Remote Australia Online

The National Rural Health Alliance (the Alliance) released its new strategic plan 2019-20221 in September 2019, following my appointment as Chief Executive Officer (CEO) in July. The strategic plan marks a shift in the direction of the Alliance, which is reflected in our vision for “healthy and sustainable rural, regional and remote communities.” The word “sustainable” in this context encompasses the three interrelated elements of (a) society—including the principles of equity, empowerment, accessibility and inclusiveness—(b) the environment and (c) the economy, with the view that health policies must integrate human and planetary health, as well as promote economic vitality in a way that does not compromise other aspects of sustainability.2, 3 This seems particularly pertinent in the context of persistent drought across many parts of Australia and the catastrophic bushfires that swept through Queensland, NSW, Victoria and South Australia this summer. The physical and mental health and well-being of so many rural communities across Australia will be affected for many years to come, augmented by the devastating impact that these severe weather events have had on our natural and built environment and the economy. To achieve the vision for health and sustainable rural, regional and remote communities, the Alliance proposes the creation of six placed-based health and wellbeing networks (PBHNs) in rural and remote communities in Modified Monash Model (MMM) areas 4-7. It relies on a modest outlay from the Australian Government and illustrates our commitment to achieving the vision for healthy and sustainable rural, regional and remote communities. The PBHNs expand on an earlier demonstration site concept4 by promoting a holistic, person-centred model of care that focusses on preventive health and integrates health services with community and social services. The underlying philosophy for the PBHNs is that health care moves beyond the paradigm of service delivery to a broader framework that privileges wellness and well-being over sickness, while striving for more sustainable communities. At the community level, the health sector is projected to be a large employer in regional Australia in coming decades.5 Indeed, the viability of this sector is essential to local people's livelihood, to the livability of places, and to the health and well-being of residents. However, building viable rural and remote health care businesses is challenging in thin market contexts. Many allied health professionals in rural areas frequently work across multiple sectors to earn a livable wage. They may make up a full-time equivalent by working part-time with the local health district, taking on roles in the NGO sector funded by the local Primary Health Network (PHN), working within an aged care facility, or conducting private practice. Nevertheless, to make a rural public-private partnership model attractive to health professionals, exploring alternative funding arrangements—such as pooled funding arrangements between State and Commonwealth Governments—is imperative. The National Rural Health Commissioner has recommended the formation of Rural and Remote Allied Health Consortia (RRAHC), which will need to be supported with government funding. The multidisciplinary RRAHC will form the basis of the PBHN model and are designed to be flexible, allowing people to receive a range of allied health public and private services. Services may be delivered either through face-to-face appointments or telehealth services that will be connected to general practitioners and nurse practitioners, specialists, community pharmacists, dentists and local health district services (including acute care or midwifery). To meet the need for “localised” workforce recruitment and retention strategies, the PBHNs will consider a range of incentives that are not just financial in nature. Concepts such as sense of place, place attachment and belonging in place will be considered in the development of person-centred approaches. In line with this concept, the project will also draw on findings from the implementation of Cosgrave's whole-of-person retention improvement framework incorporating three key life domains (workplace/organisational, role/career and community/place), which was trialled in 2018-2019 by two rural public health services in Victoria.6 To support social connection of health workers, especially newcomers, the PBHNs will consider establishing a Recruitment and Community Connector position, in line with the model developed in Marathon, Ontario, Canada.7 Further evidence from Canada indicates that a distributed model of medical education into rural and regional communities can have a positive economic benefit for those communities.8 Hence, training of GPs and allied health professionals in their respective rural generalist pathways, as well as Aboriginal and Torres Strait Islander health practitioners and workers, will be incorporated into these PBHNs. They will have links to University Departments of Rural Health, Rural Clinical Schools, Regional Training Hubs and Aboriginal Community Controlled Health Services, providing professional support and development. It is expected that the PBHNs will operate across the health, community, education, disability and aged care sectors for preventive health and early intervention programmes, to address the needs of an ageing population, the epidemic of chronic conditions and the rising costs of health care.9 To address the social and ecological determinants of health, aligning with building healthy sustainable communities, the PBHNs will work with local groups to create community food hubs, similar to The Stop10 programme in Toronto, Canada. Such programmes can improve understanding of sustainable food systems, offer practical solutions to food insecurity, increase physical activity and promote social cohesion. It is envisaged that these community food hubs could become thriving centres for community engagement in food production and preparation, involving young children, adolescents and the elderly. In addition to a place-based community food hub, the Orange Declaration suggests that place-based interventions for those with mental health problems—that are holistic, integrated and co-designed by local communities—show promise and could be evaluated through this initiative.11 Rural, regional and remote communities in MMM areas 4-7 that currently have poor access to high quality, affordable and integrated care provide an excellent avenue in which to test the efficacy of alternative funding and service delivery models via the proposed PBHNs. Their focus on preventive health, increasing social cohesion and promoting strong and viable health and community services, will all contribute to advancing healthy and sustainable rural, regional and remote communities.

Background: The diverse rural medical education initiatives that have been developed in Australia to address the medical workforce maldistribution have been less successful in many smaller and remote communities. This study explored the factors that attract and retain GP registrars and supervisors and the impact that localised training (i.e., rural and remote workplace-based training and support) has on both GP registrars and supervisors, and the GP workforce in rural and remote underserved areas. Methods: A purposive sample of 79 GP registrars, supervisors, practice managers, health services staff and community representatives living and working in areas of low GP workforce in rural and remote Australia were invited to participate in semi-structured interviews and one focus group divided over two phases. Thematic analysis was used to explore themes within the data. Findings: Attractors and barriers to rural and remote practice were identified as the main themes. Attractors include family and community lifestyle factors, individual intrinsic motivators, and remote medicine experiences. In contrast, barriers include work related, location, or family factors. Further, localised GP training was reported to specifically influence GP registrars and supervisors through education, social and financial factors. Conclusion: The current study has provided a contemporary overview of the issues encountered in expanding GP training capacity in rural and remote communities to improve the alignment of training opportunities with community and workforce needs. Strategies including matching scope of practice to registrar interests have been implemented to promote the attractors and lessen the barriers associated with rural and remote practice.

Background Culturally responsive, strengths-based early-intervention mental health treatment programs are considered most appropriate to influence the high rates of psychological distress and suicide experienced by Aboriginal and Torres Strait Islander youth. Few early intervention services effectively bridge the socio-cultural and geographic challenges of providing sufficient and culturally relevant services in rural and remote Australia. Mental Health apps provide an opportunity to bridge current gaps in service access if co-designed with Aboriginal and Torres Strait Islander youth to meet their needs. Aims This paper reports the results of the formative stage of the AIMhi-Y App development process which engaged Aboriginal and Torres Strait Islander youth in the co-design of the new culturally informed AIMhi-Y App. Methods Using a Participatory Design approach, a series of co-design workshops were held across three sites with five groups of young people. Workshops explored concepts, understanding, language, acceptability of electronic mental health tools (e-mental health) and identified important characteristics of the presented applications and websites, chosen for relevance to this group. An additional peer supported online survey explored use of technology, help seeking and e-mental health design elements which contribute to acceptability. Results Forty-five, Aboriginal and Torres Strait Islander youth, aged 10–18 years, from three sites in the Northern Territory (NT) were involved in the workshops (n = 29). Although experiencing psychological distress, participants faced barriers to help seeking. Apps were perceived as a potential solution to overcome barriers by increasing mental health literacy, providing anonymity if desired, and linking young people with further help. Preferred app characteristics included a strength-based approach, mental health information, relatable content and a fun, appealing, easy to use interface which encouraged app progression. Findings informed the new AIMhi-Y App draft, which is a strengths-based early intervention wellbeing app for Aboriginal and Torres Strait Islander Youth. Conclusions Research findings highlight the need, feasibility and potential of these types of tools, from the perspective of Aboriginal and Torres Strait Islander youth.

Australian mammals have exhibited exceptionally high rates of decline since European settlement 230 years ago with much focus on small mammals in northern tropical savannas. In these systems, little scientific attention has been given to the suite of grazing macropods, family Macropodidae, (common wallaroo (Osphranter robustus), antilopine wallaroo (O. antilopinus) and agile wallaby (Notamacropus agilis)). These species may be impacted by feral herbivores and contemporary fire regimes, two threats linked to small mammal declines. A multi-scale approach using aerial surveys, road surveys and camera trapping was utilised to determine the effects of feral cattle and fire on the distribution and abundance of large macropods in the North Kimberley bioregion. Feral cattle density and biomass exceeded that of macropods regardless of survey technique. Density estimates for cattle were up to 125 times higher (0.3?10.0 km?2) than estimates for macropods (0.08?0.49 km?2). Cattle biomass, based on the aerial survey estimates (corrected for perception bias), were 15 and 95 times higher than macropods for infertile (279 vs. 19 kg km?2) and fertile savannas (518 vs. 5 kg km?2), respectively. Proximity to the nearest pastoral station was a significant predictor of the aerial sightings of feral cattle (P ≤ 0.05). Abundance and foraging activity of cattle were positively associated (P ≤ 0.05) with recently burnt areas. In contrast, camera trapping showed agile wallaby and wallaroo occurrence and foraging were associated with longer unburnt areas (P ≤ 0.05). Agile wallaby and wallaroo were negatively associated with cattle (P ≤ 0.05) and showed substantial diurnal and seasonal separation consistent with an antagonistic interspecific interaction. Results also suggest that the agile wallaby is the primary prey of the dingo, not wallaroo. Collectively, this study suggests that recent landscape changes such as altered fire regimes and introduced herbivores have negatively impacted large grazing macropod species.

Objective: The effectiveness of probiotic therapy for acute rotavirus infectious diarrhoea in an indigenous setting with bacterial/parasitic diarrhoea is unclear. In the present study, we assessed the efficacy of probiotics in Australian Aboriginal children in the Northern Territory admitted to hospital with diarrhoeal disease. Patients and Methods: A randomised double-blind placebo-controlled study was conducted in Aboriginal children (ages 4 months–2 years), admitted to hospital with acute diarrhoeal disease (>3 loose stools per day). Children received either oral Lactobacillus GG (5 × 109 colony-forming units 3 times per day for 3 days; n = 33) or placebo (n = 31). Small intestinal functional capacity was assessed by the noninvasive 13C-sucrose breath test on days 1 and 4. Results: Both groups showed mean improvement in the sucrose breath test after 4 days; however, there was no difference (mean, 95% confidence interval) between probiotic (2.9 [cumulative percentage of dose recovered at 90 minutes]; 1.7–4.2) and placebo (3.7; 2.3–5.2) groups. Probiotics did not change the duration of diarrhoea, total diarrhoea stools, or diarrhoea score compared with placebo. There was a significant (P < 0.05) difference in diarrhoea frequency on day 2 between probiotics (3.3 [loose stools]; 2.5–4.3) and placebo (4.7; 3.8–5.7) groups. Conclusions: Lactobacillus GG did not appear to enhance short-term recovery following acute diarrhoeal illness in this setting.

The ‘Scenario planning for remote community risk management in northern Australia’ project is part of CDU’s northern hub second round suite of projects, commencing in July 2017. The hub involves collaborations between the Darwin Centre for Bushfire Research (DCBR) at Charles Darwin University (CDU), the North Australia Indigenous Land & Sea Management Alliance Ltd (NAILSMA), the Aboriginal Research Practitioners Network (ARPNet) also based at CDU, and regional stakeholders including north Australian Fire and Emergency Management agencies, conservation agencies and remote Indigenous communities. In this report, we provide summaries of the work undertaken over the project period in the two main components of the Northern hub’s scenario planning project. Firstly, we have been developing a framework for the Fire & Emergency Services agencies to engage with remote Indigenous communities to potentially improve Emergency Services delivery. The agencies recognise the need to improve the services provided remotely, but also recognise that some jurisdictions (particularly the NT) are not adequately resourced to achieve this,. The classic model of volunteering does not suit remote significantly disadvantaged Indigenous community members in remote communities. However, the expanding Indigenous Ranger program is a potential means to more appropriately engage with local Indigenous people to build local emergency management (EM) capacity, preparedness, resilience and disaster response. This research has developed a suite of case studies. In each case, interviews/workshops have been conducted with members of the, now, wide- spread Indigenous Ranger Groups (IRGs) to ascertain the aspirations, willingness and capacity of the Indigenous Rangers to engage in EM activities. In this report, we provide summaries of the activities undertaken and information gathered to date at Hermannsberg and Yuendumu in Central Australia, Broome, Beagle Bay and Bidyadanga in the Kimberley, Galiwinku on Elcho Island off Arnhem Land, in Bulukhuduru, Ramingining and Ngukkurr in Arnhem Land, and Borroloola on the Gulf of Carpentaria. Main identified issues across the selected remote communities include little engagement of locals, if any, in managing emergency situations around the community, inappropriate placement of EM plans in police stations, lack of resoruces and services in remote communities, broader recognition of IRGs capacity to deliver EM services, and willingness of IRGs to participate in EM services. Secondly, this research continues the service delivery program of land management, monitoring and evaluation tools to assist fire managers in remote north Australia. To develop “Improved Fire Management Regimes”, we provide information with respect to the spatial distribution, and effects of fires on tropical savanna and rangeland habitats through the Savanna Monitoring & Evaluation Reporting Framework (SMERF). In particular, we include the development of a fire severity map product, not only to inform land management, but to improve Savanna Burning greenhouse gas emissions calculations. Finally, this report addresses ongoing priorities identified by partner agencies and community stakeholders requiring further action-based research and implementation, especially addressing: • Understanding the full “costs and benefits” of engaging with IRGs in delivery of effective EM in remote community settings; • Full accounting of the costs of natural hazards and disasters in northern Australia and; • Ongoing development of tools to assist savanna fire managers, for example: fire behavior models, improved fire mapping resolution, curing mapping.

For over 30 years, the radiometric chronologies of Newman Rockshelter and Newman Orebody XXIX have been central to archaeological discussions on the Pleistocene Aboriginal occupation of the Hamersley Plateau and greater Pilbara region. Until 2009, these two sites were heralded as having the oldest evidence of human occupation on the plateau, dating to the last glacial maximum (LGM) ∼ 26–20 ka. More recently however, the excavations at several other rockshelters have shown that ancient Aboriginal peoples occupied the Hamersley Plateau many thousands of years before the onset of the last glacial cycle, when regional climatic conditions were wetter and more amenable. This paper presents the results of our re-excavation of both Newman Rockshelter and Newman Orebody XXIX. Our research has resulted in the compilation and analysis of large lithic datasets for each of these sites and the construction of geo-chronologies using modern radiometric techniques, including AMS-radiocarbon dating and optically stimulated luminescence dating. These new radiometric chronologies and artefact data indicate that both sites were occupied between 45 and 40 ka. Despite having significant early occupational evidence, neither of the rockshelters present strong evidence for sustained or persistent site use during the LGM proper ca. 23–19 ka; however, there is substantial evidence for more routine occupation of these localities during the terminal Pleistocene and Holocene.

KEY POINTS: Mucormycosis is almost exclusively an opportunistic infection that occurs in the setting of immunosuppression. Rapidly progressive or persistent infective symptoms despite broad-spectrum antibiotics in high-risk individuals should prompt investigation for invasive fungal infection such as mucormycosis. More than 1 infection may be present in a patient, particularly in those who are immunosuppressed. A 40-year-old Indigenous Australian woman was airlifted to hospital from a remote community. She had central chest pain, dyspnea, pedal edema and diabetic ketoacidosis, which she had developed after she stopped taking insulin because of her chest pain. Anxious to remain in her community, she had initially declined an earlier transfer but agreed 3 days later because her diabetic ketoacidosis was deteriorating despite additional insulin. Her medical history included type 1 diabetes, stage 1 chronic kidney disease, hypertension and asthma. She was on a basal–bolus insulin regimen, ramipril, amlodipine and amitriptyline. Her glycosylated hemoglobin at the time of admission was 10.3%. On examination, the patient was lethargic and tachypnoeic (respiratory rate 23 breaths per minute). She had signs of congestive cardiac failure, including raised jugular venous pressure, bibasal pulmonary crackles and pitting edema to her knees. Her heart sounds were normal. On investigation, her electrocardiogram showed new T-wave inversion in the inferolateral leads. She had a blood pH of 7.02 (reference range 7.35–7.45) with high anion gap, plasma glucose 38 (reference range 4.0–7.8) mmol/L, plasma ketones 7.6 (normal < 0.6) mmol/L, high-sensitivity troponin elevation from 199 to 264 (normal < 13) ng/L, hypophosphatemia 0.30 (reference range 0.75–1.50) mmol/L, hyponatremia 120 (reference range 135–145) mmol/L, serum potassium 4.8 (reference range 3.5–4.5) mmol/L and serum creatinine 175 (reference range 60–110) μmol/L. She had neutrophilia of 13 (reference range 2.0–7.5) ×109/L. Her C-reactive protein was 28.5 (normal < 5.0) mg/L. HIV serology was negative. A chest radiograph showed peribronchial cuffing with no focal consolidation. A transthoracic echocardiogram revealed moderate left ventricular hypertrophy. We thought that her diabetic ketoacidosis had been precipitated by an acute myocardial infarction. The patient declined to undergo a cardiac angiogram. Within 24 hours, her diabetic ketoacidosis had resolved with fluid and insulin infusion. On the third day of admission, she reported bloody sputum, sharp right-sided chest pain and painful swallowing. Chest computed tomography (CT) showed a 2.2 × 2.0-cm right lower-lobe cavitary mass (Figure 1). Sputum microscopy showed pauci-septated filamentous fungi, which subsequently grew Rhizopus microsporus, a Mucorales species (Figure 2). The minimum inhibitory concentrations for amphotericin B and posaconazole were 0.5 mg/L and 1 mg/L, respectively.

Objective: To examine the extent and nature of coverage of nutrition in the Koori Mail. Methods: Content and framing analysis were used to examine articles in the Koori Mail published between 2013 and 2017 that included the terms 'nutrition', 'diet', 'food', 'eating', 'weight', 'tucker' or 'sugary drinks'. The analysis focused on the portrayal of Aboriginal and Torres Strait Islander people/communities, inclusion of First Peoples' voices and the framing of nutrition issues. Results: A total of 102 articles were included. Most articles (88%, n=90) portrayed Aboriginal and Torres Strait Islander communities in a neutral or positive way and more than half (53%, n=54) included an Aboriginal or Torres Strait Islander voice. While nutrition was often framed as an individual or community responsibility, articles predominantly promoted programs or initiatives undertaken in local communities. Conclusion: Despite the limited prominence of Aboriginal and Torres Strait Islander nutrition in the mainstream media, the coverage of nutrition issues in the Koori Mail demonstrates the salience of this topic for local communities. This study highlights how journalism can better reflect the diversity and strengths of First Peoples. Implications for public health: Including more Aboriginal and Torres Strait Islander voices and using a strengths-based approach in press releases may improve media advocacy.

Editorial: Point-of-care (POC) diagnostic tests conducted at the time of the patient visit have the potential to improve treatment and management of curable sexually transmissible infections (STI) such as chlamydia, gonorrhoea and trichomoniasis. For Aboriginal and Torres Strait Islander remote communities, STI remain an important and long-standing public health issue. They are associated with serious sequelae including pelvic inflammatory disease, infertility and systemic disease,1and are particularly prevalent in remote communities. In 2009,chlamydia and gonorrhoea notification rates for Aboriginal and Torres Strait Islander peoples were very high at 2620 and 2252 per 100 000 population, respectively, equating to chlamydia and gonorrhoea prevalence above 10% in many remote communities. HIV diagnosis rates in the same communities remain low at 1 per 100 000 population in 2009.

The Ngaanyatjarra land is located in the Gibson Desert in the state of Western Australia, and is the home of 12 major communities primarily made up of indigenous peoples. These communities are spread over a 250,000 square kilometre radius, with the population of each community ranging from 75 to 450. The remote location of these communities, far from major rural centres, has limited the roll-out of advanced communication technologies. One area of concern has been the limited availability of personal communication services to provide communication links within and between these communities.

The 1990s witnessed a rapid growth in research interests in mobile ad hoc networks (MANETs). The infrastructureless and dynamic nature of these networks demand that a new set of networking strategies be implemented to provide efficient end-to-end communication. This, along with the diverse application of these networks in many different scenarios, such as battlefield and disaster recovery, have seen MANETs being researched by many different organizations. MANETs employ the traditional TCP/IP structure to provide end-to-end communication between nodes. However, due to their mobility and the limited resources in wireless networks, each layer in the TCP/IP model requires redefinition or modifications to function efficiently in aMANET. One interesting research area inMANETs is routing. Routing inMANETs is a challenging task and has received a tremendous amount of attention from researchers. This has led to the development of many different routing protocols for MANETs. This chapter presents a discussion on a number of different routing protocols proposed for ad hoc networks and presents a number of future challenges in ad hoc and mobile ad hoc networking.

Internationally, schools have recognised the need for supporting and improving the resilience of students, particularly those facing a multiplicity of challenges. However, social and emotional learning programmes, including those aimed at enhancing resilience, are often not evaluated thoroughly nor detail process and economic evaluations. This paper evaluates a multi-component integrated intervention designed to strengthen the resilience of remote-living Aboriginal and Torres Strait Islander students attending boarding schools. This evaluation is largely process-based, focussing on the acceptability, feasibility, preliminary outcomes and affordability of implementation of the intervention. Fourteen boarding or teaching staff members, eight female and six who identified as Aboriginal, were interviewed. The interviews were conducted with staff members at eight Queensland boarding sites where the intervention was delivered. Qualitative inductive thematic analysis was used to evaluate feasibility and acceptability and outcomes described by staff. A descriptive analysis of the costs (AU$ 2018) was performed in Microsoft Excel 2013. This evaluation identified multiple major themes around feasibility and acceptability, including sharing experience across sites, staff knowledge, attitudes and behaviours, and perceived student achievement, leadership and relationships. Implementation of the resilience intervention was considered feasible and affordable, and embraced by boarding providers. School-based participatory action research interventions aimed at improving culturally appropriate support structures for Indigenous boarding students are achievable with the appropriate resourcing and time to implement and embed change.

This chapter presents a protocol for assessing the effects dietary seafood consumption on depressive symptoms. We designed a cross-sectional study of 206 participants recruited in two Torres Strait Island communities. Depressive symptoms were assessed using the adapted Patient Health Questionnaire-9 (aPHQ-9), diet was analyzed with a structured questionnaire, omega-3 and omega-6 fatty acid concentrations were measured via a capillary dried blood spot system, and plasma levels of triglycerides and cholesterol were measured by gas-phase chromatography. Finally, we tested the relationship between seafood consumption, blood lipid concentrations, and depression scores using independent samples t-tests and a logistic and quantile regression model.

The helminth and arthropod parasite communities occurring in macropodid, vombatid and notoryctid marsupials as well as in rodents in the arid zone of Australia are compared with those found in related host species in adjacent semi-arid and humid zones and are also related, where possible, to the changes in the mammalian fauna of central Australia over a geological time scale. Across the marsupials and rodents for which parasitological data are available, there is an obvious contrast in the helminth communities between inhabitants of high rainfall areas and those inhabiting semi-arid and arid zones in terms of parasite genera present in the marsupials. The differences between the inhabitants of semi-arid and arid environment communities are less overt and are observable only the parasite species level in the case of the kangaroos and wallabies. In the case of the rodents, there appears to be a significant lack of diversity in helminth faunas associated with the transition to an arid environment. Differences in the arthropod parasite communities between climatic regions are more marked than is the case with the helminths. The general lack of life cycle studies of these parasites provides an impediment to identifying the means by which they have adapted to the increasing aridity in central Australia over geological time, but appears to offer opportunities for future study.

While Indigenous Australians are believed to be at a high risk of psychological illness, few screening instruments have been designed to accurately measure this burden. Rather than simply transposing western labels of symptoms, this paper describes the process by which a screening tool for depression was specifically adapted for use across multiple Indigenous Australian communities.

Over the last two decades there has been a steady decline in youth migration to Australian rural communities. Generally, inland agricultural communities are the most seriously impacted by this trend. Coupled with high rates of youth out-migration, many rural communities face difficulties in attracting young people to fill skilled job vacancies and apprentice positions. Declining youth in-migration also has social consequences, effectively reducing the capacity of rural communities to replenish their skill base and social networks. This research identifies how urban-based youth perceive rural lifestyles and employment opportunities and how this is linked to their willingness to move to rural areas. The study reveals that young people attach undesirable aesthetic values to the physical environment of inland rural communities and perceive them as socially isolating and as having minimal opportunities for career advancement. However, the perceptions of those who live, or had lived, in rural areas are far more positive than those who have had little experience in rural communities. Accordingly, those who had previously lived in inland regions were far more likely to move to rural areas than those who had limited lived experience of rural communities. Overall, the research found that perceptions of lifestyle and employment opportunities were important influences on young people's willingness to move to rural communities.

Education policies are enacted differently according to school contexts and geographies. This is particularly the case in large countries such as Australia where context and geographies for schooling differ greatly. Within regional, rural and remote Australia, schools are witnessing a trend in geographic disadvantage in that as distance from urban centres increase, nationally benchmarked scores tend to decrease. Overcoming this geographic disadvantage has become a national goal for policy makers; however, policies fail to fully consider regional, rural and remote context. This study aims to review literature regarding the contextual factors that affect policy enactment in regional, rural and remote Australian schools. 54 journal articles, national reviews, books and policy documents were identified, read and reviewed. The literature confirms that context is an important consideration in policy enactment. Findings reveal that educational policy enactment is impacted by four major contextual factors: (1) situational context, (2) professional context, (3) material context and (4) external context. These factors have been used as a thematic organiser in this review to understand policy enactment in RRR schools specifically. This literature review concludes that context needs to be at the forefront of policy enactment in RRR areas. Policies need to be enacted within place, using community participation to be effective. This research is a fruitful endeavour as there is a need to contextualise not only policies, but also pedagogy and practice.

This paper presents an argument for an integrated approach to attracting and retaining rural and remoteteachers. It describes existing government funded research and state government policies in this domain. Itbuilds upon existing sociological models to propose a model of the factors influencing teacher decisions toteach in a rural location and to stay in a location. Based upon this model and the background literature thepaper proposes that policy ought to be directed towards addressing both internal and external influences uponteacher behaviours in an integrated way.

Faults bounding the Flinders Ranges of South Australia and the Barrier Ranges of New South Wales display clear evidence of significant Quaternary displacements. Kinematic analysis of the Wilkatana, Burra and Mundi Mundi Faults indicates that reverse-oblique fault slip occurred in response to east ? west compression, consistent with maximum compressive stress (SHMax) orientations derived from historical earthquake focal mechanisms. Surface-rupturing events resulted from a series of moment magnitude (M) ≥6.6 palaeo-earthquakes over the past ?100 000 years. The timing of the most recent surface-rupturing events was determined on each fault from optically stimulated luminescence dating of faulted and post-faulting strata. The Wilkatana Fault has been the site of at least two major earthquakes since around 67 ka, making this one of the youngest prehistoric fault scarp exposures in Australia. Thickness estimates of faulted Pliocene and Quaternary footwall sediment imply minimum fault slip rates of 20 ? 30 m per million years, while extrapolation of a domed planation envelope in the bedrock hangingwall to the fault plane yields fault slip rates of 36 ? 51 m per million years. Movement at these rates over the Pliocene to Holocene interval accounts for a significant proportion of the contemporary relief in the Flinders Ranges. The relative intensity of neotectonic activity and historical seismicity in the Flinders Ranges reflects the role of structural and thermal heterogeneities in a regional stress field dominated by far-field plate-boundary forces.

Twelve trilobite species, plus rare agnostid arthropods, are described from the Giles Creek Dolostone (Cambrian Series 3, Stage 5; Templetonian) at Ross River Gorge and Gaylad Dam in the north-eastern Amadeus Basin, Northern Territory, central Australia. Amphoton krusei sp. nov., Nepea ommacrada sp. nov., Penarosa oepiki sp. nov. and Schopfaspis shergoldi sp. nov. are described in association with Deiradonyx toddi Öpik, 1982, Dinesus sp., Kootenia sp., Pagetia silicunda Jell, 1975, Solenoparia sp., Tonkinella? sp., Xystridura filifera Öpik, 1975a, and Xystridura gayladia Öpik, 1975a, in addition to indeterminate agnostids. Pagetia silicunda and Xystridura filifera suggest an early Templetonian age, within the Pentagnostus anabarensis or Pentagnostus praecurrens Zone. This is supported by the co-occurrence of Amphoton Lorenz, 1906, Deiradonyx, Öpik, 1982, Dinesus Etheridge, 1896 and Kootenia Walcott, 1889, all of which occur in Templetonian successions in the Georgina Basin (Northern Territory and Queensland), Gnalta Shelf (western New South Wales) and the Heathcote Greenstone Belt (Victoria). We argue that the Tempe Formation (central Amadeus Basin) and the Giles Creek Dolostone are not contemporaneous as previously suggested, indicating that regional stratigraphical schemes need to be amended.

Background People living in rural and remote regions have mortality and morbidity rates worse than their counterparts in metropolitan cities. Distance to access healthcare and limited access to health professionals highlights the need for expanded pharmacy services to address the health disparity facing rural and remote Australia. Objectives Examining consumers’ perspective of expanded pharmacy services with a view to improving the health of their local community is a focus of the study. Methods A questionnaire was provided to 20 rural and remote community pharmacies across Australia, to be administered to pharmacy consumers during July–September 2019. The questionnaire involved consumers choosing expanded services that they would like to see provided by their local pharmacy. The data were manually entered, exported into IBM SPSS Statistic 25 and summarised using descriptive statistics. Results 406 consumers from rural and remote locations completed the questionnaire. Vaccinations, chronic disease management and mental health services represented eight out of the ten most frequently chosen services. Over 95% of respondents agreed or strongly agreed that they would support the expanded services and that pharmacists have the required skills and knowledge to deliver these services. Findings indicated that the remote and very remote participants chose all of the 26 services more frequently than those in large and medium towns. Age also significantly influenced the frequency of choosing particular services, including osteoporosis testing, vision and eye checks, counselling services, swallowing checks, diet checks and breastfeeding advice and support. Conclusion This study demonstrates that consumers believe that the health of the people in their community will improve with the provision of expanded services. These preliminary findings provide useful baseline information suggesting the development of expanded pharmacy services in rural and remote communities is likely to be well accepted by consumers.

In arid environments, infiltration from ephemeral rivers is believed to be a primary source of groundwater recharge. However, ephemeral river studies have mostly focussed on estimation of transmission loss or riverbed infiltration rates. Where river flows lead to the development of perched aquifers, transmission loss and riverbed infiltration can be much greater than aquifer recharge, as much of the infiltrated water can subsequently be lost to evapotranspiration. The Woodforde River in central Australia has flowed on 34 occasions within the past 16 years. River sediments are highly permeable, but the river is incised into clay sands of lower permeability, leading to the development of a perched aquifer. During an intensively monitored flow, the downstream decrease in river discharge was approximately equal to the volume of the perched aquifer, indicating that infiltration is the main source of river loss during flows. The perched aquifer persists for several months or longer, and water levels decline slowly over time. Comparison between chloride concentrations of river water and soil water from beneath the perched aquifer suggests that 25% of this water leaks through the low permeability sediments to recharge the deep aquifer. The remainder is used by the riparian vegetation or lost to evaporation.

This article discusses the diversity, distribution, and qualities of materials and substances categorized as red among Pitjantjatjara- and Yankunytjatjara-speaking Western Desert Aboriginal people: Anangu. Valued red materials and substances include elements of the encultured landscape - country - such as ochre, timber, food, blood, and fire, alongside cloth and other industrially produced materials. Previous scholarship defines reds among central Australian Aboriginal cultures only in static symbolic terms as representing blood. Based on long-term fieldwork, this article discusses how Anangu employ a system of analogy across domains which connects together red materials and substances with particular affordances. I argue that Anangu conceptualize these red materials and substances as making visible kurunpa/spirit. This has implications for concepts of health and for constructing the local cultural value of consumer goods and substances found in country. Reds connect the mental and the material. The article contributes to studies of how contemporary Anangu mediate relationships between kin and country and participate in a wider market economy. It addresses anthropological knowledge about, and the importance of, the materiality of colours and the role of coloured materials and substances in shaping local ontologies and epistemologies.

Zebra Finches Taeniopygia guttata are renowned for breeding opportunistically in arid Australia and for their ability to nest immediately in response to rain at any time of year. However, this conclusion has rested on short-term and incidental observations. We monitored breeding of Zebra Finches at Alice Springs, central Australia, over a seven-year period by estimating the month of hatching of free-flying subadults caught at a walk-in trap. Capture-mark-recapture analysis suggested that the monitored population was open and highly mobile and exploited a large home range. Despite gaps in the sampling a multiple regression analysis found a significant statistical relationship between breeding and the incidence of rainfall. When conditions were favourable in a given year Zebra Finches had a very long reproductive period with 10.6 equally good consecutive months for breeding. Breeding was possible in every month of the year but was least in April and greatest n October. Low winter temperatures did not prevent breeding. The heavier the rainfall, the more intense and the longer the breeding episode. Once a breeding episode began, surges of breeding activity corresponded with follow-up rains. We did not observe the immediate response to rainfall described by earlier authors. On the contrary, the statistical analysis revealed that rain had a negative effect on breeding in the month in which it fell, and in the following month. There was a lag between the onset of the first rains and the onset of breeding, ranging from one to two months in summer to two to three months in winter. The statistical analysis revealed that rain four months previously had the most profound positive effect on breeding. Hatching of the first clutches coincided with the first availability of ripening grass seeds. The artificial supply of abundant dry seed, on its own, did not stimulate breeding. The timing of seed set by grasses in central Australia is complex, depending on the species composition, the prevailing temperatures immediately after rain, and the amount and timing of previous falls of rain. We suggest that Zebra Finches track these factors and breed opportunistically as soon as new supplies of seed are available.