence analysis of gltA, ompA and ompB, various spotted fever group rickettsiae closely related to R. raoultii, R. heilongjiangensis, R. felis-like organisms, R. tamurae, Rickettsia sp. TCM1, R. felis, Rickettsia sp. LON13 and R. hulinensis were identified from tick/flea samples in animal farms, indigenous villages and urban areas. This study describes rickettsial seropositivity of the Malaysian indigenous community and animal farm workers, and provides molecular evidence regarding the presence of rickettsial agents in ticks/fleas infesting domestic animals in Peninsular Malaysia. PMID:28400593

Rickettsial seropositivity in the indigenous community and animal farm workers, and vector surveillance in Peninsular Malaysia.

PubMed

Kho, Kai Ling; Koh, Fui Xian; Hasan, Lailatul Insyirah Mohd; Wong, Li Ping; Kisomi, Masoumeh Ghane; Bulgiba, Awang; Nizam, Quaza Nizamuddin Hassan; Tay, Sun Tee

2017-04-12

Rickettsioses are emerging zoonotic diseases that are often neglected in many countries in Southeast Asia. Rickettsial agents are transmitted to humans through exposure to infected arthropods. Limited data are available on the exposure of indigenous community and animal farm workers to the aetiological agents and arthropod vectors of rickettsioses in Peninsular Malaysia. Serological analysis of Rickettsia conorii and Rickettsia felis was performed for 102 individuals from the indigenous community at six rural villages and 87 workers from eight animal farms in Peninsular Malaysia in a cross-sectional study. The indigenous community had significantly higher seropositivity rates for R. conorii (P<0.001) and R. felis (P<0.001), as compared to blood donors from urban (n=61). Similarly, higher seropositivity rates for R. conorii (P=0.046) and R. felis (P<0.001) were noted for animal farm workers, as compared to urban blood donors. On the basis of the sequence analysis of gltA, ompA and ompB, various spotted fever group rickettsiae closely related to R. raoultii, R. heilongjiangensis, R. felis-like organisms, R. tamurae, Rickettsia sp. TCM1, R. felis, Rickettsia sp. LON13 and R. hulinensis were identified from tick/flea samples in animal farms, indigenous villages and urban areas. This study describes rickettsial seropositivity of the Malaysian indigenous community and animal farm workers, and provides molecular evidence regarding the presence of rickettsial agents in ticks/fleas infesting domestic animals in Peninsular Malaysia.

Using breath carbon monoxide to validate self-reported tobacco smoking in remote Australian Indigenous communities.

PubMed

Maclaren, David J; Conigrave, Katherine M; Robertson, Jan A; Ivers, Rowena G; Eades, Sandra; Clough, Alan R

2010-02-20

This paper examines the specificity and sensitivity of a breath carbon monoxide (BCO) test and optimum BCO cutoff level for validating self-reported tobacco smoking in Indigenous Australians in Arnhem Land, Northern Territory (NT). In a sample of 400 people (>/=16 years) interviewed about tobacco use in three communities, both self-reported smoking and BCO data were recorded for 309 study participants. Of these, 249 reported smoking tobacco within the preceding 24 hours, and 60 reported they had never smoked or had not smoked tobacco for >/=6 months. The sample was opportunistically recruited using quotas to reflect age and gender balances in the communities where the combined Indigenous populations comprised 1,104 males and 1,215 females (>/=16 years). Local Indigenous research workers assisted researchers in interviewing participants and facilitating BCO tests using a portable hand-held analyzer. A BCO cutoff of >/=7 parts per million (ppm) provided good agreement between self-report and BCO (96.0% sensitivity, 93.3% specificity). An alternative cutoff of >/=5 ppm increased sensitivity from 96.0% to 99.6% with no change in specificity (93.3%). With data for two self-reported nonsmokers who also reported that they smoked cannabis removed from the analysis, specificity increased to 96.6%. In these disadvantaged Indigenous populations, where data describing smoking are few, testing for BCO provides a practical, noninvasive, and immediate method to validate self-reported smoking. In further studies of tobacco smoking in these populations, cannabis use should be considered where self-reported nonsmokers show high BCO.

Indigenous students transitioning to school: responses to pre-foundational mathematics.

PubMed

Sarra, Grace; Ewing, Bronwyn

2014-01-01

Australian Indigenous students' mathematics performance continues to be below that of non-Indigenous students. This occurs from the early years of school, due largely to knowledge and social differences on entry to formal schooling. This paper reports on a mathematics research project conducted in one Aboriginal community school in New South Wales, Australia. The project aimed to identify and explain the ways that young Australian Indigenous students (age 2-4 years) learn number language and processes, specifically attribute language, sorting, 1-1 correspondence and, counting. The project adopted a mixed methods approach. That is, the methodology was decolonising (Smith 1999) in that it collaborated with and gave benefit back to the Indigenous community and school being researched. It was qualitative and interpretative (Burns 2000) and incorporated an action-research teaching-experiment approach where and teachers collaborated with the researchers to try new teaching methods. This paper draws on data pertaining to students' response to diagnostic interview questions, the pre- and post-test results of the interview and photographic evidence as observations during mathematics learning time. Participants referred to in this paper include one female principal (N = 1), and the transition class of students' pre- (N = 6) and post-test (N = 3) results of the pre-foundational processes (also referred to as attributes). The results were encouraging with improvements in colour (34%), patterns (33%) and capacity (38%). As a result of this project, our epistemology regarding the importance of finding out about students' pre-foundational knowledge and understandings and providing a culturally appropriate learning environment with resources has been built upon.

Indigenous Respiratory Outreach Care: the first 18 months of a specialist respiratory outreach service to rural and remote Indigenous communities in Queensland, Australia.

PubMed

Medlin, Linda G; Chang, Anne B; Fong, Kwun; Jackson, Rebecca; Bishop, Penny; Dent, Annette; Hill, Deb C; Vincent, Stephen; O'Grady, Kerry-Ann F

2014-09-01

Respiratory diseases are a leading cause of morbidity and mortality in Indigenous Australians. However, there are limited approaches to specialist respiratory care in rural and remote communities that are culturally appropriate. A specialist Indigenous Respiratory Outreach Care (IROC) program, developed to address this gap, is described. The aim of the present study was to implement, pilot and evaluate multidisciplinary specialist respiratory outreach medical teams in rural and remote Indigenous communities in Queensland, Australia. Sites were identified based on a perception of unmet need, burden of respiratory disease and/or capacity to use the clinical service and capacity building for support offered. IROC commenced in March 2011 and, to date, has been implemented in 13 communities servicing a population of approximately 43000 Indigenous people. Clinical service delivery has been possible through community engagement and capacity building initiatives directed by community protocols. IROC is a culturally sensitive and sustainable model for adult and paediatric specialist outreach respiratory services that may be transferrable to Indigenous communities across Queensland and Australia.

Australian and New Zealand Indigenous mothers' report respect for smoking bans in homes.

PubMed

Glover, Marewa; Kira, Anette; Johnston, Vanessa; Walker, Natalie; Brown, Ngiare; Thomas, David

2015-03-01

There is limited data about the reasons behind residential rules to reduce environmental tobacco smoke (ETS) exposure or the establishment or enforcement of such rules in Indigenous populations. We aimed to gain an understanding of smokefree rules around Australian and New Zealand (NZ) Indigenous infants. This was a qualitative study nested within a randomised controlled trial that aimed to test the efficacy of a family-centred tobacco control programme about environmental tobacco smoke (ETS) to improve the respiratory health of Indigenous infants in Australia and New Zealand. Qualitative semi-structured interviews were conducted with 26 Indigenous mothers of infants in Australia (n=7) and NZ (n=19). We asked about the presence of smokefree rules, who set the rules, how the rules were set and enforced, and presence of smokefree rules in participants' wider social circle. Interviews were audiotaped, transcribed, and inductively analysed to identify key themes. Sixty-nine percent of mothers had partners, 77% smoked and all reported some presence of smokefree rules for house and car. Three main themes were identified: strategies to minimise exposure to ETS, establishing smokefree rules in homes and cars, and, adherence and enforcement of smokefree rules. Several strategies were identified to limit children's exposure to ETS, including rules to limit exposure to third-hand smoke. Mothers extended their smokefree rules to apply to other people's houses or cars, and reported that their family and social circles also had smokefree rules. The main reason for having smokefree rules was for the health of their children. Rules were most commonly set by the mother, often jointly with their partner. Few mothers reported challenges or problems with other people adhering to the smokefree rules. Women tried very hard to, and believed that they were effective in, protecting their children from the harmful effects of ETS exposure. In this context, health professionals need to emphasise smoking cessation in parents, so that children are maximally protected from ETS exposure. Copyright © 2014 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Patterns and correlates of self-reported racial discrimination among Australian Aboriginal and Torres Strait Islander adults, 2008–09: analysis of national survey data

PubMed Central

2013-01-01

Background There is now considerable evidence that racism is a pernicious and enduring social problem with a wide range of detrimental outcomes for individuals, communities and societies. Although indigenous people worldwide are subjected to high levels of racism, there is a paucity of population-based, quantitative data about the factors associated with their reporting of racial discrimination, about the settings in which such discrimination takes place, and about the frequency with which it is experienced. Such information is essential in efforts to reduce both exposure to racism among indigenous people and the harms associated with such exposure. Methods Weighted data on self-reported racial discrimination from over 7,000 Indigenous Australian adults participating in the 2008–09 National Aboriginal and Torres Strait Islander Survey, a nationally representative survey conducted by the Australian Bureau of Statistics, were analysed by socioeconomic, demographic and cultural factors. Results More than one in four respondents (27%) reported experiencing racial discrimination in the past year. Racial discrimination was most commonly reported in public (41% of those reporting any racial discrimination), legal (40%) and work (30%) settings. Among those reporting any racial discrimination, about 40% experienced this discrimination most or all of the time (as opposed to a little or some of the time) in at least one setting. Reporting of racial discrimination peaked in the 35–44 year age group and then declined. Higher reporting of racial discrimination was associated with removal from family, low trust, unemployment, having a university degree, and indicators of cultural identity and participation. Lower reporting of racial discrimination was associated with home ownership, remote residence and having relatively few Indigenous friends. Conclusions These data indicate that racial discrimination is commonly experienced across a wide variety of settings, with public, legal and work settings identified as particularly salient. The observed relationships, while not necessarily causal, help to build a detailed picture of self-reported racial discrimination experienced by Indigenous people in contemporary Australia, providing important evidence to inform anti-racism policy. PMID:23816052

Patterns and correlates of self-reported racial discrimination among Australian Aboriginal and Torres Strait Islander adults, 2008-09: analysis of national survey data.

PubMed

Cunningham, Joan; Paradies, Yin C

2013-07-01

There is now considerable evidence that racism is a pernicious and enduring social problem with a wide range of detrimental outcomes for individuals, communities and societies. Although indigenous people worldwide are subjected to high levels of racism, there is a paucity of population-based, quantitative data about the factors associated with their reporting of racial discrimination, about the settings in which such discrimination takes place, and about the frequency with which it is experienced. Such information is essential in efforts to reduce both exposure to racism among indigenous people and the harms associated with such exposure. Weighted data on self-reported racial discrimination from over 7,000 Indigenous Australian adults participating in the 2008-09 National Aboriginal and Torres Strait Islander Survey, a nationally representative survey conducted by the Australian Bureau of Statistics, were analysed by socioeconomic, demographic and cultural factors. More than one in four respondents (27%) reported experiencing racial discrimination in the past year. Racial discrimination was most commonly reported in public (41% of those reporting any racial discrimination), legal (40%) and work (30%) settings. Among those reporting any racial discrimination, about 40% experienced this discrimination most or all of the time (as opposed to a little or some of the time) in at least one setting. Reporting of racial discrimination peaked in the 35-44 year age group and then declined. Higher reporting of racial discrimination was associated with removal from family, low trust, unemployment, having a university degree, and indicators of cultural identity and participation. Lower reporting of racial discrimination was associated with home ownership, remote residence and having relatively few Indigenous friends. These data indicate that racial discrimination is commonly experienced across a wide variety of settings, with public, legal and work settings identified as particularly salient. The observed relationships, while not necessarily causal, help to build a detailed picture of self-reported racial discrimination experienced by Indigenous people in contemporary Australia, providing important evidence to inform anti-racism policy.

Self-report of gingival problems and periodontitis in indigenous and non-indigenous populations in Chiapas, Mexico.

PubMed

García-Pérez, Álvaro; Borges-Yáñez, Socorro Aída; Jiménez-Corona, Aida; Jiménez-Corona, María Eugenia; Ponce-de-León, Samuel

2016-04-01

To estimate the prevalence of self-reported gingival and periodontal conditions and their association with smoking, oral hygiene, indigenous origin, diabetes and location (urban or rural) in indigenous and non-indigenous adults in Chiapas, Mexico. A cross-sectional study of 1,749 persons, ≥20 years of age, living in four rural and four urban marginal localities in Comitán (Chiapas, México). The variables investigated were: age; sex; indigenous origin; oral hygiene; halitosis; chewing ability; gingival conditions; periodontitis; smoking; alcoholism; diabetes; and location. Bivariate analysis and a logistic regression model were used to identify the association of periodontitis with the independent variables. In total, 762 (43.6%) indigenous and 987 (56.4%) non-indigenous persons were interviewed. Their mean age was 41 ± 14 years, 66.7% were women and 43.8% lived in rural locations. Gingival problems were reported by 68.5% and periodontitis by 8.7%. In total, 17.9% had used dental services during the previous year, 28.7% wore a removable partial or a complete dental prosthesis, 63.7% had lost at least one tooth, the prevalence of diabetes was 9.2% and the prevalence of smoking was 12.2%. The logistic regression model showed that age, diabetes and the interaction between rural location and indigenous origin were associated with the presence of periodontitis. Indigenous people living in rural areas are more likely to have periodontitis. It is necessary to promote oral health practices in indigenous and marginalised populations with a focus on community-oriented primary care. © 2016 FDI World Dental Federation.

Mortality trends in Australian Aboriginal peoples and New Zealand Māori.

PubMed

Phillips, Bronwen; Daniels, John; Woodward, Alistair; Blakely, Tony; Taylor, Richard; Morrell, Stephen

2017-01-01

The health status of Indigenous populations of Australia and New Zealand (NZ) Māori manifests as life expectancies substantially lower than the total population. Accurate assessment of time trends in mortality and life expectancy allows evaluation of progress in reduction of health inequalities compared to the national or non-Indigenous population. Age-specific mortality and life expectancy (at birth) (LE) for Indigenous populations (Australia from 1990 and NZ from 1950); and all Australia and non-Māori NZ (from 1890), males (M) and females (F), were obtained from published sources and national statistical agency reports. Period trends were assessed for credible estimates of Indigenous LE, and the LE gap compared to the total population for Australia, and non-Māori for NZ. Period trends in premature adult mortality, as cumulative probability of dying over 15-59 years, were assessed similarly. The relative contribution of differences in age-specific mortality to the LE gap between Indigenous and the all-Australia population, and the non-Māori NZ, was estimated for each country by sex for the most recent period: 2010-2012 for Australia, 2012-2014 for NZ. LE increased for all populations, although LE gaps between Indigenous and all Australia showed little change over time. LE gaps between NZ Māori and non-Māori increased significantly from the early 1980s to the mid-1990s, and since then have fallen again. Recent LE gaps in Australia (M 12.5; F 12.0 years in 2010-2012) were larger than in NZ (M 7.3; F 6.8 years in 2012-2014). Premature adult mortality (15-59 years) improved for all populations, but mortality ratios show little change since 2000, with Indigenous at 3½-4 times that of all Australians, and Māori 2-3 times that of non-Māori. Using decomposition analysis, the age interval contributing most strongly to differences in LE between Indigenous and all Australia was 35-59 years, but between Māori and non-Māori it was 60-74 years. In Australia and NZ, Indigenous LE and adult mortality are improving in absolute terms, but not relative to the entire or non-Indigenous populations, causing gaps in life expectancy to persist.

Muskrat Theories, Tobacco in the Streets, and Living Chicago as Indigenous Land

ERIC Educational Resources Information Center

Bang, Megan; Curley, Lawrence; Kessel, Adam; Marin, Ananda; Suzukovich, Eli S., III; Strack, George

2014-01-01

In this paper, we aim to contribute to ongoing work to uncover the ways in which settler colonialism is entrenched and reified in educational environments and explore lessons learned from an urban Indigenous land-based education project. In this project, we worked to re-center our perceptual habits in Indigenous cosmologies, or land-based…

Responding to Cultural Loss: Providing an Integral Indigenous Perspective of a "Kichwa Child"

ERIC Educational Resources Information Center

Maigua, Yolanda Terán; Gutierrez-Gomez, Cathy

2016-01-01

As Indigenous populations around the world migrate, urbanize, and come into contact with a variety of other cultures, they risk loss of their ancient languages and cultural practices. In 2007, the UN General Assembly adopted the Declaration on the Rights of Indigenous Peoples. In addition to the broader human rights like employment, security, and…

ICTs and Indigenous Languages as Agents for the Actualization of Millennium Development Goals in Nigeria

ERIC Educational Resources Information Center

Olise, Festus Prosper

2013-01-01

This paper advocates for the use of Information and Communication Technologies (ICTs) and indigenous languages for the actualization of Millennium Development Goals (MDGs) in Nigeria because both tools are capable of transforming the rural and urban populace. It explores the MDGs so as to unravel the ways ICTs and indigenous languages can…

A systematic review of evaluated suicide prevention programs targeting indigenous youth.

PubMed

Harlow, Alyssa F; Bohanna, India; Clough, Alan

2014-01-01

Indigenous young people have significantly higher suicide rates than their non-indigenous counterparts. There is a need for culturally appropriate and effective suicide prevention programs for this demographic. This review assesses suicide prevention programs that have been evaluated for indigenous youth in Australia, Canada, New Zealand, and the United States. The databases MEDLINE and PsycINFO were searched for publications on suicide prevention programs targeting indigenous youth that include reports on evaluations and outcomes. Program content, indigenous involvement, evaluation design, program implementation, and outcomes were assessed for each article. The search yielded 229 articles; 90 abstracts were assessed, and 11 articles describing nine programs were reviewed. Two Australian programs and seven American programs were included. Programs were culturally tailored, flexible, and incorporated multiple-levels of prevention. No randomized controlled trials were found, and many programs employed ad hoc evaluations, poor program description, and no process evaluation. Despite culturally appropriate content, the results of the review indicate that more controlled study designs using planned evaluations and valid outcome measures are needed in research on indigenous youth suicide prevention. Such changes may positively influence the future of research on indigenous youth suicide prevention as the outcomes and efficacy will be more reliable.

Utilisation of the healthcare system for authentic early experience placements.

PubMed

Hays, Richard B

2013-01-01

Authentic early experience in clinical contexts adds interest and relevance to basic medical education, and is regarded positively by both learners and teachers. However, with the recent expansion of medical education, the healthcare system appears close to reaching its capacity for student supervision. This study explores the utilisation of the healthcare system for early clinical placements. A secondary analysis was conducted of data from the Medical Schools Outcomes Database, collected from the 2010 annual questionnaire, focusing on the timing, duration and location of clinical placements during 2009 within the first half of basic medical education programs in Australia. Data was received for 67% of Australian medical students, reporting a total of 16 812 early clinical placements that occupied 97 319 days of supervised time in a wide variety of hospital, general practice and Indigenous health contexts, both urban and rural, across the Australian healthcare system. These early placements occupied about 16% of total clinical placement time for all students in all training years during 2009. The majority of these placements were for only a few hours or days; exceptions were longitudinal placements in regional and rural communities at a minority of schools. Early clinical placements may pose significant resource costs for placement providers, particularly supervision time and expertise. As medical education expands and the teaching capacity of the Australian healthcare system appears to reach its limits, it may be necessary to allocate placements according to their specific learning outcomes, prioritise more acute settings for more senior students, and increase capacity in less acute health and social care settings.

Gateway to understanding: Indigenous ecological activism and education in urban, rural, and remote contexts

NASA Astrophysics Data System (ADS)

Lowan-Trudeau, Gregory

2017-03-01

This article is a response to Kassam, Avery, and Ruelle's insights as presented in this forum on rural science education. Topics considered include troubling the urban/rural divide in the context of Indigenous knowledge and expanding to include the common Canadian notion of the "remote", a designation rooted in our national colonial narrative for the mythic, typically northern, wilderness sparsely inhabited by primarily Indigenous peoples. These concepts are further considered through exploration of Indigenous and allied ecological activism in Canada and the United States related to the proposed Northern Gateway and Keystone XL pipelines. This discussion concludes with an argument for the inherent pedagogical opportunity presented by such cases for contemporary educators to engage students in consideration of wicked problems, geographically rooted cognitive diversity, and the legal, economic, ecological, and cultural underpinnings and ramifications of the current events prominent in their home communities and abroad.

Nondiabetic retinal pathology - prevalence in diabetic retinopathy screening.

PubMed

Nielsen, Nathan; Jackson, Claire; Spurling, Geoffrey; Cranstoun, Peter

2011-07-01

To determine the prevalence of photographic signs of nondiabetic retinal pathology in Australian general practice patients with diabetes. Three hundred and seven patients with diabetes underwent retinal photography at two general practices, one of which was an indigenous health centre. The images were assessed for signs of pathology by an ophthalmologist. Signs of nondiabetic retinal pathology were detected in 31% of subjects with adequate photographs. Features suspicious of glaucoma were detected in 7.7% of subjects. Other abnormalities detected included signs of age related macular degeneration (1.9%), epiretinal membranes (2.4%), vascular pathology (9.6%), chorioretinal lesions (2.9%), and congenital disc anomalies (2.9%). Indigenous Australian patients were more likely to have signs of retinal pathology and glaucoma. Signs of nondiabetic retinal pathology were frequently encountered. In high risk groups, general practice based diabetic retinopathy screening may reduce the incidence of preventable visual impairment, beyond the benefits of detection of diabetic retinopathy alone.

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 children with CI and reduced visual information processing given the potential effect of these conditions on school performance.

The association between C-reactive protein levels and the risk for chronic kidney disease hospitalizations in adults of a remote Indigenous Australian community - A prospective cohort study.

PubMed

Arnold, Luke W; Hoy, Wendy E; Wang, Zhiqiang

2017-09-01

Indigenous Australians are significantly burdened by chronic kidney disease (CKD). Elevated levels of C-reactive protein (CRP) have been associated with diabetes and cardiovascular incidence in previous studies. Elevated CRP has been associated with albuminuria and reduced eGFR in cross-sectional studies. This study investigated the long-term predictive association between CRP measured at a baseline exam and the incidence of a CKD-related hospitalization. Health screening examinations were conducted in individuals of a remote indigenous Australian community between 1992 and 1998. The risk of subsequent CKD hospitalisations, documented through Northern Territory hospital records up to 2010, was estimated with Cox proportional hazard models in people aged over 18 years at the baseline screen and who had albumin-creatinine ratios (ACRs) less than 34g/mol. 546 participants were eligible for our study. Individuals in the highest CRP tertile at baseline had increased levels of traditional cardiovascular risk factors. They also had almost 4 times the risk of a CKD-related hospitalisation compared with participants in the lowest CRP tertile (HR=3.91, 95%CI 1.01-15.20, P=0.049) after adjustment for potential confounding factors. Participants with CRP concentrations greater than 3mg/L had almost 3 times the risk of CKD hospitalisations than those ≤3mg/L (HR=2.84, 95%CI 1.00-8.00, P=0.049). Furthermore, risk of CKD hospitalisations increased 34% per doubling of baseline CRP (HR=1.34, 95%CI 1.04-1.74, P=0.024). In individuals in this remote indigenous community without overt albuminuria at baseline the risk for incident CKD related hospitalisations was predicted by elevated C-reactive protein levels almost a decade earlier. Further research is needed to understand the roles that CRP and systemic inflammation play in CKD risk. © 2016 Asian Pacific Society of Nephrology.

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 and acceptable means of lowering symptoms for mental health disorders in remote communities is via appropriately designed self-help apps. Trial registration number ACTRN12613000104752. PMID:28132007

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.

Alcohol, metabolic risk and elevated serum gamma-glutamyl transferase (GGT) in Indigenous Australians.

PubMed

Haren, Matthew T; Li, Ming; Petkov, John; McDermott, Robyn A

2010-08-03

The interaction between overweight/obesity and alcohol intake on liver enzyme concentrations have been demonstrated. No studies have yet examined the interaction between metabolic syndrome or multiple metabolic risk factors and alcohol intake on liver enzymes. The aim of this study was to examine if alcohol consumption modifies the effect of metabolic risk on elevated serum GGT in Indigenous Australians. Data were from N = 2609 Indigenous Australians who participated in a health screening program in rural far north Queensland in 1999-2000 (44.5% response rate). The individual and interactive effects of metabolic risk and alcohol drinking on elevated serum GGT concentrations (>or=50 U/L) were analyzed using logistic regression. Overall, 26% of the population had GGT>or=50 U/L. Elevated GGT was associated with alcohol drinking (moderate drinking: OR 2.3 [95%CI 1.6 - 3.2]; risky drinking: OR 6.0 [4.4 - 8.2]), and with abdominal obesity (OR 3.7 [2.5 - 5.6]), adverse metabolic risk cluster profile (OR 3.4 [2.6 - 4.3]) and metabolic syndrome (OR 2.7 [2.1 - 3.5]) after adjustment for age, sex, ethnicity, smoking, physical activity and BMI. The associations of obesity and metabolic syndrome with elevated GGT were similar across alcohol drinking strata, but the association of an adverse metabolic risk cluster profile with elevated GGT was larger in risky drinkers (OR 4.9 [3.7 - 6.7]) than in moderate drinkers (OR 2.8 [1.6 - 4.9]) and abstainers (OR 1.6 [0.9 - 2.8]). In this Indigenous population, an adverse metabolic profile conferred three times the risk of elevated GGT in risky drinkers compared with abstainers, independent of sex and ethnicity. Community interventions need to target both determinants of the population's metabolic status and alcohol consumption to reduce the risk of elevated GGT.

Alcohol, metabolic risk and elevated serum gamma-glutamyl transferase (GGT) in Indigenous Australians

PubMed Central

2010-01-01

Background The interaction between overweight/obesity and alcohol intake on liver enzyme concentrations have been demonstrated. No studies have yet examined the interaction between metabolic syndrome or multiple metabolic risk factors and alcohol intake on liver enzymes. The aim of this study was to examine if alcohol consumption modifies the effect of metabolic risk on elevated serum GGT in Indigenous Australians. Methods Data were from N = 2609 Indigenous Australians who participated in a health screening program in rural far north Queensland in 1999-2000 (44.5% response rate). The individual and interactive effects of metabolic risk and alcohol drinking on elevated serum GGT concentrations (≥50 U/L) were analyzed using logistic regression. Results Overall, 26% of the population had GGT≥50 U/L. Elevated GGT was associated with alcohol drinking (moderate drinking: OR 2.3 [95%CI 1.6 - 3.2]; risky drinking: OR 6.0 [4.4 - 8.2]), and with abdominal obesity (OR 3.7 [2.5 - 5.6]), adverse metabolic risk cluster profile (OR 3.4 [2.6 - 4.3]) and metabolic syndrome (OR 2.7 [2.1 - 3.5]) after adjustment for age, sex, ethnicity, smoking, physical activity and BMI. The associations of obesity and metabolic syndrome with elevated GGT were similar across alcohol drinking strata, but the association of an adverse metabolic risk cluster profile with elevated GGT was larger in risky drinkers (OR 4.9 [3.7 - 6.7]) than in moderate drinkers (OR 2.8 [1.6 - 4.9]) and abstainers (OR 1.6 [0.9 - 2.8]). Conclusions In this Indigenous population, an adverse metabolic profile conferred three times the risk of elevated GGT in risky drinkers compared with abstainers, independent of sex and ethnicity. Community interventions need to target both determinants of the population's metabolic status and alcohol consumption to reduce the risk of elevated GGT. PMID:20682033