Journal articles: 'Aboriginal Australians Northern Territory Medicine'

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Jassar, Patrick, and Garrett F. Hunter. "The importance of Hand Talk in communication rehabilitation among Aboriginal Australians in the Northern Territory." Medical Journal of Australia 184, no. 10 (May 2006): 532. http://dx.doi.org/10.5694/j.1326-5377.2006.tb00355.x.

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Ralph, Anna, Mark Raines, Jurgen W. Rode, and Bart J. Currie. "Histoplasmosis in two aboriginal patients from Australia's tropical Northern Territory." Transactions of the Royal Society of Tropical Medicine and Hygiene 100, no. 9 (September 2006): 888–90. http://dx.doi.org/10.1016/j.trstmh.2005.10.011.

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Gunaratnam, Praveena, Gill Schierhout, Jenny Brands, Lisa Maher, Ross Bailie, James Ward, Rebecca Guy, et al. "Qualitative perspectives on the sustainability of sexual health continuous quality improvement in clinics serving remote Aboriginal communities in Australia." BMJ Open 9, no. 5 (May 2019): e026679. http://dx.doi.org/10.1136/bmjopen-2018-026679.

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ObjectivesTo examine barriers and facilitators to sustaining a sexual health continuous quality improvement (CQI) programme in clinics serving remote Aboriginal communities in Australia.DesignQualitative study.SettingPrimary health care services serving remote Aboriginal communities in the Northern Territory, Australia.ParticipantsSeven of the 11 regional sexual health coordinators responsible for supporting the Northern Territory Government Remote Sexual Health Program.MethodsSemi-structured in-depth interviews conducted in person or by telephone; data were analysed using an inductive and deductive thematic approach.ResultsDespite uniform availability of CQI tools and activities, sexual health CQI implementation varied across the Northern Territory. Participant narratives identified five factors enhancing the uptake and sustainability of sexual health CQI. At clinic level, these included adaptation of existing CQI tools for use in specific clinic contexts and risk environments (eg, a syphilis outbreak), local ownership of CQI processes and management support for CQI. At a regional level, factors included the positive framing of CQI as a tool to identify and act on areas for improvement, and regional facilitation of clinic level CQI activities. Three barriers were identified, including the significant workload associated with acute and chronic care in Aboriginal primary care services, high staff turnover and lack of Aboriginal staff. Considerations affecting the future sustainability of sexual health CQI included the need to reduce the burden on clinics from multiple CQI programmes, the contribution of regional sexual health coordinators and support structures, and access to and use of high-quality information systems.ConclusionsThis study contributes to the growing evidence on how CQI approaches may improve sexual health in remote Australian Aboriginal communities. Enhancing sustainability of sexual health CQI in this context will require ongoing regional facilitation, efforts to build local ownership of CQI processes and management of competing demands on health service staff.

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Howarth, Timothy, Raelene Brunette, Tanya Davies, Ross M. Andrews, Bhavini K. Patel, Steven Tong, Federica Barzi, and Therese M. Kearns. "Antibiotic use for Australian Aboriginal children in three remote Northern Territory communities." PLOS ONE 15, no. 4 (April 17, 2020): e0231798. http://dx.doi.org/10.1371/journal.pone.0231798.

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Howarth, Timothy, Raelene Brunette, Tanya Davies, Ross M. Andrews, Bhavini K. Patel, Steven Tong, Federica Barzi, and Therese M. Kearns. "Correction: Antibiotic use for Australian Aboriginal children in three remote Northern Territory communities." PLOS ONE 15, no. 5 (May 14, 2020): e0233533. http://dx.doi.org/10.1371/journal.pone.0233533.

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Renes, Cornelis M. B. "Alexis Wright’s The Swan Book: Indigenous-Australian Swansong or Songline?" Humanities 10, no. 3 (July 15, 2021): 89. http://dx.doi.org/10.3390/h10030089.

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The Swan Book (pub. 2013) by the Indigenous-Australian author Alexis Wright is an eco-dystopian epic about the Indigenous people’s tough struggle to regain the environmental balance of the Australian continent and recover their former habitat. The book envisions a dire future in which all Australian flora and fauna—humans included—are under threat, suffering, displaced, and dying out as the result of Western colonization and its exploitative treatment of natural resources. The Swan Book goes beyond the geographical and epistemological scope of Wright’s previous two novels, Plains of Promise (pub. 1997) and Carpentaria (pub. 2006) to imagine what the Australian continent at large will look like under the ongoing pressure of the Western, exploitative production mode in a foreseeable future. The occupation of Aboriginal land in Australia’s Northern Territory since 2007 has allowed the federal government to intervene dramatically in what they term the dysfunctional remote Aboriginal communities; these are afflicted by transgenerational trauma, endemic domestic violence, alcoholism, and child sexual and substance abuse—in themselves the results of the marginal status of Indigeneity in Australian society—and continued control over valuable resources. This essay will discuss how Wright’s dystopian novel exemplifies an Indigenous turn to speculative fiction as a more successful way to address the trials and tribulations of Indigenous Australia and project a better future—an enabling songline rather than a disabling swansong.

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Harrison, Kristie H., KS Kylie Lee, Timothy Dobbins, Scott Wilson, Noel Hayman, Rowena Ivers, Paul S. Haber, et al. "Supporting Aboriginal Community Controlled Health Services to deliver alcohol care: protocol for a cluster randomised controlled trial." BMJ Open 9, no. 11 (November 2019): e030909. http://dx.doi.org/10.1136/bmjopen-2019-030909.

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IntroductionIndigenous peoples who have experienced colonisation or oppression can have a higher prevalence of alcohol-related harms. In Australia, Aboriginal Community Controlled Health Services (ACCHSs) offer culturally accessible care to Aboriginal and Torres Strait Islander (Indigenous) peoples. However there are many competing health, socioeconomic and cultural client needs.Methods and analysisA randomised cluster wait-control trial will test the effectiveness of a model of tailored and collaborative support for ACCHSs in increasing use of alcohol screening (with Alcohol Use Disorders Identification Test-Consumption (AUDIT-C)) and of treatment provision (brief intervention, counselling or relapse prevention medicines).SettingTwenty-two ACCHSs across Australia.RandomisationServices will be stratified by remoteness, then randomised into two groups. Half receive support soon after the trial starts (intervention or ‘early support’); half receive support 2 years later (wait-control or ‘late support’).The supportCore support elements will be tailored to local needs and include: support to nominate two staff as champions for increasing alcohol care; a national training workshop and bimonthly teleconferences for service champions to share knowledge; onsite training, and bimonthly feedback on routinely collected data on screening and treatment provision.Outcomes and analysisPrimary outcome is use of screening using AUDIT-C as routinely recorded on practice software. Secondary outcomes are recording of brief intervention, counselling, relapse prevention medicines; and blood pressure, gamma glutamyltransferase and HbA1c. Multi-level logistic regression will be used to test the effectiveness of support.Ethics and disseminationEthical approval has been obtained from eight ethics committees: the Aboriginal Health and Medical Research Council of New South Wales (1217/16); Central Australian Human Research Ethics Committee (CA-17-2842); Northern Territory Department of Health and Menzies School of Health Research (2017-2737); Central Queensland Hospital and Health Service (17/QCQ/9); Far North Queensland (17/QCH/45-1143); Aboriginal Health Research Ethics Committee, South Australia (04-16-694); St Vincent’s Hospital (Melbourne) Human Research Ethics Committee (LRR 036/17); and Western Australian Aboriginal Health Ethics Committee (779).Trial registration numberACTRN12618001892202; Pre-results.

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Kearns, Therese, Abbey Diaz, Lisa J. Whop, Suzanne P. Moore, John R. Condon, Ross M. Andrews, Judith M. Katzenellenbogen, et al. "Investigating inequities in cardiovascular care and outcomes for Queensland Aboriginal and Torres Strait Islander people: protocol for a hospital-based retrospective cohort data linkage project." BMJ Open 11, no. 3 (March 2021): e043304. http://dx.doi.org/10.1136/bmjopen-2020-043304.

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IntroductionCardiovascular disease (CVD) represents a significant burden of disease for Aboriginal and Torres Strait Islander people, a population that continues to experience a lower life expectancy than other Australians. The aim of the Better Cardiac Care Data Linkage project is to describe patient care pathways and to identify disparities in care and health outcomes between Aboriginal and Torres Strait Islander people and other Queensland residents diagnosed with CVD in the state of Queensland.MethodsThis is a population-based retrospective cohort study using linked regional, state and national health and administrative data collections to describe disparities in CVD healthcare in primary and secondary prevention settings and during hospitalisation. The CVD cohort will be identified from the Queensland Hospital Admitted Patient Data Collection for admissions that occurred between 1 July 2010 and 31 June 2016 and will include relevant International Classification of Disease codes for ischaemic heart disease, congestive heart failure, stroke, acute rheumatic fever and rheumatic heart disease. Person-level data will be linked by Data Linkage Queensland and the Australian Institute of Health and Welfare (AIHW) in accordance with ethical and public health approvals to describe the patient journey prior to, during and post the hospital admission.AnalysisThis project will focus largely on descriptive epidemiological measures and multivariate analysis of clinical care standards and outcomes for Aboriginal and Torres Strait Islander people compared with other Queenslanders, including identification of risk factors for suboptimal care and change over time. Variation in care pathways and patient outcomes will be compared by Indigenous status, sex, age group, remoteness of residence, year of index hospitalisation and socioeconomic status. Cox models for time-to-event data and mixed models or generalised estimating equations for longitudinal data will be used to measure change over time where temporal effects exist.Ethics and disseminationEthical approval has been granted by Human Research Ethics Committees of the Prince Charles Hospital (HREC/15/QPCH/289) and the AIHW (EO2016-1-233). The Northern Territory Department of Health and Menzies School of Health Research have also provided reciprocal ethical approval of the project (HREC 2019–3490). The deidentified results will be summarised in a report and shared with investigators, advisory groups, Queensland Health and key stakeholders. Findings will be disseminated through workshops, conferences and will be published in peer-reviewed journals.

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Whop, Lisa J., Tamara L. Butler, Julia M. L. Brotherton, Kate Anderson, Joan Cunningham, Allison Tong, and Gail Garvey. "Study protocol: Yarning about HPV Vaccination: a qualitative study of factors influencing HPV vaccination among Aboriginal and Torres Strait Islander adolescents in Australia." BMJ Open 11, no. 8 (August 2021): e047890. http://dx.doi.org/10.1136/bmjopen-2020-047890.

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IntroductionAboriginal and Torres Strait Islander women experience a higher burden of cervical cancer than non-Indigenous women in Australia. Cervical cancer is preventable partly through human papillomavirus (HPV) vaccination; in Australia, this is delivered through the national school-based immunisation programme. While HPV vaccination uptake is high among Australian adolescents, there remain gaps in uptake and completion among Aboriginal and Torres Strait Islander adolescents. This study aims to gain a comprehensive understanding of the barriers and facilitators to HPV vaccination uptake and completion among Aboriginal and Torres Strait Islander adolescents in Queensland, Australia.Methods and analysisThe study will be guided by an Indigenist research approach and an ecological model for health promotion. Yarning, a qualitative Indigenous research method, will be conducted in up to 10 schools. Participants will include Year 7 (12/13 years old) Aboriginal and Torres Strait Islander adolescents; parents/caregivers; and local key informants and immunisation programme partners involved in the delivery of school-based HPV immunisation programme. Participants will be recruited through school representatives and investigator networks using purposive and snowball sampling and samples of convenience. Field notes, HPV vaccination clinic observations and sequential diagramming of the HPV vaccination process will be conducted. Thematic analysis of data will be led by Aboriginal and Torres Strait Islander researchers. Synthesised sequential diagrams of the process of HPV vaccination and qualitative themes summarising key findings will be produced.Ethics and disseminationThe Aboriginal Health and Medical Research Council of New South Wales Ethics Committee (1646/20), the Australian National University Human Research Ethics Committee (HREC, 2020/478), the HREC of the Northern Territory Department of Health and Menzies School of Health Research (19-3484) and the Townsville Hospital and Health Service HREC (HREC/QTHS/73789) have approved the study. Dissemination will occur via conferences and peer-reviewed publications. Further dissemination will be determined in partnership with the Aboriginal and Torres Strait Islander Steering Committee, including Youth Representatives and Consultation Network.

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Hoy, Wendy E., Susan Anne Mott, and Beverly June McLeod. "Transformation of mortality in a remote Australian Aboriginal community: a retrospective observational study." BMJ Open 7, no. 8 (August 2017): e016094. http://dx.doi.org/10.1136/bmjopen-2017-016094.

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ObjectivesTo describe trends in ages and causes of death in a remote-living Australian Aboriginal group over a recent 50-year period.DesignA retrospective observational study, from 1960 to 2010, of deaths and people starting dialysis, using data from local clinic, parish, dialysis and birthweight registers.SettingA remote island community in the Top End of Australia’s Northern Territory, where a Catholic mission was established in 1911. The estimated Aboriginal population was about 800 in 1960 and 2260 in 2011.ParticipantsAll Aboriginal residents of this community whose deaths had been recorded.Outcome measuresAnnual frequencies and rates of terminal events (deaths and dialysis starts) by age group and cause of death.ResultsAgainst a background of high rates of low birth weight, 223 deaths in infants and children and 934 deaths in adults (age>15 years) were recorded; 88% were of natural causes. Most deaths in the 1960s were in infants and children. However, over time these fell dramatically, across the birthweight spectrum, while adult deaths progressively increased. The leading causes of adult natural deaths were chronic lung disease, cardiovascular disease and, more recently, renal failure, and rates were increased twofold in those of low birth weight. However, rates of natural adult deaths have been falling briskly since 1986, most markedly among people of age ≥45 years. The population is increasing and its age structure is maturing.ConclusionsThe changes in death profiles, the expression of the Barker hypothesis and the ongoing increases in adult life expectancy reflect epidemiological and health transitions of astonishing rapidity. These probably flow from advances in public health policy and healthcare delivery, as well as improved inter-sectoral services, which are all to be celebrated. Other remote communities in Australia are experiencing the same phenomena, and similar events are well advanced in many developing countries.

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Waddington, Claire S., Charlie McLeod, Peter Morris, Asha Bowen, Mark Naunton, Jonathan Carapetis, Keith Grimwood, et al. "The NICE-GUT trial protocol: a randomised, placebo controlled trial of oral nitazoxanide for the empiric treatment of acute gastroenteritis among Australian Aboriginal children." BMJ Open 8, no. 2 (February 2018): e019632. http://dx.doi.org/10.1136/bmjopen-2017-019632.

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IntroductionDiarrhoeal disease is the second leading cause of death in children under 5 years globally, killing 525 000 annually. Australian Aboriginal and Torres Strait Islander (hereafter Aboriginal) children suffer a high burden of disease. Randomised trials in other populations suggest nitazoxanide accelerates recovery for children with Giardia, amoebiasis, Cryptosporidium, Rotavirus and Norovirus gastroenteritis, as well as in cases where no enteropathogens are found.Methods and analysisThis double blind, 1:1 randomised, placebo controlled trial is investigating the impact of oral nitazoxanide on acute gastroenteritis in hospitalised Australian Aboriginal children aged 3 months to <5 years. Dosing is based on age-based dosing. The primary endpoint is the time to resolution of ‘significant illness’ defined as the time from randomisation to the time of clinical assessment as medically ready for discharge, or to the time of actual discharge from hospital, whichever occurs first. Secondary endpoints include duration of hospitalisation, symptom severity during the period of significant illness and following treatment, duration of rehydration and drug safety. Patients will be followed for medically significant events for 60 days. Analysis is based on Bayesian inference. Subgroup analysis will occur by pathogen type (bacteria, virus or parasite), rotavirus vaccination status, age and illness severity.Ethics and disseminationEthics approval has been granted by the Central Australian Human Research Ethics Committee (HREC-14–221) and the Human Research Ethics Committee of the Northern Territory Department of Health and Menzies School of Health Research (HREC2014-2172). Study investigators will ensure that the trial is conducted in accordance with the principles of the Declaration of Helsinki. Individual participant consent will be obtained. Results will be disseminated via peer-reviewed publication.Trial registration numberACTRN12614000381684.

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Howarth, Timothy, Belinda Davison, and Gurmeet Singh. "Grip strength among Indigenous and non-Indigenous Australian adults: a longitudinal study of the effects of birth size and current size." BMJ Open 9, no. 4 (April 2019): e024749. http://dx.doi.org/10.1136/bmjopen-2018-024749.

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ObjectivesIndigenous Australians are born smaller than non-Indigenous Australians and are at an increased risk of early onset of frailty. This study aimed to identify the relationship between birth size, current size and grip strength, as an early marker of frailty, in Indigenous and non-Indigenous young adults.DesignCross sectional data from two longitudinal studies: Aboriginal birth cohort (Indigenous) and top end cohort (non-Indigenous).SettingParticipants reside in over 40 urban and remote communities across the Northern Territory, Australia.ParticipantsYoung adults with median age 25 years (IQR 24–26); 427 participants (55% women), 267 (63%) were remote Indigenous, 55 (13%) urban Indigenous and 105 (25%) urban non-Indigenous.Outcome measuresReliable birth data were available. Anthropometric data (height, weight, lean mass) and grip strength were directly collected using standardised methods. Current residence was classified as urban or remote.ResultsThe rate of low birthweight (LBW) in the non-Indigenous cohort (9%) was significantly lower than the Indigenous cohort (16%) (−7%, 95% CI −14 to 0, p=0.03). Indigenous participants had lower grip strength than non-Indigenous (women, −2.08, 95% CI −3.61 to –0.55, p=0.008 and men, −6.2, 95% CI −9.84 to –2.46, p=0.001). Birth weight (BW) was associated with grip strength after adjusting for demographic factors for both women (β=1.29, 95% CI 0.41 to 2.16, p=0.004) and men (β=3.95, 95% CI 2.38 to 5.51, p<0.001). When current size (lean mass and body mass index [BMI]) was introduced to the model BW was no longer a significant factor. Lean mass was a positive indicator for grip strength, and BMI a negative indicator.ConclusionsAs expected women had significantly lower grip strength than men. Current size, in particular lean mass, was the strongest predictor of adult grip strength in this cohort. BW may have an indirect effect on later grip strength via moderation of lean mass development, especially through adolescence and young adulthood.

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Chamberlain, Catherine, Graham Gee, Stephanie Janne Brown, Judith Atkinson, Helen Herrman, Deirdre Gartland, Karen Glover, et al. "Healing the Past by Nurturing the Future—co-designing perinatal strategies for Aboriginal and Torres Strait Islander parents experiencing complex trauma: framework and protocol for a community-based participatory action research study." BMJ Open 9, no. 6 (June 2019): e028397. http://dx.doi.org/10.1136/bmjopen-2018-028397.

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IntroductionChild maltreatment and other traumatic events can have serious long-term physical, social and emotional effects, including a cluster of distress symptoms recognised as ‘complex trauma’. Aboriginal and Torres Strait Islander (Aboriginal) people are also affected by legacies of historical trauma and loss. Trauma responses may be triggered during the transition to parenting in the perinatal period. Conversely, becoming a parent offers a unique life-course opportunity for healing and prevention of intergenerational transmission of trauma. This paper outlines a conceptual framework and protocol for an Aboriginal-led, community-based participatory action research (action research) project which aims to co-design safe, acceptable and feasible perinatalawareness, recognition, assessmentandsupportstrategies for Aboriginal parents experiencing complex trauma.Methods and analysisThis formative research project is being conducted in three Australian jurisdictions (Northern Territory, South Australia and Victoria) with key stakeholders from all national jurisdictions. Four action research cycles incorporate mixed methods research activities including evidence reviews, parent and service provider discussion groups, development and psychometric evaluation of a recognition and assessment process and drafting proposals for pilot, implementation and evaluation. Reflection and planning stages of four action research cycles will be undertaken in four key stakeholder workshops aligned with the first four Intervention Mapping steps to prepare programme plans.Ethics and disseminationEthics and dissemination protocols are consistent with the National Health and Medical Research Council Indigenous Research Excellence criteria of engagement, benefit, transferability and capacity-building. A conceptual framework has been developed to promote the application of core values of safety, trustworthiness, empowerment, collaboration, culture, holism, compassion and reciprocity. These include related principles and accompanying reflective questions to guide research decisions.

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BURNS, C. B., P. D'ABBS, and B. J. CURRIE. "Patterns of petrol sniffing and other drug use in young men from an Australian Aboriginal community in Arnhem Land, Northern Territory." Drug and Alcohol Review 14, no. 2 (April 1995): 159–69. http://dx.doi.org/10.1080/09595239500185221.

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Zhao, Yuejen, Kanakamani Jeyaraman, Paul Burgess, Christine Connors, Steven Guthridge, Louise Maple-Brown, and Henrik Falhammar. "All-cause mortality following low-dose aspirin treatment for patients with high cardiovascular risk in remote Australian Aboriginal communities: an observational study." BMJ Open 10, no. 1 (January 2020): e030034. http://dx.doi.org/10.1136/bmjopen-2019-030034.

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ObjectivesTo evaluate the benefit and risk of low-dose acetylsalicylic acid (aspirin) in patients from remote Aboriginal communities in the Northern Territory, Australia.DesignRetrospective cohort study using primary care and hospital data routinely used for healthcare. Aspirin users and non-users were compared before and after controlling confounders by matching. Marginal structural models (MSM) were applied to ascertain the benefit and risk.SettingThe benefit and harm of aspirin were investigated in patients aged ≥18 years from 54 remote Aboriginal communities.ParticipantsNone had a previous cardiovascular event or major bleeds. Patients on anticoagulants or other antiplatelets were excluded.InterventionAspirin at a dose of 75–162 mg/day.Outcome measuresEndpoints were all-cause, cardiovascular mortality and incidences of cardiovascular events and major bleeds.Results8167 predominantly Aboriginal adults were included and followed between July 2009 and June 2017 (aspirin users n=1865, non-users n=6302, mean follow-up 4 years with hospitalisations 6.4 per person). Univariate analysis found material differences in demographics, prevalence of chronic diseases and outcome measures between aspirin users and non-users before matching. After matching, aspirin was significantly associated with reduced all-cause mortality (HR=0.45: 95% CI 0.34 to 0.60; p<0.001), but not bleeding (HR=1.13: 95% CI 0.39 to 3.26; p=0.820). After using MSMs to eliminate the effects of confounders, loss of follow-up and time dependency of treatment, aspirin was associated with reduced all-cause mortality (HR=0.60: 95% CI 0.47 to 0.76; p<0.001), independent of age (HR=1.06; p<0.001), presence of diabetes (HR=1.42; p<0.001), hypertension (HR=1.61; p<0.001) and alcohol abuse (HR=1.81; p<0.001). No association between aspirin and major bleeding was found (HR=1.14: 95% CI 0.48 to 2.73; p=0.765). Sensitivity analysis suggested these findings were unlikely to have been the result of unmeasured confounding.ConclusionAspirin was associated with reduced all-cause mortality. Bleeding risk was less compared with survival benefits. Aspirin should be considered for primary prevention in Aboriginal people with high cardiovascular risk.

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Fitts, Michelle S., John Humphreys, Terry Dunbar, Lisa Bourke, Edward Mulholland, Steven Guthridge, Yuejen Zhao, et al. "Understanding and responding to the cost and health impact of short-term health staffing in remote and rural Aboriginal and Torres Strait Islander community-controlled health services: a mixed methods study protocol." BMJ Open 11, no. 8 (August 2021): e043902. http://dx.doi.org/10.1136/bmjopen-2020-043902.

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IntroductionAccess to high-quality primary healthcare is limited for remote residents in Australia. Increasingly, remote health services are reliant on short-term or ‘fly-in, fly-out/drive-in, drive-out’ health workforce to deliver primary healthcare. A key strategy to achieving health service access equity, particularly evident in remote Australia, has been the development of Aboriginal Community Controlled Health Services (ACCHSs). This study aims to generate new knowledge about (1) the impact of short-term staffing in remote and rural ACCHSs on Aboriginal and Torres Strait Islander communities; (2) the potential mitigating effect of community control; and (3) effective, context-specific evidence-based retention strategies.Methods and analysisThis paper describes a 3-year, mixed methods study involving 12 ACCHSs across three states. The methods are situated within an evidence-based programme logic framework for rural and remote primary healthcare services. Quantitative data will be used to describe staffing stability and turnover, with multiple regression analyses to determine associations between independent variables (population size, geographical remoteness, resident staff turnover and socioeconomic status) and dependent variables related to patient care, service cost, quality and effectiveness. Qualitative assessment will include interviews and focus groups with clinical staff, clinic users, regionally-based retrieval staff and representatives of jurisdictional peak bodies for the ACCHS sector, to understand the impact of short-term staff on quality and continuity of patient care, as well as satisfaction and acceptability of services.Ethics and disseminationThe study has ethics approval from the Human Research Ethics Committee of the Northern Territory Department of Health and Menzies School of Health Research (project number DR03171), Central Australian Human Research Ethics Committee (CA-19-3493), Western Australian Aboriginal Health Ethics Committee (WAAHEC-938) and Far North Queensland Human Research Ethics Committee (HREC/2019/QCH/56393). Results will be disseminated through peer-reviewed journals, the project steering committee and community/stakeholder engagement activities to be determined by each ACCHS.

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Zhao, Yuejen, Deborah Jane Russell, Steven Guthridge, Mark Ramjan, Michael P. Jones, John S. Humphreys, and John Wakerman. "Costs and effects of higher turnover of nurses and Aboriginal health practitioners and higher use of short-term nurses in remote Australian primary care services: an observational cohort study." BMJ Open 9, no. 2 (February 2019): e023906. http://dx.doi.org/10.1136/bmjopen-2018-023906.

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ObjectivesTo compare the costs and effects of higher turnover of resident nurses and Aboriginal health practitioners and higher use of agency-employed nurses in remote primary care (PC) services and quantify associations between staffing patterns and health outcomes in remote PC clinics in the Northern Territory (NT) of Australia.DesignObservational cohort study, using hospital admission, financial and payroll data for the period 2013–2015.Setting53 NT Government run PC clinics in remote communities.Outcome measuresIncremental cost-effectiveness ratios were calculated for higher compared with lower turnover and higher compared with lower use of agency-employed nurses. Costs comprised PC, travel and hospitalisation costs. Effect measures were total hospitalisations and years of life lost per 1000 person-months. Multiple regression was performed to investigate associations between overall health costs and turnover rates and use of agency-employed nurses, after adjusting for key confounders.ResultsHigher turnover was associated with significantly higher hospitalisation rates (p<0.001) and higher average health costs (p=0.002) than lower turnover. Lower turnover was always more cost-effective. Average costs were significantly (p<0.001) higher when higher proportions of agency-employed nurses were employed. The probability that lower use of agency-employed nurses was more cost-effective was 0.84. Halving turnover and reducing use of a short-term workforce have the potential to save $32 million annually in the NT.ConclusionHigh turnover of health staff is costly and associated with poorer health outcomes for Aboriginal peoples living in remote communities. High reliance on agency nurses is also very likely to be cost-ineffective. Investment in a coordinated range of workforce strategies that support recruitment and retention of resident nurses and Aboriginal health practitioners in remote clinics is needed to stabilise the workforce, minimise the risks of high staff turnover and over-reliance on agency nurses and thereby significantly reduce expenditure and improve health outcomes.

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Barton, Elsa, Toby Freeman, Fran Baum, Sara Javanparast, and Angela Lawless. "The feasibility and potential use of case-tracked client journeys in primary healthcare: a pilot study." BMJ Open 9, no. 5 (May 2019): e024419. http://dx.doi.org/10.1136/bmjopen-2018-024419.

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ObjectivesTo determine the feasibility of case-tracking methods in documenting client journeys at primary healthcare (PHC) services in order to investigate the comprehensiveness of service responses and the experiences of clients.DesignProspective pilot study. Quantitative and qualitative case management data were collected from staff via questionnaire or interview.SettingFive Australian multidisciplinary PHC services were involved including four South Australian state-managed and one Northern Territory Aboriginal community-controlled PHC service.ParticipantsClients using services for depression (95) or diabetes (185) at the PHC services were case tracked over a 12-month period to allow construction of client journeys for these two conditions. Clients being tracked were invited to participate in two semi-structured interviews (21) and complete a health log.ResultsThough a number of challenges were encountered, the case-tracking methods were useful in documenting the complex nature of client journeys for those with depression or diabetes accessing PHC services and the need to respond to the social determinants of health. A flexible research design was crucial to respond to the needs of staff and changing organisational environments.ConclusionsThe client journeys provided important information about the services’ responses to depression and diabetes, and about aspects unique to comprehensive PHC such as advocacy and work that takes into account the social determinants of health.

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Cuningham, Will, Lorraine Anderson, Asha C. Bowen, Kirsty Buising, Christine Connors, Kathryn Daveson, Joanna Martin, et al. "Antimicrobial stewardship in remote primary healthcare across northern Australia." PeerJ 8 (July 22, 2020): e9409. http://dx.doi.org/10.7717/peerj.9409.

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Background The high burden of infectious disease and associated antimicrobial use likely contribute to the emergence of antimicrobial resistance in remote Australian Aboriginal communities. We aimed to develop and apply context-specific tools to audit antimicrobial use in the remote primary healthcare setting. Methods We adapted the General Practice version of the National Antimicrobial Prescribing Survey (GP NAPS) tool to audit antimicrobial use over 2–3 weeks in 15 remote primary healthcare clinics across the Kimberley region of Western Australia (03/2018–06/2018), Top End of the Northern Territory (08/2017–09/2017) and far north Queensland (05/2018–06/2018). At each clinic we reviewed consecutive clinic presentations until 30 presentations where antimicrobials had been used were included in the audit. Data recorded included the antimicrobials used, indications and treating health professional. We assessed the appropriateness of antimicrobial use and functionality of the tool. Results We audited the use of 668 antimicrobials. Skin and soft tissue infections were the dominant treatment indications (WA: 35%; NT: 29%; QLD: 40%). Compared with other settings in Australia, narrow spectrum antimicrobials like benzathine benzylpenicillin were commonly given and the appropriateness of use was high (WA: 91%; NT: 82%; QLD: 65%). While the audit was informative, non-integration with practice software made the process manually intensive. Conclusions Patterns of antimicrobial use in remote primary care are different from other settings in Australia. The adapted GP NAPS tool functioned well in this pilot study and has the potential for integration into clinical care. Regular stewardship audits would be facilitated by improved data extraction systems.

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Sarna, Mohinder, Ross Andrews, Hannah Moore, Michael J. Binks, Lisa McHugh, Gavin F. Pereira, Christopher C. Blyth, et al. "‘Links2HealthierBubs’ cohort study: protocol for a record linkage study on the safety, uptake and effectiveness of influenza and pertussis vaccines among pregnant Australian women." BMJ Open 9, no. 6 (June 2019): e030277. http://dx.doi.org/10.1136/bmjopen-2019-030277.

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IntroductionPregnant women and infants are at risk of severe influenza and pertussis infection. Inactivated influenza vaccine (IIV) and diphtheria-tetanus-acellular pertussis vaccine (dTpa) are recommended during pregnancy to protect both mothers and infants. In Australia, uptake is not routinely monitored but coverage appears sub-optimal. Evidence on the safety of combined antenatal IIV and dTpa is fragmented or deficient, and there remain knowledge gaps of population-level vaccine effectiveness. We aim to establish a large, population-based, multi-jurisdictional cohort of mother-infant pairs to measure the uptake, safety and effectiveness of antenatal IIV and dTpa vaccines in three Australian jurisdictions. This is a first step toward assessing the impact of antenatal vaccination programmes in Australia, which can then inform government policy with respect to future strategies in national vaccination programmes.Methods and analysis‘Links2HealthierBubs’ is an observational, population-based, retrospective cohort study established through probabilistic record linkage of administrative health data. The cohort includes births between 2012 and 2017 (~607 605 mother-infant pairs) in jurisdictions with population-level antenatal vaccination and health outcome data (Western Australia, Queensland and the Northern Territory). Perinatal data will be the reference frame to identify the cohort. Jurisdictional vaccination registers will identify antenatal vaccination status and the gestational timing of vaccination. Information on maternal, fetal and child health outcomes will be obtained from hospitalisation and emergency department records, notifiable diseases databases, developmental anomalies databases, birth and mortality registers.Ethics and disseminationEthical approval was obtained from the Western Australian Department of Health, Curtin University, the Menzies School of Health Research, the Royal Brisbane and Women’s Hospital, and the West Australian Aboriginal Health Ethics Committees. Research findings will be disseminated in peer-reviewed journals, at scientific meetings, and may be incorporated into communication materials for public health agencies and the public.

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Hoy, W. E. "Kidney disease in Aboriginal Australians: a perspective from the Northern Territory." Clinical Kidney Journal 7, no. 6 (November 13, 2014): 524–30. http://dx.doi.org/10.1093/ckj/sfu109.

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Wang, Zhiqiang, and Wendy E. Hoy. "Body mass index and mortality in Aboriginal Australians in the Northern Territory." Australian and New Zealand Journal of Public Health 26, no. 4 (August 2002): 305–10. http://dx.doi.org/10.1111/j.1467-842x.2002.tb00176.x.

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Griziotis, George, Christopher Hawkins, Antony G Mackinlay, and Ross H Crozier. "Genetic Variation in Mitochondrial DNA from some Aboriginal Australians." Australian Journal of Biological Sciences 40, no. 2 (1987): 171. http://dx.doi.org/10.1071/bi9870171.

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Mitochondrial (mt) DNAs from 17 aboriginal Australians, predominantly from the coastal region of the Northern Territory were isolated and digested with four four-base restriction endonucleases, two of which revealed variation between samples. The observed fragment patterns were used directly in parsimony analyses of phylogenetic relationships between the samples, and were also converted to estimates of the number of substitutions per nucleotide position between samples (0), which estimates were then used in distance analyses of phylogeny. The inferred fragment patterns of the completely sequenced 'Cambridge' human mtDNA were also included in these analyses. No strong evidence of geographic variation was found, consistent with previous findings of Australian aborigines and other humans generally, although the most divergent sample was one of two from Sydney, indicating that further work is desirable. The estimate of mean difference between samples (diversity), 0�0017 � 0�0003 (mean � 95% confidence interval), is significantly lower than that reported previously for humans generally.

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Roffee, James A. "Rhetoric, Aboriginal Australians and the Northern Territory Intervention: A Socio-legal Investigation into Pre-legislative Argumentation." International Journal for Crime, Justice and Social Democracy 5, no. 1 (March 1, 2016): 131–47. http://dx.doi.org/10.5204/ijcjsd.v5i1.285.

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Presented within this article is a systematic discourse analysis of the arguments used by the then Australian Prime Minister and also the Minister for Indigenous Affairs in explaining and justifying the extensive and contentious intervention by the federal government into remote Northern Territory Aboriginal communities. The methods used within this article extend the socio-legal toolbox, providing a contextually appropriate, interdisciplinary methodology that analyses the speech act’s rhetorical properties. Although many academics use sound-bites of pre-legislative speech in order to support their claims, this analysis is concerned with investigating the contents of the speech acts in order to understand how the Prime Minister’s and Minister for Indigenous Affairs’ argumentations sought to achieve consensus to facilitate the enactment of legislation. Those seeking to understand legislative endeavours, policy makers and speech actors will find that paying structured attention to the rhetorical properties of speech acts yields opportunities to strengthen their insight. The analysis here indicates three features in the argumentation: the duality in the Prime Minister’s and Minister’s use of the Northern Territory Government’s Little Children are Sacred report; the failure to sufficiently detail the linkages between the Intervention and the measures combatting child sexual abuse; and the omission of recognition of Aboriginal agency and consultation.

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Cleary, Paul. "Native title contestation in Western Australia's Pilbara region." International Journal for Crime, Justice and Social Democracy 3, no. 3 (December 1, 2014): 132–48. http://dx.doi.org/10.5204/ijcjsd.v3i3.182.

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The rights afforded to Indigenous Australians under the Native Title Act 1993 (NTA) are very limited and allow for undue coercion by corporate interests, contrary to the claims of many prominent authors in this field. Unlike the Commonwealth’s first land rights law, Aboriginal Lands Rights (Northern Territory) Act 1976 (ALRA) , the NTA does not offer a right of veto to Aboriginal parties; instead, they have a right to negotiate with developers, which has in practice meant very little leverage in negotiations for native title parties. And unlike ALRA, developers can deal with any Indigenous corporation, rather than land councils. These two factors have encouraged opportunistic conduct by some developers and led to vexatious litigation designed to break the resistance of native title parties, as demonstrated by the experience of Aboriginal corporations in the iron ore-rich Pilbara region of Western Australia.

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Gorman, Julian, and Sivaram Vemuri. "Social implications of bridging the gap through ‘caring for country’ in remote Indigenous communities of the Northern Territory, Australia." Rangeland Journal 34, no. 1 (2012): 63. http://dx.doi.org/10.1071/rj11037.

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‘Caring for country’ is a term used to describe the complex spiritual affiliation that encompasses the rights and responsibilities that Aboriginal Australians have with their land. It includes their custodial responsibilities for keeping the land healthy and its species abundant. This ontology and associated practice of ‘caring for country’ continues across large sections of the Northern Territory of Australia through customary practice and through the Indigenous Ranger Program. This Program has been described as a ‘two toolbox approach’, which combines traditional ecological knowledge with more conventional land management practice, to manage landscapes for their natural and cultural values. Since 2007 there have been several policy initiatives which have changed the dynamics in Aboriginal communities which in turn has affected the structure of the Indigenous Ranger Program. In response to the dire social conditions facing Aboriginal communities in the Northern Territory, the Commonwealth Government initiated the Northern Territory Emergency Response, which was a ‘top down’ approach with very little community engagement. At around the same time there was a shift in the way Indigenous Rangers jobs were funded. The unintended impact of this was a reduction in the number of Aboriginal people connected to the Ranger Program and potentially less input from culturally appropriate decision makers for land management. Another influencing policy change involved a shift in Commonwealth funding for land management from Natural Heritage Trust to Caring For Our Country funding. This new funding is more targeted and has changed the nature of the Ranger Program to being less ‘program based’ and more ‘outcome based’ by packaging many land management activities as ‘Fee for Service’ contracts. The transformation is taking place in a prescriptive manner. In this paper we advocate a more community-based approach which allows for greater community involvement in planning, decision making and governance.

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Fitzgerald, Xavier, Ana Herceg, Kirsty Douglas, and Nadeem Siddiqui. "Cardiovascular disease risk assessment in an Aboriginal community-controlled health service: comparing algorithms." Australian Journal of Primary Health 26, no. 4 (2020): 281. http://dx.doi.org/10.1071/py19216.

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Aboriginal and Torres Strait Islander people have high rates of cardiovascular disease (CVD). The National Vascular Disease Prevention Alliance (NVDPA) CVD risk assessment algorithm is used for all Australians. The Central Australian Rural Practitioners Association (CARPA) algorithm used in the Northern Territory adds five percentage points to all NVDPA risk scores for Indigenous Australians. Information was extracted from an Aboriginal Community-Controlled Health Service for all Aboriginal and Torres Strait Islander regular clients aged 35–74 years without known CVD (n=1057). CVD risk scores were calculated using both algorithms. Prescription of lipid-lowering medications was assessed. Clients with high-risk scores were reviewed and recalled if required. CVD risk scores were calculated for 362 (34.4%) clients. Clients with high CVD risk comprised 17.7% (NVDPA) or 23.8% (CARPA), with most determined clinically. Clients with low CVD risk comprised 73.7% (NVDPA) or 47.2% (CARPA). More than 30% of those with high risk were not on lipid-lowering medications. Significant health and social issues affected treatment uptake. It is unclear which algorithm is most applicable; however, this service has decided to continue to use the NVDPA algorithm. Use of CVD risk assessment and management of high-risk clients could be increased in primary care.

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Prasad, V. "PR06ï¿½MANDIBULAR FRACTURES IN INDIGENOUS AUSTRALIANS IN NORTHERN TERRITORY." ANZ Journal of Surgery 79 (May 2009): A55. http://dx.doi.org/10.1111/j.1445-2197.2009.04927_6.x.

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Li, Shu Q., Natalie J. Gray, Steve L. Guthridge, and Sabine L. M. Pircher. "Avoidable hospitalisation in Aboriginal and non‐Aboriginal people in the Northern Territory." Medical Journal of Australia 190, no. 10 (May 2009): 532–36. http://dx.doi.org/10.5694/j.1326-5377.2009.tb02551.x.

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Gibson, Odette R., and Leonie Segal. "Avoidable hospitalisation in Aboriginal and non‐Aboriginal people in the Northern Territory." Medical Journal of Australia 191, no. 7 (October 2009): 411–12. http://dx.doi.org/10.5694/j.1326-5377.2009.tb02858.x.

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31

Li, Shu Q., Natalie J. Gray, Steve L. Guthridge, and Sabine L. M. Pircher. "Avoidable hospitalisation in Aboriginal and non‐Aboriginal people in the Northern Territory." Medical Journal of Australia 191, no. 7 (October 2009): 411–12. http://dx.doi.org/10.5694/j.1326-5377.2009.tb02859.x.

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Li, Shu Q., Natalie J. Gray, Steve L. Guthridge, and Sabine L. M. Pircher. "Avoidable hospitalisation in Aboriginal and non‐Aboriginal people in the Northern Territory." Medical Journal of Australia 191, no. 10 (November 2009): 1. http://dx.doi.org/10.5694/j.1326-5377.2009.tb03296.x.

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33

Haynes, Emma, Minitja Marawili, Makungun B. Marika, Alice Mitchell, Roz Walker, Judith M. Katzenellenbogen, and Dawn Bessarab. "Living with Rheumatic Heart Disease at the Intersection of Biomedical and Aboriginal Worldviews." International Journal of Environmental Research and Public Health 19, no. 8 (April 12, 2022): 4650. http://dx.doi.org/10.3390/ijerph19084650.

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Rheumatic heart disease (RHD) significantly impacts the lives of First Nations Australians. Failure to eliminate RHD is in part attributed to healthcare strategies that fail to understand the lived experience of RHD. To rectify this, a PhD study was undertaken in the Northern Territory (NT) of Australia, combining Aboriginal ways of knowing, being and doing with interviews (24 participants from clinical and community settings) and participant observation to privilege Aboriginal voices, including the interpretations and experiences of Aboriginal co-researchers (described in the adjunct article). During analysis, Aboriginal co-researchers identified three interwoven themes: maintaining good feelings; creating clear understanding (from good information); and choosing a good djalkiri (path). These affirm a worldview that prioritises relationships, positive emotions and the wellbeing of family/community. The findings demonstrate the inter-connectedness of knowledge, choice and behaviour that become increasingly complex in stressful and traumatic health, socioeconomic, political, historical and cultural contexts. Not previously heard in the RHD domain, the findings reveal fundamental differences between Aboriginal and biomedical worldviews contributing to the failure of current approaches to communicating health messages. Mitigating this, Aboriginal co-researchers provided targeted recommendations for culturally responsive health encounters, including: communicating to create positive emotions; building trust; and providing family and community data and health messages (rather than individualistic).

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Thomas, David P., Ian P. Anderson, and Margaret A. Kelaher. "Accessibility and quality of care received in emergency departments by Aboriginal and Torres Strait Islander people." Australian Health Review 32, no. 4 (2008): 648. http://dx.doi.org/10.1071/ah080648.

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Objectives: To examine the accessibility and quality of care received in emergency departments by Aboriginal and Torres Strait Islander people compared with other Australians. Methods: We examined 2004?05 data from the National Non-admitted Patient Emergency Department Care database from the Northern Territory and Western Australia, the only jurisdictions where Indigenous identification in the database was considered acceptable. Results: In the NT, Indigenous people were 1.7 times as likely to present to an emergency department as non-Indigenous people. Indigenous patients in the NT and WA do not appear to use EDs for ?primary care? problems more than non- Indigenous patients. More NT Indigenous patients walked out before being seen or before their treatment was completed. However, Indigenous patients generally waited a similar time, and often slightly shorter, to be seen as similar non-Indigenous patients in WA and the NT. Conclusions: We recommend the regular monitoring of equity in the accessibility and quality of ED care for Indigenous people compared with other Australians. Indigenous identification in the database needs to improve so monitoring of ED performance can extend beyond WA and the NT.

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Roper, Lucinda, Vincent Yaofeng He, Oscar Perez-Concha, and Steven Guthridge. "Complex early childhood experiences: Characteristics of Northern Territory children across health, education and child protection data." PLOS ONE 18, no. 1 (January 19, 2023): e0280648. http://dx.doi.org/10.1371/journal.pone.0280648.

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Early identification of vulnerable children to protect them from harm and support them in achieving their long-term potential is a community priority. This is particularly important in the Northern Territory (NT) of Australia, where Aboriginal children are about 40% of all children, and for whom the trauma and disadvantage experienced by Aboriginal Australians has ongoing intergenerational impacts. Given that shared social determinants influence child outcomes across the domains of health, education and welfare, there is growing interest in collaborative interventions that simultaneously respond to outcomes in all domains. There is increasing recognition that many children receive services from multiple NT government agencies, however there is limited understanding of the pattern and scale of overlap of these services. In this paper, NT health, education, child protection and perinatal datasets have been linked for the first time. The records of 8,267 children born in the NT in 2006–2009 were analysed using a person-centred analytic approach. Unsupervised machine learning techniques were used to discover clusters of NT children who experience different patterns of risk. Modelling revealed four or five distinct clusters including a cluster of children who are predominantly ill and experience some neglect, a cluster who predominantly experience abuse and a cluster who predominantly experience neglect. These three, high risk clusters all have low school attendance and together comprise 10–15% of the population. There is a large group of thriving children, with low health needs, high school attendance and low CPS contact. Finally, an unexpected cluster is a modestly sized group of non-attendees, mostly Aboriginal children, who have low school attendance but are otherwise thriving. The high risk groups experience vulnerability in all three domains of health, education and child protection, supporting the need for a flexible, rather than strictly differentiated response. Interagency cooperation would be valuable to provide a suitably collective and coordinated response for the most vulnerable children.

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Fitts, Michelle S., Katrina Bird, John Gilroy, Jennifer Fleming, Alan R. Clough, Adrian Esterman, Paul Maruff, Yaqoot Fatima, and India Bohanna. "A Qualitative Study on the Transition Support Needs of Indigenous Australians Following Traumatic Brain Injury." Brain Impairment 20, no. 2 (August 22, 2019): 137–59. http://dx.doi.org/10.1017/brimp.2019.24.

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AbstractObjective:A growing body of qualitative literature globally describes post-hospital experiences during early recovery from a traumatic brain injury. For Indigenous Australians, however, little published information is available. This study aimed to understand the lived experiences of Indigenous Australians during the 6 months post-discharge, identify the help and supports accessed during transition and understand the gaps in service provision or difficulties experienced.Methods and Procedure:Semi-structured interviews were conducted at 6 months after hospital discharge to gain an understanding of the needs and lived experiences of 11 Aboriginal and Torres Strait Islander Australians who had suffered traumatic brain injury in Queensland and Northern Territory, Australia. Data were analysed using thematic analysis.Results:Five major themes were identified within the data. These were labelled ‘hospital experiences’, ‘engaging with medical and community-based supports’, ‘health and wellbeing impacts from the injury’, ‘everyday living’ and ‘family adjustments post-injury’.Conclusions:While some of the transition experiences for Indigenous Australians were similar to those found in other populations, the transition period for Indigenous Australians is influenced by additional factors in hospital and during their recovery process. Lack of meaningful interaction with treating clinicians in hospital, challenges managing direct contact with multiple service providers and the injury-related psychological impacts are some of the factors that could prevent Indigenous Australians from receiving the supports they require to achieve their best possible health outcomes in the long term. A holistic approach to care, with an individualised, coordinated transition support, may reduce the risks for re-admission with further head injuries.

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MacDonald, Kerrie T., and Alan C. Walker. "Rheumatic heart disease in Aboriginal children in the Northern Territory." Medical Journal of Australia 150, no. 9 (May 1989): 503–5. http://dx.doi.org/10.5694/j.1326-5377.1989.tb136596.x.

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Kennett, Rod, N. Munungurritj, and Djawa Yunupingu. "Migration patterns of marine turtles in the Gulf of Carpentaria, northern Australia: implications for Aboriginal management." Wildlife Research 31, no. 3 (2004): 241. http://dx.doi.org/10.1071/wr03002.

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Marine turtles regularly migrate hundreds to thousands of kilometres between nesting beaches and home foraging grounds. Effective conservation of marine turtles requires understanding of migration patterns in order to facilitate regional cooperation across the turtles' migratory range. Indigenous Australians maintain traditional rights and responsibilities for marine turtle management across much of the northern Australian coast. To better understand turtle migrations and identify with whom the Aboriginal people of north-east Arnhem Land (Yolngu) share turtles, we used satellite telemetry to track the migration routes of 20 green turtles (Chelonia mydas) departing from a nesting beach ~45 km south of Nhulunbuy, north-east Arnhem Land, Northern Territory, Australia. All tracked turtles remained within the Gulf of Carpentaria. These results suggest that the foraging habitat for adults of this nesting population may be largely confined to the Gulf, offering an optimistic scenario for green turtle conservation. Given these results and the critical role indigenous people play in conserving and managing marine turtles, we recommend that a formal network of indigenous communities be established as the foundation of a community-based turtle-management strategy for the Gulf of Carpentaria region.

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FLEMING, JILLIAN, CAROL WATSON, DAVID MCDONALD, and KERRYN ALEXANDER. "Drug use patterns in Northern Territory Aboriginal communities 1986-1987." Drug and Alcohol Review 10, no. 4 (October 1991): 367–80. http://dx.doi.org/10.1080/09595239100185421.

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40

Tyler, William. "Community-Based Strategies in Aboriginal Criminal Justice: The Northern Territory Experience." Australian & New Zealand Journal of Criminology 28, no. 2 (June 1995): 127–42. http://dx.doi.org/10.1177/000486589502800201.

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Recent attempts to involve the remote and small town communities of Northern Australia in their own policing and correctional services have often been held up as a model for developing Aboriginal criminal justice policies. Such a proposal raises important questions as to both the construction of the post-colonial ‘community’ in remote and settled Australia and the sociological principles by which these criminal justice schemes (eg night patrols, community wardens, community corrections) have been constituted. The paper explores the constructions of the Aboriginal community over the past two decades (ethnographic, politico-administrative and postmodernist) as a background to the development and implementation of community-based criminal justice schemes in the Northern Territory. A typology of post-colonial criminal justice strategies is developed which identifies four ‘ideal types’ in which the initiatives may be positioned. These are the mediative (community wardens, night patrols), the educative (community justice programs), the neo-colonialist (new forms of imposed European laws and policing) and the incorporative (pervasive and totalising forms of control). The possibility of transposing these Northern Territory schemes to other Aboriginal situations is then critically evaluated in the light of differing socio-political constructions of ‘community’.

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Zhao, Yuejen, Steve Guthridge, Anne Magnus, and Theo Vos. "Burden of disease and injury in Aboriginal and non‐Aboriginal populations in the Northern Territory." Medical Journal of Australia 180, no. 10 (May 2004): 498–502. http://dx.doi.org/10.5694/j.1326-5377.2004.tb06051.x.

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Nakata, Martin, and Elizabeth Mackinlay. "Editorial." Australian Journal of Indigenous Education 44, no. 2 (October 7, 2015): iii. http://dx.doi.org/10.1017/jie.2015.28.

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This special issue of The Australian Journal of Indigenous Education presents a second volume of papers which specifically address the issue of remote education for Indigenous Australians. ‘Red Dirt Revisited’, edited by John Guenther, presents findings from his team working on the Remote Education Systems (RES) project within the Cooperative Research Centre for Remote Economic Participation (CRC-REP). Focusing on a number of remote Aboriginal and Torres Strait Islander educational sites in the Northern Territory, Western Australia and South Australia, the RES project is now in its final stages and the main intention behind this special issue is to share significant findings from this important research. Much of the work presented here is by postgraduate students and AJIE is very pleased to be able to provide a voice and forum to support and ‘grow’ early career researchers in our field.

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Majoni, S. W., and A. Abeyaratne. "Renal transplantation in Indigenous Australians of the Northern Territory: closing the gap." Internal Medicine Journal 43, no. 10 (October 2013): 1059–66. http://dx.doi.org/10.1111/imj.12274.

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Cunningham, Joan, and John R. Condon. "Premature mortality in Aboriginal adults in the Northern Territory, 1979‐1991." Medical Journal of Australia 165, no. 6 (September 1996): 309–12. http://dx.doi.org/10.5694/j.1326-5377.1996.tb124987.x.

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Wilson, George C. "Premature mortality in Aboriginal adults in the Northern Territory, 1979–1991." Medical Journal of Australia 166, no. 5 (March 1997): 278. http://dx.doi.org/10.5694/j.1326-5377.1997.tb140120.x.

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Stephens, D. "Critical Illness and its Impact on the Aboriginal People of the Top End of the Northern Territory, Australia." Anaesthesia and Intensive Care 31, no. 3 (June 2003): 294–99. http://dx.doi.org/10.1177/0310057x0303100310.

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The Royal Darwin Hospital (RDH) services a relatively large and geographically remote Aboriginal population who account for 45% of intensive care unit admissions. Critical illness in the Aboriginal population is different from the non-Aboriginal population of the “Top End” of the Northern Territory. The critically ill Aboriginal patient is younger, has more chronic health problems and a higher severity of illness at presentation. The city and the hospital environment are foreign to many Aboriginal patients retrieved from remote communities and this adds to the stress of the critical illness. English is a second, third or fourth language for many Aboriginal people from remote communities and strategies must be put in place to ensure informed consent and effective communication are achieved. Despite the increased severity of illness and complexity, the Royal Darwin Hospital ICU achieves the same survival rates for both Aboriginal and non-Aboriginal patients.

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Treacy, Peter J., John B. North, Therese Rey-Conde, Jennifer Allen, and Robert S. Ware. "Outcomes from the Northern Territory Audit of Surgical Mortality: Aboriginal deaths." ANZ Journal of Surgery 85, no. 1-2 (November 4, 2014): 11–15. http://dx.doi.org/10.1111/ans.12896.

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Mathai, Deepa, Nadarajah Kangaharan, Marcus Ilton, Mark Haste, Hugh Auckram, and Karen Sobey. "Improving cardiac care for the Top-End Northern Territory Aboriginal patients." Heart, Lung and Circulation 28 (2019): S66. http://dx.doi.org/10.1016/j.hlc.2019.05.175.

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Condon, John R., Joan Cunningham, Tony Barnes, and Bruce K. Armstrong. "Long‐term trends in cancer mortality for Indigenous Australians in the Northern Territory." Medical Journal of Australia 180, no. 10 (May 2004): 504–7. http://dx.doi.org/10.5694/j.1326-5377.2004.tb06052.x.

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Condon, John R., Tony Barnes, Bruce K. Armstrong, Sid Selva‐Nayagam, and J. Mark Elwood. "Stage at diagnosis and cancer survival for Indigenous Australians in the Northern Territory." Medical Journal of Australia 182, no. 6 (March 2005): 277–80. http://dx.doi.org/10.5694/j.1326-5377.2005.tb06700.x.

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Journal articles on the topic 'Aboriginal Australians Northern Territory Medicine'

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