Remote Australia Online

This paper addresses the potential importance of assistant teachers in confronting the challenges of Indigenous literacy education. A discussion is raised with reference to a range of relevant literature, while reflections drawn from the author's involvement in evaluating the National Accelerated Literacy Program (NALP) in the Northern Territory are used to highlight an urgent need and vital opportunity to support assistant teachers – as mainstay figures in Indigenous education – in becoming “wellsprings” of literate practice and principled pedagogy. An overview of Accelerated Literacy methodology and the NALP is provided as a framework for considering how to embed strong literate practices and principled pedagogy in remote Indigenous communities through the provision of empowering professional development to Indigenous assistant teachers: facilitating for them a genuine and qualified status as literacy educators. The prospects and challenges of pursuing such an opportunity, in the context of NALP, are likewise considered.

INTRODUCTION: Rural health workforce shortages are a global phenomenon. Countries like Australia, with industrialised economies, large land masses and broadly dispersed populations, face unique rural health challenges in providing adequate services and addressing workforce shortages. This article focuses on retention of early-career nursing and allied health professionals working in rural and remote Australia. Some of Australia's most severe and protracted rural workforce shortages, particularly among early-career health professionals, are in public sector community mental health (CMH), a multidisciplinary workforce staffed primarily by nurses and allied health professionals. This study investigated how employment and rural-living factors impacted the turnover intention of early-career, rural-based CMH professionals in their first few years of working. METHODS: A constructivist grounded theory methodological approach, primarily guided by the work of Charmaz, was selected for the study. By implication, the choice of a grounded theory approach meant that the research question would be answered through the development of a substantive theory. Twenty-six nursing and allied health professionals working in CMH in rural New South Wales (NSW) for the state health department services participated in in-depth, semi-structured interviews. The study sought to identify the particular life factors - workplace conditions, career-advancement opportunities and social and personal determinants - affecting workers' turnover intention. The substantive grounded theory was developed from an identified core category and basic social process. RESULTS: The turnover intention theory provides a whole-of-person explanation of turnover intention. It was developed based on an identified core category of professional and personal expectations being met and an identified basic social process of adjusting to change. The theory posits that an individual's decision to stay or leave their job is determined by the meeting of life aspirations, and this relates to the extent of the gap between individuals' professional and personal expectations and the reality of their current employment and rural-living experience. The extent of individuals' professional and personal expectations can be measured by their satisfaction levels. A major finding from the identification of the basic social process was that, in the adjustment stages (initial and continuing), turnover intention was most strongly affected by professional experiences, in particular those relating to the job role, workplace relationships and level of access to continuing professional development. In this stage, personal satisfaction mostly concerned those with limited social connections in the town (ie non-local - newcomers). Having reached the 'having adapted' stage, the major influence on turnover intention shifted to personal satisfaction, and this was strongly impacted by individuals' life stage. By drawing on the turnover intention theory and the basic social process, it is possible to make a risk assessment of individuals' turnover intention. Three levels of risk were identified: highly vulnerable, moderately vulnerable and not very vulnerable. CONCLUSIONS: The study offers a holistic explanation of life factors influencing the turnover intention of early-career health professionals working in public health services in rural NSW. These findings and the turnover intention risk matrix are thought to be suitable for use by Australian public health services and governments, as well as in other highly industrialised countries, to assist in the development of policies and strategies tailored for individual health professionals' work-experience level and life stage. By adopting such a whole-of-person approach, health services and governments will be better positioned to address the life aspirations of rural-based, early-career health professionals and this is likely to assist in the reduction of avoidable turnover.

Background Threatened preterm labour is a common reason for medical transfer from remote communities; however, many transferred women do not deliver preterm. A tool for prediction of preterm birth such as fetal fibronectin may reduce transfers and related social and economic costs. Aim To review the use of fetal fibronectin testing in women transferred for threatened preterm labour from Cape York to Cairns Hospital between 2011 and 2015 and determine the role testing could play in reducing transfers and associated costs. Materials/methods Records from the Royal Flying Doctor Service and Cairns Hospital were accessed. Women transferred solely for threatened preterm labour were included in the study. Fetal fibronectin testing, hospital admission, outpatient stays and birth outcome data were collated and analysed. Costs were assigned using the National Hospital Cost Data Collection, round 19. Results Forty-seven women were included in the study; however, only 20 underwent fetal fibronectin testing. Transfer of 30 women who had either a negative test or were not tested but delivered at term resulted in 41 inpatient nights and 443 excess outpatient nights, costing an estimated AU$57 408. Aeromedical transfers were estimated to cost a further $151 500. Conclusion Adherence to clinical guidelines and greater availability and use of fetal fibronectin testing in Cape York have the potential to reduce aeromedical transfers for threatened preterm labour. Substantial inpatient and excess outpatient stays could be avoided with associated reduction in health system and social costs. Strategies to improve adherence to guidelines and increase access to testing are required.

Effective mathematics teaching for Indigenous language speaking students needs to be based on fair expectations of both students and teachers. Concepts of ‘age-appropriate learning’ and ‘school readiness’ structure assessment expectations that entire cohorts of Indigenous language speaking students are unable to meet. This institutionalises both student and teacher failure, as both are exhorted to meet unachievable expectations. The voices of teachers teaching in a very remote school provide insight into teachers’ responses to the mismatch between the system expectations and the teaching context. Teacher interviews in a small Northern Territory school, conducted within an ethnographic study, showed that teachers’ decisions regarding the level of mathematics curriculum taught were informed by students’ prior learning and by the language dynamic in their classrooms. The need and pressure to teach Standard Australian English also affected how mathematics was taught. This leads to a reformulation of the concept of school readiness to ask how schools can be more ready for their Indigenous language speaking students in terms of preparing and supporting teachers.

The Lurujarri Dreaming Trail is an ancestral dreaming track near Broome in the Kimberley region of north-western Australia. Walked each barrgana season by Goolarabooloo traditional custodians and non-Indigenous people, this trail was also recently the site of a major land use dispute. Conflicts over what the land is and how it should be valued have defined Indigenoussettler relations since the first wave of colonisation of Australia’s First Peoples and their ancestral estates (Wilson & Ellender, 2002). At the heart of these conflicts are different ways of conceptualising and relating to the land, and ultimately, divergent ontologies. This paper reflects on my doctoral research and the recent dispute in the Kimberley which foregrounded my research, to contribute to conversations on how research methodology can recognise the ontological politics (Verran, 2007) enacted in place. It explores how I, as an ethnographic researcher, used ontological openness to work ethically and productively with the different realities being performed in place. It also explores the broader implications of this approach in terms of decolonising research practice and supporting respectful dialogue between Indigenous and Western peoples and realities.

This paper critiques a 2008 Queensland Studies Authority (QSA) assessment initiative known as Queensland Comparable Assessment Tasks, or QCATs. The rhetoric is that these centrally devised assessment tasks will provide information about how well students can apply what they know, understand and can do in different contexts (QSA, 2009). The QCATs are described as “authentic, performance based assessment” that involves a “meaningful problem”, “emphasises critical thinking and reasoning” and “provides students with every opportunity to do their best work” (QSA, 2009). From my viewpoint as a teacher, I detail my professional concerns with implementing the 2008 middle primary English QCAT in one case study Torres Strait Islander community. Specifically I ask “QCATs: Comparable with what?” and “QCATs: Whose authentic assessment?” I predict the possible collateral effects of implementing this English assessment in this remote Indigenous community, concluding, rather than being an example of quality assessment, colloquially speaking, it is nothing more than a “dog”.

In a policy landscape dominated by forces that seek to continually reshape education according to market logics, there are particular impacts on the seemingly intractable crisis of Indigenous education policy making. Entrenched discourses of deficit result in education policy continually being ‘done to’ communities, with little heed paid to the effects of such efforts on the learning opportunities available to young Indigenous learners, particularly those living in remote communities. This paper examines the contemporary network of policy levers that come to shape how literacy policy is framed for Indigenous Australians through narratives of failure and crisis. In doing so, we ask what learning is made (im)possible and what are some of the ‘flattening’ effects on literacy curriculum and pedagogy as a result? Further, this paper seeks to open up the conversation around what learning is possible when the policy landscape is unflattened, when policy is ‘done with’ communities, and when pedagogical practices are opened up, rather than closed down.

OBJECTIVE: To examine activity patterns of the Royal Flying Doctor Service of Australia (RFDS) in far western New South Wales and to determine whether frequent use of RFDS services, particularly emergency evacuations, is a useful indicator of patients who may benefit from care planning and review. DESIGN, SETTING AND PARTICIPANTS: We conducted a retrospective audit of the RFDS South Eastern Section's Broken Hill patient database. Patients with a residential address in the study area who had accessed at least one RFDS medical service between 1 July 2000 and 30 June 2005 were included in the study. MAIN OUTCOME MEASURES: Number of evacuations, clinic consultations and remote consultations; clinic usage by frequent evacuees; number of primary diagnoses recorded for frequent evacuees; number of frequent users who might benefit from multidisciplinary care or specialist shared care. RESULTS: Between July 2000 and June 2005, the number of residents requiring evacuation or remote consultations declined by 26% and 19%, respectively, and the number of residents accessing clinics declined by 6%. (Over the same period, the population of the study area fell by about 24%.) Of the 78 patients who were identified as frequent users of the evacuation service (> or = 3 evacuations/year), 34 had three or more primary diagnoses recorded; 15 were infrequent or non-users of the clinics (< or = 3 attendances/year); 53 may have benefited from multidisciplinary care, and 41 from specialist shared care. CONCLUSIONS: Simple, practical clinical review systems can help health care organisations in rural and remote communities to achieve better outcomes by identifying patients who may benefit from planned care.

This paper explores Aboriginal perspectives of tertiary education “online” from rural and remote community locations in New South Wales. It does so within a frame of enquiry as to how neo-liberal educational policy reforms are impacting on equity issues in distance education “online”. Accounts from Aboriginal university students in health point to a range of tensions between changes brought about by the reform in relation to student subjectivity and university governance, and culturally preferred ways of learning for many Aboriginal people. The paper offers suggestions for how these forms of educational governance can be reconciled with educational support needs of remote Aboriginal learners.

INTRODUCTION: In 2000, the Australian College of Rural and Remote Medicine (ACRRM) developed a national radiology quality assurance (QA) and continuing medical education (CME) program for rural and remote non-specialist Australian doctors. The program commenced on 1 January 2001. It required rural doctors to obtain 30 radiology QA/CME points over a 4 year period. At least 15-20 of these points had to be obtained by one of two mandatory options of the program, either: (1) film interpretation, report and review clinical audit activity; or (2) a radiology clinical attachment. METHOD: Doctors submitted their completed film review forms and clinical attachment logbooks to the program manager as confirmation of their educational activity to receive their professional development points. Data from film review forms and clinical attachment logbooks were de-identified and entered into two Microsoft EXCEL spreadsheets. The data were categorised and analysed in EXCEL. RESULTS: From 1 January 2001 to September 2004, 823 rural and remote doctors enrolled in the ACRRM radiology program. This included 281 locums who enrolled in the short-term locum option of the program and 563 doctors who enrolled in the full program. In September 2004, 419 doctors had completed a radiology film review with a radiologist and 41 doctors completed a radiology clinical attachment in 31 different public and private radiology practices. One hundred and ninety-five doctors completed the short-term locum activity. Ninety-two different specialist radiologists participated in the program and assisted rural and remote doctors to enhance their radiology knowledge, confidence and skills. This article describes results from the two mandatory activities. CONCLUSION: The evaluation of the ACRRM radiology program after its first 3 years and 9 months shows there are a large number of rural and remote Australian doctors undertaking professional development and quality assurance activities in radiology.

INTRODUCTION: Rural and remote Australia has a severe shortage of health professionals and the health of its people is relatively poor. For decades, national and international studies have demonstrated that health professionals who grow up in rural areas are more likely to practise in rural areas when compared with health professionals raised in the city. However, an often unrecognised consequence of the severe shortage of health professionals is the severe shortage of role models to inspire rural and remote school students to go on to become health professionals. So how do these school students paint a picture for themselves of what it would be like to be a health professional? Do they acquire images from school? Career development theorists suggest that children start to shape ideas about careers before preschool and then continue to shape these ideas throughout their school years. They also agree that, to aspire to a career, a student must first know about that career. At the time of writing, no review of primary school curricular materials in rural and remote Australia related to information inspiring students to health professions was available in the literature. METHODS: This article reports on an analysis of all the Department of Education set curricular materials studied by rural and remote distance-education school students in years 3-7 in one Australian state. The aim was to look for content relevant to careers in the health professions. RESULTS: Students are provided with very little information to help them build an image of these careers. Some of the information, provided in the students' curricular materials, painted negative images of health professionals, especially doctors. CONCLUSIONS: These findings contribute to an understanding of why relatively few students from rural and remote Australia go on to become health professionals. It is exhilarating to realise these findings are modifiable, with the potential to improve future rural health workforce recruitment and retention.

Growth in the first year of life was studied prospectively, at monthly intervals, in 49 Aboriginal babies born into 6 remote communities in the tropical north-west of Australia. Birthweights, on average, were slightly lower than international (NCHS) reference values but growth velocity in the first 3 months of life exceeded international reference values. After that, growth rates in Aboriginal infants slowed and their attained weights and lengths fell behind expected values for age. By 12 months of age the Kimberley boys were 1·35 kg lighter and 4 cm shorter than the NCHS values while the Kimberley girls were 1·04 kg and 2·8 cm less than the international reference values. Environmental factors are considered dominant in determining these growth patterns in Australian Aboriginal infants.

This paper addresses issues of ‘distance’ between remote and metropolitan audiences, and the use of communications technologies as tools to dispel such distance. Using the satellite-delivered RCTS broadcasting as a case study — given that this was part of the thrust to ‘dispel’ this distance — the research reported here interrogates notions of difference and inclusion as perceived, experienced and expressed by people resident in remote and regional Western Australia. The argument advanced is that new communications technologies do not dispel distance; rather, they act as catalysts through which distance is re-experienced and redefined. These distinctions are of continuing and growing importance in a climate within which Networking the Nation and digital TV again promise more equalisation of differences and services, and more dispelling of distance.

Schooling for Aboriginal and Torres Strait Islander students in remote or ‘Red Dirt’ communities has been cast as ‘problematic’, and ‘failing’. The solutions to deficit understandings of remote schooling are often presented as simple. But for those who work in Red Dirt schools, the solutions are not simple, and for education leaders positioned between the local Red Dirt school and upward accountability to departments of education, they are complex. Between 2011 and 2016, the Cooperative Research Centre for Remote Economic Participation's (CRC-REP) Remote Education Systems project explored how education could better meet the needs of those living in remote communities. More than 1000 people with interests in remote education contributed to the research. Education leaders were identified as one stakeholder group. These leaders included school-based leaders, bureaucrats, community-based leaders and teacher educators preparing university graduates for Red Dirt schools. This paper focusses on what Red Dirt education leaders think is important for schooling. The findings show school leaders as ‘caught in the middle’ (Gonzalez & Firestone, ) between expectations from communities, and of system stakeholders who drive policy, funding and accountability measures. The paper concludes with some implications for policy and practice that follow on from the findings.

Radiation recall is an uncommon phenomenon describing an acute localised inflammatory toxicity affecting tissue previously exposed to radiotherapy. It is precipitated by administration of certain medications, including chemotherapy. We describe a case involving a 50-year-old Aboriginal male smoker from a remote community in Northern Australia who underwent treatment for stage IV non-small cell lung cancer with localised radiotherapy to the primary right upper lung lobe tumour. This was followed by a course of gemcitabine, which was ceased prematurely after four cycles when he presented with radiation recall to his right pectoralis major. Our case description is complemented with a brief review of current literature regarding our case and gemcitabine-related radiation recall. This was in the context of concurrent musculoskeletal strain, an as-yet unreported association with radiation recall. His condition settled with steroid administration and discontinuation of gemcitabine.

This paper is a reflection and discussion on doing decolonising research in the intercultural space. It flows from a larger PhD research study on pathways for Indigenous people from remote communities into teacher education. Academic research is steeped in western colonised traditions and behaviours. Conscious of this, it was important while undertaking the work toward this thesis to pay attention to the process of working together within the research. This came out of a desire to embody rather than observe cultural and ethical guidelines about doing research involving Indigenous people and knowledge systems. Through a series of interrupting tools used throughout the work, some key insights were captured that were significant in illustrating one process for collaborative decolonizing research. Three insights in particular stood out as guides for how to do decolonising research in the intercultural space. This paper will explain and discuss these three areas and their implications for working in what Verran (2013) calls ‘good faith’.

Many major studies of depression in Australia are under-representative of rural and remote residents, limiting the generalizability of their findings. This study explores the contributions of a range of individual, social, and community factors to the trajectory of depressive symptoms among a cohort of rural and remote residents.

Indigenous migratory practices have never been comfortably explained using deterministic theories of migration. In this paper, we argue that translocalism offers new hopeful possibilities for building more robust and nuanced understandings of Indigenous migration and for extending theorisations of translocality in postcolonial settler-states. Drawing on empirical evidence from a small-scale exploratory study of Indigenous adults who migrated from rural/remote Australia, to Perth, Western Australia, to study at a university, we suggest that a particular politics of place-making characterises Indigenous translocal subjectivities in settler states. These politics are evidenced by the ways in which the very act of movement from rural/remote areas to large cities for education can draw the authenticity of Indigenous identities into contestation. It also speaks to the resultant importance of translocal networks and places that provide relational spaces to share experiences of, and respond to, these contestations. The participants in this study made use of Indigenous student centres at their universities to develop a sense of place, build translocal networks, nurture their cultural identities, and contest settler assumptions that situate “authentic” Indigenous identities in a remote wilderness past.

Because higher-than-average turnover rates for nurses who work in remote and rural areas are the norm, the authors conducted a study to identify professional and personal factors that influenced rural nurses’ decisions to resign. Using a mail survey, the authors gathered qualitative and quantitative data from nurses who had resigned from rural and remote areas in Queensland, Australia. Their findings, categorized into professional and rural influences, highlight the importance of work force planning strategies that capitalize on the positive aspects of rural and remote area practice, to retain nurses in nonmetropolitan areas.

INTRODUCTION: There is emerging concern in the health literature about the impacts of non-resident work modes on the quality of service delivery particularly in sparsely populated or remote areas, but little is known about what non-resident health workers themselves see as the advantages and disadvantages of their modes of work, and whether non-resident workers face the same or different social/personal and professional barriers to rural and remote practice as their resident colleagues. Although literature from the resources sector provides insights into the expected social/personal advantages and disadvantages, very little is said about professional issues. METHODS: This article reports on semi-structured interviews conducted with seven non-resident nurses working in remote locations in Australia's Northern Territory in 2011. All nurses lived outside the Northern Territory when not at work. The interviews focussed on how the separation of place of residence and place of work affected nurses' private and professional lives. RESULTS: Social/personal issues faced by these nurses are similar to what has been reported in the broader literature on non-resident work. Nurses who successfully engage in non-resident work develop strategies to manage their lives across multiple locations. However, questions are raised about the professional impacts of non-resident work, in terms of the continuing competency of the workers themselves, the performance of work teams that consist of resident and non-resident workers, and the maintenance of context-specific skills. CONCLUSIONS: Non-resident work is likely to become more common in remote areas such as Australia's Northern Territory because of the advantages workers experience in their personal lives. There is an urgent need to address professional issues associated with non-resident work modes.

The history of remote school education in the Northern Territory can best be summarised as years of lost opportunities, pedagogies of discrimination, and diminished lives for those parents and children who trusted and responded to the government’s invitation to come to school. From late 2001 to 2005 historic educational change occurred in the remote Community Education Centre of Kalkaringi and Daguragu in the Northern Territory, the site for the delivery of the Northern Territory’s first Year 12 Indigenous graduates studying in their own community school. At the heart of the historic achievement was a radical change in thinking about education for Indigenous students. This paper discusses some of the policy parameters and educational circumstances that prevented significant change in the delivery model of education for the Community Education Centres in addition to a conceptualisation of how that school circumvented the policy parameters and instituted real change from the ground up. The paper examines, through a critical lens, the nature of the culture change that was crafted and built upon within Kalkaringi School and its communities, despite an initial and significant sense of powerlessness felt by families and to some extent the teachers and principal within the school. Through the development and embrace of a metaphor of possibility and hope - the challenge of climbing the educational mountain formed the foundation for a dedicated and committed enactment of an equitable educational entitlement for remote Indigenous students.

In meeting the social and emotional learning (SEL) needs of Aboriginal and Torres Strait Islander students, the capacities of school staff are critical. There is very limited evidence for relevant capacity development initiatives. This evaluation reports a multicomponent SEL training intervention delivered to staff of an Australian education service that operates independently of any particular school to assist with the transitions of students from remote communities to boarding schools. A participatory action research (PAR) approach was implemented over 13-months with 21 staff participants. Results from a pre-, mid- and six months post-training survey and staff interviews were analysed and fed back through reflective group discussions. The training was associated with improved staff attitudes to mental health and skills to support student wellbeing. Sixteen participants received a tertiary qualification. Despite ‘working in challenging environments’, staff were ‘dedicated to help’ students, and ‘acknowledged the need for change’ to better support student wellbeing. However, given the service's brokering role between families and schools, fewer staff members reported feeling empowered to influence issues in their workplace. The evaluation demonstrated the value of SEL training for education staff and potential utility for school teachers and boarding staff who have direct duty of care for Indigenous students. The multicomponent training described in this study would need to be condensed for school settings.

In Australia, a (re)emerging and hot trend is featuring native foods in restaurants, food tours and culinary arts. Based on the conceptual analysis for research undertaken for a pilot project examining the interface between restaurants and Indigenous Australian native foods providers, this paper argues that this emerging industry should be directed to ensuring Indigenous Australian benefit from the opportunities that are offered. Informed by an Indigenist philosophy, this paper takes a position that the Indigenous foods sector should serve Indigenous Australian economic, political, legal, socio-cultural and environmental interests. Such an argument is based on the values of the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP), the preeminent status of Indigenous peoples and their knowledges and the imperative to address Indigenous Australian disadvantage. Acknowledging an Indigenous cuisine might offer: an authentic identity, nourishing and sustainable food sources, a path to reconciliation and most importantly, Indigenous Australian well-being.

In many Indigenous territories, continuing processes of primitive accumulation driven by governments’ claims to resources and territory simultaneously deny Indigenous rights and insist on market forces as the foundation for economic and social futures in Indigenous domains. Drawing on research in North Australia, this paper identifies the erasure of Indigenous governance, the development of wickedly complex administrative systems, continuing structural and procedural racism and state hostility to Indigenous rights as constructing Indigenous vulnerability to poverty, addiction and underdevelopment. Shaping sustainable Indigenous futures in remote areas that are characterised by long-term development failure requires rethinking of remote local and regional economic relationships. Recognising remote regional economies as hybrid economies that rely on environmental, social and cultural wealth is an important first step in reorienting policy settings. It is also crucial that we acknowledge sustainable Indigenous futures cannot arise from policy interventions that rely on creating wealth for state and corporate appropriation and assume enough of this wealth can be redistributed to local Indigenous communities to constitute ‘development’. Politically constructed crisis interventions, such as Australia’s recent actions in remote Northern Territory communities, represent a failure of state relationships rather than an appropriate and sustainable response to the challenge of Indigenous vulnerability. This paper argues that attention to Indigenous rights and development of good relationships and good processes of governance, autonomy and responsibility within communities as well as between them and governments is fundamental to sustainable Indigenous futures. Without this, neither government programs nor large-scale natural resource-based development projects can deliver sustainable futures for remote Indigenous groups.

Objective:This paper aims to describe the growth of a regionally-based mental health team providing services to remote Indigenous communities in far north Queensland.Conclusions:By drawing on their experience, the authors are able to identify factors supporting the development and sustained capacity of integrated mental health teams, working in challenging remote settings.