Relevant bibliographies by topics / Aboriginal and Torres Strait Islander people

Academic literature on the topic 'Aboriginal and Torres Strait Islander people'

Author: Grafiati
Published: 10 December 2022
Last updated: 20 February 2023

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Journal articles on the topic "Aboriginal and Torres Strait Islander people"

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Costa, Nadia, Mary Sullivan, Rae Walker, and Kerin M. Robinson. "Emergency Department Presentations of Victorian Aboriginal and Torres Strait Islander People." Health Information Management Journal 37, no. 3 (October 2008): 15–25. http://dx.doi.org/10.1177/183335830803700303.

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This paper explains how routinely collected data can be used to examine the emergency department attendances of Victorian Aboriginal and Torres Strait Islander people. The data reported in the Victorian Emergency Minimum Dataset (VEMD) for the 2006/2007 financial year were analysed. The presentations of Aboriginal and Torres Strait Islander and non-Aboriginal people were compared in terms of age, gender, hospital location (metropolitan and rural) and presenting condition. Aboriginal and Torres Strait Islander people were found to attend the emergency department 1.8 times more often than non-Aboriginal people. While the emergency department presentation rates of metropolitan Aboriginal and Torres Strait Islander and non-Aboriginal people were similar, rural Aboriginal and Torres Strait Islander people presented to the emergency department 2.3 times more often than non-Aboriginal people. The injuries or poisonings, respiratory conditions and mental disorders presentation rates of the Aboriginal and Torres Strait Islander and non-Aboriginal population were compared. No previous studies have assessed the accuracy of the Indigenous status and diagnosis fields in the VEMD; therefore the quality of this data is unknown.
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Williams, Hayley M., Kate Hunter, Bronwyn Griffin, Roy Kimble, and Kathleen Clapham. "Fire and Smoke: Using Indigenous Research Methodologies to Explore the Psychosocial Impact of Pediatric Burns on Aboriginal and Torres Strait Islander Families." International Journal of Qualitative Methods 20 (January 1, 2021): 160940692199048. http://dx.doi.org/10.1177/1609406921990486.

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Aboriginal and Torres Strait Islander children and adolescents are disproportionately affected by burn injuries, yet often omitted from burns literature or inadequately portrayed under Western frameworks. We highlight and address the urgent need for knowledge about pediatric burns among Aboriginal and Torres Strait Islander people to be produced from within Indigenous research methodologies and in response to Aboriginal and Torres Strait Islander peoples’ expressed needs. Through the use of decolonial ethnography, we applied a novel combination of participant observations, retrospective thinking aloud, and yarning methods to explore the psychosocial impact of pediatric burn injuries and care on Aboriginal and Torres Strait Islander families. To our knowledge, this is the first example of these three methods being interwoven to explore a multifaceted health issue and in a way that privileges Aboriginal and Torres Strait Islander peoples' knowledge systems, voices, and experiences. We suggest that these approaches have strong relevance and potential for other complex issues affecting Aboriginal and Torres Strait Islander people.
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Garvey, Gail, Kate Anderson, Alana Gall, Tamara L. Butler, Joan Cunningham, Lisa J. Whop, Michelle Dickson, et al. "What Matters 2 Adults (WM2Adults): Understanding the Foundations of Aboriginal and Torres Strait Islander Wellbeing." International Journal of Environmental Research and Public Health 18, no. 12 (June 8, 2021): 6193. http://dx.doi.org/10.3390/ijerph18126193.

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Aboriginal and Torres Strait Islander people experience a greater range of health and social disadvantages compared to other Australians. Wellbeing is a culturally-bound construct, and to date, a national evidence base around the components of wellbeing for Aboriginal and Torres Strait Islander people is lacking. Understanding and measurement of wellbeing for this population is critical in achieving health equity. This paper aims to identify and describe the foundations of wellbeing for Aboriginal and Torres Strait Islander adults. This national qualitative study was underpinned by an Indigenist research approach which privileges the voices of Aboriginal and Torres Strait Islander people. Aboriginal and Torres Strait Islander adults were purposively recruited from around Australia between September 2017 and September 2018 to participate in Yarning Circles, led by Aboriginal and Torres Strait Islander researchers. Yarning Circles were audio recorded, transcribed and analyzed. A Collaborative Yarning Methodology was used, which incorporated reflexive thematic analysis to identify and describe the foundations of wellbeing reported by participants. A total of 359 Aboriginal and Torres Strait Islander adults participated. Our analysis revealed five foundations of wellbeing: belonging and connection; holistic health; purpose and control; dignity and respect; and basic needs. These foundations were deeply interwoven by three interconnected aspects of Aboriginal and Torres Strait Islander life: family, community and culture. The findings of this study will substantially aid our efforts to develop a new wellbeing measure for Aboriginal and Torres Strait Islander adults. The iterative Indigenist methods used in this study provide a robust research methodology for conducting large-scale, nationally-relevant qualitative research with Aboriginal and Torres Strait Islander people. Policies and practices that are informed by our results have the potential to address outcomes that are meaningful for Aboriginal and Torres Strait Islander people.
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Tashkent, Yasmina, John Olynyk, and Alan Wigg. "Liver Disease in Aboriginal and Torres Strait Islander People." Journal of the Australian Indigenous HealthInfoNet 3, no. 4 (2022): 1–27. http://dx.doi.org/10.14221/aihjournal.v3n4.5.

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Aboriginal and Torres Strait Islander people have a substantially higher prevalence of liver disease than non-Indigenous Australians. Cirrhosis and its complications were the sixth leading cause of mortality for Aboriginal and Torres Strait Islander people in 2020. Liver disease has been estimated to be the third leading cause of the mortality gap between Aboriginal and Torres Strait Islander and non-Indigenous people due to chronic disease, accounting for 11% of this gap. While current trends show reducing mortality rates for Aboriginal and Torres Strait Islander people for conditions including circulatory disease, diabetes and kidney disease, there are no data to suggest a similar decline for liver disease. This review highlights the common causes of liver disease affecting Aboriginal and Torres Strait Islander people, which include hepatitis B, hepatitis C, alcohol related liver disease, metabolic dysfunction-associated fatty liver disease, and cirrhosis and its complications including hepatocellular carcinoma. Current treatments including liver transplantation as well as suggestions for improving detection, treatment and access to liver care will also be discussed. Recent revolutions in the detection and treatment of liver disease make efforts to improve access to treatment and outcomes an urgent priority for Aboriginal and Torres Strait Islander people.
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Wilson, Annabelle, Tamara Mackean, Liz Withall, Eileen Willis, Odette Pearson, Colleen Hayes, Kim O'Donnell, et al. "Protocols for an Aboriginal-led, Multi-methods Study of the Role of Aboriginal and Torres Strait Islander Health Workers, Practitioners and Liaison Officers in Quality Acute Health Care." Journal of the Australian Indigenous HealthInfoNet 3, no. 1 (2022): 1–13. http://dx.doi.org/10.14221/aihjournal.v3n1.2.

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Objectives Aboriginal and Torres Strait Islander Health Workers/Practitioners and Liaison Officers play an important, often critical role providing advocacy and cultural and emotional support for Aboriginal and Torres Strait Islander patients. The main goals of this research are to explore i) how Aboriginal and Torres Strait Islander Health Workers/Practitioners and Liaison Officers are integrated in the routine delivery of care for Aboriginal and Torres Strait Islander peoples in hospital, and ii) how the role of Aboriginal and Torres Strait Islander Health Workers/Practitioners and Liaison Officers facilitates quality health outcomes. Methods This study is being conducted in three different hospitals using a multi-method approach including: yarning and Dadirri, patient journey mapping, survey and semi-structured interviews. Ethics approval has been provided from four ethics committees covering the three project sites in Australia (Adelaide, South Australia; Sydney, New South Wales and Alice Springs, Northern Territory). Significance This study uses innovative methodology founded on the privileging of Aboriginal and Torres Strait Islander knowledges to collect Aboriginal and Torres Strait Islander perspectives and understand patient journeys within acute health care systems. This project is led by Aboriginal and Torres Strait Islander researchers and guided by the Project Steering Committee comprised of stakeholders. Implications There is limited research that explores quality acute care processes and the integration of Aboriginal and Torres Strait Islander Health Workers/Practitioners work within health care teams. This research will make a valuable contribution to understanding how hospital services can achieve quality acute health care experiences for Aboriginal and Torres Strait Islander People.
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Adams, Mick, Kootsy (Justin) Canuto, Neil Drew, and Jesse John Fleay. "Postcolonial Traumatic Stresses among Aboriginal and Torres Strait Islander Australians." ab-Original 3, no. 2 (September 1, 2020): 233–63. http://dx.doi.org/10.5325/aboriginal.3.2.233.

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Abstract The mental health of Aboriginal and Torres Strait Islander males in Australia is often misunderstood, mainly because it has been poorly researched. When analyzing the quality of life of Aboriginal and Torres Strait Islander males, it is crucial to consider the associated factors that have directly and indirectly contributed to their poor health and wellbeing, that is, the effects of colonization, the interruption of cultural practices, displacement of societies, taking away of traditional homelands and forceful removal of children (assimilation and other policies). The displacement of families and tribal groups from their country broke up family groups and caused conflict between the original inhabitants of the lands and dislocated Aboriginal and Torres Strait Islander tribal groups. These dislocated Aboriginal and Torres Strait Islander people were forced to reside on the allocated government institutions where they would be (allegedly) protected. Whilst in the institutions they were made to comply with the authority rules and were forbidden to practice or participate in their traditional rituals or customs or speak their own tribal languages. Additionally, the dispossession from Aboriginal and Torres Strait Islander traditional lands and the destruction of culture and political, economic, and social structures have caused many Aboriginal and Torres Strait Islander people to have a pervading sense of hopelessness for the future. The traditional customs and life cycles of Aboriginal and Torres Strait Islander males were permanently affected by colonization adversely contributing to mental health problems in Aboriginal and Torres Strait Islander communities. In this article we aim to provide a better understanding of the processes impacting on Aboriginal and Torres Strait Islander males' social and emotional wellbeing.
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Ride, Katherine, and Samantha Burrow. "Review of diabetes among Aboriginal and Torres Strait Islander people." Journal of the Australian Indigenous HealthInfoNet 3, no. 2 (2022): 1–43. http://dx.doi.org/10.14221/aihjournal.v3n2.1.

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Diabetes is the fastest growing chronic disease condition globally. Type 2 diabetes in particular, has reached epidemic proportions, with the greatest burden falling on socially disadvantaged groups and Indigenous peoples. This review focuses primarily on type 2 diabetes among Aboriginal and Torres Strait Islander people, which is responsible for the majority of cases of diabetes in this population. It provides general information on the social and cultural context of diabetes, and the behavioural and biomedical factors that contribute to diabetes among Aboriginal and Torres Strait Islander people. This review provides detailed information on: the extent of diabetes among Aboriginal and Torres Strait Islander people, including incidence and prevalence data; hospitalisations; mortality and burden of disease the prevention and management of diabetes relevant programs, services, policies and strategies that address the health issue of diabetes among Aboriginal and Torres Strait Islander people two special population groups: adolescents pregnant and post-partum women. This review concludes by suggesting possible future directions for combatting the growing epidemic of diabetes among Aboriginal and Torres Strait Islander people. This review is part of a suite of knowledge exchange products that includes a summary, a video, and a fact sheet.
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McGuffog, Romany, Catherine Chamberlain, Jaqui Hughes, Kelvin Kong, Mark Wenitong, Jamie Bryant, Alex Brown, et al. "Murru Minya–informing the development of practical recommendations to support ethical conduct in Aboriginal and Torres Strait Islander health research: a protocol for a national mixed-methods study." BMJ Open 13, no. 2 (February 2023): e067054. http://dx.doi.org/10.1136/bmjopen-2022-067054.

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IntroductionConducting ethical and high-quality health research is crucial for informing public health policy and service delivery to reduce the high and inequitable burden of disease experienced by Aboriginal and Torres Strait Islander people. Ethical guidelines and principles specifically for health research with Aboriginal and Torres Strait Islander people have been developed for use since 1987. However, there has been limited examination of how these are being applied to the conduct of research.Methods and analysisMurru Minyawill be a large-scale national study to examine the implementation of ethical processes in Aboriginal and Torres Strait Islander health research. A mixed-methods design will be used in fourbaarra(steps). The first threebaarrawill collect knowledge, experiences and wisdom from three key groups: Aboriginal and Torres Strait Islander communities, research academics, and Human Research Ethics Committees using online surveys, yarning, and semistructured interviews. This knowledge will inform the finalbaarraof developing a set of practical recommendations to support ethical conduct in Aboriginal and Torres Strait Islander health research into the future.Ethics and disseminationEthical approval for this research project has been granted by National, State and Territory Human Research Ethics Committees. This research has been developed in collaboration with Aboriginal and Torres Strait Islander researchers, Aboriginal Community Controlled Health Organisation representatives, Aboriginal community members, the National Health Leadership Forum, and Aboriginal and Torres Strait Islander research team. The knowledge translation plan will be integrated and revised throughout the project as partnerships and engagement with Aboriginal and Torres Strait Islander communities continue. All findings will be shared with peak Aboriginal research bodies and Aboriginal and Torres Strait Islander communities in ways that are meaningful to them.
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Miller, Jenna, and Emily Berger. "A review of school trauma-informed practice for Aboriginal and Torres Strait Islander children and youth." Educational and Developmental Psychologist 37, no. 1 (May 11, 2020): 39–46. http://dx.doi.org/10.1017/edp.2020.2.

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AbstractAboriginal and Torres Strait Islander people in Australia are especially vulnerable to traumatic and discriminatory experiences. However, limited literature and research has implemented and evaluated school-based interventions designed to assist Aboriginal and Torres Strait Islander children and young people to overcome their adversity and achieve their potential at school. This article reviews the literature and frameworks on school programs designed for Aboriginal and Torres Strait Islander students who have experienced trauma. The key aspects of trauma-informed programs in schools for Aboriginal and Torres Strait Islander students is explored and recommendations made for further research and greater acknowledgement of cultural and historical issues for Aboriginal and Torres Strait Islander students when implementing culturally informed and trauma-informed practices in schools.
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McKay, Fiona H., and Stephanie L. Godrich. "Interventions to address food insecurity among Aboriginal and Torres Strait Islander people: a rapid review." Applied Physiology, Nutrition, and Metabolism 46, no. 12 (December 2021): 1448–58. http://dx.doi.org/10.1139/apnm-2020-1075.

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Food insecurity disproportionately impacts Aboriginal and Torres Strait Islander Australians. This review sought to investigate research and evaluations of programs and interventions implemented to address food insecurity among Aboriginal and Torres Strait Islander communities. A rapid review was conducted to collate the available research from 6 databases. The search was conducted in May 2020. Search constructs related to food insecurity, Aboriginal and Torres Strait Islander people, and Australia. Twenty-five publications were included in this review, 24 reported on an intervention, while 9 were evaluations of an intervention. Interventions included behaviour change projects, including projects that sought to change purchasing and cooking behaviours, school-based education programs, and gardening programs. In general, the studies included in this sample were small and lacked a systematic consideration of the factors that shape the experience of food insecurity among Aboriginal and Torres Strait Islander people specifically. Based on the findings of this review, authors suggest greater consideration to the systematic determinants of food insecurity among Aboriginal and Torres Strait Islander communities to have lasting and sustainable impact on food insecurity. This review has been registered with the international prospective register of systematic reviews (PROSPERO: CRD42020183709). Novelty: Food insecurity among Aboriginal and Torres Strait Islander people poses significant risk to health and wellbeing. Small-scale food security interventions may not provide ongoing and sustained impact. Any intervention to promote food security will need to involve Aboriginal and Torres Strait Islander people and be sustained once external parties have left.
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Dissertations / Theses on the topic "Aboriginal and Torres Strait Islander people"

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Macniven, Rona Margaret. "Physical activity and Aboriginal and Torres Strait Islander People in Australia." Thesis, The University of Sydney, 2017. http://hdl.handle.net/2123/17811.

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Background Globally, non-communicable diseases (NCDs) such as cardiovascular disease and diabetes represent an issue of epidemic proportion, responsible for tens of millions of premature deaths annually. NCDs are also responsible for reducing quality of life and causing detrimental social and economic effects. Disparities across population groups are evident. In Australia, NCDs were a leading cause of the total burden of disease in 2011. Aboriginal and Torres Strait Islanders have a shorter life expectancy and poorer health risk factors and outcomes than non-Indigenous Australians. Much of this gap in life expectancy has been attributed to preventable NCDs. Physical activity is a key modifiable cause of the excess burden of disease and mortality. Among Aboriginal and Torres Strait Islanders, there is a lack of evidence around the associations between physical activity and health and demographic factors and the impact of strategies to increase physical activity, compared to mainstream evidence. Aims This thesis aims to contribute towards building an evidence base around the association of physical activity on the health of Aboriginal and Torres Strait Islanders. The first aim is to examine cross-sectional associations between physical activity and a range of lifestyle, environmental and social factors among adults. Subsequently, the thesis identifies and describes physical activity patterns and influencing factors among adolescents. The third aim is to describe characteristics of physical activity programs targeting Aboriginal and Torres Strait Islanders. Lastly, the thesis aims to measure the effects of a community-based physical activity program. Methods The series of studies used a range of methods. The first study examined whether achievement of national physical activity recommendations was associated with healthy lifestyle behaviours, neighbourhood environmental characteristics and social support among Aboriginal and non- Aboriginal adults in New South Wales (NSW) (Chapter 2). The second study examined cross-sectional demographic, social, psychosocial and health correlates of physical activity among Aboriginal and non- Aboriginal adolescents in NSW (Chapter 3). The third study examined age related declines in physical activity among Aboriginal and non-Aboriginal young people and their variation by season, setting and type among Aboriginal and non-Aboriginal children from between 2007/8 and 2011/12 (Chapter 4). The fourth study reviewed the scientific and grey literature for physical activity programs targeting Aboriginal and Torres Strait Islanders operating between 2012 and 2015, described their characteristics and engaged with program coordinators to verify sourced information (Chapter 5). The final study examined the health and community impacts of the Indigenous Marathon Program (IMP) in a remote Torres Strait island community, using questionnaire and semi-structured interview mixed methods (Chapter 6). Results In Chapter 2, a similar proportion of Aboriginal and non-Aboriginal adults achieved national physical activity recommendations and factors relating to achieving recommendations were similar in both groups. However, neighbourhood features and social support were less favourable among Aboriginal adults. Among Aboriginal and non-Aboriginal adolescents, physical activity levels were similarly low but some correlates differed by Aboriginality (Chapter 3). Aboriginal girls were less active than boys, as were those whose mothers were unemployed. In Chapter 4, serial physical activity declines were found in a population of Aboriginal and non-Aboriginal young people over five years, but not across all seasons, settings and types. Chapter 5, identifies 110 programs that aimed to increase physical activity for health or broader social outcomes. Around half were found to collect process or impact evaluation data but this is underrepresented in the scientific literature. In Chapter 6, impacts of Indigenous Marathon Program were the adoption of running and broader healthy lifestyle factors in a remote community with a high initial level of community readiness. Barriers to running were both personal, cultural and environmental. Conclusion The findings from this thesis make a novel contribution to building an evidence base of associations between physical activity and the health of Aboriginal and Torres Strait Islanders. A number of factors associated with physical activity in adults and children are unique to Aboriginal and Torres Strait Islanders populations; other factors are similar to those experienced by mainstream populations. It is vitally important that physical activity programs that aim to improve health or social outcomes can determine their value through evaluation.
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Lukaszyk, Caroline. "Falls in older Aboriginal people: risk factors, burden, and development of a culturally appropriate fall prevention intervention." Thesis, The University of Sydney, 2017. http://hdl.handle.net/2123/18045.

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Abstracts – oral conference presentations Lukaszyk, C., Harvey, L., Sherrington, C., Close, J., Coombes, J., Mitchell, R., Moore, R., Ivers, R. Fallrelated injury hospitalisations for Aboriginal and Torres Strait Islander people aged 50+ in New South Wales, Australia, 15th World Congress on Public Health, April 2017, Melbourne, Australia Lukaszyk, C., Harvey, L., Sherrington, C., Close, J., Coombes, J., Ivers, R. Investigating hospitalisations due to fall-related injury for older Aboriginal and Torres Strait Islander people in New South Wales, Australia, 7th Biennial Australia and New Zealand Falls Prevention Conference, November 2016, Melbourne, Australia Lukaszyk, C., Coombes, J., Sherrington, C., Keay, L., Tiedemann, A., Cumming, R., Broe, T., Ivers, R. Preventing falls amongst older Aboriginal people: development and pilot evaluation of the Ironbark Program, 15th National Conference of Emerging Researchers in Ageing, October 2016, Canberra, Australia Lukaszyk, C., Approaches to preventing falls amongst older Aboriginal people, Travelling Rural Fall Prevention Network Forum, September 2016, Broken Hill, Dubbo, Australia, invited speaker Lukaszyk, C., Coombes, J., Sherrington, C., Keay, L., Tiedemann, A., Cumming, R., Broe, T., Ivers, R. Developing and trialling a culturally appropriate fall prevention program for older Aboriginal people, Australian Health Promotion Association, June 2016, Perth, Australia Lukaszyk, C., Coombes, J., Sherrington, C., Keay, L., Tiedemann, A., Cumming, R., Broe, T., Ivers, R. Approaches to developing a falls prevention program for older Aboriginal people, Australian Injury Prevention Network, November 2015, Sydney, Australia Lukaszyk, C., Coombes, J., Falls Prevention in Older Aboriginal People: Approaches to Program Development, Championing Falls in April Forum, April 2015, Sydney, Australia, invited speaker Lukaszyk, C., Coombes, J., Sherrington, C., Keay, L., Tiedemann, A., Cumming, R., Broe, T., Ivers, R. Falls prevention in older Aboriginal people: service audit and yarning circle discussions, Australian Injury Prevention Network, November 2014, Sydney, Australia Lukaszyk, C., Coombes, J., Sherrington, C., Keay, L., Tiedemann, A., Cumming, R., Broe, T., Mack, H., Ivers, R. The Ironbark Project: Fall Prevention in Older Aboriginal People in NSW, Australian and New Zealand Falls Prevention Conference, November 2014, Sydney, Australia Lukaszyk, C., Coombes, J., Sherrington, C., Keay, L., Tiedemann, A., Cumming, R., Broe, T., Ivers, R. Ironbark Project Service Audit on Fall Prevention in Aboriginal People, Emerging Health Policy Research Conference, October 2014, Sydney, Australia Abstracts – poster conference presentations Lukaszyk, C., Coombes, J., Keay, L., Sherrington, C., Tiedemann, A., Turner, NJ., Cumming, R., Broe, T., Hillmann, E., Ivers, R. Working together to develop and trial a culturally appropriate fall prevention program for older Aboriginal people. Lowitja Institute International Indigenous Health and Wellbeing Conference, November 2016, Melbourne, Australia Lukaszyk, C., Harvey, L., Close, J., Ivers, R. Investigating fall-related injury hospitalisations for older Indigenous people in Australia, 12th World Conference on Injury Prevention and Safety Promotion, September 2016, Tampere, Finland Lukaszyk, C., Coombes, J., Sherrington, C., Keay, L., Tiedemann, A., Cumming, R., Broe, T., Ivers, R. Developing and trialling a culturally appropriate fall prevention program for older Aboriginal people, RICH forum, March 2015, Multiple locations, Australia Workshops “Fall prevention for older Aboriginal people: lessons from the Ironbark Aboriginal Fall Prevention Project”, pre-conference workshop for the 7th Biennial Australia and New Zealand Falls Prevention Conference, Melbourne, November 2016 Awards Cross Cultural Public Health Research Award. May 2017. University of Sydney and University of Western Sydney. Postgraduate Research Support Scheme Travel Grant. October 2017. University of Sydney, School of Public Health. Postgraduate Research Support Scheme Travel Grant. October 2016. University of Sydney, School of Public Health.
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Bray, Carly. "Aboriginal and Torres Strait Islander people(s) in Australian print news: A corpus-based critical discourse analysis." Thesis, Department of Linguistics, 2021. https://hdl.handle.net/2123/25889.

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This thesis investigates the representation of Aboriginal and Torres Strait Islander people(s) in mainstream Australian newspapers. It combines approaches from corpus linguistics and critical discourse analysis to examine factors such as terms of reference, prominent themes and salient discourses employed in this coverage. The data consists of a purpose-built corpus of articles containing mention of Aboriginal people(s) or issues published in the 12 major metropolitan dailies within a 3-month period in mid 2019. The analysis confirmed a number of previous findings, as well as identifying two previously unidentified discourses—those of economic success and non-agential cooperation—and the linguistic resources used to construct them. One particularly valuable contribution is the finding that the agency of Aboriginal participants in cooperative events is often undermined using prepositions, a part of speech regularly overlooked in both corpus linguistic and critical discourse analytic studies.
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Simone, Nicole R. "Teachers perspectives of embedding Aboriginal and Torres Strait Islander peoples' histories and cultures in mathematics." Thesis, Queensland University of Technology, 2022. https://eprints.qut.edu.au/227459/1/Nicole_Simone_Thesis.pdf.

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This thesis explored how six teachers of mathematics embedded Aboriginal and Torres Strait Islander Peoples’ Histories and Cultures into the core mathematics curriculum. Semi-structured interviews were conducted, then written transcripts were analysed through the use of Bernstein’s Theory of Pedagogic Discourse. Teachers shared their perspectives on how they have developed their cultural capabilities, and how this has informed culturally responsive teaching of mathematics. Recommendations are made for how to support in-service teachers with their personal cultural capabilities to authentically embed Aboriginal and Torres Strait Islander Peoples’ Histories and Cultures in mathematics curriculum.
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Farnbach, Sara. "Conducting high-quality, culturally-appropriate primary healthcare research with Aboriginal and Torres Strait Islander peoples." Thesis, The University of Sydney, 2018. http://hdl.handle.net/2123/18850.

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Health research should inform culturally-appropriate, evidence-based primary healthcare (PHC), potentially enhancing social and emotional wellbeing (SEWB) among Aboriginal and Torres Strait Islander (hereafter referred to as Indigenous) Peoples. When conducting such research, scientific and ethical quality should be forefront. Aim To identify approaches and enablers to conducting high-quality, culturally-appropriate Indigenous-focused SEWB PHC research. Methods This thesis comprises three sections: firstly, two systematic reviews of the Indigenous-focused SEWB PHC research literature; secondly, an in-depth critical and reflective case study of an Indigenous-focused SEWB PHC research project entitled Getting it Right: the validation study (hereafter referred to as Getting it Right); finally, a process evaluation of Getting it Right using a grounded theory approach. Results Twenty-five research projects were included in the systematic reviews. Two were judged as high quality using scientific and ethical criteria. Research projects that were judged as ethical used culturally-sensitive approaches, focused on developing relationships and involved community members. These approaches also appeared to enable this research. Getting it Right had an adaptive protocol (where localised approaches were developed within certain requirements) and PHC services were reimbursed on a per participant basis. The research was evaluated as meeting scientific and ethical quality criteria. The process evaluation showed that the research was acceptable to most participating staff (n=36), community members (n=4) and participants (n=500). Many were willing to participate in research and speak about SEWB. Staff reported that the reimbursement provided to the service sufficiently resourced the research. Conclusion High-quality, culturally-appropriate Indigenous-focused SEWB PHC research can be facilitated by culturally-sensitive, flexible, collaborative and sufficiently-funded approaches.
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Weatherall, Teagan Joan. "IMPROVING OUR UNDERSTANDING OF ALCOHOL DEPENDENCE AMONG INDIGENOUS PEOPLES: AN INTERNATIONAL SYSTEMATIC REVIEW AND QUANTITATIVE STUDY OF TWO AUSTRALIAN ABORIGINAL COMMUNITIES." Thesis, The University of Sydney, 2022. https://hdl.handle.net/2123/29707.

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Alcohol use is common globally and the health risks from drinking are recognised. However, Indigenous Peoples who have been impacted by colonisation, trauma and racism, could be at greater risk of developing alcohol-related harms. One of these harms could be alcohol dependence, the strong internal drive to use alcohol with an inability to control use, prioritising alcohol and also physiological characteristics. The way alcohol dependence is interpreted or identified can be different across cultures and for Indigenous Peoples. The overall aim of this thesis was to identify the prevalence of alcohol dependence among Indigenous Peoples globally, and the associations of dependence in an Indigenous Australian community sample. Chapter 2 is a systematic review of the prevalence of alcohol dependence among Indigenous Peoples globally and examines how dependence is identified. Chapter 3 estimates the prevalence and describes the correlates of alcohol dependence in a representative community sample of Indigenous Australians. Chapter 4 identifies the associations between alcohol dependence with harms and getting help for drinking in a representative community sample of Indigenous Australians. This research reports that the prevalence of current alcohol dependence among Indigenous Peoples globally from similarly colonised countries varies widely and shows few tools have been validated for Indigenous Peoples. The prevalence in the representative community sample of Indigenous Australians is similar to the general Australian population. Dependent drinkers were more likely to report harms and more likely to get help for their drinking. Researchers, health professionals and clinicians do well to use Indigenous-specific survey tools or operationalise existing tools when trying to identify alcohol dependence among Indigenous Peoples. Accurate prevalence data can better inform treatment needs and unmet needs. Indigenous Australians need support and treatment options that are readily available, accessible and culturally appropriate. Identifying these needs could help with funding and resource allocation.
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Shay, Marnee. "Practices of alternative schools in Queensland in supporting Aboriginal and Torres Strait Islander young people to remain engaged in education." Thesis, University of the Sunshine Coast, 2013. https://eprints.qut.edu.au/71023/1/71023_SHAY_Thesis_final.pdf.

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Alternative schools are an emerging model of education offered to young people who have been disenfranchised from conventional schooling opportunities. The body of literature on alternative schools in Australia has not identified how many Indigenous young people are engaged with alternative schools and how alternative schools are supporting Indigenous young people to remain engaged in education. It is well documented that Aboriginal and Torres Strait Islander people experience significant disadvantage including poorer educational outcomes than their non-Indigenous peers. This study seeks to contribute to improving educational outcomes for Aboriginal and Torres Strait Islander young people through exploring Aboriginal and Torres Strait Islander interactions with alternative schools in Queensland and investigating the practices of alternative school leaders in terms of how they are supporting Indigenous young people to remain engaged in education. Critical race theory informed the development of this study. An Aboriginal researcher sought to shift the focus of this study away from Indigenous young people to Principals; to explore their perspective of their own knowledge and practices in supporting Aboriginal and Torres Strait Islander young people at their school. Using survey methodology, a web-based questionnaire was developed to survey Principals’ providing data on alternative schools in Queensland including the demographics of the alternative school; self-reported knowledge of Indigenous cultures and communities and practices that support Aboriginal and Torres Strait Islander young people at their alternative school. There are nine key findings that emerged through the analysis of this study: key finding one is the high percentage of Aboriginal and Torres Strait Islander young people enrolled in schools surveyed; key finding two is there is a high percentage of Aboriginal and Torres Strait Islander staff employed in the schools; key finding three is the majority of the schools are located in low socio-economic areas; key finding four is the strong willingness of Principals’ in this study to engage in self-directed learning in relation to Aboriginal and Torres Strait Islander cultures; key finding five is the limited demonstration of understandings of Aboriginal and Torres Strait Islander cultures and communities; key finding six is the most prevalent practice of Principals’ in this study is the celebration of cultural events and cultural activities; key finding seven is the limited Principal engagement with Aboriginal and Torres Strait Islander young people, their families and the local community; key finding eight is the practice of alternative schools provides limited support and nurturing of Aboriginal and Torres Strait Islander young person’s cultural identity and key finding nine is that Principals’ are relying heavily on informal discussions with staff to know what their staff’s knowledge and skills are in relation to supporting Aboriginal and Torres Strait Islander young people. There are multiple implications that have arisen from this study. The data demonstrated high numbers of Aboriginal and Torre Strait Islander students and staff. The data also revealed that Principal’s demonstration of knowledge in relation to Indigenous cultures and communities was limited, as well as limited Principal engagement with Indigenous young peoples, families and communities. Therefore a major practical implication of this study is the urgent need for quality cultural learning opportunities for leaders of alternative schools to improve practices. Additionally, the implications of this study support an urgent need for further research on the role alternative schools are playing in supporting Indigenous young people to remain engaged in education.
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Hughes, Bridget Y. "Collective impact: Closing the gap in educational outcomes for Aboriginal and Torres Strait Islander peoples in Queensland." Thesis, Queensland University of Technology, 2022. https://eprints.qut.edu.au/230011/1/Bridget_Hughes_Thesis.pdf.

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This thesis examined the educational outcomes for Indigenous children enrolled in Queensland state (public) primary schools from the perspective of the collective and social impact of programs and services. The study used quantifiable data to show that the gap is not closing, regardless of an improvement in attendance, along with literacy and numeracy achievement levels, in certain regions of Queensland.
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Aldrich, Rosemary Public Health &amp Community Medicine Faculty of Medicine UNSW. "Flesh-coloured bandaids: politics, discourse, policy and the health of Aboriginal and Torres Strait Islander Peoples 1972-2001." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2006. http://handle.unsw.edu.au/1959.4/27276.

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This thesis concerns the relationship between ideology, values, beliefs, politics, language, discourses, public policy and health outcomes. By examining the origins of federal health policy concerning Aboriginal and Torres Strait Islander Peoples 1972-2001 I have explored the idea that the way a problem is constructed through language determines solutions enacted to solve that problem, and subsequent outcomes. Despite three decades of federal policy activity Aboriginal and Torres Strait Islander children born at the start of the 21st Century could expect to live almost 20 years less than non-Indigenous Australians. Explanations for the gap include that the colonial legacy of dispossession and disease continues to wreak social havoc and that both health policy and structures for health services have been fundamentally flawed. The research described in this thesis focuses on the role of senior Federal politicians in the health policy process. The research is grounded in theory which suggests that the values and beliefs of decision makers are perpetuated through language. Using critical discourse analysis the following hypotheses were tested: 1. That an examination of the language of Federal politicians responsible for the health of Aboriginal and Torres Strait Islander Peoples over three decades would reveal their beliefs, values and discourses concerning Aboriginal and Torres Strait Islander Peoples and their health 2. That the discourses of the Federal politicians contributed to policy discourses and frames in the Aboriginal and Torres Strait Islander health policy environment, and 3. That there is a relationship between the policy discourses of the Aboriginal and Torres Strait Islander health policy environment and health outcomes for Aboriginal and Torres Strait Islander Peoples. The hypotheses were proven. I concluded that there was a relationship between the publicly-expressed values and beliefs of politicians responsible for health, subsequent health policy and resulting health outcomes. However, a model in which theories of discourse, social constructions of people and problems, policy development and organisational decision-making were integrated did not adequately explain the findings. I developed the concept of "policy imagination" to explain the discrete mechanism by which ideology, politics, policy and health were related. My research suggests that the ideology and values which drove decision-making by Federal politicians responsible for the health of all Australians contributed to the lack of population-wide improvement in health outcomes for Aboriginal and Torres Strait Islander Peoples in the late 20th Century.
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Ravindran, Subahari. "A critical comparison of the similarities and differences in the conceptualisation of disability between Indigenous people in Australia and New South Wales disability service agencies." Thesis, Discipline of Occupational Therapy, 2016. http://hdl.handle.net/2123/14210.

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This thesis critically compares the conceptualisation of disability in the public discourse between Indigenous people and New South Wales (NSW) government and non-government disability service agencies. This study explores intersections of the conceptualisations of disability at the Cultural Interface using the Occupational Justice Framework (Gilroy, 2009; Durocher, Gibson and Rappolt, 2014). This thesis consists of two sections. Section 1: Literature Review Section 2: Journal manuscript The first section of this thesis is the literature review. The literature review examines the low participation rate of indigenous people in disability services and the need for culturally appropriate disability services for Indigenous people. In order to ensure culturally appropriate services are provided for Indigenous people, the Western and Indigenous perspectives of disability need to be understood and each are discussed in turn in the literature review. The review initially discusses the Western conceptualisation of disability, followed by the Indigenous conceptualisation of disability. The review also explores how both Indigenous and Western perspectives on disability influence each other. The developments in disability conceptualisation throughout history are also discussed, followed by the current literature that led to the development of this study. The second section of this thesis is a journal manuscript. The journal manuscript explores the intersections and tensions between Indigenous people and NSW government and non- government disability service agencies regarding the conceptualisation of disability. The journal manuscript also examines the outcomes and implications of the findings.
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Books on the topic "Aboriginal and Torres Strait Islander people"

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Green, Frances. Chronic kidney disease in Aboriginal and Torres Strait Islander people 2011. Canberra: Australian Institute of Health and Welfare, 2011.

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Telling stories: Aboriginal Australian and Torres Strait Islander performance. North Melbourne, Vic: Australian Scholarly, 2012.

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Jamieson, L. M. Oral health of Aboriginal and Torres Strait Islander children. [Canberra]: Australian Institute of Health and Welfare, Dental Statistics and Research Unit, 2007.

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Australian Institute of Health and Welfare. Housing and homelessness services: Access for Aboriginal and Torres Strait Islander people. Canberra: Australian Institute of Health and Welfare, 2011.

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Library and Information Service of Western Australia. Public library Aboriginal and Torres Strait Islander services plan: A plan to develop public library services for Aboriginal and Torres Strait Islander people in Western Australia. [Perth]: Library Board of Western Australia, 1995.

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Statistics, Australian Bureau of. 1996 census of population and housing: Aboriginal and Torres Strait Islander people, Victoria. [Melbourne]: Australian Bureau of Statistics, 1998.

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Welfare, Australian Institute of Health and. Expenditures on health for Aboriginal and Torres Strait Islander peoples, 2001-02. Canberra: Australian Institute of Health and Welfare, 2005.

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Helps, Yvonne L. M. Reported injury mortality of Aboriginal and Torres Strait Islander people in Australia, 1997-2000. Canberra: Australian Institute of Health and Welfare, 2004.

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Australian Institute of Health and Welfare. The health and welfare of Australia's Aboriginal and Torres Strait Islander people: An overview 2011. Canberra: Australian Institute of Health and Welfare, 2011.

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Gray, Barbara. Assessing the quality of identification of Aboriginal and Torres Strait Islander people in hospital data. [Canberra]: Australian Institute of Health and Welfare, 1999.

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Book chapters on the topic "Aboriginal and Torres Strait Islander people"

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Collins, Melinda, Prue Shanahan, Nicole Watt, and Carrie Lethborg. "Social Work with Aboriginal and Torres Strait Islander People in Health." In Social Work Practice in Health, 146–58. 2nd ed. London: Routledge, 2022. http://dx.doi.org/10.4324/9781003330745-15.

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Liddle, Celeste. "First Peoples: Aboriginal and Torres Strait Islander Participation in Higher Education." In Student Equity in Australian Higher Education, 53–67. Singapore: Springer Singapore, 2016. http://dx.doi.org/10.1007/978-981-10-0315-8_4.

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Ambrey, Christopher L., Christopher Fleming, and Matthew Manning. "Subjective wellbeing of the Aboriginal and Torres Strait Island people of Australia." In Routledge Handbook of Indigenous Wellbeing, 342–54. Abingdon, Oxon ; New York, NY : Routledge, 2019. | Series: Routledge international handbooks: Routledge, 2019. http://dx.doi.org/10.4324/9781351051262-26.

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Ferguson, Monika, Amy Baker, and Nicholas Procter. "A Culturally Competent Approach to Suicide Research with Aboriginal and Torres Strait Islander Peoples." In Handbook of Research Methods in Health Social Sciences, 1707–22. Singapore: Springer Singapore, 2019. http://dx.doi.org/10.1007/978-981-10-5251-4_41.

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Ferguson, Monika, Amy Baker, and Nicholas Procter. "A Culturally Competent Approach to Suicide Research with Aboriginal and Torres Strait Islander Peoples." In Handbook of Research Methods in Health Social Sciences, 1–16. Singapore: Springer Singapore, 2017. http://dx.doi.org/10.1007/978-981-10-2779-6_41-1.

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Fatima, Yaqoot, Anne Cleary, Stephanie King, Shaun Solomon, Lisa McDaid, Md Mehedi Hasan, Abdullah Al Mamun, and Janeen Baxter. "Cultural Identity and Social and Emotional Wellbeing in Aboriginal and Torres Strait Islander Children." In Family Dynamics over the Life Course, 57–70. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-12224-8_4.

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AbstractConnection with Country, community, and culture lies at the heart of Aboriginal and Torres Strait Islander peoples’ health and wellbeing. Although there is some evidence on the role of cultural identity on the mental health of Indigenous adults, this relationship is relatively unexplored in the context of Indigenous Australian children. Robust empirical evidence on the role of cultural identity for social and emotional wellbeing is necessary to design and develop effective interventions and approaches for improving the mental health outcomes for Indigenous Australian children. Drawing on data from the Longitudinal Study of Indigenous Children (LSIC), we explore social and emotional wellbeing in Indigenous Australian children and assesses whether cultural identity protects against social-emotional problems in Indigenous children. The results show that Indigenous children with strong cultural identity and knowledge are less likely to experience social and emotional problems than their counterparts. Our work provides further evidence to support the change from a deficit narrative to a strengths-based discourse for improved health and wellbeing of Indigenous Australian children.
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Thrift, A. G., S. L. Gall, and A. D. Brown. "Burden of Cardiovascular Diseases Among Aboriginal and Torres Strait Islander Peoples: Mortality, Hospitalization and Risk Factors." In Handbook of Disease Burdens and Quality of Life Measures, 919–31. New York, NY: Springer New York, 2010. http://dx.doi.org/10.1007/978-0-387-78665-0_52.

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Yashadhana, Aryati, Miri Raven, Nellie Pollard-Wharton, and Brett Biles. "Aboriginal and Torres Strait Islander Peoples and the COVID-19 Pandemic: A Spatial and Place-Based Analysis." In The Geographies of COVID-19, 181–94. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-11775-6_15.

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Milroy, Helen, Monique Platell, and Shraddha Kashyap. "The Interface: Western Tools and the Mental Health and Wellbeing of Aboriginal and Torres Strait Islander Peoples." In Psychological Interventions from Six Continents, 259–85. New York: Routledge, 2022. http://dx.doi.org/10.4324/9781003124061-17.

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McMillan, Faye, Linda Deravin, and Glenda McDonald. "Aboriginal and Torres Strait Islander health." In Nursing in Australia, 53–64. Milton Park, Abingdon, Oxon; New York, NY: Routledge, 2021.: Routledge, 2020. http://dx.doi.org/10.4324/9781003120698-7.

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Conference papers on the topic "Aboriginal and Torres Strait Islander people"

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Crump, Vanessa, and Yvonne C. Davila. "UNDERSTANDING STUDENTS’ EXPERIENCES AFTER INCORPORATING INDIGENOUS PERSPECTIVES IN A POSTGRADUATE SCIENCE COMMUNICATION." In International Conference on Education and New Developments. inScience Press, 2022. http://dx.doi.org/10.36315/2022v2end005.

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"Many Australian universities have recently incorporated Indigenous graduate attributes into their programs, and the University of Technology Sydney (UTS) is no exception. This project aimed to investigate students’ perceptions and experiences of learning about Indigenous Knowledge systems and culture while developing science communication skills. Advanced Communication Skills in Science is a core subject in the Master of Science program at UTS. An existing assessment task, a three-minute thesis style oral presentation, was reworked to include the Indigenous Graduate Attribute (IGA) developed for the Faculty of Science. Students researched an aspect of Indigenous Science, an area of emerging interest for cultural and scientific understanding, and a mechanism for empowering Australia’s diverse first nations peoples. They then presented their key message in three minutes using a single PowerPoint slide. This task allowed students to demonstrate an awareness and appreciation of multiple ways of developing understandings of nature while enhancing their ability to understand the role of science communication in the modern world. Students were surveyed at the beginning and end of the semester to establish their Indigenous Science conceptions and reflect on their experiences. Students demonstrated an outstanding ability to integrate appropriate Aboriginal and Torres Strait Islander knowledges, experience, and analysis into a key message. Most students reported greater familiarity with concepts such as Indigenous Science and provided richer definitions of what this means. When asked if understanding Aboriginal and Torres Strait Islander knowledges and cultural practices might impact their practice as a scientist, many felt their perspective had changed and that reflecting on their cultural values and beliefs had improved their cultural capability. Most students responded that this subject challenged (at least to a degree) some firmly held assumptions, ideas, and beliefs."
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Blake, Tamara, Mark Chatfield, Anne Chang, Helen Petsky, and Margaret Mcelrea. "Spirometry reference values for Australian Aboriginal and Torres Strait Islander (Indigenous) children and young adults." In ERS International Congress 2018 abstracts. European Respiratory Society, 2018. http://dx.doi.org/10.1183/13993003.congress-2018.oa3777.

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Blake, Tamara, Mark Chatfield, Anne Chang, Helen Petsky, and Margaret Mcelrea. "Self-reported and medical chart histories of Australian Aboriginal and Torres Strait Islander (Indigenous) children and young adults." In ERS International Congress 2018 abstracts. European Respiratory Society, 2018. http://dx.doi.org/10.1183/13993003.congress-2018.pa4682.

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Finlay, E., and J. Kidd. "16 Unpacking the ‘truth’ about the health gap: decolonising methodologies, cultural archives and the national aboriginal and torres Strait Islander health plan 2013–2023." In Negotiating trust: exploring power, belief, truth and knowledge in health and care. Qualitative Health Research Network (QHRN) 2021 conference book of abstracts. British Medical Journal Publishing Group, 2021. http://dx.doi.org/10.1136/bmjopen-2021-qhrn.54.

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Reports on the topic "Aboriginal and Torres Strait Islander people"

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Go-Sam, Carroll, Kelly Greenop, Kali Marnane, and Theresa Bower. Campuses on Countries: Aboriginal and Torres Strait Islander Design Framework at The University of Queensland. Brisbane, Australia: The University of Queensland, January 2021. http://dx.doi.org/10.14264/955791e.

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Rogers, Jessa, Kate E. Williams, Kristin R. Laurens, Donna Berthelsen, Emma Carpendale, Laura Bentley, and Elizabeth Briant. Footprints in Time: Longitudinal Study of Indigenous Children. Queensland University of Technology, October 2022. http://dx.doi.org/10.5204/rep.eprints.235509.

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The Longitudinal Study of Indigenous Children (LSIC; also called Footprints in Time) is the only longitudinal study of developmental outcomes for Aboriginal and Torres Strait Islander children globally. Footprints in Time follows the development of Australian Aboriginal and Torres Strait Islander children to understand what Indigenous children need to grow up strong. LSIC involves annual waves of data collection (commenced in 2008) and follows approximately 1,700 Aboriginal and Torres Strait Islander children living in urban, regional, and remote locations. This LSIC Primary School report has been produced following the release of the twelfth wave of data collection, with the majority of LSIC children having completed primary school (Preparatory [aged ~5 years] to Year 6 [aged ~12 years]). Primary schools play a central role in supporting student learning, wellbeing, and connectedness, and the Footprints in Time study provides a platform for centring Indigenous voices, connecting stories, and exploring emerging themes related to the experience of Indigenous children and families in the Australian education system. This report uses a mixed-methods approach, analysing both quantitative and qualitative data shared by LSIC participants, to explore primary school experiences from the perspective of children, parents and teachers. Analyses are framed using a strengths-based approach and are underpinned by the understanding that all aspects of life are related. The report documents a range of topics including teacher cultural competence, racism, school-based Aboriginal and Torres Strait Islander education activities, parental involvement, engagement, attendance, and academic achievement.
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Marnane, Kali, and Theresa Bower. Campuses on Countries: Aboriginal and Torres Strait Islander Design Framework Engagement Report at The University of Queensland. St Lucia, QLD Australia: The University of Queensland, January 2021. http://dx.doi.org/10.14264/c684e38.

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Ward, Jeanette E., Seham Girgis, Kathryn Thorburn, Stefanie Oliver, Charles Weijer, and Monica Taljaard. A systemic review of self-reported ethical practices in publications of cluster randomised trials conducted in Aboriginal and Torres Strait Islander settings. Edited by Melissa Marshall, Gillian Kennedy, Anna Dwyer, and Sandra Wooltorton. Nulungu Research Institute, The University of Notre Dame Australia, 2021. http://dx.doi.org/10.32613/nrp/2021.4.

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Rankin, Nicole, Deborah McGregor, Candice Donnelly, Bethany Van Dort, Richard De Abreu Lourenco, Anne Cust, and Emily Stone. Lung cancer screening using low-dose computed tomography for high risk populations: Investigating effectiveness and screening program implementation considerations: An Evidence Check rapid review brokered by the Sax Institute (www.saxinstitute.org.au) for the Cancer Institute NSW. The Sax Institute, October 2019. http://dx.doi.org/10.57022/clzt5093.

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Background Lung cancer is the number one cause of cancer death worldwide.(1) It is the fifth most commonly diagnosed cancer in Australia (12,741 cases diagnosed in 2018) and the leading cause of cancer death.(2) The number of years of potential life lost to lung cancer in Australia is estimated to be 58,450, similar to that of colorectal and breast cancer combined.(3) While tobacco control strategies are most effective for disease prevention in the general population, early detection via low dose computed tomography (LDCT) screening in high-risk populations is a viable option for detecting asymptomatic disease in current (13%) and former (24%) Australian smokers.(4) The purpose of this Evidence Check review is to identify and analyse existing and emerging evidence for LDCT lung cancer screening in high-risk individuals to guide future program and policy planning. Evidence Check questions This review aimed to address the following questions: 1. What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? 2. What is the evidence of potential harms from lung cancer screening for higher-risk individuals? 3. What are the main components of recent major lung cancer screening programs or trials? 4. What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Summary of methods The authors searched the peer-reviewed literature across three databases (MEDLINE, PsycINFO and Embase) for existing systematic reviews and original studies published between 1 January 2009 and 8 August 2019. Fifteen systematic reviews (of which 8 were contemporary) and 64 original publications met the inclusion criteria set across the four questions. Key findings Question 1: What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? There is sufficient evidence from systematic reviews and meta-analyses of combined (pooled) data from screening trials (of high-risk individuals) to indicate that LDCT examination is clinically effective in reducing lung cancer mortality. In 2011, the landmark National Lung Cancer Screening Trial (NLST, a large-scale randomised controlled trial [RCT] conducted in the US) reported a 20% (95% CI 6.8% – 26.7%; P=0.004) relative reduction in mortality among long-term heavy smokers over three rounds of annual screening. High-risk eligibility criteria was defined as people aged 55–74 years with a smoking history of ≥30 pack-years (years in which a smoker has consumed 20-plus cigarettes each day) and, for former smokers, ≥30 pack-years and have quit within the past 15 years.(5) All-cause mortality was reduced by 6.7% (95% CI, 1.2% – 13.6%; P=0.02). Initial data from the second landmark RCT, the NEderlands-Leuvens Longkanker Screenings ONderzoek (known as the NELSON trial), have found an even greater reduction of 26% (95% CI, 9% – 41%) in lung cancer mortality, with full trial results yet to be published.(6, 7) Pooled analyses, including several smaller-scale European LDCT screening trials insufficiently powered in their own right, collectively demonstrate a statistically significant reduction in lung cancer mortality (RR 0.82, 95% CI 0.73–0.91).(8) Despite the reduction in all-cause mortality found in the NLST, pooled analyses of seven trials found no statistically significant difference in all-cause mortality (RR 0.95, 95% CI 0.90–1.00).(8) However, cancer-specific mortality is currently the most relevant outcome in cancer screening trials. These seven trials demonstrated a significantly greater proportion of early stage cancers in LDCT groups compared with controls (RR 2.08, 95% CI 1.43–3.03). Thus, when considering results across mortality outcomes and early stage cancers diagnosed, LDCT screening is considered to be clinically effective. Question 2: What is the evidence of potential harms from lung cancer screening for higher-risk individuals? The harms of LDCT lung cancer screening include false positive tests and the consequences of unnecessary invasive follow-up procedures for conditions that are eventually diagnosed as benign. While LDCT screening leads to an increased frequency of invasive procedures, it does not result in greater mortality soon after an invasive procedure (in trial settings when compared with the control arm).(8) Overdiagnosis, exposure to radiation, psychological distress and an impact on quality of life are other known harms. Systematic review evidence indicates the benefits of LDCT screening are likely to outweigh the harms. The potential harms are likely to be reduced as refinements are made to LDCT screening protocols through: i) the application of risk predication models (e.g. the PLCOm2012), which enable a more accurate selection of the high-risk population through the use of specific criteria (beyond age and smoking history); ii) the use of nodule management algorithms (e.g. Lung-RADS, PanCan), which assist in the diagnostic evaluation of screen-detected nodules and cancers (e.g. more precise volumetric assessment of nodules); and, iii) more judicious selection of patients for invasive procedures. Recent evidence suggests a positive LDCT result may transiently increase psychological distress but does not have long-term adverse effects on psychological distress or health-related quality of life (HRQoL). With regards to smoking cessation, there is no evidence to suggest screening participation invokes a false sense of assurance in smokers, nor a reduction in motivation to quit. The NELSON and Danish trials found no difference in smoking cessation rates between LDCT screening and control groups. Higher net cessation rates, compared with general population, suggest those who participate in screening trials may already be motivated to quit. Question 3: What are the main components of recent major lung cancer screening programs or trials? There are no systematic reviews that capture the main components of recent major lung cancer screening trials and programs. We extracted evidence from original studies and clinical guidance documents and organised this into key groups to form a concise set of components for potential implementation of a national lung cancer screening program in Australia: 1. Identifying the high-risk population: recruitment, eligibility, selection and referral 2. Educating the public, people at high risk and healthcare providers; this includes creating awareness of lung cancer, the benefits and harms of LDCT screening, and shared decision-making 3. Components necessary for health services to deliver a screening program: a. Planning phase: e.g. human resources to coordinate the program, electronic data systems that integrate medical records information and link to an established national registry b. Implementation phase: e.g. human and technological resources required to conduct LDCT examinations, interpretation of reports and communication of results to participants c. Monitoring and evaluation phase: e.g. monitoring outcomes across patients, radiological reporting, compliance with established standards and a quality assurance program 4. Data reporting and research, e.g. audit and feedback to multidisciplinary teams, reporting outcomes to enhance international research into LDCT screening 5. Incorporation of smoking cessation interventions, e.g. specific programs designed for LDCT screening or referral to existing community or hospital-based services that deliver cessation interventions. Most original studies are single-institution evaluations that contain descriptive data about the processes required to establish and implement a high-risk population-based screening program. Across all studies there is a consistent message as to the challenges and complexities of establishing LDCT screening programs to attract people at high risk who will receive the greatest benefits from participation. With regards to smoking cessation, evidence from one systematic review indicates the optimal strategy for incorporating smoking cessation interventions into a LDCT screening program is unclear. There is widespread agreement that LDCT screening attendance presents a ‘teachable moment’ for cessation advice, especially among those people who receive a positive scan result. Smoking cessation is an area of significant research investment; for instance, eight US-based clinical trials are now underway that aim to address how best to design and deliver cessation programs within large-scale LDCT screening programs.(9) Question 4: What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Assessing the value or cost-effectiveness of LDCT screening involves a complex interplay of factors including data on effectiveness and costs, and institutional context. A key input is data about the effectiveness of potential and current screening programs with respect to case detection, and the likely outcomes of treating those cases sooner (in the presence of LDCT screening) as opposed to later (in the absence of LDCT screening). Evidence about the cost-effectiveness of LDCT screening programs has been summarised in two systematic reviews. We identified a further 13 studies—five modelling studies, one discrete choice experiment and seven articles—that used a variety of methods to assess cost-effectiveness. Three modelling studies indicated LDCT screening was cost-effective in the settings of the US and Europe. Two studies—one from Australia and one from New Zealand—reported LDCT screening would not be cost-effective using NLST-like protocols. We anticipate that, following the full publication of the NELSON trial, cost-effectiveness studies will likely be updated with new data that reduce uncertainty about factors that influence modelling outcomes, including the findings of indeterminate nodules. Gaps in the evidence There is a large and accessible body of evidence as to the effectiveness (Q1) and harms (Q2) of LDCT screening for lung cancer. Nevertheless, there are significant gaps in the evidence about the program components that are required to implement an effective LDCT screening program (Q3). Questions about LDCT screening acceptability and feasibility were not explicitly included in the scope. However, as the evidence is based primarily on US programs and UK pilot studies, the relevance to the local setting requires careful consideration. The Queensland Lung Cancer Screening Study provides feasibility data about clinical aspects of LDCT screening but little about program design. The International Lung Screening Trial is still in the recruitment phase and findings are not yet available for inclusion in this Evidence Check. The Australian Population Based Screening Framework was developed to “inform decision-makers on the key issues to be considered when assessing potential screening programs in Australia”.(10) As the Framework is specific to population-based, rather than high-risk, screening programs, there is a lack of clarity about transferability of criteria. However, the Framework criteria do stipulate that a screening program must be acceptable to “important subgroups such as target participants who are from culturally and linguistically diverse backgrounds, Aboriginal and Torres Strait Islander people, people from disadvantaged groups and people with a disability”.(10) An extensive search of the literature highlighted that there is very little information about the acceptability of LDCT screening to these population groups in Australia. Yet they are part of the high-risk population.(10) There are also considerable gaps in the evidence about the cost-effectiveness of LDCT screening in different settings, including Australia. The evidence base in this area is rapidly evolving and is likely to include new data from the NELSON trial and incorporate data about the costs of targeted- and immuno-therapies as these treatments become more widely available in Australia.
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