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Health services research is underpinned by partnerships between researchers and health services. Partnership-based research is increasingly needed to deal with the uncertainty of global pandemics, climate change induced severe weather events, and other disruptions. To date there is very little data on what has happened to health services research during the COVID-19 pandemic. This paper describes the establishment of an Australian multistate Decolonising Practice research project and charts its adaptation in the face of disruptions. The project used cooperative inquiry method, where partner health services contribute as coresearchers. When the COVID-19 pandemic hit, data collection needed to be immediately paused, and when restrictions started to lift, all research plans had to be renegotiated with services. Adapting the research surfaced health service, university, and staffing considerations. Our experience suggests that cooperative inquiry was invaluable in successfully navigating this uncertainty and negotiating the continuance of the research. Flexible, participatory methods such as cooperative inquiry will continue to be vital for successful health services research predicated on partnerships between researchers and health services into the future. They are also crucial for understanding local context and health services priorities and ways of working, and for decolonising Indigenous health research.

Exploring the vehicle's role in imposing colonialism on Indigenous people, this book proposes an Indigenous automobility that reclaims sovereignty over place and centricity.

Exploring the vehicle's role in imposing colonialism on Indigenous people, this book proposes an Indigenous automobility that reclaims sovereignty over place and centricity.

Health services research is underpinned by partnerships between researchers and health services. Partnership-based research is increasingly needed to deal with the uncertainty of global pandemics, climate change induced severe weather events, and other disruptions. To date there is very little data on what has happened to health services research during the COVID-19 pandemic. This paper describes the establishment of an Australian multistate Decolonising Practice research project and charts its adaptation in the face of disruptions. The project used cooperative inquiry method, where partner health services contribute as coresearchers. When the COVID-19 pandemic hit, data collection needed to be immediately paused, and when restrictions started to lift, all research plans had to be renegotiated with services. Adapting the research surfaced health service, university, and staffing considerations. Our experience suggests that cooperative inquiry was invaluable in successfully navigating this uncertainty and negotiating the continuance of the research. Flexible, participatory methods such as cooperative inquiry will continue to be vital for successful health services research predicated on partnerships between researchers and health services into the future. They are also crucial for understanding local context and health services priorities and ways of working, and for decolonising Indigenous health research.

INTRODUCTION: There is a lack of standard nomenclature and a limited understanding of programmes and services delivered to people in prisons as they transition into the community to support their integration and reduce reoffending related risk factors. The aim of this paper is to outline the protocol for a modified Delphi study designed to develop expert consensus on the nomenclature and best-practice principles of programmes and services for people transitioning from prison into the community. METHODS AND ANALYSIS: An online, two-phase modified Delphi process will be conducted to develop an expert consensus on nomenclature and the best-practice principles for these programmes. In the preparatory phase, a questionnaire was developed comprising a list of potential best-practice statements identified from a systematic literature search. Subsequently, a heterogeneous sample of experts including service providers, Community and Justice Services, Not for Profits, First Nations stakeholders, those with lived experience, researchers and healthcare providers will participate in the consensus building phase (online survey rounds and online meeting) to achieve consensus on nomenclature and best-practice principles. Participants will indicate, via Likert scale, to what extent they agree with nomenclature and best-practice statements. If at least 80% of the experts agree to a term or statement (indicated via Likert scale), it will be included in a final list of nomenclature and best-practice statements. Statements will be excluded if 80% experts disagree. Nomenclature and statements not meeting positive or negative consensus will be explored in a facilitated online meeting. Approval from experts will be sought on the final list of nomenclature and best-practice statements. ETHICS AND DISSEMINATION: Ethical approval has been received from the Justice Health and Forensic Mental Health Network Human Research Ethics Committee, the Aboriginal Health and Medical Research Council Huma

BACKGROUND: With the impact of over two centuries of colonisation in Australia, First Nations families experience a disproportionate burden of adverse pregnancy and birthing outcomes. First Nations mothers are 3-5 times more likely than other mothers to experience maternal mortality; babies are 2-3 times more likely to be born preterm, low birth weight or not to survive their first year. 'Birthing on Country' incorporates a multiplicity of interpretations but conveys a resumption of maternity services in First Nations Communities with Community governance for the best start to life. Redesigned services offer women and families integrated, holistic care, including carer continuity from primary through tertiary services; services coordination and quality care including safe and supportive spaces. The overall aim of Building On Our Strengths (BOOSt) is to facilitate and assess Birthing on Country expansion into two settings - urban and rural; with scale-up to include First Nations-operated birth centres. This study will build on our team's earlier work - a Birthing on Country service established and evaluated in an urban setting, that reported significant perinatal (and organisational) benefits, including a 37% reduction in preterm births, among other improvements. METHODS: Using community-based, participatory action research, we will collaborate to develop, implement and evaluate new Birthing on Country care models. We will conduct a mixed-methods, prospective birth cohort study in two settings, comparing outcomes for women having First Nations babies with historical controls. Our analysis of feasibility, acceptability, clinical and cultural safety, effectiveness and cost, will use data including (i) women's experiences collected through longitudinal surveys (three timepoints) and yarning interviews; (ii) clinical records; (iii) staff and stakeholder views and experiences; (iv) field notes and meeting minutes; and (v) costs data. The study includes a process, impact a

BACKGROUND AND AIMS: Connections is a voluntary health program that facilitates access to opioid agonist treatment (OAT) and social services for people with opioid use exiting prison. This study aimed to measure the effectiveness of Connections in reducing recidivism and improving health outcomes for people with a history of opioid use on leaving prison. DESIGN: Retrospective cohort study with quasi-random allocation to the program. SETTING: Public adult prisons in New South Wales, Australia, 2008-2015. PARTICIPANTS: Adults released from custody with a history of opioid use. Of 5549 eligible releasees, 3973 were allocated to Connections and 1576 to treatment-as-usual. MEASUREMENTS: Outcomes were return-to-custody, all-cause mortality, and OAT participation. FINDINGS: Regression analyses on an intention-to-treat basis, and adjusting for baseline propensity scores, comparing patients allocated to Connections versus treatment-as-usual showed no difference in rates of return-to-custody within 2 years (hazard ratio [HR]: 1.01; 95% confidence interval [CI]: 0.92 -1.12). Patients allocated to the Connections program were more likely to access OAT (odds ratio [OR]: 1.21; 95% CI: 1.06-1.39) and had lower mortality within 28 days of release (0.25% vs. 0.66%; HR: 0.38; 95% CI: 0.14-1.03). Differences in mortality did not persist beyond 28 days. Subgroup analyses showed that allocation to Connections was associated with higher risk of return-to-custody within 28 days for Aboriginal and/or Torres Strait Islander (Indigenous) and female releasees. CONCLUSIONS: The Connections program for people with opioid use exiting prison did not reduce the likelihood of return-to-custody but did facilitate opioid agonist treatment participation on release from prison.

BACKGROUND AND AIMS: Connections is a voluntary health program that facilitates access to opioid agonist treatment (OAT) and social services for people with opioid use exiting prison. This study aimed to measure the effectiveness of Connections in reducing recidivism and improving health outcomes for people with a history of opioid use on leaving prison. DESIGN: Retrospective cohort study with quasi-random allocation to the program. SETTING: Public adult prisons in New South Wales, Australia, 2008-2015. PARTICIPANTS: Adults released from custody with a history of opioid use. Of 5549 eligible releasees, 3973 were allocated to Connections and 1576 to treatment-as-usual. MEASUREMENTS: Outcomes were return-to-custody, all-cause mortality, and OAT participation. FINDINGS: Regression analyses on an intention-to-treat basis, and adjusting for baseline propensity scores, comparing patients allocated to Connections versus treatment-as-usual showed no difference in rates of return-to-custody within 2 years (hazard ratio [HR]: 1.01; 95% confidence interval [CI]: 0.92 -1.12). Patients allocated to the Connections program were more likely to access OAT (odds ratio [OR]: 1.21; 95% CI: 1.06-1.39) and had lower mortality within 28 days of release (0.25% vs. 0.66%; HR: 0.38; 95% CI: 0.14-1.03). Differences in mortality did not persist beyond 28 days. Subgroup analyses showed that allocation to Connections was associated with higher risk of return-to-custody within 28 days for Aboriginal and/or Torres Strait Islander (Indigenous) and female releasees. CONCLUSIONS: The Connections program for people with opioid use exiting prison did not reduce the likelihood of return-to-custody but did facilitate opioid agonist treatment participation on release from prison.

AIM: To provide a birds-eye view of the trends of cerebral palsy (CP) for Australian Aboriginal and Torres Strait Islander children and young adults. METHOD: Data were obtained for this population-based observational study from the Australian Cerebral Palsy Register (ACPR), birth years 1995 to 2014. The Indigenous status of children was classified by maternal Aboriginal and Torres Strait Islander or non-Indigenous status. Descriptive statistics were calculated for socio-demographic and clinical characteristics. Prenatal/perinatal and post-neonatal birth prevalence was calculated per 1000 live births and per 10 000 live births respectively, and Poisson regression used to assess trends. RESULTS: Data from the ACPR were available for 514 Aboriginal and Torres Strait Islander individuals with CP. Most children could walk independently (56%) and lived in urban or regional areas (72%). One in five children lived in socioeconomically disadvantaged remote/very remote areas. The birth prevalence of prenatal/perinatal CP declined after the mid-2000s from a high of 4.8 (95% confidence interval 3.2-7.0) to 1.9 per 1000 live births (95% confidence interval 1.1-3.2) (2013-2014), with marked declines observed for term births and teenage mothers. INTERPRETATION: The birth prevalence of CP in Aboriginal and Torres Strait Islander children in Australia declined between the mid-2000s and 2013 to 2014. This birds-eye view provides key stakeholders with new knowledge to advocate for sustainable funding for accessible, culturally safe, antenatal and CP services. WHAT THIS PAPER ADDS: Birth prevalence of cerebral palsy (CP) is beginning to decline for Aboriginal and Torres Strait Islanders. Recent CP birth prevalence for Aboriginal and Torres Strait Islanders is 1.9 per 1000 live births. Most children with CP live in more populated areas rather than remote or very remote areas. One in five Aboriginal and Torres Strait Islander children with CP live in socioeconomically disadvantaged remot

AIM: To provide a birds-eye view of the trends of cerebral palsy (CP) for Australian Aboriginal and Torres Strait Islander children and young adults. METHOD: Data were obtained for this population-based observational study from the Australian Cerebral Palsy Register (ACPR), birth years 1995 to 2014. The Indigenous status of children was classified by maternal Aboriginal and Torres Strait Islander or non-Indigenous status. Descriptive statistics were calculated for socio-demographic and clinical characteristics. Prenatal/perinatal and post-neonatal birth prevalence was calculated per 1000 live births and per 10 000 live births respectively, and Poisson regression used to assess trends. RESULTS: Data from the ACPR were available for 514 Aboriginal and Torres Strait Islander individuals with CP. Most children could walk independently (56%) and lived in urban or regional areas (72%). One in five children lived in socioeconomically disadvantaged remote/very remote areas. The birth prevalence of prenatal/perinatal CP declined after the mid-2000s from a high of 4.8 (95% confidence interval 3.2-7.0) to 1.9 per 1000 live births (95% confidence interval 1.1-3.2) (2013-2014), with marked declines observed for term births and teenage mothers. INTERPRETATION: The birth prevalence of CP in Aboriginal and Torres Strait Islander children in Australia declined between the mid-2000s and 2013 to 2014. This birds-eye view provides key stakeholders with new knowledge to advocate for sustainable funding for accessible, culturally safe, antenatal and CP services. WHAT THIS PAPER ADDS: Birth prevalence of cerebral palsy (CP) is beginning to decline for Aboriginal and Torres Strait Islanders. Recent CP birth prevalence for Aboriginal and Torres Strait Islanders is 1.9 per 1000 live births. Most children with CP live in more populated areas rather than remote or very remote areas. One in five Aboriginal and Torres Strait Islander children with CP live in socioeconomically disadvantaged remot

OBJECTIVE: Evaluate ear health and hearing among urban Aboriginal children and quantify relationships with child, family and social factors. METHODS: Baseline questionnaire and ear health examinations from 1430 children with diagnoses (0.5-18 years) attending Aboriginal Health Services enrolled in SEARCH. Ear health outcomes were Otitis Media (OM), and hearing loss (three-frequency average hearing loss >20dB) diagnosed using pneumatic otoscopy, tympanometry, and audiometry. RESULTS: Half the children 0.5-3 years had OM (51.5%, 136/264). One third 0.5-18 years (30.4%; 435/1430) had OM, including 1.8% (26/1430) with perforation (0.8% chronic suppurative OM, 0.6% dry perforation and 0.4% acute OM with perforation). One quarter 0.5-18 years (25.7%; 279/1087) had hearing loss; 12.4% unilateral, 13.2% bilateral (70.6% with bilateral loss had concurrent OM). OM was associated with: younger age (0.5-<3 years versus 6-18 years) age-sex-site; adjusted prevalence ratio (aPR)=2.64, 95%, 2.18-3.19); attending childcare/preschool (aPR=1.24, 95%CI, 1.04-1.49); foster care (aPR=1.40, 95%CI, 1.10-1.79); previous ear infection/s (aPR=1.68, 95%CI, 1.42-1.98); and ≥2 people/bedroom (aPR=1.66, 95%CI, 1.24-2.21). Hearing impairment was associated with younger age (0.5-<6 years vs. ≥6 years aPR=1.89, 95%CI, 1.40-2.55) and previous ear infection (aPR=1.87, 95%CI, 1.31-2.68). CONCLUSIONS: Half the urban Aboriginal children in this cohort had OM and two-thirds with hearing impairment had OM. IMPLICATIONS FOR PUBLIC HEALTH: Findings highlight importance of early detection and support for ear health, particularly in pre-school-aged children with risk factors.

AIM: To provide a birds-eye view of the trends of cerebral palsy (CP) for Australian Aboriginal and Torres Strait Islander children and young adults. METHOD: Data were obtained for this population-based observational study from the Australian Cerebral Palsy Register (ACPR), birth years 1995 to 2014. The Indigenous status of children was classified by maternal Aboriginal and Torres Strait Islander or non-Indigenous status. Descriptive statistics were calculated for socio-demographic and clinical characteristics. Prenatal/perinatal and post-neonatal birth prevalence was calculated per 1000 live births and per 10 000 live births respectively, and Poisson regression used to assess trends. RESULTS: Data from the ACPR were available for 514 Aboriginal and Torres Strait Islander individuals with CP. Most children could walk independently (56%) and lived in urban or regional areas (72%). One in five children lived in socioeconomically disadvantaged remote/very remote areas. The birth prevalence of prenatal/perinatal CP declined after the mid-2000s from a high of 4.8 (95% confidence interval 3.2-7.0) to 1.9 per 1000 live births (95% confidence interval 1.1-3.2) (2013-2014), with marked declines observed for term births and teenage mothers. INTERPRETATION: The birth prevalence of CP in Aboriginal and Torres Strait Islander children in Australia declined between the mid-2000s and 2013 to 2014. This birds-eye view provides key stakeholders with new knowledge to advocate for sustainable funding for accessible, culturally safe, antenatal and CP services. WHAT THIS PAPER ADDS: Birth prevalence of cerebral palsy (CP) is beginning to decline for Aboriginal and Torres Strait Islanders. Recent CP birth prevalence for Aboriginal and Torres Strait Islanders is 1.9 per 1000 live births. Most children with CP live in more populated areas rather than remote or very remote areas. One in five Aboriginal and Torres Strait Islander children with CP live in socioeconomically disadvantaged remot

BACKGROUND: Delivery of recommended treatments for hip and knee osteoarthritis (OA) is known to be discordant with guideline recommendations. However, professional views related to OA management across medical and surgical disciplines are not well understood. The aim of this study was to explore the views of medical professionals about management of hip and knee OA. METHODS: Qualitative study. Semistructured individual interviews were conducted with orthopaedic surgeons, rheumatologists and general practitioners routinely involved in the management of OA. Interviews were audiotaped, transcribed, member-checked, coded and thematically analysed. RESULTS: Fifteen medical professionals were interviewed. Three main themes were: (i) recognition of the importance of nonsurgical management of hip and knee OA, focussed on self-management, exercise-therapy, weight management and analgesia; (ii) joint replacement being considered the 'last resort' for end stage disease not responding to nonsurgical management; and (iii) determination of management 'success' through patient perceptions was more common than the use of validated instruments. Views on management broadly converged across disciplines, except for the role of joint replacement, considered an adjunct in the overall management of OA by rheumatologists and as a definitive cure by orthopaedic surgeons. CONCLUSIONS: Aligning with current guidelines, medical professionals recognised the importance of nonsurgical management focussed on exercise-therapy for hip and knee OA, and concurred that joint replacement surgery should be a last resort. A focus on patient education was less prominent, which along with implementation of validated outcome measures in routine medical practice, may require greater health system support.

In this paper, we use research with Indigenous Māori women to explain the research interface to bring together Indigenous and Euro-Western ways of knowing. Our research required using an Indigenous research methodology that drew on traditional cultural knowledge with embedded critical and decolonisation theories to understand this often-marginalised group of Indigenous women. Constructivist grounded theory provided a systematic and rigorous approach to generating theory. Because of the unique histories of colonisation and contemporary realities resulting in Indigenous women’s marginalisation, globally, we argue research must be relevant, safe, and meaningful to those researched to produce transformative knowledge. Therefore, planning a research methodology to inform research with Indigenous women that counters current unhelpful constructions required careful consideration. We share how we used kaupapa Māori research methodology and constructivist grounded theory to generate an explanation of how Māori women keep safe in unsafe relationships.

In this paper, we use research with Indigenous Māori women to explain the research interface to bring together Indigenous and Euro-Western ways of knowing. Our research required using an Indigenous research methodology that drew on traditional cultural knowledge with embedded critical and decolonisation theories to understand this often-marginalised group of Indigenous women. Constructivist grounded theory provided a systematic and rigorous approach to generating theory. Because of the unique histories of colonisation and contemporary realities resulting in Indigenous women’s marginalisation, globally, we argue research must be relevant, safe, and meaningful to those researched to produce transformative knowledge. Therefore, planning a research methodology to inform research with Indigenous women that counters current unhelpful constructions required careful consideration. We share how we used kaupapa Māori research methodology and constructivist grounded theory to generate an explanation of how Māori women keep safe in unsafe relationships.

Mohwak scholar Taiaiake Alfred has remarked that in settler colonies, reconciliation is another form of re-colonisation. The “reconciliation of Indigenous people to colonialism”, in Alfred’s words, do not challenge structures of power that deny First Nations people substantive rights. We draw on Alfred’s observations to highlight the agenda of Southern Criminology. This increasingly influential school while seeking to engage epistemologies of the South reinscribes colonial relations of power, including colonial hierarchies of knowledge. It does so by uncritically bringing together the North and the South through a working partnership in criminology. Our blog represents a defence of decolonising frameworks. We contend that challenging colonial legacies in criminology is crucial for building more inclusive ideas and praxes.

Mohwak scholar Taiaiake Alfred has remarked that in settler colonies, reconciliation is another form of re-colonisation. The “reconciliation of Indigenous people to colonialism”, in Alfred’s words, do not challenge structures of power that deny First Nations people substantive rights. We draw on Alfred’s observations to highlight the agenda of Southern Criminology. This increasingly influential school while seeking to engage epistemologies of the South reinscribes colonial relations of power, including colonial hierarchies of knowledge. It does so by uncritically bringing together the North and the South through a working partnership in criminology. Our blog represents a defence of decolonising frameworks. We contend that challenging colonial legacies in criminology is crucial for building more inclusive ideas and praxes.

In this call to action, a coalition of Indigenous and non-Indigenous researchers from Australia, Aotearoa New Zealand, United States and Canada argue for the urgent need for adequately funded Indigenous-led solutions to perinatal health inequities for Indigenous families in well-resourced settler-colonial countries. Authors describe examples of successful community-driven programs making a difference and call on all peoples to support and resource Indigenous-led perinatal health services by providing practical actions for individuals and different groups.

In this call to action, a coalition of Indigenous and non-Indigenous researchers from Australia, Aotearoa New Zealand, United States and Canada argue for the urgent need for adequately funded Indigenous-led solutions to perinatal health inequities for Indigenous families in well-resourced settler-colonial countries. Authors describe examples of successful community-driven programs making a difference and call on all peoples to support and resource Indigenous-led perinatal health services by providing practical actions for individuals and different groups.

The 2020 International Year of the Nurse and Midwife has harshly revealed the need to increase the nursing and midwifery workforce and for the disciplines to invest in anti-racism initiatives. The World Health Organization (WHO) (2020) has called for a marked increase in the numbers of nurses and midwives, academics and students. However, to ensure the cultural safety of patients and staff, WHO (2020) stated this increase in workforce must include clinicians and educators from underrepresented populations, in particular Indigenous populations. Stemming from our experiences as First Nations nurses, midwives, practitioners, researchers, educators, and allies, this editorial outlines our agenda to reform Indigenous health and cultural safety curricula in Australian higher education institutions.

The 2020 International Year of the Nurse and Midwife has harshly revealed the need to increase the nursing and midwifery workforce and for the disciplines to invest in anti-racism initiatives. The World Health Organization (WHO) (2020) has called for a marked increase in the numbers of nurses and midwives, academics and students. However, to ensure the cultural safety of patients and staff, WHO (2020) stated this increase in workforce must include clinicians and educators from underrepresented populations, in particular Indigenous populations. Stemming from our experiences as First Nations nurses, midwives, practitioners, researchers, educators, and allies, this editorial outlines our agenda to reform Indigenous health and cultural safety curricula in Australian higher education institutions.

Background: Colonization continues in Australia, sustained through institutional and systemic racism. Targeted discrimination and intergenerational trauma have undermined the health and wellbeing of Australia's Aboriginal and Torres Strait Islander population, leading to significantly poorer health status, social impoverishment and inequity resulting in the over-representation of Aboriginal people in Australian prisons. Despite adoption of the 'equal treatment' principle, on entering prison in Australia entitlements to the national universal healthcare system are revoked and Aboriginal people lose access to health services modelled on Aboriginal concepts of culturally safe healthcare available in the community. Incarcerated Aboriginal women experience poorer health outcomes than incarcerated non-Indigenous women and Aboriginal men, yet little is known about their experiences of accessing healthcare. We report the findings of the largest qualitative study with incarcerated Aboriginal women in New South Wales (NSW) Australia in over 15 years. Methods: We employed a decolonizing research methodology, 'community collaborative participatory action research', involving consultation with Aboriginal communities prior to the study and establishment of a Project Advisory Group (PAG) of community expert Aboriginal women to guide the project. Forty-three semi-structured interviews were conducted in 2013 with Aboriginal women in urban and regional prisons in NSW. We applied a grounded theory approach for the data analysis with guidance from the PAG. Results: Whilst Aboriginal women reported positive and negative experiences of prison healthcare, the custodial system created numerous barriers to accessing healthcare. Aboriginal women experienced institutional racism and discrimination in the form of not being listened to, stereotyping, and inequitable healthcare compared with non-Indigenous women in prison and the community. Conclusions: 'Equal treatment' is an inappropriate stra

Nurses and midwives of Australia now is the time for change! As powerfully placed, Indigenous and non-Indigenous nursing and midwifery professionals, together we can ensure an effective and robust Indigenous curriculum in our nursing and midwifery schools of education. Today, Australia finds itself in a shifting tide of social change, where the voices for better and safer health care ring out loud. Voices for justice, equity and equality reverberate across our cities, our streets, homes, and institutions of learning. It is a call for new songlines of reform. The need to embed meaningful Indigenous health curricula is stronger now than it ever was for Australian nursing and midwifery. It is essential that nursing and midwifery leadership continue to build an authentic collaborative environment for Indigenous curriculum development. Bipartisan alliance is imperative for all academic staff to be confident in their teaching and learning experiences with Indigenous health syllabus. This paper is a call out. Now is the time for Indigenous and non-Indigenous nurses and midwives to make a stand together, for justice and equity in our teaching, learning, and practice. Together we will dismantle systems, policy, and practices in health that oppress. The Black Lives Matter movement provides us with a ‘now window’ of accepted dialogue to build a better, culturally safe Australian nursing and midwifery workforce, ensuring that Black Lives Matter in all aspects of health care.

© 2020 Informa UK Limited, trading as Taylor & Francis Group. Nurses and midwives of Australia now is the time for change! As powerfully placed, Indigenous and non-Indigenous nursing and midwifery professionals, together we can ensure an effective and robust Indigenous curriculum in our nursing and midwifery schools of education. Today, Australia finds itself in a shifting tide of social change, where the voices for better and safer health care ring out loud. Voices for justice, equity and equality reverberate across our cities, our streets, homes, and institutions of learning. It is a call for new songlines of reform. The need to embed meaningful Indigenous health curricula is stronger now than it ever was for Australian nursing and midwifery. It is essential that nursing and midwifery leadership continue to build an authentic collaborative environment for Indigenous curriculum development. Bipartisan alliance is imperative for all academic staff to be confident in their teaching and learning experiences with Indigenous health syllabus. This paper is a call out. Now is the time for Indigenous and non-Indigenous nurses and midwives to make a stand together, for justice and equity in our teaching, learning, and practice. Together we will dismantle systems, policy, and practices in health that oppress. The Black Lives Matter movement provides us with a ‘now window’ of accepted dialogue to build a better, culturally safe Australian nursing and midwifery workforce, ensuring that Black Lives Matter in all aspects of health care.

Nurses and midwives of Australia now is the time for change! As powerfully placed, Indigenous and non-Indigenous nursing and midwifery professionals, together we can ensure an effective and robust Indigenous curriculum in our nursing and midwifery schools of education. Today, Australia finds itself in a shifting tide of social change, where the voices for better and safer health care ring out loud. Voices for justice, equity and equality reverberate across our cities, our streets, homes, and institutions of learning. It is a call for new songlines of reform. The need to embed meaningful Indigenous health curricula is stronger now than it ever was for Australian nursing and midwifery. It is essential that nursing and midwifery leadership continue to build an authentic collaborative environment for Indigenous curriculum development. Bipartisan alliance is imperative for all academic staff to be confident in their teaching and learning experiences with Indigenous health syllabus. This paper is a call out. Now is the time for Indigenous and non-Indigenous nurses and midwives to make a stand together, for justice and equity in our teaching, learning, and practice. Together we will dismantle systems, policy, and practices in health that oppress. The Black Lives Matter movement provides us with a ‘now window’ of accepted dialogue to build a better, culturally safe Australian nursing and midwifery workforce, ensuring that Black Lives Matter in all aspects of health care.

OBJECTIVE: To explore barriers and enablers for referral to, and participation in, a contemporary guideline-based osteoarthritis management program - Good Life with osteoArthritis in Denmark (GLA:D Australia). DESIGN: A qualitative design was used, involving semi-structured interviews with patients with osteoarthritis and medical professionals. Interviews were audiotaped, transcribed verbatim, coded and thematically analysed. Barrier and enabler themes were mapped to the theoretical domains framework and used to inform the development of recommendations for improving uptake of guideline-based osteoarthritis management programs. RESULTS: Twenty patients with hip and/or knee osteoarthritis and 15 medical professionals (5 general practitioners, 4 rheumatologists, 6 orthopaedic surgeons) were included. Across both groups, three themes emerged as barriers (program access; misinformation about osteoarthritis; patient and program factors), one theme emerged as a barrier and enabler (health professional trust, feedback and advice), and two themes emerged as enablers (opportunity to achieve positive outcomes and potentially avoid joint replacement surgery; better program promotion, patient and health professional education, and efficient referral processes). CONCLUSIONS: Optimising uptake of guideline-based osteoarthritis management programs requires improved reimbursement models, and better promotion and educational initiatives for patients and medical professionals. A particular focus of education should include dispelling misinformation about osteoarthritis, and highlighting the safety and value of physiotherapist delivered exercise-therapy.

New Zealand, a geographically remote Pacific island with easily sealable borders, implemented a nationwide 'lockdown' of all non-essential services to curb the spread of COVID-19. Here, we generate 649 SARS-CoV-2 genome sequences from infected patients in New Zealand with samples collected during the 'first wave', representing 56% of all confirmed cases in this time period. Despite its remoteness, the viruses imported into New Zealand represented nearly all of the genomic diversity sequenced from the global virus population. These data helped to quantify the effectiveness of public health interventions. For example, the effective reproductive number, Re of New Zealand's largest cluster decreased from 7 to 0.2 within the first week of lockdown. Similarly, only 19% of virus introductions into New Zealand resulted in ongoing transmission of more than one additional case. Overall, these results demonstrate the utility of genomic pathogen surveillance to inform public health and disease mitigation.

Effectively incorporating cultural competence into tertiary institutions is paramount to the creation of cross-cultural settings where undergraduates and academics can develop understandings of how culture and belief systems influence professional decision making. Processes that incorporate cultural competence are viewed as particularly challenging in science disciplines, particularly non-vocational science disciplines where “western” or reductivist ways of teaching and “doing” science remain dominant.

Nurses and midwives of Australia now is the time for change! As powerfully placed, Indigenous and non-Indigenous nursing and midwifery professionals, together we can ensure an effective and robust Indigenous curriculum in our nursing and midwifery schools of education. Today, Australia finds itself in a shifting tide of social change, where the voices for better and safer health care ring out loud. Voices for justice, equity and equality reverberate across our cities, our streets, homes, and institutions of learning. It is a call for new songlines of reform. The need to embed meaningful Indigenous health curricula is stronger now than it ever was for Australian nursing and midwifery. It is essential that nursing and midwifery leadership continue to build an authentic collaborative environment for Indigenous curriculum development. Bipartisan alliance is imperative for all academic staff to be confident in their teaching and learning experiences with Indigenous health syllabus. This paper is a call out. Now is the time for Indigenous and non-Indigenous nurses and midwives to make a stand together, for justice and equity in our teaching, learning, and practice. Together we will dismantle systems, policy, and practices in health that oppress. The Black Lives Matter movement provides us with a ‘now window’ of accepted dialogue to build a better, culturally safe Australian nursing and midwifery workforce, ensuring that Black Lives Matter in all aspects of health care.

© The Author(s) 2020. In one sense or another, the chapters in this book have all acknowledged that cultural competence is a set of behaviours, attitudes and/or policies that come together in the higher education sector or among professional and academic staff, and students enabling them to operate efficiently in intercultural contexts (Cross, Bazron, Dennis, & Isaacs in Towards a culturally competent system of care: a monograph on effective services for minority children who are severely emotionally disturbed. Child and Adolescent Service System Program Technical Assistance Center, Georgetown University Child Development Center, Washington, DC, 1989).

© 2020 Informa UK Limited, trading as Taylor & Francis Group. Nurses and midwives of Australia now is the time for change! As powerfully placed, Indigenous and non-Indigenous nursing and midwifery professionals, together we can ensure an effective and robust Indigenous curriculum in our nursing and midwifery schools of education. Today, Australia finds itself in a shifting tide of social change, where the voices for better and safer health care ring out loud. Voices for justice, equity and equality reverberate across our cities, our streets, homes, and institutions of learning. It is a call for new songlines of reform. The need to embed meaningful Indigenous health curricula is stronger now than it ever was for Australian nursing and midwifery. It is essential that nursing and midwifery leadership continue to build an authentic collaborative environment for Indigenous curriculum development. Bipartisan alliance is imperative for all academic staff to be confident in their teaching and learning experiences with Indigenous health syllabus. This paper is a call out. Now is the time for Indigenous and non-Indigenous nurses and midwives to make a stand together, for justice and equity in our teaching, learning, and practice. Together we will dismantle systems, policy, and practices in health that oppress. The Black Lives Matter movement provides us with a ‘now window’ of accepted dialogue to build a better, culturally safe Australian nursing and midwifery workforce, ensuring that Black Lives Matter in all aspects of health care.

© The Author(s) 2020. Although cultural competence in higher education is a worthwhile starting point for teaching, learning, research and leadership in the higher education sector, it has been argued that it is the journey and not the destination that is important (Clutton in One size fits few: from cultural incompetence to contextual sensitivity in health policy development in Australia and Canada. (Unpublished doctoral thesis), Australian National University, Canberra, 2017).

© The Author(s) 2020. This chapter includes a record of the opening session of the first National Centre for Cultural Competence (NCCC) conference held in Australia in 2018 and is a yarn between the two of us. We are both Aboriginal women with qualifications in nursing and are members of Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM).

© The Author(s) 2020. In one sense or another, the chapters in this book have all acknowledged that cultural competence is a set of behaviours, attitudes and/or policies that come together in the higher education sector or among professional and academic staff, and students enabling them to operate efficiently in intercultural contexts (Cross, Bazron, Dennis, & Isaacs in Towards a culturally competent system of care: a monograph on effective services for minority children who are severely emotionally disturbed. Child and Adolescent Service System Program Technical Assistance Center, Georgetown University Child Development Center, Washington, DC, 1989).

© The Author(s) 2020. Although cultural competence in higher education is a worthwhile starting point for teaching, learning, research and leadership in the higher education sector, it has been argued that it is the journey and not the destination that is important (Clutton in One size fits few: from cultural incompetence to contextual sensitivity in health policy development in Australia and Canada. (Unpublished doctoral thesis), Australian National University, Canberra, 2017).

© The Author(s) 2020. This chapter includes a record of the opening session of the first National Centre for Cultural Competence (NCCC) conference held in Australia in 2018 and is a yarn between the two of us. We are both Aboriginal women with qualifications in nursing and are members of Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM).

BACKGROUND:Colonization continues in Australia, sustained through institutional and systemic racism. Targeted discrimination and intergenerational trauma have undermined the health and wellbeing of Australia's Aboriginal and Torres Strait Islander population, leading to significantly poorer health status, social impoverishment and inequity resulting in the over-representation of Aboriginal people in Australian prisons. Despite adoption of the 'equal treatment' principle, on entering prison in Australia entitlements to the national universal healthcare system are revoked and Aboriginal people lose access to health services modelled on Aboriginal concepts of culturally safe healthcare available in the community. Incarcerated Aboriginal women experience poorer health outcomes than incarcerated non-Indigenous women and Aboriginal men, yet little is known about their experiences of accessing healthcare. We report the findings of the largest qualitative study with incarcerated Aboriginal women in New South Wales (NSW) Australia in over 15 years. METHODS:We employed a decolonizing research methodology, 'community collaborative participatory action research', involving consultation with Aboriginal communities prior to the study and establishment of a Project Advisory Group (PAG) of community expert Aboriginal women to guide the project. Forty-three semi-structured interviews were conducted in 2013 with Aboriginal women in urban and regional prisons in NSW. We applied a grounded theory approach for the data analysis with guidance from the PAG. RESULTS:Whilst Aboriginal women reported positive and negative experiences of prison healthcare, the custodial system created numerous barriers to accessing healthcare. Aboriginal women experienced institutional racism and discrimination in the form of not being listened to, stereotyping, and inequitable healthcare compared with non-Indigenous women in prison and the community. CONCLUSIONS:'Equal treatment' is an inappropriate strategy

Nurses and midwives of Australia now is the time for change! As powerfully placed, Indigenous and non-Indigenous nursing and midwifery professionals, together we can ensure an effective and robust Indigenous curriculum in our nursing and midwifery schools of education. Today, Australia finds itself in a shifting tide of social change, where the voices for better and safer health care ring out loud. Voices for justice, equity and equality reverberate across our cities, our streets, homes, and institutions of learning. It is a call for new songlines of reform. The need to embed meaningful Indigenous health curricula is stronger now than it ever was for Australian nursing and midwifery. It is essential that nursing and midwifery leadership continue to build an authentic collaborative environment for Indigenous curriculum development. Bipartisan alliance is imperative for all academic staff to be confident in their teaching and learning experiences with Indigenous health syllabus. This paper is a call out. Now is the time for Indigenous and non-Indigenous nurses and midwives to make a stand together, for justice and equity in our teaching, learning, and practice. Together we will dismantle systems, policy, and practices in health that oppress. The Black Lives Matter movement provides us with a ‘now window’ of accepted dialogue to build a better, culturally safe Australian nursing and midwifery workforce, ensuring that Black Lives Matter in all aspects of health care.

Objective: To describe the social, emotional and physical wellbeing of Aboriginal mothers in prison. Methods: Cross-sectional survey, including a Short Form Health Survey (SF-12) and Kessler Psychological Distress Scale (5-item version) administered to Aboriginal women who self-identified as mothers. Results: Seventy-seven Aboriginal mothers in New South Wales (NSW) and 84 in Western Australia (WA) participated in the study. Eighty-three per cent (n=59) of mothers in NSW were in prison for drug-related offences, 64.8% (n=46) of mothers in WA were in prison for offences committed under the influence of alcohol. Sixty-eight per cent (n=52) of mothers in NSW and 35% (n=28) of mothers in WA reported mental health problems. Physical (PCS) and Mental (MCS) component scores of SF-12 varied for mothers in NSW and WA. Mothers in NSW experienced poorer health and functioning than mothers in WA (NSW: PCS 49.5, MCS 40.6; WA: PCS 54.4, MCS 48.3) and high levels of psychological distress (NSW: 13.1; WA 10.1). Conclusions: Aboriginal mothers in prison have significant health needs associated with physical and mental health, and psychological distress. Implications for public health: Adoption of social and emotional wellbeing as an explanatory framework for culturally secure healthcare in prison is essential to improving health outcomes of Aboriginal mothers in prison in Australia.

© 2019, © 2019 Taylor & Francis Group, LLC. Often young indigenous women are framed in ways that problematize and pathologize them, which overlooks their strengths. We interviewed 16 young Indigenous Māori women aged 14 to 18 years about their understandings of safety, being safe, and how they kept themselves and their friends safe. Reflecting and Learning, aided by progressing age and maturity, is the process that mediated their feeling unsafe and keeping safe and resulted in being safe. Young Māori women’s reflecting and learning facilitates relatively mature levels of resourcefulness for navigating being safe, including situations they encountered appear unsafe.

© 2019 The Authors Objective: This paper provides a case study of the responses to alcohol of an Aboriginal Community Controlled Health Service (The Service), and investigates the implementation of comprehensive primary health care and how it challenges the logic of colonial approaches. Methods: Data were drawn from a larger comprehensive primary health care study. Data on actions on alcohol were collected from: a) six-monthly service reports of activities; b) 29 interviews with staff and board members; c) six interviews with advocacy partners; and d) community assessment workshops with 13 service users. Results: The Service engaged in rehabilitative, curative, preventive and promotive work targeting alcohol, including advocacy and collaborative action on social determinants of health. It challenged other government approaches by increasing Aboriginal people’s control, providing culturally safe services, addressing racism, and advocating to government and industry. Conclusions: This case study provides an example of implementation of the full continuum of comprehensive primary health care activities. It shows how community control can challenge colonialism and ongoing power imbalances to promote evidence-based policy and practice that support self-determination as a positive determinant for health. Implications for public health: Aboriginal Community Controlled Health Services are a good model for comprehensive primary health care approaches to alcohol control.

© 2019 The Authors Objective: To describe the social, emotional and physical wellbeing of Aboriginal mothers in prison. Methods: Cross-sectional survey, including a Short Form Health Survey (SF-12) and Kessler Psychological Distress Scale (5-item version) administered to Aboriginal women who self-identified as mothers. Results: Seventy-seven Aboriginal mothers in New South Wales (NSW) and 84 in Western Australia (WA) participated in the study. Eighty-three per cent (n=59) of mothers in NSW were in prison for drug-related offences, 64.8% (n=46) of mothers in WA were in prison for offences committed under the influence of alcohol. Sixty-eight per cent (n=52) of mothers in NSW and 35% (n=28) of mothers in WA reported mental health problems. Physical (PCS) and Mental (MCS) component scores of SF-12 varied for mothers in NSW and WA. Mothers in NSW experienced poorer health and functioning than mothers in WA (NSW: PCS 49.5, MCS 40.6; WA: PCS 54.4, MCS 48.3) and high levels of psychological distress (NSW: 13.1; WA 10.1). Conclusions: Aboriginal mothers in prison have significant health needs associated with physical and mental health, and psychological distress. Implications for public health: Adoption of social and emotional wellbeing as an explanatory framework for culturally secure healthcare in prison is essential to improving health outcomes of Aboriginal mothers in prison in Australia.

© 2019 The Authors Objective: To describe the social, emotional and physical wellbeing of Aboriginal mothers in prison. Methods: Cross-sectional survey, including a Short Form Health Survey (SF-12) and Kessler Psychological Distress Scale (5-item version) administered to Aboriginal women who self-identified as mothers. Results: Seventy-seven Aboriginal mothers in New South Wales (NSW) and 84 in Western Australia (WA) participated in the study. Eighty-three per cent (n=59) of mothers in NSW were in prison for drug-related offences, 64.8% (n=46) of mothers in WA were in prison for offences committed under the influence of alcohol. Sixty-eight per cent (n=52) of mothers in NSW and 35% (n=28) of mothers in WA reported mental health problems. Physical (PCS) and Mental (MCS) component scores of SF-12 varied for mothers in NSW and WA. Mothers in NSW experienced poorer health and functioning than mothers in WA (NSW: PCS 49.5, MCS 40.6; WA: PCS 54.4, MCS 48.3) and high levels of psychological distress (NSW: 13.1; WA 10.1). Conclusions: Aboriginal mothers in prison have significant health needs associated with physical and mental health, and psychological distress. Implications for public health: Adoption of social and emotional wellbeing as an explanatory framework for culturally secure healthcare in prison is essential to improving health outcomes of Aboriginal mothers in prison in Australia.

© The Author(s) 2019. While there has been extensive research on the health and social and emotional well-being (SEWB) of Aboriginal women in prison, there are few qualitative studies where incarcerated Aboriginal women have been directly asked about their health, SEWB, and health care experiences. Using an Indigenous research methodology and SEWB framework, this article presents the findings of 43 interviews with incarcerated Aboriginal women in New South Wales, Australia. Drawing on the interviews, we found that Aboriginal women have holistic conceptualizations of their health and SEWB that intersect with the SEWB of family and community. Women experience clusters of health problems that intersect with intergenerational trauma, perpetuated and compounded by ongoing colonial trauma including removal of children. Women are pro-active about their health but encounter numerous challenges in accessing appropriate health care. These rarely explored perspectives can inform a reframing of health and social support needs of incarcerated Aboriginal women establishing pathways for healing.

© 2019 The Authors Objective: This paper provides a case study of the responses to alcohol of an Aboriginal Community Controlled Health Service (The Service), and investigates the implementation of comprehensive primary health care and how it challenges the logic of colonial approaches. Methods: Data were drawn from a larger comprehensive primary health care study. Data on actions on alcohol were collected from: a) six-monthly service reports of activities; b) 29 interviews with staff and board members; c) six interviews with advocacy partners; and d) community assessment workshops with 13 service users. Results: The Service engaged in rehabilitative, curative, preventive and promotive work targeting alcohol, including advocacy and collaborative action on social determinants of health. It challenged other government approaches by increasing Aboriginal people’s control, providing culturally safe services, addressing racism, and advocating to government and industry. Conclusions: This case study provides an example of implementation of the full continuum of comprehensive primary health care activities. It shows how community control can challenge colonialism and ongoing power imbalances to promote evidence-based policy and practice that support self-determination as a positive determinant for health. Implications for public health: Aboriginal Community Controlled Health Services are a good model for comprehensive primary health care approaches to alcohol control.

© 2019 Australian College of Midwives Background: Birthing on Country is an international movement to return maternity services to First Nations communities and community control for improved health and wellbeing. Question: How can we implement Birthing on Country services for Aboriginal and/or Torres Strait Islander families across Australia? Methods: We have developed a framework from theoretical, policy and research literature on Birthing on Country; Aboriginal and Torres Strait Islander voices from across Australia; reviews exploring programs that have improved outcomes for Indigenous mothers and infants; and the retrospective synthesis of learnings from two empirical studies that have redesigned maternal infant health services and improved outcomes for Aboriginal and Torres Strait Islander families. Results: The RISE Framework has four pillars to drive important reform: (1) Redesign the health service; (2) Invest in the workforce; (3) Strengthen families; and, (4) Embed Aboriginal and/or Torres Strait Islander community governance and control. We present the evidence base for each pillar and practical examples of moving from the standard ‘western’ model of maternity care towards Birthing on Country services. Conclusions: Application of the RISE framework to plan, develop and monitor Birthing on Country services is likely to result in short and long-term health gains for Aboriginal and Torres Strait Islander families.