A special drop: Characterising yeast isolates associated with fermented beverages produced by Australia's indigenous peoples.

Way-a-linah, an alcoholic beverage produced from the fermented sap of Eucalyptus gunnii, and tuba, a fermented drink made from the syrup of Cocos nucifera fructifying bud, are two of several fermented beverages produced by Australian Aboriginal and Torres Strait people. Here we describe the characterisation of yeast isolates from samples associated with the fermentation of way-a-linah and tuba. Microbial isolates were obtained from two different geographical locations in Australia - the Central Plateau in Tasmania, and Erub Island in the Torres Strait. While Hanseniaspora species and Lachancea cidri were the most abundant species in Tasmania, Candida species were the most abundant in Erub Island. Isolates were screened for tolerance to stress conditions found during the production of fermented beverages and for enzyme activities relevant to the appearance, aroma and flavour of these beverages. Based on screening results, eight isolates were evaluated for their volatile profile during the fermentation of wort, apple juice and grape juice. Diverse volatile profiles were observed for beers, ciders and wines fermented with different isolates. These findings reveal the potential of these isolates to produce fermented beverages with unique aroma and flavour profiles and highlight the vast microbial diversity associated with fermented beverages produced by Australia's Indigenous peoples.

Equality and difference: persisting historical themes in health and alcohol policies affecting Indigenous Australians.

Disseminating national health and alcohol policies to Aboriginal and Torres Strait Islander people in Australia has been a challenging task for governments and public servants. This has been for a number of reasons, including the enduring (negative) legacy of past "Aboriginal affairs" policies, the fact that Indigenous health programmes and alcohol programmes have been treated separately since the 1970s, and a more recent context in which the recognition of cultural difference was privileged. Confronted with the politics of difference, health departments were slow to examine avenues through which best practice advice emanating from WHO, and alcohol policies such as harm minimisation and early identification and treatment in primary health care, could be communicated in culturally recognisable ways to independent Indigenous services. In addition, there was hostility towards harm minimisation policies from Indigenous service providers, and Indigenous treatment programmes remained largely committed to abstinence-oriented modalities and the disease model of alcoholism, despite moves away from these approaches in the mainstream. However, genuinely innovative acute interventions and environmental controls over alcohol have been developed by Indigenous community-based organisations, approaches that are reinforced by international policy research evidence.

Fact or fiction? A critique of the National Aboriginal and Torres Strait Islander Social Survey 2002.

The ability of policy makers, practitioners and the broader public to respond appropriately in reducing the harms caused by alcohol misuse depends in large part on our understanding of the nature of the problem. In the case of consumption patterns and associated harms among indigenous minority peoples--in Australia and elsewhere--such an understanding is often difficult to achieve. There are a host of reasons for this including cultural differences between indigenous peoples and the broader populations within which they are located, cultural heterogeneity among indigenous peoples themselves, political and economic disadvantages which exacerbate misuse and its effects, methodological difficulties in the appropriate design of data collection instruments, sampling issues and the issues in the interpretation of data. All these difficulties mean that we need to subject any studies of substance misuse among indigenous peoples to a high level of scrutiny. This is particularly the case when such studies are conducted by organisations that are generally regarded as 'authoritative' sources of information. Chikritzhs & Brady have done this in the case of the National Aboriginal and Torres Strait Islander Social Survey 2002, conducted by the Australian Bureau of Statistics. In their review of this and other surveys, they demonstrate that to produce valid information about indigenous alcohol misuse, as well as having the skills to conduct broad population surveys, it is necessary to have an understanding of both methods of collecting data on alcohol consumption and Indigenous cultures themselves.

The role of a rural sobering-up centre in managing alcohol-related harm to Aboriginal people in South Australia.

There is a paucity of literature on the topic of sobering-up centres (non-custodial safe overnight accommodation for the publicly intoxicated). This paper presents findings of a retrospective longitudinal case study of a sobering-up centre in regional South Australia over the ten years 1991 to 2000. There were 6,486 admissions during this period, 97.1% of which were of Aboriginal people. We collated and analysed primary data including demographic details of admissions and re-admissions, and qualitative and quantitative measures of intoxication. The findings from this case study, considered together with contextual understandings from a wider social study in this region by three of the authors, provide supporting evidence of the important role of sobering-up centres in averting the known harms of a custodial response to public drunkenness, as well as avoiding the potential harm of alcohol-related injury among vulnerable Aboriginal people.

Historical and cultural roots of tobacco use among Aboriginal and Torres Strait Islander people.

Tobacco smoking has been identified as a major contributor to the high morbidity and mortality rates of Aborigines and Torres Strait Islanders. After years of inattention, smoking cessation projects designed for Indigenous Australians are beginning to emerge. Dealing successfully with smoking cessation would be enhanced by an understanding of the long-standing historical, social and cultural antecedents to present-day usage of tobacco. This paper provides a brief account of the historical precursors to present-day patterns of tobacco use among Aboriginal and Torres Strait Islander people. Historical records and mission documents, together with ethnographic accounts, suggest that Indigenous tobacco use today demonstrates strong continuity with past patterns and styles of use. These sources also reveal that Europeans deliberately exploited Aboriginal addiction to nicotine.

Other people, other drugs: the policy response to petrol sniffing among indigenous Australians.

This paper examines the policy response of Australian governments to petrol sniffing in Indigenous communities from the 1980s until the present. During this period, despite the formation of numerous inquiries, working parties and intergovernmental committees, there has been little accumulation of knowledge about the nature and causes of sniffing, or about the effectiveness of interventions. Policies are fragmentary; programmes are rarely evaluated, and most rely on short-term funding. The paper sets out to explain why this should be so. It draws upon a conceptual framework known as 'analytics of government' to examine the ways in which petrol sniffing comes to the attention of government agencies and is perceived as an issue; the mechanisms deployed by governments to address petrol sniffing; ways in which knowledge about sniffing is generated; and the underlying assumptions about people that inform policy-making. Drawing upon case studies of policy responses, the paper argues that a number of structural factors combine to marginalize petrol sniffing as an issue, and to encourage reliance on short-term, one-off interventions in place of a sustained policy commitment. Four recommendations are advanced to help overcome these factors: (1) agreements should be reached within and between levels of government on steps to be taken to reduce risk factors before the eruption of petrol-sniffing crises; (2) the evidence base relevant to petrol sniffing (and other inhalants) should be improved by funding and directing one or more existing national drug research centres to collate data on inhalant-caused mortality and morbidity, and to conduct or commission research into prevalence patterns, effectiveness of interventions and other gaps in knowledge; (3) the current pattern of short-term, pilot and project funding should be replaced with longer-term, evidence-based interventions that address the multiple risk and protective factors present in communities; and (4) insistence by governments that communities must take 'ownership' of the problem should be replaced by a commitment to genuine partnerships involving governments, non-government and community sectors.

The feasibility and acceptability of introducing brief intervention for alcohol misuse in an urban aboriginal medical service.

We report on the feasibility and perceived acceptability of brief motivational interviewing for hazardous alcohol use in an urban Aboriginal health service. General practitioners (GPs) were trained in brief motivational interviewing, and health workers in other aspects of the intervention. Screening was initially carried out using the AUDIT, but subsequently reduced to two simple questions. Information was obtained through a combination of participant observation by the study team, ongoing ad hoc review and feedback from staff, periodic group meetings, and one-on-one interviews with health workers and GPs. The AUDIT was felt to be intrusive and some questions were poorly understood. Brief intervention seemed to be culturally appropriate, but barriers to wider administration included lack of time and the complexity of patients' presenting health problems. As a result of the research there was an increase in general awareness and acceptability of addressing alcohol issues at the health service. This study raises a number of issues that both support and threaten the wide implementation of brief intervention in urban Aboriginal primary care settings.

Making tuba in the Torres Strait Islands: the cultural diffusion and geographic mobility of an alcoholic drink.

There is relatively scant evidence of the Indigenous production and consumption of intoxicating drinks on the Australian mainland prior to the arrival of outsiders. Although Australian Aboriginal peoples had mastered fermentation in some regions, the Indigenous manufacture of much stronger drinks by distillation was unknown on the Australian mainland. However, following contact with Pacific Island and Southeast Asian peoples in the 19th century, Islanders in the Torres Strait adopted techniques for fermenting and distilling what became a quasi-indigenous alcoholic drink known as tuba. This paper discusses the historical process of the diffusion of this substance as a result of labour migration and internationalisation in the Strait, and provides present-day accounts of tuba production from Torres Strait Islanders.

The demise of a planned randomised controlled trial in an urban Aboriginal medical service.

To fill a gap in knowledge about the effectiveness of brief intervention for hazardous alcohol use among Indigenous Australians, we attempted to implement a randomised controlled trial in an urban Aboriginal Medical Service (AMS) as a joint AMS-university partnership. Because of low numbers of potential participants being screened, the RCT was abandoned in favour of a two-part "demonstration project". Only 16 clients were recruited for follow-up in six-months, and the trial was terminated. Clinic, patient, Aboriginal health worker, and GP factors, interacting with study design factors, all contributed to our inability to implement the trial as designed. The key points to emerge from the study are that alcohol misuse is a difficult issue to manage in an Indigenous primary health care setting; RCTs involving inevitably complex study protocols may not be acceptable or sufficiently adaptable to make them viable in busy, Indigenous primary health care settings; and "gold-standard" RCT-derived evidence for the effectiveness of many public health interventions in Indigenous primary health care settings may never be available, and decisions about appropriate interventions will often have to be based on qualitative assessment of appropriateness and evidence from other populations and other settings.