Remote Australia Online

Australia, like other post-colonial countries, witnesses an over-representation of Indigenous children in the child protection sector and the trend continues to rise. International indigenous scholarship in child protection seeks to problematise relation-based practice to instantiate decolonising standards. However, much of this transformative agenda is situated in psychosocial approaches that focus on inherent power relations and thereby jettison strategies enabling social workers to engage in emotional learning to contain their defences against anxieties. An autoethnography of practice stressors in remote Aboriginal Australian communities is provided and a call for the restoration of relational psychodynamics as the most responsive form to decolonising practice standards.

This companion document gives background details for the main Child and Adolescent Health and Wellbeing Plan document. It explains the foundation information used to create the plan. This information includes more detail on: target population statistics; direct consultations with youth; the contributions of our partners across government and in the non-government sector; and other useful information on potential monitoring to be used during implementation. We will work together with our partners to refine and complete the monitoring to be used during the first year of the Plan’s implementation. This companion document includes: • statistics on children, adolescents and young people 0 to 24 years old; • a summary analysis of consultations with children and youth from 12 to 24 years old • a table detailing the input received from our partners • examples of programs that work that are evidence based and consistent with the plan’s principles, particularly those around place based design and local involvement or co-design • a detailed timeline on implementation and monitoring • a potential Monitoring Report using a KPI traffic light matrix • a discussion on data governance and data sovereignty – the key to Aboriginal data sharing • a full Reference List for both Plan documents.

Background Paediatric Cryptococcus gattii disease is rare, with only two previous cases recorded in the Northern Territory (NT) over the last 54 years. Immune reconstitution inflammatory syndrome (IRIS) is a recognised complication of C. gattii infection, even in the absence of an identified immunodeficiency syndrome; however, limited paediatric data exist. We present a series of three paediatric patients treated for C. gattii infection in the NT during 2016/2017. Case Discussions All three cases were males aged 8–13 years at the time of presentation. Two were Aboriginal Australians from remote NT communities, and the third was a Timorese child from a remote district in Timor-Leste. All cases had evidence of brain cryptococcomas, and two had associated pulmonary lesions. Each child was treated with a 6-week induction phase of intravenous liposomal amphotericin and flucytosine and then continued on a 2-year course of eradication oral fluconazole. Persistent high intracranial pressure (ICP) complicated each case, requiring serial lumbar punctures and, in two cases, insertion of ventriculoperitoneal shunts. All three cases were diagnosed with IRIS between 5 and 10 weeks after commencement of antifungal treatment and were managed with high-dose corticosteroids, which were weaned slowly (6–20 months post-commencement). Conclusions Paediatric C. gattii disease is rare, although three recent cases in the NT highlight some of the challenges involved in managing the infection, including persistent raised ICP and complications such as IRIS. There is a need for further collaborative research into paediatric C. gattii disease.

The language education policy research based on the views of remote Indigenous communities that is the subject of this paper involved a complex metaphoric dance but one centred on the lead of Aboriginal collaborative research participants. The researchers in this dance, fortunately, had enough experience in traditional Aboriginal decision-making processes and so knew the tilts and sways that ensured the emergence of a reliable picture of remote Indigenous knowledge authority. However, as with most Indigenous research, the de-colonisation process and the use of Indigenous research methods hit a misstep when it came to the academy’s ethical procedures and institutional gatekeeping. This almost led to a position from which the research would not recover and from which a contentious but important Indigenous topic on Indigenous language education remained unvoiced.

As the global predictions and effects of climate change have been emerging in recent years, thermal comfort is a growing concern for the marginalised, remote populations of the world including First Nations peoples. This paper draws on data from a qualitative climate change study with Australian Aboriginal people in the remote semi-arid region of Northwest Queensland and other regional studies to explore ways that yards can enhance thermal performance around conventional housing. Our investigations demonstrate that despite evidence of appropriate housing designs, living spaces outside of the house continue to be overlooked and under-utilised. Aboriginal people have modified their behaviour and made changes to their external living environments, often without sufficient resources, to achieve social and cultural continuity, energy efficiency and particularly to enhance thermal comfort. For these reasons, yards demand greater attention in the policy, planning and provision of housing and associated services for Aboriginal people.

Enhancing resilience is key to reducing teacher attrition and addressing the challenges of the profession but scant research exists on resilience in regional and remote settings, where there is a shortage of quality, specialist and lead teachers. The aim of this study was to combine ecological and relational perspectives on resilience to examine pre-service and early career teacher resilience in the remote context of central Australia. The findings suggest that beginning teacher resilience in central Australia involves a particular set of enablers and constraints which are characterised by teachers? capacity to build connections to place, connections as a learner and connections in relationships. A transactional systems model is presented that articulates the dynamism of the resilience processes and offers a way to better understand the ecological interdependencies unique to a particular context and culture. This understanding will enable teachers, initial teacher educators, school leaders and policy makers to better address the challenges facing this profession.

In 2008, community government was abolished in the remote Aboriginal communities of the Northern Territory and centralised in large shires. It seems safe to assume that, for the foreseeable future, the population of most of these communities will remain predominantly Aboriginal. While such communities will continue to be centres of change, the co-residence of large populations of Aboriginal people also facilitates the reproduction of values and practices, some of which create a ?seemingly intractable gulf between policy goals and actual community life? (M and R Tonkinson 2010, 68). Ignoring this problem is not the answer. Despite past problems with community government, it is one of the few avenues for real community development and a chance to build a notion of civil society.

Indigenous peoples around the world are increasingly claiming and exercising sovereignty and self-determination. One important method for this is through economic development, but this raises tensions between Indigenous values and those of the marketplace. While this tension is real, we argue that economic development that is underpinned by Aboriginal values is an act of prefigurative resistance and helps nations move towards self-determination. Based on ethnographic research with the Gugu Badhun Aboriginal nation, we explore theories of recognition and anticolonialism through economic development processes. The experience of Gugu Badhun indicates that a contemporary Aboriginal economy can have very different values to those of neoliberalism, but also demonstrates that this is a slow process that must be built on a firm cultural foundation. In so doing, Gugu Badhun are navigating the tensions and working through them in a process of self-determination in action.

The majority of the still limited literature on education in non-metropolitan areas adopts an understanding of rurality as a fixed and known geographic entity. This paper departs from such a functionalist perspective to explore how rurality is constructed in a programme for at-risk teenagers in remote Australia. Drawing on a range of texts about the programme, including a documentary series entitled Outback Kids, we examine how the rural space is imagined as simultaneously therapeutic and disciplining and therefore appropriate for troubled youth. Alongside this discussion we map the way in which other qualities and values associated with bifurcated definitions of the rural as a place of tradition and authenticity, and the urban as a place of disorder and pretence, are engaged in the texts to endorse the programme and its practices.

Mental health nursing in New South Wales, Australia has experienced considerable change as a profession over the past 20 years. In a climate of reduced funding and heightened service need, rural and remote geographies continue to affect workplace environments and experiences. This article presents qualitative focus group data to identify what workplace strategies and experiences mental health nurses working in rural and remote communities used in their day-to-day practices. Findings demonstrate socially patterned working conditions and experiences consistent with national and international research outcomes, specifically that emotional and physical resilience is required to survive and thrive as a mental health professional. Specific workplace experiences reveal three key themes (workplace culture; professional pride; rewards, people and places) which characterise participants? perceptions and overall work satisfaction. Examples from each of these themes are presented to illustrate what contributed or detracted from individual mental health nurses? overall perception of their workplaces, and particularly such positive feelings as, ?I love my job?. From consideration of these experiences, greater insight into the profession may be gained that fosters policies and practices to address ongoing issues of low retention and high turnover rates.

Women's Business: Cross-cultural Collaborations in Remote Indigenous Art Centres

This thesis argues that, when reconsidered strategically, construction in remote Indigenous Northeast Arnhem Land can better meet identified needs, contribute to socio-economic networks and support territorially widespread settlement. From the analysis of existing Capital Works Investments and building practices, the possibility for an alternative ‘Regional Woven Distribution (RWD)’ framework emerged. RWD is the ‘distributed’ allocation of assets across a territory, or ‘region’, for building in response to identified needs. As needs are complex and interdependent, building responses necessarily ‘weave’ available assets to maximise efficiencies and effectiveness. RWD supports the development regional systems of production and construction that are adaptable, domestic in scale, employ local resources, and account for contextual differences. The framework argues this approach can result in an improved level of response to identified community needs and support local industrial development.

Smoking prevalence in remote Australian Aboriginal communities remains extraordinarily high, with rates reported of up to 82%. Widespread exposure to environmental tobacco smoke (ETS) is exacerbated by overcrowded housing. Implementation of existing smoke-free policies is challenged by the normalization of smoking and a lack of appropriate regulation resources. This paper celebrates a grassroots approach to control of environmental tobacco smoke (ETS) in these settings. We report on selected findings from a tobacco intervention study in Arnhem Land, Northern Territory in 2007–2012. In community-level tobacco use surveys at baseline (n = 400 ≥ 16 years), participants reported concern about the constant exposure of non-smokers to tobacco smoke. Suggestions for action included restricting smoking in private and public spaces. We selected three case studies illustrating management of ETS from observational data during the study’s intervention phase. Using a critical realist approach, the context and mechanisms that contributed to specific strategies, or outcomes, were examined in order to develop a hypothesis regarding more effective management of ETS in these environments. Our results suggest that in discrete, disadvantaged communities, enhanced local ownership of smoke-free policies and development of implementation strategies at the grassroots level that acknowledge and incorporate cultural contexts can contribute to more effective management of ETS.

Katherine Hospital (KH) is a small regional hospital with two operating theatres around 320km south of Darwin in the Northern Territory (NT). The Katherine region is huge, covering an area of about 340 000 square kilometres stretching across the NT from Western Australia to Queensland. Much of the surgery at KH is conducted by visiting consultants so telehealth can play a vital role in how perioperative care is delivered to the patients in the region, especially when the patient is from a remote community.

In remote Australian Aboriginal communities, medical interactions between non-Aboriginal nurses and Aboriginal patients often use health narratives to enact and contest social identities. Nursing staff complain that Aboriginal patients do not comply with their prescribed medication nor attend the clinic appropriately. Nurses often blame these behaviours on irresponsibility and laziness. Conversely, Aboriginal people complain that nursing staff are racist and state that foods and medicines from the bush are more efficacious than biomedical treatment. Through medical interactions and discourse, non-Aboriginal and Aboriginal residents seek to circumscribe and challenge notions of Aboriginality.

Naturally occurring elevated levels of nitrates are detected in many of the groundwater bores in the arid zone of Central Australia. Such levels are associated with anemia in young babies, pregnant women and other vulnerable groups. Further, there is evidence that links long-term exposure to elevated levels of nitrates with gastric cancer. In many parts of arid Central Australia alternative sources of water are not available. The capacity to operate and maintain water treatment and supply systems in remote Indigenous communities varies due to access and levels of service provision, mobility of the residents and balance of skills within the communities. A need has thus been identified for a low maintenance nitrate removal system. Conventional treatment processes do not remove nitrates. Alternatives, such as reverse osmosis, ion exchange or biological denitrification are either complex, energy and water intensive, expensive, produce waste products requiring disposal or require continual maintenance and monitoring. Such preconditions are not able to be met in remote Indigenous communities. This paper reviews the problems of nitrates in the arid zone of Central Australia and explores existing technologies for their removal, relative to remote Indigenous settings. It identifi es a need for further investigations to tailor technology to the unique social, economic and cultural characteristics of these settings.

Despite frequent exposure to severe natural hazards including extensive bushfires, tropical cyclones and floods, remote Indigenous communities across northern Australia typically have little engagement in managing, mitigating or planning for such hazards. The BNHCRC scenario planning project explores how remote communities can effectively and sustainably mitigate the risks of natural hazards, and develop effective partnerships with emergency management (EM) decision-making processes. This research integrates and analyses EM resources and services available through various agencies responsible for remote locations, and related EM costs. The project provides opportunities for responsible agencies to eng age and plan with remote communities to deliver efficient, cost - effective and culturally appropriate EM services. Scenario planning workshops, applying business as usual and enhanced risk mitigation scenarios, are underway involving active participation of multiple stakeholders including rangers from remote locations namely, Borroloola, Hermannsburg and Yuendumu, representatives from emergency services in the Northern Territory (NT Emergency Services, Fire and Rescue Services, Bushfires NT), the Northern an d Central Land Councils, and other local organizations. Initial discussions with rangers and Traditional Owners from the selected remote communities, representatives from the relevant EM agencies, and other interested parties have indicated keen interest f or participating in the project. Workshop discussions and associated data analyses will be presented, offering new insights into the delivery of cost - effective and improved EM services that can empower vulnerable remote communities.

Australia’s National Disability Insurance Scheme Specialist Disability Accommodation (NDIS SDA) program anticipates new, disability specific, housing stock being built by private investors incentivized by cash payments and rental income. To date, very few new SDA dwellings have been constructed and the majority of the research and analysis of the program’s potential has been in the context of apartment construction in major capital city markets in Australia. This paper uses a hypothetical case study of building SDA accommodation in a discrete regional Indigenous community, Yarrabah, in Queensland. It investigates underlying assumptions within the scheme, particularly around the relationship of land to investment outcomes, as well as cultural considerations. An important aspect is to test how effectively the design guidelines associated with the scheme translate into an appropriate built form that is culturally and environmentally appropriate in locations outside major urban centres. The results suggest that housing actors from the not-for-profit sector may benefit from the SDA at the expense of profit-driven, market-based housing developers, and that the SDA design categories offer limited flexibility for participants with changing care needs, potentially restricting resident continuity in occupancy and ongoing return on investment. The work offers an early assessment on the workability of the SDA in the context of housing investment in a new market for the private housing industry.

BACKGROUND The distribution of RBC antigens, which define blood group types, differs among populations. In contrast to many world populations, blood group profiles for Indigenous Australians have not been well studied. As it is now possible to predict comprehensive blood group antigen profiles from genomic data sets, we aimed to apply this for Indigenous Australians and to provide a comparison to other major world populations. STUDY DESIGN AND METHODS Whole exome sequence data for 72 Western Desert Indigenous Australians was provided by the Telethon Kids Institute. Variants (against hg19) were annotated using computer software (ANNOVAR, Qiagen Bioinformatics) and filtered to include only variants in genes for 36 blood group systems, and the transcription factors KLF1 and GATA1. The RHCE*C allele and RHD zygosity were identified by copy number variant analysis of sequence alignments. The impact of missense variants was investigated in silico using a meta-predictor of disease-causing variants (Meta-SNP). RESULTS For 21 blood group systems the predicted blood group antigen frequencies were comparable to those for other major world populations. For 13 systems, interesting points of contrast were identified. Furthermore, we identified 12 novel variants, one novel D allele, and four rare variants with potential clinical significance. CONCLUSION This is the first systematic assessment of genomic data to elucidate blood group antigen profiles for Indigenous Australians who are linguistically and culturally diverse. Our study paves the way to understanding the geographic distribution of blood group variants in different Indigenous groups and the associated RBC phenotypes. This in turn is expected to guide transfusion practice for Indigenous individuals.

For Indigenous Australians, health transcends the absence of disease, and includes the health and wellbeing of their community and Country: their whole physical, cultural and spiritual environment. Stronger relationships with Country and greater involvement in cultural practices enhance the wellbeing of Indigenous Australians, and those in more remote regions have greater access to their Country and higher levels of wellbeing. However this does not translate into improvements in clinical indicators, and Indigenous Australians in more remote regions suffer higher levels of morbidity and mortality than Indigenous people in non-remote areas, and other Australians.

Distinct from rurality, the Australian desert has long functioned as a signifier of remoteness in the dominant imagination; a product of spatialised binary relations between ?progressive? (white) mainstream or idealised white countryside, and disordered/dangerous Aboriginal periphery. Remoteness constitutes a complex racial dynamic that has historically mediated white teachers? and missionaries? desires to travel to the social margins. This article adopts a discursive understanding of remoteness to examine contemporary white teachers? decisions to work in Aboriginal schools in the desert ? decisions that are often articulated through unwitting recourse to the ?three Ms? or ?tourist?. The article explores these identity constructs and how they enable different performances of whiteness. It examines how white people?s desires are often covertly raced but does not however, position the teacher as a priori racist. Rather, desire is theorised as a social construct in which subjects invest, which may at times contribute toward processes of decolonisation. This rendering moves beyond a logic of individualism and underpins the argument that recognising how these dynamics play out is vital with respect to understanding the place of white teachers inside remote Indigenous Education. Moreover, such insights are valuable for appreciating how whiteness continues to be reproduced in White Australia under a guise of good intentions.

This research investigates why Indigenous workers decide to enter, stay or leave their positions in art centres that serve as important social enterprises in remote Australia. We develop a framework that integrates identity theory and push?pull theory via institutional logics, thereby extending Wry and York (2017)?s typology configurations that is applicable to other actors in the entrepreneurial eco-system, including Indigenous art centre workers. Based on a qualitative study of 72 Indigenous art centre workers employed in remote Australia, the results indicate that although art centres have dual for-profit and social missions, it is mainly pull factors related to paid, local employment aligned to vocational interests, and pro-social motives that are important in explaining why Indigenous Australians choose to work there. Career motives also explain workers? decision to stay, while diverse pull and push factors explain why workers quit. Importantly, the factors that explain employment decisions are multi-factorial, interrelated and closely tied to the social and cultural logics of community life. The research furthers our understanding of how identity factors contribute to decisions by Indigenous art centres workers to enter, leave or stay in their role, providing a more complete understanding of HRM within the context of social enterprises.

Background: The Nurse Family Partnership Program developed in the USA, designed to improve mother and infant/child outcomes, has reported lower rates of child protection system involvement. The study tested the hypothesis that an adapted Nurse Family Partnership Program implemented in an Aboriginal community in Central Australia (the FPP) would improve Child Protection outcomes. Methods: This was a retrospective and prospective cohort study drawing on linked administrative data, including birth registry, primary health care client information system, FPP program data, and child protection data. Participants were children of women eligible for the FPP program (an exposed and a control group of women, eligible but not referred) live-born between 1/3/2009 (program commencement) and 31/12/2015. Child protection data covered all reports, investigations, substantiations and out-of-home care placements from the time of the child’s birth to 31/12/2016. Generalised linear modelling was used to estimate the relative risk (RR) of involvement with child protection and type of involvement (report, investigation, substantiation, out-of-home-care placement) among FPP and control children. Results: FPP mothers (n = 291) were on average younger, were more likely to be first-time mothers and experiencing housing instability than control mothers (n = 563). Among younger mothers ≤20 years, FPP children had statistically significantly lower rates of involvement with child protection (ARRreport = 0.49, 95% CI: 0.29 to 0.82; ARRinvestigation = 0.34, 95% CI: 0.19 to 0.64; ARRsubstantiation = 0.45, 95% CI: 0.21 to 0.96) and experience fewer days in care (ARR = 0.10, 95% CI: 0.02 to 0.48). Among children of first-time mothers, FPP children also had statistically significantly lower rates of involvement with child protection (ARRreport = 0.50, 95% CI: 0.30 to 0.83; ARRinvestigation = 0.36, 95% CI: 0.19 to 0.67; ARRsubstantiation = 0.38, 95% CI: 0.18 to 0.80) and fewer days in care (ARR = 0.06, 95% CI: 0.01 to 0.27). Conclusion: Study results suggest a modified Nurse Family Partnership delivered by an Indigenous community-controlled organisation may have reduced child protection system involvement in a highly vulnerable First Nations population, especially in younger or first-time mothers. Testing these results with an RCT design is desirable.

This chapter is an attempt to think through the relationship between the experiences of survivors and their representation by feminist experts. This is examined through the lens of a significant controversy in Australian feminism, the ‘Bell debate’, which centred on the right of Diane Bell, a white American anthropologist, to ‘speak out’ about high levels of sexual violence in remote Aboriginal communities. Revisiting this debate, the chapter insists that postcolonial analyses of power relations between and among women are crucial for understanding the political and ethical responsibilities of feminists in relation to narratives of sexual violence. The Bell debate demonstrates, I argue, the importance of subjecting the actions of feminist interlocutors of women’s experiences to critical scrutiny.

The concept of ‘unconscionable dealing’ in statutory consumer protection provisions, such as s 12CB of the Australian Securities and Investments Commission Act 2001 (Cth), has been the subject of extensive consideration in the Federal Court of Australia and the superior courts of the states. The evaluative approach taken by the courts is emerging as a principled approach in its own right, although informed by equity’s jurisdiction. The upcoming appeal in Australian Securities and Investments Commission v Kobelt provides the High Court of Australia with the opportunity to further articulate the application of the evaluative approach to be undertaken by Australian courts. The factual matrix provides a unique impetus for the High Court to do so, involving the intersection of national financial services laws with the cultural norms and practices of the residents of the Anangu Pitjantjatjara Yankunytjatjara Lands in South Australia when purchasing daily necessities from a remote general store. This column argues that the Full Court of the Federal Court erred in its use of the cultural norms and practices of the Anangu community to conclude that conduct, which would otherwise be unconscionable dealing, is not so. The High Court is expected to elucidate the correct application of the evaluative process in assessing statutory unconscionability where the cultural norms and practices of the consumer differ from that of the broader Australian community.