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Objective: The purpose of this study was to explore the benefits of a partnership between a university dental school and a Community Controlled Health Service, specifically in relation to improving the oral health of an underserved rural Indigenous community. We sought community opinions on health and social outcomes arising from the service provided by the dental student clinical outplacement. Setting: In Dalby, Queensland. Participants: In total, 38 participants in five focus groups were representative of local Indigenous community Elders, community health support group members and management and staff. Design: A descriptive qualitative study employing semi‐structured audio‐recorded focus group discussions conducted with purposefully selected Indigenous community groups to explore participant views and experience of the partnership model. Qualitative data were analysed using thematic content analysis. Results: The Indigenous community representatives expressed positive benefit in both their general and oral health awareness, in improved access to dental care provided in their own safe space, while they were pleased to assist with students' learning. They viewed the partnership as mutually beneficial. Suggestions for enhancement of the oral health service were also offered. Conclusion: This partnership between a university and a Community Controlled Health Service provides sustainable positive social and health benefits for the targeted Indigenous community and for the wider local population, while simultaneously providing enhanced educational benefits for students on clinical outplacement. Translation and uptake of this successful model of care would benefit both underserved communities and dental and other health care professional educators worldwide. [ABSTRACT FROM AUTHOR]

Psychiatry and anthropology have a long relationship, and it is worth examining aspects of how that relation is carried over into the developing field of Global Mental Health (GMH). One place at which the two disciplines overlap significantly is in addressing religious phenomena and ritual performance in relation to mental health, and one of the greatest challenges for GMH is how productively to take into account forms of indigenous healing based on religion and ritual. In this paper I compare recent texts in GMH written from the standpoint of psychiatry and anthropology, observing that the psychiatric texts emphasize evidence-based determination of treatment efficacy, while the anthropological texts emphasize ethnographic understanding of treatment experience. Reconciling these two emphases constitutes a challenge to the field, attending to contextual variations in treatment events, illness episodes, phenomenological factors both endogenous and intersubjective, and sociopolitical factors both interpersonal and structural. In addressing this challenge, I propose an approach to therapeutic process that on the empirical level can facilitate comparison across the diversity of healing forms, and on the conceptual level can constitute a bridge between efficacy and experience. This approach is predicated on a rhetorical model of therapeutic process including components of disposition, experience of the sacred, elaboration of alternatives, and actualization of change that highlights experiential specificity and incremental change. Deploying this model can help meet the challenge of understanding efficacy and experience in indigenous healing, and prepare the ground for the further challenge of how practitioners of GMH relate to and interact with such forms of healing. [ABSTRACT FROM AUTHOR]

The current paper describes the shared ideas around feminism and social work profession. Based on the theoretical discourses, it attempts to contextualise the practice framework for feminist social work. It seeks to present few efficacious initiatives in the form of case studies from Indian grassroots and highlight various success stories based on social work practice from a feminist perspective. The central idea of the paper is to explore learning insights from the field based on successful practice based models and how these can be amalgamated to develop an indigenous framework for the practice of feminist social work in India. [ABSTRACT FROM AUTHOR]

Vaccines are temperature‐sensitive, and they may lose effectiveness without correct storage. Research in remote Australia raised questions regarding the integrity of the vaccine cold chain to Aboriginal communities and prompted the development of a video resource, Vaccine Story, to raise awareness of maintaining the cold chain. This study describes the development and evaluation of the Vaccine Story video. Local engagement helped to refine and produce the video. Ethics approval was gained from the Menzies School of Health Research Human Ethics Committee (20–3807) and the Central Australian Human Ethics Committee (17–2869) in 2020. The evaluation was considered low risk to all participants. An online anonymous survey tested the appropriateness and effectiveness of the Vaccine Story video to enhance knowledge and awareness of risks to the vaccine cold chain and the potential implementation of the Vaccine Story video. Diverse health professionals and other staff (n = 83) completed the survey. Responses highlighted a lack of training around the packing and transport of vaccines, particularly for non‐clinical support staff. Respondents stated the health messaging in the Vaccine Story video was effective. Over half of respondents (52%) recommend the use of the video as a training tool. The Vaccine Story video addresses some concerns regarding vaccine transportation and storage in remote Aboriginal communities through strengthening understanding of the importance of cold chain. [ABSTRACT FROM AUTHOR]

Objective: To assess the observed pain behaviours of Aboriginal residents with cognitive impairment in aged care facilities and compare these results with a matched national sample of non‐Aboriginal residents. Methods: Observed pain behaviours of Aboriginal residents (N = 87) with cognitive impairment in aged care facilities across the Northern Territory of Australia were assessed using PainChek® Adult and compared with data from a matched national sample of non‐Aboriginal residents (N = 420). Pain scores were derived from inbuilt automated facial recognition and analysis software plus a series of digital checklists requiring manual input by care staff. Results: The median total pain score for the Aboriginal residents was 2 (IQR 1–4) and for the matched external residents was 3 (IQR 2–5). In a multivariable negative binomial regression model, this difference in total pain score was statistically significant (p < 0.001). The pain score derived from the automated facial recognition and analysis component of the PainChek® Adult app was not statistically different between the two groups when adjusted for multiple observations and context of observation (odds ratio = 1.06, 95% confidence interval 0.97–1.16, p = 0.169). Conclusions: We found under‐reporting of observed pain signs and behaviours for Aboriginal aged care residents by assessors. Further training in the assessment of pain in Aboriginal and Torres Strait Islander aged care residents may be necessary and a continuing shift in clinical practice to using technology and point‐of‐care assessment. [ABSTRACT FROM AUTHOR]

Background: An epidemic of type 2 diabetes in remote Aboriginal people in Central Australia, contributes to high rates of morbidity and mortality. Remote non-Aboriginal Health Care Workers (HCW) and the Aboriginal people they serve inhabit a complex cultural interface. This study aimed to recognise racial microaggressions in the everyday discourse of HCWs. It proposes a model of interculturality for remote HCWs that avoids racialisation and essentialising of Aboriginal people's identities and cultures. Methods: Semi-structured in-depth interviews were undertaken with HCWs from two Primary Health Care services in very remote Central Australia. Fourteen interviews were analysed from seven Remote Area Nurse, five Remote Medical Practitioners and two Aboriginal Health Practitioners. Discourse analysis was employed to explore racial microaggressions and power relations. NVivo software assisted in the thematic organisation of microaggressions according to a predefined taxonomy. Results: Seven microaggression themes were identified - racial categorization and sameness, assumptions about intelligence and competence, false colour blindness, criminality and dangerousness, reverse racism and hostility, treatment as second-class citizens and pathologizing culture. A model of interculturality for remote HCWs was based on concepts of the third space, deCentred hybrid identities and small culture formation on-the-go combined with a duty-conscious ethic, cultural safety and humility. Conclusions: Racial microaggressions are common in the discourse of remote HCWs. The model of interculturality proposed could improve intercultural communication and relationships between HCWs and Aboriginal people. This improved engagement is required to address the current diabetes epidemic in Central Australia. [ABSTRACT FROM AUTHOR]

Background: The continued use of a deficit discourse when researching Aboriginal and Torres Strait Islander Peoples of Australia is problematic. Understanding and challenging the researchers position and the power of the words they use is important. It will ensure we do not persist in framing Aboriginal and Torres Strait Islander People as a problem to be solved. Design: Indigenist review of the evidence of Aboriginal young people's health and well‐being. Methods: This review was conducted using an Indigenist approach to identify texts which amplified the voices of Aboriginal young people of Australia and presents a narrative summary of their accounts. This review is reported in line with the PRISMA‐ScR reporting guidelines. Results: Culture and connection are critical components of Aboriginal young people's health and well‐being. Aboriginal young people describe feeling of powerlessness to influence health and well‐being of their community, and they understood the risks they and their communities faced. Young people identified the importance of connection to culture, community and Elders as crucial to their social and emotional well‐being. Conclusion: By harnessing an Indigenous analysis, we were able to reveal a strong counter narrative of strength and resilience within their historical, social, and political contexts through the storied accounts of Aboriginal young people. Relevance to clinical practice: Most of the currently available evidence about Aboriginal health and well‐being is immersed in deficit discourse. Literature reviews being the foundation of research and informing nursing practice, we call for a purposeful shift towards the adoption of an Indigenist strength‐based approach which emphasises the strength and resilience of Aboriginal young people. [ABSTRACT FROM AUTHOR]

Remote-living and Indigenous Australians can experience menstrual health and hygiene challenges. The topic is not often openly discussed as it is considered private 'women's business'. We were invited into a remote Indigenous town and community to discuss the lived experience of menstruation with female students as well as clinical, educational and community workers. Our yarning circles and interviews collated 16 barriers in four clusters: structural living situation; knowledge, culture and behavior; discomfort and public life; and finances. Targeted efforts by relevant organizations, including schools and government agencies, were identified by participants to better support menstrual health and hygiene without associated pain, ranging moods and a sense of shame. [ABSTRACT FROM AUTHOR]

Copyright of Saúde Coletiva is the property of MPM Comunicacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Health & Society is the property of Instituto de Ensino e Pesquisa Periodicojs and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Lack of access, late engagement and limited referral for palliative care remain critical issues in supporting Indigenous Australians with life limiting illness. Aim: To explore the experiences and perspectives of Indigenous and non-Indigenous health professionals regarding the provision of palliative care for Indigenous people with advanced disease. Design: Qualitative study involving semi-structured focus groups/interviews with analysis following an inductive thematic approach. Setting/participants: A purposive sample (n = 54) of medical, nursing, allied health and Indigenous Hospital Liaison Officers engaged in caring for Indigenous patients at a metropolitan teaching hospital in Australia. Results: Four overarching themes were identified regarding provision of palliative care for Indigenous patients. These were (1) the intersection of cultures – Indigenous peoples, health and palliative care, (2) bridging the cultural divide: the integral role of Indigenous Hospital Liaison Officers, (3) health professionals devolve their responsibility to provide culturally appropriate care and (4) building towards a more holistic, culturally aware provision of palliative care. Conclusions: For many Indigenous people, the health system may be experienced as inflexible, narrowly focused and even prejudiced and traumatising. For Indigenous patients at the end of life, these challenges are heightened. The Indigenous Hospital Liaison Officers, working at the intersections of these two cultures, are key to negotiating such challenges as they seek opportunities to facilitate communication and understanding between firmly held cultural needs. [ABSTRACT FROM AUTHOR]

Summary: Few tools and mechanisms exist to assist the reorientation of health services, especially in the Indigenous Australian health context; where improving health status and life expectancy is a priority. We developed a health promotion systems assessment tool (HPSAT) to provide health services with the information and support they need to drive health system change. Tool development occurred using a participatory, iterative approach that included a literature review, expert input by Indigenous and non-Indigenous stakeholders and annual group workshops in four Indigenous Australian primary health care (PHC) services. Four health system components: (i) organizational environment; (ii) service delivery systems; (iii) information systems and decision support; and (iv) adaptability and integration, form the framework of the tool. A scoring system monitors system change over time. The HPSAT provides a constructive framework to support health services to collectively assess and support reorientation in Indigenous Australian PHC services. Participation of key stakeholders with an intimate knowledge about the local context was pivotal in developing a user-friendly and fit-for-purpose tool. Maximum benefits of the tool are likely to be gained when used as part of a continuous quality improvement intervention. Lay Summary: Primary health care services are important providers of health promotion approaches. In Australia, the health status and life expectancy of Indigenous peoples is much lower than that of the general population. Meeting Indigenous peoples' acute and chronic care needs can influence PHC service delivery models. Few tools and mechanism are available to support the reorientation of Indigenous Australian PHC services from an acute and chronic care model to a more comprehensive model, with greater emphasis on health promotion and prevention. This article describes the development and trialling of a tool providing Indigenous Australian PHC services with the information and support they need to reorient their health systems towards health promotion. The health promotion systems assessment tool provides a useful framework to facilitate collective appraisal of service delivery models and to identify opportunities for health system reorientation in Indigenous Australian PHC context. The tool has the potential to benefit many other health services seeking to reorient their systems towards health promotion. [ABSTRACT FROM AUTHOR]

Exploration into disproportionate representation of marginalized populations in child welfare traditionally focuses on the ratio of child welfare involved youth rather than the disparities in needs, trajectories, and experiences while in foster care. Little is known about how American Indian and Alaskan Native children fare in foster care and no prior research using national data has used the individual as the unit of analysis. This study explores the experiences of Indigenous youth in foster care through their socio-demographic, physical and mental health, and foster care/placement factors. Differences in all domains were found between Indigenous and Non-Indigenous youth. [ABSTRACT FROM AUTHOR]

A personal narrative is presented which explores the authors experience of being people known as the original descendants, traditional right holders, and custodians.

Settler colonisation continues to cause much damage across the globe. It has particularly impacted negatively on Indigenous peoples' health and wellbeing causing great inequity. Health professional education is a critical vehicle to assist in addressing this; however, non‐Indigenous educators often feel unprepared and lack skill in this regard. In this qualitative study, 20 non‐Indigenous nursing, physiotherapy and occupational therapy educators in Australia were interviewed about their experiences and perspectives of teaching Indigenous health. Findings from the inductive thematic analysis suggest educators require skill development to: identify their discomfort in teaching cultural safety; contextualise the sources of this discomfort and; reflect on how this understanding can improve their teaching. Additionally, educators require professional training to become practitioners of cultural humility and to be facilitators and colearners (rather than experts) of the Aboriginal‐led curriculum. Of relevance to this is educator training in how to decentre non‐Indigenous needs and perspectives. Educators can also renew their teaching practices by understanding what a dominant settler paradigm is, identifying if this is problematically present in their teaching and knowing how to remedy this. Crucial to improved cultural safety teaching is institutional support, which includes Indigenous leadership, institutional commitment, relevant policies, and well‐designed professional development. [ABSTRACT FROM AUTHOR]

Storytelling was, is and will be a vital part of the ways in which Indigenous Peoples create and maintain connection with each other, our ancestors and our relations. Storytelling and talking story create generative spaces and connections that emphasise and reiterate the importance of stories of strength, resilience, healing, survival and thriving, as well as and opposed to only stories of kaumaha, taumaha and trauma. Further, these interactions create reciprocal spaces that often ensure ethical, reciprocal communication and relationships, and (re)centre our Indigenous ways of conceptualising and enacting our sovereignty and self-determination. In this paper, we talk story with each other to share experiences of storytelling and health. As Indigenous wāhine, Kānaka Māoli and Māori, we Tautitotito and Kama‘ilio with each other and explore how we utilise storytelling within our practice as Indigenous researchers and educators and how this relates to Indigenous health. This paper explores our context and how we shape these communication land and seascapes to enhance and create ethical, reciprocal connections and seek restoration within the Westernised institutional spaces within which we occupy. [ABSTRACT FROM AUTHOR]

Grounded in relational worldviews and ways of being, Indigenous health on Turtle Island once thrived. However, colonization disrupted and sought to delegitimize Indigenous relationships, having devastating impacts on Indigenous health and contributing to persistent Indigenous health disparities. Making matters worse, Indigenous Peoples face barriers to engagement in mainstream Canadian healthcare, including racism and the marginalization of Indigenous relational conceptions of health and ways of caring. Using an Indigenous methodology, we explored Kanyen'kehá:ka (Mohawk) relationality between community members and community-based healthcare providers (n = 25), and how these ways of relating shaped engagement in community-based care. Our analysis identified three key themes: in Kenhté:ke (Tyendinaga) the concept of health goes beyond western definition and is broadly defined and relational; connectedness and shared experiences are foundational to Kenhté:ke identity and ways of caring; and relationships that reflect community connection foster more engagement in healthcare than otherwise in western care settings. These findings have critical implications for western norms of healthcare professional training and practice and the need to include Indigenous relational ways of caring and conceptions of health. • Kanyen'kehá:ka conceptions of health are wholistic and relational. • Connection is foundational to Kenhté:ke identity and ways of caring. • In Kenhté:ke, connection facilitates engagement in community-based healthcare. • Community connection also has the potential to facilitate engagement in self-care. [ABSTRACT FROM AUTHOR]

This study investigated the Australian general public's views on trade-offs between reducing health inequalities and improving total health. It elicited relative equity weights, comparing inequalities in life expectancy at birth across three equity-relevant dimensions: income (comparing poorest versus richest fifth), ethnic (comparing Indigenous versus non-Indigenous), and geographic (comparing rural/remote versus major cities). A benefit trade-off exercise was administered via online survey to a sample of Australian adults (n = 3105) using quota sampling to ensure population representativeness across key demographic variables (age, gender, state of residence, household income and education level). When comparing income groups, 88% (95% Confidence Interval (CI): 82%–92%) of the respondents were health inequality averse, with 42% (95% CI: 34%–51%) demonstrating extreme inequality aversion. When considering Indigenous status, 85% (95% CI: 79%–90%) showed inequality aversion, and 40% (95% CI: 31%–49%) displayed extreme aversion. Lastly, looking at different geographic locations, 74% (95% CI: 66%–80%) of the respondents were inequality averse, with 37% (95% CI: 29%–46%) showing extreme inequality aversion. The relative equity weights were calculated, allowing for varying baseline inequalities in life expectancy – proportional gaps of 10.8%, 5.1% and 6.3%, respectively. The results imply that the public is willing to weight incremental health gains to the poorest fifth five times more than to the richest fifth, six times more for Indigenous versus non-Indigenous, and four times more for people living in rural and remote areas compared to major cities. • Inequalities between Indigenous, income, and geographic groups are of concern. • The majority is willing to sacrifice total health gains to reduce health inequality. • Inequality aversion parameters imply prioritizing health gains to the worst-off. • Results can facilitate the use of Distributional Cost-Effectiveness Analysis. [ABSTRACT FROM AUTHOR]

Objective: to identify in the literature the nursing care actions for the health of indigenous populations. Method: this is a scoping review, whose search was conducted in September 2022 in the following databases: Nursing Database (BDENF), CAPES Theses and Dissertations Catalog, Google Scholar, Latin American and Caribbean Literature on Health Sciences (LILACS), Pan American Health Organization (PAHO), National Library of Medicine and National Institutes of Health (PUBMED) and Scientific Electronic Library Online (SCIELO). The results were evaluated by summarizing the selected articles. Results: the main actions directed to the indigenous population were nursing consultations and health promotion and prevention activities. The main difficulty encountered in relation to indigenous peoples is the language barrier. Conclusion: the nursing team encounters difficulties, such as: the difficult location of the villages; high work overload due to the lack of medical professionals; language barrier; and inadequate conditions.

The Choctaw Nation of Oklahoma's Historic Preservation Department (HPD) and the Center for Indigenous Health Equity (CIIHE) are partnering to implement and evaluate food sovereignty interventions to better understand the potential impact of such programs on individual and community health. The HPD's Growing Hope Program is a food sovereignty initiative that aims to restore traditional Choctaw gardens, which were once a physical, social, and cultural center of Choctaw life. The program combines heirloom seeds and the stories of their origins, gardening education and technical assistance, cooking classes, and a Choctaw youth internship program to support intergenerational knowledge and the restoration of culture and food security. Since its inception the program has provided Choctaw families with ancestral Choctaw cultivar seeds and provided the technical assistance to support the growing of sustainable, healthy, traditional Choctaw foods. [ABSTRACT FROM AUTHOR]

Aboriginal participatory action research (APAR) has an ethical focus that corrects the imbalances of colonisation through participation and shared decision-making to position people, place, and intention at the centre of research. APAR supports researchers to respond to the community's local rhythms and culture. APAR supports researchers to respond to the community's local rhythms and culture. First Nations scholars and their allies do this in a way that decolonises mainstream approaches in research to disrupt its cherished ideals and endeavours. How these knowledges are co-created and translated is also critically scrutinised. We are a team of intercultural researchers working with community and mainstream health service providers to improve service access, responsiveness, and Aboriginal client outcomes. Our article begins with an overview of the APAR literature and pays homage to the decolonising scholarship that champions Aboriginal ways of knowing, being, and doing. We present a research program where Aboriginal Elders, as cultural guides, hold the research through storying and cultural experiences that have deepened relationships between services and the local Aboriginal community. We conclude with implications of a community-led engagement framework underpinned by a relational methodology that reflects the nuances of knowledge translation through a co-creation of new knowledge and knowledge exchange. [ABSTRACT FROM AUTHOR]

The social participation of older adults occupies a central position in international discourse regarding ageing, the ecological model makes it possible to examine and assess the different factors that influence the understanding of what encourages social participation by older adults. This study used the ecological model to analyse how personal, community and environmental factors are related to satisfaction with social participation among Chilean older adults, a majority of whom are indigenous, living in rural areas (n = 800). The results confirmed that satisfaction with social participation was related to personal factors (feelings of depression, functioning into basic activities of daily living (ADL) and autonomy), community factors (perceived social support from social group) and environmental factors (accessibility of physical setting within the village). Our findings confirmed a high level of social participation among indigenous adults, with rural and indigenous surroundings appearing to be a factor that protects and promotes social integration. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Occupational Therapy is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Enfermagem e Atenção à Saúde (REAS) is the property of Revista de Enfermagem e Atencao a Saude - Reas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims: To focus on the needs, challenges and opportunities to improve access to cardiac rehabilitation (CR) (Heart: Road to health [HRH]) for Aboriginal and Torres Strait Islander peoples in rural and remote (R&R) areas of North Queensland. Context: It is known that there is insufficient access to HRH for Aboriginal and Torres Strait Islander peoples in R&R areas of NQ, who have the highest rates of heart disease and socioeconomic disadvantage mainly due to poor social determinants of health. However, at least in part due to the impact of colonialism and predominantly western medicalised approach to health care, few gains have been made. Approach: This commentary draws on recent research and literature and reflects on cultural issues that impact on improving access to an HRH for Aboriginal and Torres Strait Islander peoples in R&R areas. The underutilisation of the skills of Aboriginal and Torres Strait Islander Health Workers (ATSIHW) and a lack of a defined process to ensure access to culturally responsive HRH are discussed. Finally, a way forward is proposed that includes the development of policies, pathways and guidelines to ensure that appropriate support is available in the client's home community. Conclusion: It is proposed that culturally responsive, accessible and effective HRH is achievable through the reorientation of current health systems that include a continuous client‐centred pathway from hospital to home. In this model, ATSIHW will take a lead or partnership role in which their clinical, cultural brokerage and health promotion skills are fully utilised. [ABSTRACT FROM AUTHOR]

In this essay, I examine the relationality between life and water in the context of its intercorporeal manifestations. Drawing on key aspects of Merleau-Pontian phenomenology, my concern is to reflect on water's enfleshment of life and its complex ecologies of intercorporeity. These Merleau-Pontian key aspects, I note, are in close dialogue with a number of Indigenous cosmo-epistemologies that envisage the world as constituted by profound ecologies of intercorporeal relationality. The loci of my analysis are the Sonoran Desert and the lands of the Tohono O'odham people, all situated within the ongoing violent relations of power unleashed by the forces of settler colonialism, including the partitioning of Indigenous nations by the Mexico–US border, the ecological devastation left in the wake of the construction of the Trump border wall and the increasingly fraught situation of undocumented migrants attempting to cross the US border. The bodies of water that I discuss in this essay disclose the cycles of life and death that turn on the presence and absence of water. These cycles are increasingly ensnared in aquapolitical regimes of governmentality that, in settler colonial contexts, unleash lethal effects that kill both bodies of water and the entities that depend on them for life. [ABSTRACT FROM AUTHOR]

Objective: Using a strength-based framework, we aimed to describe and compare First Nations patients who completed care in an ED to those who took their own leave. Methods: Routinely collected adult patient data from a metropolitan ED collected over a 5-year period were analysed. Results: A total of 6446 presentations of First Nations patients occurred from 2016 to 2020, constituting 3% of ED presentations. Of these, 5589 (87%) patients waited to be seen and 857 (13%) took their own leave. Among patients who took their own leave, 624 (73%) left not seen and 233 (27%) left at own risk after starting treatment. Patients who were assigned a triage category of 4-5 were significantly more likely to take their own leave (adjusted odds ratio [OR] 3.17, 95% confidence interval [CI] 2.67-3.77, P < 0.001). Patients were significantly less likely to take their own leave if they were >60 years (adjusted OR 0.69, 95% CI 1.01-1.36, P = 0.014) and had private health insurance (adjusted OR 0.61, 95% CI 0.45-0.84, P < 0.001). Patients were more likely to leave if they were women (adjusted OR 1.17, 95% CI 1.01-1.36, P = 0.04), had an unknown housing status (adjusted OR 1.76, 95% CI 1.44-2.15, P < 0.001), were homeless (adjusted OR 1.50, 95% CI 1.22-1.93, P < 0.001) or had a safety alert (adjusted OR 1.60, 95% CI 1.35-1.90, P < 0.001). Conclusion: A lower triage category is a strong predictor of First Nations patients taking their own leave. It has been documented that First Nations patients are under-triaged. One proposed intervention in the metropolitan setting is to introduce practices which expediate the care of First Nations patients. Further qualitative studies with First Nations patients should be undertaken to determine successful approaches to create equitable access to emergency healthcare for this population. [ABSTRACT FROM AUTHOR]

Objective: The Composite International Diagnostic Interview 3.0 is a standardised diagnostic interview commonly used in population-based mental health surveys, but has not been used in community-residing Indigenous Australians. This paper seeks to determine whether the Composite International Diagnostic Interview 3.0 can produce valid diagnostic information when compared with a diagnostic interview in an urban Indigenous Australian sample. Method: This research was conducted over 10 weeks with adult Indigenous clients of two participating Aboriginal Medical Services in South-East Queensland. Using a cross-sectional, repeated-measures design, participants were administered the Composite International Diagnostic Interview 3.0 by an Indigenous interviewer and within 2 weeks attended a second appointment with an Indigenous clinical psychologist, who produced a diagnostic summary. The Composite International Diagnostic Interview 3.0 diagnoses were compared with the diagnostic summaries and clinical concordance between the two measures was calculated. Results: The diagnostic accuracy of the Composite International Diagnostic Interview 3.0 differed by module. The Post-traumatic Stress Disorder and Major Depression modules had good utility in diagnosing post-traumatic stress disorder and major depressive episodes, respectively; however, the Mania module that provides diagnoses of bipolar disorder was found to be unsuitable for this population. Although there were no identified contraindications for the use of the Generalised Anxiety and Alcohol Use Disorder modules, further research on the diagnostic accuracy of these modules is warranted. Conclusions: The Composite International Diagnostic Interview 3.0 can accurately diagnose some common mental disorders in an Indigenous Australian population, but was found to be unsuitable for others. Given these findings, care should be taken when using the Composite International Diagnostic Interview 3.0 in epidemiological prevalence studies with Indigenous Australian populations. [ABSTRACT FROM AUTHOR]

This report describes one community health center's response to COVID-19 by integrating Pacific Island (PI) values—which prioritize dignity, agency, and ancestral philosophies—within the context of deep relationship building. We share impacts and insights with the hope this work will resonate with other PI and Indigenous communities. [ABSTRACT FROM AUTHOR]

Globally, Indigenous Peoples experience pervasive oral health inequities due to a complex interplay of social determinants of health including the sustained effects of colonisation, racism, and intergenerational disruption to Indigenous communities. This qualitative systematic review aimed to synthesise evidence related to facilitators and challenges that affect the ability of global Indigenous communities to maintain oral health. Two independent reviewers searched PubMed, SCOPUS, Web of Science, and Embase. Qualitative studies including illustrations from Indigenous Peoples regarding facilitators and challenges to oral health maintenance were considered. Included articles were critically appraised. The search identified 4,247 articles eligible for inclusion; 22 articles were included. Challenges and facilitators were synthesised across child, carer, community, and service levels during the meta-aggregation. The prioritisation of integrated oral health services, programs, and research that encompass multiple factors at various levels of influence are needed to strengthen the oral health of Indigenous communities. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented which discusses various reports within the issue on topics including opinion of Indigenous women's worldview of food-related research in Canada, relationship between social determinants and physical activity among Indigenous adults in Canada, and role of genetics and lifestyle changes on metabolic health in Inuit in Greenland, since colonization.

This study aimed to explain the spousal role in the lives of Iranian middle-aged women. This qualitative study was conducted in Iran from July 2018 to November 2019. The participants included 25 middle-aged women selected through purposive sampling. The data were collected using semi-structured interviews and analyzed through conventional content analysis. The theme of reviving the spousal role was explained by three main categories of paying more attention to the spouse's needs, enhancing feminine charms, and maintaining married life. A deeper understanding of the middle-aged women's spousal role may help health-care personnel to develop indigenous marriage-enrichment programs for middle-aged individuals. [ABSTRACT FROM AUTHOR]

When health systems are overwhelmed during a public health crisis regular care is often delayed and deaths result from lapses in routine care. Indigenous primary healthcare (PHC) can include a range of programmes that incorporate treatment and management, prevention and health promotion, as well as addressing the social determinants of health (SDoH) and a focus on redressing health inequities. We examined how Indigenous PHC mobilises and innovates during a public health crisis to address patient needs and the broader SDoH. A rapid review methodology conducted from January 2021 – March 2021 was purposefully chosen given the urgency with COVID-19, to understand the role of Indigenous PHC during a public health crisis. Our review identified five main themes that highlight the role of Indigenous PHC during a public health crisis: (1) development of culturally appropriate communication and education materials about vaccinations, infection prevention, and safety; (2) Indigenous-led approaches for the prevention of infection and promotion of health; (3) strengthening intergovernmental and interagency collaboration; (4) maintaining care continuity; and (5) addressing the SDoH. The findings highlight important considerations for mobilising Indigenous PHC services to meet the needs of Indigenous patients during a public health crisis such as the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Recently in Australia, access to culturally safe developmental practices for Aboriginal and Torres Strait Islander families has been enhanced by the availability of a culturally appropriate developmental screening tool, the Ages and Stages Questionnaire – Talking about Raising Aboriginal Kids (ASQ‐TRAK). This paper aims (i) to describe the uptake of the ASQ‐TRAK developmental screening tool in Aboriginal Community Controlled Organizations and mainstream services in Australia and (ii) to explore the extent to which organizations using the ASQ‐TRAK have engaged training for staff. Methods: A retrospective review of ASQ‐TRAK sales and training records from January 2015 to May 2020 to determine the ASQ‐TRAK distribution by jurisdiction and service type and the number of services that have engaged training. Results: Five hundred ASQ‐TRAK kits have been distributed across 77 agencies. Of those, 100 kits (20%) have been purchased by Aboriginal Community Controlled Organizations. Most have been distributed in the Northern Territory (NT) (178, 36%), Western Australia (165, 33%) and South Australia (64, 13%). Of the 15 ASQ‐TRAK training workshops, nine have been in the NT. Of the 196 practitioners trained, 25 were identified as facilitators for their organization. Conclusion: Despite substantive research translation across Australia, with evidence of its acceptability in different contexts, most Aboriginal Community Controlled Organizations have not yet accessed the ASQ‐TRAK, and most organizations have not participated in training. There is an imperative to progress knowledge translation to improve quality and accessibility of culturally appropriate developmental care. Adequately resourced ASQ‐TRAK implementation support is needed to ensure sustainable implementation at scale. [ABSTRACT FROM AUTHOR]

Objective: The establishment of reference values for a subset of leukocytes is common in clinical practice, and ethnic variations are strongly associated with disease development. In Brazil, indigenous people are vulnerable to infections, and few studies have described the health and disease conditions of this population. This study aimed to provide reference values for immunological cell subsets in indigenous Brazilians living in the state of Mato Grosso do Sul. Methods: Flow cytometry and 4-color combinations of monoclonal antibodies were used to characterize cells. A total of 115 healthy adults, mostly females (72%), were included in the study. The results are presented as mean and median (2.5%-97.5% percentiles) for T and B lymphocytes, CD4+ T cells, CD8+ T cells, Natural Killer cells, monocytes, and dendritic cells, providing an average immunological profile for the population in question. Results: The relative medians of CD3+, CD4+, and CD8+ T cells were significantly higher in women than in men in a healthy indigenous population. Conclusion: To our knowledge, cell reference data from indigenous Brazilians are unknown in the literature. The immune cell results presented in this pioneering study will contribute to the clinical and laboratory evaluation of the Brazilian indigenous population, especially given the important differences when compared with other Brazilian ethnic groups. [ABSTRACT FROM AUTHOR]

The aim of this study was obtaining pertinent evidence from contemporary expert counselors and relevant professionals on societal understanding and interest to receive counseling service in their lifetime. Counseling organizations were purposively selected from modern counseling structure and practices based on its relevance to the intended inquiry. Qualitative research approach with a thematic data analysis method was employed. Semi-structured interviews, observation, and focus group discussions were conducted with the selected participants. The study result identified that societal understanding of counseling and counseling practices in a real-life situation needs more effort to work in the country. Institutions providing services focus on indigenous wisdom, personal experience, and knowledge captured from educational institutes. It is concluded that concerned government and non-government organizations need to boost the purpose and functions of counseling to maintain adolescents' holistic development in and out of school. Accordingly, counseling in Ethiopia needs reworking to provide proper services to community. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: to identify in the literature the nursing care actions for the health of indigenous populations. Method: this is a scoping review, whose search was conducted in September 2022 in the following databases: Nursing Database (BDENF), CAPES Theses and Dissertations Catalog, Google Scholar, Latin American and Caribbean Literature on Health Sciences (LILACS), Pan American Health Organization (PAHO), National Library of Medicine and National Institutes of Health (PUBMED) and Scientific Electronic Library Online (SCIELO). The results were evaluated by summarizing the selected articles. Results: the main actions directed to the indigenous population were nursing consultations and health promotion and prevention activities. The main difficulty encountered in relation to indigenous peoples is the language barrier. Conclusion: the nursing team encounters difficulties, such as: the difficult location of the villages; high work overload due to the lack of medical professionals; language barrier; and inadequate conditions. [ABSTRACT FROM AUTHOR]

Copyright of Cogitare Enfermagem is the property of Cogitare Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cogitare Enfermagem is the property of Cogitare Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Gaucha de Enfermagem is the property of Revista Gaucha de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Study Objectives Obstructive sleep apnea (OSA) is reported to be highly prevalent among Aboriginal Australians. However, no studies have assessed the implementation and efficacy of continuous positive airway pressure (CPAP) therapy in this population. Hence, we compared the clinical, self-reported perception of sleep quality and polysomnographic (PSG) characteristics among Aboriginal patients with OSA. Methods Adult Aboriginal Australians who underwent both diagnostic (Type 1 and 2) and in-lab CPAP implementation studies were included. Results Total of 149 patients were identified (46% female, median age 49 years, body mass index 35 kg/m2). The OSA severity was 6% mild, 26% moderate, and 68% severe on the diagnostic PSG. On application of CPAP, there were significant improvements in; total arousal index (diagnostic 29 to 17/h on CPAP), total apnea–hypopnea index (AHI) (diagnostic 48 to 9/h on CPAP), non-rapid eye movement AHI (diagnostic 47 to 8/h on CPAP), rapid eye movement (REM) AHI (diagnostic 56 to 8/h on CPAP) and oxygen saturation (SpO2) nadir (diagnostic 77% to 85% on CPAP) (p < 0.001 for each). Following a single night of CPAP, 54% of patients reported sleeping "better than normal" compared to 12% following the diagnostic study (p = 0.003). In multivariate regression models, males had a significantly lesser change in REM AHI than females (5.7 events/hour less change (IQR 0.4, 11.1), p = 0.029). Conclusions There is substantial improvement in several sleep-related domains on the application of CPAP among Aboriginal patients with a good initial acceptance of treatment. Whether the positive impact observed in this study translates to better sleep health outcomes with long-term adherence to CPAP therapy is yet to be assessed. [ABSTRACT FROM AUTHOR]

Copyright of South African Journal of Art History / Suid-Afrikaanse Tydskrif vir Kunsgeskiedenis is the property of Art Historical Work Group of South Africa and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Health and well-being are holistic concepts that are perceived to be inseparable for Aboriginal and Torres Strait Islander peoples. We examined relationships between parent-reported ear symptoms for 787 Indigenous children at two time points (age 2–3 years, age 4–5 years) and two parent-reported speech and language outcomes one year later (age 5–6 years). Most parents (80.2%) reported no concern about their child's expressive language and (93.8%) receptive language. Binary logistic regression models examined ear health as a predictor of children's expressive and receptive speech and language adjusting for sociodemographic and health covariates. For children without parent-reported ear symptoms, there were lower odds of parental concern about expressive speech and language (aOR = 0.45; 95% CI 0.21–0.99) and receptive language (aOR = 0.24; 95% CI 0.09–0.62). Parents were less likely to have concerns about the child's expressive speech and language if their child was female, lived in urban or regional areas, had excellent or very good global health, or had no disability when aged 2–5 years. Since parent-reported ear health and speech and language concerns were related, Aboriginal and Torres Strait Islander children could benefit from culturally safe, strength-based, and family-centered integrated speech, language, and ear health services. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Art Therapy is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Women with a history of preterm delivery (PTD) have significantly increased risk of experiencing cardiovascular disease (CVD) later in life. However, the risk of long-term recurrence of CVD in this population remains unknown. Materials and Methods: The study was based on a cohort of Victorian women who had a singleton birth between 1999 and 2008. The primary outcome was a CVD event resulting in an Emergency Department visit/hospitalization or death. Women who do not have a PTD during the study period were adopted as the comparator. The Andersen and Gill model, which generalizes the Cox proportional hazards regression model, was used for the analysis of recurrent CVD, while adjusting for covariates, including indigenous status. Results: After excluding cases not meeting the inclusion criteria, 34,128 Victoria women who had a history of PTD and 374,538 women who had deliveries at terms were analyzed. A history of PTD was shown to be associated with significantly increased risk of recurrent CVD, while adjusting for all covariates, including indigenous status, with an adjusted hazard ratio (aHR) of 1.70 (95% confidence interval [CI]: 1.54–1.86, p < 0.0001). Aboriginal and Torres Strait Islander women had substantially increased risk of experiencing recurrent CVD after birth over their lifetime (aHR: 3.22, 95% CI: 2.39–4.35, p < 0.0001). Conclusions: Recognizing PTD as a nontraditional risk factor of CVD may play a role in the formulation of care plans for primary and secondary CVD prevention in women with such a history. [ABSTRACT FROM AUTHOR]