scholarly journals Understanding the Roles of Remoteness and Indigenous Status in Rural and Remote Road Trauma in North Queensland: Using a Mixed-Methods Approach

2020 ◽  
Vol 17 (5) ◽  
pp. 1467 ◽  
Author(s):  
Colin Edmonston ◽  
Victor Siskind ◽  
Mary Sheehan
Keyword(s):  
Indigenous Communities ◽  
Local Health ◽  
Policy Recommendations ◽  
Rural And Remote ◽  
Indigenous Status ◽  
Traffic Crash ◽  
Vehicle Controllers ◽  
Significant Health ◽  
Alcohol Dependent ◽  
Transport Disadvantage

Road trauma is a significant health problem in rural and remote regions of Australia, particularly for Indigenous communities. This study aims to identify and compare the circumstances leading to (proximal causation) and social determinants of (distal causation) crashes of Indigenous and non-Indigenous people in these regions and their relation to remoteness. This is a topic seriously under-researched in Australia. Modelled on an earlier study, 229 persons injured in crashes were recruited from local health facilities in rural and remote North Queensland and interviewed, mainly by telephone, according to a fixed protocol which included a detailed narrative of the circumstances of the crash. A qualitative analysis of these narratives identified several core themes, further explored statistically in this sample, supplemented by participants in the earlier study with compatible questionnaire data, designed to determine which factors were more closely associated with Indigenous status and which with remoteness. Indigenous participants were less often vehicle controllers, more likely to have recently been a drink driver or passenger thereof; to be unemployed, unlicensed, distracted or fatigued before the crash, alcohol dependent and have lower perceived social, but not personal, locus of control in a traffic crash than non-Indigenous persons. Differences between Indigenous and non-Indigenous participants are largely ascribable to hardship and transport disadvantage due to lack of access to licensing and associated limitations on employment opportunities. Based on these findings, a number of policy recommendations relating to educational, enforcement and engineering issues have been made.

scholarly journals Developing the Canadian Indigenous Cognitive Assessment for Use With Indigenous Older Anishinaabe Adults in Ontario, Canada

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Kristen Jacklin ◽  
Karen Pitawanakwat ◽  
Melissa Blind ◽  
Megan E O’Connell ◽  
Jennifer Walker ◽  
...  
Keyword(s):  
Cognitive Assessment ◽  
Indigenous Communities ◽  
Cultural Safety ◽  
Indigenous Populations ◽  
Face Validity ◽  
Advisory Council ◽  
Cognitive Test ◽  
Public Health Issue ◽  
Research Approach ◽  
Local Health

Abstract Background and Objectives Dementia is a growing public health issue for aging Indigenous populations. Current cognitive assessments present varying degrees of cultural, educational, and language bias, impairing their application in Indigenous communities. Our goal is to provide Anishinaabe communities in Canada with a brief cognitive test that can be administered within the community setting by community health workers or professionals. The purpose of this study was to adapt the Kimberly Indigenous Cognitive Assessment (KICA) for use as a brief cognitive test with Anishinaabe populations in Canada. Research Design and Methods We used a community-based participatory research approach coupled with two-eyed seeing to provide an equitable space for Indigenous knowledge. Adaptation of the KICA was accomplished over 22 months using an iterative cycle of monthly consultations between an 11-member expert Anishinaabe language group (EALG) and the investigators, with ad hoc consultations with an Indigenous Elder, a community advisory council, and the KICA authors. Face validity was established with two pilot studies using cognitive interviewing with Indigenous older adults (n = 15) and a focus group consultation with local health professionals (n = 7). Results Each question of the KICA was scrutinized by the EALG for cultural appropriateness, language and translation, and cultural safety. Every domain required adaptation to reflect cultural values, specificity of language, tone, and a culturally safe approach. Orientation, verbal comprehension and fluency, praxis, and naming domains required the most adaptations. The first pilot for face validity resulted in additional changes; the second confirmed satisfactory adaptation of all changes. Discussion and Implications The research resulted in the new Canadian Indigenous Cognitive Assessment. The findings reveal important cultural and linguistic considerations for cross-cultural cognitive assessment in Indigenous contexts. This new culturally appropriate and safe brief cognitive test may improve case finding accuracy and lead to earlier diagnosis and improved dementia care for Indigenous peoples.

scholarly journals The Exploitation of Indigenous Communities by Commercial Actors: Traditional Knowledge and Traditional Cultural Expression

2021 ◽  
Vol 8 (4) ◽  
pp. 91
Author(s):  
Desak Putu Dewi Kasih ◽  
Ni Ketut Supasti Dharmawan ◽  
Ida Bagus Wyasa Putra ◽  
Kadek Agus Sudiarawan ◽  
Ayu Suci Rakhima
Keyword(s):  
Traditional Knowledge ◽  
Secondary Data ◽  
Indigenous Communities ◽  
Economic Benefits ◽  
Legal Rights ◽  
Future Research ◽  
Policy Recommendations ◽  
Cultural Expression ◽  
Legal Reforms ◽  
Future Research Directions

The protection of traditional knowledge (TK) and traditional cultural expression (TCE) of underprivileged indigenous communities is threatened due to frequent exploitation attempts by commercial actors for economic benefits. The literature highlighting the legal gaps and necessities to support such legal reforms to protect those communities are scarce in the literature, which has been studied in the current research. The current study aims to provide insightful recommendations for policymakers to help protect the legal rights of underprivileged communities scattered in various parts of the world. Indonesian study setting provided a perfect case to achieve the study objectives. Using a qualitative doctrinal legal research design, the secondary data were collected, and content was analyzed using phenomenological and linguistic analysis. The results revealed that the protection of TK and TCE in Indonesia and several underprivileged communities in various countries need serious legal amendments in local legislation considering international laws.  Contextually, the Indonesian Copyright Law is inadequate to accommodate the full protection for TCE. Meanwhile, Indonesian laws that regulate traditional knowledge are overlapping and immature to protect national cultural heritage comprehensively. A new regulation is recommended to ensure that all international legal instruments related to traditional knowledge should help the community of traditional knowledge copyrights in Indonesia with affirmative action towards indigenous communities. Policy recommendations and future research directions are suggested to protect Traditional Cultural Expression and Traditional Knowledge of underprivileged communities in general and Indonesia in focus.

scholarly journals H1N1 in Retrospect: A Review of Risk Factors and Policy Recommendations

2013 ◽  
Vol 4 (2) ◽  
Author(s):  
Mark Mousseau
Keyword(s):  
Infectious Disease ◽  
Indigenous Health ◽  
Poor Performance ◽  
Indigenous Communities ◽  
H1n1 Pandemic ◽  
Policy Recommendations ◽  
Health Issues ◽  
Local Conditions ◽  
Pandemic Planning ◽  
Pharmaceutical Interventions

The H1N1 pandemic of 2009 devastated Indigenous communities worldwide. In order to explain infection patterns and prevent repeating history in future pandemics, associations with infection were investigated. This revealed that the vulnerability of Indigenous communities to infection was associated with poor performance on measurements of social determinants of health. Several policy recommendations pertaining to non-pharmaceutical interventions, prioritization of scarce health care resources, and pandemic planning are made to improve this situation. The best approach would be to empower Indigenous communities to take control over and improve local conditions. Success of such strategies in the battle against other Indigenous health issues suggests that these interventions would be invaluable against emerging infectious disease.

scholarly journals "If it wasn't for OTDs, there would be no AMS": overseas-trained doctors working in rural and remote Aboriginal health settings

2008 ◽  
Vol 32 (4) ◽  
pp. 655 ◽  
Author(s):  
Marisa T Gilles ◽  
John Wakerman ◽  
Angela Durey
Keyword(s):  
Health Service ◽  
Aboriginal Health ◽  
Local Health ◽  
Cultural Issues ◽  
Rural And Remote ◽  
Factors Affecting ◽  
Local Health Service ◽  
Rural And Remote Areas ◽  
Building Community ◽  
Training And Support

Australian-trained doctors are often reluctant to work in rural and remote areas and overseastrained doctors (OTDs) are recruited to practise in many rural Aboriginal medical services. This paper focuses on recent research carried out in Australia to analyse factors affecting OTDs? professional, cultural and social integration and examine their training and support needs. Ten case studies were conducted throughout Australia with OTDs, which also included interviews with spouses/partners, professional colleagues, co-workers, and Aboriginal and Torres Strait Islander community members associated with the health service. Key themes emerging from the data across all informants included the need to better address recruitment, orientation and cross-cultural issues; the importance of effective communication and building community and institutional relationships, both with the local health service and the broader medical establishment.

scholarly journals Smart Indigenous Youth: The Smart Platform Policy Solution for Systems Integration to Address Indigenous Youth Mental Health

10.2196/21155 ◽  
2020 ◽  
Vol 3 (2) ◽  
pp. e21155
Author(s):  
Tarun Reddy Katapally
Keyword(s):  
Mental Health ◽  
Digital Health ◽  
Community Based Participatory Research ◽  
Indigenous Communities ◽  
Youth Mental Health ◽  
Public Health Issue ◽  
Culturally Appropriate ◽  
Rural And Remote ◽  
Indigenous Youth ◽  
School Curricula

Indigenous youth mental health is an urgent public health issue, which cannot be addressed with a one-size-fits-all approach. The success of health policies in Indigenous communities is dependent on bottom-up, culturally appropriate, and strengths-based prevention strategies. In order to maximize the effectiveness of these strategies, they need to be embedded in replicable and contextually relevant mechanisms such as school curricula across multiple communities. Moreover, to engage youth in the twenty-first century, especially in rural and remote areas, it is imperative to leverage ubiquitous mobile tools that empower Indigenous youth and facilitate novel Two-Eyed Seeing solutions. Smart Indigenous Youth is a 5-year community trial, which aims to improve Indigenous youth mental health by embedding a culturally appropriate digital health initiative into school curricula in rural and remote Indigenous communities in Canada. This policy analysis explores the benefits of such upstream initiatives. More importantly, this article describes evidence-based strategies to overcome barriers to implementation through the integration of citizen science and community-based participatory research action.

scholarly journals Local perspectives and context in relation to feeding practices of children under 2 years in the mountain villages of northern Thailand

2018 ◽  
Vol 21 (16) ◽  
pp. 2989-2997 ◽  
Author(s):  
Anna Roesler ◽  
Lisa G Smithers ◽  
Pattanee Winichagoon ◽  
Prasit Wangpakapattanawong ◽  
Vivienne Moore
Keyword(s):  
Young Children ◽  
Food Insecurity ◽  
Breast Feeding ◽  
Feeding Practices ◽  
Indigenous Communities ◽  
Local Health ◽  
Child Feeding ◽  
Northern Thailand ◽  
Early Introduction ◽  
Young Child Feeding

AbstractObjectiveTo gain an in-depth understanding of infant and young child feeding practices, accompanying beliefs and their sociocultural context in the Karen and Lua ethnic communities of northern Thailand.DesignA two-day workshop and thirty in-depth interviews were undertaken in June 2014. Dialogue occurred with the assistance of translators and was recorded, transcribed and translated. A detailed thematic analysis was undertaken.SettingNorthern Thai indigenous communities in which one-third of the children under 5 years of age are stunted.SubjectsPeople with various roles in the local health system and twenty-six villagers who cared for infants and young children.ResultsPredominant breast-feeding was said to occur for 1 to 3 months but was not exclusive due to early introduction of water and/or rice. Exclusive breast-feeding for 6 months was impeded by the need for mothers to return to farming work, with the early introduction of solids enabling infants to be cared for by other family members. Low variety in complementary foods was typical during infancy, with few local foods having appropriate texture and special preparation of foods rarely described. A pervasive underlying issue is women’s responsibility to labour and lack of time to care for their young children. Poverty and food insecurity also featured in participants’ accounts.ConclusionsIn combination, women’s limited time to care, poverty and food insecurity are perpetuating poor nutrition of children in early life. Agricultural solutions that are being explored should also attend to the burden of work for women.

Case Study

2011 ◽  
pp. 191-203
Author(s):  
E. Saurman ◽  
D. Perkins ◽  
D. Lyle ◽  
M. Patfield ◽  
R. Roberts
Keyword(s):  
Mental Health ◽  
Health Service ◽  
New South ◽  
New South Wales ◽  
Health Staff ◽  
Local Health ◽  
Rural And Remote ◽  
South Wales ◽  
Western Area ◽  
Area Health

The MHEC-RAP project involves the innovative application of video conferencing to mental health assessment in rural NSW. The preliminary evaluation findings of the project are presented. Mental health emergencies in rural and remote settings cause particular problems and are not amenable to conventional health service solutions. Patients and local health care staff may be isolated from specialist mental health staff and from acute inpatient services. Decisions to transport patients for specialist assessments or treatment may be required at night or at weekends and may involve families, police, ambulance services and local health staff. Such decisions need to be made promptly but carefully and the ability to obtain a specialist assessment may assist in making a decision about how best to care for the patient bearing in mind the need to provide a responsive, high quality and safe service to patients and local clinicians. In this chapter we examine a novel approach which uses audio-visual technology to conduct remote emergency mental health patient assessment interviews and provide consultations to local clinicians in rural communities in western NSW. The Mental Health Emergency Care – Rural Access Project or ‘MHEC-RAP’ was developed in 2007 following a series of consultations held in rural towns and implemented in 2008 within the Greater Western Area Health Service (GWAHS), New South Wales, Australia. GWAHS is a primary example of a rural and remote health service. It serves 287,481 people (8.3% of whom are Indigenous Australians) in an area that is 445,197sq km or 55% of the state of New South Wales (Australian Bureau of Statistics, 2001; Greater Western Area Health Service, 2007, 2009). The communities within GWAHS are mostly small, the towns are widely dispersed and local services are “limited by distance, expense, transport, and the difficulty of recruiting health professionals to these areas” (Dunbar, 2007 page 587). The chapter focuses on the design of the service, its implementation and its performance in the first year. We conclude with a discussion about the service, its broader relevance, transferability and its sustainability.

Learning Preferences and Impacts of Education Programs in Dog Health Programs in Five Rural and Remote Australian Indigenous Communities

2011 ◽  
Vol 40 ◽  
pp. 48-58 ◽  
Author(s):  
Sophie Constable ◽  
Roselyn Dixon ◽  
Robert Dixon
Keyword(s):  
Word Of Mouth ◽  
Knowledge Exchange ◽  
Indigenous Communities ◽  
Learning Preferences ◽  
Health Programs ◽  
Rural And Remote ◽  
Education Programs ◽  
Black And White ◽  
Condition Score ◽  
Average Condition

As part of strategies to improve dog and community health in rural and remote Indigenous communities, this study investigated preferences and impacts of dog health education programs. Semistructured interviews with 63 residents from five communities explored learning preferences. Though each community differed, on average yarning was preferred by most (68.4%) respondents, followed by visual (65.0%) and practical learning (46.9%). Text-based and computer/screen-based learning were important to 16.2% and 14.6% of respondents respectively. With paper-based visual and text resources, respondents reported a preference for locally made (28/36 or 78%) over mainstream resources. Twenty eight residents involved in the creation of locally made resources reported satisfaction, knowledge exchange, and displayed enthusiasm for the process. Colour resources were more successful than black and white resources or word of mouth in terms of program advertising, alerting 67% (10/15) of respondents compared to 6% to 24% for programs using word of mouth. Dog health programs that incorporated education programs based on these identified preferences achieved significantly better results in terms of improvements in mange prevalence and average condition score, partly through increased community understanding and engagement with the program. Thus, culturally appropriate and locally relevant education programs can significantly improve the success of dog health programs.

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