Remote Australia Online

This is a co-constructed narrative between both Marie, an early career teacher, Stephen an artist and colleague in the school’s creative arts faculty and Colin, an Aboriginal teacher and researcher. They met throughout 2012 and discussed issues that related to their discursive interactions that occurred in this small rural school between its teachers and the town’s largely Aboriginal community. These discussions were conducted within the context, of Marie’s experiences as a new scheme teacher [1], Stephen’s reflexive observations as a teacher of many years’ experience and Colin, who had worked with the school on various curriculum projects. These narratives give witness to their experiences, their failures and successes and of the discursive concerns seen to affect school student success and community relationships. These narratives connect with the town’s history of race relations and the aspirations and concerns of Aboriginal people living in this community. This paper, which focuses on Marie’s efforts to engage her Year 8 music students in the new and ‘alien’ environment is juxtaposed with Stephen’s, whose commentary, based on proximity and practice, gives a counter insight into the world of teaching. This paper is a three-way critical reflection on the place of contested and conflicted relationships between teachers and students, the impact of teachers’ limited appreciation of the histories of this community and its impact on their lives.

School systems and Aboriginal and Torres Strait Islanders have long acknowledged the levels of social, cultural and epistemic conflict that has historically existed between teachers and schools, and Aboriginal students, families and their local communities. This relationship is both symptomatic and causal of the broader and highly complex field of issues and policies found to underpin the fraught histories existing between many Aboriginal communities and schools. This systematic review of the research literature reports on findings and insights into the everyday environments of these interactions and the possibilities of Aboriginal communities being able to affect the establishment of genuine and productive interactions with schools. The review looks to focus on those factors seen to either enable or act as barriers to this process, and comment on their impact on Aboriginal communities, their students and schools’ capacity for purposeful engagement.

The goal of global equity in health care requires that the training of health-care professionals be better tuned to meet the needs of the communities they serve. In fact medical education is being driven into isolated communities by factors including workforce undersupply, education pedagogy, medical practice and research needs.Rural and remote medical education (RRME) happens in rural hospitals and rural general practices, singly or in combination, generally for periods of 4 to 40 weeks. An effective RRME programme matches the context of the local health service and community. Its implementation reflects the local capacity for providing learning opportunities, facilitates collaboration of all participants and capitalises on local creativity in teaching. Implementation barriers stem from change management, professional culture and resource allocation. Blending learning approaches as much as technology and local culture allow is central to achieving student learning outcomes and professional development of local medical teachers.RRME harnesses the rich learning environment of communities such that students rapidly achieve competence and confidence in a primary care/generalist setting. Longer programmes with an integrated (generalist) approach based in the immersion learning paradigm appear successful in returning graduates to rural practice and a career track with a quality lifestyle.

Australian Aboriginal and Torres Strait Islander peoples (Indigenous Australians) smoke at much higher rates than non-Indigenous people and smoking is an important contributor to increased disease, hospital admissions and deaths in Indigenous Australian populations. Smoking cessation programs in Australia have not had the same impact on Indigenous smokers as on non-Indigenous smokers. This paper describes the outcome of a study that aimed to test the efficacy of a locally-tailored, intensive, multidimensional smoking cessation program.

Introducing a revolutionary new classification system has changed the way the remote community of Galiwin'ku on Elcho Island utilises its local community library.

Objective To document change in prevalence of obesity, diabetes and other cardiovascular diease (CVD) risk factors, and trends in dietary macronutrient intake, over an eight-year period in a rural Aboriginal community in central Australia. Design Sequential cross-sectional community surveys in 1987, 1991 and 1995. Subjects All adults (15 years and over) in the community were invited to participate. In 1987, 1991 and 1995, 335 (87% of eligible adults), 331 (76%) and 304 (68%), respectively, were surveyed. Main outcome measures Body mass index and waist:hip ratio; blood glucose level and glucose tolerance; fasting total and high density lipoprotein (HDL) cholesterol and triglyceride levels; and apparent dietary intake (estimated by the store turnover method). Intervention A community-based nutrition awareness and healthy lifestyle program, 1988-1990. Results At the eight-year follow-up, the odds ratios (95% CIs) for CVD risk factors relative to baseline were obesity, 1.84 (1.28-2.66); diabetes, 1.83 (1.11-3.03); hypercholesterolaemia, 0.29 (0.20-0.42); and dyslipidaemia (high triglyceride plus low HDL cholesterol level), 4.54 (2.84-7.29). In younger women (15-24 years), there was a trebling in obesity prevalence and a four- to fivefold increase in diabetes prevalence. Store turnover data suggested a relative reduction in the consumption of refined carbohydrates and saturated fats. Conclusion Interventions targeting nutritional factors alone are unlikely to greatly alter trends towards increasing prevalences of obesity and diabetes. In communities where healthy food choices are limited, the role of regular physical activity in improving metabolic fitness may also need to be emphasised.

Working in Alice Springs didn't give Dr Eliza Milliken all the answers to improving Indigenous health. It did, however, force her to ask some hard questions about the limits of a medical system that fails to acknowledge the impact of history.

In 2018, the WA Country Health Service (Kimberley) initiated the Graduate Nurse Program into the Kimberley Population Health Unit.

Conflicts between mining operators and local communities often stem from the latter feeling excluded from decision-making processes. Consequently, regulators sometimes commission a representative consultative group to facilitate interactions among the wider community, miners and regulators. The realised effectiveness of this sort of representative group, however, has rarely been assessed from the perspectives of community participants. We interviewed members of a long running consultative committee for a zinc mine in rural South Australia. Initially, the town’s inexperience with mining meant many held negative views about potential environmental impacts of mining. Those fears were allayed as the mine developed and the committee felt they better understood and could question the mine’s technical operations. Over time, the committee felt their input led to significant changes in a range of mine operations and, while perceiving their committee’s role differently, all thought it effective and strengthened their relationship with the mine operator and regulators. Nonetheless, some negative interactions from the initial stages of engagement have lingered. We conclude that if community trust is gained by operators and efforts are made to help communities understand mining, then consultative committees can play a central role in ensuring that people do not feel disenfranchised by mining operations.

Introduction and Aims Aboriginal residential rehabilitation services provide healing for Aboriginal people who misuse substances. There is limited available research that empirically describes client characteristics of these services. This study examined 5 years of data of a remote Aboriginal residential rehabilitation service. Design and Methods Retrospective analysis of 329 client admissions to Orana Haven Drug and Alcohol Rehabilitation Centre from 2011 to 2016. Multinomial and binary logistic regressions were conducted to identify trends in the data. Results There were 66 admissions recorded annually, of which most identified as Aboriginal (85%). Mean length of stay was 56 days, with one in three (36%) discharging within the first month. A third (32%) completed, 47% self-discharged and 20% house-discharged from the program. Client age significantly increased over time (P = 0.03), with most aged from 26 to 35. Older clients were significantly more likely to readmit (P < 0.002) and stay longer than 90 days (P = 0.02). Most clients were referred from the criminal justice system, significantly increasing from 79% (2011–2012) to 96% (2015–2016) (P < 0.001) and these clients were more likely to self-discharge (P < 0.01). Among a subset of clients, most (69%) reported concerns with polysubstance use and half (51%) reported mental illness. Discussion and Conclusions The current study makes a unique contribution to the literature by empirically describing the characteristics of clients of a remote Aboriginal residential rehabilitation service to more accurately tailor the service to the client's needs. Key recommendations include integrating these empirical observations with staff and client perceptions to co-design a model of care, standardise data collection, and routinely following-up clients to monitor treatment effectiveness.

Experiences with implementing the H2S method for testing bacterial quality of drinking water in remote aboriginal communities in Australia

The rationale for the present study was that temporarily reversing the urbanization process in diabetic Aborigines should improve all aspects of their carbohydrate and lipid metabolism that are linked to insulin resistance. Ten full-blood, diabetic Aborigines from the Mowanjum Community (Derby, Western Australia) agreed to be tested before and after living for 7 wk as hunter-gatherers in their traditional country in northwestern Australia. They were middle aged (53.9 ±1.8 yr) and overweight (81.9 ± 3.4 kg), and all lost weight steadily over the 7-wk period (average, 8 kg). A detailed analysis of food intake over 2 wk revealed a low-energy intake (1200 kcal/person/day). Despite the high contribution of animal food to the total energy intake (64%), the diet was low in total fat (13%) due to the very low fat content of wild animals. Oral glucose tolerance tests (75 g glucose) were conducted in the urban setting and repeated at the end of 7 wk of traditional lifestyle. The marked improvement in glucose was due to both a fall in fasting glucose (11.6 ± 1.2 mM before, 6.6 ± 0.8 mM after) and an improvement in postprandial glucose clearance (incremental area under the glucose curve: 15.0 ±1.2 mmol/ L/h before, 11.7 ± 1.2 mmol/L/h after). Fasting plasma insulin concentration fell (23 ± 2 mU/L before, 12 ± 1 mU/L after) and the insulin response to glucose improved (incremental area under the insulin curve: 61 ± 18 mU/L/h before, 104 ± 21 mU/L/h after). The marked fall in fasting plasma triglycerides (4.0 ± 0.5 mM before, 1.2 ± 0.1 mM after) was due largely to the fall in VLDL triglyceride concentration (2.31 ± 0.31 mM before, 0.20 ± 0.03 mM after). In conclusion, the major metabolic abnormalities of type II diabetes were either greatly improved or completely normalized in this group of Aborigines by relatively short reversal of the urbanization process. At least three factors known to improve insulin sensitivity (weight loss, low-fat diet, and increased physical activity) were operating in this study and would have contributed to the metabolic changes observed.

All studies published to date indicate that urban or non-traditionally living Aborigines have marginal to low levels of serum folate, B-group vitamins and vitamin C (Kamien et al, 1974; Kamien et al, 1975; Davis et al, 1975). In addition, low serum zinc and iron levels together with high copper levels have been reported in Kimberley Aboriginal communities, in association with high frequencies of intestinal parasitic infections (Holt et al, 1980; Cheek et al 1982). To our knowledge there is no data available on levels of vitamins, trace metals and minerals in traditionally-living Aborigines. Analysis of bushfoods reveals them to be rich sources of many vitamins and minerals (Brand et al, 1983; Cherikoff et al, 1985; Brand et al, 1985; Brand and Cherikoff, 1985; Brand et al, 1982) and it is most unlikely that any major deficiencies of these nutrients would have been evident in traditionally-living Aborigines. A s part of a larger study on the relationship between lifestyle change and type 2 diabetes in Kimberley Aborigines the results of which have been published elsewhere (OT>ea, 1984; O'Dea and Sindair, 1985), we measured plasma levels of vitamin A, vitamin E, vitamin B12 and folic acid, plasma and hair zinc and the activity of plasma alkaline phosphatase (a zinc-dependent enzyme) in a group of middle-aged, westernized Aborigines (diabetic and normal) before and after they reverted to living as traditional hunter-gatherers for a 7 week period. In addition, we examined the possibility that liver may have served as a source of dietary vitamin C for Aborigines traditionally and thereby prevented scurvy during those times of the year when very Utile vegetable food was available. Vitamin C is known to be unstable in meat and blood. However, the data presented below show that in liver it is not destroyed by cooking.

In the present study we measured the bleeding times in fourteen Aborigines (10 diabetic, 4 non-diabetic) before and after 2 weeks on a diet of tropical seafood (rich in both arachidonic acid and the ω3 PUFA), followed by 3 weeks on a diet in which kangaroo and freshwater fish (linoleic and arachidonic acid-rich) were the major fat sources. Both diets were very low in fat. Bleeding times increased in all subjects after the 2 weeks of tropical seafood and continued to rise on the mixed diet. The increase over 5 weeks from 4.1±0.4 to 5.9±0.4 min was highly significant (p<0.01). Due to the extreme isolation of the study location it was only possible to measure the plasma fatty acid composition at the beginning and end of the study. The concentration of arachidonic acid in the plasma lipids doubled whereas that of linoleic acid was almost halved, despite the fact that the diet in the second part of the study contained considerably more linoleic than arachidonic acid. That there appeared to be preferential incorporation of arachidonic acid into the plasma lipids is further supported by the observation that the rise in arachidonic acid in the cholesterol ester and phospholipid fractions was almost exactly counter-balanced by the fall in linoleic acid. In conclusion, the present study demonstrated a rise in bleeding time associated with an increased concentration of arachidonic acid and decreased concentration of linoleic acid in plasma lipids, and suggests that the mechanism by which diet modulates haemostatic function may be more complex than currently assumed.

Aboriginal school students, especially those living in rural and remote areas, continue to achieve below the national standard in oral language, literacy and numeracy. On leaving school their unemployment rate is three times that of non-Aboriginal people. At the same time we know academic and career success is closely tied to one’s self-identity. Therefore, the aim of this research is twofold: firstly, within the context of living in a rural community, explore which factors contribute to a positive self-identity amongst Aboriginal youth; and secondly, examine how this relates to their educational experience and transition into the workplace. The participants were five Aboriginal males aged between 16 – 18 years at the commencement of the study who attended the local high school and were supported by Clontarf Academy staff who were located at this school. The data were collected over an 18 month period using observation, formal and informal interviews (i.e., yarning). This was done from an 'inside' perspective as one of the researchers had a long term mentoring relationship with all the participants. This rich and thick data was used to formulate in-depth, ethnographic case studies which were further interrogated to identify themes to address the research aims. The findings show that 'family' play a key role in the maintenance of both language and culture, that style of communication continues to be strong marker of Aboriginality, and their location in the rural area and particularly as part of the Academy served to support and sustain strong Aboriginal identities.

Health systems are known for being complex. Yet, there is a paucity of evidence about programs that successfully develop competent frontline managers to navigate these complex systems. There is even less evidence about developing frontline managers in areas of contextual complexity such as geographically remote and isolated health services. This study used a customised management development program containing continuous quality improvement (CQI) approaches to determine whether additional levels of evaluation could provide evidence for program impact. Generalisability is limited by the small sample size; however, the findings suggest that continuous improvement approaches, such as action learning workplace-based CQI projects not only provide for real-world application of the manager’s learning; they can potentially produce the type of data needed to conduct evaluations for organisational impact and cost-benefits. The case study contributes to the literature in an area where there is a scarcity of empirical research. Further, this study proposes a pragmatic method for using CQI approaches with existing management development programs to generate the type of data needed for multi-level evaluation.

We use ideas from futurist Sohail Inayatullah and others to unpack the layers of a values-driven evaluation, and the potential role for such an evaluation strategy to support Aboriginal people in Australia to gain acknowledgement of the past and to support a desired future. Inayatullah’s Causal Layered Analysis (CLA) is used as a way of understanding the deep context of evaluation and the way in which a project might meet community priorities emerging from a dark history and its legacy. We present a proposed evaluation strategy centred around the CLA domains of Narrative, Discourse, Systems and Litany. We then use a case study from remote Australia to illustrate the kinds of community priorities that emerge from this deep context, and suggest that in an environment of complex and evolving relations, rather than measuring the contribution of a particular project to economic opportunity or social change, evaluation may need to focus on the ways in which the project becomes integrated into stories of change and other activities, either as a catalyst, an affirmation of commitment, or as part of an array of connected activities enabling change.

Key findings for the Fitzroy catchmentIntroduction The Fitzroy catchment covers an area of approximately 94,000 km2. The Fitzroy River flows more than 700 km from its upper reaches to King Sound. The population is approximately 7500 people with two main population centres at Derby and Fitzroy Crossing. The dominant land use is pastoralism (over 95% of the catchment) with natural and conservation uses prioritised in the remaining areas.Indigenous people have continuously occupied and managed the Fitzroy catchment for tens of thousands of years and retain significant and growing rights and interests in land and water resources, including crucial roles in water and development planning and as co-investors in future development.Agriculture and aquaculture opportunitiesThe Fitzroy catchment has up to 5.4 million ha of potentially irrigable agricultural soils. Of this land area, 4.0 million ha are suitable for spray irrigation of cereals, between 400,000 ha and 590,000 ha for furrow irrigation of cereals, 2.8 million ha for spray-irrigated sugarcane, and about 400,000 ha for sugarcane with furrow irrigation. For aquaculture, such as prawns and barramundi, about 55,000 ha of land are suitable using lined ponds. For all of these uses the land is considered moderately suitable with considerable limitations and would require careful soil management.Livestock enterprises are already proven in the Fitzroy catchment. The use of irrigated forage (Figure 1-1) to overcome the feed gap, especially for lactating cows, could significantly increase beef production by increasing calving percentage, enabling earlier weaning and increasing rate of weight gain.Up to 120 GL/year of groundwater (<5% of recharge) could be extracted from the interconnected Grant Group and Poole Sandstone aquifers. Under a wet season sowing on loamy soils, this volume of water could irrigate about 20,000 ha of a crop such as cotton at an annual gross value of production of approximately $90 million, creating about $140 million of regional economic activity reoccurring annually and the generation of about 560 jobs. There is up to 50 GL/year of additional groundwater across the catchment that would allow numerous small (<1 GL) to medium-scale (1 to 5 GL) developments suited to irrigated forage production.It is physically possible to pump 1700 GL of water in 85% of years from major rivers and tributaries in the Fitzroy catchment into ringtanks near agricultural soils. This volume of water would fill 425 ringtanks (each of capacity 4 GL) and cost approximately $935 million. This would enable 160,000 ha of clay soils under dry-season cotton to be irrigated. This could generate an annual gross value of production of approximately $750 million, and the region would benefit from $1.1 billion of additional annual economic activity and generation of about 4700 jobs.Impacts and risksWhether based on groundwater or offstream storage, irrigated agricultural development has a wide range of potential benefits and risks that differentially intersect diverse stakeholder views on ecology, economy and culture. The detailed reports upon which this catchment report is based provide information that can be used to quantify the trade-offs required for agreed development plans.Streams, wetlands and riparian areas remain of critical importance to Indigenous people. They have cultural significance and provide nutritional food. These habitats are also key to the movement of animals, plants and nutrients through a highly interconnected system, keeping the ecosystem healthy, supporting critical downstream habitats like mangroves and salt flats and providing food for recreational and commercial fishing. The catchment harbours a diverse assemblage of fish. Forty-two different species have been recorded, many of which depend on being able to move up and down the river systems to complete their life cycle. Many of the fish species are dependent on the highly seasonal flow pulses that characterise the Fitzroy River. King Sound and the adjacent Fitzroy catchment is one of the few known remaining habitats for the early life stages of the remnant population of freshwater sawfish.

Key findings for the Darwin catchmentsIntroduction In the Darwin catchments the Finniss, Adelaide, Mary and Wildman rivers flow through extensive coastal and marine floodplains into the Arafura Sea. Land use in the 30,000 km2 that make up the Darwin catchments is dominated by conservation and natural environments (38%), extensive grazing (32%) and dryland and irrigated cropping (7%). About 140,000 people live in the 2% of the landscape comprising urban and peri-urban development.Indigenous people have continuously occupied and managed the Darwin catchments for tens of thousands of years and retain significant and growing rights and interests in land and water resources, including crucial roles in water and development planning and as co-investors in future development.Agriculture and aquaculture opportunitiesThe Darwin catchments have up to 1 million ha of potentially irrigable agricultural soils. Of this land area, 800,000 ha are suitable for trickle-irrigated crops such as mangoes ( Figure 1-1), whereas about 90,000 ha are suitable for flood-irrigated crops such as rice. A further 420,000 ha of land is moderately suitable for aquaculture, including species such as prawns and barramundi, grown in lined ponds. For all of these uses the land is considered moderately suitable with considerable limitations and would require careful soil management.Groundwater is the Darwin catchments’ most important consumptive water resource. Aquifers in the Darwin Rural Water Control District (DRWCD) currently provide an estimated 25 gigalitres (GL) for the purpose of irrigated agriculture, horticulture, public water supplies and local domestic use. New groundwater resources outside of the DRWCD (35 GL) could, if allocated, enable an additional 7800 ha of trickle-irrigated vegetable production, which could add $320 million and 345jobs to the regional economy.Significant new instream surface water storage is possible. Potential dams at Mount Bennett on the Finniss River (343 GL capacity) and the upper Adelaide River (298 GL capacity) could releaseapproximately 436 GL for agriculture in 85% of years. This could support 40,000 ha of mangoes or 60,000 ha of trickle-irrigated vegetables, enabling just 2% of the area of the catchment to add $2.3 billion and 2500 jobs to the regional economy.Offstream water harvesting is possible on the Margaret River in the Adelaide catchment (200 GL) and the McKinley and Mary rivers in the Mary catchment (400 GL). This could provide water sufficient to trickle irrigate 50,000 ha of vegetables, although the proximity of irrigable soils to locations suitable for water storage may be a limitation of this area.Impacts and risksWhether based on groundwater, instream dams or offstream storage, irrigated agricultural development has a wide range of potential benefits and risks that differentially intersect diverse stakeholder views on ecology, economy and culture. The detailed reports upon which this catchment report is based provide information that can be used to quantify the trade-offs required for agreed development plans.The general impacts of potential new groundwater-based developments may include a reduction in spring flows and an increase in the depth to groundwater beneath groundwater-dependent vegetation. These impacts can be reduced with good planning, such as evidence based water allocations and appropriately siting groundwater bore infrastructure. In some areas with existing groundwater development, there may be opportunity to intentionally recharge water to underlying aquifers, referred to as managed aquifer recharge (MAR), for subsequent recovery or to provide environmental benefit. Instream storages, such as the potential upper Adelaide River dam, require trade-offs that occur over both time and space. Construction of large instream dams provide water that is generally secure across many years. This requires significant upfront investment ($190 million) that is intended to generate a future income stream that may contribute to the cost of investment. Instream dams significantly disrupt their immediate upstream and downstream environments but, when located high in the catchment, as with the potential upper Adelaide River dam, have negligible to minor impacts on coastal floodplains and their related mosaic of nationally important wetlands. Streams, wetlands and riparian areas remain of critical importance to Indigenous people. They have cultural significance and provide nutritional food.Pumping water into offstream storages (water harvesting) generally has less impact on freshwater aquatic, riparian and marine ecosystems than major instream dams, in part because water extraction occurs mainly during floods and is restricted during low-flow periods. Offstream storages are readily scaled to match the availability of financial and physical capital. They are not usually capable of securing water for more than 1 year and, as a result, they ‘make good wet seasons better’ rather than reliably ‘making dry seasons wet'.

Key findings for the Mitchell catchment: Introduction. The Mitchell catchment is approximately 72,000 km2 and flows into the Gulf of Carpentaria. It includes part of the Mareeba–Dimbulah Water Supply Scheme (MDWSS) (Figure 1-1) and supports a population of approximately 6000 people. There are no major urban centres. Pastoralism comprises over 95% of the catchment land use. The second largest land use, conservation reserves, covers about 3% of the catchment. Indigenous people have continuously occupied and managed the Mitchell catchment for tens of thousands of years and retain significant and growing rights and interests in land and water resources, including crucial roles in water and development planning and as co-investors in future development.Agriculture and aquaculture opportunitiesThe Mitchell catchment has up to 3 million ha of potentially irrigable agricultural soils. Of this land area, 2.5 million ha are suitable for dry-season spray irrigation of cereals, cotton and soybean. The area suitable for furrow irrigation of the same crops is 1.3 million ha. There are 2.5 million ha and 1.3 million ha suitable for irrigation of sugarcane by spray and furrow irrigation, respectively. Just over 3 million ha are suitable for Rhodes grass with spray irrigation and 600,000 ha suitable for wet-season forage sorghum with spray irrigation. About 235,000 ha are suitable for aquaculture, such as prawns and barramundi grown in lined ponds. For all of these uses the land is considered moderately suitable with considerable limitations and would require careful soil management.The total amount of beef produced each year by existing cattle breeding enterprises could be increased by using irrigated forages to overcome some of the productivity constraints inherent with reliance on native pastures. Access to standing green forage or high-quality hay (Figure 1-1) could increase weight gain in young cattle and enable early weaning of calves which, in turn, increases subsequent calving percentage by reducing nutritional pressure on lactating cows.Significant new instream storages are possible. The four most cost-effective major instream dams in the Mitchell catchment are capable of delivering approximately 2800 GL in 85% of years, which is sufficient water to irrigate 140,000 ha of sugarcane. This could generate an annual gross value of production of approximately $720 million, and the region would benefit from $1.5 billion of economic activity reoccurring annually and the generation of about 7250 jobs. Of the 2800 GL, 65% could be delivered by two potential dams, the Pinnacles dam site on the Mitchell River (2316 GL capacity) and Rookwood dam site on the Walsh River (1288 GL storage). These would yield 1248 GL and 575 GL, respectively, to agriculture in 85% of years. Offstream water harvesting could extract 2000 GL annually, with 85% reliability, which would be sufficient to irrigate 200,000 ha of cotton. Groundwater opportunities in the catchment are relatively small and localised, with the Bulimba aquifer offering up to a total of 5 GL/year with well-placed bores. Impacts and risks: Whether based on groundwater or offstream storage, irrigated agricultural development has a wide range of potential benefits and risks that differentially intersect diverse stakeholder views on ecology, economy and culture. The detailed reports upon which this catchment report is based provide information that can be used to quantify the trade-offs required for agreed development plans.Instream storages, such as the potential Pinnacles and Rookwood dams, require trade-offs that occur over both time and space. The upfront cost of the potential Pinnacles dam is estimated at $755 million and would generate an income stream that may contribute to the cost of construction. The dam would have a major impact on habitat immediately below the dam, and would potentially have an ongoing moderate impact downstream by affecting the perennial flow of the Mitchell River. Pumping water into offstream storages (water harvesting) was predicted to have a minor impact to the flow habitat of freshwater aquatic, riparian and marine ecosystems. Offstream water storages usually have lower impacts than major instream dams, partly because water extraction occurs during floods and is restricted in low-flow periods. Streams, wetlands and riparian areas remain of critical importance to Indigenous people. They have cultural significance and provide nutritional foo

More than 4000 Indigenous Australian students enrol and take up a placement at boarding school each year. While reasons for attending boarding school vary, the impetus for many remote and very remote-dwelling students is restricted secondary educational opportunities in their home communities. A large multi-site study is being undertaken across Queensland to understand the conditions required for these students to be resilient while studying away from home. This paper reports on levels of student satisfaction with Queensland Department of Education's Transition Support Service (TSS) that provide assistance to remote-dwelling Indigenous students in the transition to boarding schools. A survey instrument administered to students included 22 close-ended questions to elicit levels of student satisfaction with TSS. Data were collected electronically using SurveyMonkey™ and analysed in SPSS v24. Descriptive statistics were calculated for variables assessing service support, student perceptions and experiences. A total of 294 primary, secondary and re-engaging students across 21 sites responded. Nearly all primary students (97%) anticipated that TSS would assist their move to boarding school. All secondary students identified that TSS had assisted their transition to boarding school. All re-engaging students agreed that TSS support had increased their capacity to cope when things go wrong. Lower scores related to students’ ability to access TSS when needed. Very high levels of satisfaction with TSS were countered by constraints of distance between TSS and students, and resources available to support the work of TSS. Findings point to the need for equitable provision of transition services in Queensland that emphasise the importance of relationship between service provider and student, and can inform the design of similar transition services across Australia.

Background Silver fluoride 40% followed by 10% stannous fluoride (AgF) has been used in dental practice in some parts of Australia for many years. This study compared the effectiveness of application of AgF with atraumatic restorative technique (ART) in managing cavitated carious primary molars Methods The study was a community effectiveness trial in two remote Aboriginal communities where AgF has been used for some time. Children between four and eight years of age with caries on primary molars were randomised by birth date to receive AgF or ART. There were 210 children who were included in the study with 384 eligible teeth. Children were followed up for periods between nine months and four years. Negative outcomes such as dental pain, extraction, use of antibiotics and more extensive restorative treatment were considered as the primary outcomes of the study Results Those negative outcomes were infrequent in both treatment groups. The prevalence ratio of negative sequelae for children treated with AgF compared with those treated with ART was lower at 0.18 Conclusions Silver fluoride was well accepted, easy to use and at least as effective a treatment as ART for dental caries in primary molars in young Aboriginal children in remote areas This article is protected by copyright. All rights reserved.

Background: Indigenous Australians experience a suicide rate over twice that of the general population. With nonfatal deliberate self-harm (DSH) being the single most important risk factor for suicide, characterizing the incidence and repetition of DSH in this population is essential. Aims: To investigate the incidence and repetition of DSH in three remote Indigenous communities in Far North Queensland, Australia. Method: DSH presentation data at a primary health-care center in each community were analyzed over a 6-year period from January 1, 2006 to December 31, 2011. Results: A DSH presentation rate of 1,638 per 100,000 population was found within the communities. Rates were higher in age groups 15–24 and 25–34, varied between communities, and were not significantly different between genders; 60% of DSH repetitions occurred within 6 months of an earlier episode. Of the 227 DSH presentations, 32% involved hanging. Limitations: This study was based on a subset of a larger dataset not specifically designed for DSH data collection and assesses the subset of the communities that presented to the primary health-care centers. Conclusion: A dedicated DSH monitoring study is required to provide a better understanding of DSH in these communities and to inform early intervention strategies.

OBJECTIVE: To examine trends in glucose tolerance and coronary risk among Aboriginal people from a group of homeland communities in central Australia during a 7-year follow-up period. RESEARCH DESIGN AND METHODS: Community-based screenings of adult volunteers were performed in 1988 (n = 437; 93% response rate) and in 1995 (n = 424; 85% response rate). A health promotion intervention program commenced after the 1988 survey that focused on the benefits of exercise and appropriate diet. RESULTS: Mean (95% CI) BMI increased significantly from 22.8 kg/m2 (22.3-23.2) to 24.2 kg/m2 (23.8-24.7) during the follow-up period (P < 0.001). This increase was similar for men and women and across all age-groups. The increase in BMI was greater among subjects residing adjacent to a store compared with those residing in communities located far from a store (P < 0.001). Decreases were evident in the prevalence of impaired glucose tolerance (IGT) (from 22.5 to 10.1% among women, P < 0.001; from 12.2 to 6.5% among men, P = 0.074) and hypercholesterolemia (from 36.7 to 25.8% among women, P < 0.01; from 52.4 to 44.0% among men, P = 0.147), but no change was evident in the prevalence of diabetes. Smoking remained rare among women (<4%) and decreased among men (from 52.9 to 40.8%, P < 0.05). CONCLUSIONS: The trends in glucose intolerance were clearly better than have been observed in other Aboriginal communities. The institution of an intervention program corresponded with reductions in the prevalence of IGT, hypercholesterolemia, and smoking. The prevalence of diabetes remained unaltered despite a significant increase in mean BMI, possibly because of the promotion of increased physical activity levels.

Low circulating folate concentrations lead to elevations of plasma homocysteine. Even mild elevations of plasma homocysteine are associated with significantly increased risk of cardiovascular disease (CVD). Available evidence suggests that poor nutrition contributes to excessive premature CVD mortality in Australian Aboriginal people. The aim of the present study was to examine the effect of a nutrition intervention program conducted in an Aboriginal community on plasma homocysteine concentrations in a community-based cohort. From 1989, a health and nutrition project was developed, implemented and evaluated with the people of a remote Aboriginal community. Plasma homocysteine concentrations were measured in a community-based cohort of 14 men and 21 women screened at baseline, 6 months and 12 months. From baseline to 6 months there was a fall in mean plasma homocysteine of over 2 ¬mol/L (P = 0.006) but no further change thereafter (P = 0.433). These changes were associated with a significant increase in red cell folate concentration from baseline to 6 months (P < 0.001) and a further increase from 6 to 12 months (P < 0.001). In multiple regression analysis, change in homocysteine concentration from baseline to 6 months was predicted by change in red cell folate (P = 0.002) and baseline homocysteine (P < 0.001) concentrations, but not by age, gender or baseline red cell folate concentration. We conclude that modest improvements in dietary quality among populations with poor nutrition (and limited disposable income) can lead to reductions in CVD risk.