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Aboriginal People have inhabited the Australian continent before time began, but archaeologists and anthropologists state there is evidence for approximately 51,000 to 71,000 years of continual habitation. During this time, the Australian continent has experienced many environmental and climatic changes, which have contributed to mass animal extinction. The skeletal remains of Aboriginal Australians were examined for evidence, which may be indicative of fast running which would assist survival. The skull and mandible bones of the Kaurna People were examined for signs evolutional traits related to survival. Aboriginal culture, knowledge of medical treatment and traditional medicines were also investigated. Oral storytelling of factual events, passed down unchanged for millennia, contributed to survival. The Kaurna People exhibited evolutionary facial features that would have assisted survival. Kaurna People had excellent knowledge of medicine and the capacity to heal their community members. The process of mobility and relocation may have embedded the need to be mobile in some Aboriginal Australian cultures, and why many Aboriginal tribes did not invest too much time and resources in building permanent structures and dwellings. Navigating these extremely harsh, rapidly changing conditions is an incredible story of survival of Aboriginal Australians. The findings of this investigation suggest that Aboriginal Australians' survival methods were complex and multi-faceted. Although this paper could not examine every survival method, perhaps Aboriginal Peoples' knowledge of flora and fauna, (for nourishment and medicine) living in clans, and avoiding mass cohabitation was paramount to our survival. [ABSTRACT FROM AUTHOR]

Background: Research into the effectiveness of antenatal education classes is crucial for Indigenous Peoples from Aotearoa New Zealand, Australia, Canada and the United States who experience poorer maternal and infant health outcomes compared to non-Indigenous populations. Our systematic review questions were intended to determine the extent of Indigenous Peoples prioritisation and involvement in antenatal education classes, and to understand the experience of Indigenous Peoples from these countries in antenatal education classes. Methods: Using a standardised protocol, we systematically searched five electronic databases for primary research papers on antenatal education classes within the four countries noted and identified 17 papers that met the criteria. We undertook a qualitative meta-synthesis using a socio-critical lens. Results: Systematic review of the academic literature demonstrates that Indigenous Peoples of Aotearoa New Zealand, Australia, Canada and the United States are not prioritised in antenatal education classes with only two of 17 studies identifying Indigenous participants. Within these two studies, Indigenous Peoples were underrepresented. As a result of poor engagement and low participation numbers of Indigenous Peoples in these antenatal education classes, it was not possible to understand the experiences of Indigenous Peoples. Conclusion: Given that Indigenous Peoples were absent from the majority of studies examined in this review, it is clear little consideration is afforded to the antenatal health needs and aspirations of Indigenous Peoples of Aotearoa New Zealand, Australia, Canada and the United States. To address the stark antenatal health inequities of Indigenous Peoples, targeted Indigenous interventions that consider culture, language, and wider aspects of holistic health must be privileged. Trial registration: PROSPERO Registration ID: CRD4202017658 [ABSTRACT FROM AUTHOR]

Access to adequate and appropriate service provision has a direct positive impact on health and wellbeing. Experiences of inaccessible, discriminatory, and culturally unsafe services and/or service providers are considered a root cause for the health inequalities that exist among Indigenous queer youth. Experiences of discrimination and cultural inappropriateness are commonplace, with Indigenous queer youth noting issues related to access to services and treatment, stereotyping, and a lack of quality in the care provided, which discourage Indigenous people from accessing care. This paper examines the perspectives of Indigenous LGBTIQ+ youth and health service providers to identify what challenges, obstacles and opportunities are currently being faced and what could be implemented to improve the health and wellbeing outcomes for Indigenous LGBTIQ+ youth in the future. [ABSTRACT FROM AUTHOR]

Enhancing health literacy can empower individuals and communities to take control over their health as well as improve safety and quality in healthcare. However, Indigenous health studies have repeatedly suggested that conceptualisations of health literacy are confined to Western knowledge, paradigms, and practices. The exploratory qualitative research design selected for this study used an inductive content analysis approach and systematic iterative analysis. Publicly available health literacy-related policy and practice documents originating from Australia, Canada, and New Zealand were analysed to explore the extent to which and the ways in which Indigenous knowledges are recognised, acknowledged, and promoted. Findings suggest that active promotion of Indigenous-specific health knowledges and approaches is limited and guidance to support recognition of such knowledges in practice is rare. Given that health services play a pivotal role in enhancing health literacy, policies and guidelines need to ensure that health services appropriately address and increase awareness of the diverse strengths and needs of Indigenous Peoples. The provision of constructive support, resources, and training opportunities is essential for Indigenous knowledges to be recognised and promoted within health services. Ensuring that Indigenous communities have the opportunity to autonomously conceptualise health literacy policy and practice is critical to decolonising health care. [ABSTRACT FROM AUTHOR]

This paper reviews practical policy lessons from trade in a dietary supplement (or nutraceutical) processed from Terminal/a ferdinandiana (Combretaceae), which contains extremely high levels of natural ascorbic acid (vitamin C). Most production is from wild harvest by Aboriginal people, who get USD 14 per kilogram (kg) for picked, sorted fruit. However, the main Australian company involved is struggling to get the 12 tons/year it requires, and could market much more. Although Aboriginal people ideally should benefit economically from harvest of T. ferdinandiana, there are major challenges to this objective, including Australia's high labor costs compared to Asia, Africa, and Latin America where T. ferdinandiana can be grown. In addition, although Australia is a signatory to and plays a leading role in the international Convention on Biodiversity (CBD), this has meant lithe in practice so far. "Cultural branding" and certification of organic, wild harvested T. ferdinandiana fruit collected by Aboriginal people working in partnership with commercial companies offers a possibility for Aboriginal people to continue to benefit from wild harvest or enrichment plantings. However, even the establishment of commercial horticultural production within Australia faces several challenges. For Australia to maintain and develop the international market, future development of this bush food must include: (a) implementation of existing international and national policies on protection of genetic resources; (b) formation of a producer association to increase production efficiencies; (c) functioning partnerships between Aboriginal producers and commercial partners that guarantee and expand reliable supply and develop cultural branding and certification as marketing tools; and (d) scientific research into improving I ferdinandiana fruit yields and production methods, based on improved resource management and efficient processing methods. [ABSTRACT FROM AUTHOR]

Purpose: This study explores accounting practice in an Indigenous organization. This organization is embedded within a rural Aboriginal community in the country currently known as Australia. In doing so, this study illustrates the intertwining of accounting practice, practitioners, organizations and social/cultural context, while recognizing that the cultural embeddedness of accounting is not uniform. Design/methodology/approach: Empirical materials were collected as part of a qualitative field study with an Indigenous organization. Specific methods include interviews, informal conversations, documentary reviews and participant observations. These materials were analysed through a Bourdieusian perspective. Findings: By working with Indigenous Peoples on the ground, rather than relying on secondary materials, this study highlights how the values of a community challenge and reorient accounting practice towards community aspirations. This study illustrates how fields beyond the organization influence accounting practice, including in budgeting and assurance. Originality/value: Exploring Indigenous practices of accounting maintains Indigenous agency and opens up space for alternative understandings and practices of accounting. By illustrating how a community can influence the accounting practice of an organization, this study has implications for wider understandings of the cultural embeddedness of mainstream accounting and possible alternatives. [ABSTRACT FROM AUTHOR]

Background: Indigenous peoples in developed countries have reduced life expectancies, particularly from chronic diseases. The lack of access to and take up of palliative care services of Indigenous peoples is an ongoing concern. Objectives: To examine and learn from published studies on provision of culturally safe palliative care service delivery to Indigenous people in Australia, New Zealand (NZ), Canada and the United States of America (USA); and to compare Indigenous peoples' preferences, needs, opportunities and barriers to palliative care. Methods: A comprehensive search of multiple databases was undertaken. Articles were included if they were published in English from 2000 onwards and related to palliative care service delivery for Indigenous populations; papers could use quantitative or qualitative approaches. Common themes were identified using thematic synthesis. Studies were evaluated using Daly's hierarchy of evidence-for-practice in qualitative research. Results: Of 522 articles screened, 39 were eligible for inclusion. Despite diversity in Indigenous peoples' experiences across countries, some commonalities were noted in the preferences for palliative care of Indigenous people: to die close to or at home; involvement of family; and the integration of cultural practices. Barriers identified included inaccessibility, affordability, lack of awareness of services, perceptions of palliative care, and inappropriate services. Identified models attempted to address these gaps by adopting the following strategies: community engagement and ownership; flexibility in approach; continuing education and training; a whole-of-service approach; and local partnerships among multiple agencies. Better engagement with Indigenous clients, an increase in number of palliative care patients, improved outcomes, and understanding about palliative care by patients and their families were identified as positive achievements. Conclusions: The results provide a comprehensive overview of identified effective practices with regards to palliative care delivered to Indigenous populations to guide future program developments in this field. Further research is required to explore the palliative care needs and experiences of Indigenous people living in urban areas. [ABSTRACT FROM AUTHOR]

Background: Aboriginal and Torres Strait Islander peoples are the first people of Australia. Consequences of historic and contemporary settler-colonialism including racism, trauma, grief and loss (of land, culture, spirituality, and freedoms) have led to substantial negative health and wellbeing impacts. The Kessler Psychological Distress Scales are population and individual-level tools designed to measure general psychological health status. There has been limited assessment of the psychometric properties and validity of the Kessler Psychological Distress Scale for use with the Aboriginal and Torres Strait Islander population in Australia, despite its widespread use.Methods: A national sample of Aboriginal and Torres Strait Islander adults (n = 6988 ≥ 16 years) was used in the psychometric assessment of the MK-K5, which involved face validity, acceptability, internal consistency/reliability, construct validity, and convergent and divergent validity testing. Receiver Operator Characteristics (ROC) curves were produced to assess clinical utility for depression and anxiety screening.Results: The MK-K5 demonstrated face validity for psychological distress in two focus groups, and had good acceptability, good internal consistency/reliability (α = 0.89), good construct validity (uni-dimensional; one underlying component explaining 70.1% of variance), and demonstrated convergent and divergent validity in the sample. The MK-K5 had good clinical utility at a cut-off score of 11 for detecting ever being diagnosed with depression or anxiety.Conclusions: The MK-K5 is a valid measure of psychological distress and has clinical utility in the Aboriginal and Torres Strait Islander population. [ABSTRACT FROM AUTHOR]

Background: Globally, interpreters are underused by health providers in hospitals, despite 40 years of evidence documenting benefits to both patients and providers. At Royal Darwin Hospital, in Australia's Northern Territory, 60-90% of patients are Aboriginal, and 60% speak an Aboriginal language, but only approximately 17% access an interpreter. Recognising this system failure, the NT Aboriginal Interpreter Service and Royal Darwin Hospital piloted a new model with interpreters embedded in a renal team during medical ward rounds for 4 weeks in 2019.Methods: This research was embedded in a larger Participatory Action Research study examining cultural safety and communication at Royal Darwin Hospital. Six Aboriginal language speaking patients (five Yolŋu and one Tiwi), three non-Indigenous doctors and five Aboriginal interpreter staff were purposefully sampled. Data sources included participant interviews conducted in either the patient's language or English, researcher field notes from shadowing doctors, doctors' reflective journals, interpreter job logs and patient language lists. Inductive narrative analysis, guided by critical theory and Aboriginal knowledges, was conducted.Results: The hospital experience of Yolŋu and Tiwi participants was transformed through consistent access to interpreters who enabled patients to express their clinical and non-clinical needs. Aboriginal language-speaking patients experienced a transformation to culturally safe care. After initially reporting feeling "stuck" and disempowered when forced to communicate in English, participants reported feeling satisfied with their care and empowered by consistent access to the trusted interpreters, who shared their culture and worldviews. Interpreters also enabled providers to listen to concerns and priorities expressed by patients, which resulted in holistic care to address social determinants of health. This improved patient trajectories and reduced self-discharge rates.Conclusions: A culturally unsafe system which restricted people's ability to receive equitable healthcare in their first language was overturned by embedding interpreters in a renal medical team. This research is the first to demonstrate the importance of consistent interpreter use for providing culturally safe care for Aboriginal patients in Australia. [ABSTRACT FROM AUTHOR]

Background: Aboriginal people face challenges on several fronts when it comes to the health and wellbeing of their community, compared to the rest of the Australian population. This is no different in urban areas such as Australia's largest urban Aboriginal community located in Blacktown, NSW, where sexually transmitted infections (STIs) remain an issue of concern. Across Australia, rates of infectious syphilis, human immunodeficiency virus (HIV), and hepatitis C infection have increased by 400, 260, and 15% respectively while gonorrhoea decreased 12% in the 5-year period from 2013 to 2017. This study explores how to address the barriers that prevent young Aboriginal people under 30 years of age from accessing STI treatment through Government Sexual Health Services. Methods: This qualitative study will use purposeful sampling to recruit 20 male and 20 female health consumers, 10 Aboriginal elders and 10 sexual health clinicians. This recruitment will be undertaken with the assistance of the local Government Health Services and local Aboriginal organisations. One-on-one semi-structured interviews will be undertaken by someone of the same gender in order to address cultural preferences. Data will be entered into NVivo and thematically analysed. Discussion: This study will seek to add to the literature that explores why young Aboriginal people do not access sexual health services. This study seeks to understand the experience of clinicians, Aboriginal elders and Aboriginal young people to provide practical policy and clinical redesign evidence that can be used to improve the experience and cultural safety of sexual health services in urban areas of Australia. The results of the qualitative research will be disseminated with the assistance of participating local Aboriginal organisations, and the findings will be published through peer-reviewed scientific journals and conference presentations. Trial registration: The study is approved by the Western Sydney Local Health District Human Research Ethics Committee (HREC/16/WMEAD/449) and the New South Wales Aboriginal Health and Medical Research Council's Human Research Ethics Committee (1220/16). [ABSTRACT FROM AUTHOR]

In collaboration with Ngemba First Nation in Brewarrina, Australia, this research involves co-designing and co-developing an innovative community digital entrepreneurial platform that includes a mobile app and a website. The methodology is informed by theories of relatedness, Indigenist standpoint, and by the principles of Indigenist research and related ways of being, knowing, and doing research. It uses an Indigenist technology co-design and co-development method. The platform proposes several practical applications, including individual and community entrepreneurship promotion and skills development. This research is motivated by the Australian government's First Nations priorities through the Close the Gap initiative, including the digital divide, employment and business, and economic development. This research project proposes a paradigm shift from a focus on welfare to a focus on entrepreneurial enterprise. [ABSTRACT FROM AUTHOR]

Background: Indigenous Australians have poorer cancer outcomes in terms of incidence mortality and survival compared with non-Indigenous Australians. The factors contributing to this disparity are complex. Identifying and addressing the psychosocial factors and support needs of Indigenous cancer patients may help reduce this disparity. The Supportive Care Needs Assessment Tool for Indigenous People (SCNAT-IP) is a validated 26-item questionnaire developed to assess their unmet supportive care needs. This qualitative study reports on patient and clinician attitudes towards feasibility and acceptability of SCNAT-IP in routine care. Methods: Forty-four in-depth semi-structured interviews were conducted with 10 clinical staff and 34 Indigenous cancer patients with heterogeneous tumours. Participants were recruited from four geographically diverse Australian cancer clinics. Transcripts were imported into qualitative analysis software (NVivo 10 Software), coded and thematic analysis performed. Results: Indigenous patients (mean age 54.4 years) found the SCNAT-IP beneficial and easy to understand and they felt valued and heard. Clinical staff reported multiple benefits of using the SCNAT-IP. They particularly appreciated its comprehensive and systematic nature as well as the associated opportunities for early intervention. Some staff described improvements in team communication, while both staff and patients reported that new referrals to support services were directly triggered by completion of the SCNAT-IP. There were also inter-cultural benefits, with a positive and bi-directional exchange of information and cultural knowledge reported when using the SCNAT-IP. Although staff identified some potential barriers to using the SCNAT-IP, including the time required, the response format and comprehension difficulties amongst some participants with low English fluency, these were outweighed by the benefits. Some areas for scaled improvement were also identified by staff. Conclusions: Staff and patients found the SCNAT-IP to be an acceptable tool and supported universal screening for Indigenous cancer patients. The SCNAT-IP has the potential to help reduce the inequalities in cancer care experienced by Indigenous Australians by identifying and subsequently addressing their unmet support needs. Further research is needed to explore the validity of the SCNAT-IP for Indigenous people from other nations. [ABSTRACT FROM AUTHOR]

Background/objectives: Little is known about trends in risk factors and mortality for Aboriginal Australians with heart failure (HF). This population-based study evaluated trends in prevalence of risk factors, 30-day and 1-year all-cause mortality following first HF hospitalization among Aboriginal and non-Aboriginal Western Australians in the decade 2000-2009. Methods: Linked-health data were used to identify patients (20-84 years), with a first-ever HF hospitalization. Trends in demographics, comorbidities, interventions and risk factors were evaluated. Logistic and Cox regression models were fitted to test and compare trends over time in 30-day and 1-year mortality. Results: Of 17,379 HF patients, 1,013 (5.8 %) were Aboriginal. Compared with 2000-2002, the prevalence (as history) of myocardial infarction and hypertension increased more markedly in 2006-2009 in Aboriginal (versus non-Aboriginal) patients, while diabetes and chronic kidney disease remained disproportionately higher in Aboriginal patients. Risk factor trends, including the Charlson comorbidity index, increased over time in younger Aboriginal patients. Risk-adjusted 30-day mortality did not change over the decade in either group. Risk-adjusted 1-year mortality (in 30-day survivors) was non-significantly higher in Aboriginal patients in 2006-2008 compared with 2000-2002 (hazard ratio (HR) 1.44; 95 % CI 0.85-2.41; p-trend = 0.47) whereas it decreased in non-Aboriginal patients (HR 0.87; 95 % CI 0.78-0.97; p-trend = 0.01). Conclusions: Between 2000 and 2009, the prevalence of HF antecedents increased and remained disproportionately higher in Aboriginal (versus non-Aboriginal) HF patients. Risk-adjusted 1-year mortality did not improve in Aboriginal patients over the period in contrast with non-Aboriginal patients. These findings highlight the need for better prevention and post-HF care in Aboriginal Australians. [ABSTRACT FROM AUTHOR]

Recent archaeological investigation at Box Gully, located on the north western tip of the Lake Tyrrell lunette, has resulted in the first documentation of pre-30,000 calBP Aboriginal occupation of the extensive area between the Murray River and the Tasmanian highlands. The remains of repeated small scale camping episodes were uncovered in a palaeosol capping a buried pelletal clay lunette. Five new radiocarbon determinations on charcoal associated with cultural material in the palaeosol range from ca. 32,000 calBP near the bottom to ca. 26,600 calBP near the top, and are supported by both conventional radiocarbon and Optically Stimulated Luminescence dates obtained independently during geomorphic investigations of Box Gully. Hearth features, stone artefacts and the remains of bettong, hare-wallaby, shingle-backed lizard, emu and fresh water mussel were present within the palaeosol. Review of the late Pleistocene archaeological record of the western Murray Basin allows the finds at Box Gully to be placed in a human occupation context of adaptation to severe climatic stress leading to the Last Glacial Maximum. As conditions deteriorated further after ca. 27,000 calBP, lacustrine localities including the Willandra Lakes, Lake Tandou and the Lower Darling were much less heavily frequented than previously, or like Lake Tyrrell, abandoned. At the same time sustained occupation of the Murray River valley occurred, as did the initial occupation of rockshelters in the highlands of southern Victoria. [ABSTRACT FROM AUTHOR]