Search

Despite considerable investment, health outcomes for First Nations people are well below those of the rest of the population in several countries, including Canada, the United States, and Australia. In this article, the authors draw on actor-network theory and the case of Birthing on Country, a successful policy initiative led by First Nations Australians, to explore the decolonization of health services. Using publicly available archival data and the theoretical guidance of actor-network theory, the analysis offers insight into how marketing techniques and technologies can be deployed to achieve improved health outcomes and implement decolonized approaches. The insights provided have theoretical implications for marketing scholarship, social implications for understanding and implementing an agenda of decolonization, and practical implications for health care marketing. [ABSTRACT FROM AUTHOR]

From 2017–2019 I was counsel representing the families in a coronial inquest which looked at Aboriginal youth deaths in the Kimberley region of Australia with a particular regard to self-harm. A coronial inquest is a judicial proceeding that investigates unexplained deaths, unusual deaths, or deaths in state custody. In this paper I consider the epistemic violence my clients experienced, and I particularly examine the potential for affect and relationality to create connectors between epistemes in the hope of a more emancipatory conception of justice. I draw on Audre Lorde's corpus as one that is worthy of serious regard in critical legal studies and useful in my work. In particular, I turn my gaze inwards and draw on Audre Lorde's creation of biomythography as a method for legal writing and legal practice, to offer an account of my role in the Inquest. Biomythography is a form of writing which grounds subjective individual and collective experience, and its interrelationship with history and myth to centre experiences of justice and injustice. In using this methodology, I consider ways the civil law, through its interpretive function and authority in the coronial jurisdiction, oppresses First Nations Australians. Through writing my biomythography I show that the Coroner's fact finding role arrives at truth in a way inherently embedded in Western knowledge systems and I regard the Coroner's truth determining function as violent. Finally, I consider the potential of affect as a connector between epistemes to create emancipatory possibilities for justice. [ABSTRACT FROM AUTHOR]

BackgroundObjectiveMethodResultsConclusions\nKEY POINTSAboriginal and Torres Strait Islander young people experience markedly higher suicide mortality than non-Indigenous youth in Australia, yet there is little evidence of effective preventative strategies. Many are misaligned to the needs of First Nations young people due to a lack of consideration of protective factors such as community and cultural connection.To date no research has examined whether increasing cultural connectedness may reduce Aboriginal and Torres Strait Islander youth suicidality. The current study outlines the development, implementation, and pilot evaluation of Project Yarn Circle, a school-based suicide prevention initiative utilising cultural education and connection.Project Yarn Circle was piloted by an Indigenous owned and managed youth mental health organisation, delivering 5 weekly sessions to 276 young people at 9 schools in Southeast Queensland, Australia, between 2019 and 2023. Sessions connected students to cultural knowledge and practices (stories, painting, dance, Indigenous languages) with Elders and local cultural knowledge facilitators.Pre- and post-program evaluation questionnaires completed 6–8 weeks apart found that participants had significantly lower suicidal ideation (GHQ-18-SS), pre 7.16, post 6.61, p = .043 higher positive ideation/reasons for living (PANSI-PI) pre 22.44, post 23.60, p = .009, and higher self-esteem (RSES) pre 16.55, post 23.60, p = .005. Analyses of cultural connectedness items co-designed for this evaluation study and validated using Exploratory Factor Analysis found that students demonstrated greater cultural identity clarity, peer cultural competence, strength from culture, salience of cultural continuity and sense of belonging.These findings provide new evidence towards utilising cultural connectedness as an intervention mechanism in Indigenous youth suicide prevention.What is already known about this topic: Aboriginal and Torres Strait Islander youth suicide rates are persistently higher than for other young people, with little evidence of effective suicide prevention strategies.Interventions often are misaligned to the different risk and protective factors experienced by First Nations young people.Connection to culture is promoted as a unique protective factor to reduce suicide risk for First Nations young people.Aboriginal and Torres Strait Islander youth suicide rates are persistently higher than for other young people, with little evidence of effective suicide prevention strategies.Interventions often are misaligned to the different risk and protective factors experienced by First Nations young people.Connection to culture is promoted as a unique protective factor to reduce suicide risk for First Nations young people.What this topic adds: To our knowledge this is the first published cultural engagement intervention to report significant improvement in Aboriginal and Torres Strait Islander youth suicidality, providing an example of the development and delivery of a new program approach.This is the first study to explore increases in connection to culture in conjunction with lowered suicidal ideation and higher reasons for living.The findings suggest that connection to culture can be used as a therapeutic mechanism to reduce suicidality.To our knowledge this is the first published cultural engagement intervention to report significant improvement in Aboriginal and Torres Strait Islander youth suicidality, providing an example of the development and delivery of a new program approach.This is the first study to explore increases in connection to culture in conjunction with lowered suicidal ideation and higher reasons for living.The findings suggest that connection to culture can be used as a therapeutic mechanism to reduce suicidality. [ABSTRACT FROM AUTHOR]

Issue Addressed: While social determinants frameworks are still popular in research about First Nations health in Australia, a growing body of research prefers cultural determinants of health models. Cultural determinants models provide a holistic, strength‐based framework to explain connections between health and contextual factors, including the potential role of music and its impact on social and emotional well‐being. Given the growing international recognition of links between music, health, and wellbeing through bodies such as the World Health Organisation, this article examines whether and how music practices are acknowledged in First Nations determinants of health literature. Method s : We conducted a scoping narrative review of literature from five databases: Scopus, PsycInfo, CINAHL, PubMed and ProQuest Central. The search returned 60 articles published since 2017, which we analysed in NVivo for common themes. Results: Music was only explicitly identified as a determinant of health in two studies. Yet, participants in five studies identified music and song as directly impacting their social and emotional well‐being. When we broadened our frame of analysis to include other forms of expressive cultural practice, one quarter of included studies empirically acknowledged the role of expressive cultural practice for social and emotional well‐being. Conclusion: While many recent studies identify the impact of First Nations' expressive practices broadly, they miss important features of First Nations music as a potentially unique cultural, social, political and ecological determinant of health. So What?: There is an opportunity for future research and health determinant modelling to explicitly examine the role of First Nations music and other creative practices for social and emotional well‐being. [ABSTRACT FROM AUTHOR]

This Special Issue of the journal Art, Design & Communication in Higher Education (ADCHE) revisits the purpose and potential of art and design from an Australian perspective. It draws on the November 2023 Australian Council of University Art & Design Schools (ACUADS) 43rd conference, co-convened by Thao Nguyen, School of Art, RMIT University and myself. This national forum sought to consider the following: (1) how can creative education and research embrace our unique Australian perspective and integrate First Nations knowledge to cultivate a 'thriving future'? (2) What is the potential of creative research and pedagogy in responding to the climate crisis and other urgent societal concerns? (3) How has the global pandemic disrupted and catalysed innovation in creative art education, including the rapid uptake of digital media by traditionally haptic disciplines? What are the key technological agendas for art and design schools? Drawing on our unique perspective, with particular acknowledgement of First Nations knowledge and ways of being, our colonial history and Asia–Pacific context, this edition considers how creative education and research can contribute not only to economies but also to the array of pressing social, environmental and cultural issues necessary to enable thriving futures. [ABSTRACT FROM AUTHOR]

This paper focuses on the settler colonial landscapes of tourism in the regional city of Dubbo, Australia. Dubbo is situated on Wiradyuri Country in the Orana region of New South Wales. Focusing specifically on the heritage-listed Old Dubbo Gaol and the Dundullimal Homestead, a former pastoral station, I explicate how these tourist sites offer experiences that normalise settler dwelling and occupation of First Nations Country. The Old Dubbo Gaol and Dundullimal occupy a broader settler colonial landscape where Dubbo is presented historically as 'empty' until settlers exploited the town's 'natural' resources. By occluding the relationship between invasion, pastoralism, and Indigenous dispossession, the sites reproduce for visitors settler colonial metanarratives of dwelling. Using Tim Ingold's notion of taskscape, I show how the tourist sites create taskscapes which invite visitors and consumers to engage in settler forms of dwelling that normalise a settler colonial landscape. Tourist taskscapes consist of the activities and interactions in a heritage site that encourage visitors to take an active role in experiencing place and history. By aligning these experiences and activities to settler narratives and histories, the sites interpellate visitors into the processes of autochthony that were/are used to negate First Nations sovereignties. While these taskscapes are leaky and contain the presence of First Nations in select parts of the heritage sites, the taskscapes dominate heritage tourism and normalise settler colonisation as a feature of place-making that does not require explicit explanation or education. [ABSTRACT FROM AUTHOR]

This article reports on promising pilot research which indicates that intergenerational musical practices in diverse First Nations families and communities in Vanuatu and Australia can shape cultural determinants of health (CDoH). Wecontend that such strength- and culture-based approaches to health promotion may help to disrupt colonial and deficit constructions of First Nations People and our health and wellbeing. The pilot study used Indigenist yarning which prioritized First Nations ideas, concepts, and knowledges during informal and relational semi-structured interviews with 9 diverse First Nations musicians in Australia and Vanuatu. The pilot study underpins an ongoing international 3-year research project examining First Nations music as a determinant of health led by Griffith University, The University of the Sunshine Coast, The University of Queensland, and Edith Cowan University. Yarning interviews were analyzed using collaborative thematic analysis and Indigenous visual art responses. Major themes emerging from the data related to intergenerational music activity and transmission. Themes include Music as an intergenerational medium of cultures; Music as a bond between older and younger generations; Intergenerational musical activism and advocacy; and Musical lineages and strengths. Intergenerational musical practices in diverse First Nations families may provide protective cultural, social, economic, educative, and professional determinants of health. The study indicates that more research and new theory may unlock the potential of First Nations musical activities as protective and agentic cultural practices in our families and communities. [ABSTRACT FROM AUTHOR]

Indigenous people and the land they manage are integral to biodiversity conservation worldwide, with threatened species projects in Australia increasingly using a two-way collaborative approach between Indigenous people and scientists. There is increasing interest in the nature of these relationships and how Indigenous culture, people and knowledge can be prioritised better, while increasing conservation outcomes. One example is the recent successful surveys of endangered night parrot (Pezoporus occidentalis) populations by Aboriginal rangers across Australia's desert areas. This perspective article documents our collaborative effort, between Aboriginal rangers and scientists, to survey night parrot in Western Australia, from 2017 to 2023, the results, and the nature of our two-way scientific relationships. Night parrot working groups and workshops allowed rangers to learn from scientific and ranger experts, to build capacity and plan for surveys on their countries through two-way partnerships with supportive scientific organisations. This resulted in 13 ranger groups from Western Australia leading standardised night parrot acoustic surveys, with recordings analysed for unique calls by scientific experts. Over the 6 years, the rangers conducted 8613 surveys, at 75 sites, with 22 new night parrot sites being found on five different Native Title areas (Ngurra Kayanta, Ngururrpa, Martu, Birriliburu and Kiwirrkurra). As of August 2024, these sites represent an estimated 54% of known night parrot sites in Australia, and 75% of those found outside of Queensland. Our results have greatly expanded our knowledge of night parrot distribution and ecology in Australia. Key to this success was our respectful two-way scientific relationships that prioritised Aboriginal peoples, culture and leadership, regionally building momentum and collaboration through workshops and networks, while ensuring good scientific practice. Our work provides another important example of how respectful two-way science relationships can create significant conservation outcomes while supporting Indigenous knowledge, leadership and cultural practice. [ABSTRACT FROM AUTHOR]

The current Special Issue focuses on the Indigenous and Native American perspectives on mental health and well-being. This introduction highlights the need to explore how psychological health is conceptualized and operationalized among this population and the ways in which their mental health needs can be better met. The article also provides a brief review of each of the articles in the Special Issue. [ABSTRACT FROM AUTHOR]

Purpose: This article uses an Indigenous concept of family violence as a frame to interrogate interviews held with Indigenous LGBTIQSB + people in Australia. The article reorients family violence away from Western heteronormative framings and aims to contribute towards a new conversation about family violence. Methods: A qualitative thematic analysis was used to analyse 16 interviews with Indigenous LGBTIQSB + people in the state of New South Wales, Australia. This is one of a series of articles that provide preliminary findings from a research project into the social and emotional wellbeing of Indigenous LGBTIQSB + young people living in New South Wales. Results: The interviews highlight the complex impact family violence on Indigenous LGBTIQSB + youth. The article shows differences in reactions between family and community in urban settings with those experienced in rural settings highlighting intergenerational differences, with older family members such as grandparents, more likely to exhibit negative reactions and behaviours. These experiences are interconnected as many young people were living in urban areas while extended family often lived in rural or remote communities. Conclusions: The findings of this study demonstrate the intersectional nature of family violence highlighting the fact that Indigenous LGBTIQSB + young people are integral parts of extended kinship networks, families and communities and are deeply impacted by any acts of family violence. The study's findings also support current research into family and community violence for LGBTIQ + people that shows the differential behaviours and actions of rural and urban families as well as the different reactions between generations within families. [ABSTRACT FROM AUTHOR]

Since the establishment of early colonial museums, concerns around collection storage, funding, and staffing levels have continued to exacerbate 'curation crises'. In 2020, the Museum of Tropical Queensland began to address its own 'curation crisis' by restructuring the First Nations collections in storage and auditing collection knowledge. The project reconfigured embedded colonial structures where objects were stored by 'object type' or 'collector', and instead grouped collections by Country and Traditional Owners. The restructure enabled curators to identify the extent of provenance information missing from the collections and highlighted the need for more in-depth and continuous engagement with First Nations communities to better understand and give voice to the collections in the care of cultural institutions, and to the communities they belong to. This paper intends to challenge the global museological issue of 'paralysis by provenance' and encourage new ways of prioritising collection knowledge. [ABSTRACT FROM AUTHOR]

Recently, there has been increased focus on the origins and history of common names for organisms, especially birds. Of particular interest are eponymous common names that reflect our colonial past. While identification of alternative names can be straightforward for some species, for those that migrate across jurisdictions including the lands of multiple Traditional Owner/Indigenous groups, reaching consensus on a single name that reflects the features of the species and their cultural importance can be substantially more complex. Using the migratory Ardenna carneipes as a case study, we propose a new common name (Sable Shearwater) for the species and discuss the many challenges that others will need to consider when navigating this important yet sensitive space. [ABSTRACT FROM AUTHOR]

Background: The Elders Mentoring Program (EMP) is part of a strengths-based community-based participatory research partnership with the Cree communities of Maskwacîs, Alberta, Canada. The EMP objective is to promote maternal and child health through traditional Cree teachings and support from community Elders to pregnant women and their partners. During the COVID-19 pandemic, the Elders decided to shift the program to an online format in early 2021. The Elders continued to offer mentorship to program participants virtually by Zoom and telephone, and online workshops. The objective of this study was to qualitatively explore the experiences of women that took part in the virtual EMP. Methods: We utilized qualitative description as our method, informed by our overarching community-led research partnership. Semi-structured phone interviews were conducted by Maskwacîs research assistants (RAs) with 11 women who participated in the virtual program. Interviews were conducted between December 2021 and June 2022. The participants were asked about their perceptions of the program and its benefits. The interviews were recorded, transcribed, and coded by four RAs using thematic analysis. Results: Although cultural teachings are traditionally offered in person, the shift to the virtual platform was greatly appreciated by all the women. Technology can be a useful tool for cultural teachings and language to be shared among community members when they cannot be physically together. Four main themes emerged from the data, representing the participants' experiences, and learning through their interactions with the Elders from the EMP. The themes are: Ohpikihâwasowin (grounding and guiding on the path to be a healthy parent); Indigenous ways of healing; On the path of cultural learning; and Identity for self and baby. Conclusion: The virtual adaptation of the EMP allowed a space for Elders to offer support to women living in and out of the community to provide guidance with their pregnancies and into motherhood. The workshops and one-on-one calls allowed for cultural revitalization which is critical for Indigenous well-being. All the participants found that the teachings and interactions positively impacted their pregnancy and parenthood. Overall, the virtual program demonstrated a venue for intergenerational healing and resilience. [ABSTRACT FROM AUTHOR]

Jordan's Principle is a legal requirement for the Canadian government to address gaps in services for First Nations children and ensure timely services that meet their needs and best interests. This article synthesizes and discusses some of the key research findings described in a report on the implementation of Jordan's Principle in Manitoba, produced by a team of academic researchers in partnership with the Assembly of Manitoba Chiefs. Findings provide insights into a relational approach to the implementation of Jordan's Principle and inter-related structural factors that constrain the efficacy of this approach. Findings reinforce the need for First Nations–led processes and Jordan's Principle policies that fully fund and support First Nations in addressing high caseloads and growing waiting lists, complex responsibilities, stress and staff turnover, administrative burden, and inadequate physical and digital infrastructure. Sufficient resources for First Nations capacity enhancement initiatives and regional coordination and support are also identified priorities. [ABSTRACT FROM AUTHOR]

The middle-school years (Year 7 to Year 9) is a particular challenge for socially disadvantaged populations, with high proportions of children either repeating school years or dropping out of school. In Australia, a group of particular concern is First Nations children for whom there is a collective effort by all governments to improve education outcomes, although there have been few studies of their transition through the middle-school years. This retrospective study, using individual-level linked data, followed a cohort of 7881 First Nations students for 2 years after enrolment in Year 7 (Y7) in any Northern Territory (NT) government school in the years from 2008 to 2014 to quantify the transitional pathways through middle school and identify the factors associated with faltering progress. We used multinomial multilevel logistic regression to identify the factors associated with school dropout and repeating Y7 or Y8 (Y7/8). Two years after Y7 enrolment, eight in ten First Nations students progressed to Y9 (78.8%), more than one in ten students had dropped out of school (13.3%) before reaching Y9, and one in 12 (7.9%) repeated Y7/8. The likelihood of either dropping out of school or repeating years was higher among students who were enrolled in Y7 when aged less than 11.5 years, had a low Y7 school attendance rate, moved to either interstate or non-government schools and who lived in a remote area. Students who were not born in the NT and those with a record of substantiated child maltreatment during Y7 were more likely to repeat Y7/8. Planning interventions to improve school retention through the middle-school years should consider these factors. [ABSTRACT FROM AUTHOR]

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

Introduction: First Nations are most at risk of developing end-stage kidney disease. Kidney transplantation is the best treatment option for these patients; however, First Nations donors are underrepresented. The aim of this study was to describe and understand barriers and facilitators of culturally safe organ transplantation and donation from the perspective of First Nations and Health Professionals in the Province of Quebec, Canada. Methods/Approach: This was a qualitative descriptive study using the decolonizing Two-Eyed Seeing approach. The sample consisted of First Nations people and health professionals living in Quebec, Canada, who have had an experience of organ transplantation or donation. Semi-structured interviews were conducted between May and September 2021 with 11 people, including 5 healthcare professionals and 6 First Nations people. Findings: This study enrolled 11 participants. Several individual and contextual factors influencing culturally safe organ transplantation and donation among First Nations people were identified: language barrier, impacts of relocation, lack of knowledge about transplantation, mistrust of the healthcare system, family support and accompaniment, and transplant testimonials. Discussion: This study identified several avenues for reinforcing culturally safe transplantation and donation among First Nations, including the presence of a companion in medical consultations, focusing on access to culturally safe accommodation and sharing transplant testimonials. Further work in partnership with First Nations is needed to improve access to culturally safe organ transplantation [ABSTRACT FROM AUTHOR]

This article identifies community-based alternatives to secure care being utilised in The Netherlands, Canada, Hawaii and Scotland. These countries offer ways to not only reduce or eliminate the need to deprive children and young people of their liberty in secure care but also reduce rates of child removal and alternative care placements. Secure care is the containment of children and young people, often subject to child protection interventions and residing in residential care, in a locked facility when they pose a significant risk of harm to the community and themselves. An admission to secure care exposes children to restrictive practices, such as seclusion, use of force and restraint. Jurisdictions have an ethical imperative, and often legislative obligation, to ensure there are less intrusive community-based supports available, which could be utilised instead of a secure care admission where possible. However, there is little research on what alternatives effectively divert secure care admissions. Hawaii, Canada, The Netherlands and Scotland demonstrate how countries can reduce the number of vulnerable children deprived of their liberty and exposed to restrictive practices by enhancing research linkages, responding to the voice of lived experience, and positioning secure care and alternatives within system-wide reform. [ABSTRACT FROM AUTHOR]

Abstract Background The Elders Mentoring Program (EMP) is part of a strengths-based community-based participatory research partnership with the Cree communities of Maskwacîs, Alberta, Canada. The EMP objective is to promote maternal and child health through traditional Cree teachings and support from community Elders to pregnant women and their partners. During the COVID-19 pandemic, the Elders decided to shift the program to an online format in early 2021. The Elders continued to offer mentorship to program participants virtually by Zoom and telephone, and online workshops. The objective of this study was to qualitatively explore the experiences of women that took part in the virtual EMP. Methods We utilized qualitative description as our method, informed by our overarching community-led research partnership. Semi-structured phone interviews were conducted by Maskwacîs research assistants (RAs) with 11 women who participated in the virtual program. Interviews were conducted between December 2021 and June 2022. The participants were asked about their perceptions of the program and its benefits. The interviews were recorded, transcribed, and coded by four RAs using thematic analysis. Results Although cultural teachings are traditionally offered in person, the shift to the virtual platform was greatly appreciated by all the women. Technology can be a useful tool for cultural teachings and language to be shared among community members when they cannot be physically together. Four main themes emerged from the data, representing the participants’ experiences, and learning through their interactions with the Elders from the EMP. The themes are: Ohpikihâwasowin (grounding and guiding on the path to be a healthy parent); Indigenous ways of healing; On the path of cultural learning; and Identity for self and baby. Conclusion The virtual adaptation of the EMP allowed a space for Elders to offer support to women living in and out of the community to provide guidance with their pregnancies and into motherhood. The workshops and one-on-one calls allowed for cultural revitalization which is critical for Indigenous well-being. All the participants found that the teachings and interactions positively impacted their pregnancy and parenthood. Overall, the virtual program demonstrated a venue for intergenerational healing and resilience.

Bringing together individuals of diverse perspectives in a research team can be challenging, especially when one perspective has been largely unacknowledged. The phrase 'Value co-creation' is used in marketing to include the voice of the consumer in the development of offerings so as to create value for both the organisation and the consumer. This study examines how well value co-creation model captures a process of research collaboration that privileges marginalised voices in a culturally sensitive and safe way. We examine a project that brought together three different, but not necessarily mutually exclusive, groups of people: Aboriginal community members; health care practitioners, policymakers and marketing experts. It is revealed that the value co-creation model exemplifies many of the elements needed to weave together different methodological perspectives and manage the dynamics of a research team. However, some adaptations were required, particularly: the inclusion of a 'cultural broker'; a means of 'cultural governance'; and the addition of a sixth pillar to the model – 'evaluation'. [ABSTRACT FROM AUTHOR]

Abstract Background Addressing Indigenous food security and food sovereignty calls for community-driven strategies to improve access to and availability of traditional and local food. Participatory approaches that integrate Indigenous leadership have supported successful program implementation. Learning Circles: Local Healthy Food to School is a participatory program that convenes a range of stakeholders including food producers, educators and Knowledge Keepers to plan, implement and monitor local food system action. Pilot work (2014–2015) in Haida Gwaii, British Columbia (BC), showed promising results of the Learning Circles (LC) approach in enhancing local and traditional food access, knowledge and skills among youth and adolescents. The objective of the current evaluation was therefore to examine the process of scaling-up the LC vertically within the Haida Nation; and horizontally across three diverse First Nations contexts: Gitxsan Nation, Hazelton /Upper Skeena, BC; Ministikwan Lake Cree Nation, Saskatchewan; and Black River First Nation, Manitoba between 2016 and 2019. Methods An implementation science framework, Foster-Fishman and Watson’s (2012) ABLe Change Framework, was used to understand the LC as a participatory approach to facilitate community capacity building to strengthen local food systems. Interviews (n = 52), meeting summaries (n = 44) and tracking sheets (n = 39) were thematically analyzed. Results The LC facilitated a collaborative process to: (1) build on strengths and explore ways to increase readiness and capacity to reclaim traditional and local food systems; (2) strengthen connections to land, traditional knowledge and ways of life; (3) foster community-level action and multi-sector partnerships; (4) drive actions towards decolonization through revitalization of traditional foods; (5) improve availability of and appreciation for local healthy and traditional foods in school communities; and (6) promote holistic wellness through steps towards food sovereignty and food security. Scale-up within Haida Gwaii supported a growing, robust local and traditional food system and enhanced Haida leadership. The approach worked well in other First Nations contexts, though baseline capacity and the presence of champions were enabling factors. Conclusions Findings highlight LC as a participatory approach to build capacity and support iterative planning-to-action in community food systems. Identified strengths and challenges support opportunities to expand, adopt and modify the LC approach in other Indigenous communities with diverse food systems.

Abstract Background This paper describes how First Nations Kidney Warriors (Aboriginal and Torres Strait Islander people living with kidney disease), dental hygienists, kidney health care professionals, an Aboriginal hostel accommodation manager and researchers co-designed an approach to improve oral health in South Australia. Kidney Warriors have strong connection to Country, Community and family that underpins health, wellbeing and approaches to research. However, significant colonisation, racism and marginalisation have impacted Kidney Warriors’ social, cultural and financial determinants of health, leading to increased chronic conditions including kidney disease. Access to culturally safe, affordable and responsive oral health care is vital but challenging for First Nations Peoples undergoing dialysis and kidney transplantation; Australian oral health care is generally provided privately, in metropolitan centres, by professionals who may hold unconscious bias about First Nations Peoples and incorrect assumptions regarding equal access to care. Methods The AKction – Aboriginal Kidney Care Together Improving Outcomes Now kidney care oral health working group codesigned strategies to address disparities and gaps in care, and co-create more accessible, responsive, culturally safe and sustainable models of care. A decolonising and collaborative participatory action research was informed by Dadirri Deep Listening and Ganma Knowledge Sharing with repeated cycles of Look and Listen, Think and Discuss, Take Action Together. A small pilot evaluation survey of clinical placement in an Aboriginal setting was undertaken. Results Four phases of collaboration were undertaken. Community and health professional consultations identified key gaps and priorities. Clinical yarning and cultural safety training and an interprofessional skills day was co-facilitated. Dental hygienist student clinical placement at Kanggawodli Aboriginal Hostel was initiated and evaluated. First Nations Kidney Warriors were positioned as educators and experts of their own lives and health care needs. A new framework for kidney health—oral health cultural safety and clinical education was developed. Conclusion This codesigned approach involving inter-professional collaboration and joint decision making with community members has significantly informed improvements in oral health care information, services and referral with and for First Nations Peoples with kidney disease. This project provides a working example of how to decolonise health service and education programs from the ground up. Trial registration NHMRC PAR 2004389.

Abstract Background Aboriginal and Torres Strait Islander peoples are disproportionately impacted by type 2 diabetes. Continuous glucose monitoring (CGM) technology (such as Abbott Freestyle Libre 2, previously referred to as Flash Glucose Monitoring) offers real-time glucose monitoring that is convenient and easy to use compared to self-monitoring of blood glucose (SMBG). However, this technology’s use is neither widespread nor subsidised for Aboriginal and Torres Strait Islander peoples with type 2 diabetes. Building on existing collaborations with a national network of Aboriginal and Torres Strait Islander communities, this randomised controlled trial aims to assess the effect of CGM compared to SMBG on (i) haemoglobin A1c (HbA1c), (ii) achieving blood glucose targets, (iii) reducing hypoglycaemic episodes and (iv) cost-effective healthcare in an Aboriginal and Torres Strait Islander people health setting. Methods This is a non-masked, parallel-group, two-arm, individually randomised, controlled trial (ACTRN12621000753853). Aboriginal and Torres Strait Islander adults with type 2 diabetes on injectable therapy and HbA1c ≥ 7.5% (n = 350) will be randomised (1:1) to CGM or SMBG for 6 months. The primary outcome is change in HbA1c level from baseline to 6 months. Secondary outcomes include (i) CGM-derived metrics, (ii) frequency of hypoglycaemic episodes, (iii) health-related quality of life and (iv) incremental cost per quality-adjusted life year gained associated with the CGM compared to SMBG. Clinical trial sites include Aboriginal Community Controlled Organisations, Aboriginal Medical Services, primary care centres and tertiary hospitals across urban, rural, regional and remote Australia. Discussion The trial will assess the effect of CGM compared to SMBG on HbA1c for Aboriginal and Torres Strait Islander people with type 2 diabetes in Australia. This trial could have long-term benefits in improving diabetes management and providing evidence for funding of CGM in this population. Trial registration Australian and New Zealand Clinical Trials Registry ACTRN12621000753853. Registered on 15th June 2021.

Abstract Background Indigenous people in Australia experience far poorer health than non-Indigenous Australians. A growing body of research suggests that Indigenous people who are strong in their cultural identity experience better health than those who are not. Yet little is known about how Indigenous people create and maintain strong cultural identities in the contemporary context. This paper explores how Indigenous people in south-eastern Australia create and maintain strong cultural identities to support their health and wellbeing. Methods Data were collected from 44 Indigenous people living in the south-eastern Australian state of Victoria via yarning. Yarning is a cultural mode of conversation that privileges Indigenous ways of knowing, doing and being. Yarning participants were selected for their prominence within Victorian Indigenous health services and/or their prominence within the Victorian Indigenous community services sector more broadly. Due to the restrictions of COVID-19, yarns were conducted individually online via Zoom. Data were analysed employing constructivist grounded theory, which was the overarching qualitative research methodology. Results All yarning participants considered maintaining a strong cultural identity as vital to maintaining their health and wellbeing. They did this via four main ways: knowing one’s Mob and knowing one’s Country; connecting with one’s own Mob and with one’s own Country; connecting with Community and Country more broadly; and connecting with the more creative and/or expressive elements of Culture. Importantly, these practices are listed in order of priority. Indigenous people who either do not know their Mob or Country, or for whom the connections with their own Mob and their own Country are weak, may therefore be most vulnerable. This includes Stolen Generations survivors, their descendants, and others impacted by historical and contemporary child removal practices. Conclusions The yarns reveal some of the myriad practical ways that Indigenous people maintain a strong cultural identity in contemporary south-eastern Australia. While programs designed to foster connections to Community, Country and/or Culture may benefit all Indigenous participants, those most disconnected from their Ancestral roots may benefit most. Further research is required to determine how best to support Indigenous Victorians whose connections to their own Mob and their own Country are unable to be (re)built.

Introduction Objective Design Findings Discussion Conclusions Disparities in the health of Indigenous people and in the health of rural populations are well described. University Departments of Rural Health (UDRHs) in Australia are federally funded under a program to address ongoing challenges with health workforce distribution for rural and remote areas. They have a significant role in research in regional, rural and remote areas, including research related to Indigenous health. However, a comprehensive analysis of their contributions to original Indigenous health related to Indigenous health is lacking.This study examines the contributions of UDRHs to Indigenous issues through analysis of publications of UDRHs focused on Indigenous health during the period 2010–2021.This paper examines a database of UDRH Indigenous‐related publications from 2010 to 2021.A total of 493 publications to which UDRHs contributed were analysed, including 354 original research articles. Health services research was the most common category, followed by epidemiology and papers exploring Indigenous culture and health. While health services research substantially increased over the period, the numbers of original research papers specifically focused on Indigenous workforce issues, whether related to Indigenous people, students or existing workforce was relatively small.This broad overview shows the nature and trends in Indigenous health research by UDRHs and makes evident a substantial contribution to Indigenous health research, reflecting their commitment to improving the health and well‐being of Indigenous communities.The analysis can help direct future efforts, and future analyses should delve deeper into the impact of this research and further engage Indigenous researchers. [ABSTRACT FROM AUTHOR]

Background: Addressing Indigenous food security and food sovereignty calls for community-driven strategies to improve access to and availability of traditional and local food. Participatory approaches that integrate Indigenous leadership have supported successful program implementation. Learning Circles: Local Healthy Food to School is a participatory program that convenes a range of stakeholders including food producers, educators and Knowledge Keepers to plan, implement and monitor local food system action. Pilot work (2014–2015) in Haida Gwaii, British Columbia (BC), showed promising results of the Learning Circles (LC) approach in enhancing local and traditional food access, knowledge and skills among youth and adolescents. The objective of the current evaluation was therefore to examine the process of scaling-up the LC vertically within the Haida Nation; and horizontally across three diverse First Nations contexts: Gitxsan Nation, Hazelton /Upper Skeena, BC; Ministikwan Lake Cree Nation, Saskatchewan; and Black River First Nation, Manitoba between 2016 and 2019. Methods: An implementation science framework, Foster-Fishman and Watson's (2012) ABLe Change Framework, was used to understand the LC as a participatory approach to facilitate community capacity building to strengthen local food systems. Interviews (n = 52), meeting summaries (n = 44) and tracking sheets (n = 39) were thematically analyzed. Results: The LC facilitated a collaborative process to: (1) build on strengths and explore ways to increase readiness and capacity to reclaim traditional and local food systems; (2) strengthen connections to land, traditional knowledge and ways of life; (3) foster community-level action and multi-sector partnerships; (4) drive actions towards decolonization through revitalization of traditional foods; (5) improve availability of and appreciation for local healthy and traditional foods in school communities; and (6) promote holistic wellness through steps towards food sovereignty and food security. Scale-up within Haida Gwaii supported a growing, robust local and traditional food system and enhanced Haida leadership. The approach worked well in other First Nations contexts, though baseline capacity and the presence of champions were enabling factors. Conclusions: Findings highlight LC as a participatory approach to build capacity and support iterative planning-to-action in community food systems. Identified strengths and challenges support opportunities to expand, adopt and modify the LC approach in other Indigenous communities with diverse food systems. [ABSTRACT FROM AUTHOR]

Background: Aboriginal and Torres Strait Islander peoples are disproportionately impacted by type 2 diabetes. Continuous glucose monitoring (CGM) technology (such as Abbott Freestyle Libre 2, previously referred to as Flash Glucose Monitoring) offers real-time glucose monitoring that is convenient and easy to use compared to self-monitoring of blood glucose (SMBG). However, this technology's use is neither widespread nor subsidised for Aboriginal and Torres Strait Islander peoples with type 2 diabetes. Building on existing collaborations with a national network of Aboriginal and Torres Strait Islander communities, this randomised controlled trial aims to assess the effect of CGM compared to SMBG on (i) haemoglobin A1c (HbA1c), (ii) achieving blood glucose targets, (iii) reducing hypoglycaemic episodes and (iv) cost-effective healthcare in an Aboriginal and Torres Strait Islander people health setting. Methods: This is a non-masked, parallel-group, two-arm, individually randomised, controlled trial (ACTRN12621000753853). Aboriginal and Torres Strait Islander adults with type 2 diabetes on injectable therapy and HbA1c ≥ 7.5% (n = 350) will be randomised (1:1) to CGM or SMBG for 6 months. The primary outcome is change in HbA1c level from baseline to 6 months. Secondary outcomes include (i) CGM-derived metrics, (ii) frequency of hypoglycaemic episodes, (iii) health-related quality of life and (iv) incremental cost per quality-adjusted life year gained associated with the CGM compared to SMBG. Clinical trial sites include Aboriginal Community Controlled Organisations, Aboriginal Medical Services, primary care centres and tertiary hospitals across urban, rural, regional and remote Australia. Discussion: The trial will assess the effect of CGM compared to SMBG on HbA1c for Aboriginal and Torres Strait Islander people with type 2 diabetes in Australia. This trial could have long-term benefits in improving diabetes management and providing evidence for funding of CGM in this population. Trial registration: Australian and New Zealand Clinical Trials Registry ACTRN12621000753853. Registered on 15th June 2021. [ABSTRACT FROM AUTHOR]

AbstractMusic has been linked to improved social and emotional wellbeing for First Nations Peoples, yet little research directly explores the link between music and social emotional wellbeing of Lesbian, Gay, Bisexual, Transgender, Intersex, Queer, Asexual, Sistergirl, and Brotherboy (LGBTIQA+SB) First Nation Peoples in Australia. This article reports on a hybrid scoping narrative review of existing literature that explores LGBTIQA+SB social emotional wellbeing and potential links to music practices, such as music listening, performance, and composing. Findings suggest that music and creative practices can be linked to feelings of elation, positive self-regard, and safety. Music and performance can promote and celebrate the diversity and complexities of Queer First Nations people and identities through art and performance, enhancing a sense of belonging and links to community, generating feelings of pride, and contributing to knowledge sharing. Community connections built through creative arts and digital platforms are seen as enhancing social emotional wellbeing for First Nations Lesbian, Gay, Bisexual, Transgender, Intersex, Queer/Questioning, Brotherboy, Sistergirl people. [ABSTRACT FROM AUTHOR]

Objective: The 'Deadly RED' project primarily aimed to improve culturally competent care to reduce the number of First Nations patients presenting to a Queensland ED who 'Take own leave' (TOL). The secondary aim was to evaluate the implementation project. Methods: A pre/post‐test quasi experimental study design using mixed methods was co‐designed with adherence to Indigenous research considerations. Quantitative analysis of First Nations presentations before and after Deadly RED implementation was performed using SPSS. Qualitative analysis of transcribed research yarns in NVIVO was coded and themed for analysis. Staff experiences and perspectives were collated using electronically distributed surveys and process audits were performed. Results: A total of 1096 First Nations presentations June to August 2021 and 1167 in the matched 2022 post‐implementation period were analysed. Significantly more patients were recorded as TOL post‐implementation (13.0% pre vs 21.3% post) and representations rates were unchanged. Forty‐six staff surveyed identified improvements in all parameters including cultural appropriateness and quality of care. Qualitative analysis of 85 research yarns revealed themes migrated to increasingly acceptable, accessible, and usable care. Notably, 45% of the First Nation's patients recorded as TOL self‐reported that their treatment was complete. The study was feasible as 80% of packs distributed and 73% follow‐up screening after TOL. Conclusions: The Deadly RED evaluation revealed significant discrepancies in the reported data points of TOL and the 'story' of the First Nations persons experience of appropriate and completed care. Staff awareness and cultural capability improved significantly, and yarning allowed knowledge translation and improvements in communication which contributed to a better healthcare experience for First Nations patients attending our ED. [ABSTRACT FROM AUTHOR]

Background: Provision of a Medication Action Plan (MAP) on admission and a Discharge Medication Record (DMR) are associated with reduced medication‐related harm. Aim: To report factors associated with the provision of MAPs and DMRs in rural and regional hospitals in Queensland, Australia. Method: A literature search, environmental scan and department consultations were conducted to develop Clinical Pharmacy Key Performance Indicators (cpKPIs) and design a cpKPI dashboard. Two of the five KPIs included in the dashboard, relating to medication action plans on admission and medication records on discharge, were reported for all the hospitals and were included in the study. A retrospective, period‐prevalence study was conducted to evaluate the coverage and equity of clinical pharmacy service provision for patients admitted for longer than 24 h. The proportions of patients who received MAPs and DMRs were stratified by age, gender, Indigeneity and hospital type. Statistical analysis used chi‐squared tests and logistic regression in R. This project was exempt due to the local policy requirements that constitute research by the Far North Queensland Human Research Ethics Committee (Reference no: EX/2023/QCH/94383‐1684QA). The justification for this exemption is as follows: the project was determined to be negligible risk research and involved the use of existing collection of data or records that contain only non‐identifiable data about human beings. Results: In total, 13 818 patients (37.9% of admissions) received a MAP and 11 631 patients (32.7% of discharges) received a DMR. The proportion of MAPs and DMRs was significantly higher in rural hospitals than in regional hospitals (MAP 50.6% vs 34.6%, DMR 33.1% vs 31.3%) and for male patients than female patients (MAP 42.2% vs 33.7%, DMR 36.4% vs 29.2%). When stratified by age, First Nations patients received a higher proportion of MAPs and DMRs in each age group, except for age 85 years and over. The proportion of First Nations patients aged 50 years and over who received MAP was lower compared to that for non‐Indigenous patients aged 65 years and over (56.3% vs 59.8%), whilst the proportion for DMRs was similar (50.4% vs 49.3%). Conclusion: The study defined the clinical pharmacy key performance indicators for measuring equity of clinical pharmacy service provision in Australia. When adjusted for a difference in life expectancy, the proportion of MAPs for First Nations patients was lower compared to the proportion of MAPs for non‐Indigenous patients. Further improvements are required to achieve equity of service provision for First Nations patients and female patients. [ABSTRACT FROM AUTHOR]

We will discuss the impact of AI on storytelling, particularly in the context of Indigenous media-making. We will do this broadly in reference to our own practices and artistic processes and our current collaboration, Tomorrow’s Pasts, specifically in relation to our experience of developing and creating artistic and creative projects with AI-generative media.We will speak to the notion that Indigenous knowledge systems tend to be relational whereas Western knowledge systems can be cumulative and extractive, and that these points of difference expose a colonial imprint on conceptualizing and producing projects that deal with artistic and cultural production in general and emerging technologies in the narrative space in particular. In this we will refer to the growing field of research into indigenous data sovereignty.We will draw directly on 3 ‘events’ in which we participated in 2023: (1) Frame Doco Lab, Victoria, Australia (2) The International Sami Film Institute’s Indigenous Film Conference in Guovdageaidnu, Norway and (3) Art + Australia’s Study-In on AI + Race + Art, Melbourne, Australia. our in-conversation at the Indigenous Film Conference (August 17–20) presented by the International Sami Film Institute in Norway. [ABSTRACT FROM AUTHOR]

Background: This paper describes how First Nations Kidney Warriors (Aboriginal and Torres Strait Islander people living with kidney disease), dental hygienists, kidney health care professionals, an Aboriginal hostel accommodation manager and researchers co-designed an approach to improve oral health in South Australia. Kidney Warriors have strong connection to Country, Community and family that underpins health, wellbeing and approaches to research. However, significant colonisation, racism and marginalisation have impacted Kidney Warriors' social, cultural and financial determinants of health, leading to increased chronic conditions including kidney disease. Access to culturally safe, affordable and responsive oral health care is vital but challenging for First Nations Peoples undergoing dialysis and kidney transplantation; Australian oral health care is generally provided privately, in metropolitan centres, by professionals who may hold unconscious bias about First Nations Peoples and incorrect assumptions regarding equal access to care. Methods: The AKction – Aboriginal Kidney Care Together Improving Outcomes Now kidney care oral health working group codesigned strategies to address disparities and gaps in care, and co-create more accessible, responsive, culturally safe and sustainable models of care. A decolonising and collaborative participatory action research was informed by Dadirri Deep Listening and Ganma Knowledge Sharing with repeated cycles of Look and Listen, Think and Discuss, Take Action Together. A small pilot evaluation survey of clinical placement in an Aboriginal setting was undertaken. Results: Four phases of collaboration were undertaken. Community and health professional consultations identified key gaps and priorities. Clinical yarning and cultural safety training and an interprofessional skills day was co-facilitated. Dental hygienist student clinical placement at Kanggawodli Aboriginal Hostel was initiated and evaluated. First Nations Kidney Warriors were positioned as educators and experts of their own lives and health care needs. A new framework for kidney health—oral health cultural safety and clinical education was developed. Conclusion: This codesigned approach involving inter-professional collaboration and joint decision making with community members has significantly informed improvements in oral health care information, services and referral with and for First Nations Peoples with kidney disease. This project provides a working example of how to decolonise health service and education programs from the ground up. Trial registration: NHMRC PAR 2004389. [ABSTRACT FROM AUTHOR]

Introduction: Geese harvesting is a longstanding cultural tradition deeply ingrained among the Omushkego Cree in Fort Albany First Nation, embodying a holistic approach to health that integrates Indigenous knowledge, community wellbeing, and resilience. Despite historical disruptions stemming from colonization and assimilation policies, women have played a pivotal role in preserving and passing down traditional practices. The significance of goose harvesting extends beyond providing a nutrient-rich and cost-effective food source; it serves as a vehicle for cultural preservation and education, particularly fostering language acquisition among children. Nevertheless, concerns persist regarding the potential decline in the transmission of Indigenous knowledge. The interruption of intergenerational knowledge transfer not only poses implications for overall wellbeing but also worsens historical trauma within the community. In response to these challenges, the Niska (goose) harvesting program was developed with an aim to revitalize community harvesting practices, with a specific focus on incorporating the perspectives of women, especially in the preparatory and smoking phases of the geese. Methods: Omushkego Cree women were approached to participate. The study was conducted during the spring of 2018, and employed photovoice and semi-structured interviews that explored the impact of geese preparatory activities on the healthand wellbeing of Indigenous women. Results: Major themes from the qualitative data included the importance of knowledge sharing, cultural continuity, healing, and the profound connection to the land. Women emphasized the value of sharing acquired knowledge, passing on traditions, and maintaining a connection to their cultural identity. Cultural continuity, depicted through intergenerational teachings and experiences, emerged as crucial for overall wellbeing. Participants spoke of the healing dynamics derived from engaging in traditional activities, highlighting the positive impact on physical, mental, emotional, and spiritual wellbeing. The land was identified as a central element in this healing process, representing more than just a physical space but an extension of home, contributing to a sense of peace and tranquility. The land became a medium for transmitting cultural teachings, shaping identity, and sustaining a subsistence lifestyle. Conclusion: The study emphasizes the importance of future research including more female youth participants to uncover specific challenges and strengths within this demographic. Overall, the Niska program demonstrates a comprehensive approach that intertwines cultural revitalization, community engagement, and holistic wellbeing, emphasizing the need for interventions that go beyond immediate challenges to create enduring positive impacts on Indigenous communities. [ABSTRACT FROM AUTHOR]

Introduction: The aim of the study was to explore, in one remote hospital, emergency department healthcare providers' experience and perceptions of the factors surrounding a patient's decision to discharge against medical advice (DAMA). The secondary objective was to gain insight into staff experiences of the current protocols for managing DAMA cases and explore their recommendations for reducing DAMA incidence. Methods: This was a cross-sectional study involving a survey and semi-structured interviews exploring healthcare providers' (n=19) perceptions of factors perceived to be influencing DAMA, current practice for managing DAMA and recommendations for practice improvements. Health professionals (doctors, nurses, Aboriginal Health Workers) all worked in the emergency department of a remote community hospital, Queensland, Australia. Responses relating to influencing factors for DAMA were provided on a threepoint rating scale from 'no influence/little influence' to 'very strong influence'. DAMA management protocol responses were a threepoint rating scale from 'rarely/never' to 'always'. Semi-structured interviews were conducted after the survey and explored participants' perceptions in greater detail and current DAMA management protocol. Results: Feedback from the total of 19 participants across the professions presented four prominent yet interconnected themes: patient, culture, health service and health provider, and health literacy and education-related factors. Factors that were perceived to have a strong influence on DAMA events included alcohol and drug abuse (100%), a lack of culturally sensitive healthcare services (94.7%), and family commitments or obligations (89.5%). Healthcare provider recommendations for preventing DAMA presented themes of right communication, culturally safe care (right place, right time) and the right staff to support DAMA prevention. The healthcare providers described the pivotal role the Indigenous Liaison Officer (ILO) plays and the importance of this position being filled. Conclusion: DAMA is a multifaceted issue, influenced by both personal and hospital system-related factors. Participants agreed that the presence of ILO and/or Aboriginal Health Workers in the emergency department may reduce DAMA occurrences for Indigenous Australians who are disproportionately represented in DAMA rates, particularly in rural and remote regions of Australia. [ABSTRACT FROM AUTHOR]

Objective. There are complex and interrelated factors that lead to inequitable healthcare delivery in Canada. Many of the factors that underlie these inequities for Canada's geographically dispersed Indigenous peoples remain underexamined. Methods. A cohort of 831 First Nations (FN) individuals from urban and remote communities were recruited into a longitudinal study of rheumatoid arthritis (RA) risk from 2005 to 2017. Data from each participant's initial enrollment visit were assessed using a survey that captured concerns with healthcare access. Results. We found that remote participants with RA reported poor access compared to remote first-degree relatives (FDRs; P < 0.001); this difference was not observed for urban participants with RA. We observed substantial differences based on sex; female participants perceived access to care to be more difficult than male participants in both urban and remote cohorts (P < 0.001). We also observed that male participants with RA reported poor access to care compared to male FDRs. Importantly, access to care in remote communities appeared to improve over the duration of the study (P = 0.01). In a logistic regression analysis, female sex, remote location, and older age were independent predictors of poor access to care. Predictors of poor access in participants with RA also included female sex, remote location, and older age. Conclusion. FN peoples living in remote communities, particularly those with an established RA diagnosis, report more problems accessing health care. Sex-based inequities exist, with FN female individuals reporting greater difficulties in accessing appropriate health care, regardless of RA diagnosis. Addressing these sex-based inequities should be a high priority for improving healthcare delivery. [ABSTRACT FROM AUTHOR]

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

Aim Materials and Methods Results Conclusions To examine low birth weight (LBW) in First Nations babies born in a large metropolitan health service in Queensland, Australia.A retrospective population‐based study using routinely collected data from administrative data sources. All singleton births in metropolitan health services, Queensland, Australia of ≥20 weeks gestation or at least 400 g birthweight and had information on First Nations status and born between 2019 and 2021 were included. The study measured birthweight and birthweight z‐score, and also identified the predictors of LBW. Multivariate regression models were adjusted by demographic, socioeconomic and perinatal factors.First Nations babies had higher rates of LBW (11.4% vs 6.9%, P < 0.001), with higher rates of preterm birth (13.9% vs 8.8%, P < 0.001). In all babies, the most important factors contributing to LBW were: maternal smoking after 20 weeks of gestation; maternal pre‐pregnancy underweight (body mass index <18.5 kg/m2); nulliparity; socioeconomic disadvantage; geographical remoteness; less frequent antenatal care; history of cannabis use; pre‐existing cardiovascular disease; pre‐eclampsia; antepartum haemorrhage; and birth outcomes including prematurity and female baby. After adjusting for all contributing factors, no difference in odds of LBW was observed between First Nations and non‐First Nation babies.First Nations status was not an independent factor influencing LBW in this cohort, after adjustment for identifiable factors. The disparity in LBW relates to modifiable risk factors, socioeconomic disadvantage, and prematurity. Upscaling culturally safe maternity care, focusing on modifiable risk factors is required to address LBW in Australian women. [ABSTRACT FROM AUTHOR]

Aim: This study examined the outcomes of a telehealth model for sleep health assessment among Indigenous and non‐Indigenous children residing in remote and regional communities at the Top End Northern Territory (NT) of Australia. Methods: Video telehealth consultation, that included clinical history and relevant physical findings assessed virtually with an interstate paediatric sleep physician was conducted remotely. Polysomnography (PSG) and therapeutic interventions were carried out locally at Darwin, NT. The study participants were children referred between 2015 and 2020. Results: Of the total 812 children referred for sleep assessment, 699 underwent a diagnostic PSG. The majority of patients were female (63%), non‐Indigenous (81%) and resided in outer regional areas (88%). Indigenous children were significantly older and resided in remote or very remote locations (22% vs. 10%). Referral patterns differed according to locality and Indigenous status – (non‐Indigenous via private (53%), Indigenous via public system (35%)). Receipt of referrals to initial consultation was a median of 16 days and 4 weeks from consult to PSG. Remote children had slightly longer time delay between the referral and initial consult (32 vs. 15 days). Fifty one percent were diagnosed to have OSA, 27% underwent adenotonsillectomy and 2% were prescribed with CPAP therapy. Conclusions: This study has demonstrated that a telehealth model can be an effective way in overcoming logistical barriers and in providing sleep health services to children in remote and regional Australia. Further innovative efforts are needed to improve the service model and expand the reach for vulnerable children in very remote communities. [ABSTRACT FROM AUTHOR]

Peace processes require societies to break with animosity and violence. Scholars and practitioners have traditionally focused on institutional and structural mechanisms. Recent contributions have stressed the need to address the emotional legacies of destructive conflicts and how they influence peace processes. We build on these contributions by engaging current debates on decolonisation. We advance a three-part argument that places decolonising emotion at the core of peace and conflict studies. First, prevailing concepts and practices of peace rely on collective emotions that are western and colonial in origin. Emotions are central to the power dynamics that sustain colonial legacies and the practices of exclusion and injustice that ensue from them. Second, decolonising emotion requires an openness to different feelings which, in turn, can open up possibilities for creative ways of thinking about and practising peace. Third, these realms – colonial legacies and resistant ways of being and feeling – do not exist in isolation. Potentials for peace-making emerge from complex 'interfaces' between them, which we examine through two cases: the emotion of Han (한/恨) in Korean traditions of conflict resolution; and links between mourning and conflict management in the Maluilgal First Nation of the Torres Strait in far northern Australia. [ABSTRACT FROM AUTHOR]

Situated in the curriculum space created by the recent enhancements to First Nations content is the opportunity for teachers to better connect with First Nations perspectives. Using constructivist theory methodology and drawing on two studies, a small qualitative school-based study of teachers who teach in the early years of schooling, and a large-scale study of professional development across two Australian states, the paper explores teachers’ preparedness to teach First Nations content. The tenets of critical literacy frame the discussion and are positioned as reflective tools that can be used to support the ‘settler teacher’ in self-reflection. Audio-recorded transcripts of planning sessions, a teacher survey, comments from feedback forms and researcher memos form the data sets. Findings from the study necessitate discursive practices for the development of teacher knowledge, dispositions, and confidence, and highlight the imperative for teacher critical self-reflection. [ABSTRACT FROM AUTHOR]

In Australia, there is insufficient exploration and understanding of how we can strengthen the critical role played by Indigenous fathers. This paper argues that for Indigenous fathers to feel supported in childrearing, greater attention must be given to their social and cultural determinants of health and well‐being. To gain insights into the challenges experienced by Indigenous fathers and the support they require in fatherhood, we primarily apply thematic analysis to data from the Longitudinal Study of Indigenous Children (LSIC). The findings reveal that most fathers identify a social or cultural health and well‐being determinant challenging their fatherhood journey. We examine these results and suggest why and how appropriately focussing on the social and cultural determinants of health and well‐being will enhance and support Indigenous men in fatherhood. [ABSTRACT FROM AUTHOR]

Concern exists that the growing over-representation of Aboriginal and Torres Strait Islander children and young people in out-of-home care (OOHC) across Australia is perpetuating historical, discriminatory child removal policies and practices. The disproportionate number of Indigenous children in OOHC is increasing at the same time as growing multi-jurisdictional policy and legal mandate for Indigenous self-determination, leadership, and cultural connectedness in the OOHC space. This study aims to provide evidence and instruction to social work educators, policymakers and practitioners in Australia's complex child protection, wellbeing, and justice systems about why and how Aboriginal and Torres Strait Islander-controlled organizations are best placed to lead OOHC service delivery for Indigenous children, their family and community. The qualitative research, located in Queensland, engages the knowledge and experience of Elders, Indigenous child safety professionals and Aboriginal and Torres Strait Islander young adults who have recently exited OOHC to explore the importance of Indigenous-led OOHC service provision for generating genuine, intergenerational systemic change. Ten themes or authoritative Directives to non-Indigenous stakeholders are elicited and discussed. The paper concludes with three recommendations that press for a shift in the Western values and practices that underscore the monitoring and evaluation of Indigenous-led OOHC service providers by government. [ABSTRACT FROM AUTHOR]

Colonization is understood as a determinant of health for Indigenous people globally. Understanding colonization through a lens of historical trauma offers new insights into the field of Aboriginal young peoples' health and wellbeing. Grounded in the Indigenous research paradigm, this study conducted interviews with 15 Aboriginal young people living on Gamilaroi Country, New South Wales, Australia. Three stories are presented to explain how Aboriginal young people understand their resilience, strength and resistance as an integral component of historical trauma. Aboriginal young people identified the need to connect and to continue to draw strength from their ancestors and to be cognizant of the hope and strengths they have as Aboriginal people and describe how this strength can ensure Aboriginal culture is sustained for generations to come. [ABSTRACT FROM AUTHOR]

The increasing frequency and severity of wildfires threaten the safety and sustainability of community drinking water systems. There is a need to strengthen regulations and health protection programs to increase the resilience of drinking water systems and ensure access to clean, safe, and reliable drinking water in areas prone to wildfires. But what aspects of drinking water supply system infrastructure and operations are most important for resilience? A literature review was conducted on drinking water system resilience to wildfire. Themes identified were then shared in interviews with key informants from the BC Southern Interior to gain further insight into the most important elements for water systems impacted by wildfires. Those interviewed, and in particular those from First Nations communities, highlighted gaps in the current recommendations regarding the importance of proactive watershed management and protection for community water systems resilience. This paper identifies tangible changes in infrastructure and operations that drinking water suppliers can implement to reduce vulnerability to wildfire impacts. Water suppliers and regulators should commit to implementing these improvements and increase community water system resilience. Disclosure: This work was supported by a Pacific Institute for Climate Solutions intern grant (#36170-50280) with in-kind support provided from Interior Health and the BC First Nations Health Authority. [ABSTRACT FROM AUTHOR]

Historically and currently, federal policies governing American Indian country do not typically resemble policies that economists think would stimulate economic and cultural prosperity. This special issue employs Public Choice and New Institutional Economics to analyze the origins and consequences of these policies. This approach, which emphasizes rent seeking, government failure, and formal and informal institutions offers new insights into the understanding of persistent barriers to prosperity and sovereignty in Indian country and what changes might be necessary to break down the obstacles. [ABSTRACT FROM AUTHOR]

Recent changes in Canadian legislation have enabled First Nations to adopt property taxation and other forms of taxation on reserves, thereby allowing them to directly finance their local governments through local tax revenues. In this paper, we compile data on the passage of First Nations tax laws over a 30-year period from a centralized national database on First Nations by-laws, the First Nations Gazette. We combine those data with additional sources to analyze the factors that are associated with First Nations exercising their taxation authority. We find evidence of geographic policy diffusion consistent with First Nations learning from their neighbors and direct evidence that formal educational and institutional resources are important correlates of tax law adoption. Understanding that process informs the broader literature on the evolution of taxation structures and local political incentives, the analysis may contain important lessons for Indigenous tax jurisdiction in other contexts. It is also a critical first step towards assessing the long-term consequences of First Nations' new fiscal powers. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to determine regional variation in need for mental health care for Aboriginal and Torres Strait Islander adults (18+ years). Methods: Three Australian Indigenous health surveys were analysed, and prevalence rates of high/very high psychological distress (as per the Kessler-5 tool) by the Index of Relative Socio-economic Disadvantage were computed and combined via meta-analysis. These estimates were applied to census population data to estimate regional needs and summed to geographic planning regions. Final estimates were assessed for face validity by comparing with other existing estimates of mental health need. Results: The Index of Relative Socioeconomic Disadvantage had a dose–response relationship with high/very high psychological distress, whereby the more disadvantaged an area, the greater the levels of reported distress. This methodology resulted in varying levels of need within South East Queensland. Conclusions: The approach was found to have good face validity and provides a data-driven method to determine relative levels of need. Implications for Public Health: To ensure equity of mental health service provision, planners should account for variation in levels of need within a catchment. This method may be used throughout Australia to determine regional variation in need for care where other data are lacking to ensure evidence-based investment planning decisions at the local level.

Introduction: Geese harvesting is a longstanding cultural tradition deeply ingrained among the Omushkego Cree in Fort Albany First Nation, embodying a holistic approach to health that integrates Indigenous knowledge, community wellbeing, and resilience. Despite historical disruptions stemming from colonization and assimilation policies, women have played a pivotal role in preserving and passing down traditional practices. The significance of goose harvesting extends beyond providing a nutrient-rich and cost-effective food source; it serves as a vehicle for cultural preservation and education, particularly fostering language acquisition among children. Nevertheless, concerns persist regarding the potential decline in the transmission of Indigenous knowledge. The interruption of intergenerational knowledge transfer not only poses implications for overall wellbeing but also worsens historical trauma within the community. In response to these challenges, the Niska (goose) harvesting program was developed with an aim to revitalize community harvesting practices, with a specific focus on incorporating the perspectives of women, especially in the preparatory and smoking phases of the geese. Methods: Omushkego Cree women were approached to participate. The study was conducted during the spring of 2018, and employed photovoice and semi-structured interviews that explored the impact of geese preparatory activities on the health and wellbeing of Indigenous women. Results: Major themes from the qualitative data included the importance of knowledge sharing, cultural continuity, healing, and the profound connection to the land. Women emphasized the value of sharing acquired knowledge, passing on traditions, and maintaining a connection to their cultural identity. Cultural continuity, depicted through intergenerational teachings and experiences, emerged as crucial for overall wellbeing. Participants spoke of the healing dynamics derived from engaging in traditional activities, highlighting the positive impact on physical, mental, emotional, and spiritual wellbeing. The land was identified as a central element in this healing process, representing more than just a physical space but an extension of home, contributing to a sense of peace and tranquility. The land became a medium for transmitting cultural teachings, shaping identity, and sustaining a subsistence lifestyle. Conclusion: The study emphasizes the importance of future research including more female youth participants to uncover specific challenges and strengths within this demographic. Overall, the Niska program demonstrates a comprehensive approach that intertwines cultural revitalization, community engagement, and holistic wellbeing, emphasizing the need for interventions that go beyond immediate challenges to create enduring positive impacts on Indigenous communities.

TBC