Remote Australia Online

The nature of the human?animal bond in contemporary Australian Indigenous communities is little researched, but it is essential to understand this bond in order to develop much needed appropriate animal health and management practices. A semi-structured interview format was used to elicit information on attitudes to dogs in seven Australian Indigenous communities. This explored the importance of dogs to the community and to the individual, and the balance between the positives and negatives of having dogs in the communities, with particular reference to improving dog and community health and welfare. Theme analysis of the semi-structured interview responses (n = 137) revealed a variety of attitudes to dogs within the communities. A strong theme was the importance of dogs at a community level. Many of the reasons given for the importance of dogs in the community were based on traditional cultural values or beliefs. These included dogs being necessary to guard people at night from spirits, and as part of the kin system. Further, the cultural practice of ?pay-back? for wrong-doing included wrong-doing directed at dogs in all communities, even the most westernized. Occurring simultaneously with these positive attitudes, the poor health and overpopulation of dogs in the community was acknowledged and the negative effects on people's lives recognized. However, the value of the dogs to the community meant that shooting dogs without consent or poisoning them were not seen as appropriate solutions to overpopulation. Many people were prepared to euthanize some of their dogs (via an overdose of barbiturate) or have them undergo sterilization surgery. Thus, contrary to appearances from a Western perspective, the traditional Indigenous human?dog bond was found to be strong, and thus must be taken into account in developing appropriate and sustainable animal health and management practices.

This article critically examines definitions of policy ‘success’ in the context of historical Indigenous higher education policy in the Northern Territory (NT), Australia. We begin by summarising applications of the often-used but arbitrary, rarely-critiqued terms ‘policy success’ and ‘what works’. The paper chronologically articulates what ‘policy success’ has looked like in the context of historical Northern Territory higher education, based on a critical analysis of policy documents. We then apply Critical Race Theory and Indigenous research theories to highlight the power processes that are attached to representation of policy issues, creation of policy goals, and ultimately definitions of ‘success’. We also consider the role of ethical principles in framing conceptions about what constitutes a worthy policy goal. We suggest expansion and resourcing of formalised Indigenous governance mechanisms is needed to create more productive dialogue about Indigenous higher education policy goals and, ultimately, discussions around what ‘works’.

Much has been assumed and written about the reasons Anangu walked out of their desert homelands and took up residence on pastoral stations and mission settlements in Central Australia. Anangu oral histories of these migrations work to illuminate the contingent nature of historical knowledge and the inherent difficulties in writing the history of a colonial frontier. This article seeks to move beyond the question of why, and explore how people came to be at particular places so far away from home. Such an approach privileges the spatial perspective of Anangu historical narratives and demonstrates a complex and gradual historical process, located both in places and within socio-cultural contexts.This article has been peer reviewed.

In February 2018 the Remote Medical Practitioner (RMP)-led telehealth model for providing both primary care advice and aeromedical retrievals in Central Australia was replaced by the Medical Retrieval and Consultation Centre (MRaCC) and Remote Outreach Consultation Centre (ROCC). In this new model, specialists with advanced critical care skills provide telehealth consultations for emergencies 24/7 and afterhours primary care advice (MRaCC) while RMPs (general practitioners) provide primary care telehealth advice in business hours via the separate ROCC. Objective: To evaluate changes in clinicians' perceptions of efficiency and timeliness of the new (MRaCC) and (ROCC) model in Central Australia. Design: There were 103 and 72 respondents, respectively, to pre- and post-implementation surveys of remote clinicians and specialist staff. Findings: Both emergency and primary care aspects of telehealth support were perceived as being significantly more timely and efficient under the newly introduced MRaCC/ROCC model. Importantly, health professionals in remote community were more likely to feel that their access to clinical support during emergencies was consistent and immediately available. Discussion: Respondents consistently perceived the new MRaCC/ROCC model more favourably than the previous RMP-led model, suggesting that there are benefits to having separate referral streams for telehealth advice for primary health care and emergencies, and staffing the emergency stream with specialists with advanced critical care skills. Conclusion: Given the paucity of literature about optimal models for providing pre-hospital medical care to remote residents, the findings have substantial local, national and international relevance and implications, particularly in similar geographically large countries, with low population density.

Infectious diarrhoea is common in young Australian Aborigines [1–3] and is one of the main causes for their unsatisfactory health standards with consequent widespread failure to thrive and undernutrition [4–5]. Most published reports relate to patients in hospital or to hospital admission statistics and give little indication of the extent or severity of diarrhoeal disease in children in Aboriginal communities.The present investigation involved more than 100 Aboriginal children up to 5 years of age living in remote communities in the tropical north of Western Australia who were studied prospectively over a 12–month period.

Delivering equitable eye services for rural and remote communities represents a unique challenge to healthcare providers. Within Western Australia (WA), the integration of teleophthalmology in service delivery has played a pivotal role in addressing these challenges. Lions Outback Vision was established in 2010 at the Lions Eye Institute in Perth and now serves 51 communities with visiting optometry and/or ophthalmology. This article first presents an overview of the journey towards the development of an integrated teleophthalmology model over the past decade, with a focus on the key lessons building an effective telemedicine service. The article then considers the future of teleophthalmology in Australia, making the case that optometrist-facilitated collaborative care models may be translated into urban areas to address the problem of burgeoning specialist waitlists. The coronavirus disease 2019 (COVID-19) pandemic has accelerated telemedicine capability across the globe and catapulted its applications beyond traditional geographic barriers to healthcare.

Objectives: We tested a dental health program in remote Aboriginal communities of Australia’s Northern Territory, hypothesizing that it would reduce dental caries in preschool children. Methods: In this 2-year, prospective, cluster-randomized, concurrent controlled, open trial of the dental health program compared to no such program, 30 communities were allocated at random to intervention and control groups. All residents aged 18–47 months were invited to participate. Twice per year for 2 years in the 15 intervention communities, fluoride varnish was applied to children’s teeth, water consumption and daily tooth cleaning with toothpaste were advocated, dental health was promoted in community settings, and primary health care workers were trained in preventive dental care. Data from dental examinations at baseline and after 2 years were used to compute net dental caries increment per child (d3mfs). A multi-level statistical model compared d3mfs between intervention and control groups with adjustment for the clustered randomization design; four other models used additional variables for adjustment. Results: At baseline, 666 children were examined; 543 of them (82%) were re-examined 2 years later. The adjusted d3mfs increment was significantly lower in the intervention group compared to the control group by an average of 3.0 surfaces per child (95% CI = 1.2, 4.9), a prevented fraction of 31%. Adjustment for additional variables yielded caries reductions ranging from 2.3 to 3.5 surfaces per child and prevented fractions of 24–36%. Conclusions: These results corroborate findings from other studies where fluoride varnish was efficacious in preventing dental caries in young children.

INTRODUCTION: Like Indigenous populations in other countries, an epidemic of chronic disease has swept across Australia's Indigenous communities in the past decade. The Northern Territory and Queensland health departments initiated preventable chronic disease strategies in 1999 and 2001, respectively. Yet finding innovative ways to translate this to the health workforce was challenging. Through support from the Australian Government, three universities, two health departments and two Indigenous organisations worked in partnership to improve workforce capacity in remote and rural communities through innovative education. METHODS: The methods included: (i) a training needs analysis consisting of 76 semi-structured interviews with key informants, and 35 surveys of remote staff; (ii) a literature and resource review; (iii) the development of a curriculum framework using: the existing competencies and standards across the health disciplines; the identified workforce needs; and what the workforce can impact upon; (iv) a multidisciplinary workshop with 35 educators across northern Australia that resulted in the basis for agreement of the final curriculum content and framework; (v) the development of a chronic disease self-assessment tool that was piloted with remote health staff; (vi) an assisted integration process for key stakeholders. An evaluation framework was also developed, as a separate project, in conjunction with the project partners during this time. RESULTS: This project identified that a paradigm shift is required in the way in which we educate the entire health workforce to deal effectively with the impact of chronic disease across remote, rural and Indigenous populations. In particular a need was found to educate the educators in the chronic care model and in using a population health approach. The training needs analysis identified very little difference between the education and training needs across the rural and remote health disciplines; it was perceived that they managed chronic disease fairly well yet found prevention and early detection to be at the 'hard end'. The main barriers identified were the demands of acute care over chronic disease management, compounded by high workforce turnover in remote areas. The curriculum framework, in particular the domains of remote practice, is being used by several Australian universities, health departments and non-government organisations in adapting their existing or new education programs. The self-assessment tool was based on the curriculum outcomes and was piloted in 2005 and found to be very useful for pre- and post-training purposes and as a discussion starter for all disciplines and groups. CONCLUSIONS: A practical curriculum framework now exists to integrate a population health approach for the prevention and early detection of chronic disease when educating the primary healthcare workforce. It is relevant to all health disciplines and is flexible in that it can be adapted, or adopted, depending on the educational needs of the disciplinary group. It is being imbedded into numerous undergraduate, postgraduate, and professional development programs in Australia. It includes: the core learning outcomes expected of any workforce, resources, and a self-assessment tool in chronic disease. These tools are assisting educators in the required paradigm shift required of the workforce to alter the single disease based practice model towards a comprehensive and integrated population based approach required for the workforce in the 21st century.

The papers in this issue emerged from the inaugural Knowledge Intersections Research Symposium held in May 2017 at the Desert Peoples Centre campus of Batchelor Institute of Indigenous Tertiary Education located in Alice Springs, Australia. The theme ‘Knowledge Intersections’ was Adopted for the research symposium and has continued into this volume. The symposium was held in conjunction with the 2017 Northern Territory (NT) Writers’ Festival, which had the theme of ‘Crossings | Iwerre-Atherre’. The language in the title came from local Arrernte people who interpreted crossings as iwerre-atherre, meaning two roads meeting, neither blocking nor erasing the other; two-way learning or travelling together. Each of the papers included in this special edition explores how local researchers and the research work they are doing reflect these ideas of ‘crossings’ and ‘knowledge intersections’. Contributors were challenged to reflect on these two questions; How can/does research help create intersections or meeting points for knowledge systems, without one blocking or erasing the other? How does two-way learning happen in research and how does it help us to travel together?

During April to November 1986 and May to October 1987, a systematic survey of patterns of use of alcohol, kava, tobacco and analgesics by Northern Territory Aboriginal people aged 15 years and older was conducted. The objectives of the study were to ascertain the prevalence of drug use, the frequency of drug use and the quantity of drugs used. In addition, information about Aboriginal people's perceptions of the drugs, their beliefs about drug use and the value of drugs in their culture was collected. This paper describes only the quantitative aspects of drug use of this population. A stratified sampling procedure was used to sample 10 per cent of the target population. Using two survey instruments, an individual questionnaire and a group questionnaire, data were gathered from 1764 Aboriginal people living in the Northern Territory. As a whole, the Northern Territory Aboriginal people have a drug consumption pattern quite distinct from urban Australians.

Introduction: Attracting and retaining an efficient allied health workforce is a challenge faced by communities in Australia and overseas. High rates of staff turnover in the professional workforce diverts resources away from core business and results in the loss of valuable skills and knowledge. Understanding what attracts professionals to a particular place, and why they leave, is important for developing effective strategies to manage turnover and maximise workforce productivity. The Northern Territory (NT) faces particular workforce challenges, in part because of its geographic location and unusual demography. Do these factors require the development of a tailored approach to recruitment and retention? This article reports on a study undertaken to examine the motivations for coming to, staying in and leaving the NT for dental professionals, and the implications of results on workforce management practices. Methods: In 2006, dentists, dental specialists, dental therapists and dental hygienists who were working or had worked in the NT, Australia, in the recent past were surveyed to collect demographic and workforce data and to establish the relative importance of social and work-related factors influencing their migration decisions. Multivariate logistic regression models were generated to describe the demographic characteristics of dental professionals who stayed in the NT for more than 5 years and to analyse why dental professionals left. The analyses, based on a 42% response rate, explained 60-80% of the variation in responses. Results: Generally dental professionals who had stayed for more than 5 years were older, had invested in the purchase of homes and were more involved in social and cultural activities. Those who moved to the NT as a result of financial incentives or who had strong expectations that working in the NT would be an exciting, novel experience tended to stay for no more than 5 years, often leaving because they found the work environment too stressful. In contrast, those who stayed longer came because they had existing social networks and were familiar with the NT environment, staying primarily because they have enjoyed the NT lifestyle, particularly the sense of community and the opportunities available through living in smaller centres. Conclusion: There are benefits in actively engaging newly recruited professionals and their families in social networks. Work related stress and departure was associated with administrative deficiencies within the management system. Despite the NT’s unusual demographic profile, the factors influencing recruitment and retention are not markedly different from those reported elsewhere.

Purpose Promoting positive psychological, social and functional health outcomes for Aboriginal and Torres Strait Islander people requires health services to be culturally safe, respecting culture as central to the individuals and their communities. This study explored the experience of Aboriginal and Torres Strait Islander people, participating in a co-designed student-assisted community rehabilitation service in a remote Aboriginal community in Far North Queensland.Materials and methods Observation, informal yarning and semi-structured interviews with older Aboriginal and Torres Strait Islander people (n?=?6) engaged in the service was conducted over a 7?week period. Interpretive phenomenological analysis was applied through inductive thematic analysis.Results Four themes illustrated that experiences within the program promoted: A connection to people, both within the program and those significant in people?s lives; a connection to past experiences, roles and events; a connection to the future of cultural knowledge; and a sense of achievement and fun. Participants shared their unique stories on their positive experience of the culturally responsive approach in the activities.Conclusions These results suggest that knowledge translation and reciprocity provide a strong foundation for rehabilitation programs that support healthy ageing for Aboriginal and Torres Strait Islander people and encourage active and ongoing individual and community involvement.

Learning to read as a child living in a remote Indigenous community in Australia is impacted by many known social, cultural and contextual factors. In the remote Indigenous community of Wadeye, learning to read in English is further complicated by language and health factors. Much of the research aimed at improving literacy in remote Indigenous communities is predominantly focused on how pedagogical approaches can better deliver reading instruction to Indigenous children. However, there has been no investigation into the central assumption that what we know about the very process of learning to read, based on research conducted with Western, Educated, Industrialised, Rich and Democratic (WEIRD) populations, is the same for Indigenous and non-Indigenous cultural groups. Neuroscientific and cognitive research tells us that phonological awareness, visuospatial processing and working memory are key neurocognitive processes that drive reading acquisition. Yet we do not know how environment and culture might influence the development of these neurocognitive processes or whether these processes facilitate reading acquisition for Indigenous children in the same way that they facilitate reading for non-Indigenous children. Additionally, while some research has demonstrated the visuospatial and working memory strengths of Australian Indigenous populations, there has been no subsequent research to ascertain whether these potential strengths can be targeted to scaffold literacy learning for remote Indigenous children. Finally, there has also been little research into whether Indigenous and non-Indigenous children approach reading-related cognitive tasks in the same way, or whether any cultural differences in cognitive approach might affect perceived performance outcomes. The primary aim of the current research was to investigate the reading aptitude of Indigenous and non-Indigenous children, using language-independent tasks that minimise cultural bias. In this context, reading aptitude is conceptualised as a child's capacity or propensity to develop pre-literate skills necessary to achieve reading proficiency. The current research uses culturally-fair, language independent neurocognitive tasks to investigate possible cultural differences in phonological awareness, visuospatial processing and working memory between Australian and Indigenous and non-Indigenous children. This research also investigates whether there are cultural differences in the approach to cognitive tasks that may affect task performance. Careful consideration was given to the research approaches and methodologies employed in the current studies to ensure a culturally-safe testing environment for Indigenous participants from the remote community of Wadeye. Outcomes from this research reveal a complex interplay between language, culture, context, and reading ability. Cross-cultural similarities and differences in performance on neurocognitive tasks are discussed, with consideration of the broader cultural, linguistic and contextual factors that might influence performance and development. Chosen tasks and methodologies were also critically evaluated in the process of interpreting and discussing the current findings. Further research is needed to gain a comprehensive understanding of the neurocognitive development of phonological awareness, visuospatial processes, and working memory, to construct a comprehensive scientific understanding of their relationship to reading acquisition for remote Indigenous children. Practical recommendations are made for future research.

In January 2022, as the COVID pandemic reached remote communities in Central Australia, The Northern Territory Health Central Australian Regional Health Service and the Royal Flying Doctor Service (RFDS) executed 'COVID on Country', a program designed to triage cases and to implement treatment and clinical review of individuals in their community without the need to be relocated to larger centres for safe provision of care. The program assessed patient factors and community/capacity factors to triage and enact pathways. Remote living people who qualified for the program or who declined aeromedical retrieval, were provided with comprehensive clinical support, including administration of intravenous sotrovimab by daily scheduled visits to all affected communities by a doctor transported on an RFDS plane. Evaluation of the program demonstrated that it was a safe and effective way to provide complex care in a culturally safe manner.

Between Indigenous sovereignty and settler colonisation lie contested frontiers. I suggest Australia's Northern Territory is one such frontier. This paper explores the 1998 settler campaign for Northern Territory statehood, the key to which was the framing of a constitution designed to eliminate Indigenous autonomy and empower settlers. I make three contributions. First, I showcase how settler colonialism is metapolitical, implicating political theory's notorious 'boundary problem' in an effort to reconstitute Indigenous territories as 'ours' and Indigenous demoi as 'us'. Second, I show that settlers may wage this metapolitical campaign using individual rights, to challenge as illiberal, and thus de-constitute, Indigenous demotic and territorial boundaries. Finally, I show that when Indigenous peoples resist by seeking to constitutionally entrench their own, alternate answers to the 'boundary question', there arises a dilemma over whether settler rights or Indigenous boundaries are the rightful 'subject of justice'.

The Human T-Lymphotropic Virus type 1 (HTLV-1) infects at least 5–10 million people worldwide. In developed countries, the most frequently reported HTLV-1 associated diseases include a fatal hematological malignancy, Adult T-cell Leukemia/Lymphoma (ATLL), and the neurological disorder, HTLV-1 associated myelopathy (HAM), which arise in <10% of HTLV-1 carriers during their lifetime. However, most HTLV-1 carriers live in resource-poor areas where infectious diseases, such as strongyloidiasis, could be more important causes of morbidity. Demonstrating such an effect is difficult due to the resource constraints experienced by developing countries in which populations with a substantial burden of infectious diseases reside in areas that are highly endemic for HTLV-1. This is not the case in HTLV-1 endemic central Australia where Indigenous Australians have, for example, among the highest reported blood stream infection rates worldwide in a setting in which sophisticated medical facilities are readily available. We report that bronchiectasis, blood stream infections and admissions with lower respiratory tract infections and strongyloidiasis are associated with HTLV-1 infection. These conditions were far more common than HTLV-1 associated malignancies or neurological conditions in this socially disadvantaged Indigenous population. The spectrum of HTLV-1 related diseases therefore varies according to the social circumstances of the affected population.

In the tropical north of Australia there are high rates of infections in Aboriginal children living in remote communities. In addition to the burden of respiratory infections, diarrhoeal disease and skin sepsis, there are high rates of acute rheumatic fever, outbreaks of poststreptococcal glomerulonephritis and gonococcal conjunctivitis, endemic trachoma and various intestinal parasites. A number of infections generally restricted to the tropics are also present and can cause disease in both indigenous and non-indigenous children. These include melioidosis, Murray Valley encephalitis and dengue on the east coast. With global warming, these infections may become more common and more widespread within Australia and the potential for establishment of introduced infections such as Japanese encephalitis and malaria may increase.

BACKGROUND: Outcomes related to maternal smoked tobacco (cigarette) use have been substantially examined over the past 50 years with resultant public health education targeted towards the reduction of use during pregnancy. However, worldwide the effects of maternal smokeless tobacco use have been less well explored and in Australia, there has been no examination of maternal outcomes in relation to the use of Australian Nicotiana spp. (tobacco plant) as a smokeless tobacco, colloquially known as pituri. The aim of this study is to describe the maternal outcomes of a group of central Australian Aboriginal women in relation to their self-reported tobacco use. METHODS: Eligible participants were > 18 years of age, with a singleton pregnancy, > 28 weeks gestation, and who planned to birth at the Alice Springs Hospital (the major regional hospital for central Australia, in the Northern Territory, Australia). The sample consisted of 73 conveniently recruited women categorized by tobacco-use status as no-tobacco users (n = 31), pituri chewers (n = 19), and smokers (n = 23). RESULTS: There were differences in the groups in relation to teenage pregnancies; 35% of no-tobacco users, compared with 5% of pituri users, and 13% of smokers were <  20 years of age. The chewers had a higher rate (48%) of combined pre-existing and pregnancy-related elevated glucose concentrations compared with smokers (22%) and no-tobacco users (16%).The pituri chewers had the lowest rate (14%) of clinically significant post-partum hemorrhage (> 1000 ml) compared with 22% of smokers and 36% of the no-tobacco users. CONCLUSIONS: This is the first research to examine pituri use in pregnancy and the findings indicate possible associations with a range of adverse maternal outcomes. The use of smokeless tobacco needs to be considered in maternal healthcare assessment to inform antenatal, intrapartum and postpartum care planning. IMPLICATIONS FOR PUBLIC HEALTH: Female smokeless tobacco use is a global phenomenon and is particularly prevalent in low and middle income countries and in Indigenous populations. The findings contribute to the developing knowledge around maternal smokeless tobacco use and maternal outcomes. Maternal screening for a broader range of tobacco and nicotine products is required. NOTE TO READERS: In this research, the central Australian Aboriginal women chose the term 'Aboriginal' to refer to themselves, and 'Indigenous' to refer to the broader First Peoples. That choice has been maintained in the reporting of the research findings.

Background Impetigo or skin sores are estimated to affect >162 million people worldwide. Detailed descriptions of the anatomical location of skin sores are lacking. Methods We used prospectively collected data from a randomised control trial of treatments for impetigo in Aboriginal children in Australia. We generated heat-map distributions of skin sores on the human body from 56 predefined anatomical locations and stratified skin sore distribution by sex, age, causative pathogen and co-infection with scabies, tinea and head lice. We compared the distribution of sores between males and females, between sores with only Streptococcus pyogenes and sores with only Staphylococcus aureus; and across age groups with a Fisher’s exact test. Results There were 663 episodes of impetigo infections among 508 children enrolled in the trial. For all 663 episodes, the lower limbs were the most affected body sites followed by the distal upper limbs, face and scalp. On the anterior surface of the body, the pre-tibial region was the most affected while on the posterior surface, the dorsum of the hands and calves predominated. There was no observable difference between males and females in distribution of sores. Children up to 3 years of age were more likely to have sores on the upper posterior lower limbs and scalp than older age groups, with the distribution of sores differing across age groups (p = 3 × 10−5). Sores from which only Staphylococcus aureus was cultured differed in distribution to those with only Streptococcus pyogenes cultured (p = 3 × 10−4) and were more commonly found on the upper posterior lower limbs. Conclusions Skin sores were predominantly found on exposed regions of the lower leg and distal upper limbs. The distribution of sores varied by age group and pathogen. These results highlight key areas of the body for clinicians to pay attention to when examining children for skin sores.

Within the Australian democratic nation there are towns where the citizens are governed by administrations that have not been democratically elected by the residents. These unique residential centres are termed ?special purpose towns? that can be transformed to a permanent community governed by a democratic structure through a process termed normalisation. This paper examines the special purpose mining town of Nhulunbuy in the Northern Territory of Australia, which is on the cusp of the normalisation process. The paper outlines the similarities and differences of local government roles and responsibilities with Australian towns or shires that have publicly elected executive members. How Indigenous people are facilitating the normalisation of Nhulunbuy, through cultural perceptions of opportunity, is discussed. A concluding focus challenges well established conventional frameworks endorsing the roles of governments and miners in the normalisation phenomenon.

Strongyloidiasis is an infection caused by the helminth, Strongyloides stercoralis. Up to 370 million people are infected with the parasite globally, and it has remained endemic in the Indigenous Australian population for many decades. Strongyloidiasis has been also reported in other Australian populations. Ignorance of this disease has caused unnecessary costs to the government health system, and been detrimental to the Australian people’s health. This manuscript addresses the 12 criteria required for a disease to be included in the Australian National Notifiable Disease List (NNDL) under the National Health Security Act 2007 (Commonwealth). There are six main arguments that provide compelling justification for strongyloidiasis to be made nationally notifiable and added to the Australian NNDL. These are: The disease is important to Indigenous health, and closing the health inequity gap between Indigenous and non-Indigenous Australians is a priority; a public health response is required to detect cases of strongyloidiasis and to establish the true incidence and prevalence of the disease; there is no alternative national surveillance system to gather data on the disease; there are preventive measures with high efficacy and low side effects; data collection is feasible as cases are definable by microscopy, PCR, or serological diagnostics; and achievement of the Sustainable Development Goal (SDG) # 6 on clean water and sanitation.

Strongyloidiasis, which is caused by infection with the nematode Strongyloides stercoralis, is endemic to areas of northern Australia. Diagnosis in this region remains difficult due to the distances between endemic communities and diagnostic laboratories, leading to lengthy delays in stool processing for microscopy and culture. PCR represents a viable solution to this difficulty, having potential for high sensitivity detection of S. stercoralis, even in older, unpreserved faecal samples. We prospectively collected 695 faecal specimens that were submitted to The Townsville Hospital Microbiology Laboratory from the North Queensland region for routine parasitological examination, and subjected them to a Strongyloides sp. real-time (q)PCR. Results were confirmed with a novel nested conventional PCR assay targeting the 18S rRNA gene, followed by single-strand conformation polymorphism analysis (SSCP). Of the 695 specimens tested, S. stercoralis was detected in three specimens (0.4%) by classical parasitological methods (direct microscopy and formyl-ether acetate concentration), whereas 42 positives were detected by qPCR (6.0%). Conventional PCR confirmed the real-time PCR results in 24 of the samples (3.5%). Several apparent false-positive results occurred at higher cycle times (Ct) in the qPCR. Use of real-time PCR in these populations is promising for the enhanced detection of disease and to support eradication efforts.

Yirrkala is an Aboriginal community in north-east Arnhem Land in the Northern Territory. Residents aged five years and over participated in a survey to establish the prevalence and causes of anaemia. Eleven per cent were anaemic (haemoglobin level less than 110 g/L). Most of these were iron deficient, and this deficiency was attributed, at least in part, to hookworm infestation; 15% were folate deficient; none was vitamin B12 deficient. There was no haemoglobinopathy, thalassaemia trait or glucose-6-phosphate dehydrogenase (G6PD) deficiency detected.

This paper presents a single-site case study to explicate some of the issues that relate to developing a genuine and successful role for Indigenous education workers (IEWs) especially those who reside in remote Australian communities. It draws attention to the lost opportunities for agency and leadership in culturally relevant literacy teaching with families, schools and community. The study employs a social justice framework to explore a theory of intended change resultant from the inclusion of IEWs in a professional learning coalition of school leaders, teachers, and Indigenous elders with university researchers throughout an 18-month project. This evidence of intended change focuses on the IEWs’ display of agency in leading families and community in the production of culturally relevant story texts to support children’s reading inside and outside school. The paper contributes to a scant body of literature highlighting the valuable work conducted by IEWs, and justifies more meaningful employment and formal leadership roles in schools and in the community. This work lays the foundation for further research involving IEWs’ leadership in producing culturally relevant criteria for measuring change in children’s literacy outcomes and change in family-community engagement in children’s reading.

With limited access to animal health services, and high disease burdens among domesticated animals, Aboriginal and Torres Strait Islander communities in Australia face higher risk of disease including zoonoses. However, we lack understanding of the contribution of often preventable zoonoses to the health of these communities, which would enable us to enhance public health strategies and improve health outcomes. We conducted a scoping review to identify the current state of evidence on zoonoses in the Aboriginal and Torres Strait Islander population. We examined the size, scope and characteristics of the evidence base and analysed the zoonoses detected in the studies within a One Health framework. We identified 18 studies that detected 22 zoonotic pathogens in animals, people, and the environment, with most studies detecting pathogens in a single One Health sector and no studies investigating pathogens in all three sectors. Findings indicate that despite the strong conceptual foundations of One Health throughout the evidence base, evidence is lacking in application of this concept. There is a need to undertake further research that prioritises Aboriginal and Torres Strait Islander leadership, considers the contribution of human, animal and environmental health factors, and investigates the prevalence and impact of zoonoses in communities through a One Health approach.