non-Indigenous People Research Articles

Models of Care for Older People: A Scoping Review.

International recognition of the increasing importance of care for older people has seen growing interest in models of care for older people. Yet there is limited information about the scope and breadth of models of care for older people. This article clarifies what is known about models of care for older people by summarizing relevant publications, describing the models depicted in these publications, and synthesizing the outcomes and impact presented in the publications. A scoping review was conducted that involved searching multiple databases to identify relevant publications, published in English, which presented a model of care for older people-specifically, non-Indigenous people aged ≥ 65 years and/or Indigenous people aged ≥ 50 years; and included evidence, broadly defined, about the utility or otherwise of the model. Commentaries, narrative letters, editorials, and reviews were excluded. From 21,767 publications, 276 were deemed relevant. From these, four key findings are apparent. First, models of care for older people are understood in disparate ways and are typically devoid of clear stepwise guidance. Second, most of the publications reported on a multidisciplinary approach. Third, they generally failed to involve carers. Fourth, very few publications reported on studies conducted in a rural area, and none involved Indigenous people. Given the heterogeneity and breadth of models of care for older people, further research is needed to establish: a definition of a model of care for older people; reporting standards; the factors that help or hinder their effectiveness; how to ensure carer involvement; and how to adapt models of care for older people for priority populations.

Opioid toxicity deaths in Indigenous people who experienced incarceration in Ontario, Canada 2015-2020: A whole population retrospective cohort study

While Indigenous people are overrepresented in Canada's prisons and in the toxic drug supply crisis, we lack data on the harms related to opioids for Indigenous people with experiences of incarceration. We aimed to examine opioid toxicity deaths in Indigenous peoples who experienced incarceration and to compare opioid toxicity mortality rates with rates for people with no incarceration. This retrospective cohort study linked correctional data for all people who were incarcerated in provincial correctional facilities and coronial data for all people who died from opioid toxicity in Ontario, Canada between 2015 and 2020. We calculated opioid mortality rates for Indigenous people who experienced incarceration and for people who did not experience incarceration using publicly available population data and calculated age-standardized mortality rates for Indigenous and non-Indigenous people who experienced incarceration compared with people who did not experience incarceration. Of 14,885 Indigenous people who experienced incarceration, 2% (N=242) died from opioid toxicity in custody or post-release, representing 2.9% of all opioid toxicity deaths in Ontario during this period. The crude opioid toxicity mortality rate per 100 person-years was 0.53 for Indigenous females and 0.36 for Indigenous males who experienced incarceration, compared with 0.0060 for females and 0.0132 for males who did not experience incarceration. Rates of opioid toxicity death were highest in the month post-release for Indigenous people who experienced incarceration, at 1.13 per 100 person-years. Standardized for age and compared with people with no incarceration, the mortality ratio was 81.0 (95% CI 62.1-100.0) for Indigenous females who experienced incarceration and 23.6 (95% CI 20.1-27.1) for Indigenous males who experienced incarceration. The SMRs for Indigenous and non-Indigenous females who experienced incarceration were not significantly different, at 81.0 compared with 76.4, and were significantly different for Indigenous and non-Indigenous males who experienced incarceration, at 23.6 compared with 28.5. This whole-population study identified a substantial and inequitable burden of opioid toxicity death for Indigenous people who experienced incarceration, similar to the burden for non-Indigenous people who experienced incarceration. The large burden is particularly concerning in the context of the overrepresentation of Indigenous people in correctional facilities. Focus is warranted to prevent substance use harms for Indigenous people, including through community- and custody-based interventions to support health. Canadian Institutes of Health Research through the Canadian Research Initiative in Substance Misuse (SMN-139150 and REN-181677).

Pharmacogenetic Testing in Admixed Populations: Frequency of the Association for Molecular Pathology Pharmacogenomics Working Group Tier 1 Variant Alleles in Brazilians.

This article examines the frequency distribution of tier 1 pharmacogenetic variants of the Association for Molecular Pathology Pharmacogenomics Working Group Recommendations in two large (>1000 individuals) cohorts of the admixed Brazilian population, and in patients from the Brazilian Public Health System enrolled in pharmacogenetic trials. Three tier 1 variants, all in DPYD, were consistently absent, which may justify their noninclusion in genotyping panels for Brazilians; 13 variants had frequency ≤1.0%, and the remaining 21 variants ranged in frequency from 1.2% (NUDT15∗3) to 76.4% (CYP3A5∗3). The frequency of some CYP2C9, CYP2D6, CYP3A4, and VKORC1 variants differed significantly across the three major race/Color categories of the Brazilian Census (White, Brown, and Black), as a consequence of different proportions of individual European and African ancestry. However, it is recommended that selection of variants for inclusion in pharmacogenetic testing panels and implementation of pharmacogenetic-informed dosing guidelines for Brazilians should not be determined by race/Color categories. Native Americans (0.4% of the Brazilian population), virtually absent from the study cohorts, display wide interethnic diversity in frequency of some tier 1 variants (eg, NUDT15∗3 and TPMT∗3A) and/or differ markedly from non-Indigenous people in frequency of some variant alleles (eg, CYP2C19∗17). Collectively, the data support the notion that population diversity must be taken into account on the design and implementation of pharmacogenetic testing panels.

Indigenous women’s evaluation of anti-Indigenous violence: an intersectional analysis

This study examines how Indigenous women evaluate their experiences regarding inequality, discrimination, and violence using an intersectionality approach. The contributions of ethnicity, class, and gender as robust systems have been mainly overlooked in traditional studies on anti-Indigenous violence. However, this study shows significant disparities in perception and experience based on gender and ethnic identities through 33 in-depth semi-structured interviews. Participants experienced inequality, discrimination, and violence rooted in gender and Indigenous identity. Indigenous women also implied that they were misrepresented or negatively represented due to ethnicity and being culturally distinct historically by non-Indigenous scholars. Such negative representation leads Indigenous women to experience various kinds of formal, informal, physical, and verbal discrimination and violence at the workplace, where non-Indigenous people often defamed the participants using Indigenous slurs. In addition, findings suggest multiple layers of oppression because of their social position oppressed Indigenous women; this should be examined through intersectional lens.

Abalones at risk: A global Red List assessment of Haliotis in a changing climate

There is increasing awareness that marine invertebrates such as abalones are at risk from the combined stressors of fishing and climate change. Abalones are an important marine fishery resource and of cultural importance to Indigenous and non-Indigenous people. A highly priced marine delicacy, they are inherently vulnerable: individuals are slow-growing and long-lived and successful reproduction requires dense assemblages. However, their global conservation status is poorly understood. Using IUCN Red List methodology, we assessed the extinction risk to all 54 species of abalone (genus Haliotis). Of the 21 fished commercially for human consumption either now and/or in the past, 15 (71.43%) are classified as threatened, i.e., those identified as Critically Endangered, Endangered or Vulnerable. Of the 33 unexploited species, only five (15.15%) are so classified, making exploited species over four times more likely to face extinction, underscoring the impact of fishing on abalones already confronting a changing climate. The highest concentration of threatened species occurs along the North American Pacific coast. Here six of the seven species have been exploited, yet despite years of fishery closures with exemptions only in Alaska and Mexico, all are categorised as threatened. Climate driven stressors have led to mass mortalities, with competition from sea urchins and disease, aggravated by harmful algal blooms. In Australia the picture is mixed despite robust stock management, with some regions experiencing mass mortalities from marine heatwaves and viral spread. Poaching has reached its apogee in South Africa, where organised criminal gangs have reduced the legal fishery of Haliotis midae, ‘perlemoen’ almost to a footnote, accompanied by widespread recruitment failure. In response, the authorities have focused on abalone ranching and stock enhancement. In Japan, with a long history of abalone fishing, wild stocks are routinely supplemented with hatchery-bred juveniles. Collaboration between restoration aquaculture and fisheries, including sea urchin control and kelp restoration, offers hope for rebuilding stocks against a backdrop of escalating environmental stressors.

Yarning about vaccinations: Empowering individuals to have supportive conversations with Aboriginal peoples about vaccinations, using a community-engaged approach.

This study assessed the effectiveness of Aboriginal-led vaccine workshops to enhance knowledge, confidence and supportive conversations regarding scheduled and recommended vaccinations for Aboriginal and Torres Strait Islander people in Hunter New England, New South Wales, Australia. We adapted and indigenised an existing vaccine conversation program. Aboriginal and Torres Strait Islander and non-Indigenous people were recruited to workshops delivered either online or face to face. Seventy participants attended the workshops. Most reported high satisfaction with the workshop content and format, and most reported increased confidence in having vaccine conversations. Post-workshop yarns highlighted the positive impact on community knowledge and collaboration. Aboriginal-informed and -led education enables and empowers service providers and community members to engage in supportive vaccine conversations with Aboriginal and Torres Strait Islander people. These findings highlight the need for localised strategies to enhance vaccine understanding with Aboriginal and Torres Strait Islander communities, as well as offering valuable insights to tailor immunisation programs and rollouts of future vaccines.

Preserving Cultural Heritage in Indigenous Pandemic Fiction: “Coming-to” Stories of Resistance in Cherie Dimaline’s The Marrow Thieves

This study intends to investigate Indigenous pandemic fiction through an analysis of The Marrow Thieves by Métis writer Cherie Dimaline. By depicting the journey of the Métis protagonist Frenchie, the novel explores Indigenous identity in a dystopian scenario where non-Indigenous people have succumbed to a plague affecting the ability to dream. Taking into consideration Jan Assmann’s concept of cultural memory and N. Scott Momaday’s depiction of the power of language, the paper would focus on the role of storytelling and linguistic heritage in the process of ‘survivance’ of Indigenous identity. The novel outlines dreams as spaces of resistance bound to the protection of cultural identity, by also revisiting the history of forced assimilation through the Residential School System. Frenchie’s journey presents the act of dreaming as the ultimate symbol of hope in a posthuman scenario where humankind has lost control over the Earth.

The antimicrobial potential of traditional remedies of Indigenous peoples from Canada against MRSA planktonic and biofilm bacteria in wound infection mimetic conditions.

Methicillin-resistant Staphylococcus aureus (MRSA) is the leading cause of wound infections, often progressing into serious invasive bloodstream infections. MRSA disproportionately affects Indigenous peoples in Canada with higher rates of skin and wound infections, an example of persistent gaps in health outcomes between Indigenous and non-Indigenous peoples precipitated by the legacy of colonialism. Conversely, Indigenous peoples have long used natural remedies for infections and other diseases; however, their knowledge was rarely considered for modern medicine. The stagnant antibiotic discovery pipeline and alarming rise of resistance to current antibiotics prompted us to turn to Indigenous medicine as an untapped source of antimicrobials. As such, we collected and prepared 85 extracts of medicinal plants of value to Indigenous peoples spanning the Canadian Prairies. We explored the antimicrobial potential of these extracts against MRSA under wound infection-mimetic conditions compared with culture media typically used to study bacterial antibiotic responses and biofilms but not adequately representative of infection sites. We identified extracts with MRSA growth inhibitory [e.g., bergamot, dock, gaillardia, and dandelion extracts] and biofilm prevention and eradication [e.g., gumweed extracts] activities. Extracts, including those of chokecherry, hoary puccoon, and Northern bedstraw, were only active under wound infection-mimetic conditions, highlighting the benefit of antibiotic discovery under host-relevant conditions. Testing growth inhibitory extracts against an S. aureus cross-resistance platform suggested that they act through mechanisms likely distinct from known antibiotic classes. Together, through an interdisciplinary partnership leveraging Western approaches and traditional Indigenous knowledge, we identified plant extracts with promising antimicrobial potential for drug-resistant MRSA wound infections.IMPORTANCEWe explored the antimicrobial potential of traditional Indigenous remedies against MRSA under wound infection-mimetic conditions. We chose to tackle MRSA wound infections because they constitute an Indigenous health priority, ensuring mutual benefits and reciprocity, which are important principles in partnerships between Indigenous and non-Indigenous researchers. Our partnerships strive to serve as steps towards reconciliation with Indigenous peoples in Canada and a roadmap inspiring similar interdisciplinary collaborations to tackle other healthcare priorities. We identified extracts with promising antibacterial growth inhibitory, biofilm prevention, and eradication activities against MRSA. The antimicrobial potential of some extracts was only observed under wound infection-mimetic conditions, a proof-of-concept that screening under infection-mimetic conditions reveals novel activity undetected under standard conditions. The natural product antimicrobial extracts discovered herein warrant further investigation into their mode of action and chemical composition; they may address the dire need for new antimicrobial and anti-biofilm activity to counter the AMR crisis.

Indigenous Diffuse Support and Descriptive Representation in the Canadian House of Commons

AbstractDo Indigenous peoples in present-day Canada display lower levels of diffuse support than non-Indigenous settlers? Given settler colonial relations (both historic and contemporary) and Indigenous peoples’ own political thought, we can expect that Indigenous peoples would have even lower perceptions of state legitimacy than non-Indigenous peoples. However, there are conflicting expectations regarding whether the descriptive representation of Indigenous peoples in settler institutions is likely to make a difference: on one hand, Indigenous people may see themselves reflected in these institutions and consequently feel better represented; on the other hand, these forms of representation do not challenge the underlying colonial nature of these institutions. Using data from the 2019 and 2021 Canadian Election Studies, our statistical analysis demonstrates that: (1) diffuse support is significantly lower among Indigenous peoples than non-Indigenous peoples, including people of color; (2) Indigenous respondents across multiple peoples have similarly low levels of diffuse support, and (3) being represented by an Indigenous Member of Parliament does not change the levels of diffuse support among Indigenous peoples. Overall, our research highlights the outstanding challenges to achieving reconciliation through the Canadian state and points to ways large-N analyses may be made more robust.

Indigenous and Non-Indigenous Unemployment, Employment, and Participation Rates Through 2023: Education Remains Critical

Employment, unemployment, participation, and wage rates have been more favourable for the non-Indigenous population than for the Indigenous population. With one exception, this has been the case in every year since 2007, when the data first became available. While wages were higher in 2022 than they were in 2021 for both Indigenous and non-Indigenous populations, the overall employment picture for the Indigenous population was worse in 2023 than in 2022. Their unemployment rate was higher, while their employment and participation rates were lower. In comparison, all three rates were higher for non-Indigenous people in 2023. A critical factor related to each of these three rates is the education level achieved. Higher completed educational levels are directly related to lower unemployment rates and higher employment and participation rates as well as to higher wage levels.

Advancing microbiome research in Māori populations: insights from recent literature exploring the gut microbiomes of underrepresented and Indigenous peoples.

The gut microbiome plays vital roles in human health, including mediating metabolism, immunity, and the gut-brain axis. Many ethnicities remain underrepresented in gut microbiome research, with significant variation between Indigenous and non-Indigenous peoples due to dietary, socioeconomic, health, and urbanization differences. Although research regarding the microbiomes of Indigenous peoples is increasing, Māori microbiome literature is lacking despite widespread inequities that Māori populations face. These inequities likely contribute to gut microbiome differences that exacerbate negative health outcomes. Characterizing the gut microbiomes of underrepresented populations is necessary to inform efforts to address health inequities. However, for microbiome research to be culturally responsible and meaningful, study design must improve to better protect the rights and interests of Indigenous peoples. Here, we discuss barriers to Indigenous participation in research and the role disparities may play in shaping the gut microbiomes of Indigenous peoples, with a particular focus on implications for Māori and areas for improvement.

Leadership as Métissage: Seeking to Indigenize our faculty of education

As a faculty of education, we have ethical, professional, and legal commitments that compel us to make meaningful and significant contributions to reconciliation between Indigenous and non-Indigenous people. This work is long overdue, justice has too long been denied, the ongoing legacies of colonization that play out through education need to be disrupted now. Yet this work must be done in a good way, decolonization is required, many complexities exist stemming from the past and present dominance of Eurocentric knowledge in our society, K-12, and post-secondary education systems. The authors of this paper made up all of the full-time staff members in a faculty of education. We used a collaborative scholarship of teaching and learning research project and a Métissage methodology to seek to collectively lead the Indigenization of learning, teaching, leadership, and scholarship in our faculty. In braided narrative vignettes, we situate ourselves in relationship to this work, explore tensions and complexities, wrestle with axiological considerations, reflect on practices we have engaged in, share how we have taken up this work with our students, colleagues, and school partners, identify questions and steps in front of us, and reflect on how Métissage has served as a shared leadership process to support the Indigenization of our faculty and our University as a whole. Our stories are situated in a Bachelor of Education after degree program that serves approximately 120 students located in the traditional territories of the Blackfoot Confederacy, the Tsuut’ina Nation, and the Stoney Nakoda Nations.

Perspectives on improving wound care for Aboriginal health workers in rural and remote communities in Queensland, Australia

BackgroundThe care of wounds is an ongoing issue for Indigenous people worldwide, yet culturally safe Indigenous wound care training programs for rural and remote Australian Aboriginal Health Workers are largely unavailable. The higher prevalence of chronic disease, lower socioeconomic status and poorer access to services experienced by Aboriginal and Torres Strait Islanders compared to non-Indigenous people, leads to a greater incidence of chronic wounds in Aboriginal and Torres Strait Islander people. Identifying the barriers and enablers for delivering wound care will establish areas of need for facilitating the development of a specific wound care program for Aboriginal Health Workers and Aboriginal Health Practitioners. This paper reports the first phase of a larger project directly aligned to the Indigenous Australians’ Health Program’s objective of supporting the delivery and access to high quality, culturally appropriate health care and services to Aboriginal and Torres Strait Islander Australians. This study aimed to examine experiences of Aboriginal Health Workers, Aboriginal Health Practitioners, and nurses for managing chronic wounds within rural and remote Aboriginal Medical Services in Queensland, Australia.MethodsYarning facilitated by two Aboriginal researchers among Aboriginal Health Workers, Aboriginal Health Practitioners, and nurses currently employed within four Aboriginal Medical Services located in rural and remote areas of Queensland, Australia.ResultsTwo themes were developed through rigorous data analysis of yarning information and responses: participants’ experiences of managing wounds and barriers and enablers to effective wound care.ConclusionsThis study contributes an insight into the experiences of Aboriginal Health Workers on the current barriers and enablers to timely treatment of chronic wounds. Results from this study indicate a significant barrier to obtaining timely and effective wound care in regional and remote settings is access to an appropriately skilled, culturally competent, and resourced health work force. A lack of education and professional development for Aboriginal Health Workers can compromise their ability to maximise patient outcomes and delay wound healing. Findings have informed the development of an evidence based, culturally competent open access chronic wound care education program for Aboriginal Health Workers.

A novel framework for Indigenous eye health care in New Zealand: Ngā Mata o te Ariki

ABSTRACT Clinical relevance Development of an Indigenous eye health framework could offer the opportunity for eye health professionals to enhance engagement with Indigenous populations. Background Indigenous populations globally experience disproportionately poorer eye health outcomes than non-Indigenous peoples. Incorporating Māori perspectives of eye care and pre-existing Indigenous models of health offers potential to enhance Māori experience and engagement with eye health services. This study seeks to develop and refine a practical framework for eye health care that incorporates nine established Indigenous health principles. Methods Qualitative methodology, guided by Indigenous Māori research principles, was used to evaluate interviews with five leading senior Māori academics surrounding the ongoing development and refinement of a Kaupapa Māori (Māori worldview centric) framework for eye care in Aotearoa New Zealand, created following Māori health consumer consultation. Interviews were semi-structured and analysed using reflexive thematic analysis. Results Seven key themes arose in relation to the development of a Kaupapa Māori framework for eye care in Aotearoa New Zealand: 1) vision is critical to Māori well-being, 2) cultural safety is important, 3) Māori health beliefs must be upheld, 4) achieving pae ora (healthy futures) is important, 5) key concepts and focus of the framework must be clear, 6) pūrākau (traditional Indigenous stories) are valuable resources in developing health frameworks and 7) embedding Matariki (fundamental Māori) principles is valuable. Conclusions Using Kaupapa Māori principles allowed development and refinement of a framework that encourages clinicians to consider Indigenous health principles when engaging with Māori patients who seek eye care. Application of this framework may contribute to enhancing cultural safety and responsiveness of eye care for Māori.

REVISITING PRIBUMI – NONPRIBUMI DISCOURSES IN THE POST-SUHARTO INDONESIA

This study explores the ideological shifts surrounding the terms pribumi (native Indonesian) and nonpribumi (non-indigenous people) in the post-Suharto era (1998-2020). The data source are 173 news articles from the Indonesian press containing the term ‘pribumi.’ By employing Van Dijk’s ‘Ideological Square’ Critical Discourse Analysis (CDA) the study portrays groups in terms of dominance, inequality, difference, and victimization to understand power dynamics and ideological constructions in the language. The findings reveal that pribumi are portrayed positively as rooted in ethnic origin, cultural heritage, and mainly Muslim identity in recent periods, but also as economically disadvantaged landowners. Conversely, nonpribumi are depicted negatively as foreign, racially distinct, and economically dominant. Negative representations of pribumi as oppressors and politically dominant are de-emphasized, while positive portrayals of nonpribumi as passive victims are mitigated. The study suggests that evolving nuances stem from democratic transitions and heightened identity politics tensions. Economic perceptions linked to these terms persist across periods. These insights might help scholars and policymakers understand mobilization patterns and potential identity-related conflicts, prompting further research into using dichotomous terms within specific social and cultural contexts.

Kidney transplantation access and outcomes for Aboriginal and Torres Strait Islander children and young adults, 1963-2020: an ANZDATA registry study.

To assess differences between Aboriginal and Torres Strait Islander and non-Indigenous Australian children and young adults in access to and outcomes of kidney transplantation. A cohort study based on prospectively collected data; analysis of Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) data. Children and young adults aged 0-24 years who commenced kidney replacement therapy in Australia during 1963-2020. Proportions of children and young adults who received kidney transplants within five years of commencing dialysis; 5- and 10-year death-censored graft survival; and 5- and 10-year survival of children and young adults who received kidney transplants or who remained on dialysis. During 1963-2020, 3736 children and young adults received kidney replacement therapy in Australia: 213 (5.8%) Aboriginal and Torres Strait Islander and 3523 (94.2%) non-Indigenous children and young adults. During follow-up (median, eight years; interquartile range [IQR], 2.6-15 years), 2762 children and young adults received kidney transplants: 93 Aboriginal and Torres Strait Islander (43.7% of those receiving kidney replacement therapy) and 2669 non-Indigenous children and young adults (75.8%). Smaller proportions of Aboriginal and Torres Strait Islander than of non-Indigenous children and young adults received transplants within five years of commencing dialysis (99, 46% v 2924, 83.0%), received living donor transplants (19, 20% v 1170, 43.9%), or underwent pre-emptive transplantation (one, 1.1% v 363, 13.6%). Five-year graft survival for Aboriginal and Torres Strait Islander recipients was similar to non-Indigenous recipients (61% v 75%; adjusted hazard ratio [aHR], 1.43; 95% confidence interval [CI], 0.02-2.05), but 10-year graft survival was lower (35% v 61%; aHR, 1.69; 95% CI, 1.25-2.28). Five- and 10-year survival after kidney transplantation was similar for Aboriginal and Torres Strait Islander and non-Indigenous people. Among those who remained on dialysis, 10-year survival was poorer for Aboriginal and Torres Strait Islander than non-Indigenous children and young adults (aHR, 1.50; 95% CI, 1.08-2.10). Five-year graft and recipient survival were excellent for Aboriginal and Torres Strait Islander children and young adults who received kidney transplants; however, a lower proportion received transplants within five years of dialysis initiation, than non-Indigenous children and young adults. Improving transplant access within five years of dialysis commencement should be a priority.

First stroke incidence, causes, treatments, and outcomes for Aboriginal Peoples in South Australia and the Northern Territory: a pilot prospective study.

We performed a pilot stroke incidence study, focused on feasibility and inclusion of the CONSIDER reporting guidelines, to model the design of a future population-based study aiming to definitively determine stroke incidence, antecedents, treatment, and outcomes. Prospective stroke incidence study (pilot study). All people aged 15 years or older who lived in postcode-defined areas of South Australia and Northern Territory (885 472 people, including 45 127 Aboriginal people [5.1%]) diagnosed with stroke for the first time during 1 October - 31 December 2015 and admitted to public hospitals or stroke and transient ischaemic attack clinics. Feasibility of a prospective population-based stroke incidence study. Of the 123 participants with first strokes, ten were Aboriginal (8%); the median age of Aboriginal people was 45 years (interquartile range [IQR], 33-55 years), of non-Indigenous people 73 years (IQR, 62-84 years). For Aboriginal people, the age-standardised incidence of stroke was 104 (95% confidence interval [CI], 84-124) per 100 000 person-years, for non-Indigenous people 33 (95% CI, 22-44) per 100 000 person-years. We found that a prospective population-based stroke incidence study in Aboriginal people was feasible, including with respect to establishing an adequate sample size, diagnostic confirmation, identification of incident stroke, confirming stroke subtypes, establishing a stable statistical population, standardising data reporting for comparison with other stroke incidence studies, and ethical research reporting that conforms to CONSIDER guidelines. A larger, population-based study of the incidence of stroke in Aboriginal people is both feasible and needed to provide robust estimates of stroke incidence, antecedents, treatments and outcomes to help guide strategies for reducing the risk of and outcomes of stroke in Aboriginal people.

Exploring Sense of Purpose and Conscientiousness as Correlates to Health and Well-Being With Indigenous and Low Socioeconomic Communities on Coast Salish Territories, Vancouver, Canada.

Research is needed to better understand factors promoting health and well-being with Indigenous Peoples and people with socioeconomic barriers in Canada, given they face multiple social determinants that are barriers to health. Individual dispositions, sense of purpose and conscientiousness, are known to predict health and well-being in broader samples. In a community-based approach, guided by Indigenous Elders with traditional ways of knowing, we aimed to determine whether these measures correlate with self-rated health and well-being among Indigenous (n = 149) and non-Indigenous (n = 151) Peoples in Vancouver, Canada. The majority of participants (mean age 49 years, and 58% male) had relatively low income (≤$15,000/year) and educational attainment (<high school). Factors were valid and reliable in all groups. Mean scores were similar between Indigenous and non-Indigenous groups, and lower among participants with lower than with higher income. Correlations were similar between Indigenous and non-Indigenous groups: purpose significantly correlated with health (SF-6; 0.34 and 0.28, p < .001) and life satisfaction (0.55 and 0.58, p < .001), and conscientiousness with health (0.19 and 0.18, p < .05). Correlations were similar between income groups. When exploring and promoting the health, equity, and well-being of Indigenous and low socioeconomic status communities, purpose and personal disposition are factors to consider alongside social determinants of health.

The survival benefit of deceased donor kidney transplantation for Aboriginal and Torres Strait Islander people, 2006-20: a retrospective national cohort study.

To quantify the survival benefit of kidney transplantation for Aboriginal and Torres Strait Islander people waitlisted for deceased donor kidney transplantation in Australia. Retrospective cohort study; analysis of linked data from the Australia and New Zealand Dialysis and Transplant (ANZDATA) registry, the Australia and New Zealand Organ Donation (ANZOD) registry, and OrganMatch (Australian RedCross). All adult Aboriginal and Torres Strait Islander people (18 years or older) who commenced dialysis in Australia during 1 July 2006 - 31 December 2020 and were included in the kidney-only deceased donor transplant waiting list. Survival benefit of deceased donor kidney transplantation relative to remaining on dialysis. Of the 4082 Aboriginal and Torres Strait Islander people who commenced dialysis, 450 were waitlisted for kidney transplants (11%), of whom 323 received deceased donor transplants. Transplantation was associated with a significant survival benefit compared with remaining on dialysis after the first 12 months (adjusted hazard ratio [HR], 0.38; 95% confidence interval [CI], 0.20-0.73). This benefit was similar to that for waitlisted non-Indigenous people who received deceased donor kidney transplants (adjusted HR, 0.47; 95% CI, 0.40-0.57; Indigenous status interaction: P=0.22). From twelve months post-transplantation, deceased donor transplantation provides a survival benefit for Aboriginal and Torres Strait Islander people. Our findings provide evidence that supports efforts to promote the waitlisting of Aboriginal and Torres Strait Islander people who are otherwise eligible for transplantation.

Collective fishing with representatives of indigenous peoples of the North as a legalization of fishing for non-indigenous rural residents in the Primorsky Krai

Rural population who lives in the same natural and cultural landscape, and sometimes within the same vil-lage, are differentiated in their rights to access natural resources. People classified as indigenous population of the North, Siberia and the Far East (KMNS), unlike officially non-indigenous population, receive legal access to various biological resources. Positive discrimination of particular groups, for various reasons attributed to ‘more’ indigenous, has been causing controversy among anthropologists and sociologists for several decades, espe-cially regarding the situation of non-indigenous residents of multi-ethnic rural areas who do not have the right of access to natural resources, while living in the same environment. In Russia, this problem is specifically relevant for the coastal regions of the Far East, where fish and salmon roe have been historically the most important re-source of self-sustainment for both indigenous residents and resettlers. Using the example of one of the coastal areas of Primorsky Krai, where representatives of indigenous and non-indigenous peoples live alongside each other, we show how unequal distribution of rights to extract natural resources affects communication between them. Based on semi-structured interviews, informal conversations and observations collected during the field research, we have found that individual salmon fishing quotas are becoming a way to partially legalize informal fishing. Villagers go out fishing with their fellow villagers, and in case of the appearance of law enforcement agen-cies, fishermen from among KMNS take full responsibility for the catch and fishing gear on themselves. Regard-less of nationality, rural residents consider it unfair that non-indigenous peoples, who live in the same natural and climatic conditions, and have similar to KMNS economy, have no rights to catch salmonids. Thus, against the background of allocation of quotas for salmonid catching only to indigenous fishermen, new practices of reproduc-tion of solidarity and reciprocity are emerging in multiethnic rural communities.