Understanding practitioner professionalism in Aboriginal and Torres Strait Islander health: lessons from student and registrar placements at an urban Aboriginal and Torres Strait Islander primary health care service

Aboriginal and Torres Strait Islander peoples continue to be pathologised in medical curriculum, leaving graduates feeling unequipped to effectively work cross-culturally. These factors create barriers to culturally safe health care for Aboriginal and Torres Strait Islander peoples. In this pilot pre-post study, we followed the learning experiences of 7 medical students and 4 medical registrars undertaking clinical placements at an urban Aboriginal and Torres Strait Islander primary health care service in 2014. Through analysis and comparison of pre- and post-placement responses to a paper-based case study of a fictitious Aboriginal patient, we identified four learning principles for medical professionalism: student exposure to nuanced, complex and positive representations of Aboriginal peoples; positive practitioner role modelling; interpersonal skills that build trust and minimise patient-practitioner relational power imbalances; and, knowledge, understanding and skills for providing patient centred, holistic care. Though not exhaustive, these principles can increase the capacity of practitioners to foster culturally safe and optimal health care for Aboriginal peoples. Furthermore, competence and effectiveness in Aboriginal health contexts is an essential component of medical professionalism

Healing conversations: Developing a practical framework for clinical communication between Aboriginal communities and healthcare practitioners

In recognition of the ongoing health disparities experienced by Aboriginal and Torres Strait Islander peoples (hereafter Aboriginal), this scoping review explores the role and impact of the clinical communication process on Aboriginal healthcare provision. A medical education lens is applied, looking at the utility of a tailored clinical communication framework to assist health practitioners work more effectively with Aboriginal peoples and communities. The initial framework, building on existing communication guides, proposes four domains: content, process, relational and environmental. It places emphasis on critical self-reflection of the health practitioner’s own cultural identity and will be guided by collective Aboriginal world-views in select Australian settings. Using a two-eyed seeing approach the framework will be developed and tested in health professional education. The aim of this research journey is to enable health practitioners to have more effective healthcare conversations with Aboriginal peoples, working toward more socially just and equitable healthcare interactions and outcome

Putting an End to the Silence: Educating Society about the Canadian Residential School System

This paper advocates for the increased education of Canadian society regarding the Indian Residential School System. Many Canadian’s tend to be uninformed on the history of the schools and as a result risk subjecting Aboriginal peoples to further harm. The contents of this paper demonstrates by informing all Canadian citizens of the truth regarding the assimilative schools and their enduring legacy on Aboriginal peoples, several benefits can occur. Specifically, through revealing the truth regarding the residential schools, healing becomes possible for victims, over-representation within the criminal justice system can be better understood as well as addressed, and future harm can be more easily identified as well as prevented. Overall, remaining silent and uninformed about Canadian residential schools can be harmful to Aboriginal peoples, thus it is important society be informed on this history

THE URGENCY OF POSTSECONDARY EDUCATION FOR ABORIGINAL PEOPLES

Canada has an unprecedented need to increase the number of Aboriginal peoples who undertake and complete postsecondary programs. Endorsing postsecondary education for Aboriginal peoples advocates an invigorating, fortifying future for Aboriginal peoples, their families, and their communities. Additionally, the postsecondary educational achievements of Aboriginal peoples support the health and sustainability of the Canadian nation; spearheaded by Western Canada’s current economic prosperity, human resources supplied by Aboriginal peoples have become increasingly important. Captured herein are demographic, social, educational, and economic trends reinforcing the rationale that Aboriginal peoples urgently need to be provided with greater opportunities to succeed in postsecondary education.

'We got needs too': Aboriginal and Torres Strait Islander students in urban areas (Speaker's notes)

Despite over 70 % of all Aboriginal and Torres Strait Islander people in Australia now living in urban or regional urban areas (ABS 2008), there is limited research which highlights their issues or the issues that impact on their education outcomes. The statistics demonstrate that living in urban centres is as much part of reality for Aboriginal and Torres Strait Islander people as living in a remote discrete community. This paper will explore some of the issues for urban Aboriginal and Torres Strait Islander peoples against a backdrop of statistics and some of the current literature. Examples will be highlighted from the South-East Queensland region to expose the need for specific education strategies and programs for Aboriginal and Torres Strait Islander peoples in this region and in other urbanised regions in Queensland and Australia

Waterfowl Harvest Benefits in Northern Aboriginal Communities and Potential Climate Change Impacts

Migratory waterfowl are important to the diets of residents in Canada’s northern communities. Contrary to recreational hunters, indigenous peoples have rights to harvest wildlife for subsistence needs without permits. As a result, migratory waterfowl are an important component of diets of Aboriginal peoples in northern Canada, substituting for expensive beef transported from the south. Wild geese and duck provide many benefits to native people, including improved nutrition and health. In this paper, scaled-down data from global climate models are used in a wildlife model to project potential migratory waterfowl abundance in the Northwest Territories for three future periods up to 2080. The models project potential future harvests of geese and ducks by Aboriginal hunters and the financial and nutritional benefits. It turns out that northern Aboriginal peoples can benefit significantly as a result of climate change that affects migratory waterfowl, but likely at the expense of hunters and recreationists in other regions of North America.subsistence harvests by indigenous peoples; diet and nutrition; climate change

Incidence and Prevalence of Chronic Obstructive Pulmonary Disease among Aboriginal Peoples in Alberta, Canada

Background Chronic obstructive pulmonary disease (COPD) is a major respiratory disorder, largely caused by smoking that has been linked with large health inequalities worldwide. There are important gaps in our knowledge about how COPD affects Aboriginal peoples. This retrospective cohort study assessed the epidemiology of COPD in a cohort of Aboriginal peoples relative to a non-Aboriginal cohort. Methods We used linkage of administrative health databases in Alberta (Canada) from April 1, 2002 to March 31, 2010 to compare the annual prevalence, and the incidence rates of COPD between Aboriginal and non-Aboriginal cohorts aged 35 years and older. Poisson regression models adjusted the analysis for important sociodemographic factors. Results Compared to a non-Aboriginal cohort, prevalence estimates of COPD from 2002 to 2010 were 2.3 to 2.4 times greater among Registered First Nations peoples, followed by the Inuit (1.86 to 2.10 times higher) and the Métis (1.59 to 1.67 times higher). All Aboriginal peoples had significantly higher COPD incidence rates than the non-Aboriginal group (incidence rate ratio [IRR]: 2.1; 95% confidence interval [CI]: 1.97, 2.27). COPD incidence rates were higher in First Nation peoples (IRR: 2.37; 95% CI: 2.19, 2.56) followed by Inuit (IRR: 1.92; 95% CI: 1.64, 2.25) and Métis (IRR: 1.49; 95% CI: 1.32, 1.69) groups. Conclusions We found a high burden of COPD among Aboriginal peoples living in Alberta; a province with the third largest Aboriginal population in Canada. Altogether, the three Aboriginal peoples groups have higher prevalence and incidence of COPD compared to a non-Aboriginal cohort. The condition affects the three Aboriginal groups differently; Registered First Nations and Inuit have the highest burden of COPD. Reasons for these differences should be further explored within a framework of social determinants of health to help designing interventions that effectively influence modifiable COPD risk factors in each of the Aboriginal groups

Les activités internationales des autochtones du Canada

Aboriginal peoples of Canada have never limited themselves to the national scène in their struggle to obtain the recognition of their collective rights and powers. Since 1974, this phenomenon has increased noticeably and the international activities of Aboriginal peoples can be seen as a major event in Canadian external affairs. However, Aboriginal peoples of Canada are not a homogenous group. Their participation in the international Systems or institutions is as varied as the traditions and the expectations of each aboriginal nation towards political action. Beyond a typology of the external relations of Aboriginal peoples, the approach used in this article offers new perspectives over the extent and the meaning of their international personality : without being a condition of aboriginal self-government, the participation in the international arena is certainly promoting the realization of this ideal

National Indigenous Palliative Care Needs Study

This study involved extensive consultation with the community to identify the needs of Aboriginal and Torres Strait Islander peoples in palliative care

'Big mobs in the city now' : the increasing number of Aboriginal and Torres Strait Islander people living in urban areas

The locations and settings in which Australian Indigenous people live varies, however over 70 % of all Aboriginal and Torres Strait Islander people in Australia now live in urban or regional urban areas (ABS 2008). Over half of the total population lives in the two states Queensland and New South Wales. The 2006 Census data indicates that 146, 400 Aboriginal and Torres Strait Islander peoples or 28.3% lives in Queensland. The number of Aboriginal and Torres Strait Islander students in schools in the greater Brisbane area is approximately 29% of the Queensland population. There are other sizeable urban Indigenous populations along the Queensland coast and larger rural towns. The statistics demonstrate that living in urban centres is as much part of reality for Aboriginal and Torres Strait Islander people as living in a remote discrete Aboriginal community. Historically, discrete rural and remote Aboriginal and Torres Strait Islander communities have been the focus of most of the research conducted with Indigenous populations. These locations have provided researchers with an easily identifiable study population. However, unlike rural and remote communities, identifying and accessing urban Indigenous communities can be much more difficult despite the growing number of Aboriginal and Torres Strait Islander people living in urban areas. Limited research has been undertaken on the issues that impact on urban Indigenous communities or have explored methods of undertaking research with urban Indigenous communities. This paper will explore the some of the issues and needs of urban Aboriginal and Torres Strait Islander peoples in South East Queensland and highlight some of the emerging policy, program and research responses