The death of a baby, stillborn or living only briefly after birth, is a moral affront to the cycle of life, leaving parents without the life stories and material objects that traditionally offer comfort to the bereaved, nor—in an increasingly secularized society—a religious framework for making sense of their loss. For the grieving mother, it is also a physical affront, as her body continues to rehearse its part in its symbiotic relationship with a baby whose own body is disintegrating. Attempting to forge continuing bonds with her child after death makes special demands upon the notion of embodied spirituality, as she attempts to make sense of this tragedy in an embodied way. This paper, which reconciles the distinct perspectives of bereaved mothers and children’s doctors, proposes that the thoughtful re-presentation of medical insight into pregnancy and fetal development may assuage parents’ grief by adding precious detail to their baby’s life course, and by offering the mother a material basis to conceptualize her own body as part of the distributed personhood of her baby.

This article reports on a study that explored what it means to be a mature-age Aboriginal and Torres Strait Islander university graduate in the context of age, life-stage, history, culture, socioeconomic status, race and place. Using narrative interview data and fieldwork observation, we focus on the graduates’ workplace experiences and take a case study approach to amplify their voices. We argue that the data challenges the ideological construct of Australia as a ‘post-racial’ society and illustrates how interrelated variants of structural racism function to sanction, silence and control educated Aboriginal and Torres Strait Islander people, divide communities into quasi-hierarchies, and sustain white power and privilege. We show how these variants are expressed as low expectations, shadeism, culturism and privilege protectionism, and argue that their enactment can erect an invisible barrier to Aboriginal and Torres Strait Islander professional progression: a ‘white ceiling’ above which many graduates struggle to ascend.

Executive functioning and self-regulation influence a range of outcomes across the life course including physical and mental health, educational success, and employment. Children prenatally exposed to alcohol or early life trauma (ELT) are at higher risk of impairment of these skills and may require intervention to address self-regulation deficits. Researchers partnered with the local Aboriginal health organization and schools to develop and pilot a manualized version of the Alert Program® in the Fitzroy Valley, north Western Australia, a region with documented high rates of fetal alcohol spectrum disorder and ELT. This self-controlled cluster randomized trial evaluated the effect of an 8-week Alert Program® intervention on children's executive functioning and self-regulation skills. Following parent or caregiver consent (referred to hereafter as parent), 271 students were enrolled in the study. This reflects a 75% participation rate and indicates the strong community support that exists for the study. Teachers from 26 primary school classrooms across eight Fitzroy Valley schools received training to deliver eight, one-hour Alert Program® lessons over eight-weeks to students. Student outcomes were measured by parent and teacher ratings of children's behavioral, emotional, and cognitive regulation. The mean number of lessons attended by children was 4.2. Although no significant improvements to children's executive functioning skills or behavior were detected via the teacher-rated measures as hypothesized, statistically significant improvements were noted on parent-rated measures of executive functioning and behavior. The effectiveness of future self-regulation programs may be enhanced through multimodal delivery through home, school and community based settings to maximize children's exposure to the intervention. Despite mixed findings of effect, this study was an important first step in adapting and evaluating the Alert Program® for use in remote Australian Aboriginal community schools, where access to self-regulation interventions is limited.

Studies in north-western Australia Aboriginal communities identified executive functioning and behavioural regulation as significant issues for children. Exposure to alcohol prenatally and adverse childhood experiences are known risk factors for impaired self-regulation and executive function, these risk factors being present in remote communities. In response, a partnership was initiated to trial a teacher-delivered self-regulation intervention based on the Alert Program?. While student outcomes were assessed, this paper describes the implementation and impact of the intervention on teachers through the five dimensions of the RE-AIM framework (Reach, Efficacy, Adoption, Implementation, Maintenance). Trained classroom teachers (n =?29) delivered eight Alert Program? lessons to students over 8- weeks. Impact and implementation outcomes were assessed through teacher training and student lesson attendance data, and pre-training and post-intervention teacher questionnaires. Data were analysed using paired-samples t-tests and descriptive statistics. Eighty-one to 100% of prescribed lessons were implemented and teacher understanding of self-regulation and the Alert Program? improved significantly following the intervention (n =?14, p ??.001). Most teachers (88%) reported changing their teaching and behaviour management practices because of the intervention and agreed there were benefits in teaching the Alert Program? to students in a region with high reported rates of foetal alcohol spectrum disorder and self-regulation impairment.

We propose the use of the analytic frame of "nutrition justice" to reconcile the separate imperatives of Global Health for nutritional sufficiency for all, the requirement to eradicate childhood malnutrition, and the need for strategies to check the emerging pandemic of the double burden of malnutrition in the Global South. Malnutrition and its consequences of growth stunting are the result of disruption to the nutritional ecology of childhood from structural violence. This is mediated through loss of food security and perturbation to the cultural status of food, and on the prerequisites for nurture during infancy and early childhood. These socio-political factors obscure the role of biological adaptation to nutritional constraint on growth and hence the causal pathway to the double burden of malnutrition. In this paper we describe how the effects of historical and contemporary structural violence on the nutritional ecology of childhood are mediated using the examples of remote Aboriginal Australia and the Lao PDR. Both populations live by force of circumstance in a "metabolic ghetto" that has disrupted the prerequisites for parental nurturing through loss of food security and of traditional sources of transitional staple foods for weaning. Growth faltering and stunting of stature are markers of adaptation to nutritional constraint yet are also the first steps on the track to the double burden. We discuss the implications of these observations for strategies for global food sufficiency by mean of a thought-experiment of the effect of food and nutrient sufficiency for growth on future health and metabolic adaptation.

Background Despite a national focus on closing the gap between Aboriginal and non-Aboriginal child health outcomes in Australia, there remain significant challenges, including provision of health services in very remote communities. We aimed to identify and map child health services in the very remote Fitzroy Valley, West Kimberley, and document barriers to effective service delivery. Methods Identification and review of all regional child health services and staffing in 2013. Verification of data by interview with senior managers and staff of key providers in the Western Australian Country Health Service, Kimberley Population Health Unit, Nindilingarri Cultural Health Services and non-government providers. Results We identified no document providing a comprehensive overview of child health services in the Fitzroy Valley. There were inadequate numbers of health professionals, facilities and accommodation; high staff turnover; and limited capacity and experience of local health professionals. Funding and administrative arrangements were complex and services poorly coordinated and sometimes duplicated. The large geographic area, distances, extreme climate and lack of public and private transport challenge service delivery. The need to attend to acute illness acts to deprioritise crucial primary and preventative health care and capacity for dealing with chronic, complex disorders. Some services lack cultural safety and there is a critical shortage of Aboriginal Health Workers (AHW). Conclusions Services are fragmented and variable and would benefit from a coordinated approach between government, community-controlled agencies, health and education sectors. A unifying model of care with emphasis on capacity-building in Aboriginal community members and training and support for AHW and other health professionals is required but must be developed in consultation with communities. Innovative diagnostic and care models are needed to address these challenges, which are applicable to many remote Australian settings outside the Fitzroy Valley, as well as other countries globally. Our results will inform future health service planning and strategies to attract and retain health professionals to work in these demanding settings. A prospective audit of child health services is now needed to inform improved planning of child health services with a focus on identifying service gaps and training needs and better coordinating existing services to improve efficiency and potentially also efficacy.

Self-regulation and executive functioning impairments are common in children with fetal alcohol spectrum disorder. Given the high rates of fetal alcohol spectrum disorder identified amongst children living in the remote Fitzroy Valley region of Western Australia, the Alert Program® was identified as a culturally safe intervention for use in local primary schools. Researchers collaborated with Aboriginal Elders, community members, and staff from a Fitzroy Valley primary school to trial the Alert Program®. Teachers were trained to deliver eight Alert Program® lessons to children in class. Self-regulation and executive functioning were measured using teacher and parent/caregiver questionnaires three times. Data were analyzed using repeated-measures ANOVA. Teacher-led delivery of the Alert Program® was feasible in a region with high fetal alcohol spectrum disorder rates. As measured by teacher and parent/caregiver ratings, this curriculum may improve the self-regulation and executive functioning of children for some outcomes and provide sustained effects for some children. This community partnered pilot research, evaluated a school-based program to reduce the behavioral impact of fetal alcohol spectrum disorder, and informed design of a larger trial across eight Aboriginal community schools.

101 102 103 104 University of Newcastle 105 1 Deborah Rose Bird, Reports from a Wild Country: Ethics for Decolonization (Sydney: UNSW Press, 2004). 2 Gordon Briscoe, Counting, Health and Identity: A History of Aboriginal Health and Demography in Western Australia and Queensland, 1900–1940 (Canberra: Aboriginal Studies Press, 2003), 263–74. 3 Johan Galtung, “Violence, Peace, and Peace Research”, Journal of Peace Research 6, no. 3 (1969): 167–91. 4 Paul Farmer, “An Anthropology of Structural Violence”, Current Anthropology 45, no. 3 (2002): 305–25. 5 Anna Haebich, For Their Own Good: Aborigines and Government in the Southwest of Western Australia, 1900–1940 (Perth: UWA Press, 1988), 83. 6 Anna Haebich, Broken Circles: Fragmenting Indigenous Families 1800–2000 (Fremantle: Fremantle Arts Centre Press, 2000), 229. 7 Maurizio Meloni, Political Biology: Science and Social Values in Human Heredity from Eugenics to Epigenetics (London: Palgrave Macmillan, 2016). 8 Bastiann T. Heijmans, Elmar W. Tobi, Arhey D. Stein, et al., “Persistent Epigenetic Differences Associated with Prenatal Exposure to Famine in Humans”, Proceedings of the National Academy of Sciences (United States) 105 (2008): 17046–9. 9 N.P.F. Kellerman, “Epigenetic Transgenerational Transmission of Holocaust Trauma: Can Nightmares be Inherited?’, The Israel Journal of Psychiatry and Related Sciences 50 (2013): 33–9. 10 R. Yehuda, N.P. Daskalakis, A. Lehrner, et al., “Influences of Maternal and Paternal PTSD on Epigenetic Regulation of the Glucocorticoid Receptor Gene in Holocaust Survivor Offspring”, American Journal of Psychiatry 171 (2014): 172–80. 11 M. Pembrey et al. “Human Transgenerational Responses to Early-life Experience: Potential Impact on Development, Health and Biomedical Research”, Journal of Medical Genetics 51 (2014): 563–72; Kellerman, 33–9. 12 Steve Hawke, A Town is Born: The Fitzroy Crossing Story (Broome: Magabala Books, 2013). 13 Closing the Gap Prime Minister’s Report (Commonwealth of Australia, Department of the Prime Minister and Cabinet, 2017). 14 Beth Mah, L. Weatherall, J. Burrows, et al., “Post-Traumatic Stress Disorder Symptoms in Pregnant Australian Indigenous Women Residing in Rural and Remote New South Wales: A Cross-sectional Descriptive Study”, Australian and New Zealand Journal of Obstetrics and Gynecology 57, no. 5 (2017): 1–6. 15 Clare Wood. “Stories we Need to Tell”, ABC Open, https://open.abc.net.au/explore/80848 (accessed 26 November 2018). ...

Background: Despite multiple risk factors for neurodevelopmental vulnerability, few studies have assessed neurodevelopmental performance of Australian Aboriginal children. An important risk factor for neurodevelopmental vulnerability is prenatal alcohol exposure (PAE), which places children at risk for Fetal Alcohol Spectrum Disorder (FASD).Aims: This study assesses neurodevelopment outcomes in a population of Australian Aboriginal children with and without PAE.Methods and procedures: Children born in 2002/2003, and living in the Fitzroy Valley, Western Australia between April 2010 and November 2011, were eligible (N = 134). Sociodemographic and antenatal data, including PAE, were collected by interview with 127/134 (95%) consenting parents/caregivers. Maternal/child medical records were reviewed. Neurodevelopment was assessed by clinicians blinded to PAE in 108/134 (81%) children and diagnoses on the FASD spectrum were assigned.Outcomes and results: Neurodevelopmental disorder was documented in 34/108 children (314.8 per 1000). Any diagnosis on the FASD spectrum was made in 21/108 (194.4 per 1000) children

Objective: Aboriginal leaders concerned about high rates of Fetal Alcohol Spectrum Disorder (FASD) in the Fitzroy Valley, remote north-western Australia, introduced restrictions on access to take-away full-strength alcohol. Following this, Aboriginal leaders engaged strategic partners in a broader strategy to address FASD in the region. The aim of this study was to develop and implement a community-led, researcher-supported, FASD strategy. Methods: A review of literature focusing on community-led FASD strategies identified key components that informed the Marulu FASD strategy. These included strategy ownership, leadership, and governance by participating communities, and a research framework. Results: Community meetings and workshops led to the development of The Marulu FASD Strategy (2008). Feasibility and community consent to conduct a FASD prevalence study (the Lililwan Project) was confirmed, and implementation was progressed (2010-2013). Concurrent FASD prevention activities were conducted. In 2012, the Marulu FASD Unit was established within a local Aboriginal organisation to sustain and coordinate ongoing strategy activities. Conclusions: Community control of public health initiatives can be achieved when Aboriginal communities prioritise issues of significant concern, and engage strategic partners to overcome them. Implications for public health: The Marulu Strategy forms a template for action to address FASD and other public health issues in Aboriginal communities in Australia and internationally.

This chapter uses a personal narrative to illustrate how structural violence played out in the life of one individual: Coolibah. The Coolibah's life story illustrates one or other aspect of the structural violence which Coolibah or a member of his family suffered as a consequence of the marked differential in power, wealth, and access to civic amenities. Coolibah, the tall wiry stockman and legendary rider, his body worn out by relentless physical work, maintained a dignified figure in the midst of the busy children's ward. Coolibah's narrative provides a way of understanding how the disadvantage suffered by Aboriginal Australians has its origins in structural violence. Coolibah's story is emblematic of the lateral violence suffered by Aboriginal people which plays out in lethal dysfunction within and between families and is measured by the statistics for school attendance and consequent low literacy, and in high rates of juvenile detention.

AimAboriginal leaders concerned about high rates of alcohol use in pregnancy invited researchers to determine the prevalence of fetal alcohol syndrome (FAS) and partial fetal alcohol syndrome (pFAS) in their communities.MethodsPopulation-based prevalence study using active case ascertainment in children born in 2002/2003 and living in the Fitzroy Valley, in Western Australia (April 2010-November 2011) (n = 134). Socio-demographic and antenatal data, including alcohol use in pregnancy, were collected by interview with 127/134 (95%) consenting parents/care givers. Maternal/child medical records were reviewed. Interdisciplinary assessments were conducted for 108/134 (81%) children. FAS/pFAS prevalence was determined using modified Canadian diagnostic guidelines.ResultsIn 127 pregnancies, alcohol was used in 55%. FAS or pFAS was diagnosed in 13/108 children, a prevalence of 120 per 1000 (95% confidence interval 70-196). Prenatal alcohol exposure was confirmed for all children with FAS/pFAS, 80% in the first trimester and 50% throughout pregnancy. Ten of 13 mothers had Alcohol Use Disorders Identification Test scores and all drank at a high-risk level. Of children with FAS/pFAS, 69% had microcephaly, 85% had weight deficiency and all had facial dysmorphology and central nervous system abnormality/impairment in three to eight domains.ConclusionsThe population prevalence of FAS/pFAS in remote Aboriginal communities of the Fitzroy Valley is the highest reported in Australia and similar to that reported in high-risk populations internationally. Results are likely to be generalisable to other age groups in the Fitzroy Valley and other remote Australian communities with high-risk alcohol use during pregnancy. Prevention of FAS/pFAS is an urgent public health challenge.

Motion thresholds were determined at 9 degrees eccentricity in infants (mean = 14 weeks old). The stimuli used were computer-generated sinusoidal gratings presented through a 7.45 degrees aperture at a contrast ratio of .83. The range of velocities (.5, 1, 2, 4, and 6 degrees per s) was examined at only one spatial frequency (1 cycle per degree). At low velocities (less than 2 degrees per s), the infants showed no clear preference for the moving stimulus over the stationary stimulus. At faster velocities (2-6 degrees per s), the infants exhibited a clear preference for the moving stimulus. The results were interpreted as indicating that infants at 3 months of age are relatively insensitive to slow motions for low spatial frequency stimuli.

Abstract We have employed an in vitro system to study the time-course of beta-endorphin (beta-EP) immunoreactivity release from anterior pituitary cells stimulated with corticotropin-releasing factor (CRF) and whether exposure to CRF desensitizes the cells to subsequent stimulation. Ovine anterior pituitaries were enzymatically disrupted into single cells, mixed with Siegel P2 and superfused in mini-columns with carbogen-gassed medium at 37 degrees C. Superfusate fractions were collected at 5-min intervals and beta-EP immunoreactivity in the eluate was measured by radioimmunoassay. Peaks of beta-EP release that rose significantly above baseline noise were detected using the PULSAR algorithm. Unstimulated cell columns did not display any spontaneous peaks of beta-EP discharge detectable by PULSAR whereas peaks were identified in the output of columns exposed to 1 nM CRF for 100 min. beta-EP release increased after 10 min of stimulation and maximum stimulated output was achieved after 20 min of continuous CRF exposure. Between 20 and 60 min of CRF stimulation the rate of beta-EP release declined progressively but stabilized in the last 40 min of the exposure at a level significantly above controls for baseline secretion. Peak duration did not depend on the inclusion of calcium in the superfusion medium while peak amplitude and area were significantly reduced when cells were denied extracellular calcium. Following a 100-min exposure to 1 nM CRF, pituitary cell columns were given a 30-min rest period then restimulated with either 1 nM CRF or 50 mM KCI for 20 min. The columns given prior exposure to CRF did not mount a response (detectable by PULSAR) to a subsequent dose of 1 nM CRF whereas PULSAR detected a clear response in all members of a control group that had not received prior CRF challenge. Both CRF exposed and control columns responded to 50 mM KCI although the response was significantly attenuated in the cells that had received prior CRF treatment. These results indicate that unstimulated superfused isolated ovine anterior pituitary cells do not possess an inherent rhythmicity of beta-EP release that can be detected by the PULSAR algorithm while treatment of the cells with CRF results in detectable discharge. The rapid response of beta-EP discharge to CRF treatment suggests the presence of intracellular beta-EP stores available for rapid mobilization. Continuous exposure to 1 nM CRF can tonically amplify corticotrope output for the duration of its presence in the environment of the corticotrope, but the maximum rate of release cannot be maintained. An inrush of extracellular calcium is not essential for the corticotrope to mount a detectable response to continuous CRF exposure but the release of a maximum amount of beta-EP relies on calcium entry. Long-term treatment with CRF prevents the corticotrope releasing a detectable peak of beta-EP on subsequent CRF stimulation and therefore CRF exposure leaves a lasting impression on the physiological machinery of the corticotrope. The attenuation of responsiveness to 50 mM KCI after long-term CRF treatment indicates that depletion of beta-EP stores may play a part in corticotrope desensitization although a reduction in CRF receptor number and an alteration in the intracellular mechanisms controlling beta-EP release may also be a factor.

Rudolf von Leyden: Die Welt der indischen Spielkarten. (Veröffentlichungen zum Archiv für Völkerkunde, Bd. 8.) 159 pp. Wien: Wilhelm Braumüller, 1981. ÖS. 380. - Rudolf von Leyden: Ganjifa: the playing cards of India: a general survey, with a catalogue of the Victoria and Albert Museum Collection. xiv, 128 pp. London: Victoria and Albert Museum [1982]. - Volume 46 Issue 2

Anncharlott Eschmann and others(ed.): The cult of Jagannath and the regional tradition of Orissa. South Asia Interdisciplinary Regional Research Programme: Orissa Research Project. Edited by Anncharlott Eschmann, Hermann Kulke and Gaya Charan Tripathi. (South Asia Institute, New Delhi Branch, Heidelberg University. South Asian Studies, No. VIII.) [xxi], 536 pp., front., 28 plates, 8 maps. [New Delhi]: Manohar, 1978. Es. 100. - Volume 43 Issue 2