Remote Australia Online

Can educators and researchers rethink what theory does in public education so as not to repeat colonial theories and policies predicated on mis/conceptions of “terra nullius” and “terra incognita”? My initial concern as a teacher and administrator working in Northern Territory for over two decades, was the question: “What theories underpin public education policy directives and implementation plans?” Recently my focus has shifted to include what theory is and what it is doing in shaping whose lives (human and non-human) matter. The shift occurred because many theories appeared to perpetuate “more of the same” outcomes, specifically for Indigenous students and their communities. The shifts from what theory is to what theory is doing in the world occur through the daily rhythms – as a precedent of Arrernte practices – of walking Country. Through quotidian acts of walking, I begin to understand that theory is the inseparability of being, doing and thinking, what Barad’s agential realism calls “ethico-onto-epistem-ology”. To show how walking of country is doing theory, I diffractively read several texts (including the non-English and poetic). This gives a sense of what theory is doing in and of the specific matters it inhabits: Arrernte Country, colonisation, education policy directives, walking and creative expression. Theory is taken up through the ethics of those lives rendered un/thinkable, in/visible in public education in Mparntwe (Alice Springs). A diffractive approach in this context opens theory up, to express thinking differently with the commitment to unsettle education policy as a continued reflection of ongoing colonisation.

INTRODUCTION: There is much evidence to indicate a shortage of Registered Nurses (RNs) in Australia and to suggest that the shortage may be more pronounced in rural and remote locations. Attracting RNs to work in rural and remote areas may not be as simple as increasing the intake of students into university undergraduate pre-registration nursing courses. There is some evidence indicating that student nurses may be more likely to enter the nursing workforce in rural and remote locations if they have existing associations with rural and remote areas and/or their undergraduate education provides opportunities to undertake supported placements in rural and remote settings. Two important difficulties have been associated with measuring outcomes in relation to rural and remote pre-registration nursing students. One is defining what constitutes a rural or remote location and the other is suspect data on the number of nursing students enrolled in, and completing, nursing courses. The aims of this study were to provide a longitudinal profile of the number of domestic students studying and completing undergraduate pre-registration nursing courses in Australia, with a particular emphasis on identifying those at rural and remote university campuses, and to compare results across States and Territories. METHODS: This study presents the combined findings from two investigative reports. Data on undergraduate pre-registration nursing student numbers were collected via electronic survey instruments completed by staff at all Australian educational institutions offering undergraduate pre-registration nursing education programs in 2001 and 2002. Australian domestic students were the focus of this study. Data included the total number of domestic students enrolled in undergraduate pre-registration nursing courses in 2001 and 2002, the number of domestic students who successfully completed courses in 1999, 2000 and 2001, and estimates for the number expected to complete in 2002. Surveys were sent to course coordinators or other staff nominated by heads of divisions of nursing at each institution. RESULTS: There was a 100% response rate. Twenty-four rural and remote campus locations were identified using an adjusted form of the Rural, Remote and Metropolitan Areas (RRMA) classification system. The Australian Capital Territory and the Northern Territory did not have any rural or remote campus locations. In contrast, undergraduate pre-registration nursing in Tasmania was offered at a rural campus only (for the first 2 years). From 2001 to 2002, there was an increase of just over 5% in the total number of domestic students enrolled in undergraduate pre-registration nursing courses in Australia (2002 total = 22,811 students). Rural and remote location students accounted for slightly more than 25% of these students in 2001, and almost 27% in 2002. The States Victoria, New South Wales and Queensland had the highest percentage of students enrolled at rural and remote campus locations, greater than the Australian average for both years. In contrast, South Australia and Western Australia had less than 11% of students enrolled at rural and remote campus locations for each year. Total undergraduate pre-registration course completions increased by approximately 16% across Australia between 1999 (n = 4868) and 2002 (n = 5667), although for 2002, the figure was projected. Of these total course completions, the percentage of students completing at rural and remote campus locations increased from almost 23% to nearly 28% during the same period. Of the States/Territories with both metropolitan and rural/remote campus locations, only Victoria and Queensland had more than 25% of their total student completions consisting of students enrolled at rural and remote campus locations for each year. In contrast, South Australia and Western Australia had approximately 6% of student completions consisting of students enrolled at rural and remote campus locations in 1999, increasing to approximately 12% projected for 2002. CONCLUSIONS: In this study, the authors attempted to improve the accuracy of data collection in relation to the number of domestic undergraduate pre-registration nursing students in Australia, which is representative of the potentially new Australian domestic RN workforce. There was a trend towards an increasing number of students being enrolled in undergraduate pre-registration nursing courses, and also toward an increasing number of course completions. From the perspective of the rural and remote RN workforce, the percentage of students enrolled and completing courses at rural and remote campus locations was found to be increasing. However, there may be some areas of concern for education and workforce planners in States and Territories that are providing a smaller percentage of their undergraduate pre-registration nursing courses in rural and remote areas. Several study limitations are discussed and suggestions made for future research.

Light Warlpiri is a newly emerged Australian mixed language that systematically combines nominal structure from Warlpiri (Australian, Pama-Nyungan) with verbal structure from Kriol (an English-lexified Creole) and English, with additional innovations in the verbal auxiliary system. Lexical items are drawn from both Warlpiri and the two English-lexified sources, Kriol and English. The Light Warlpiri verb system is interesting because of questions raised about how it combines elements of its sources. Most verb stems are derived from Kriol or English, but Warlpiri stems also occur, with reanalysis, and stems of either source host Kriol-derived transitive marking (e.g., hit-im ‘hit-TR’). Transitive marking is productive but also variable. In this paper, we examine transitivity and its marking on Light Warlpiri verbs, drawing on narrative data from an extensive corpus of adult speech. The study finds that transitive marking on verbs in Light Warlpiri is conditioned by six of Hopper and Thompson’s semantic components of transitivity, as well as a morphosyntactic constraint.

The absolute and relative deprivation experienced by Indigenous people in remote and very remote Australia is well known. However, Indigenous people in remote areas are often lumped together as a single national category. There is little understanding of how the different states and territories perform in terms of the economic wellbeing of Indigenous people in remote and very remote areas. The major finding of this research is that the Northern Territory has the worst economic outcomes for Indigenous people in remote or very remote locations of any state or territory in Australia by some margin, while South Australia has the best.

The Groote Eylandt archipelago is unique within Australia, by having one of the longest trajectories of rock art recording. Commencing in 1803 when paintings at Chasm Island were noted by Matthew Flinders and sketched by William Westall, a sustained program of research began in earnest in the early twentieth century. Largely comprising the work of anthropologists and archaeologists, along with the observations of keen-eyed amateurs, this history reveals a rich vein of approaches, analytical methods, theories and techniques. From Norman Tindale in the 1920s to George Chaloupka in the 1980s, each researcher brought something of themselves and their own agenda just as they grappled with the opportunities and constraints characteristic of their time and purpose. Hence, this twentieth-century history of rock art research on Groote Eylandt conveys a range of questions and interpretive frameworks, which we propose collectively reflect the glow of a Golden Age of rock art research in the archipelago.

Background Edible native flora, or ‘Bushfoods’ of Australia include a diverse range of novel species in terms of their flavours and natural colours. Bushfoods have been recognised for high bio-active phytonutrient content. Bushfoods are also Traditionally valuable to Aboriginal and Torres Strait Islander cultures, where industry participation facilitates capital and social benefits to remote communities. Currently, the suitability of native Australian plants for use as natural food flavouring and colourings is unknown, particularly in ‘fringe’ species which have minimal market adoption. Therefore, an appraisal of bushfoods suitability for natural additives is needed to promote new sector growth. Scope and approach This review presents key fields relevant to appraising the suitability of bushfoods for development of natural additives. The relevant fields are market assessment of natural additives and consumer motivations, directions of natural compound extraction, assessment of valuable fringe bushfoods species, and ethical and technical challenges to industry participation. Key findings and conclusions The growth of the bushfoods industry can be facilitated through natural additives development. Consumer trends are dictating industry adoption of natural food additives. Consumers are expected to be receptive of bushfoods derived additives, particularly in the Australian domestic market. Bushfoods are found to contain significant phytochemical content. Research focus on natural additive application of these compounds is presently minimal. An assessment of native Australian flora resulted in a high likelihood of identifying valuable species for natural additives investigation, with a collection of 17 fringe species being identified and summarised from literature. However, technical risks include a lack of food safety assessment of fringe species, as well as maintaining ethical development which observes Traditional Owner's rights and complies with the Nagoya Protocol. The review finds that natural additives development using bushfoods is practical, though further market surveying, food safety investigation, and ethical food industry participation are necessary to facilitate industry application.

In recent years STEM education has been the focus of Australian government funding initiatives, policy and curriculum development at the national and state levels and a key driver of school innovation. Principals, teachers and students have been called upon to develop their capability and interest in the individual STEM discipline subjects or to engage in interdisciplinary STEM activities. Much of the focus on STEM has been driven by a national agenda informed by the needs of industry, and research that indicates that the students graduating from schools and universities today with STEM qualifications will not be sufficient for society’s needs. While the agenda encompasses more than individual teachers or schools, it is teachers who are at the forefront of its implementation in classrooms. In this paper we report on the perceptions of teachers about issues impacting on the effective teaching of STEM in rural, regional and remote Australia, and strategies they use to overcome issues/barriers and building the confidence and capacity of STEM teachers. Based on these, the paper reports some potential solutions to the issues faced by schools in rural, regional and remote Australia addressing the demands of the STEM Education focus.

Background: To determine the prevalence of trachoma and diabetes-related eye disease within the adult Aboriginal population screened by the South Australian Eye Health Program between 1999 and 2004 inclusive. Methods: The South Australian Eye Health Program visited 22 Aboriginal communities in remote South Australia. Visiting ophthalmologists and optometrists systematically collected data on the cohort of adult patients seen over the period 1999-2004. Prevalence and grade of trachoma according to World Health Organization classification and the prevalence and degree of diabetic retinopathy according to the Early Treatment Diabetic Retinopathy Study and National Health and Medical Research Council guidelines were recorded. Results: A population of 1651 Aboriginal patients was examined. Sixty-two per cent were female and 38% were male. Twenty patients (1.2%) had evidence of active trachoma with 260 (15.7%) patients having either lid scarring, trichiasis or corneal opacity. There was no significant association between gender and the prevalence of trachoma (P = 0.48). Seven hundred and seventy-one patients within the examined population had diabetes mellitus (46.70%). Significantly more women than men were affected and prevalence increased with age (P < 0.0001). One hundred and sixty-nine patients (22%) with diabetes mellitus had features of diabetic retinopathy, and of these patients 77 had background diabetic retinopathy (46%) and 92 (54%) had either proliferative diabetic retinopathy or maculopathy. Prevalence of clinically significant macula oedema among those with maculopathy (14 of 50 patients) was 28%. Conclusions: The data suggest that although trachoma is still endemic in this South Australian Aboriginal population the prevalence and severity are less than previously reported. Diabetes mellitus has a high prevalence within this population and great potential for detrimental visual sequelae.

Background: The Katherine Region Diabetic Retinopathy Study (KRDRS) was carried out in the Lower Top End of the Northern Territory of Australia between 1993 and 1996 as part of the Northern Territory Eye Health Program. It investigated diabetic eye conditions and its determinants in the Aboriginal Australian population of the region. Methods: The study provided cross-sectional data about diabetic retinopathy in the Aboriginal diabetic population of the Katherine region in 1993 and in 1996. A total of 234 people with diabetes were examined in 1993 and 243 in 1996. Results: The prevalence of retinopathy was 18% in 1993 and 21% in 1996. The respective findings for maculopathy were 13% and 10%, for clinically significant macula oedema 8% and 6%, for proliferative stage subject retinopathy 0.9 and 1.3% and for vision-threatening retinopathy 8.5% and 6.7%. In 1993 the prevalence of diabetic retinopathy was 18% in the four major centres compared with 16% in the smaller communities. The findings for 1996 were 25% and 13%, respectively. In 1993 the prevalence of vision-threatening retinopathy was 8% in major centres compared with 7% in other communities. The findings for 1996 were 7% and 8%, respectively. Sex was not significantly related to the prevalence of retinopathy. Conclusion: Diabetic retinopathy is as much a problem in Aboriginal communities as in the wider Australian population but presents a unique set of challenges for health services and for clinicians.

BACKGROUND: Among Indigenous Australians, studies examining the clinical significance of airway bronchodilator responsiveness (BDR) are limited. In this retrospective study, we examined the nature of underlying lung disease in adult Indigenous patients with BDR referred for lung function testing (LFT) in the Top End Health Service region of the Northern Territory of Australia. METHODS: Presence or absence of BDR as per usual (FVC or FEV(1) change pre to post ≥12% and ≥0.2L) and updated (2021 ">10% predicted) ATS/ERS criteria among Indigenous and non-Indigenous Australians was determined. The radiological findings in the Indigenous study participants with and without BDR were next assessed for the presence of underlying chronic airway/lung disease. RESULTS: We found that 123/742 (17%) Indigenous and 578/4579 (13%) non-Indigenous patients had a significant BDR. Indigenous patients with BDR were younger (mean difference 7 years), with a greater proportion of females (52 vs 32%), underweight (15 vs 4%) and current smokers (52 vs 25%). Indigenous patients with BDR displayed lower LFT values, and a higher proportion exhibited FVC BDR compared to non-Indigenous (34 vs 20%). Almost half (46%) of Indigenous patients with BDR had evidence of COPD and/or bronchiectasis on radiology. Adjusting for the presence of radiologic or spirometric evidence of COPD, the presence of BDR was similar between Indigenous and non-Indigenous patients (5-8 vs 7-11%), irrespective of which BDR criteria was used. CONCLUSION: BDR was higher overall among Indigenous in comparison to non-Indigenous patients; however, a significant proportion of Indigenous patients demonstrating BDR had evidence of underlying COPD/bronchiectasis. This study highlights that although presence of BDR among Indigenous people may indicate asthma, it may also be observed among patients with COPD/bronchiectasis or could represent asthma/COPD/bronchiectasis overlap. Hence, a combination of clinical history, LFT and radiology should be considered for precise diagnosis of lung disease in this population.

Human interactions with the world and each other across time are most clearly represented in one of the most enduring legacies of humanity – rock art. Found around the world, the creativity and complex cultural interactions and associations of First Nations peoples are illustrated in these paintings, engravings and other media, conveying inherent understandings of relationships with Country, culture and kin. Here in Australia, this creative practice is shared by Aboriginal and Torres Strait Islander people in cultural landscapes stretching across the country from the remote tropical north of Western Australia to the cold landscapes of Tasmania. Challenges to celebrate, protect, preserve and manage rock art in a changing world have been increasing exponentially, particularly since the mining and infrastructure development booms that followed World War II introduced many outsiders to remote areas of Australia. By the late 1960s, impacts to rock art sites from complex development pressures were being identified and described (Marshall 2020:122). At places such as Murujuga in Dampier, on the West Australian coast (Bednarik 2006), the Quinkan reserves on the Cape York Peninsula (Trezise 1971) and the Arnhem Land Plateau (Chaloupka 1974), such issues were brought to the attention of the Australian public, whereby advocates sought to support Indigenous communities in the face of these previously unidentified problems. For the Arnhem Land Plateau, recognition of the significance, value and importance of Aboriginal heritage during the twentieth century culminated in the establishment of Kakadu National Park in the 1970s and 1980s (hereafter ‘Kakadu’ or ‘the Park’). Kakadu was created to protect not only environmental landscapes, but also the living cultural heritage of the 13 clan groups in the area. With the increasing footprint of mining and industry in close proximity, the need to protect and preserve the plethora of rock art found here was vital. With 5000 known sites recorded in Kakadu alone and a further 10,000–15,000 expected, the full extent of the rock art of this northern region may never be fully quantified. Nonetheless, endeavours to scientifically protect and preserve the sites here were among the earliest attempts at rock art conservation in Australia.

Introduction Foetal alcohol spectrum disorder (FASD) is a neurodevelopmental impairment that may result in individuals experiencing poor development, cognitive issues and disruptive behaviours. In Australia, the prevalence of FASD is unknown; however, two studies have revealed the prevalence of FASD in high risk populations in Western Australia. Individuals with FASD may experience higher rates of negative outcomes including poor school performance, involvement with the justice system and incarceration, substance use and are at risk of being placed in out-of-home care. Caregivers of children with FASD can experience challenges and high levels of stress due to the disruptive behaviours displayed by many children diagnosed with FASD. Whilst experiences of caregivers raising children with FASD have been documented globally, little is known about the experiences of caregivers in a remote Australian context, particularly from an Australian Aboriginal perspective. This study aimed to investigate the experiences of caregivers in a remote Australian context. The findings will be valuable to inform programs at the family, community and broader policy levels that can help enhance children's development and wellbeing. METHODS: Participants (n=7) in this qualitative study were recruited through a FASD diagnostic clinic and family support organisation in the Port Hedland region of Western Australia. Eligible participants were previous or current caregivers of children with a FASD diagnosis or risk of FASD and provided informed consent before participating in semi-structured interviews using a phenomenological approach. The interviews were 30-60 minutes in duration and were audio-recorded and transcribed verbatim using NVivo 11 computer software, with all identifying information removed. RESULTS: The caregivers provided rich, descriptive narratives revealing the challenges and stress they experienced when they first started caring for their child with FASD. Caregivers articulated how they developed and adapted strategies through trial and error that enabled them to better manage disruptive behaviours and maintain a stable, calm environment. A thematic analysis revealed four major themes: the importance of routine and structure for the child and family, the importance of family support, the benefits of peer support groups and various social issues impacting children's development. Maintaining routine and structure had helped many caregivers mitigate stress and reduce disruptive behaviours, and family support allowed caregivers some respite whilst ensuring children remained connected to their biological families and culture. The caregivers also shared that peer support groups would be beneficial to share stories and strategies with others experiencing similar circumstances. Broader societal issues requiring attention at the community level were discussed, in addition to caregivers having awareness of the complexities impacting the children's biological families. CONCLUSION: The caregivers in this study have gained valuable knowledge and wisdom through caring for a child with FASD that can benefit health professionals and the broader community. Whilst the caregivers in this study have overcome challenges through developing and adapting their own strategies, support services providing tailored programs for caregivers when they first start caring for a child with FASD would be beneficial. Furthermore, formal respite was not utilised by the caregivers in this study due to safety issues, inconsistent parenting and interrupted routines, therefore investigation into training respite caregivers in the area of FASD would be beneficial. Furthermore, respite services should consider provisions to include extended families and kinship relationships in a formal context to enable ongoing cultural and family connection, consistent parenting strategies and routines.

Research on rock art in Central Australia1 has moved from a basic record of its presence (1870–1890), where it was mostly approached as an ethnographic curiosity, to more nuanced understandings of the sociocultural contexts underpinning production of rock art that emerged from anthropological research between 1890 and 1940. It was not until 1965, with pioneering research by Bob Edwards, that rock art moved to centre stage of archaeological studies and became the focus of dedicated research. Specialised rock art research in Central Australia involving rock paintings, engravings and post-European contact graphics increased after 1990 with a range of studies that approached rock art as a historical record of cultural geography, looking at changing style, structure and composition of the art and its likely age. Despite this proliferation of studies, detailed regional surveys of rock art in Central Australia did not begin until 1988.

The aim of this study was to prospectively evaluate the impact of a Central Australian cultural awareness training program for health care staff. A mixed methods approach was used. Program participants completed a baseline and post-program questionnaire, which included an attitude scale assessing cultural safety, critical thinking and transformative unlearning, and open-ended questions. An online follow-up survey two months later repeated these questions. Mean scale scores were compared using paired and unpaired t-tests. Qualitative data were analysed thematically. Baseline scale mean was 45.7. At post-program it had statistically significantly increased to 47.3, using both the paired (p<0.01) and unpaired t-test (p=<0.03). By the time of the two-month follow-up it had decreased to 42.2 (95% confidence interval 39.4 – 45.0).

Indigenous families have culturally-specific strengths, priorities, and methods for assessing their children’s development. Recognition and support of children’s and families’ strengths are important for identity, health and wellbeing. However, strengths can be missed in assessment processes developed in non-Indigenous contexts. Yolŋu are First Nations Australian peoples from North-East Arnhem Land. This study was conducted to explore Yolŋu early childhood development, assessment and support in response to concerns that Yolŋu strengths and priorities are often not recognised. The cultural and linguistic expertise of Yolŋu researchers was central in this qualitative study. Rich empirical data were collected through a form of video reflexive ethnography with six children and their extended families over seven years and through in-depth interviews with 38 other community members. An iterative process of data collection and analysis engaged Yolŋu families and researchers in a collaborative, culturally responsive research process which drew on constructivist grounded theory methods. Findings illustrate how Yolŋu children are immersed in complex layers of intertwined and continuous testing and teaching processes integrating holistic frameworks of cultural identity and connection, knowledge and practices. Yolŋu families monitor and recognise a child’s development through both direct and explicit testing and through observing children closely so that children can be supported to keep learning and growing into their knowledge, strengths and identity. Yolŋu expressed concern that such learning is invisible when the child is viewed through non-Yolŋu lenses and assessed with processes and tools from outside the community. Indigenous peoples have a right to culturally congruent assessment of their children. Those who share the child’s culture and language have the expertise to ensure that cultural strengths and priorities are recognised and understood.

Arnhem Land rock art, including that of Kakadu National Park, has been known to the outside world since the early 1800s but it was not until the 1940s that it became a subject of serious investigation (e.g. see McCarthy 1955, 1960; Rose 1942). Eight key research themes developed over time with different approaches, questions and subjects of concern. These themes, from an initial one of discovery and reporting to the most recent employing digital technology, structure this paper. However, the focus is on the multicultural investigation of Arnhem Land rock art and the ways in which this has shaped the history and course of research, including the testing and adoption of many pioneering approaches to rock art recording, interpretation, dating, conservation, management and tourism. Over 100 non-Indigenous individuals from 12 countries have contributed to our understanding of Arnhem Land rock art, with Australians, Brits, Czechs and Canadians, in particular, advancing knowledge. But there has always equally been a strong interest from Aboriginal Australians in better understanding, promoting and protecting their rock art heritage with over 100 key individuals from across Arnhem Land and beyond actively participating in Arnhem Land research. Consequently, Indigenous and non-Indigenous research perspectives have been intertwined for over 70 years, resulting in a deservedly rich and enriched rock art research history.

This article frames the history of rock art research in the Kimberley in north-western Australia through four tropes of colonialism. We distinguish three phases of research, starting with ‘Explorers and colonisers’ from 1838 to the early 1900s, followed by the move ‘Towards an Indigenous understanding of Australian rock art’ that derived from early missionary and ethnographic studies conducted during the first half of the twentieth century up to 1960, before developing into ‘Diverging fields of rock art research’ from the 1960s. We conclude our discussion around the year 2000 but refer to current research topics and discourses when apposite.

Substance use is a leading contributor to global disease, illness and death. Compared with non-Indigenous Australians, Aboriginal and Torres Strait Islander Australians are at an increased risk of substance-related harms due to the experience of additional social, cultural, and economic factors. While preventive approaches, including screening and early interventions are promising, currently there are limited options available to healthcare workers that are culturally appropriate for use in Aboriginal and Torres Strait Islander populations. Therefore, the aim of this research was to translate and culturally adapt the World Health Organization endorsed, Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) into Pitjantjatjara. This paper first describes the process of translation and adaptation of the instrument (Phase 1). The process of focus-group testing the translated instrument for accuracy and cultural appropriateness is also discussed (Phase 2). Key findings from both phases are presented in the context of how the research team worked with key stakeholders in the community to identify facilitators and work through barriers to implementation. The findings from this paper will be used to inform the development of a digital, app-based version of the instrument for the purposes of pilot-testing and validation.

Introduction Since 2011, remote Australian Aboriginal and Torres Strait Islander communities have experienced an outbreak of infectious syphilis, with young people aged 15–29 years over-represented in notifications. The Young Deadly Syphilis Free multi-media campaign was implemented in 12 remote regions in four Australian jurisdictions over nine months from 2017–2018. Campaign components included television and radio advertisements, social media posts, and health promotion resources available via a dedicated website. The aim of this research was to evaluate the impacts (proximal, mediator, distal) of the Young Deadly Syphilis Free campaign for young Aboriginal people and health and community workers residing in remote campaign regions. Methods A cross-sectional (post-only) evaluation design was used. Data were collected through online surveys; metrics for social media (Facebook, Instagram) were also collected to determine campaign engagement via social media. A 22-item young people survey assessed campaign awareness, exposure, message recognition and diagnostics (proximal variables); along with intended behaviour and knowledge and attitudes (mediator variables). A 24-item health and community worker survey assessed campaign awareness, exposure, message recognition and diagnostics (proximal variables); and changes in professional practice (distal variable). Descriptive statistics summarised demographic characteristics and univariate analysis examined associations between key variables. Results Just over half (n = 25, 58%) of young people and three quarters (n = 36; 75%) of health and community workers were aware of the campaign. Recognition of key campaign messages was high for both participant groups (>64%), and television, Facebook, and website were the most common campaign exposure routes. Positive impacts on intended behaviour (young people) and professional practice (health and community workers) were also reported. Facebook was effective in engaging some young people in campaign content and was preferred by young people for accessing information. Conclusion The findings point to the value of utilising a multi-media campaign in raising awareness about syphilis among young Aboriginal people and health and community workers in remote Australian regions. A longer-term campaign that accommodates the diverse needs of Aboriginal young people from geographically remote communities would optimise campaign impacts and support behavioural change.

Rural populations experience injury-related mortality and morbidity rates 1.5 times greater than metropolitan residents. Motivated by a call for stronger epidemiological evidence around rural injuries to inform prevention, a systematic review of peer-reviewed literature published between January 2010 and March 2021 was undertaken to explore the epidemiology of rural injury and associated risk factors in Australia. A subsequent aim was to explore definitions of rurality used in injury prevention studies. There were 151 papers included in the review, utilizing 23 unique definitions to describe rurality. People living in rural areas were more likely to be injured, for injuries to be more severe, and for injuries to have greater resulting morbidity than people in metropolitan areas. The increase in severity reflects the mechanism of rural injury, with rural injury events more likely to involve a higher energy exchange. Risk-taking behavior and alcohol consumption were significant risk factors for rural injury, along with rural cluster demographics such as age, sex, high socio-economic disadvantage, and health-related comorbidities. As injury in rural populations is multifactorial and nonhomogeneous, a wide variety of evidence-based strategies are needed. This requires funding, political leadership for policy formation and development, and implementation of evidence-based prevention interventions.

Aim To describe the establishment of a cross-border and multi-university collaboration in rural Australia to mitigate potential competition, maximise Rural Health Multidisciplinary Training (RHMT) Programme investments and regional health workforce outcomes. Context Rural Health Multidisciplinary Training programme investments have enabled the establishment of 19 Australian University Departments of Rural Health (UDRH) and 17 Rural Clinical Schools. The importance of these investments is acknowledged. However, in regional settings, due to limited clinical placement and training opportunities, there is potential for heightened competition between universities who are operating within shared geographical footprints. Competition between universities risks focusing RHMT programme activity on individual reporting requirements and activities, in preference to: regional needs; existing community?university relationships; and place-based approaches to health workforce development. Participants A rural New South Wales and Victorian RHMT-funded departments, collectively known as the Sunraysia Collaboration. Approach Strategic and operational processes, structures and actions underpinning collaboration formation and relationship consolidation will be described. Co-design methodologies employed to collectively define collaboration vision and aims, governance framework and guiding principles, reporting structures and co-contributions to teaching, research and service will be discussed. Collaboration sensitivity to the social, cultural, relationship and economic connectedness within the region and existing health workforce flows will also be explored. Conclusion The Sunraysia collaboration demonstrates one approach towards mitigating potential competition between RHMT Programme funded universities within rural and remote Australia. The collaboration is an exemplar of co-design in action providing an alternative approach to address RHMT Programme parameters and regional needs whilst supporting rural-remote health workforce training and education innovations.

Purpose: To determine the central corneal thickness (CCT) and its demographic associations among Aboriginal people attending eye clinics in remote South Australia. Methods: A clinic-based cross-sectional study was conducted involving opportunistic sampling of patients. Eligible participants underwent measurement of CCT by ultrasound pachymetry. The results were compared with a group of Caucasian control patients. Results: All patients (189) who were invited to participate in the study had their CCT measured. The mean age was 44.8 ± 14.5 years, and women comprised 57.7% of the sample. The control group consisted of 115 Caucasian participants. The mean age was 47.1 ± 14.8 years, and women accounted for 55.7% of the sample. Mean CCT for Aboriginal participants was 514.9 ± 30.5 m in the right eye and 515.6 ± 30.5 m in the left eye (t = 1.1, P = 0.3). Mean right CCT for Caucasian participants was 544.6 ± 31.9 m and mean left CCT in this group was 547.1 ± 32.2 m (t = 4.6, P < 0.001). There was a significant difference between the right (t = 8.4, P < 0.001) and left (t = 8.8, P < 0.001) CCT of Aboriginal and Caucasian participants. Conclusions: The CCT among Aboriginal patients attending eye clinic in remote South Australia was significantly thinner than that of a Caucasian control group. Thinner corneas among this group of Aboriginal patients may indicate a need to adjust intraocular pressure according to CCT and to be more vigilant for glaucoma.

Cultural practices and development level can influence a population’s household structures and mixing patterns. Within some populations, households can be organized across multiple dwellings. This likely affects the spread of infectious disease through these communities; however, current demographic data collection tools do not record these data. Methods: Between June and October 2018, the Contact And Mobility Patterns in remote Aboriginal Australian communities (CAMP-remote) pilot study recruited Aboriginal mothers with infants in a remote northern Australian community to complete a monthly iPad-based contact survey. Results: Thirteen mother–infant pairs (participants) completed 69 study visits between recruitment and the end of May 2019. Participants reported they and their other children slept in 28 dwellings during the study. The median dwelling occupancy, defined as people sleeping in the same dwelling on the previous night, was ten (range: 3.5–25). Participants who completed at least three responses (n = 8) slept in a median of three dwellings (range: 2–9). Each month, a median of 28% (range: 0–63%) of the participants travelled out of the community. Including these data in disease transmission models amplified estimates of infectious disease spread in the study community, compared to models parameterized using census data. Conclusions: The lack of data on mixing patterns in populations where households can be organized across dwellings may impact the accuracy of infectious disease models for these communities and the efficacy of public health actions they inform.

Background: The Lililwan Project is the first population-based study to determine Fetal Alcohol Spectrum Disorders (FASD) prevalence in Australia and was conducted in the remote Fitzroy Valley in North Western Australia. The diagnostic process for FASD requires accurate assessment of gross and fine motor functioning using standardised cut-offs for impairment. The Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) is a norm-referenced assessment of motor function used worldwide and in FASD clinics in North America. It is available in a Complete Form with 53 items or a Short Form with 14 items. Its reliability in measuring motor performance in children exposed to alcohol in utero or living in remote Australian Aboriginal communities is unknown. Methods: A prospective inter-rater and test-retest reliability study was conducted using the BOT-2 Short Form. A convenience sample of children (n = 30) aged 7 to 9 years participating in the Lililwan Project cohort (n = 108) study, completed the reliability study. Over 50% of mothers of Lililwan Project children drank alcohol during pregnancy. Two raters simultaneously scoring each child determined inter-rater reliability. Test-retest reliability was determined by assessing each child on a second occasion using predominantly the same rater. Reliability was analysed by calculating Intra-Class correlation Coefficients, ICC(2,1), Percentage Exact Agreement (PEA) and Percentage Close Agreement (PCA) and measures of Minimal Detectable Change (MDC) were calculated. Results: Thirty Aboriginal children (18 male, 12 female: mean age 8.8 years) were assessed at eight remote Fitzroy Valley communities. The inter-rater reliability for the BOT-2 Short Form score sheet outcomes ranged from 0.88 (95%CI, 0.77 – 0.94) to 0.92 (95%CI, 0.84 – 0.96) indicating excellent reliability. The test-retest reliability (median interval between tests being 45.5 days) for the BOT-2 Short Form score sheet outcomes ranged from 0.62 (95%CI, 0.34 – 0.80) to 0.73 (95%CI, 0.50 – 0.86) indicating fair to good reliability. The raw score MDC was 6.12. Conclusion: The BOT-2 Short Form has acceptable reliability for use in remote Australian Aboriginal communities and will be useful in determining motor deficits in children exposed to alcohol prenatally. This is the first known study evaluating the reliability of the BOT-2 Short Form, either in the context of assessment for FASD or in Aboriginal children.

Alcohol related harms disproportionately affect Aboriginal people in Australia. Motives to drink have been identified as the most proximal factor to alcohol consumption. Objectives: The aim of this study is to assess the validity of a culturally modified Drinking Motives Questionnaire-Revised (DMQ-R) (Cooper, 1994) with Aboriginal participants. Design: The study was cross sectional, utilising data collected via face-to-face surveys with a sample of adult Aboriginal participants. Participants: A convenience sample of 135 Aboriginal men (n=41) and women (n=94) from the Pilbara Region of Western Australia, who had consumed alcohol in the preceding 12 months. Outcome MeasuresOutcome Measures: The Culturally modified DMQ-R (CDMQ-R) developed in consultation with Aboriginal community researchers and a local Aboriginal Community Reference Group was the primary outcome measure for this study. Results: Confirmatory Factor Analysis indicated the four-factor model of drinking motives as measured by a culturally modified DMQ-R was valid for use with Aboriginal people of the Pilbara region. Conclusions: While most items loaded on the factor solution as hypothesised, there were some minor discrepancies which suggest further modification may be needed. In addition, the reduction of the original five-point scale to a three-point scale created statistical challenges. Future research might seek to further refine the DMQ-R for this population and determine an appropriate method for expanding the response scale incorporating advice from Aboriginal people