The social and emotional wellbeing of Indigenous youth: reviewing and extending the evidence and examining its implications for policy and practice

This report contains a synthesis of learnings from in depth case studies with six programs that explicitly aim to promote the social and emotional wellbeing of Aboriginal and Torres Strait Islander young people through art and mural making, caring for country, cultural celebration, school programs and mentoring. The report offers advice and tools for policy and practice in striving for effectiveness, sustainability, growth and achievement of potential. Executive summary Background to the study The project began with the recognition that many Aboriginal and Torres Strait Islander young people experience life circumstances that seriously challenge their social and emotional wellbeing and limit their capacity to fulfill their life potential. This most likely contributes to and results from the visible disparities across most measures of health, education, employment and involvement in the justice system. In this same space, however, there are many reports of programs that help young Aboriginal and Torres Strait Islander people build their strength and resilience by discovering their creativity, capability, leadership potential and achievement. Limited systematic attempts have been made to articulate the factors that are critical to achieving success, sustainability and growth of promotion, prevention, early intervention and treatment/support services and programs working to support the social and emotional wellbeing of Aboriginal and Torres Strait Islander young people. The Commonwealth Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA) has recognised the need to become better informed about how policy can support good practice – what works – to promote the social and emotional wellbeing (SEWB) of Aboriginal and Torres Strait Islander youth. Overall aims and methods The aim of this project was to obtain a deeper and broader understanding of current knowledge in this area and translate this understanding into practical and useful information to enhance policy, resource allocation decisions and practice. The project involved four components with each informing the next, namely: a systematic review of the existing published and grey literature covering research on Aboriginal and Torres Strait Islander youth SEWB up to 2010; a review of current policies at national and jurisdictional levels and a review of programs and services specifically addressing Aboriginal and Torres Strait Islander youth SEWB; completion of in-depth case studies of six programs with evidence of success and capacity to inform across a range of settings and groups. These studies utilized a structured, focussed comparison and appreciative inquiry approach to capture insightful explorations by those with hands on experience. The data included program-specific documents, interviews with program participants, developers, deliverers, managers and stakeholders and participant observations; and cross-case analyses identifying themes and variations across the six case studies and a metasynthesis generating four sets of key distilled and cohesive messages to advance theory and assist policy and practice to foster program strength and impact. Authored by Melissa R. Haswell, Ilse Blignault, Sally Fitzpatrick and Lisa Jackson Pulver

The well-being of carers of older Aboriginal people living in the Kimberley region of remote Western Australia: Empowerment, depression, and carer burden

Objective: To describe demographic features and well-being of carers of Aboriginal Australians aged ≥45 years in remote Western Australia. Method: Carer burden, empowerment, and depression were assessed in 124 Aboriginal carers in four remote Aboriginal communities. Results: Carers were aged 38.8 ± 15.0 years, 73.4% were female, and 75.8% were children or grandchildren of the person cared for. The mean Zarit-6 score was 3.7 ± 3.6. Attending high school (odds ratio [OR] = 0.3; 95% confidence interval [CI] = [0.1, 0.7]) and feeling empowered (OR = 0.2; 95% CI = [0.1, 0.8]) were inversely associated with carer burden; female carers were less likely to feel empowered (OR = 0.4; 95% CI = [0.2, 0.9]); and empowerment was inversely associated with depression (OR = 0.3; 95% CI = [0.1, 0.7]). Discussion: Aboriginal carers in remote communities are relatively young and most are children or grandchildren. Carer burden was lower than anticipated. However, existing tools may not adequately measure Aboriginal perspectives. Education and empowerment are key factors which support programs must consider

Returning home, back to community from custodial care: Learnings from the first year pilot project evaluation of three sites around Australia

Muru Marri was requested by the Australian Primary Health Care Research Institute to conduct an evaluation of the “Returning Home, Back to Community from Custodial Care” program funded by the Department of Health and Ageing. The program is commencing at three Medicare Locals in Geraldton WA, Townsville QLD and Blacktown NSW. The Program aims to implement effective and feasible models of care to Aboriginal and Torres Strait Islander women who have served a custodial sentence and are returning back home. In order to be effective, the program will need to put in place sustainable processes to assist women to address the current health, social, housing, income, employment and practical challenges that they face, which make post-release a particularly vulnerable time. This program adopts a holistic model of care approach involving coordinated and integrated case management and structures to facilitate re-engagement with a range of service providers in the communities they return to. To be sustainable, the assistance provided also must strengthen the women’s own capacity, resilience and support networks to create the life circumstances that provide meaning, purpose and direction to their future.The research reported in this paper is a project of the Australian Primary Health Care Research Institute which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research Evaluation and Development Strategy

Indigenous Health – Australia, Canada, New Zealand and the United States - Laying Claim to a Future that Embraces Health for Us All.

Improving the health of all peoples has been a call across the globe for many decades and unfortunately remains relevant today, particularly given the large disparities in health status of peoples found around the world. Rather than differences in health, or health inequalities, we use a different term, health inequities. This is so as mere differences in health (or inequalities ) can be common in societies and do not necessarily reflect unfair social policies or practices. For example, natural ageing implies older people are more prone to illness. Yet, when differences are systematic, socially produced and unfair, these are considered health inequities. Certainly making judgments on what is systematic, socially produced and unfair, reflects value judgments and merit open debate. We are making explicit in this paper what our judgments are, and the basis for these judgment

Defining success in graduate school

[Response to Weiner OD (2014) How should we be selecting our graduate students. Mol Biol Cell 25:429–430. doi: 10.1091/mbc.E13-11-0646.

Diagnosis of helminths depends on worm fecundity and the distribution of parasites within hosts

Helminth transmission and morbidity are dependent on the number of mature parasites within a host; however, observing adult worms is impossible for many natural infections. An outstanding challenge is therefore relating routine diagnostics, such as faecal egg counts, to the underlying worm burden. This relationship is complicated by density-dependent fecundity (egg output per worm reduces due to crowding at high burdens) and the skewed distribution of parasites (majority of helminths aggregated in a small fraction of hosts). We address these questions for the carcinogenic liver fluke Opisthorchis viverrini, which infects approximately 10 million people across Southeast Asia, by analysing five epidemiological surveys (n = 641) where adult flukes were recovered. Using a mechanistic model, we show that parasite fecundity varies between populations, with surveys from Thailand and Laos demonstrating distinct patterns of egg output and density-dependence. As the probability of observing faecal eggs increases with the number of mature parasites within a host, we quantify diagnostic sensitivity as a function of the worm burden and find that greater than 50% of cases are misdiagnosed as false negative in communities close to elimination. Finally, we demonstrate that the relationship between observed prevalence from routine diagnostics and true prevalence is nonlinear and strongly influenced by parasite aggregation

Safe levels of cadmium intake to prevent renal toxicity in human subjects

The present review attempts to provide an update of the scientific knowledge on the renal toxicity which occurs in human subjects as a result of chronic ingestion of low-level dietary Cd. It highlights important features of Cd toxicology and sources of uncertainty in the assessment of health risk due to dietary Cd. It also discusses potential mechanisms for increased susceptibility to Cd toxicity in individuals with diabetes. Exposure assessment on the basis of Cd levels in foodstuffs reveals that vegetables and cereals are the main sources of dietary Cd, although Cd is also found in meat, albeit to a lesser extent. Cd accumulates particularly in the kidney and liver, and hence offal contains relatively high amounts. Fish contains only small quantities of Cd, while crustaceans and molluscs may accumulate larger amounts from the aquatic environment. Data on Cd accumulation in human kidney and liver obtained from autopsy studies are presented, along with results of epidemiological studies showing the relationship between renal tubular dysfunction and kidney Cd burden. These findings suggest that a kidney Cd level of 50 mug/g wet weight is a maximum tolerable level in order to avoid abnormal kidney function. This renal Cd burden corresponds to a urinary Cd excretion of 2 mug/d. Accordingly, safe daily levels of Cd intake should be kept below 30 mug per person. Individual variations in Cd absorption and sensitivity to toxicity predicts that a dietary Cd intake of 30 mug/d may result in a slight renal dysfunction in about 1% of the adult population. The previous guideline for a maximum recommended Cd intake of 1 mug/kg body weight per d is thus shown to be too high to ensure that renal dysfunction does not occur as a result of dietary Cd intake

The genetic architecture of the human cerebral cortex

The cerebral cortex underlies our complex cognitive capabilities, yet little is known about the specific genetic loci that influence human cortical structure. To identify genetic variants that affect cortical structure, we conducted a genome-wide association meta-analysis of brain magnetic resonance imaging data from 51,665 individuals. We analyzed the surface area and average thickness of the whole cortex and 34 regions with known functional specializations. We identified 199 significant loci and found significant enrichment for loci influencing total surface area within regulatory elements that are active during prenatal cortical development, supporting the radial unit hypothesis. Loci that affect regional surface area cluster near genes in Wnt signaling pathways, which influence progenitor expansion and areal identity. Variation in cortical structure is genetically correlated with cognitive function, Parkinson's disease, insomnia, depression, neuroticism, and attention deficit hyperactivity disorder

The genetic architecture of the human cerebral cortex

The cerebral cortex underlies our complex cognitive capabilities, yet little is known about the specific genetic loci that influence human cortical structure. To identify genetic variants that affect cortical structure, we conducted a genome-wide association meta-analysis of brain magnetic resonance imaging data from 51,665 individuals. We analyzed the surface area and average thickness of the whole cortex and 34 regions with known functional specializations. We identified 199 significant loci and found significant enrichment for loci influencing total surface area within regulatory elements that are active during prenatal cortical development, supporting the radial unit hypothesis. Loci that affect regional surface area cluster near genes in Wnt signaling pathways, which influence progenitor expansion and areal identity. Variation in cortical structure is genetically correlated with cognitive function, Parkinson's disease, insomnia, depression, neuroticism, and attention deficit hyperactivity disorder