Aboriginal Health

L’analyse thématique de contenu repose sur un codage humain, reconnu pour sa richesse interprétative, mais très coûteux en temps et en ressources. Ce type d’analyse par intelligence artificielle (IA) propose d’accélérer ces étapes. Toutefois, en psychologie, son efficacité relative, comparée à celle d’un codeur humain, reste à documenter. Cette étude compare, dans un cadre d’analyse thématique réflexive, la convergence descriptive entre des codes générés par une IA et ceux produits par un analyste humain. Un script standardisé basé sur une méthodologie d’analyse thématique a été développé pour informer le codeur IA. Six verbatims issus d’entretiens de groupe (deux personnes survivantes d’agressions sexuelles, un-e intervenant-e psychosocial-e) ont été codés par un analyste humain et une IA. Les deux analystes ont généré indépendamment un arbre thématique rapportant les thèmes et les sous-codes. Un appariement sémantique, entre les deux corpus indépendants, a ensuite comparé la convergence des thèmes et la granularité des sous‑codes. L’appariement démontre qu’environ 69% des thèmes correspondent. Ces résultats démontrent une convergence adéquate des thèmes et granularité des sous-codes. La majorité des divergences proviennent d’un manque de synthèse du codeur IA, segmentant des thèmes proches sémantiquement. Le codage par IA semble prometteur pour fournir une ossature initiale de l’arbre thématique. Son usage est optimal en amont, suivi d’un raffinement pour éviter la fragmentation de catégories proches. L’emploi d’un seul système d’IA et le nombre restreint de verbatims constituent des limites importantes. Une étude ultérieure, mobilisant plusieurs analystes humains et IA à partir d’un corpus plus vaste, permettra d’en évaluer la généralisation.

IntroductionCardiovascular diseases are the main cause of mortality and disability worldwide, so the prevention becomes a priority in terms of public health. Therefore, it is necessary to use validated strategies to adequately identify these patients in daily clinical practice. The objective of this scope review is to comprehend and comprehensively describe the anthropometric indicators used in studies, such as such as weight, height, circumferences, lengths and skin folds, that address its association with coronary artery calcification to identify cardiovascular risk in the adult population.Methods and analysisUsing Arksey and O'Malley's scoping review methodology as a guide, our scoping review of published reviews begins by searching several databases: Cochrane Central Register of Controlled Trials in the Cochrane Library, Medline Complete (EbscoHost), Embase, LILACS (Literatura Latino-Americana e do Caribe em Ciências da Saúde-BIREME Literatura Latino-Americana e do Carib...

to that community [6]. However, what academics perceive as a benefit and what communities wish to receive or prioritise may not align and require further exploration. That is, are there secondary or even tertiary benefits that aren't prioritised by researchers, but have more value for the community? Discussions such as these are integral to collaborative frameworks and a key reason the Summer internship for Indigenous peoples in Genomics Australia (SING Australia) holds an annual workshop. SING brings together Indigenous Elders, Indigenous community members with and without scientific backgrounds, health workers, and researchers from the scientific and humanities disciplines. The inaugural workshop was held in 2019 in response to the lack of Indigenous people engaged within genomic disciplines in Australia. As part of a global consortium, SING Australia is a sister-program to SING U.S.A, SING Canada, and SING

Managing genetic disease using medically assisted reproductive technology is increasingly promoted as a feasible option, given revolutionary advances in genomics. Far less attention has been directed to the issue of whether there is equitable access to this option. Context and circumstance determine equitable access; however, reporting has drawn overwhelmingly from affluent Anglo-western populations in developed countries. The experiences of poorer, less educated subpopulations within affluent countries and populations in less developed countries are underreported. The ability of consumers to understand the opportunities and risks of medically assisted reproductive technology is likewise not well described in the literature despite significant technological complexity and evidence that genetic disease may be overrepresented within some disadvantaged population groups. Equity is achieved by identifying barriers and allocating appropriate resources to enable understanding and access. In the case of utilising medically assisted technology, social and power relationships, regulations, and the presumptions of authority figures and policymakers reduce equitable access. Physical or cultural marginalisation from mainstream health services may result in reduced access to genetic and prenatal testing, in-vitro fertilisation and genetic screening of embryos necessary for medically assisted reproduction. Cost and regulatory frameworks can likewise limit opportunities to engage with services. Moreover, the quality of the information provided to prospective users of the technology and how it is received governs understanding of prevention and inhibits adequately informed choice. Best practice care and adequately informed choice can only be achieved by conscientiously attending to these accessibility issues. Deep engagement with at-risk people and critical reflection on mainstream accepted standpoints is required. This paper outlines issues associated with engaging with medically assisted reproduction encountered by Aboriginal families living with Machado-Joseph Disease in some of the most remote areas of Australia. It is the right of these families to access such technologies regardless of where they live. Current barriers to access raise important questions for service providers with implications for practice as new technologies increasingly become part of standard medical care.

Emma Kowal's Haunting Biology: Science and Indigeneity (2023) investigates the history of biological and medical research about Indigenous peoples in Australia. This book forum invited contributors to provide nuanced insights that engage the book's central contributions to debates in medical anthropology about decoloniality and racial science. Bringing together medical historians, anthropologists, and scholars of science and technology Trevor Engel, Beth Greenhough, Frederic Keck, and Ros Williams, the forum's contributors highlight the profound utility of Kowal's insights and the necessity of attending to the spectral presence of the colonial-era ghosts that haunt the ground on which contemporary biological science, including genetics and epigenetics, is practised. The forum contributors draw out the multivalent affects that ghosts provoke, brought to presence through Kowal's ethnographic observations and rich archival research. They engage ghostly characters like British scientist Baldwin Spencer, who sits out of sight but not out of mind in a museum storeroom, and surgeon and Australian anatomist Sir William Colin Mackenzie, who haunts the dreams of Goenpul Indigenous filmmaker Romaine Moreton. Each contributor shows the productive tension gained by following Kowal's directive to listen to these and other ghosts around us, and gesture towards the possibilities of decolonial scientific practices.

Background: To date, determinants of respiratory health in First Nations people living on reserves and means of addressing and redressing those determinants have not been well established. Hence the Saskatchewan First Nations Lung Health Project (FNLHP) is a new prospective cohort study of aboriginal people being conducted in two First Nations reserves to evaluate potential health determinants associated with respiratory outcomes. Using the population health framework (PHF) of Health Canada, instruments designed with the communities, joint ownership of data, and based on the 4-phase concept of the First Nations Regional Longitudinal Health Survey, the project aims to evaluate individual factors, contextual factors, and principal covariates on respiratory outcomes. The objective of this report is to clearly describe the methodology of (i) the baseline survey that consists of two components, an interviewer-administered questionnaire and clinical assessment; and (ii) potential intervention programs; and present descriptive results of the baseline data of longitudinal FNLHP.

A team of Aboriginal and non-Aboriginal researchers from three NSW universities has spent the last two years investigating what might be done to make transitions to primary school as successful as possible for Aboriginal and Torres Strait Islander children and their families. Some of ...

We express our thanks to the Elders, community members and health professionals in Queensland, New South Wales, Victoria, Tasmania, the Australian Capital Territory and South Australia for the valuable information they shared with us throughout the consultation process. We particularly thank Coralie Ober and Bevan Ah Kee (Queensland), Scott Wilson (South Australia), Vicki Russell (Tasmania), Simone Andy (Victoria), and staff of the Aboriginal Health & Medical Research Council (NSW) for facilitating introductions to individuals and services, and in some cases facilitating the workshops, in their respective states. We are indebted to the assistance of the Reference Group members. Vic Rechichi, Communications Officer at the National Drug Research Institute (NDRI), provided assistance with the finalisation of images contained in the PosterMaker database.

Improving access to better, more efficient, and rapid cancer diagnosis is a necessary component of a highquality cancer system. How diagnostic services ought to be organized, structured, and evaluated is less understood and studied. Our objective was to address this gap. As a quality initiative of Cancer Care Ontario's Program in Evidence-Based Care, the Diagnostic Assessment Standards Panel, with representation from clinical oncology experts, institutional and clinical administrative leaders, health service researchers, and methodologists, conducted a systematic review and a targeted environmental scan of the unpublished literature. Standards were developed based on expert consensus opinion informed by the identified evidence. Through external review, clinicians and administrators across Ontario were given the opportunity to provide feedback. The body of evidence consists of thirty-five published studies and fifteen unpublished guidance documents. The evidence and consensus opinion consistently favoured an organized, centralized system with multidisciplinary team membership as the optimal approach for the delivery of diagnostic cancer assessment services. Independent external stakeholders agreed (with higher mean values, maximum 5, indicating stronger agreement) that dap standards are

The importance of including minority populations in research is increasingly recognised.1 Advances in clinical and research genomics have highlighted the need for and challenges of inclusion of Indigenous populations in genomic studies.2,3 Previous negative experiences in genomics research in Indigenous populations4,5 have placed substantial barriers, but the opportunity now exists to take a fresh approach through genuine partnership with, and leadership from, Indigenous communities and their representatives. In this article, we reflect on the lessons learned from a recent genomewide association study of rheumatic heart disease (RHD) with Aboriginal Australian participants.6

Using non-Indigenous perspectives of parental social and emotional wellbeing in the design and application of parent support programs can undermine program effectiveness as it may not account for Indigenous family structures and community values. With a clearer understanding of Indigenous parent wellbeing and its determinants, parenting interventions can be more appropriately designed and tailored to provide support for Indigenous families. This study utilised a communitybased participatory action research approach involving collaboration between the research team, participants, and community advisory groups to explore Indigenous parents' and carers' conceptions of wellbeing. Participants' cultural perspectives on parent wellbeing were collected through semistructured focus groups and in-depth interviews (N = 20). Thematic analysis was undertaken using theory-driven and interpretative phenomenological analysis. Eleven themes emerged as risk and protective factors across three domains: child domain (i.e., school attendance and education, respect, routine, development), parent domain (i.e., role modelling, self-regulation of body, self-regulation of mind and emotions, parenting strategies), and context domain (i.e., connections to family and kinship, community, access to services). It is noteworthy that parents reported three super-ordinate intersecting themes across all domains: connection to culture, Country, and spirituality. In addition, Indigenous parents' and carers' conception of their own wellbeing is closely linked to their children's wellbeing, their lived community context, and expected personal indicators. In recognising and working with this holistic view of Indigenous parent wellbeing, parent support programs can be optimally designed and implemented in Indigenous communities.

Si 80% des etudiants evaluent leur etat de sante comme etant «bon», 20% d’entre eux jugent leur etat de sante plutot moins bon que l’annee precedente.La sante a une influence sur la reussite des etudes et de nombreux etudiants (1/3) renoncent a se soigner par manque de temps et/ou de moyens financiers. La sante des etudiants n’est pas a considerer comme un element independant, mais comme le temoin de la sante de l’Universite. Apres avoir dresse un etat des lieux de la sante des etudiants en France, nous reviendrons sur differents determinants de sante et ferons le lien avec les politiques de sante menees et a mener, notamment a l’universite de La Reunion.

The paper provides a reflection on the stigma associated with HIV in Cameroon, highlighting its multiple socioeconomic and health implications. Interviews were conducted with people living with HIV and health facility officials in the Far North region of Cameroon. Through a qualitative approach, this research explored various aspects to better understand the profound impacts on individuals living with HIV and to identify adequate responses. Stigma represents a major obstacle to equitable access to health services, education, employment, and other fundamental rights for people living with HIV. This issue transcends geographic and cultural barriers, disproportionately affecting women and exacerbating regional disparities. The main objective is to assess the forms of stigma in order to identify appropriate solutions and advocate for change, promoting better inclusion of people living with HIV. This stigma manifests through various forms of social exclusion, discrimination in healthcare, violations of confidentiality, and prejudices reinforced by the media. These factors not only hinder access to medical care and social support but also negatively affect the quality of life and overall well-being of the individuals concerned.
Keywords: stigma, vulnerability, access to services, human rights Keywords: stigma, vulnerability, access to services, human rights

Metis ethnogenesis is an illdefi ned pro cess of cultural creation for those who study it, just as it was for those who lived through it. Accessing the pro cess is hard because those who experienced it often did not do so deliberately or consciously, and few recorded the pro cess for historians to discover. Ancestors of the Metis, both Eu ro pe an and indigenous, did not have categories of ethnic and cultural identity that match with those in use today. Indigenous ancestors in par tic u lar orga nized their worlds through relationships with people, landscapes, and the spirits they called on for assistance and guidance to survive and fl ourish.1 When scholars write about men in the fur trade, it is often diffi cult to distinguish who was French Canadian, Metis, Cree, or Ojibwe. We can try to discover where someone grew up, who their parents were, what languages they spoke, those with whom they traded, and where they chose to live and work. But are these things the actual ingredients ...

Introduction : L’Approche Psychosociale Communautaire (APC) « Guérir Ensemble » a été promue par la Coopération Suisse et certaines organisations partenaires. Elle a pour but de faire renaître la solidarité, l’entraide et la participation communautaire pour lutter contre les violences sexuelles basées sur le genre. Objectif : Cette étude analyse le changement à travers certains facteurs de développement (psychologique, social, économique…) chez les bénéficiaires directs à l’Est de la République Démocratique du Congo (RDC). Matériels et méthodes : Elle a eu recours à des techniques qualitatives et quantitatives pour appréhender en profondeur le changement observé (focus group, interview et récit de vie) et par la suite, il s’agissait de compléter ces résultats en mesurant objectivement les indicateurs de changement ou de développement à chaque niveau chez les bénéficiaires dans les sites d’étude (territoire de Walungu). Les données ont été traitées et analysées à l’aide des logiciels Excel 2013, Epi Info 3.5.4. et QDA Miner. Résultats : Les résultats ont montré que les violences ont toujours existé, mais la situation s’est accentuée avec la présence des groupes armés et des rebelles depuis les années 1994 et 1996. Il existe également certaines pratiques culturelles rétrogrades, en plus des causes liées à l’insécurité. Le manque de collaboration, les bagarres, les tortures, la justice populaire, les mariages forcés et précoces, la discrimination des femmes, le viol des filles et des femmes… constituent les manifestations des violences dans la communauté. Les femmes et les jeunes filles restent la catégorie la plus vulnérable. Ces traumatismes ont déclenché chez la victime l’esprit de vengeance, de honte, de solitude, le sentiment d’infériorité, d’isolement, le recours à la justice populaire et la culpabilité. Les membres intègrent les ateliers de l’approche «  guérir en semble » par la sensibilisation. Le changement s’observe ; la guérison des blessures intérieures, la disparition de l’esprit de vengeance, de solitude, de conflit. Le travail en équipe (homme-femme), le développement socio-économique individuel, familial et communautaire ont été appréhendé. Les bénéficiaires sont engagés à animer les ateliers mais suggèrent une formation des personnes-ressources et un appui économique. De plus, une grande partie a déjà commencé à sensibiliser d’autres membres (soit 87,2 %). La majorité participe aux travaux en équipe (soit 96,4 %). La majorité est également déjà ouverte à la collaboration intercommunautaire (soit 92,4 %). Conclusion : Cette étude montre les effets transformateurs de cette approche « Guérir Ensemble » et met en évidence le changement à travers les facteurs de développement qui ont concouru à la réduction des violences. Il y a urgence à pérenniser et à consolider les acquis en passant par son institutionnalisation et le renforcement des activités y relatives au sein des communautés et des institutions de l’État.

The Baby When I found out that the rabbit had died, I was pretty depressed. It seemed like the end of so many possibilities. I wouldn't be able to go off and write now; I'd have to get a regular job. I tried half-heartedly to hide how I was feeling, but the disappointment must have been written all over my face. Mimi also had some reservations. Though of course she wanted to have kids, this was a little sooner than she had expected. We hadn't been out of college a year yet; we'd been married even less. She, too, had wanted to live in Paris someday. The day we found out about the rabbit, we went driving over the bumpiest road we could find. Though an abortion was out of the question-only girls who weren't married even considered them back in those days-still she was willing to give nature a nudge in the wrong direction. It actually got very funny and we were laughing hysterically. "I'm going to bust the springs if nothing else!" I shouted as we careened along a country road at sixty miles an hour, bouncing over rocks and gullies. Looking back on it now, I see that was one of the happiest days of our marriage-which doesn't mean we didn't have plenty of others, but just that there was a kind of craziness in us that day that seldom recurred as our life began to get burdened down with responsibilities. Naturally, nothing happened, the rabbit didn't miraculously come back to life, and we began looking at the future a little more seriously. Not that we hadn't been serious up until then-Mimi had a job, I was in graduate school-but having a baby was different, and now we knew we'd never be free, just the two of us. That was the thing. We hadn't known each other for years the way some couples do, going to movies, meeting for lunch, seeing each other whenever we wanted to. Ours had been

Health promotion for Australian Aboriginal and Torres Strait Islander communities and their people has generally had limited efficacy and poor sustainability. It has largely failed to recognise and appreciate the importance of local cultures and continues to have minimal emphasis on capacity building, community empowerment and local ownership. Culturally Appropriate Health Promotion is a framework of principles developed in 2008 with the World Health Organization and the Global Alliance for Health Promotion. It serves as a guide for community-focused health promotion practice to be built on and shaped by the respect for understanding and utilisation of local knowledge and culture. Culturally Appropriate Health Promotion is not about targeting, intervening or responding. Rather, it encourages health programme planners and policymakers to have a greater understanding, respect, a sense of empowerment and collaboration with communities, and their sociocultural environment to improve health. This commentary aims to examine and apply the eight principles of Culturally Appropriate Health Promotion to the Australian Aboriginal and Torres Strait Islander context. It proposes a widespread adoption of the framework for a more respectful, collaborative, locally suitable and therefore appropriate approach to Australian Aboriginal and Torres Strait Islander health promotion. (