Australian Aborigines Research Articles

Inequalities between Aboriginal and non-Aboriginal Australians seen through the lens of oral health: time to change focus.

Inequitable social environments can illustrate changes needed in the social structure to generate more equitable social relations and behaviour. In Australia, British colonization left an intergenerational legacy of racism against Aboriginal people, who are disadvantaged across various social indicators including oral health. Aboriginal Australian children have poorer health outcomes with twice the rate of dental caries as non-Aboriginal children. Our research suggests structural factors outside individual control, including access to and cost of dental services and discrimination from service providers, prevent many Aboriginal families from making optimum oral health decisions, including returning to services. Nader's concept of 'studying up' redirects the lens onto powerful institutions and governing bodies to account for their role in undermining good health outcomes, indicating changes needed in the social structure to improve equality. Policymakers and health providers can critically reflect on structural advantages accorded to whiteness in a colonized country, where power and privilege that often go unnoticed and unexamined by those who benefit incur disadvantages to Aboriginal Australians, as reflected in inequitable oral health outcomes. This approach disrupts the discourse placing Aboriginal people at the centre of the problem. Instead, refocusing the lens onto structural factors will show how those factors can compromise rather than improve health outcomes. This article is part of the theme issue 'Evolutionary ecology of inequality'.

Clinicians' views on cognitive assessment with Aboriginal Australians.

A shortage of standardised cognitive assessment tools for use with Aboriginal Australians is evident. Clinicians also miss the range of guidelines necessary to inform test selection and interpretation for all Aboriginal clients. This mixed methods study examines clinicians' confidence, views and current practices when conducting cognitive assessments with Aboriginal Australian clients. Clinicians were asked about factors that influence their likelihood of using standardised testing in Aboriginal vs non-Indigenous Australian people. Twenty-one health professionals with experience conducting cognitive assessments with Aboriginal and non-Aboriginal Australians participated. Clinicians were presented with a series of different scenarios per the client's level of education and language of origin via an online survey. Clinicians rated their likelihood and confidence using standardised cognitive assessment for each scenario. Open-ended questions captured clinicians' views and information about their current clinical practices. Clients' age, education and language of origin influence the likelihood of clinicians' use of standardised cognitive assessment measures with Aboriginal people. Overall, clinicians reported feeling only slightly more confident working with non-Indigenous clients than Aboriginal clients. Qualitative data indicate a lack of consistency regarding test selection. Clinicians expressed concerns about the validity of available cognitive assessment tools for use with Aboriginal Australians and the absence of evidence to assist decision-making. Cited barriers included language, educational attainment and cultural factors.

The effect of general practice contact on cancer stage at diagnosis in Aboriginal and non-Aboriginal residents of New South Wales

PurposeOlder age, risks from pre-existing health conditions and socio-economic disadvantage are negatively related to the prospects of an early-stage cancer diagnosis. With older Aboriginal Australians having an elevated prevalence of these underlying factors, this study examines the potential for the mitigating effects of more frequent contact with general practitioners (GPs) in ensuring local-stage at diagnosis.MethodsWe compared the odds of local vs. more advanced stage at diagnosis of solid tumours according to GP contact, using linked registry and administrative data. Results were compared between Aboriginal (n = 4,084) and non-Aboriginal (n = 249,037) people aged 50 + years in New South Wales with a first diagnosis of cancer in 2003–2016.ResultsYounger age, male sex, having less area-based socio-economic disadvantage, and fewer comorbid conditions in the 12 months before diagnosis (0–2 vs. 3 +), were associated with local-stage in fully-adjusted structural models. The odds of local-stage with more frequent GP contact (14 + contacts per annum) also differed by Aboriginal status, with a higher adjusted odds ratio (aOR) of local-stage for frequent GP contact among Aboriginal people (aOR = 1.29; 95% CI 1.11–1.49) but not among non-Aboriginal people (aOR = 0.97; 95% CI 0.95–0.99).ConclusionOlder Aboriginal Australians diagnosed with cancer experience more comorbid conditions and more socioeconomic disadvantage than other Australians, which are negatively related to diagnosis at a local-cancer stage. More frequent GP contact may act to partly offset this among the Aboriginal population of NSW.

Incidence of Stroke in the Aboriginal and Non-Aboriginal Populations of Australia: A Data Linkage Study.

Most estimates of stroke incidence among Aboriginal and Torres Strait Islander (hereinafter Aboriginal) Australians are confined to single regions and include small sample sizes. We aimed to measure and compare stroke incidence in Aboriginal and non-Aboriginal residents across central and western Australia. Whole-population multijurisdictional person-linked data from hospital and death datasets were used to identify stroke admissions and stroke-related deaths (2001-2015) in Western Australia, South Australia, and the Northern Territory. Fatal (including out-of-hospital deaths) and nonfatal incident (first-ever) strokes in patients aged 20-84 years were identified during the 4-year study period (2012-2015), using a 10-year lookback period to exclude people with prior stroke. Incidence rates per 100 000 population/year were estimated for Aboriginal and non-Aboriginal populations, age-standardized to the World Health Organization World Standard population. In a population of 3 223 711 people (3.7% Aboriginal), 11 740 incident (first-ever) strokes (20.6% regional/remote location of residence; 15.6% fatal) were identified from 2012 to 2015, 675 (5.7%) in Aboriginal people (73.6% regional/remote; 17.0% fatal). Median age of Aboriginal cases (54.5 years; 50.1% female) was 16 years younger than non-Aboriginal cases (70.3 years; 44.1% female; P<0.001), with significantly greater prevalence of comorbidities. Age-standardized stroke incidence in Aboriginal people (192/100 000 [95% CI, 177-208]) was 2.9-fold greater than in non-Aboriginal people (66/100 000 [95% CI, 65-68]) aged 20-84 years; fatal incidence was 4.2-fold greater (38/100 000 [95% CI, 31-46] versus 9/100 000 [95% CI, 9-10]). Disparities were particularly apparent at younger ages (20-54 years), where age-standardized stroke incidence was 4.3-fold greater in Aboriginal people (90/100 000 [95% CI, 81-100]) than non-Aboriginal people (21/100 000 [95% CI, 20-22]). Stroke occurred more commonly, and at younger ages, in Aboriginal than non-Aboriginal populations. Greater prevalence of baseline comorbidities was present in the younger Aboriginal population. Improved primary prevention is required. To optimize stroke prevention, interventions should include culturally appropriate community-based health promotion and integrated support for nonmetropolitan health services.

Connections across the Coral Sea

The absence of archaeological narratives in Australian museums reflects a complex post-colonial history of research and museology. In this context,Connections across the Coral Seaat the Queensland Museum (December 2021 to 9 July 2023), Brisbane, is a welcome contribution to the important mission of sharing the ancient Australian past with the public. This object-rich exhibition illuminates the lives of coastal peoples, as understood through the ‘Coral Sea Cultural Interaction Sphere’ hypothesis—that is, the idea that during the late Holocene, this was a region of substantial maritime-based exchange between mainland Aboriginal Australians inhabiting Cape York and the peoples of the south coast of Papua New Guinea and the Torres Strait Islands (see McNivenet al.2004; Figure 1). The key archaeological content on display includes evidence from excavations on Lizard Island (Jiigurru) off the east coast of Cape York, short films on the Cultural Interaction Sphere hypothesis and how it has been investigated, and a 3D-printed stratigraphic section accompanied by an impressive interactive virtual stratigraphic section (Figure 2). Proponents of the Coral Sea Cultural Interaction Sphere hypothesis argue that, although groups shared ideas, they continued to maintain their individual identities, in many cases choosing not to adopt technologies used in other areas (e.g. the continued use of spear throwers in Australia versus bows and arrows in the Torres Strait Islands and Papua New Guinea).

The Aboriginal Australians and the League of Coloured Peoples in London

During the 1930s and into the 1940s, the League of Coloured Peoples in London, part of the Black diaspora with links to the West Indies, included Aboriginal Australia among its global concerns. This article sets out to investigate the LCP’s efforts, through its newsletter and by direct appeals to Australian governments, to promote the rights of Indigenous Australians. It did so as one aspect of its larger agenda as a Black organisation to shape the future of the British Commonwealth and end white racism globally. This hitherto overlooked aspect of the League’s history was informed in part by its interactions with the Anti-Slavery Society and the British Commonwealth League, two networks with Australian participants based in London that are more usually associated with internationalising the Aboriginal cause in this era. At the same time as the LCP was claiming to speak for Aboriginal Australia, however, Indigenous activists were promoting their own reform agendas and actively engaging in internationalism largely from within Australia.

No Longer Indigenous

Investigating individual level-Indigenous identification change by Aboriginal and Torres Strait Islander Australians has been enabled through the linkage of census data across time. This study focusses on the population who moved from an identification of Indigenous in the 2011 census to not Indigenous in the 2016 census. We calculated transition probabilities for a range of personal characteristics to investigate the influence of broad life-course transitions on the pattern of identification change. In addition to age, we found that sex, employment, mixed ancestry, interstate migration, and living arrangements had the strongest associations with the risk of a transition to not Indigenous. The highest transition probabilities were at each end of the adult life-course and the role of “not stated” was implicated, destabilising assumptions that decisions to identify as Indigenous, or not, always reflect personal agency. Finally, the paper challenges the adequacy of an origin-based identity question to define the increasingly complex ethnic histories of Aboriginal and/or Torres Strait Islander people. Both improved definition and enumeration of Indigenous Australians are fundamental to current national conversations about constitutional recognition and continuing gaps in measured health and wellbeing.

The Impact of Lung Function Parameters on Sleep Among Aboriginal Australians - A Polysomnography and Spirometry Relationship Study.

Sleep disorders such as obstructive sleep apnoea (OSA) are known to overlap significantly with airway diseases in various populations. This study assessed the relationship between lung function parameters against polysomnography (PSG) and continuous positive airway pressure (CPAP) adherence data amongst an Aboriginal Australian population. Patients who undertook both a diagnostic PSG and spirometry were included. Restrictive, obstructive, and mixed impairments were assessed via global lung function initiative (GLI-2012, ATS/ERS) criteria/guidelines. PSG and CPAP data were evaluated between patients with or without spirometry impairments. Of the total 771 patients, 248 had PSG and spirometry data available (52% female, 44% remote residents, 78% obese). The majority (89%) had OSA (51% severe), 95 (38%) were observed to have a restrictive impairment, and 31 (13%) had an obstructive or mixed impairment on spirometry. Compared to patients with no spirometric impairment, those with restrictive or obstructive/mixed impairments demonstrated significantly lower sleep efficiency (median 84% vs 79% and 78%), higher apnoea-hypopnea index (AHI) during rapid eye movement (REM) sleep (median 32 vs 52 and 55 events/hour), reduced REM oxygen saturation (SpO2) (median 94.0% vs 92.0% and 92.5%) and reduced adherence to CPAP therapy (median 39% vs 22% and 17%). Differences in sleep efficiency, REM AHI, and NREM SpO2 held for patients with obstructive/mixed impairments in multivariate modelling. Aboriginal Australian patients with OSA have a higher concurrent lung function' impairment. Spirometric impairment appears to negatively influence sleep efficiency, nocturnal SpO2 and CPAP adherence. This may have substantial implications for OSA management among Aboriginal Australians.

Competing visions of ‘the people’ in Australia: First Nations and the state

In 2020 the Australian High Court decided the case of Love v. Commonwealth; Thoms v. Commonwealth, a claim of constitutional belonging by two Aboriginal men. The Court was fractured in its reasoning and conclusion, a majority deciding that ‘Aboriginal Australians’ cannot be aliens. The case sits within a longer and ongoing story regarding the interaction between First Nations peoples and the Australian settler colonial state. The reasoning of the Love/Thoms case reveals two contrasting visions of the constitutional identity of ‘the people’ – one being a plural and diverse conception potentially capable of accommodating a distinct identity of First Nations peoples, the other being a unified conception dominated by formal equality and democratic participation. A study of the Love/Thoms case in its context also speaks to broader questions of constitutional identity. First, that constitutional identity is constructed through the interaction of multiple actors. It is through an ongoing dialogic between constitutional actors that constitutional identity evolves over time. Second, that there is a relationship between the identity of ‘the people’ and of their Constitution. A study of the construction of the constitutional identity of ‘the people’ in this case reveals principal characteristics of the Australian state’s constitutionalism: going to institutional and substantive questions regarding the respective roles of the people and the Courts, equality and sovereignty.

Co‐design of an Aboriginal Health Practitioner‐led dementia prevention program (DAMPAA) using a Theory of Change framework

AbstractBackgroundDementia prevalence and incidence in Aboriginal Australians is three to five times that of the general population. Many of the known risk factors for dementia in this population are modifiable (e.g., head injury, hypertension, previous stroke and poor mobility). However, there is currently no evidence‐base on how to delay or prevent cognitive decline and dementia in Aboriginal Australians. Therefore, a comprehensive program to target dementia risk factors in this population is required.MethodIn partnership with three Aboriginal Community Controlled Health Services (ACCHS) in Western Australia, we have developed an Aboriginal health practitioner‐led health program (DAMPAA) to target key dementia risk factors for Aboriginal people over 45 years. The DAMPAA program was co‐designed by the research team, Elders and Aboriginal community‐controlled organisations. Qualitative data to inform the co‐design was collected through ACCHS staff workshops, Elders yarning groups and interviews with DAMPAA Aboriginal and non‐Aboriginal researchers using a Theory of Change framework. Additionally, a small pilot study was conducted in 2020, which included participant exit interviews conducted by Aboriginal researchers. Qualitative data from all data sources was analysed thematically by a qualitative researcher, and member checked by two DAMPAA Aboriginal researchers and the Elders Governance group.ResultThe DAMPAA program includes group physical activity, education, goal setting and medication management. Program enablers identified by ACCHS, research staff and participants include (but not limited to) group Aboriginal community controlled organisation based walking and yarning sessions, with additional activities such as aqua aerobics, tai chi and boot scooting, a buddy system for home exercising, connecting with others, transport, healthy food, being Aboriginal led, and the ACCHS partnership. An additional enabler identified by the Elders governance group include Aboriginal language education sessions. Program barriers identified include (but not limited to) family commitments, caring for grandchildren, travel for funerals and other appointments and participant contact details changed.ConclusionThe barriers and enablers identified from participants, ACCHS and DAMPAA staff have informed the development of the program protocol. DAMPAA will be evaluated through a randomised controlled trial implemented at four sites in Western Australia and process evaluation using a Theory of Change framework.

Performing Aboriginal Rights in 1951: From Australia's Top End to Southeast

In 1951, performers from Daly River and Tiwi Islands Aboriginal communities staged a corroboree strike. The musicians and dancers had routinely entertained visiting cruise ships in the Darwin Botanic Gardens, but now joined dockside workers to protest the jailing and exiling of two Aboriginal agitators Lawrence Wurrpen (Urban) and Fred (Nadpur) Waters. In Melbourne, the Australian Aborigines' League expressed solidarity with the Darwin strikes and protested the exclusion of Aboriginal voices from the Jubilee of Australian Federation. The League's leaders Doug Nicholls and Bill Onus produced a new work of musical theatre featuring east coast Aboriginal performers Fred Foster, Margaret Tucker, Georgia Lee, Harold Blair, and others in ‘Out of the Dark — An Aboriginal Moomba’. In this paper we examine political uses of performance in Australia's assimilation era, and show how Aboriginal agitators used music and dance to connect struggles for rights across Australia, and to keep cultural identity alive. In doing so we show how performance operated both as work and as assertion of cultural sovereignty.

Aboriginal Community Views about a Native Plant-Based Enterprise Development in Northern Australia

As global populations rapidly increase, there is a need to maintain sustainable landscapes through innovative agricultural systems and practices that continue to work towards addressing Sustainable Development Goal 2, Zero Hunger. Indigenous people around the world seek culturally appropriate and sustainable livelihood opportunities to improve their socioeconomic status, and there is a rich diversity of existing globally important agricultural heritage systems that have been developed by Indigenous cultures over millennia. Wild harvest of plant products is an innovative agricultural practice which has been conducted by Aboriginal Australians for thousands of years and is a more acceptable form of agriculture on Aboriginal land than more intensive forms, such as horticulture. Wild harvest is typically more culturally appropriate, less intensive, and involves less impact. However, enterprise development programs in Aboriginal communities across Northern Australia have historically had very limited economic success. Such communities often experience high welfare dependency and few economic development opportunities. This research takes a case study approach to explore community views about the development of an Aboriginal plant-based enterprise in the Northern Territory, Australia. We used qualitative methods to engage with community members about their experiences, current attitudes, and future aspirations towards the Enterprise. We found that there was broad support from across all sectors of the community for the Enterprise and clear understanding of its monetary and non-monetary benefits. However, there was limited knowledge of, and involvement in, the business beyond the role of provider and producer, and of the governance aspects of the Enterprise. Using this case study as our focus, we advocate for deeper understanding and stronger inclusion of community aspirations, realities, and perspectives on Aboriginal economic development. Cultural values and knowledge need to inform business development. Additionally, there is a need to invest in basic infrastructure to account for the low base of private asset ownership in this context. A holistic, multifunctional landscape approach is required to support sustainable agricultural practices on Aboriginal lands across Northern Australia.

Evaluating the role of asymptomatic throat carriage of Streptococcus pyogenes in impetigo transmission in remote Aboriginal communities in Northern Territory, Australia: a retrospective genomic analysis

Streptococcus pyogenes, or group A Streptococcus (GAS), infections contribute to a high burden of disease in Aboriginal Australians, causing skin infections and immune sequelae such as rheumatic heart disease. Controlling skin infections in these populations has proven difficult, with transmission dynamics being poorly understood. We aimed to identify the relative contributions of impetigo and asymptomatic throat carriage to GAS transmission. In this genomic analysis, we retrospectively applied whole genome sequencing to GAS isolates that were collected as part of an impetigo surveillance longitudinal household survey conducted in three remote Aboriginal communities in the Northern Territory of Australia between Aug 6, 2003, and June 22, 2005. We included GAS isolates from all throats and impetigo lesions of people living in two of the previously studied communities. We classified isolates into genomic lineages based on pairwise shared core genomes of more than 99% with five or fewer single nucleotide polymorphisms. We used a household network analysis of epidemiologically and genomically linked lineages to quantify the transmission of GAS within and between households. We included 320 GAS isolates in our analysis: 203 (63%) from asymptomatic throat swabs and 117 (37%) from impetigo lesions. Among 64 genomic lineages (encompassing 39 emm types) we identified 264 transmission links (involving 93% of isolates), for which the probable source was asymptomatic throat carriage in 166 (63%) and impetigo lesions in 98 (37%). Links originating from impetigo cases were more frequent between households than within households. Households were infected with GAS for a mean of 57 days (SD 39 days), and once cleared, reinfected 62 days (SD 40 days) later. Increased household size and community presence of GAS and scabies were associated with slower clearance of GAS. In communities with high prevalence of endemic GAS-associated skin infection, asymptomatic throat carriage is a GAS reservoir. Public health interventions such as vaccination or community infection control programmes aimed at interrupting transmission of GAS might need to include consideration of asymptomatic throat carriage. Australian National Health and Medical Research Council.

Cohort Study Examining the Presentation, Distribution, and Outcomes of Peripheral Artery Disease in Aboriginal, Torres Strait Islander, and Non-Indigenous Australians

This retrospective cohort study investigated the anatomical distribution, severity, and outcome of peripheral artery disease (PAD) in Aboriginal and Torres Strait Islander compared with non-Indigenous Australians. The distribution, severity, and outcome of PAD were assessed using a validated angiographic scoring system and review of medical records in a cohort of Aboriginal and Torres Strait Islander and non-Indigenous Australians. The relationship between ethnicity and PAD severity, distribution, and outcome were examined using non-parametric statistical tests, Kaplan-Meier and Cox proportional hazard analyses. Seventy-three Aboriginal and Torres Strait Islander and 242 non-Indigenous Australians were included and followed for a median of 6.7 [IQR 2.7, 9.3] years. Aboriginal and Torres Strait Islander patients were more likely to present with symptoms of chronic limb threatening ischaemia (81% vs. 25%; p < .001), had greater median [IQR] angiographic scores for the symptomatic limb (7 [5, 10] vs. 4 [2, 7]) and tibial arteries (5 [2, 6] vs. 2 [0, 4]) and had higher risk of major amputation (HR 6.1, 95% CI 3.6 - 10.5; p < .001) and major adverse cardiovascular events (HR 1.5, 95% CI 1.0 - 2.3; p = .036) but not for revascularisation (HR 0.8, 95% CI 0.5 - 1.3; p = .37) compared with non-Indigenous Australians. The associations with major amputation and major adverse cardiovascular events were no longer statistically significant when adjusted for limb angiographic score. Compared with non-Indigenous patients, Aboriginal and Torres Strait Islander Australians had more severe tibial artery disease and higher risk of major amputation and major adverse cardiovascular events.

A longitudinal mediation analysis of the effect of Aboriginal Australian mothers’ experience of perceived racism on children’s social and emotional well-being

ABSTRACT Objectives It is known that parental experiences of perceived racism are associated with poorer mental health in children. However, little is known about the mechanism of transmission of intergenerational racism among Aboriginal Australians. This study aims to explore the causal effect of Aboriginal mothers’ experience of perceived racism on children’s social and emotional well-being mediated by parenting sense of competence. Method Pregnant Aboriginal women (N = 159) reported their experiences of perceived racism using the Measure of Indigenous Racism Experiences instrument, and completed a five year follow-up survey, reporting their sense of parenting competence using the Parenting Sense of Competence Scale and their child’s social and emotional well-being using the Strengths and Difficulties Questionnaire. A single causal mediation analysis was used to examine the causal effects while accounting for confounding variables (mother’s age, education, and socioeconomic status). Results Mothers who experienced perceived racism in at least one setting were at an increased odds of their child experiencing social and emotional difficulties (OR = 1.28, 95% CI [0.55, 2.98]). This effect was not mediated by parenting sense of competence, despite an effect between parenting competence and children’s social and emotional well-being (OR = 0.44, 95% CI [0.19, 1.06]). Conclusions The findings suggest that maternal experiences of perceived racism has a longitudinal effect on their children’s social and emotional well-being, which is not mediated through the mothers’ parenting sense of competence. These findings highlight the importance of reducing racism as these may have far-reaching effects across generations on socio-social and emotional well-being.

Reclaiming Aboriginal Identity in the Select Novels of Kim Scott’s: True Country Using Identity Theory

Australian Aboriginal stories were presented from the traditional Aboriginal oral narratives. These narratives present the stories of Aboriginals with prior to the colonial dispute which resulted in the destruction of Aboriginal identity. These Aboriginals have necessitated the urge to reclaim their Aboriginality using oral narratives which was later transcribed into various written forms. The reclamation using traditional oral narratives has emphasized on the significance of Aboriginal identity and their cultural belonging. The current paper examines the impact of European colonization and reveals the lost Aboriginal identity of the Australian Aboriginals using the novel True Country by Kim Scott. The objective of this paper is to emphasize on the challenges evolved in reclaiming the lost Aboriginal identity, through various Aboriginal voices in the novel. The study focuses on reclaiming the lost self and cultural Aboriginal identities examined through oral narratives using the identity theory.

The high burden of comorbidities in Aboriginal and Torres Strait Islander Australians living with chronic hepatitis B in Far North Queensland, Australia, and the implications for patient management.

Aboriginal and Torres Strait Islander Australians living with chronic hepatitis B virus (HBV) infection have a significant burden of hepatocellular carcinoma (HCC). The prevalence of comorbidities that increase the risk of HCC in this population is incompletely defined. This cross-sectional study was performed in remote tropical Queensland, Australia in January 2021. All individuals living with chronic HBV in the region were identified; the prevalence of relevant comorbidities was determined by reviewing medical records. All 236 individuals in the cohort identified as Aboriginal and Torres Strait Islander Australians; their median (interquartile range (IQR)) age was 48 (40-62) years; 120/236 (50.9%) were female. Of the 194/236 (82.2%) engaged in HBV care, 61 (31.4%) met criteria for HBV therapy and 38 (62.2%) were receiving it. However, 142/236 (60.2%) were obese, 73/236 (30.9%) were current smokers and 57/236 (24.2%) were drinking alcohol hazardously; 70/236 (29.7%) had ≥2 of these additional risk factors for HCC, only 43/236 (18.2%) had none. Among the 19 patients with confirmed cirrhosis, 9 (47%) were obese, 8 (42%) were currently-or had a history of-drinking alcohol hazardously and 5 (26.3%) were current smokers. Patients also had a median (IQR) of 3 (2-4) cardiovascular risk factors (cigarette smoking, hypertension, impaired glucose tolerance, dyslipidaemia, renal impairment/proteinuria). Only 9/236 (3.8%) did not have one of these 5 comorbidities. Aboriginal and Torres Strait Islander Australians living with chronic HBV in this region of remote Australia have a high engagement with HBV care and the majority of individuals eligible for antiviral therapy are receiving it. However, a significant comorbidity burden increases their risk of cirrhosis, HCC, and premature death. It is essential to integrate chronic HBV care with management of these comorbidities-rather than focusing on HBV alone-to achieve optimal health outcomes.

From Deficit to Strength-Based Aboriginal Health Research-Moving toward Flourishing.

Aboriginal Australians have a fundamental human right to opportunities that lead to healthy and flourishing lives. While the impact of trauma on Aboriginal Australians is well-documented, a pervasive deficit narrative that focuses on problems and pathology persists in research and policy discourse. This narrative risks further exacerbating Aboriginal disadvantage through a focus on 'fixing what is wrong' with Aboriginal Australians and the internalising of these narratives by Aboriginal Australians. While a growing body of research adopts strength-based models, limited research has sought to explore Aboriginal flourishing. This conceptual paper seeks to contribute to a burgeoning paradigm shift in Aboriginal research, seeking to understand what can be learned from Aboriginal people who flourish, how we best determine this, and in what contexts this can be impactful. Within, we argue the case for a new approach to exploring Aboriginal wellbeing that integrates salutogenic, positive psychology concepts with complex systems theory to understand and promote Aboriginal wellbeing and flourishing. While deeper work may be required to establish the parameters of a strength-based, culturally aligned Aboriginal conceptualisation of positive psychology, we suggest the integration of Aboriginal and Western methodologies offers a unique and potent means of shifting the dial on seemingly intractable problems.

Mexico in the spotlight of polyglot studies

This paper is a review of the Polyglot Conference 2022 in Cholula and the 3rd International Seminar on Linguistics &amp; Polyglot Studies, both united by the topic of Mexico’s linguistic and cultural heritage. Discussed are the social and psychological aspects of polyglottery, language museums, Mexican Spanish, works of Yuri Knorozov, written sources of the Nahua culture, reading acquisition in modern and ancient languages, counting systems of Australian Aboriginals, and broader issues of multilingual and minority language studies.

Co-design of dementia prevention program for Aboriginal Australians (DAMPAA).

Dementia is highly prevalent in older Aboriginal Australians, with several modifiable risk factors. Currently, there is limited evidence on how to prevent cognitive decline in Aboriginal Australians. Based on our Theory of Change (ToC) framework, we co-developed the Dementia risk management and prevention program for Aboriginal Australians (DAMPAA) aged over 45 years in partnership with Aboriginal community-controlled organizations (ACCOs) and Elders. Qualitative data were collected through ACCO staff workshops, Elders yarning, and governance groups to inform the protocol. Additionally, we conducted a small pilot study. Expected DAMPAA ToC outcomes are: (1) improved daily function, (2) better cardiovascular risk management, (3) falls reduction, (4) improved quality of life, and (5) reduced cognitive decline. Attendance enablers are social interaction, environment, exercise type/level, and logistics. Findings suggest that ToC is an effective collaborative approach for co-designing Aboriginal health programs.