Conceptions of health held by Aboriginal, Torres Strait Islander and Papua New Guinea health care students

Health is considered to be a fundamental human right. Concurrently health is assumed to be a global social goal (Bloom, 1987) yet many third-world countries and some sub-populations within developed countries do not enjoy a healthy existence. The research reported in this paper examined the conceptions of health, conceptions of illness and health practices for a group of Aboriginal, Torres Strait Islander, and Papua New Guinea university students studying health science courses. Results found three conceptions of health and three conceptions of illness that showed these students held traditional/cultural and Western beliefs about health and health practices. These findings may contribute to the development of health care courses that are more specific to how these students understand health. This may also serve to improve the educational status of Aboriginal and Torres Strait Islander people and potentially improve the health status within these communities (author abstract)

A preliminary adaptation of the Problem Gambling Severity Index for Indigenous Australians: internal reliability and construct validity

Objective: This paper describes the process employed to adapt the Problem Gambling Severity Index (PGSI) for use with Indigenous Australian populations.Methods: This study comprised a two-stage process: an initial consultation with Indigenous health workers, informing the textual and conceptual adaptation of items, followed by trial of the adjusted instrument with Indigenous community members (n=301).Results: Internal reliability was demonstrated: Australian Indigenous Problem Gambling Index (AIPGI) Cronbach's alpha α = 0.92 (Original PGSI, α = 0.84). Item-rest correlations confirmed that responses to items were consistent and related to the total score of remaining items. The AIPGI could predict gambling severity based on gambling frequency, when controlling for age and gender (OR=1.28, 95%CI 1.17–1.40).Conclusions: The adapted instrument is accessible to a cross-section of Indigenous Australians and has demonstrated properties of reliability and validity. An extended trial is needed to test the application of the instrument to a broader Indigenous audience and to further explore and confirm psychometric properties of the adapted instrument.Implications: This study introduces a culturally adapted tool for measuring rates of disordered gambling among Indigenous Australians.

The Centre of Clinical Research Excellence in Aboriginal Health : an operational rationale and some reflections on progress so far

The Centre of Clinical Research Excellence (CCRE) in Aboriginal and Torres Strait Islander Health was established in late 2003 through a major National Health and Medical Research Council (NHMRC) grant involving collaboration between the Aboriginal Health Council of South Australia (AHCSA), Flinders University, and Aboriginal Health Services. Our foundation research communities are the Aboriginal communities served by these Aboriginal Health Services in the Spencer Gulf / Eyre Peninsula region. In recent years a number of collaborative research programs involving chronic illness management, self-management and coordinated care have been implemented in these communities and this work is the basis of the initial CCRE activities. Key objectives of the CCRE are to improve the health status of Indigenous people through conducting relevant and meaningful Aboriginal controlled health research, providing formal training for Indigenous health researchers and developing innovative approaches to health care that can be readily translated and applied to support communities. The inclusion, empowerment and engagement of Indigenous people in the process of managing community health represent tangible strategies for achieving more equitable health outcomes for Aboriginal people. This paper outlines the CCRE operational rationale and presents early activities and outcomes across the three strategic areas of CCRE operations: research, education and training, and translation. Some critical reflections are offered on the progress and experience of the CCRE thus far. A common obstacle this CCRE has encountered is that the limited (especially staff) resources available to the Aboriginal Health Services with which we are collaborating make it difficult for them to engage with and progress the projects we are pursuing.

Comparison of fracture rates between indigenous and non-indigenous populations: a systematic review protocol

INTRODUCTION: Over recent years, there has been concerted effort to 'close the gap' in the disproportionately reduced life expectancy and increased morbidity experienced by indigenous compared to non-indigenous persons. Specific to musculoskeletal health, some data suggest that indigenous peoples have a higher risk of sustaining a fracture compared to non-indigenous peoples. This creates an imperative to identify factors that could explain differences in fracture rates. This protocol presents our aim to conduct a systematic review, first, to determine whether differences in fracture rates exist for indigenous versus non-indigenous persons and, second, to identify any risk factors that might explain these differences.

METHODS AND ANALYSIS: We will conduct a systematic search of PubMed, OVID, MEDLINE, CINAHL and EMBASE to identify articles that compare all-cause fracture rates at any skeletal site between indigenous and non-indigenous persons of any age. Eligibility of studies will be determined by 2 independent reviewers. Studies will be assessed for methodological quality using a previously published process. We will conduct a meta-analysis and use established statistical methods to identify and control for heterogeneity where appropriate. Should heterogeneity prevents numerical syntheses, we will undertake a best-evidence analysis to determine the level of evidence for differences in fracture between indigenous and non-indigenous persons.

ETHICS AND DISSEMINATION: This systematic review will use published data; thus, ethical permissions are not required. In addition to peer-reviewed publication, findings will be presented at (inter)national conferences, disseminated electronically and in print, and will be made available to key country-specific decision-makers with authority for indigenous health.

Keystone media: the Australian and Indigenous affairs

This article conceptualises The Australian as the nation’s ‘keystone media’ on Indigenous affairs.Nielsen’s term ‘keystone media’ captures the critical importance of particular news outlets that play what he terms an outsize role in defining the state and structure of wider media and politicalenvironments. The article analyses the factors at play in The Australian’s sponsorship of a particular political agenda for this complex field of social policy. The argument is illustrated through an examination of Indigenous health coverage from 1988 to 2008, textual analysis of 137 columnswritten by Noel Pearson, and research interviews with key actors in the Indigenous policy realm, including journalists, public servants and Indigenous commentators. Through this examination of its reporting and collaboration with Pearson, we contend The Australian has advanced a range of neoliberal and interventionist policies to government and the public.

Best Practice

The overall theme for the 4th Biennial International Network of Indigenous Health Knowledge and Development (INIHKD)Conference was ‘Knowing Our Roots: Indigenous Medicines, Health Knowledges and Best Practices’. Conference activities were grouped around the following broad themes: •Building of Indigenous research capacity, partnerships and workforce; •Sharing of innovative, traditional and contemporary Indigenous knowledges, especially with respect to culturally-grounded interventions and evidenced-based “best and promising practices”; •Identification of successful Indigenous health policy solutions; and •Sharing of ethical, Indigenous-based research protocols and methodologies. This keynote plenary presentation focused on 'best practice' in research asking the questions: What kind of research will I do? What kind of research will I be? What is the contribution that I will make? what will be my legacy?