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Background: Aboriginal and Torres Strait Islander (hereinafter respectfully termed Aboriginal) people have a greater incidence of stroke at a younger age than non-Indigenous people in Australia. The needs and preferences of Aboriginal people for rehabilitation and longer-term support remain largely unknown., Objectives: To identify the long-term rehabilitation needs of Aboriginal people who have a stroke, from the perspectives of Aboriginal persons with stroke and health care providers., Methods: Aboriginal people who had experienced stroke in the previous three years were interviewed to obtain their experiences of rehabilitation care. Health professionals who provided care in each of six designated hospitals and nearby community health sites were involved in focus groups and individual interviews. Information obtained was thematically analyzed separately for Aboriginal people with stroke and health professionals, and compared using Nvivo., Results: Among six Aboriginal people with stroke and 78 healthcare providers, four main themes emerged: the importance of family; variable access to services; the impact of stroke on Aboriginal peoples' lives; and making positive choices. Communication and involvement of family was highlighted as essential for a shared understanding, particularly when making decisions about participating in short and long-term rehabilitation. Co-morbidities, conflicting priorities, and inadequate or inflexible services and transport compounded issues with changing life roles. Stories of resilience were also shared., Conclusions: Aboriginal people report making positive lifestyle changes, but experience significant unmet rehabilitation needs. Addressing issues of communication, advocacy and flexible delivery should improve some of the shortfalls in service provision, particularly in regional and remote areas.

Background: Respectful maternity care is a fundamental human right, and an important component of quality maternity care., Objective: The aim of this study was to quantify the frequency and categories of D&A and identify factors associated with reporting D&A among women in north Showa zone of Ethiopia., Method: A cross-sectional study was conducted with 435 randomly selected women who had given birth at public health facility within the previous 12 months in North Showa zone of Ethiopia. A digital (tablet-based) structured and researcher administered tool was used for data collection. Frequencies of D&A items organised around the Bowser and Hill categories of D&A and presented in the White Ribbon Alliance's Universal Rights of Childbearing Women Framework were calculated. Multivariable logistic regression was used to identify the association between experience of disrespect and abuse and interpersonal and structural factors at p-value <0.05 and odds ratio values with 95% confidence interval., Results: All participants reported at least one form of disrespect and abuse during childbirth. Types of disrespect and abuse experienced by participants were physical abuse 435 (100%), non-consented care 423 (97.2%), non-confidential care 288 (66.2%), abandonment/neglect (34.7%), non-dignified care 126 (29%), discriminatory care 99 (22.8%) and detention 24 (5.5%). Hospital birth [AOR: 3.04, 95% CI: 1.75, 5.27], rural residence [AOR: 1.44, 95% CI: 0.76, 2.71], monthly household income less than 1,644 Birr (USD 57) [AOR: 2.26, 95% CI: 1.20, 4.26], being attended by female providers [AOR: 1.74, 95% CI: 1.06, 2.86] and midwifery nurses [AOR: 2.23, 95% CI: 1.13, 4.39] showed positive association with experience of disrespect and abuse., Conclusion: Hospital birth showed consistent association with all forms of disrespect and abuse. Expanding the size and skill mix of professionals in the hospitals, sensitizing providers consequences of disrespect and abuse could promote dignified and respectful care.

Background: Alcohol use is a common phenomenon within Australian culture. While there has been significant focus on alcohol use among young Australians, there has been little on health promotion or early interventions focussing on older Australians. Methods: This paper presents the findings of an explorative study that used four interactive focus group workshops to ask the question: Is an existing World Health Organisation alcohol and drug screening tool called the Alcohol, Smoking and Substance Involvement Screening Test (originally developed for young people) acceptable and suitable for older people? The data were analysed based on the question using thematic coding. Results: Participants generally considered that they would be more comfortable talking with their health providers about their alcohol and drug use rather than filling out the Alcohol, Smoking and Substance Involvement Screening Test themselves. This suggests that the tool should be modified to accommodate the differences in health status that reflect life events of the different older age groups. Conclusion: Due to potential complex medical and diverse range of pharmacotherapies common among this age group, it is recommended that, if the tool is used, it be administered by health practitioners such as nurses.

Objectives: This is the second of 2 papers reporting on the result of the Circumpolar Inuit Cancer Review, an international collaborative effort involving researchers and health officials from Alaska, Canada and Greenland., Methods: Inuit cancer cases by age-sex group and anatomic site were obtained from the regional cancer registries., Results: Cancer in general is increasing among Inuit, in all regions, and among both men and women. Inuit continue to be at extreme high risk, relative to non-Inuit and to comparisons of global populations, for the historically recognized so-called traditional cancers (such as cancer of the nasopharynx and salivary glands). Among the so-called modern cancers prevalent in developed societies, lung cancer is rapidly increasing in incidence (especially in Canada), such that the rate in both Inuit men and women is the highest in the world; other cancers, such as colorectal cancer, are also on the rise (especially in Alaska), while breast and prostate cancer remain low relative to the non-Inuit population. The decline in cervical cancer is a positive development; in the 3 regions, the rate in Greenland is the highest., Conclusions: Data such as these can form the basis of interventions directed towards known risk factors such as smoking, diet, obesity, viral and bacterial infections, and low screening prevalence. Cancer surveillance is a basic task of the public health system; in the Arctic, it is particularly important as Inuit continue to undergo further changes in their life-styles and social environments.

Objectives: This is first of 2 papers on the Circumpolar Inuit Cancer Review, an international collaborative effort involving researchers and health officials from Alaska, Canada and Greenland. It covers the period 1989-2003, updating the last review (1969-1988) and together provides an overview of the trends and patterns of cancer among the Inuit in 3 countries and over a 35-year period., Methods: Inuit cancer cases by age-sex group and anatomic site were obtained from the regional cancer registries. The sources of the age-sex distribution of various Inuit populations include the population registry (Greenland), and annual estimates and periodic censuses (Alaska and Canada). Incidence rates were age-standardization by the direct method to the standard world population of the International Agency for Research on Cancer., Conclusions: This project demonstrates the feasibility of international partnerships in cancer surveillance, and when these partnerships are extended to other diseases and health conditions, they can contribute to the development of a Circumpolar Health Observatory.

This article describes my journey as a nurse as I search for better ways to work with urban Aboriginal women. Learning as I build and maintain trusting relationships with Elders, Aboriginal health professionals and communities has been an important first step. Incorporating reflective practice, participatory action research and ethical guidelines has further assisted me to work in more culturally safe and respectful ways. While there has been increasing recognition of access and equity issues in Australia's current neo-colonial period, actual improvements have been very slow to emerge. Meanwhile many Aboriginal people continue to experience poor levels of health. My hope is that this article can contribute to the growing body of knowledge that recognises the impact of past and present colonisation practices and shifts health care towards collaborative healing and well being models that are more supportive of Aboriginal people and their needs. The emphasis on Aboriginal women's health rather than mixed gender health care comes from my experiences in sexual health, where many Australian Aboriginal women prefer to access 'women only' services.