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Introduction Methods Results Discussion and Conclusions The Northern Territory (NT) of Australia has the highest rates of alcohol consumption and injury in the country. We aimed to: (i) describe the epidemiology of alcohol‐related injury (ARI) hospitalisations in the NT; (ii) estimate the proportion of alcohol involvement in injury hospitalisations; and (iii) consider the influence of alcohol policies on ARI hospitalisation trends.We conducted a retrospective time‐series study using coded hospitalisation data from NT public hospitals between 2007 and 2022. ARI hospitalisation was defined combining indicators for injury and acute alcohol use. We undertook descriptive analyses and calculated alcohol involvement against all injury hospitalisations. Annual percent changes (APC) were computed using joinpoint regression to examine the influence of alcohol policies on ARI hospitalisation trends by NT geographical regions (Central Australia and Top End).Alcohol use was associated with 22.6% of all injury hospitalisations. The most common cause of ARI hospitalisations was assault (46%). In Central Australia, a significant trend decline (APC −12.2; p = 0.011) was observed after 2017 following alcohol policies implemented between 2017 and 2018 (Banned Drinkers Register v2; Minimum Unit Price; and Police Auxiliary Liquor Inspectors). Consecutive years with the greatest decrease in Central Australia were 2013–2014 (APC −25.8) and 2018–2019 (APC −35.1); likely influenced by alcohol policies in effect at the time. In the Top End, a non‐significant trend decline (APC −26.1; p = 0.186) was observed after 2020.Alcohol policies implemented between 2017 and 2018 were associated with reduced ARI hospitalisations in Central Australia. Alcohol policies that demonstrated reduced harm should be sustained. [ABSTRACT FROM AUTHOR]

The concept of policy 'success' has been subject to much contestation. In the Indigenous higher education setting, Indigenous (and non-Indigenous) scholars have brought attention to the relevance of experiential knowledge to understanding the effects of power and race on policy, including how success is theorised. This paper aims to interrogate the notion of policy success by exploring how Indigenous users of higher education policy in the Northern Territory (NT), Australia, conceive the term 'success'. We conducted semi-structured interviews with twelve (n = 12) Indigenous people with expertise in NT Indigenous higher education policy. Our findings highlight that while some of our participant's conceptions of policy success align to those within current policy frameworks, there are also differences due to power and race relations. We reflect on the impact on policy outcomes, and discuss how a critical understanding of such relations can advance Indigenous higher education policy in the NT. [ABSTRACT FROM AUTHOR]

Objective: Examine the nature of domestic and family violence (DFV) presentations to an ED in the Northern Territory and identify potential gaps in service delivery. Methods: Prospective descriptive study of DFV presentations in November 2021. Results: A total of 70 presentations were identified, representing 1.2% of all presentations aged 16 years and older. Disproportionately impacted were First Nations people (90%), women (77.1%) and those aged less than 40 years (67.1%). Most (81.4%) arrived outside of business hours and only 37.1% were assessed by the social worker. Case complexity was increased by high rates of homelessness (30%), concurrent alcohol consumption (44.3%) and pregnancy (11.1% of females). More than a third (37.1%) had attended on one to four occasions in the previous 6 months with a DFV‐related injury. Compared to non‐DFV attendances, the median ED length of stay was approximately twice as long (456 vs 210 min), admissions rates to the ED short stay unit five times higher (25.7% vs 5.7%; P < 0.01, odds ratio [OR] = 5.7 and 95% confidence interval [CI] = 3.3–9.8) and rates of self‐discharge prior to completion of care 9 times higher (12.9% vs 1.5%; P < 0.01, OR = 9.5 and 95% CI = 4.6–19.7). Conclusion: The data highlights the need for a 24 h trauma‐informed, culturally safe and integrated service to support people experiencing DFV. This could be achieved by a specialist unit designed and staffed by First Nations health practitioners. [ABSTRACT FROM AUTHOR]

Aim: Indigenous Australians with lung cancer have poorer survival than non‐Indigenous Australians. The reasons for the disparity are not fully understood and this study hypothesized that there may be a difference in the molecular profiles of tumors. The aim of this study, therefore, was to describe and compare the characteristics of non‐small cell lung cancer (NSCLC) in the Northern Territory's Top End, between Indigenous and non‐Indigenous patients, and describe the molecular profile of tumors in the two groups. Methods: A retrospective review was conducted of all adults with a new diagnosis of NSCLC in the Top End from 2017 to 2019. Patient characteristics assessed were Indigenous status, age, sex, smoking status, disease stage, and performance status. Molecular characteristics assessed were epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK), v‐raf murine sarcoma viral oncogene homolog B (BRAF), ROS proto‐oncogene 1 (ROS1), Kirsten rat sarcoma viral oncogene homolog (KRAS), mesenchymal‐epithelial transition (MET), human epidermal growth factor receptor 2 (HER2), and programmed death‐ligand 1 (PD‐L1). Student's t‐test and Fisher's Exact Test were used in the statistical analysis. Results: There were 152 patients diagnosed with NSCLC in the Top End from 2017–2019. Thirty (19.7%) were Indigenous and 122 (80.3%) were non‐Indigenous. Indigenous patients compared to non‐Indigenous patients were younger at diagnosis (median age 60.7 years versus 67.1 years, p = 0.00036) but were otherwise similar in demographics. PD‐L1 expression was similar between Indigenous and non‐Indigenous patients (p = 0.91). The only mutations identified among stage IV non‐squamous NSCLC patients were EGFR and KRAS but testing rates and overall numbers were too small to draw conclusions about differences in prevalence between Indigenous and non‐Indigenous patients. Conclusion: This is the first study to investigate the molecular characteristics of NSCLC in the Top End. [ABSTRACT FROM AUTHOR]

This article critically examines safety and innovation in out-of-home care, with a particular focus on addressing the entrenched overrepresentation of Aboriginal and Torres Strait Islander children and young people in the child welfare system. Grounded in the practical insights of safe house workers and managers, the purpose of this article is to share an innovative practice case study—the Tangentyere Safe House in Alice Springs, Northern Territory, Australia. As a case study within an Aboriginal Community-Controlled Organisation, Tangentyere Safe House emerges as a site for understanding the confluence of cultural safety, familial connections, and strategies to mitigate overrepresentation. Key themes explored include promoting cultural safety and supporting connections with the family of origin. Through a methodological lens that privileges practice-based knowledge, this article captured the on-the-ground experiences of those actively engaged in child safety. The findings underscore the innovative practices employed by Tangentyere Safe House in navigating out-of-home care within an Indigenous context to argue for a holistic and culturally informed approach to child protection interventions, drawing attention to the practical strategies employed by safe house workers. The article showcases the central role of Aboriginal Community-Controlled Organisations in providing care alongside families in out-of-home care. IMPLICATIONS The innovative approach of the Tangentyere Safe House highlights the importance and unique role of Aboriginal Community-Controlled Organisations in out-of-home care. The role of Aboriginal Community-Controlled Organisations should be formally recognised in the Aboriginal and Torres Strait Islander Child Placement Principle hierarchy. Frontline safe house workers' knowledge and expertise regarding Aboriginal and Torres Strait Islander children in out-of-home care can inform all stakeholder involvement including police interventions. [ABSTRACT FROM AUTHOR]

This article discusses the use of Chinese indentured labor by the British Phosphate Commissioners (BPC) in mining operations on Ocean Island and Nauru from the 1920s to 1942. The Chinese workers lived in BPC accommodation and had agreements regarding their work, benefits, and wages. In 1942, due to the threat of a Japanese attack, the Chinese miners were evacuated and later employed to mine wolfram in Hatches Creek and Wauchope in the Northern Territory. However, they went on strike shortly after arriving, accusing the government of not fulfilling its promises. The article compares the working and living conditions of Chinese miners in different locations and aims to broaden the historical understanding of their lives. [Extracted from the article]

Background: Use of immune checkpoint inhibitors is growing, but clinical trial data may not apply to Indigenous patients or patients living in remote areas. Aims: To provide real‐world incidence of immune‐related adverse events (irAE) in the Top End of the Northern Territory and compare incidence between demographic subgroups. Methods: This retrospective, observational, cohort study collected data from electronic records of patients living in the Top End with solid organ cancer treated with immunotherapy between January 2016 and December 2021. The primary outcome was cumulative incidence of any‐grade and severe irAE. Secondary outcomes were overall survival, treatment duration and reason for treatment discontinuation. Results: Two hundred and twenty‐six patients received immunotherapy. Forty‐eight (21%) lived in a remote or very remote area, and 36 (16%) were Indigenous. Cumulative incidence of any‐grade irAE was 54% (122/226 patients); incidence of severe irAE was 26% (59/226 patients). Rates were similar between Indigenous and non‐Indigenous patients of any‐grade (42% vs 56%, P = 0.11) and severe (11% vs 18%, P = 0.29) irAE. However, Indigenous patients had shorter treatment duration, more frequently discontinued treatment due to patient preference and appeared to have shorter median overall survival than non‐Indigenous patients (17.1 vs 30.4 months; hazard ratio (HR) = 1.5, 95% confidence interval (CI) = 0.92–2.66). There was no difference in mortality between remote and urban patients (median overall survival 27.5 vs 30.2 months; HR = 1.1, 95% CI = 0.7–1.7). Conclusions: Rates of irAE in our cohort are comparable to those in the published literature. There was no significant difference in any‐grade or severe irAE incidence observed between Indigenous and non‐Indigenous patients. [ABSTRACT FROM AUTHOR]

Objective: To provide the first document map of sustainability and decarbonisation actions across the Australian healthcare sector, as reported in publicly available documents online, and to identify gaps in actions. Methods: Healthcare providers were identified across all state and territories. Structured Google searches between August and December 2022 were followed by document searches. Updates were undertaken, most recently in December 2023. Targeted documents included position statements, strategies, and reports. Key points from these documents pertaining to sustainability and/or decarbonisation were extracted and descriptively analysed. Results: A total of 294 documents were included, mostly focused on power generation, transport, building design, and circular procurement/waste pathways. In contrast, relatively few plans for decarbonisation of clinical care were identified (n = 42). National and two state governments (New South Wales, Western Australia) have established healthcare sustainability and decarbonisation units, and two further states have publicly committed to doing so (Queensland, Tasmania). However, these documents generally reported separate, siloed actions. While attempts were made to make this review comprehensive, some documents may have been missed or are only available inside an organisation, and new actions will continue to emerge. Conclusion: Broad sustainability plans have been developed by many healthcare providers; however, to achieve net zero, decarbonising of clinical practices is also needed, and this is where the least action is currently occurring. To decarbonise clinical care, the sector needs to come together in a more coordinated way. What is known about the topic? Little is known about what actions are occurring to make healthcare more sustainable and to reduce the carbon footprint of healthcare in Australia. What does this paper add? This paper provides a snapshot of publicly available documents from healthcare providers and professional organisations as they relate to healthcare sustainability and helps reveal the gaps and siloed nature of current actions. What are the implications for practitioners? This paper can help jurisdictions identify gaps or areas for improvement and may aid in targeted and coordinated interventions, especially as they relate to decarbonised clinical care. [ABSTRACT FROM AUTHOR]

Parkinson's disease (PD) is a prevalent neurodegenerative condition, ranking as the most common among movement disorders. People living with Parkinson's disease benefit from the specialised skills and expertise of a dedicated Parkinson's disease and movement disorders nurse specialist (PDMDNS) (Bramble, Carroll, & Rossiter, 2018). Access to a PD nurse embedded into the local health setting impacts the potential to avoid hospital admissions due to worsening of symptoms, improving quality of life through improved access to specialist services and reducing carer burden (Bramble et al. 2018) The World Health Organisation advocates for the tracking healthcare workforce demographics and distribution trends to ensure equity of health care services and robust economic planning to meet future needs (WHO 2016). This marks the fourth publication in an ongoing annual series examining the longitudinal trends of the PDMDNS workforce in Australia (Williams et al., 2021, 2023). [ABSTRACT FROM AUTHOR]

Sri Lankan cassava mosaic virus (SLCMV) is one of the viruses that cause cassava mosaic disease. Strong mosaic symptoms on a cassava plant in the Northern Territory tested positive in begomovirus specific PCR testing. The DNA sequence of the amplicon was 96.38% similar (over 528 bp) to SLCMV, a result confirmed by sequencing genomic DNA. This is the first record of SLCMV in Australia, and outside of Asia. [ABSTRACT FROM AUTHOR]

At the core of practice for many non-Indigenous Australian social workers is learning how to work in deeply respectful, culturally appropriate ways alongside First Nations Peoples. Larrakia and Warumungu woman, and Northern Territory social work scholar, Dr Christine/Karen King’s (2011) writings provided the impetus for this inquiry. King (2011) invites social workers to critically reflect on their practice and worldviews. Responding to this invitation, 10 non-Indigenous social workers with policy, academic, and/or practice experience conducted a co-operative inquiry into the question “What have we learnt about practising social work in the Northern Territory, Australia?” We explored the uniqueness of the Northern Territory and identified three interwoven themes. The first theme grounds our practice to Place—on Country. Here, we identified the importance of engaging with the diverse histories of the Peoples we work alongside. Second, we reflected on our vulnerability as social workers and explored the limitations of our professional knowledge base for working with First Nations Peoples. The third theme relates to the importance of engaging with First Nations Peoples’ worldviews. We conclude by affirming the importance of social work practice being led by First Nations People on Country.IMPLICATIONS Social workers working in the Northern Territory alongside First Nations Peoples will benefit from engaging with vulnerability, reflexivity, and critical reflection on their values, understandings, language, and unexamined aspects of practice and cultural self.Social workers in the Northern Territory need to commit to ongoing learning and ground their practice with First Nations’ worldviews and wisdom.Social workers working in the Northern Territory alongside First Nations Peoples will benefit from engaging with vulnerability, reflexivity, and critical reflection on their values, understandings, language, and unexamined aspects of practice and cultural self.Social workers in the Northern Territory need to commit to ongoing learning and ground their practice with First Nations’ worldviews and wisdom. [ABSTRACT FROM AUTHOR]

BACKGROUND: While some evidence has potentially linked climate change to carcinogenic factors, the long-term effect of climate change on liver cancer risk largely remains unclear. OBJECTIVES: Our objective is to evaluate the long-term relationship between temperature increase and liver cancer incidence in Australia. METHODS: We mapped the spatial distribution of liver cancer incidence from 2001 to 2019 in Australia. A Bayesian spatial conditional autoregressive (CAR) model was used to estimate the relationships between the increase in temperature at different lags and liver cancer incidence in Australia, after controlling for chronic hepatitis B prevalence, chronic hepatitis C prevalence, and the Index of Relative Socio-economic Disadvantage. Spatial random effects obtained from the Bayesian CAR model were also mapped. RESULTS: The research showed that the distribution of liver cancer in Australia is spatially clustered, most areas in Northern Territory and Northern Queensland have higher incidence and relative risk. The increase in temperature at the lag of 30 years was found to correlate with the increase in liver cancer incidence in Australia, with a posterior mean of 30.57 [95% Bayesian credible interval (CrI): 0.17, 58.88] for the univariate model and 29.50 (95% CrI: 1.27, 58.95) after controlling for confounders, respectively. The results were not highly credible for other lags. DISCUSSION: Our Bayesian spatial analysis suggested a potential relationship between temperature increase and liver cancer. To our knowledge, this research marks the first attempt to assess the long-term effect of global warming on liver cancer. If the relationship is confirmed by other studies, these findings may inform the development of prevention and mitigation strategies based on climate change projections. [ABSTRACT FROM AUTHOR]

Background: Despite disproportionate rates of mental ill-health compared with non-Indigenous populations, few programs have been tailored to the unique health, social, and cultural needs and preferences of young Aboriginal and Torres Strait Islander males. This paper describes the process of culturally adapting the US-based Young Black Men, Masculinities, and Mental Health (YBMen) Project to suit the needs, preferences, culture, and circumstances of Aboriginal and Torres Strait Islander males aged 16–25 years in the Northern Territory, Australia. YBMen is an evidence-based social media-based education and support program designed to promote mental health, expand understandings of gender and cultural identities, and enhance social support in college-aged Black men. Methods: Our adaptation followed an Extended Stages of Cultural Adaptation model. First, we established a rationale for adaptation that included assessing the appropriateness of YBMen's core components for the target population. We then investigated important and appropriate models to underpin the adapted program and conducted a non-linear, iterative process of gathering information from key sources, including young Aboriginal and Torres Strait Islander males, to inform program curriculum and delivery. Results: To maintain program fidelity, we retained the core curriculum components of mental health, healthy masculinities, and social connection and kept the small cohort, private social media group delivery but developed two models: 'online only' (the original online delivery format) and 'hybrid in-person/online' (combining online delivery with weekly in-person group sessions). Adaptations made included using an overarching Aboriginal and Torres Strait Islander social and emotional wellbeing framework and socio-cultural strengths-based approach; inclusion of modules on health and wellbeing, positive Indigenous masculinities, and respectful relationships; use of Indigenous designs and colours; and prominent placement of images of Aboriginal and Torres Strait Islander male sportspeople, musicians, activists, and local role models. Conclusions: This process resulted in a culturally responsive mental health, masculinities, and social support health promotion program for young Aboriginal and Torres Strait Islander males. Next steps will involve pilot testing to investigate the adapted program's acceptability and feasibility and inform further refinement. Keywords: Aboriginal, Torres Strait Islander, Indigenous, Australia, male, cultural adaptation, social media, mental health, masculinities, social support. [ABSTRACT FROM AUTHOR]

Bark paintings represent a unique artform that originated in Australia and continues to this day. This paper presents a scientific investigation into both the pigments and binders used by Aboriginal artists from across the Northern Territory (NT) and the Kimberley region in Western Australia (WA) and represents the first major study dedicated to identifying these materials in samples taken from paintings. Laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS), Fourier transform infrared (FTIR) and Raman spectroscopy were used to identify the pigments in the four colors commonly associated with works by Aboriginal artists: red, yellow, black, and white. Iron oxides are used for red and yellow. Typically, kaolin is used for white and carbon or natural manganese ores are used for black, although the use of other pigments such as huntite (white) and battery black were seen in paintings from specific locations. Evidence of trade could not be established during this study; however, analysis shows that artists may use different pigments based on location and availability. A combination of FTIR and pyrolysis-gas chromatography-mass spectrometry (pyrolysis-GC-MS) was utilized to investigate the presence of a binder in the paint. Plant-based materials were identified as the binder in the majority of the paintings. The use of orchid juice was common, both as a preparatory layer on the bark substrate and as a paint binder. The presence of synthetic resins was more widespread than anticipated, attributed to both conservation efforts and more modern painting practices. [ABSTRACT FROM AUTHOR]

Background: The gaps in healthy life expectancy (HLE) between Indigenous and non-Indigenous Australians are significant. Detailed and accurate information is required to develop strategies that will close these health disparities. This paper aims to quantify and compare the causes and their relative contributions to the life expectancy (LE) gaps between the Indigenous and non-Indigenous population in the Northern Territory (NT), Australia. Methods: The age-cause decomposition was used to analyse the differences in HLE and unhealthy life expectancy (ULE), where LE = HLE + ULE. The data was sourced from the burden of disease and injury study in the NT between 2014 and 2018. Results: In 2014–2018, the HLE at birth in the NT Indigenous population was estimated at 43.3 years in males and 41.4 years in females, 26.5 and 33.5 years shorter than the non-Indigenous population. This gap approximately doubled the LE gap (14.0 years in males, 16.6 years in females) at birth. In contrast to LE and HLE, ULE at birth was longer in the Indigenous than non-Indigenous population. The leading causes of the ULE gap at birth were endocrine conditions (explaining 2.9–4.4 years, 23–26%), followed by mental conditions in males and musculoskeletal conditions in females (1.92 and 1.94 years, 15% and 12% respectively), markedly different from the causes of the LE gap (cardiovascular disease, cancers and unintentional injury). Conclusions: The ULE estimates offer valuable insights into the patterns of morbidity particularly useful in terms of primary and secondary prevention. [ABSTRACT FROM AUTHOR]

Background: The burden of chronic kidney disease (CKD) is high in the Northern Territory (NT), Australia. This study aims to describe the healthcare use and associated costs of people at risk of CKD (e.g. acute kidney injury, diabetes, hypertension, and cardiovascular disease) or living with CKD in the NT, from a healthcare funder perspective. Methods: We included a retrospective cohort of patients at risk of, or living with CKD, on 1 January 2017. Patients on kidney replacement therapy were excluded from the study. Data from the Territory Kidney Care database, encompassing patients from public hospitals and primary health care services across the NT was used to conduct costing. Annual healthcare costs, including hospital, primary health care, medication, and investigation costs were described over a one-year follow-up period. Factors associated with high total annual healthcare costs were identified with a cost prediction model. Results: Among 37,398 patients included in this study, 23,419 had a risk factor for CKD while 13,979 had CKD (stages 1 to 5, not on kidney replacement therapy). The overall mean (± SD) age was 45 years (± 17), and a large proportion of the study cohort were First Nations people (68%). Common comorbidities in the overall cohort included diabetes (36%), hypertension (32%), and coronary artery disease (11%). Annual healthcare cost was lowest in those at risk of CKD (AUD$7,958 per person) and highest in those with CKD stage 5 (AUD$67,117 per person). Inpatient care contributed to the majority (76%) of all healthcare costs. Predictors of increased total annual healthcare cost included more advanced stages of CKD, and the presence of comorbidities. In CKD stage 5, the additional cost per person per year was + $53,634 (95%CI 32,769 to 89,482, p < 0.001) compared to people in the at risk group without CKD. Conclusion: The total healthcare costs in advanced stages of CKD is high, even when patients are not on dialysis. There remains a need for effective primary prevention and early intervention strategies targeting CKD and related chronic conditions. [ABSTRACT FROM AUTHOR]

Background: Aboriginal and Torres Strait Islander communities in remote Australia have initiated bold policies for health-enabling stores. Benchmarking, a data-driven and facilitated 'audit and feedback' with action planning process, provides a potential strategy to strengthen and scale health-enabling best-practice adoption by remote community store directors/owners. We aim to co-design a benchmarking model with five partner organisations and test its effectiveness with Aboriginal and Torres Strait Islander community stores in remote Australia. Methods: Study design is a pragmatic randomised controlled trial with consenting eligible stores (located in very remote Northern Territory (NT) of Australia, primary grocery store for an Aboriginal community, and serviced by a Nutrition Practitioner with a study partner organisation). The Benchmarking model is informed by research evidence, purpose-built best-practice audit and feedback tools, and co-designed with partner organisation and community representatives. The intervention comprises two full benchmarking cycles (one per year, 2022/23 and 2023/24) of assessment, feedback, action planning and action implementation. Assessment of stores includes i adoption status of 21 evidence-and industry-informed health-enabling policies for remote stores, ii implementation of health-enabling best-practice using a purpose-built Store Scout App, iii price of a standardised healthy diet using the Aboriginal and Torres Strait Islander Healthy Diets ASAP protocol; and, iv healthiness of food purchasing using sales data indicators. Partner organisations feedback reports and co-design action plans with stores. Control stores receive assessments and continue with usual retail practice. All stores provide weekly electronic sales data to assess the primary outcome, change in free sugars (g) to energy (MJ) from all food and drinks purchased, baseline (July-December 2021) vs July-December 2023. Discussion: We hypothesise that the benchmarking intervention can improve the adoption of health-enabling store policy and practice and reduce sales of unhealthy foods and drinks in remote community stores of Australia. This innovative research with remote Aboriginal and Torres Strait Islander communities can inform effective implementation strategies for healthy food retail more broadly. Trial registration: ACTRN12622000596707, Protocol version 1. [ABSTRACT FROM AUTHOR]

Quantifying stroke incidence and mortality is crucial for disease surveillance and health system planning. Administrative data offer a cost-effective alternative to "gold standard" population-based studies. However, the optimal methodology for establishing stroke deaths from administrative data remains unclear. We aimed to determine the optimal method for identifying stroke-related deaths in administrative datasets as the fatal component of stroke incidence, comparing counts derived using underlying and all causes of death (CoD). Using whole-population multijurisdictional person-level linked data from hospital and death datasets from South Australia, the Northern Territory, and Western Australia, we identified first-ever stroke events between 2012 and 2015, using underlying CoD and all CoD to identify fatal stroke counts. We determined the 28-day case fatality for both counts and compared results with gold standard Australian population-based stroke incidence studies. The total number of incident stroke events was 16,150 using underlying CoD and 18,074 using all CoD. Case fatality was 24.7% and 32.7% using underlying and all CoD, respectively. Case fatality using underlying CoD was similar to that observed in four Australian "gold standard" population-based studies (20%–24%). Underlying CoD generates fatal incident stroke estimates more consistent with population-based studies than estimates based on stroke deaths identified from all-cause fields in death registers. [ABSTRACT FROM AUTHOR]

The Carpentarian Pseudantechinus (Pseudantechinus mimulus, Dasyuridae) is a little‐known, saxicolous dasyurid marsupial from the Mount Isa Inlier bioregion in Queensland (QLD) and the Gulf Coastal bioregion in the Northern Territory (NT), Australia. A paucity of targeted survey effort across broad swathes of potentially suitable habitat means that the species' distribution and habitat associations are uncertain. This study aimed to (1) refine the contemporary distribution of P. mimulus, (2) determine the landscape and floristic variables that may predict P. mimulus presence, and (3) assess the current conservation status of P. mimulus. We conducted camera trap surveys covering 631 camera stations at 227 independent sites over 4 years for a total of 28 767 trap‐nights throughout QLD and NT in known and predicted suitable habitat. Stepwise generalized linear models were used to test the effect of landscape and floristic predictors on P. mimulus presence. The species' contemporary distribution was assessed using a MAXENT species distribution model. We collated a database of 292 records of P. mimulus, including 111 recorded during this study, extending the species' known range in QLD. The proposed holotype location of the Mittiebah Range was surveyed twice during this study but P. mimulus was not recorded. Pseudantechinus mimulus had the highest probability of presence on most non‐northerly aspects on metamorphic landforms. Eleven plant taxa had a significant effect on P. mimulus presence. This study provides new evidence for landscape and floristic factors that help predict the presence of P. mimulus. Our results indicate the possibility of two disjunct populations, but large swathes of potential habitat still require additional effort to determine the species' true distribution. Our estimate for area of occupancy partially satisfies a threatened species listing; however, more focused research on population dynamics, trends in habitat quality, and landscape‐scale threats is necessary. [ABSTRACT FROM AUTHOR]

Introduction: Community water fluoridation (CWF) is a costeffective intervention to reduce dental caries at population level. This Australian study used a difference-in-difference (DiD) analysis to measure dental caries in children exposed to CWF in the Northern Territory (NT), Australia. Methods: Oral health data obtained from the NT Department of Health contained 64 399 person-year observations from 2008 to 2020, totalling 24 546 children aged 1-17 years. Drinking water quality data for fluoride levels, held by the Power and Water Corporation, were obtained for 50 remote communities and linked to the oral health dataset. The DiD analysis used a treatment group and two control groups to compare the effects of CWF on dental caries outcomes in children, measured using the decayed, missing and filled teeth (dmft/DMFT) index. The treatment group consisted of records from children residing in five remote NT communities that implemented CWF in 2014.The control 1 group included records of children residing in communities with naturally occurring fluoride in drinking water supplies at levels at or above the Department of Health policy threshold of 0.5 mg/L. The control 2 group included records of children residing in communities with naturally occurring fluoride in drinking water supplies below the level recommended by the Department of Health policy (<0.5 mg/L). The data were grouped into time periods prior to the inception of CWF in five remote communities in 2014 (preintervention) and after 2014 (post-intervention). Results: Our results demonstrated that dental caries was significantly decreased for children in the treatment group following the implementation of CWF at a greater magnitude than both control groups for the same time period. Overall, children assigned to the treatment group exhibited a decline in the number of teeth affected by caries by an average of 0.28 (p=0.001). Notably, children of ages 7-10 years and 11-17 years experienced significantly greater post-intervention declines in average dmft/DMFT, by 0.32 (p=0.051) and 0.40 (p=0.012) fewer affected teeth respectively. Conclusion: While dental caries disproportionately impacts Aboriginal children in remote and very remote NT, it is clear that CWF produces population-level reductions in overall dental caries for these populations. Additionally, our study demonstrates the application of the DiD method in a public health policy evaluation. Our findings suggest that the longstanding policy position of the NT Department of Health on CWF has supported improvements in oral health among child populations that experience high levels of dental caries in remote NT communities. [ABSTRACT FROM AUTHOR]

Background: Patients with a large vessel occlusion require a transfer from a primary stroke centre to access thrombectomy, often over significant distances in regional areas. We sought to optimise stroke care access in the regional South Australian Tele-Strokeservice (SATS) to improve patient access to thrombectomy. Methods: We undertook a 24-month interventional historically controlled cohort study comparing acute stroke care metrics in the SATS. This consisted of a 12-month control period and a 12-month intervention monitoring period. The study intervention considered of an education package provided to the regional hospitals, a stroke neurologist roster to receive consultations and the intervention of a centralised tele-stroke system to provide treatment advice and organise patient transfers where needed. The SATS services 61 rural hospitals in South Australia, and Alice Springs in the Northern Territory. Suspected acute stroke patients presenting to the participating regional hospitals in SATS network where a telehealth consultation took place. Results: Over the study period, there were 919 patient referrals, with 449 consultations in the pre-intervention phase and 470 in the post-intervention phase. Demographic features in both epochs were similar. The post-intervention phase was associated with shorter door-to-scan time (35 min, IQR: 18,70; vs. 49 min, IQR:25,102, p < 0.0001), faster door-to-thrombolysis time (58 min, IQR: 39,91, vs.83 min, IQR: 55,100, p = 0.0324) and a higher portion of patients treated with thrombectomy (54, 11.5% vs. 26, 5.8%, p = 0.002). Conclusion: An optimised implementation of a streamlined telehealth platform with ongoing education and feedback to referring sites was associated with improved stroke workflow metrics and higher thrombectomy rates. [ABSTRACT FROM AUTHOR]

Objective: We performed a pilot stroke incidence study, focused on feasibility and inclusion of the CONSIDER reporting guidelines, to model the design of a future population‐based study aiming to definitively determine stroke incidence, antecedents, treatment, and outcomes. Study design: Prospective stroke incidence study (pilot study). Setting, participants: All people aged 15 years or older who lived in postcode‐defined areas of South Australia and Northern Territory (885 472 people, including 45 127 Aboriginal people [5.1%]) diagnosed with stroke for the first time during 1 October – 31 December 2015 and admitted to public hospitals or stroke and transient ischaemic attack clinics. Main outcome measures: Feasibility of a prospective population‐based stroke incidence study. Results: Of the 123 participants with first strokes, ten were Aboriginal (8%); the median age of Aboriginal people was 45 years (interquartile range [IQR], 33–55 years), of non‐Indigenous people 73 years (IQR, 62–84 years). For Aboriginal people, the age‐standardised incidence of stroke was 104 (95% confidence interval [CI], 84–124) per 100 000 person‐years, for non‐Indigenous people 33 (95% CI, 22–44) per 100 000 person‐years. We found that a prospective population‐based stroke incidence study in Aboriginal people was feasible, including with respect to establishing an adequate sample size, diagnostic confirmation, identification of incident stroke, confirming stroke subtypes, establishing a stable statistical population, standardising data reporting for comparison with other stroke incidence studies, and ethical research reporting that conforms to CONSIDER guidelines. Conclusions: A larger, population‐based study of the incidence of stroke in Aboriginal people is both feasible and needed to provide robust estimates of stroke incidence, antecedents, treatments and outcomes to help guide strategies for reducing the risk of and outcomes of stroke in Aboriginal people. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B is endemic amongst the Australian Aboriginal population in the Northern Territory. A participatory action research project identified the lack of culturally appropriate education tools and led to the development of the "Hep B Story" app in the Aboriginal language Yolŋu Matha. This paper describes a formal evaluation of the app's first version, which informed improvements and translation into a further ten Aboriginal languages. Methods: The evaluation employed Participatory Action Research (PAR) principles to work within Indigenous research methodologies and prioritise Indigenous knowledge to improve the app iteratively. Semi-structured interviews and focus groups were conducted across the Northern Territory with 11 different language groups. Local Community Based Researchers and Aboriginal Research team members coordinated sessions. The recorded, translated conversations were transcribed verbatim and thematically analysed using an inductive and deductive approach. Results: Between November 2018 and September 2020, 94 individuals from 11 language groups participated in 25 semi-structured interviews and 10 focus groups. All participants identified as Aboriginal. Most participants felt the app would be culturally appropriate for Aboriginal communities in the Northern Territory and improve knowledge surrounding hepatitis B. The information gathered from these interviews allowed for identifying five main themes: support for app, relationships, concept versus language, shame, and perceptions of images, along with errors that required modification. Conclusions: A "real-life" evaluation of the app was comprehensively completed using a PAR approach blended with Indigenous research methods. This evaluation allowed us to develop an updated and enhanced version of the app before creating the additional ten language versions. An iterative approach alongside strong community engagement was pivotal in ensuring the app's cultural safety and appropriateness. We recommend avoiding the use of knowledge-based evaluations in an Aboriginal setting to ensure relevant and culturally appropriate feedback is obtained. [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]

Aim: Eating disorders (EDs) are associated with significant disease burden and unacceptably high mortality rates. Early intervention significantly improves prognosis and can prevent chronic suffering; however, large numbers of people with the illness are not being identified or managed in primary healthcare. The current study aimed to test the reliability of the face‐to‐face, clinician delivery of a previously validated, co‐designed, online screening tool for eating disorders. Methods: Individuals aged 14 and over who read, English were recruited from the community in either primary care (general practice) settings or headspace youth mental health centres. They completed the InsideOut Institute Screener (IOI‐S) face‐to‐face, delivered verbally by the study researcher clinician and then online by self‐report. The primary outcome was test‐retest reliability as measured by two‐way mixed effects model Intraclass Correlation Coefficient (ICC) with absolute agreement. Results: A total of 83 participants aged 14–81 (M 36.2) completed the study in New South Wales and the Northern Territory, Australia, between April and November 2022. The ICC between successive iterations of the test was significantly positive (0.980), demonstrating strong internal validity and test–retest reliability of the scale. Conclusions: The IOI‐S is an adaptive 6‐item screening tool designed to 'start a conversation' and determine risk using gentle language conceived by individuals with lived experience. Originally designed for online use, the current study broadens its versatility to clinical settings. The screener performs equally well when delivered face‐to‐face in clinical practice. In conjunction with increased practitioner education and improved treatment referral pathways, broad implementation of the screener in early healthcare settings can support timely identification and intervention for those with EDs. [ABSTRACT FROM AUTHOR]

Background: Despite the high rates of cholecystectomy in Australia, there is minimal literature regarding the outcomes of cholecystectomy in rural Central Australia within the Northern Territory. This study aims to better characterize the outcomes for patients undergoing cholecystectomy in Central Australia and review clinical and patient characteristics, which may affect outcomes. Method: A retrospective case–control study was performed using data obtained from medical records for all patients undergoing cholecystectomy at Alice Springs Hospital in the Northern Territory from January 2018 until December 2022. Patient characteristics were gathered, and key outcomes examined included: inpatient mortality and 30‐day mortality, bile duct injury, bile leak, return to theatre, conversion to open, duration of procedure, length of stay, and up‐transfer to a tertiary referral centre. Results: A total of 466 patients were included in this study. Majority of the patients were female and there was a large portion of Indigenous Australians (56%). There were no inpatient mortalities, or 30‐day mortalities recorded. There were two bile leaks and/or bile duct injuries (0.4%) and two unplanned returned to theatres (0.4%). Indigenous Australians were more likely to require an emergency operation and had a longer median length of stay (P < 0.001). Conclusion: Cholecystectomy can be performed safely and to a high standard in Central Australia. Surgeons in Central Australia must appreciate the nuances in the management of patients who come from a significantly different socioeconomic background, with complex medical conditions when compared to metropolitan centres. [ABSTRACT FROM AUTHOR]

Simple Summary: Reports of a significant increase in young-onset cancers in South Australia (SA) with a higher-than-average incidence in the Northern Territory (NT) in the last 3 decades. Cancer incidence significantly decreased over time amongst non-Indigenous children but remained unchanged amongst Indigenous children (NT). Overall survival improved in SA, but unchanged in the NT. In the NT, overall survival of Indigenous children was significantly lower than non-Indigenous children, but survival rates in the former have improved. Ongoing targeted public health response is needed to reduce disparities in cancer health care outcomes for Indigenous Australians as outlined within the Australian and the Aboriginal and Torres Strait Islander Cancer Plans. Background & Aims: Reports of a rise in childhood cancer incidence in Australia and globally prompted the investigation of cancer incidence and survival in South Australia (SA) and the Northern Territory (NT) over a 28-year period, with emphasis on Indigenous peoples. Methods: This cross-sectional analysis of two prospective longitudinal databases, the SA and NT Cancer Registries (1990–2017), included all reported cases of childhood cancers. Poisson regression provided estimates of incidence rate ratios and survival was modelled using Cox proportional hazard models for children aged <5 and ≥5 years. Results: A total of 895 patients across SA (N = 753) and the NT (N = 142) were ascertained. Overall and in the NT, childhood cancer incidence was higher in males compared with females (IRR 1.19 [1.04–1.35] and 1.43 [1.02–2.01], respectively). Lymphocytic leukemia was the most reported cancer type across all locations. With reference to the 1990–1999 era (181.67/100,000), cancer incidence remained unchanged across subsequent eras in the combined cohort (SA and NT) (2000–2009: 190.55/100,000; 1.06 [0.91–1.25]; 2010–2017: 210.00/100,000; 1.15 [0.98–1.35]); similar outcomes were reflected in SA and NT cohorts. Cancer incidence amongst non-Indigenous children significantly decreased from the 1990–1999 era (278.32/100,000) to the 2000–2009 era (162.92/100,000; 0.58 [0.35–0.97]). Amongst 39 Indigenous children in the NT, incidence rates remained unchanged across eras (p > 0.05). With reference to the 1990–1999 era, overall survival improved in subsequent eras in SA (2000–2009: HR 0.53 [0.38–0.73]; 2010–2017: 0.44 [0.28–0.68]); however, remained unchanged in the NT (2000–2009: 0.78 [0.40–1.51]; 2010–2017: 0.50 [0.24–1.05]). In the NT, overall survival of Indigenous patients was significantly lower compared with the non-Indigenous cohort (3.42 [1.92–6.10]). While the survival of Indigenous children with cancer significantly improved in the last two eras (p < 0.05), compared to the 1990–1999 era, no change was noted amongst non-Indigenous children in the NT (p > 0.05). Conclusions: The incidence of childhood cancers has remained unchanged over 28-years in SA and the NT. Encouragingly, improved survival rates over time were observed in SA and amongst Indigenous children of the NT. Nevertheless, survival rates in Indigenous children remain lower than non-Indigenous children. [ABSTRACT FROM AUTHOR]

As online gambling becomes more prevalent, understanding the motives of online gamblers has become a key focus for research and practice. The aim of this study was to understand differences in gambling-related outcome expectancies between mixed (both online and offline) gamblers and offline-only gamblers, by incorporating gambling harm risk categories from the problem gambling severity index (PGSI). This study comprised a secondary data analysis of the 2015 Northern Territory Gambling Prevalence and Wellbeing Survey. A sample of 1207 individuals in the Northern Territory who had reported gambling at least once in the previous 12 months were used in the analyses. General linear and structural equation modelling were used to ascertain differences in gambling outcome expectancies, in relation to gambling modality (i.e., mixed, offline-only) and PGSI scores. Mixed gamblers tended to score higher on all outcome expectancies than their offline-only counterparts. Outcome expectancy scores were higher in individuals in higher-risk PGSI categories. The escape outcome expectancy was dependent on both modality and risk category. Invariance testing of a low and problem gambling risk subsample revealed differential relationships for both the escape and excitement outcome expectancies for mixed and offline-only gamblers. The results provide an important contribution to the existing literature regarding motivation and outcome expectancies in relation to gambling modality and problem gambling severity. The findings highlight the importance of considering both gambling outcome expectancies and modality when considering problem gambling. [ABSTRACT FROM AUTHOR]

The Whitlam Labor government (1972–75) is remembered for ushering in a new era in Indigenous affairs, with the move to "self‐determination", abandoning the longstanding insistence on "assimilation". The new government intended to deploy the Commonwealth's new legislative power established in the 1967 constitutional referendum to bring in a range of reforms, responding to consistent demands from Indigenous leaders, activists, and supporters through the previous decade. Whitlam's campaign speech promised anti‐discrimination legislation, provisions to allow Aboriginal communities to incorporate, and legislation of a system of land tenure. The government faced considerable political obstacles, ultimately curbing the ambitious reform agenda. Nevertheless, these initial efforts to conceptualise representation, recognition, and compensation laid important foundations for the current public debate about "Voice, Treaty, Truth", following the Uluru Statement from the Heart. This paper explores self‐determination through the path‐breaking work of the Woodward Aboriginal Land Rights Commission and the establishment of well‐resourced land councils as authoritative and legitimate representatives of Aboriginal people in the Northern Territory. The Whitlam government's willingness to experiment with power‐sharing in the sensitive area of land ownership provided a valuable prototype for genuine engagement with First Nations people today, as Australia contemplates the failure of the constitutional referendum around a Voice to parliament. [ABSTRACT FROM AUTHOR]

This document provides a comprehensive summary of events that took place in the Northern Territory of Australia from July to December 2023. It covers a range of topics including political developments, environmental issues, healthcare, alcohol restrictions, and personnel changes. Some notable events include the resignation of Chief Minister Natasha Fyles, the election of Shane Stone as President of the Country Liberal Party, and the closure of mining operations that could impact revenue and income. The document also highlights protests against fracking, legal disputes, and the passing of prominent individuals. [Extracted from the article]

Objectives: To evaluate the suitability of the Global Lung Function Initiative (GLI)‐2012 other/mixed and GLI‐2022 global reference equations for evaluating the respiratory capacity of First Nations Australians. Design, setting: Cross‐sectional study; analysis of spirometry data collected by three prospective studies in Queensland, the Northern Territory, and Western Australia between March 2015 and December 2022. Participants: Opportunistically recruited First Nations participants in the Indigenous Respiratory Reference Values study (Queensland, Northern Territory; age, 3–25 years; 18 March 2015 – 24 November 2017), the Healthy Indigenous Lung Function Testing in Adults study (Queensland, Northern Territory; 18 years or older; 14 August 2019 – 15 December 2022) and the Many Healthy Lungs study (Western Australia; five years or older; 10 October 2018 – 7 November 2021). Main outcome measures: Goodness of fit to spirometry data for each GLI reference equation, based on mean Z‐score and its standard deviation, and proportions of participants with respiratory parameter values within 1.64 Z‐scores of the mean value. Results: Acceptable and repeatable forced expiratory volume in the first second (FEV1) values were available for 2700 First Nations participants in the three trials; 1467 were classified as healthy and included in our analysis (1062 children, 405 adults). Their median age was 12 years (interquartile range, 9–19 years; range, 3–91 years), 768 (52%) were female, and 1013 were tested in rural or remote areas (69%). Acceptable and repeatable forced vital capacity (FVC) values were available for 1294 of the healthy participants (88%). The GLI‐2012 other/mixed and GLI‐2022 global equations provided good fits to the spirometry data; the race‐neutral GLI‐2022 global equation better accounted for the influence of ageing on FEV1 and FVC, and of height on FVC. Using the GLI‐2012 other/mixed reference equation and after adjusting for age, sex, and height, mean FEV1 (estimated difference, –0.34; 95% confidence interval [CI], –0.46 to –0.22) and FVC Z‐scores (estimated difference, –0.45; 95% CI, –0.59 to –0.32) were lower for rural or remote than for urban participants, but their mean FEV1/FVC Z‐score was higher (estimated difference, 0.14; 95% CI, 0.03–0.25). Conclusion: The normal spirometry values of healthy First Nations Australians may be substantially higher than previously reported. Until more spirometry data are available for people in urban areas, the race‐neutral GLI‐2022 global or the GLI‐2012 other/mixed reference equations can be used when assessing the respiratory function of First Nations Australians. [ABSTRACT FROM AUTHOR]