Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander Peoples’ Cultures and their Links to Health and Wellbeing

This report was funded by the Lowitja Institute and is part of the development of Mayi Kuwayu: The National Study of Aboriginal and Torres Strait Islander Wellbeing; a national longitudinal study exploring the relationship between Aboriginal Torres Strait Islander wellbeing and culture. This review was conducted to explore what cultural factors are important to Aboriginal and Torres Strait Islander people and gain an understanding of how these factors relate to health and wellbeing. We examined the Australian literature as well as publications from countries that have experienced similar colonisation events; primarily Aotearoa (New Zealand), Canada and the United States. Our main findings from this synthesis determined six main domains used to describe culture for Aboriginal and Torres Strait Islander peoples. These domains were: Connection to Country; Cultural Beliefs and Knowledge; Language; Family, Kinship and Community; Expression and Cultural Continuity; and Self-determination and Leadership.The Lowitja Institute Aboriginal and Torres Strait Islander Health Cooperative Research Centre funded this review under project 16-SDH-05-03

Data for action: The Family and Community Safety for Aboriginal and Torres Strait Islander peoples (FaCtS) Study

Purpose: The purpose of this paper is to describe the development, methodology, methods and final data resource for the Family and Community Safety for Aboriginal and Torres Strait Islander Peoples (FaCtS) Study. Improving family and community safety is a priority for Aboriginal and Torres Strait Islander communities and organisations, and governments, but to date there has been insufficient appropriate evidence to underpin action. The FaCtS Study aims to improve understanding of family and community safety and violence in Aboriginal and Torres Strait Islander communities, using mixed methods, Community-based Action Research. Methods: The FaCtS Study is an Aboriginal and Torres Strait Islander-led and governed study, founded on principles of participation and collaboration. Key components included self-nomination of partner communities, establishment of study governance structures, co development of data collection tools, locally-led data collection and collaborative decision-making around data ownership and use. The FaCtS Study is a mixed-method study in which Community Researchers were trained to undertake quantitative and qualitative research in communities, supported by the Study team. Primary data collection components included quantitative surveys and qualitative interviews and focus groups with community members and service provider staff, and identification (mapping) of services relevant to family and community violence operating in the communities. Results: Eighteen communities covering very remote, remote, regional, and urban areas in Australia self-nominated to take part in the Study. A training resource was developed, and over 30 Community Researchers were trained across participating communities. A total of 1584 eligible community member surveys, 98 service provider surveys, 56 community focus groups, 49 community member interviews, and 41 service provider interviews are available for analysis. Community-specific data were provided to each of the 18 communities and are being, or can be, used to inform local planning and/or advocacy. Conclusions: The FaCtS Study data resource provides valuable insight to inform effective community, policy, and service responses to support family and community safety and to improve service provision for those exposed to or involved in violence. It also serves as an exemplar of ethical research, demonstrating the application of Community-based Action Research principles, reciprocity, and local data ownership. To maximise the benefit that can come from the Study, confidentialised data will be available to communities, academics, services, and government agencies for approved research purposes under Indigenous data governance arrangements.The FaCtS Study was funded by the Australian Government Department of Social Services

Sugar-sweetened beverage consumption among Indigenous Australian children aged 0-3 years and association with sociodemographic, life circumstances, and health factors

OBJECTIVE: To explore beverage intake and associations between sugar-sweetened beverage (SSB) intake and sociodemographic, life circumstances, health and well-being factors in a national cohort of Indigenous children. Design: We calculated prevalence ratios for any SSB consumption across exposures, using multilevel Poisson regression (robust variance), adjusted for age group and remoteness. A key informant focus group contextualised these exploratory findings. SETTING: Diverse settings across Australia. PARTICIPANTS: Families of Indigenous children aged 0–3 years, in the Longitudinal Study of Indigenous Children. RESULTS: Half (50·7 %, n 473/933) of children had ever consumed SSB at survey, increasing from 29·3 % of 0–12-month-olds to 65·7 % of 18–36-month-olds. SSB consumption prevalence was significantly lower in urban and regional v. remote areas, and in families experiencing socio-economic advantage (area-level advantage, caregiver employed, financial security), better life circumstances (caregiver social support, limited exposure to stressors) and caregiver well-being (non-smoking, social and emotional well-being, physical health). SSB consumption prevalence was significantly lower among those engaged with health services (adequate health-service access, regular prenatal check-ups), except SSB consumption prevalence was higher among those who received home visits from an Aboriginal Health Worker compared with no home visits. Key informants highlighted the role of water quality/safety on SSB consumption. CONCLUSIONS: A substantial proportion of Indigenous children in this sample consumed SSB from an early age. Health provider information needs to be relevant to the context of families’ lives. Health system strategies must be paired with upstream strategies, such as holistic support programmes for families, reducing racism and improving water quality.The work was supported by the Lowitja Institute (K.A.T., reference number 1344); the National Health and Medical Research Council (R.L., reference number 1042717); the Cancer Disparities Research Network/Geographic Management Program (GMaP) Region 4 (A.G.C., reference number 3 P30 CA006927-52S2); and CTSI Mentored Career Development Award (A.G.C., reference number KL2 TR002545

'The answers were there before white man come in': stories of strength and resilience for responding to violence in Aboriginal and Torres Strait Islander communities - Family Community Safety for Aboriginal and Torres Strait Islander Peoples Study Report

In 2017, the Department of Social Services (DSS) commissioned The Australian National University to undertake the Family and Community Safety for Aboriginal and Torres Strait Islander Peoples (FaCtS) Study. The study was designed to answer the overarching question: What would it take to effectively address family and community violence in Aboriginal and Torres Strait Islander communities? We sought to answer this question by gathering both qualitative and quantitative data from community members and service providers. Our findings are augmented by a literature review. From the outset, the study team recognised that research leadership by Aboriginal and Torres Strait Islander people was fundamental to generating meaningful data. We believed that this would lead to findings valuable for informing actions by communities, service providers and the government that will be effective in reducing the incidence and impacts of violence in Aboriginal and Torres Strait Islander families and communities. To that end, the FaCtS Study is an Aboriginal and Torres Strait Islander-led and governed study which privileges Aboriginal and Torres Strait Islander voices, cultures and knowledge. It makes a significant contribution to the currently limited evidence available to inform communities, policymakers and service providers about effectively supporting those Aboriginal and Torres Strait Islander peoples, families and communities who experience and are exposed to family and community violence. We present implications for action and solutions that emerged through interviews, focus groups and surveys with community members and service providersThis report was commisioned by ANU College of Health & Medicin

Rare predicted loss-of-function variants of type I IFN immunity genes are associated with life-threatening COVID-19

BackgroundWe previously reported that impaired type I IFN activity, due to inborn errors of TLR3- and TLR7-dependent type I interferon (IFN) immunity or to autoantibodies against type I IFN, account for 15-20% of cases of life-threatening COVID-19 in unvaccinated patients. Therefore, the determinants of life-threatening COVID-19 remain to be identified in similar to 80% of cases.MethodsWe report here a genome-wide rare variant burden association analysis in 3269 unvaccinated patients with life-threatening COVID-19, and 1373 unvaccinated SARS-CoV-2-infected individuals without pneumonia. Among the 928 patients tested for autoantibodies against type I IFN, a quarter (234) were positive and were excluded.ResultsNo gene reached genome-wide significance. Under a recessive model, the most significant gene with at-risk variants was TLR7, with an OR of 27.68 (95%CI 1.5-528.7, P=1.1x10(-4)) for biochemically loss-of-function (bLOF) variants. We replicated the enrichment in rare predicted LOF (pLOF) variants at 13 influenza susceptibility loci involved in TLR3-dependent type I IFN immunity (OR=3.70[95%CI 1.3-8.2], P=2.1x10(-4)). This enrichment was further strengthened by (1) adding the recently reported TYK2 and TLR7 COVID-19 loci, particularly under a recessive model (OR=19.65[95%CI 2.1-2635.4], P=3.4x10(-3)), and (2) considering as pLOF branchpoint variants with potentially strong impacts on splicing among the 15 loci (OR=4.40[9%CI 2.3-8.4], P=7.7x10(-8)). Finally, the patients with pLOF/bLOF variants at these 15 loci were significantly younger (mean age [SD]=43.3 [20.3] years) than the other patients (56.0 [17.3] years; P=1.68x10(-5)).ConclusionsRare variants of TLR3- and TLR7-dependent type I IFN immunity genes can underlie life-threatening COVID-19, particularly with recessive inheritance, in patients under 60 years old