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Biological invasions are a main threat to biodiversity. Seebens et al. find that Indigenous Peoples' lands host 30% fewer alien species than other lands. This finding calls for additional examination of the drivers of such difference, from Indigenous Peoples' land management practices to the values that guide relations with nature. [ABSTRACT FROM AUTHOR]

PurposeMethodsResultsConclusionTo describe ophthalmic findings in an Indigenous paediatric population and the associations between fetal alcohol spectrum disorder (FASD), prenatal alcohol exposure (PAE), and eye anomalies.Medical records were reviewed for eye problems, and eye assessments were conducted by an orthoptist or ophthalmologist in the Lililwan Project cohort, which comprised 108 (81%) of all children born between 2002 and 2003, and residing in the remote Fitzroy Valley, Western Australia in 2010. Values from ophthalmic assessments and prevalence of abnormalities were presented for the total cohort and stratified by group: FASD; PAE (no FASD); and No PAE.Of children, 55% had PAE and 19% FASD. Most (98%) had normal vision; 15.6% had keratometry cylinder values indicating astigmatism and potential for improved vision with glasses. Strabismus (22.3%), short palpebral fissure length (PFL; 21.3%), upslanting palpebral fissures (12.0%), follicular trachomatous inflammation (6.9%), abnormal slit lamp assessments (6.7%), retinal tortuosity (6.7%), and blepharoptosis (5.6%) were identified. Strabismus and trachoma rates were higher than in the general child population. Ophthalmic findings were similar between groups except for prevalence of short PFL (FASD > No PAE; p = 0.003); abnormal keratometry cylinder values (FASD [29.4%] and PAE (no FASD) [20.0%] > No PAE [5.3%]; p = 0.031) and blepharoptosis (FASD [9.5%] > other groups [0%]; p = 0.040).Despite the small sample, some eye abnormalities were higher in children with PAE and/or FASD. Access to eye services or assessment of vision and structural eye anomalies is essential for Indigenous children, particularly those with PAE or FASD to allow early effective treatment. [ABSTRACT FROM AUTHOR]

In the Ngaanyatjarra Lands of desert Western Australia, older people are being encouraged to participate meaningfully in student education. This initiative is being led by two of the authors of this article, senior Ngaanyatjarra women, both of whom work with the Ngaanyatjarra Lands School with its campuses in eight remote communities spread over hundreds of kilometres. Elderly men and women, some of whom are residents in the Ngaanyatjarra Aged Care home (Ngaanyatjarra Health Service, 2021), are eagerly participating in the planning of bush trips, gathering their traditional resources, seeds, grinding stones, bush resins, recalling stories, songs, and dances—as they prepare for the bush camps with students. During the camps the schoolteachers step back and the elderly lead in what is known as two‐way science. At first glance, this work may look like it is simply focused on the educational needs of students with senior Yarnangu acting in a supporting role. However, this article will demonstrate the continuous connections and responsibilities, laid out in the Tjukurrpa (the Dreaming), between the old and the young, to their ancestral lands. It sets out how according to “Tjukurrpa thinking,” the principal way to provide good care is by helping senior people remain on country with family, pass on their knowledge to younger people, and thus keep strong languages and kurrunpa (people’s spirit) alive.

Aim: To examine whether differences in tacrolimus and mycophenolic acid (MPA) pharmacokinetics contribute to the poorer kidney transplant outcomes experienced by Aboriginal Australians. Methods: Concentration‐time profiles for tacrolimus and MPA were prospectively collected from 43 kidney transplant recipients: 27 Aboriginal and 16 Caucasian. Apparent clearance (CL/F) and distribution volume (V/F) for each individual were derived from concentration‐time profiles combined with population pharmacokinetic priors, with subsequent assessment for between‐group difference in pharmacokinetics. In addition, population pharmacokinetic models were developed using the prospective dataset supplemented by previously developed structural models for tacrolimus and MPA. The change in NONMEM objective function was used to assess improvement in goodness of model fit. Results: No differences were found between Aboriginal and Caucasian groups or empirical Bayes estimates, for CL/F or V/F of MPA or tacrolimus. However, a higher prevalence of CYP3A5 expressers (26% compared with 0%) and wider between‐subject variability in tacrolimus CL/F (SD = 5.00 compared with 3.25 L/h/70 kg) were observed in the Aboriginal group, though these differences failed to reach statistical significance (p =.07 and p =.08). Conclusion: There were no differences in typical tacrolimus or MPA pharmacokinetics between Aboriginal and Caucasian kidney transplant recipients. This means that Bayesian dosing tools developed to optimise tacrolimus and MPA dosing in Caucasian recipients may be applied to Aboriginal recipients. In turn, this may improve drug exposure and thereby transplant outcomes in this group. Aboriginal recipients appeared to have greater between‐subject variability in tacrolimus CL/F and a higher prevalence of CYP3A5 expressers, attributes that have been linked with inferior outcomes. Summary at a glance: This prospective observational study examined for differences in tacrolimus and mycophenolic acid pharmacokinetics between Aboriginal and Caucasian Australian kidney transplant recipients. No differences were found, arguing against differential drug exposure as a contributor to the poorer transplant outcomes experienced by Aboriginal Australians. [ABSTRACT FROM AUTHOR]

Marfan syndrome (MFS) is an autosomal dominantly inherited connective tissue disorder. Aortic dilatation/dissection and ectopia lentis are the most severe features, which affect physical functioning and psychological well‐being. In Aboriginal Australians, there is little psychosocial research on genetic conditions. This study explored the physical, psychological, and practical impacts of MFS on Aboriginal Australians. Eighteen (8 affected and 10 unaffected) members of a large Aboriginal Australian family with MFS participated in an ethically approved study. Semi‐structured qualitative interviews were conducted, transcribed verbatim, and analyzed thematically. All individuals reported challenges from MFS, negatively affecting day‐to‐day living. Severe vision impairment was perceived as the greatest challenge, contributing to feelings of stigma and exclusion. With aging, concerns shifted toward cardiac complications. The unpredictability of lens dislocation and aortic dissection was reported to be psychologically challenging. Participants described MFS‐related barriers to obtaining and retaining employment, especially following cardiac surgery; with consequential psychological and financial hardships. Participants articulated that their cultural drive to support the ill and respectfully mourn the deceased, regardless of distance, resulted in a significant financial burden. Additionally, when hospitalization and/or funerals occurred, financially solvent individuals were expected to share resources, without any expectation of repayment or reciprocity (i.e., 'demand sharing', common in Aboriginal Australian culture). This study documents the nature and pervasiveness of uncertainty for both affected and unaffected members of an MFS family. Many reported challenges are consistent with other MFS cohorts (including stigma, social exclusion, and unemployment). However, our findings suggest that cultural values may exacerbate the financial costs of MFS for Aboriginal Australians. [ABSTRACT FROM AUTHOR]

This paper will explain the concept of double perspective and the impact that this cultural understanding may have on the health of the Indigenous peoples of Scandinavia. In inter-cultural communication, one set of meanings may be discernible to the outsider while a whole extra set of restricted or underlying meanings are only accessible for those people who have the cultural knowledge to discern them. These different sets of meanings embody a double perspective. It is not dual perspectives on the same reality but rather seeing two separate but overlapping realities. We will discuss the layers of meaning which are involved in the interactions between public healthcare institutions, clinicians and staff, and Indigenous people including the Sámi. These interactions are influenced by the impact of colonization and the ongoing epistemicide of Indigenous thought. By realising the improved resilience that a double perspective brings to Indigenous peoples, an awareness of the inclusion and exclusion of Indigenous persons, cultures and histories should become established in public institutions and in everyday life. A double perspective carries Sámi resilience, and should be understood as a key to support individual health, and also the collective wellbeing of a people living on their traditional yet colonized land. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate program retention factors in a repeated team-based weight-loss and healthy lifestyle program for Aboriginal and Torres Strait Islander Peoples. Data comprised 3107 participants in 10 Aboriginal Knockout Health Challenge contests. Multiple variable and bivariate analyses compared age, gender, self-reported behaviors (physical activity and fruit and vegetable consumption) and objectively measured weight between completers and non-completers. First-time participants (n = 3107) who completed were more likely to be female, be older, weigh less and have more completing members in their team; only the number of team members completing was significant among participants (n = 1245) who took part in a second contest participation. Multivariate results were similar, with a participant’s odds of completing on their first and second participation occasion increasing by 1.16 and 1.18, respectively, with every teammate completed. Given that the strongest effect centered on a social factor, this highlights the importance of having community-driven design and the benefits of a group-based approach to engage and maintain First Peoples’ engagement in preventive health programs. Further, by identifying a change in factors associated with retention in successive weight-loss attempts, this study improves understanding of retention in weight-loss programs more generally.

Objective: To explore the rates and characteristics of self-harm across the Kimberley region of Western Australia. Method: Retrospective, cross-sectional audit. We obtained and descriptively analysed routinely collected self-harm data from the Kimberley District of the Western Australia Police Force (2014–2018) and the Emergency Department Data Collection (June 2017–December 2018). Variables included age, sex, Indigenous status, time of incident, and alcohol and drug use. Results: The rate of emergency department attendance for self-harm was three times higher in the Kimberley than the rest of Western Australia. Both emergency department and police data showed a disproportionately high percentage of incidents involving Aboriginal people, with highest rates in the 15–19 and 20–24 year age groups. Almost 80% of self-harm events recorded by police involving individuals aged 25–50 years involved alcohol. Many self-harm incidents occurred in the evening and at night. Conclusions: The rates of self-harm across the Kimberley region from 2014–2018 are unacceptably high. Increased funding and alignment of services to meet regional need are required as part of a holistic effort to reduce regional rates of self-harm. [ABSTRACT FROM AUTHOR]

Background and objectives Aboriginal Australians and Torres Strait Islanders (hereafter respectfully referred to as Indigenous Australians) experience a high burden of chronic non-communicable diseases (NCDs). Increased NCD risk is linked to oral diseases mediated by the oral microbiota, a microbial community influenced by both vertical transmission and lifestyle factors. As an initial step towards understanding the oral microbiota as a factor in Indigenous health, we present the first investigation of oral microbiota in Indigenous Australian adults. Methodology Dental calculus samples from Indigenous Australians with periodontal disease (PD; n  = 13) and non-Indigenous individuals both with (n  = 19) and without PD (n  = 20) were characterized using 16S ribosomal RNA gene amplicon sequencing. Alpha and beta diversity, differentially abundant microbial taxa and taxa unique to different participant groups were analysed using QIIME2. Results Samples from Indigenous Australians were more phylogenetically diverse (Kruskal–Wallis H  = 19.86, P  = 8.3 × 10−6), differed significantly in composition from non-Indigenous samples (PERMANOVA pseudo- F  = 10.42, P  = 0.001) and contained a relatively high proportion of unique taxa not previously reported in the human oral microbiota (e.g. Endomicrobia). These patterns were robust to stratification by PD status. Oral microbiota diversity and composition also differed between Indigenous individuals living in different geographic regions. Conclusions and implications Indigenous Australians may harbour unique oral microbiota shaped by their long relationships with Country (ancestral homelands). Our findings have implications for understanding the origins of oral and systemic NCDs and for the inclusion of Indigenous peoples in microbiota research, highlighting the microbiota as a novel field of enquiry to improve Indigenous health. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate program retention factors in a repeated team-based weight-loss and healthy lifestyle program for Aboriginal and Torres Strait Islander Peoples. Data comprised 3107 participants in 10 Aboriginal Knockout Health Challenge contests. Multiple variable and bivariate analyses compared age, gender, self-reported behaviors (physical activity and fruit and vegetable consumption) and objectively measured weight between completers and non-completers. First-time participants (n = 3107) who completed were more likely to be female, be older, weigh less and have more completing members in their team; only the number of team members completing was significant among participants (n = 1245) who took part in a second contest participation. Multivariate results were similar, with a participant's odds of completing on their first and second participation occasion increasing by 1.16 and 1.18, respectively, with every teammate completed. Given that the strongest effect centered on a social factor, this highlights the importance of having community-driven design and the benefits of a group-based approach to engage and maintain First Peoples' engagement in preventive health programs. Further, by identifying a change in factors associated with retention in successive weight-loss attempts, this study improves understanding of retention in weight-loss programs more generally., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The NSW Ministry of Health engaged author Bauman’s consultancy firm to conduct the study, with author Bohn-Goldbaum engaged as sub-contractor. Authors Cashmore, Milat, Reid and Sullivan have a non-financial competing interest in that they work for the organization that operates the program. Additionally, author Fonua’s former employment in the same organization overlapped with this study., (© 2022 The Author(s).)