Remote Australia Online

The proportion of remote-living Indigenous people who lived in a household that ran out of food, and could not afford to purchase more, increased from 32.8% to 38.6% between 2012–2013 and 2018–2019. This paper outlines policy options to respond to the increasing prevalence of remote Indigenous food insecurity. We argue that while it may be possible to reduce the price of food in remote stores to some degree, the cost of commercial food provision in remote Indigenous communities is likely to remain high in comparison to larger Australian towns and cities. Accordingly, policy responses should look to other means for increasing food security beyond reducing prices. We suggest that increasing social security payments and removing barriers currently impeding Indigenous communities from pursuing food sovereignty are the most promising avenues for increasing Indigenous food security. Relaxing the mutual obligations requirements facing social security recipients and supporting social enterprises would assist Indigenous communities to engage in customary food provisioning. A version of this Topical Issue was provided to the House of Representatives Standing Committee on Indigenous Affairs Inquiry into food pricing and food security in remote Indigenous communities in June 2020.

The purpose of this study was to quantify the nature and extent of the Northern Territory’s solar photovoltaic (PV) waste and to explore how end-of-life (EOL) management planning could be used to mitigate both the environmental threats posed by solar waste as well as offset the potential costs of managing this waste in the future. As the first study of its kind in the Northern Territory (NT) (and first of its kind to focus on Outer Regional, Remote and Very Remote areas of Australia), this project sought to provide insights into the current policy environment and practices and the barriers and challenges associated with managing solar PV waste, as well as generate a robust evidence base regarding the current and future solar waste trajectories in the NT. The study also aimed to identify potential options for managing this waste including opportunities for regional and remote communities. In order to address these aims, there were two key data collection activities: gathering data on solar PV panel installations from Clean Energy Regulator (CER), Power and Water Corporation (PWC) and Ekistica, in order to create a robust solar panel database, and conducting a series of stakeholder interviews regarding current policy and practice, barriers and challenges and preferred solutions for managing solar PV waste. In order to contextualise the study findings and inform on their interpretation the report includes a review of literature from Australia and overseas that relates to EOL management of solar PV waste. This review revealed a substantial body of research and development on PV recycling and material recovery processes yet found very few commercial facilities worldwide that fully recycle the modules, none of which are located in Australia. It also revealed that transport and logistics issues pose significant challenges for the economic recycling of PV panels, even in more densely populated parts of the world. Potential solutions such as decentralised recycling plants, mobile recycling plants and collaborative collection schemes have not been subject to detailed evaluation in different geographic and demographic settings. An overarching theme from the literature review that became apparent was that considerations of PV waste issues have rarely occurred within regional or remote settings and the majority of potential solutions require economies of scale. Previous research and our data indicate that in the NT there are multiple solar PV waste flows and stakeholders involved in this sector. Rather than consider solar waste management issues through the lens of a straightforward supply chain, it should be conceived of as an interconnected system, with responsibility for managing this waste shared amongst governments, industry and consumers. It follows that solutions need to involve a range of stakeholders and a collaborative approach.Using the volumes and trajectories presented in this report as a rough guide, findings suggest that economies of scale with regard to panel discards will be difficult to achieve until at least the mid-2040s. This is in part because waste trajectories vary across the regions and local government areas (LGAs); not all of the latter experience a surge or peak of solar PV waste at the same time. Given that the potential economic returns from recycling c-Si panels also appear to remain relatively modest up until the mid-2040s, the capacity to offset some of the economic costs of managing the NT’s solar PV waste through recycling appears limited. The data gathered from this study suggests that solar PV panels are often removed prematurely (i.e. before reaching end of working life) and for reasons other than technical failures or adverse weather impacts. Data also suggests that there is a real need for policy development and regulatory reform regarding solar PV waste management. Clear directions are required on ‘what to do next’ once the panels are removed. Additionally, there is a policy gap between Northern Territory Government (NTG) policies, such as the renewables policies, waste policies and public housing improvement policies.

Indigenous communities in northern Australia own and manage around 46 million ha of forest. Some of these forests currently support a small and socioeconomically important Indigenous commercial forestry and forest products industry. There is much unrealised potential for the further development of this culturally appropriate industry for remote northern Australian Indigenous communities. This study presents new and existing data on forests and forestry in regions across northern Australia and uses a literature review and stakeholder consultations to explore the growth potential of Indigenous commercial forestry in these regions. Relevant literature was mapped to identify trends, biases and gaps; three regional forums were held; and case studies were prepared for three Indigenous commercial forestry enterprises - one in western Cape York Peninsula in Queensland and one each in east Arnhem Land and the Tiwi Islands in the Northern Territory. These three regions have substantial Indigenous commercial forestry growth potential. The case studies and subsequent discussions point to key opportunities, challenges and needs for the further development of the Indigenous commercial forestry industry in northern Australia. The discussion centres around four emergent themes?commercial native forests, plantation forestry, mine rehabilitation and capacity building. Policy, investment and other priority research and development needs are outlined. These include native forest inventory, silvicultural trials and long-term monitoring; new plantation forestry trials; pre-mining forest salvage harvesting and integrated product utilisation; the processing of local timbers in community sawmills for local applications; multiple-use community forestry in mine rehabilitation; locally designed, field-based 'forest ranger' training programs; technical and tertiary professional forestry education pathways; and business development support, including mentoring. The findings can inform decision-making by regional development researchers, policymakers and investors to support local Indigenous commercial forestry initiatives for community, environmental and livelihood benefits in northern Australia and elsewhere.

Background: Reducing second-hand smoke (SHS) exposure among Indigenous children is an important public health priority in Australia. Parents and family members can be supported to quit smoking during a child's hospital admission. However, communication with Indigenous patients is often a problem for health staff in Australia. Aim: This paper examines the barriers and enablers in communication between health staff and Indigenous carers of paediatric patients in a hospital, about advice to help reduce exposure of children to SHS and child tobacco-related illnesses. Methods: This paper describes findings generated about miscommunication from a broader project analysing smoking cessation interaction between non-Indigenous health staff and Indigenous carers, recruited from a paediatric ward of a regional hospital servicing remote Indigenous communities in the Northern Territory. A constructivist grounded theory with multiphase case study design and semi-structured interviews was used. Transcripts were analysed using line-by-line coding. Results: Health staff and carers had different perceptions about raising the issue of smoking. Health staff lacked confidence to talk about smoking and questioned the cultural appropriateness of doing so. In contrast, carers expected to talk about smoking while in the hospital, and perceived it as part of a caring and protective relationship by health staff. English being a second language for carers was considered a significant communication barrier by staff; carers, however, felt that health staff needed to modify their communication styles such as slowing down their speech. Health staff had possible misperceptions about carers lack of response to messages, which they interpreted as carers not being interested in SHS messages. This led to health staff dropping the subject, when, in fact, carers were struggling with health workers communication styles. Conclusions: Health staff and carers perceive discussion around smoking differently. Cross-cultural communication education may empower staff to provide effective smoking cessation interventions in this setting. Impact statement: Reducing exposure to second-hand smoke (SHS) among Indigenous children is a significant public health priority. Improving communication between health staff will help ensure the optimal provision of smoking cessation support to carers.

In 2020, young people from remote communities in Australia’s Northern Territory are required to attend boarding school in order to access a full secondary education. Commissioned by elders in one Northern Territory remote community, this report investigates the intended and unintended consequences of this policy approach at individual and community level. Working with families, researchers tracked the education histories of 100 12–21-year-old young people identified as community members. Findings reveal that for this community, the supply of boarding places is not equal to demand, and that families experience difficulties securing secondary pathways for their children. Members of the research cohort had been dispersed among 38 different schools across 16 cities or towns in every state or territory of mainland Australia. A concerning pattern of early disengagement from education and low levels of academic attainment is apparent, with consequences for youth wellbeing and community cohesion. Findings of the study indicate the need for further systems-level research to test the generalisability of findings across other remote communities. They demonstrate that educational determinants in remote contexts (such as the community in this study) including housing, health, justice and employment need to be explicitly understood and quantified in policy discussions concerning educational effectiveness and secondary provision cost. The study has shown a large disconnect between local educational aspiration and system-level provision. Policy decisions should seek to identify models which are shown to increase the likelihood of education engagement and attainment in place. The community involved in this study are adamant that ‘place-based approaches’ to educational development must be paramount. This is likely to be generalised to other remote settings.

Remote health has been differentiated from rural health in Australia and defined as isolated, with poor service access and a relatively high proportion of Indigenous residents, necessitating different models of care. Educational strategies for remote health practice are often needs driven and the characteristics of remote health may be used to categorise remote health professional education. This scoping review aims to identify the purpose of health professional education for remote settings, the type of educational strategies implemented and the reported outcomes. A broad search of published literature available in online bibliographic databases was conducted. A total of 33 articles met the review inclusion criteria. A further 7 articles were identified for inclusion in the review through citation searches and the authors? networks giving a total of 40 articles. Six primary themes were established based on the educational purpose: (1) cultural competency; (2) social accountability; (3) rural and remote skill development for the general workforce; (4) remote specialisation; (5) specialist skills required for a remote workforce; and (6) remote teaching. These themes also reflect the philosophical change over time recognising remote health as a separate discipline and its value as a distinctive and efficacious learning environment. The concept of education for remote practice is proposed to describe this unique leaning environment which encompasses critical pedagogy to develop a sense of agency and social accountability, embedding the delivery of primary health care through service learning and developing relationships in a context which is transformative.

Background Chronic disease affects Aboriginal and Torres Strait Islander peoples at a disproportionately higher level and at younger ages, particularly for those living in remote locations, than for the overall Australian population. Aim To examine the perceptions and experiences of Aboriginal and Torres Strait Islander adults residing in remote North West Queensland regarding chronic disease education, and how they self-manage their health. Methods Semi-structured open ended ‘yarning’ interviews were conducted between March and May 2017 with Aboriginal and Torres Strait Islander adults (n = 20) with a medical diagnosis of a chronic disease/s. Interviews focussed on their views and experiences in receiving information regarding their chronic disease/s, self-management education, and how they engaged with healthcare professionals. Data were subjected to thematic analysis. Findings Three themes emerged: 1) It’s going to happen, 2) Communication as a Barrier and Facilitator, and 3) Recognising the Past and Looking Forward. Chronic disease was described as inevitable, and that communication between patient and healthcare professionals was compromised due to the constant use of medical terminology by healthcare professionals. Yarning as a strategy for patient education was suggested as a way to strengthen the relationship with healthcare professionals and to assist with chronic disease self-management abilities. Discussion For Aboriginal and Torres Strait Islander Australians, communication, particularly whilst delivering healthcare is an important factor in providing effective support to improve health outcomes. Conclusion To help improve health literacy and to build trusting relationships, healthcare professionals should adopt culturally appropriate and effective communication rather than simply relying on individuals’ functional health literacy skills.

Regional, rural and remote AustraliaAustralia is diverse, not only in terms of the landscape, but also in ways that influence cultural, spiritual and operational aspects of health service delivery. Dotted across the landscape there are 16 Australian Government funded University Departments of Rural Health (UDRHs). These UDRHs support health professional students to undertake real world, rural focussed practice-based educational experiences, facilitated by interprofessional academic teams. As such, UDRHs can lay claim to considerable expertise in the delivery of interprofessional education, as well in the development and implementation of new models of interprofessioanl team-based care. This chapter describes the features of rural health services and the numerous intersections with interprofessional education and team-based health care.

OBJECTIVE: To evaluate Deadly Thinking, a social and emotional well-being promotion program targeted to remote and rural Aboriginal and Torres Strait Islander communities. Deadly Thinking aims to improve emotional health literacy, psychological well-being and attitudes towards associated help-seeking. DESIGN: Participants completed pre/post-test evaluations via a brief self-report survey immediately before and after the Deadly Thinking workshop. SETTING: Aboriginal and Torres Strait Islander communities in rural and regional Australia. PARTICIPANTS: Data were obtained from 413 participants (69.8% female, mean age 41.6 years), of whom 70.4% identified as Aboriginal or Torres Strait Islanders. INTERVENTION: Deadly Thinking workshops involve participant's engaging with a series of videos and facilitated group discussions with other participants related to social and emotional well-being topics relevant to individuals and communities. MAIN OUTCOME MEASURES: Participants completed measures of psychological distress, suicidal ideation, substance use, changes in attitudes towards help-seeking and help-seeking intentions and satisfaction with the workshop. Additionally, participants in a train-the-trainer workshop rated their perceived confidence to deliver the program post-workshop. RESULT: Participants reported positive perceptions of community safety and well-being and low rates of marked distress, with no significant difference between train-the-trainer and community workshop participants. Results indicated significant improvement in help-seeking intentions post-workshop and high rates of satisfaction with workshop components. CONCLUSION: Initial evaluation indicates good acceptability and feasibility of delivering the Deadly Thinking program in rural and remote Indigenous communities; however, more robust evaluation of the program is warranted using controlled conditions to measure effectiveness, particularly for changing in help-seeking behaviour.

The rise and rise of English: The politics of bilingual education in Australia’s remote Indigenous schools

Sense of belonging is a fundamental human need that can affect long term education and health outcomes. It can also be impacted by the design of the built environment, in this case by the interior design of boarding schools. Within the emerging literature pertaining to experiences of boarding school for Aboriginal students in Australia, issues of loneliness, isolation, homesickness, and the feeling of being ‘between two worlds’ are commonly reported. However, there is currently a dearth of literature that connects these issues with a potential role for design. Therefore, the aim of this project was to address this gap through Participatory Action Research (PAR) in which data was collected through yarning and drawing with 52participants. 27 current boarders (all Aboriginal people, 2 male, 25 female), 18 recent alumni (All Aboriginal people, 3 male, 15 female),and 7boarding staff members (1 Aboriginal person, all female) participated. Four themes emerged that suggest a role for interior design in increasing student sense of belonging. These relate to the institutional characterisation of current boarding schools (Place Identity), avoiding ‘all or nothing’ social interaction through flexible spaces (Interior Relationships), allowing student participation in ongoing interior design (Spatial Voice), and the provision of spaces that offer social and cultural relief (Third Space). These are described in this paper using the voices of the participants. It is proposed that, although these findings report only a particular collection of voices, the potential application of these ideas may be broad and of benefit to many students.

It's been 12 years since the Closing the Gap framework was established to close the life expectancy gap between First Nations and non-First Nations people in Australia. 2020 marks a new era in the framework, as the Coalition of Australian Governments (COAG) and the Coalition of Aboriginal and Torres Strait Islander Peak Organisations (Coalition of Peaks) work to create a new National Agreement on Closing the Gap which is more inclusive of First Nations voices. IE journalist Jessica Willis breaks down the last decade of the campaign, the government framework and why a new National Agreement is necessary.

Background:Surveillance data indicate that Aboriginal and Torres Strait Islander young people are more likely than their non-Indigenous counterparts to experience sexually transmissible infections (STIs) and teenage pregnancy. Despite increasing emphasis on the need for strengths-based approaches to Aboriginal sexual health, limited published data document how young Aboriginal people reduce sexual health risks encountered in their everyday lives. Methods: In-depth interviews with 35 young Aboriginal women and men aged 16-21 years in two remote Australian settings were conducted; inductive thematic analysis examining sexual health risk reduction practices was also conducted. Results: Participants reported individual and collective STI and pregnancy risk reduction strategies. Individual practices included accessing and carrying condoms; having a regular casual sexual partner; being in a long-term trusting relationship; using long-acting reversible contraception; having fewer sexual partners; abstaining from sex; accessing STI testing. More collective strategies included: refusing sex without a condom; accompanied health clinic visits with a trusted individual; encouraging friends to use condoms and go for STI testing; providing friends with condoms. Conclusion: Findings broaden understanding of young Aboriginal people's sexual health risk reduction strategies in remote Aboriginal communities. Findings signal the need for multisectoral STI prevention and sexual health programs driven by young people's existing harm minimisation strategies and cultural models of collective support. Specific strategies to enhance young people's sexual health include: peer condom distribution; accompanied health service visits; peer-led health promotion; continued community-based condom distribution; enhanced access to a fuller range of available contraception in primary care settings; engaging health service-experienced young people as 'youth health workers'.

Households are known to be high-risk locations for the transmission of communicable diseases. Numerous modelling studies have demonstrated the important role of households in sustaining both communicable diseases outbreaks and endemic transmission, and as the focus for control efforts. However, these studies typically assume that households are associated with a single dwelling and have static membership. This assumption does not appropriately reflect households in some populations, such as those in remote Australian Indigenous communities, which can be distributed across more than one physical dwelling, leading to the occupancy of individual dwellings changing rapidly over time. In this study, we developed an individual-based model of an infectious disease outbreak in communities with demographic and household structure reflective of a remote Australian Indigenous community. We used the model to compare the dynamics of unmitigated outbreaks, and outbreaks constrained by a household-focused prophylaxis intervention, in communities exhibiting fluid versus stable dwelling occupancy. Our findings suggest that fluid dwelling occupancy can lead to larger and faster outbreaks, interfere with the effectiveness of household-focused interventions, and may contribute to the considerable burden of communicable diseases in communities exhibiting this type of structure.

Group A Streptococcus (GAS) is a ubiquitous bacterial pathogen that exists in many distinct strains, and is a major cause of death and disability globally. Vaccines against GAS are under development, but their effective use will require better understanding of how immunity develops following infection. Evidence from an animal model of skin infection suggests that the generation of enduring strain-specific immunity requires two infections by the same strain within a short time frame. It is not clear if this mechanism of immune development operates in humans, nor how it would contribute to the persistence of GAS in populations and affect vaccine impact. We used a mathematical model of GAS transmission, calibrated to data collected in an Indigenous Australian community, to assess whether this mechanism of immune development is consistent with epidemiological observations, and to explore its implications for the impact of a vaccine. We found that it is plausible that repeat infections are required for the development of immunity in humans, and illustrate the difficulties associated with achieving sustained reductions in disease prevalence with a vaccine.

Jaru is an endangered Australian Aboriginal language spoken in the East Kimberley region of Western Australia. Intergenerational transmission of Jaru is in the process of being disrupted and children are usually socialised in the English-based creole language Kriol, which also serves as a lingua franca of the wider area. Previous work on Jaru includes a reference grammar by Tsunoda (1981), and community-oriented publications by the Kimberley Language Resource Centre. Current research aims to document and explore interactional practices of Jaru speakers in ordinary conversation.

INTRODUCTION: Evaluation and monitoring of primary health care requires the establishment and maintenance of an appropriate data system. This study reviews the application and effectiveness of the Communicare data management system in the delivery of health services to the Fitzroy Valley in the Kimberley region of Western Australia. METHODS: Key demographic fields (sex, date of birth and Aboriginal status) were examined for completeness (whether the date fields were all completed and correct when compared with the paper file) while the 'conditions' field was examined for accuracy. Three chronic diseases (diabetes, hypertension and chronic kidney disease) in adults and age-specific incidence for four acute diseases (otitis media, gastroenteritis, lower respiratory tract infection and skin infection) in children were included. RESULTS: Completeness of chosen demographic fields was 100% for date of birth and sex and 98% for Aboriginal status. Chronic conditions matched the paper files 100%, while the recording of acute conditions was incomplete. Among older adults (≥55 years) the prevalences of diabetes, chronic kidney disease and hypertension were 43%, 42% and 39% respectively. Age-specific incidence of acute conditions was highest in the 0-4 years age group where 25% had had at least one episode of otitis media and 20% at least one episode of skin infection. CONCLUSIONS: The recording of demographic and chronic disease data was complete, but lower for acute conditions. Routinely collected data have a number of limitations, but nonetheless are a feasible way to establish population health indices, particularly for chronic diseases for this remote health service with minimal expenditure and effort. These rates provide useful baselines for monitoring and evaluating the impact of service delivery on health outcomes. This audit provides an indication of the accuracy of routinely collected data in the electronic system compared to the paper medical records, which have traditionally been considered the gold standard. Data collected on chronic disease information were accurate and clinically useful for health service planning, monitoring and evaluation. Acute disease data were not accurate enough to be clinically useful.

Gija is an endangered Australian Aboriginal language spoken in the east Kimberley region of northern Western Australia. It is no longer acquired as a first language, nor spoken fluently by younger generations of Gijapeople, who instead largely speak Kimberley Kriol (an English-based lingua franca) with some Gija vocabulary. Due to widespread concern about the vitality of their language, many members of the community are actively engaged in language revitalisation efforts. Although academic publications are scarce, the linguists who have worked with the Gija community since the 1980s have produced language-learning materials and records of ethnobiological knowledge, oral history, and stories told through painting. Numerous community-oriented language publications aimed at maintenance of the language and culture have also been produced. A video corpus of face-to-face Gija conversations is currently being developed to support community-led initiatives for language documentation and revitalisation.

Using an ethnographic approach, this research assesses common assumptions in rock art research in terms of their validity for Aboriginal rock art sites in the Barunga region of the Northern Territory, Australia. In particular, we assess the potential and limits of the commonly held assumption that open or restricted access to sites and/or the meaning of motifs can be assessed by determining the visibility of the site or image within the landscape. This research calls into question some assumptions that are core to contemporary archaeological method and theory. Our results challenge the notion that a secluded location, or difficulty of access, is needed to restrict access to a site. “Hidden” sites do not need to be hidden, as site access is controlled by a plethora of cultural rules. Moreover, sites that appear to be hidden within the landscape may be open access sites, although access may be restricted for periods of time. Conversely, sites that are visible and accessible from a landscape perspective can be subject to restricted access, regulated through social rules. In addition, the results question the notion that the control of secret information in rock art sites is determined by the visibility and location of motifs and sites. Hidden meanings are not necessarily related to hidden locations or the low visibility of the art, since cultures can have many other ways of hiding meaning. Finally, the results of this study challenge the commonly held dichotomy between sacred/restricted access and secular/open access.

Objective Adequate mental health service provision in rural and remote Australian communities is problematic because of the tyranny of distance. The Royal Flying Doctor Service provides air medical retrieval for people in rural and remote areas. The economic impact on both the Royal Flying Doctor Service and the public hospital system for mental health–related air medical retrievals is unknown. We aimed to estimate the direct medical costs associated with air medical retrievals and subsequent hospitalizations for mental and behavioral disorders for the 2017 calendar year. Methods All patients with a primary working diagnosis of International Statistical Classification of Diseases and Related Health Problems, 10th Version, Australian Modification F00 to F99 (mental and behavioral disorders) who underwent an air medical retrieval were included in this cost analysis. International Statistical Classification of Diseases and Related Health Problems, 10th Edition, Australian Modification codes were mapped to Australian Refined Diagnosis Related Group codes, with hospital costs applied from the National Hospital Cost Data Collection (2016/2017). All costs are reported in 2017 Australian dollars (AUDs). Results One hundred twenty-two primary evacuations and 926 interhospital transfers occurred with an in-flight diagnosis of F00 to F99, most commonly psychotic disorders, including schizophrenia and schizotypal disorders. The total direct medical costs were estimated to be AUD $20,070,527. Costs for primary evacuations accounted for 13% (AUD $2,611,260), with the majority of this associated with the subsequent hospital admission (AUD $1,770,139). Similarly, the majority of the costs associated with interhospital transfers (total costs = AUD $17,459,267) were also related to hospital costs (AUD $13,569,187). Conclusion Direct medical costs associated with air medical retrievals for people experiencing a mental health crisis are substantial. The majority of costs are associated with hospital admission and treatment; however, the indirect (loss of productivity) and intangible (quality of life) costs are likely to be far greater.

The benefits of school and community partnerships are well documented in government reports and the academic literature. A number of government initiatives have been introduced to actively involve parents and the community in school matters. In addition, various agencies have produced resource kits and guidelines to assist schools and communities to develop and foster partnerships, and partnership agreements. Much of this study has focused on working with Aboriginal peoples. The use of the term, ‘Aboriginal’ in this paper refers to Aboriginal and Torres Strait Islander people. Initiatives such as ‘What Works’ have had some success in building strong Aboriginal community and school partnerships, however, the literature also reveals that despite such initiatives, the levels of success vary from school to school, with some partnerships unable to develop or be sustained. In responding to a gap in the current knowledge, the authors examine the value of school–community partnerships in a rural and remote school where the percentage of Aboriginal Australian students is high. A brief summary of the outcomes of some of the major initiatives with aims to build effective school and community partnerships is provided. This is followed by the findings from a small pilot research study on the implementation of initiatives to build strong school–community relationships in rural and remote Indigenous school settings in Western Australia. The challenges that may inhibit the establishment of successful school–community relationships/collaboration are discussed and suggestions provided on how these challenges can be addressed.

It is widely accepted that mathematical learning builds upon students’ prior knowledge and understandings, and their identities. In this study, this phenomenon is explored with indigenous students in remote community schools in outback Australia. Through one-on-one task-based interviews, it was found that these students had some clear understandings of the measurement concepts involved, although these understandings were often idiosyncratic to these students in this context. The task-based one-on-one interview gave better insights into students’ knowledge than the written form of the National Assessment Program–Literacy and Numeracy assessment. Nevertheless, the students’ conceptions provide a useful basis upon which to build subsequent knowledge, understanding and skills in the forms required by the formal mathematics curriculum.

Access to secondary education for very remote Northern Territory Indigenous students is limited. Although many students attend distant boarding schools, very few stay to complete Year 12 (the final year of secondary school in Australia). Few families and communities are fully engaged in the whole transition process. This paper describes a case study of one very remote Indigenous community and its partnership with an interstate boarding College. The partnership is attributed with students from community staying to complete Year 12 and then seeking local employment pathways afterward. The study on which this paper is based, investigated how the elements within this partnership function. Using a qualitative methodology with a phenomenological design, two adults from the remote Indigenous Community and six staff from a partner boarding College were interviewed. Interviews were transcribed verbatim, thematically coded and participants were deidentified. Limitations included small sample size not completely representative of the students, families, Elders and staff from either the community or the college.

Eye disease is the third-highest contributor toward health inequality for Aboriginal Australians. Understanding how the Central Australian ophthalmology service addresses complexities of remote eye care is crucial in understanding how expansion can meet current and future needs. The present study analyses findings from the MEDLINE database and Governmental reports, and descriptive information from stakeholders in Central Australia and the Australian Department of Health. We describe the current Central Australian ophthalmology model at three levels; (i) the healthcare service level (specialized primary care, local/outreach optometry and ophthalmology services, and intensive extended surgical weeks), (ii) the community level (local community staff, clinics and initiatives, and eye ?champions? and mutual support), and (iii) the healthcare system level (federal and state Government, and private funding). We conclude that building full-time specialist availability, and system-wide approaches to increase patient utilisation, will facilitate overcoming barriers of remoteness, and create enduring improvements in Central Australian eye care and health-inequality.

Policy settings across governments characterise boarding schools using the language of opportunity and choice: boarding schools enable rural and remote living young people to access the best of education systems, irrespective of where they live. The papers presented in this Special Edition test this proposition. Authors from Australia and overseas address the topic of boarding, with a special focus on the experience of remote First Nations communities in Australia and overseas. Their combined insights indicate that where several preconditions are met, boarding schools can transform lives in all the best ways, but where providers fail to consider the holistic wellbeing of their students, great harm can ensue.