Indigenous engagement in health: lessons from Brazil, Chile, Australia and New Zealand.

BACKGROUND: Given the persistence of Indigenous health inequities across national contexts, many countries have adopted strategies to improve the health of Indigenous peoples. Governmental recognition of the unique health needs of Indigenous populations is necessary for the development of targeted programs and policies to achieve universal health coverage. At the same time, the participation of Indigenous peoples in decision-making and program and policy design helps to ensure that barriers to health services are appropriately addressed and promotes the rights of Indigenous peoples to self-determination. Due to similar patterns of Indigenous health and health determinants across borders, there have been calls for greater global collaboration in this field. However, most international studies on Indigenous health policy link Anglo-settler democracies (Canada, Australia, Aotearoa/New Zealand and the United States), despite these countries representing a small fraction of the world's Indigenous people. AIM: This paper examines national-level policy in Australia, Brazil, Chile and New Zealand in relation to governmental recognition of differential Indigenous health needs and engagement with Indigenous peoples in health. The paper aims to examine how Indigenous health needs and engagement are addressed in national policy frameworks within each of the countries in order to contribute to the understanding of how to develop pro-equity policies within national health care systems. METHODS: For each country, a review was undertaken of national policies and legislation to support engagement with, and participation of, Indigenous peoples in the identification of their health needs, development of programs and policies to address these needs and which demonstrate governmental recognition of differential Indigenous health needs. Government websites were searched as well as the following databases: Google, OpenGrey, CAB Direct, PubMed, Web of Science and WorldCat. FINDINGS: Each of the four countries have adopted international agreements regarding the engagement of Indigenous peoples in health. However, there is significant variation in the extent to which the principles laid out in these agreements are reflected in national policy, legislation and practice. Brazil and New Zealand both have established national policies to facilitate engagement. In contrast, national policy to enable engagement is relatively lacking in Australia and Chile. Australia, Brazil and New Zealand each have significant initiatives and policy structures in place to address Indigenous health. However, in Brazil this is not necessarily reflected in practice and although New Zealand has national policies these have been recently reported as insufficient and, in fact, may be contributing to health inequity for Maori. In comparison to the other three countries, Chile has relatively few national initiatives or policies in place to support Indigenous engagement or recognise the distinct health needs of Indigenous communities. CONCLUSIONS: The adoption of international policy frameworks forms an important step in ensuring that Indigenous peoples are able to participate in the formation and implementation of health policy and programs. However, without the relevant principles being reflected in national legislature, international agreements hold little weight. At the same time, while a national legislative framework facilitates the engagement of Indigenous peoples, such policy may not necessarily translate into practice. Developing multi-level approaches that improve cohesion between international policy, national policy and practice in Indigenous engagement in health is therefore vital. Given that each of the four countries demonstrate strengths and weaknesses across this causal chain, cross-country policy examination provides guidance on strengthening these links.

"Something Born of the Heart": Culturally Affiliated Illnesses of Older Adults in Oaxaca.

This qualitative research identifies and analyzes emotions and interventions linked to affective experiences and cultural aspects of health/illness/care processes in 219 older adults of eight Indigenous groups in Oaxaca, Mexico. Life stories are examined from perspectives of cultural gerontology, anthropology of emotions and critical medical anthropology with a gender perspective. Significance and healing of two illnesses of cultural affiliation: tiricia (sadness of the soul) and envidia (rancor against the successful) are examined. Conditions other than diabetes and hypertension are healed by traditional remedies or spiritual cleansings. Examining tiricia and envidia permit improved knowledge and understanding of the emotional culture and the community.

Implementation of midwifery continuity of care models for Indigenous women in Australia: Perspectives and reflections for the United Kingdom.

Maternity models that provide midwifery continuity of care have been established to increase access to appropriate services for Indigenous Australian women. Understanding the development and implementation of continuity models for Indigenous women in Australia provides useful insights for the development and implementation of similar models in other contexts such as those for vulnerable and socially disadvantaged women living in the United Kingdom. To ensure better health outcomes for mothers and babies, it is crucial to promote culturally competent and safe public health models in which midwives work collaboratively with the multidisciplinary team.

Ethnobotanical survey of medicinal plants used by nomadic peoples in the Algerian steppe.

ETHNOPHARMACOLOGICAL RELEVANCE: This study is the first ethnobotanical survey focusing on the herbal medicines traditionally used by the nomadic community of the Algerian steppe, identifying new medicinal plants and uses from one of the most characteristic indigenous populations in Algeria. Moreover, the study contributes to the understanding of transmission of medicinal plant knowledge in the Mediterranean basin. AIM OF THE STUDY: This work aims to document the phytotherapeutical knowledge and practice of the nomadic community of the Algerian steppe, and compare it with neighbouring sedentary populations and Mediterranean historical texts. Through this, the study strives to evaluate processes of transmission of knowledge among this population, for whom written sources have been largely unavailable. METHODS: Ethnobotanical surveys were carried out during two years (2015-2017). In total, 73 informants from nomadic populations were interviewed in several steppe regions including areas in the administrative departments of Tiaret, Saida, Naama, Djelfa and M'sila. Structured interviews about medicinal plant knowledge were combined with guided tours with the informants. Prior informed consent was always obtained. The surveys allowed for the collection of sociodemographic data and traditional knowledge about medicinal plants and their uses. Informant Consensus Factor (FIC) was calculated to evaluate agreement among informants. Results were compared to existing literature to evaluate similarities between this nomadic medicinal flora, that of neighbouring communities and historical texts and identify new plant citations and uses. RESULTS: Among Algerian nomadic communities, herbal remedies are used mostly by women and elders, who are often illiterate. We identified 97 taxa of medicinal plants belonging to 42 botanical families, importantly Lamiaceae, Asteraceae and Apiaceae, like in neighbouring communities. The most common plant parts and method of preparation are also shared with neighbouring populations. New uses are described for 25 known medicinal taxa, and nine species with undocumented medicinal uses in recent literature have been reported. However, some of these have been reported in Mediterranean materia medica. In total, 60% of the medicinal plant diversity used by Algerian nomads are well-known plants of the Mediterranean ethnopharmacological heritage. CONCLUSION: This study highlights the importance of traditional medicine for Algerian nomad communities. This indigenous population has specific knowledge about plants from their steppe environment, but also shares a pool of knowledge with sedentary Algerian populations and Mediterranean people as a whole. Our research shows that a common North African and Mediterranean ethnobotanical heritage exists.

And [They] Even Followed Her Into the Hospital: Primary Care Providers' Attitudes Toward Referral for Traditional Healing Practices and Integrating Care for Indigenous Patients.

Introduction/Importance: Given the promise of integrating traditional healing practices into primary care, we sought to examine the influence of primary care providers' racial concordance and Indigenous patients' ethnic salience on traditional healing treatment decisions. METHOD: Using a descriptive comparative design with an online clinical case vignette, we measured provider decision making via a 5-point Provider Acceptance of Traditional Healing-Referral and Consult questionnaire. Aggregated results of the main effects and interactional effects were analyzed using a 2 × 2 analysis of variance between-subjects design. RESULTS: The main effect for patient racial concordance on the dependent variable was significant, F(1, 89) = 5.71, p = .02. CONCLUSIONS: Provider-patient racial concordance does increase the providers' likelihood of consulting with and referring patients to traditional healing practices, regardless of the patient's ethnic salience. IMPLICATIONS FOR PRACTICE: All health care providers require training in traditional healing practices for Indigenous persons as guided by the cultural safety framework.

Social and emotional wellbeing assessment instruments for use with Indigenous Australians: A critical review.

RATIONALE: There is growing recognition that in addition to universally recognised domains and indicators of wellbeing (such as population health and life expectancy), additional frameworks are required to fully explain and measure Indigenous wellbeing. In particular, Indigenous Australian wellbeing is largely determined by colonisation, historical trauma, grief, loss, and ongoing social marginalisation. Dominant mainstream indicators of wellbeing based on the biomedical model may therefore be inadequate and not entirely relevant in the Indigenous context. It is possible that "standard" wellbeing instruments fail to adequately assess indicators of health and wellbeing within societies that have a more holistic view of health. OBJECTIVE: The aim of this critical review was to identify, document, and evaluate the use of social and emotional wellbeing measures within the Australian Indigenous community. METHOD: The instruments were systematically described regarding their intrinsic properties (e.g., generic v. disease-specific, domains assessed, extent of cross-cultural adaptation and psychometric characteristics) and their purpose of utilisation in studies (e.g., study setting, intervention, clinical purpose or survey). We included 33 studies, in which 22 distinct instruments were used. RESULTS: Three major categories of social and emotional wellbeing instruments were identified: unmodified standard instruments (10), cross-culturally adapted standard instruments (6), and Indigenous developed measures (6). Recommendations are made for researchers and practitioners who assess social and emotional wellbeing in Indigenous Australians, which may also be applicable to other minority groups where a more holistic framework of wellbeing is applied. CONCLUSION: It is advised that standard instruments only be used if they have been subject to a formal cross-cultural adaptation process, and Indigenous developed measures continue to be developed, refined, and validated within a diverse range of research and clinical settings.

Smoking in Pregnancy Among Indigenous Women in High-Income Countries: A Narrative Review.

INTRODUCTION: Pregnant women in socioeconomically disadvantaged circumstances, such as Indigenous women, have a high prevalence of smoking. Tobacco smoking is the most significant reversible risk factor for the health of Indigenous pregnant women and their babies. METHODS: As researchers working in this specialized area, we conducted a narrative review of the literature on smoking among Indigenous pregnant women in the United States, Canada, New Zealand, and Australia. We summarize prevalence and factors influencing tobacco use, interventions, and evidence gaps for tobacco control and smoking cessation. Recommendations are made for future interventions, policy changes, and much-needed research. RESULTS: Common themes emerging across the four countries reveal opportunities for cross-cultural collaborative studies and trials. These include the social-normative use of tobacco as barriers to quitting in pregnancy and the need for evaluations of interventions at the family and community level. Socioeconomic disparities underscore the importance of enhancing the implementation and reach of strategies to prevent and reduce prenatal tobacco smoking among Indigenous women. Elders and community health care providers as role models for nontobacco use could be explored. Qualitative work is needed to understand the barriers and opportunities, such as cultural strengths supporting quitting tobacco to develop more effective approaches. CONCLUSIONS: Although a high-priority group, there remains a dearth of research on Indigenous women's smoking in pregnancy. Studies have assessed knowledge and attitudes to smoking in pregnancy, and small feasibility studies and a few empirical trials have been conducted. Recommendations for promising culturally appropriate cessation interventions have been made. Larger trials are warranted. IMPLICATIONS: Strategies to support quitting among pregnant Indigenous women need to be multifactorial and take account of the social determinants of smoking including historical antecedents, community norms, cultural strengths, and recognition of individual and community needs. Cross-country research collaborations have the potential to leverage funding, share expertise, and strengthen approaches to tackle an important and poorly attended health disparity that has a profound impact on the entire life course for Indigenous peoples.

Medicinal Plant Diversity and Inter-Cultural Interactions between Indigenous Guarani, Criollos and Polish Migrants in the Subtropics of Argentina.

Numerous studies highlight the importance of phytotherapy for indigenous and non-indigenous people in different parts of the world. In this work we analyze the richness (number of species), diversity (plant identity and the number of illnesses for which it is used) and similarity of plant species and illnesses treated with them, in order to contribute new data and insight into the importance of plant medicines to the local medical systems of people living in Misiones province, in the subtropics of Argentina. Three sympatric groups were compared: Guarani Indians, Criollos (mestizos) and Polish migrants. Quantitative scrutiny was focused on both primary and secondary sources. The similarity and diversity of medicinal plants and uses between groups was calculated by applying the Sørensen quantitative coefficient and the Shannon-Wiener index, respectively. In order to identify the characteristic plant species used by each group, the Cultural Importance and Prevalence Value (CIPV) was calculated based on the species Indicator Value (IndVal), which combines a species relative abundance with its relative frequency of occurrence in the various groups, and modified according to the type of the analyzed data. The important finding is a great variation in the number of species used by the study groups. Altogether, 509 botanical species were registered: Guarani (397), Criollos (243) and Polish migrants (137). For all groups, the use of native medicinal plants prevailed. The Guarani appear to be the local experts in use of medicinal plants. There is the significant difference in the number of treated illnesses by each taxon among three groups. Criollos and Polish migrants exhibit the greatest similarity in illnesses treated with medicinal plants. These groups share a corpus of knowledge related to illness nosology, and have a symptomatic approach to illness treatment. The Guarani have an etiological approach to illness diagnosis and healing, which may be viewed as a barrier to the exchange of knowledge about home medicine with other ethnic groups of Misiones.

Traditional preference of Wild Edible Fruits (WEFs) for digestive disorders (DDs) among the indigenous communities of Swat Valley-Pakistan.

ETHNOPHARMACOLOGICAL RELEVANCE: Digestive disorders (DDs) causes indisposition and lead to death, especially in the underdeveloped world where hygienic conditions are scarce. A major proportion of the human populace depends on the use of traditional knowledge about the consumption of medicinal plants for many diseases, including DDs. The contemporary study summarizes the indigenous uses of Wild Edible Fruits (WEFs) of Swat Valley used for DDs and to evaluate the bio-efficacy of these pharmacologically essential fruit species from the available literature. MATERIAL AND METHODS: An ethnomedicinal study was conducted in Swat valley, Northern Pakistan. Data was collected through field assessment as well as from traditional healers and local people by means of personal interviews and semi-structured questionnaires, giving value to both rural and urban communities. The ethnomedicinal knowledge was quantitatively analysed using various indices like Familiarity Index (FI), Consensus index (CI), Informant consensus factor (ICF) and the present data was compared with previous studies in the neighbouring areas using Jaccard similarity coefficient (JI). RESULTS: The present study recorded use reports on 53 WEFs of ethnomedicinal prominence in the treatment of DDs, belonging to 23 families. The recurrent growth forms were trees (51%) shrubs (38%) and herbs (11%). High consumption of fruits (50%), leaves (27%) and flowers (12%) was recorded. The traditional preparations were mostly in the form of unprocessed dried/fresh, powder, Juice and decoction and were usually taken orally. Almost 20-30% of the plants occurred in synanthropic vegetation while more than 75% were found in natural woodland and grassland vegetation. Family Berberidaceae dominated with highest FIV (41) followed by Punicaceae (38), Oxalidaceae (36) and Moraceae (35). ICF values for carminative (0.6) showed high consensus factor followed by anthelmintic, gastroenteritis and intestinal disorders (0.5). FI value is high for Berberis lycium (0.5), Morus alba (0.5), Morus nigra (0.5) followed by Olea ferruginea (0.45). B. lycium had the high consensus index, whereas, a study conducted on Lesser Himalayas Pakistan showed high value of Jaccard similarity coefficient. CONCLUSION: WEFs are predominantly used in the treatment of various diseases in the valley and traditional knowledge about the use of these species against DDs is still prevailing. Multiple uses of these WEFs suggest further investigation into its phytochemical, toxicological and pharmaceutical potential. This study will serve as a baseline data for future pharmacological studies.

Partnering with Indigenous student co-researchers: improving research processes and outcomes.

OBJECTIVE: To examine the contribution of student co-researchers to a community-based participatory Photovoice investigation of Indigenous children's food-related lived experience. We examine co-researchers' contributions to the research process, their role in knowledge co-generation and dissemination, and factors that fostered research partnership with the teenage co-researchers. METHODS: High school students attending a First Nation community school in Canada were trained as research partners. They contributed to aspects of research design, conducted interviews with grades 3 and 4 Photovoice participants, and participated in data analysis and the development of a culturally relevant photobook. The study was initiated by the community's research committee. It is informed by critical consciousness theory and the positive youth development framework. RESULTS: Student co-researchers incorporated culturally appropriate strategies as they interviewed participants. Co-researchers adopted conversational approaches, built rapport by articulating personal and cultural connections, and engaged in mentoring and health promotion as they interviewed participants. They made critical contributions to dissemination by developing photobook content that promoted the importance of traditional foods and the vital role of family and community in healthy eating practices. Relationships and "dialogic" space were important to building partnership with and promoting capacity development among youth co-researchers. CONCLUSIONS: Partnership between university researchers and Indigenous student co-researchers holds great promise for health promotion in communities. Co-researchers developed research and leadership skills, gained understanding of health challenges facing their community, and initiated health and cultural promotion through the project's Photobook. This investigation supports the powerful potential of student co-researchers to meaningfully contribute to research processes and to build knowledge that is relevant and credible both within and outside of their communities. Findings have implications for youth, communities and researchers.

Ethnobotanical study of medicinal plants in the environs of Tara-gedam and Amba remnant forests of Libo Kemkem District, northwest Ethiopia.

BACKGROUND: Remnant forests found in areas that have long been converted to agricultural landscapes are refuges of wild useful plants; and societies inhabiting them are custodians of rich indigenous botanical knowledge. This study was undertaken to document the medicinal plants used by the people living in and around Tara-gedam and Amba remnant forests, northwestern Ethiopia, together with the associated ethnomedicinal knowledge. METHODS: Data were collected from 105 informants through semi-structured interviews, guided field walk, market survey; and analyzed using standard ethnobotanical analytical tools including ranking and comparison. RESULTS: A total of 163 medicinal plant species in 145 genera and 67 families were recorded among which Zehneria scabra drew the highest community consensus. Seventy-one percent of the medicinal plants were those used for treating human ailments only, 21% for both human and livestock and 8% for livestock only. Asteraceae, with 14 species, had the highest number of medicinal plant species. The medicinal plants mainly (79.1%) belong to the shrub and herb categories and most of them were sourced from the wild habitats. Leaves and fresh plant materials were more frequently used for medicine preparation than other parts. Protected government and church forests as well as tree propagation in nurseries followed by planting them and local practices constitute the major forest conservation efforts that indirectly protect the medicinal plants in the area. Elders and healers knew more about the medicinal plants, their distribution, the local ethnomedicinal practices and knowledge transfer patterns. Though important for the local healthcare system and with potentials for modern drug discovery, both the plants and the knowledge pool are under threat. CONCLUSION: The diversity of medicinal plants and the associated indigenous knowledge of Tara-gedam and its environs are of a considerable value to the local community and beyond. There is, therefore, a need for conservation of the vegetation and the medicinal plants along with preservation of the wealth of the indigenous knowledge.

Locally harvested foods support serum 25-hydroxyvitamin D sufficiency in an indigenous population of Western Alaska.

BACKGROUND: Low serum vitamin D is associated with higher latitude, age, body fat percentage and low intake of fatty fish. Little documentation of vitamin D concentrations is available for Alaska Native populations. OBJECTIVE: This study was undertaken to investigate serum 25-hydroxyvitamin D (25(OH)D) concentrations of the Yup'ik people of southwestern Alaska in relation to demographic and lifestyle variables, particularly with the use of locally harvested (local) foods. DESIGN: Cross-sectional study. METHODS: We estimated 25(OH)D, dietary vitamin D and calcium, percent of energy from local foods and demographic variables in 497 Yup'ik people (43% males) aged 14-92 residing in southwestern Alaska. Sampling was approximately equally divided between synthesizing and non-synthesizing seasons, although the preponderance of samples were drawn during months of increasing daylight. RESULTS: Mean vitamin D intake was 15.1 ± 20.2 µg/d, while local foods accounted for 22.9 ± 17.1% of energy intake. The leading sources of vitamin D were local fish (90.1%) followed by market foods. Mean 25(OH)D concentration was 95.6 ± 40.7 nmol/L. Participants in the upper 50th percentile of 25(OH)D concentration tended to be older, male, of lower body mass index, sampled during the synthesizing season, and among the upper 50th percentile of local food use. CONCLUSIONS: A shift away from locally harvested foods will likely increase the risk for serum 25(OH)D insufficiency in this population.

Karen and Lawa medicinal plant use: uniformity or ethnic divergence?

ETHNOPHARMACOLOGICAL RELEVANCE: We here tease apart the ethnopharmacological knowledge of plants in two Thai villages to determine to which degree the uses are particular to individual ethnic groups and to which degree they are part of a generalized and uniform set of widespread medicinal plants used over a large geographic range. We compared Karen and Lawa knowledge of medicinal plants in the Mae Cheam watershed of northern Thailand, where both ethnic groups have settled and share ecological conditions for resource extraction. We were interested in documenting the degree to which these two ethnic groups use the same or different medicinal plant species. The use of the same plant species by the two groups was considered a sign of uniform and cross-cultural local knowledge, whereas the use of different medicinal plants by each group was considered a sign of culturally specific local knowledge that developed within each ethnic group. MATERIALS AND METHODS: We inventoried the plant species in different habitats around one Karen village and one Lawa village using stratified vegetation plots and using semi-structured questionnaires we interviewed 67 key informants regarding their use of plants for medicine. We then calculated the Fidelity level FL (FL values near 100% for a species indicate that almost all use reports refer to the same way of using the species, whereas low FL values indicate that a species is used for many different purposes) and cultural importance index CI (the sum of the proportion of informants that mention each of the use categories for a given species) to estimate the variation in medicinal plant use. We used Jaccard's Index JI (This index relates the number of shared species to the total number of species) to analyze the similarity of medicinal plant use between the two villages. RESULTS: A total of 103 species of medicinal plant species in 87 genera and 41 families were identified and they were used to cure 35 ailments. The FL of the medicinal plant species varied from 10% to 100%, was different for each ailment, and differed between the two ethnic groups. The most important medicinal plant species, those with the highest CI value, were not the same in the two villages. Costus speciosus, which is used to treat urinary infections and wounds in animals, had the highest CI value in the Karen village, whereas Sambucus javanica, which is used to treat wounds, fractures, bloat, and edema in humans, had the highest CI value in the Lawa village. Only 17 medicinal species (16.5%) were shared between the two villages. Methods of preparation and application were significantly different between the two villages, whereas the plant parts used, habit, and route of administration were similar. CONCLUSION: Our study demonstrates that ethnic groups that live in the same geographic area can have significantly different traditional knowledge systems for medicinal plants, at least when it comes to the species used and their preparation and medicinal application. We assume that differences in cultural history and background in the two villages led to differences in medicinal plant use, preparation, and application.

Dentistry students' perceptions about an extramural experience with a Brazilian indigenous community.

OBJECTIVE: The aim of the present study was to evaluate dentistry students' perceptions about an extramural activity designed to deliver dental care to an indigenous community. MATERIALS AND METHODS: This was a qualitative investigation involving 4 students of dentistry who had just had the experience of delivering treatment to indigenous Brazilian people. These students answered questions about the relevance of the experience to their personal and professional lives. We performed Content Analysis to data treatment and it was analysed by Social Representation Theory. RESULTS: Two social representations were reached: a) Being capable to promote oral health; b) Facing human feeling and respect each other. CONCLUSION: We concluded that participation in an extramural project improves the students' understanding of primary health care in dentistry. Such experiences help students develop a sense of cultural respect, comprehensive care, and to understand patients in their totality as social beings with their own values, beliefs, and attitudes regarding oral health care.

Cattle cults of the Arabian Neolithic and early territorial societies.

At the cusp of food production, Near Eastern societies adopted new territorial practices, including archaeologically visible sedentism and nonsedentary social defenses more challenging to identify archaeologically. New archaeological and paleoenvironmental evidence for Arabia's earliest-known sacrifices points to territorial maintenance in arid highland southern Yemen. Here sedentism was not an option prior to agriculture. Seasonally mobile pastoralists developed alternate practices to reify cohesive identities, maintain alliances, and defend territories. Archaeological and paleoenvironmental evidence implies cattle sacrifices were commemorated with a ring of more than 42 cattle skulls and a stone platform buried by 6,400-year-old floodplain sediments. Associated with numerous hearths, these cattle rites suggest feasting by a large gathering, with important sociopolitical ramifications for territories. A GIS analysis of the early Holocene landscape indicates constrained pasturage supporting small resident human populations. Cattle sacrifice in southern Arabia suggests a model of mid-Holocene Neolithic territorial pastoralism under environmental and cultural conditions that made sedentism unsusta

Improvement of maternal Aboriginality in NSW birth data.

BACKGROUND: The Indigenous population of Australia was estimated as 2.5% and under-reported. The aim of this study is to improve statistical ascertainment of Aboriginal women giving birth in New South Wales. METHODS: This study was based on linked birth data from the Midwives Data Collection (MDC) and the Registry of Births Deaths and Marriages (RBDM) of New South Wales (NSW). Data linkage was performed by the Centre for Health Record Linkage (CHeReL) for births in NSW for the period January 2001 to December 2005. The accuracy of maternal Aboriginal status in the MDC and RBDM was assessed by consistency, sensitivity and specificity. A new statistical variable, ASV, or Aboriginal Statistical Variable, was constructed based on Indigenous identification in both datasets. The ASV was assessed by comparing numbers and percentages of births to Aboriginal mothers with the estimates by capture-recapture analysis. RESULTS: Maternal Aboriginal status was under-ascertained in both the MDC and RBDM. The ASV significantly increased ascertainment of Aboriginal women giving birth and decreased the number of missing cases. The proportion of births to Aboriginal mothers in the non-registered birth group was significantly higher than in the registered group. CONCLUSIONS: Linking birth data collections is a feasible method to improve the statistical ascertainment of Aboriginal women giving birth in NSW. This has ramifications for the ascertainment of babies of Aboriginal mothers and the targeting of appropriate services in pregnancy and early childhood.

Indigenous beliefs about biomedical and bush medicine treatment efficacy for indigenous cancer patients: a review of the literature.

BACKGROUND: Australia's indigenous people suffer from higher cancer mortality than non-indigenous Australians, a discrepancy partly caused by differences in beliefs about treatment efficacy between Indigenous patients and their non-indigenous healthcare providers. This paper critically reviews the literature associated with Indigenous beliefs about cancer treatment, both 'bush medicine' and biomedical, in order to provide recommendations to healthcare providers about accommodating indigenous beliefs when treating cancer. METHODS: A search was undertaken of peer-reviewed journal papers using electronic databases and citation snowballing. Papers were selected for inclusion based upon relevance to themes that addressed the research questions. RESULTS: Literature suggests that indigenous beliefs about treatment efficacy for cancer involve five themes: (i) concerns about the toxicity of treatment; (ii) disconnect with the physician; (iii) fears about absence from home during treatment; (iv) different beliefs about disease aetiology; (v) biomedical cancer treatments failing to address holistic health. CONCLUSIONS: Although some information is known about indigenous Australian healing beliefs and practices associated with cancer treatment, few studies have addressed ways in which indigenous and biomedical approaches to cancer treatment might be integrated. Some recent work has examined the role of belief in cancer treatment, specifically bush medicine, but more research is required.

"Poppies are democracy!" A critical geopolitics of opium eradication and reintroduction in Turkey.

Historical scholarship in traditional geopolitics often relied on documents authored by states and by other influential actors. Although much work in the subfield of critical geopolitics thus far has addressed imbalances constructed in official, academic, and popular media due to a privileging of such narratives, priority might also be given to unearthing and bringing to light alternative geopolitical perspectives from otherwise marginalized populations. Utilizing the early-1970s case of the United States' first "war on drugs," this article examines the geopolitics of opium-poppy eradication and its consequences within Turkey. Employing not only archival and secondary sources but also oral histories from now-retired poppy farmers, this study examines the diffusion of U.S. antinarcotics policies into the Anatolian countryside and the enduring impressions that the United States and Turkish government created. In doing so, this research gives voice to those farmers targeted by eradication policies and speaks more broadly to matters of narcotics control, sentiments of anti-Americanism, and notions of democracy in Turkey and the region, past and present.