Remote Australia Online

Introduction: The aim of this study was to compare the effectiveness of two geriatrician models of care, the telegeriatric service (TGS) and visiting geriatrician (VG), in regional and remote settings in terms of potential cost-savings to the health system and impact on health service use (HSU). Furthermore, to establish whether longer wait-times for clinic appointments led to increased HSU by study participants. Methods: Trends in patient emergency department presentations, hospitalisations and bed-days (HSU) were compared from 18 months before to 12 months after geriatrician appointment for the two services in the Western Australian Midwest region. The relationships between wait times, patient triage level and HSU were modelled. The costs of providing the services were offset against reductions in HSU after appointments. Results: The sample comprised consecutive patients using the TGS (n = 84) and VG service (n = 124). Patient characteristics were similar, although patients using the VG service had longer wait-times, were triaged as more urgent and demonstrated the highest levels of HSU. Both models were effective with similar rates of reduced HSU following appointments. Increased wait-times and higher patient triage urgency were associated with increased HSU. Discussion: Although TGS and VG showed similar reduced rates of HSU, TGS had the capacity to see a higher volume of patients, a broader geographical reach and improved waitlist management. Consequently, TGS was more effective at reducing avoidable hospitalisations and subsequent health deterioration due to shorter wait-times. Whilst face-to-face consultations are recognised as ‘gold standard’ a combination of the two models is most efficient.

Information technologies have been important in the emergence of new forms of control and surveillance of welfare recipients and of those who administer labour market programmes. These technologies have often appeared at the margins of accounts of welfare reform, for example as means of increasing the efficiency or consistency of services, or as constraining frontline discretion. Henman has argued, however, that information technologies need to be analysed not just as administrative tools, but as “non-human actors,” shaping policy development and implementation in ways beyond the intentions of their human creators (Henman, Governing Electronically: E-government and the Reconfiguration of Public Administration, Policy and Power, Palgrave MacMillan). This paper explores the way that the use of government information systems has shaped employment services in remote Australia where over 80 per cent of those included are Indigenous people. The article describes how the production and use of administrative data within employment services have supported and extended the framing of Indigenous people in remote communities as non-compliant and as needing external direction.

Objective Otitis media resulting in conductive hearing loss is a major health issue for Aboriginal and Torres Strait Islander children, which can also lead to the child developing spatial processing disorder (SPD). This study examined the prevalence of hearing loss and deficits in speech understanding in noise, including SPD, in Aboriginal and Torres Strait Islander children from schools varying in remoteness and socio-educational advantage. Method 288 Aboriginal and Torres Strait Islander children aged 4–14 years from three schools varying in remoteness and socio-educational advantage completed audiological assessment and the Listening in Spatialized Noise – Sentences test to assess for hearing loss and SPD. Children also completed Sound Scouts, a self-administered tablet-based hearing test which screens for these deficits. The prevalence of hearing issues was compared to what is expected from a typical population. Results The proportion of children with hearing problems was related to the school's socio-educational advantage, with higher proportions in schools with a lower socio-educational advantage. Proportions of children with speech-in-noise deficits (including SPD) was related to the remoteness of the school, with higher proportions in schools that were more remote. Conclusions The prevalence of hearing loss and SPD is much higher in Aboriginal and Torres Strait Islander children than described for non-Aboriginal populations, and is related to the socio-educational advantage or remoteness of the school. Resources are needed to reduce the incidence of hearing loss and health disparity in Aboriginal communities, especially those in remote areas with lower socio-educational advantages.

Background: Elevated waist circumference (WC) is an important risk factor for cardiovascular disease (CVD). Aboriginals in Australia are at higher risk of CVD compared to non-Aboriginals. We examined the association between waist circumference and CVD, and developed a model for projecting absolute risk of cardiovascular disease using WC and age in one high risk Australian Aboriginal community. Methods: We followed up 920 (470 men, 450 women) participants (more than 80% of the eligible population) aged 18 to 76 years, without CVD at baseline, for up to 20 years. Hazard ratios were estimated using Cox proportional hazards models adjusting for potential confounding factors. Absolute risk was estimated using the Weibull regression model. Results: Of 920 study participants, 156 males and 177 females developed CVD in the follow-up period. Incidence rates for males and females in the 4th WC quartile (Q4) were 38.3 (95% CI 29.6, 49.7) and 47.2 (95% CI 37.1, 60.3) respectively. Crude hazard ratios of CVD for Q4 WC group using Q1 (quartile 1) as the referent quartile were 2.9 (95% CI 1.8- 4.6) for males and 3.5 (95% CI 2.2- 5.5) for females. Association remained after controlling for age, smoking status and alcohol drinking status (HR = 1.8 for males and HR = 3.1 for females). At 45 years of age with baseline waist circumference of 100 cm, a male had an absolute CVD risk of 32.5%, while a female had a 30.6% risk of the disease. Conclusions: Risk of CVD among participants increased with increasing WC, and the relationship was accentuated with increasing age. The prediction model provides a tool for understanding the combined effects of WC with age on CVD events in the Australian Aboriginal community. It is simple and easily understood and will assist in identifying individuals at risk of CVD in relation to waist circumference values.

Purpose: Yolngu are Aboriginal Australians from northeast Arnhem Land in the Northern Territory (NT). Machado-Joseph disease (MJD) prevalence in the NT Aboriginal population is the highest in the world. Yolngu living with progressive dysarthria associated with MJD could benefit from augmentative and alternative communication (AAC). However, there are no aided AAC systems in Yolngu languages. This research aimed to explore the views of Yolngu with MJD about communication, speech-language pathology (SLP) services and AAC.Method: A collaborative, culturally responsive research design was informed by Indigenist Research methodology and Constructivist Grounded Theory. Yolngu with MJD (n=10) and their interested family members (n=4) participated in interviews and created visual representations of their social networks. Data were analysed through an oral interpretive process with Yolngu researchers. Result: A Yolngu metaphor, Gongdhu 'Building understanding by hand', emerged as a culturally meaningful way to represent the core understandings required for speech-language pathologists (SLPs) to work effectively with Yolngu with MJD. Elements of this metaphor include seeking to understand the complex lived experiences of Yolngu with MJD, and working with families to explore the potential benefits of SLP services and AAC.Conclusion: Yolngu with MJD and their families want to work collaboratively with SLPs to develop bilingual AAC systems and culturally responsive SLP services that build on strengths of Yolngu culture and kinship to improve communication opportunities and participation.

Introduction The population-based (Lililwan) study of fetal alcohol spectrum disorder (FASD) revealed a high prevalence of FASD in the remote communities of the Fitzroy Valley, Western Australia (WA) and confirmed anecdotal reports from families and teachers that challenging child behaviours were a significant concern. In response, Marninwarntikura Women’s Resource Centre initiated a partnership with researchers from The University of Sydney to bring the positive parenting program (Triple P) to the Valley. Triple P has been effective in increasing parenting skills and confidence, and improving child behaviour in various Indigenous communities.Methods and analysis Extensive consultation with community leaders, service providers, Aboriginal health networks and academic institutions was undertaken and is ongoing. Based on community consultations, the intervention was adapted to acknowledge local cultural, social and language complexities. Carers of children born after 1 January 2002 and living in the Fitzroy Valley are invited to participate in Group Triple P, including additional Stepping Stones strategies for children with complex needs. Programme are delivered by local community service workers, trained and accredited as Triple P providers or ‘parent coaches’. Assessments for parent coach pretraining and post-training includes their perceived ability to deliver the intervention and the cultural appropriateness of the programme. Carers complete preintervention and postintervention and 6-month follow-up assessments of parenting practices, self-efficacy and child behaviour.Ethics and dissemination Approval was granted by the University of Sydney Human Ethics Committee, WA Aboriginal Health Ethics Committee, WA Country Health Services Ethics Committee and Kimberley Aboriginal Health Planning Forum. Consultation with community is imperative for efficacy, engagement, community ownership and sustainability of the programme, and will be ongoing until findings are disseminated. Anonymous findings will be disseminated through peer-reviewed journals, community feedback sessions and scientific forums.

Despite massive funding from the Australian government, the literacy achievement of Australian Indigenous children remains significantly lower than for non-Indigenous. With the aim of identifying innovative ways to improve Indigenous children's literacy achievement, this study explored the social practices surrounding everyday mobile phone use by Indigenous people in a remote Australian community. Informed by the notion of ?placed resources?, which highlights the understanding that digital literacies are best considered as resources situated by social practices that have local effect, the study surveyed 95 people living in a remote Indigenous community about their mobile phone practices. The study also examined a video of a literacy event between a mother and her child around the use of a mobile phone. The findings revealed the strong relational aspects of phone use in remote communities. Integral to the concept of placed resources is a respect for the practices communities find important as they adopt artefacts for their everyday communication.

Objectives Machado-Joseph disease (MJD) is the most common spinocerebellar ataxia worldwide. Prevalence is highest in affected remote Aboriginal communities of the Top End of Australia. Aboriginal families with MJD from Groote Eylandt believe ‘staying strong on the inside and outside’ works best to keep them walking and moving around, in accordance with six key domains that form the ‘Staying Strong’ Framework. The aim of this current study was to review the literature to: (1) map the range of interventions/strategies that have been explored to promote walking and moving around (functional mobility) for individuals with MJD and; (2) align these interventions to the ‘Staying Strong’ Framework described by Aboriginal families with MJD.Design Scoping review.Data sources Searches were conducted in July 2018 in MEDLINE, EMBASE, CINAHL, PsychINFO and Cochrane Databases.Eligibility criteria for selecting studies Peer-reviewed studies that (1) included adolescents/adults with MJD, (2) explored the effects of any intervention on mobility and (3) included a measure of mobility, function and/or ataxia were included in the review.Results Thirty studies were included. Few studies involved participants with MJD alone (12/30). Most studies explored interventions that aligned with two ‘Staying Strong’ Framework domains, ‘exercising your body’ (n=13) and ‘searching for good medicine’ (n=17). Few studies aligned with the domains having ‘something important to do’ (n=2) or ‘keeping yourself happy’ (n=2). No studies aligned with the domains ‘going country’ or ‘families helping each other’.Conclusions Evidence for interventions to promote mobility that align with the ‘Staying Strong’ Framework were focused on staying strong on the outside (physically) with little reflection on staying strong on the inside (emotionally, mentally and spiritually). Findings suggest future research is required to investigate the benefits of lifestyle activity programmes that address both physical and psychosocial well-being for families with MJD.

Aims To assess outcomes of women in the Pregnancy and Neonatal Diabetes Outcomes in Remote Australia (PANDORA) cohort with gestational diabetes mellitus (GDM) managed by lifestyle modification compared with women without hyperglycaemia in pregnancy. Methods Indigenous (n=97) and Europid (n=113) women managed by lifestyle modification were compared to women without hyperglycaemia (n=235). Multivariate linear and logistic regressions assessed whether GDM-lifestyle women had poorer outcomes compared to women without hyperglycaemia. Results Women with GDM-lifestyle had higher body mass index and lower gestational weight gain than women without hyperglycaemia. On univariate analysis, gestational age at delivery was lower and induction rates were higher in women with GDM-lifestyle than without hyperglycaemia. On multivariable regression, GDM-lifestyle was associated with lower gestational age at delivery (by 0.73 weeks), lower birthweight z-score (by 0.26, p=0.007), lower likelihood of large for gestational age (LGA) [OR (95% CI): 0.55 (0.28, 1.02), p=0.059], and greater likelihood of labour induction [2.34 (1.49, 3.66), p < 0.001] than women without hyperglycaemia Conclusion Women with GDM managed by lifestyle modification had higher induction rates and their offspring had lower birthweight z-scores, with a trend to lower LGA than those without hyperglycaemia in pregnancy. Further studies are indicated to explore reasons for higher induction rates.

A child is brought to a remote area nursing clinic by his mother. He appears acutely unwell, is crying and scratching his head through matted hair - he has impetigo as a result of head lice. This case report describes the comprehensive wound management considerations to reduce the risk of rheumatic heart disease or renal disease secondary to infection with Group A beta-haemolytic streptococci (GAS). There is an extremely high incidence of impetigo secondary to scabies and head louse infestations in Northern Territory communities. Reducing the incidence of pyogenic skin disease and the more serious sequelae for children from remote Indigenous communities requires more than a course of antibiotics and educating the primary carers. It requires community wide action including promoting the importance of effective prevention and management of skin infections in infants and children and working with other sectors to address household overcrowding, a lack of health hardware, and a lack of ready access to affordable, effective topical head louse treatment.

Objective: This paper provides a case study of the responses to alcohol of an Aboriginal Community Controlled Health Service (The Service), and investigates the implementation of comprehensive primary health care and how it challenges the logic of colonial approaches.Methods: Data were drawn from a larger comprehensive primary health care study. Data on actions on alcohol were collected from: a) six-monthly service reports of activities; b) 29 interviews with staff and board members; c) six interviews with advocacy partners; and d) community assessment workshops with 13 service users.Results: The Service engaged in rehabilitative, curative, preventive and promotive work targeting alcohol, including advocacy and collaborative action on social determinants of health. It challenged other government approaches by increasing Aboriginal people’s control, providing culturally safe services, addressing racism, and advocating to government and industry.Conclusions: This case study provides an example of implementation of the full continuum of comprehensive primary health care activities. It shows how community control can challenge colonialism and ongoing power imbalances to promote evidence-based policy and practice that support self-determination as a positive determinant for health.Implications for public health:Aboriginal Community Controlled Health Services are a good model for comprehensive primary health care approaches to alcohol control.

Telecommunications are a vital learning medium for rural and remote dwellers but are largely neglected by communications and adult education researchers. The uses of telecommunications in rural and remote Australia were examined by gathering qualitative and quantitative data from 135 rural and remote subjects. The emphasis was upon interpreting data in order to heighten awareness of those variables which impact upon rural and remote people when they use telecommunications to learn from each other. Respondents were invited to make contact via a freecall telephone number after the research had been widely advertised through the media. Subjects completed a questionnaire and kept a diary of telecommunications interactions over two days. In addition 40 in-depth semi-structured interviews were completed as were two site studies and a number of focus group discussions. Both qualitative and quantitative data analysis procedures were employed with each approach being used to inform the research about the potential of the other. The data were also examined with reference to the thesis that telecommunications are a medium for informal and incidental learning. It is suggested, therefore, that Jarvis' model of adult learning in the social context can usefully be extended to incorporate telecommunications mediated learning and that the taxonomy of communications activities developed by Pye can be applied to the analysis of telecommunications episodes. It was discovered that UHF is an important technology but that its use is confined to functional information exchange because it is a public medium. Facsimile transmissions are also predominantly used for functional transmissions and it became apparent that public versus private, and real time versus asynchronous time are each important determinants of communications strategies. The research showed that although rural and remote subjects did not differ markedly with respect to the frequency and duration of their calls, remote people paid significantly more for their telephone services. In addition, it was found that telecommunication about personal matters tend to be nested in homogenous groups with newcomers mainly talking to, and learning from, other newcomers while locals mainly interact with and learn from other locals. It is suggested researchers should appraise the social context of telecommunications and the dynamics of telecommunications episodes in order to understand the complex telecommunications process.

This study compares remote campers' preferences for campsite attributes along the Ningaloo Reef coast, Western Australia. The foundation of this study is drawn from Schafer's (1969) study which argues that the 'average' camper does not exist. Consequently, this paper tests the hypothesis that preferences of campers concerning campsite attributes have significant differences between management regimes. Methods comprised self-completed visitor questionnaires, of which 735 were returned and analysed. The findings indicate that there two levels of campsite attribute preferences are present. The first are preferences common to all campers, which reflect the remote regions' wilderness-experience camping style. The second represent differences between camping 'Clusters', which in turn identify different groups of campers with different needs and expectations.

Objective: Remote Aboriginal community gardens (gardens) frequently operate below their full potential. A set of gardening sustainability principles may improve their planning, operation and long-term sustainability. This paper aims to document the principles of sustainability of non-profit remote Aboriginal community gardens in the Top End of the Northern Territory. Methods: Throughout 2011, gardens in the Top End of the Northern Territory were visited. Interviews and observational data were used to explore the principles of garden sustainability with participants. Subsequent iterative thematic analysis informed development of a set of gardening sustainability principles. Results: Principles of sustainability included effective garden planning; community autonomy, consultation and engagement; growing community vetted crops; employing long-term, effective, culturally sensitive managers; long-term, transparent funding organisations and cycles; garden integration into existing food supply chains; culturally appropriate employment arrangements; and physical aspects of successful gardening. Conclusions: This work uniquely consults gardeners, managers and Aboriginal and non-Aboriginal people of both genders in the largest reported study of its type, resulting in new and expanded findings, particularly including new social factors for gardening success. Implications: Expanding the understanding of what makes gardens work to include the important social factors identified here may have merit.

In this 'hot issues' paper, Jacobsen argues that even after decades of inquiry the level of Tourism Studies disconnect from Aboriginal and Torres Strait Islander people is troubling. He maintains that (relieved of Aboriginal or Torres Strait Islander voices for so long) the received literature on tourism is still dominated by non-Indigenous academics who continue to forge a discourse based on 'Othering'. The purpose of his critical review article is to substantively engage with the disconnect which seemingly plagues inquiry about tourism for Aboriginal and Torres Strait Islander people in Australia. This Jacobsen piece thereby exposes subtle, over-arching misgivings observable in the literature underscored by the presupposed 'Othering' of Aboriginal and Torres Strait Islander people as 'inferior people'. This hot issue paper therefore moves away from discourses of deficit, inertia, imposed Western-centric theorisation and superficial inquiry, towards the Aboriginalisation of research-into-tourism as inquiry which is emancipative and situated within and emanating from Aboriginal and Torres Strait Islander worldviews. In providing a number of outcomes from a 6-year national research programme in remote Australia, Jacobson reflects upon their value as the basis for 'leadership' and for 'future broad directions'. To Jacobsen, the Aboriginalisation of tourism inquiry must be based upon cultural integrity in order to drive the discourse of enabling, cultural ways of business and appropriate leadership. This hot issue paper thus draws attention to the urgent need for Tourism Studies practice to be genuinely committed to the wellbeing of Aboriginal and Torres Strait Islander people, cultures, country, and knowledge.

The regional scale of planning is increasingly being seen as an appropriate scale for the planning and management of more sustainable development, including tourism planning often through the concept of destinations. Yet regional planning faces many challenges, not least those of a contested stakeholder environment and the dangers of stakeholder bypass. In such situations it may be difficult to plan for resilient regional futures, and the sustainability of a region may be threatened by major shifts in the socio-economic and bio-physical environments. This can be particularly so in the case of tourism development in pristine and fragile environments. However if key stakeholders can be engaged in a more participative learning process, with the implications of potential future changes clearly set out for all to see, then there may be a more positive group approach to regional planning for resilient futures. The Ningaloo Destination Model project (NDM) provides an example of how such an approach can be developed and used to provide insights into the future development of an area in Western Australia which is home to one of the world's most significant fringing coral reefs. The paper focuses on how the process and use of the NDM project builds regional resilience to cope with disturbances. The various stages of model development and use are discussed. The paper concludes that the NDM needs more than good data and reliable modelling to contribute to regional planning; it also needs to encourage the characteristics that build regional resilience through the modelling process and model use.

Objective To determine the health impact of swimming pools built with the aim of improving quality of life and reducing high rates of pyoderma and otitis media. Design Intervention study assessing prevalence of ear disease and skin infections before and at six monthly intervals after opening of swimming pools. Setting Two remote Aboriginal communities in Western Australia. Participants 84 boys and 78 girls aged &lt; 17 years. Main outcome measures Changes in prevalence and severity of pyoderma and perforation of tympanic membranes with or without otorrhoea over 18 months after opening of pools. Results In community A, 61 children were seen before the pool was opened, and 41, 46, and 33 children were seen at the second, third, and fourth surveys. Equivalent figures for community B were 60, 35, 39, and 45. Prevalence of pyoderma declined significantly from 62% to 18% in community A and from 70% to 20% in community B during the 18 months after the pools opened. Over the same period, prevalence of severe pyoderma fell from 30% to 15% in community A and from 48% to 0% in community B. Prevalence of perforations of the tympanic membrane fell from 32% in both communities to 13% in community A and 18% in community B. School attendance improved in community A. Conclusion Swimming pools in remote communities were associated with reduction in prevalence of pyoderma and tympanic membrane perforations, which could result in long term benefits through reduction in chronic disease burden and improved educational and social outcomes.

Background Vulvar cancer is rare and, as a result, is understudied. Treatment is predominantly surgery, irrespective of the type of vulvar cancer, and is associated with physical, emotional and sexual complications. A cluster of human papillomavirus (HPV)-dependent vulvar cancer patients was identified in Arnhem Land Northern Territory (NT), Australia, in which young Indigenous women were diagnosed at 70 times the national incidence rate. Aims To assess whether women from the Arnhem Land cluster differ from women with vulvar squamous cell carcinoma (VSCC) and vulvar intraepithelial neoplasia (VIN) resident elsewhere in the NT in recurrence after treatment, disease progression and mortality. Materials and methods A retrospective cohort study of NT-resident women diagnosed with VIN or invasive vulvar cancer (VSCC) between 1 January 1993 and 30 June 2015 was undertaken. Time to recurrence was assessed using cumulative incidence plots and Fine and Gray competing risk regression models. Mean cumulative count was used to estimate the burden of recurrent events. Results Indigenous women from Arnhem Land experienced more recurrences after treatment than non-Indigenous women, the cancers recurred faster, and Indigenous women have worse survival at five years. Conclusions In characterising the epidemiological features of this cluster, we have identified a particularly aggressive form of vulvar cancer. This provides a unique opportunity for elucidating the aetiopathological pathways driving vulvar cancer development that may ultimately lead to preventive and therapeutic targets for this neglected malignancy. Further, these findings have important implications for clinical practice and HPV vaccination policy in the affected population.

In this paper we take on Green's (2017) orientation of the Australian Curriculum: English and consider what might it hold for the students of Australia. We set about analysing eighteen minutes of storytelling by a group of young 9-12 year old Kunibidji males from Maningrida in the far North of the Northern Territory in Australia, making this storytelling visible to the readership. In doing so, we note the rhetorical attitude held by these young people and their artful use of discourses as they translanguage between Ndjebbana, English, traditional knowledge, popular culture and mainstream Australian culture. The artful use of discourses demonstrated by these young people highlights their preference to engage in oral storytelling using scaffolds of meaning-making found in digital technological literacies. We argue that all Indigenous students should have the right to learn in their preferred language of communication as part of their linguistic human rights.

How do we produce architecture that responds to the extremes of climate and culture within the context of remote Western Australian Indigenous desert communities? ‘Extremes of culture’ refers to the radically different lifestyles and belief systems of our clients, both in respect to our own backgrounds and experiences as designers, and the differences between ‘cultures’ within an Indigenous community and between different Indigenous communities. For instance, the needs and aspirations of a young Martu family at Kunawarritiji are different to that of their grandparents, and from those of a young Spinifex family at Tjuntjuntjara. ‘Extremes of climate’ refers to the harsh natural environments of these remote locations, to the extreme heat during summer, and to the very cold temperatures of winter nights. The physicality of the landscape in each community has a profound effect on how families shape their camps and dwellings, and generally means that different parts of a dwelling are designed to respond to the dynamic nature of these environments within the timeframe of a day or a season.

Compulsory Income Management (CIM) is a form of conditional welfare that involves the mandatory quarantining of a portion of welfare recipients’ social security payments. Quarantined funds are accessible via a government-issued debit card, with restrictions surrounding where and on what funds can be spent. Official justifications of CIM have framed these policies as attempts to combat substance abuse and gambling problems, and to thus secure better outcomes for welfare recipients and their families. Central to this narrative has been the argument that welfare quarantining will ensure more money is spent on ‘essentials’, including accommodation. No existing studies, however, have specifically interrogated the impacts of CIM on housing security. This article responds to this gap in the literature by reviewing existing research concerning CIM's impacts and locating this research within broader debates regarding the causes of homelessness and the efficacy of individualised policy interventions. In doing so, it highlights CIM's potential to exacerbate housing insecurity not only through technical issues such as rental transfer failures, but also by contributing to underlying stressors such as economic disadvantage; relationship difficulties, poor health and addiction; and social stigma. The article concludes that – far from addressing the structural causes of homelessness – CIM has enflamed them.

Introduction -- Case-study area profile and methodology -- A walkabout race?: contemporary Aboriginal mobilities in Yamatji country -- State service provision and Aboriginal mobilities -- Security and belonging: re-conceptualising Aboriginal mobilities -- Security and belonging and the mainstream economy -- The ties that bind: negotiating security and belonging through family -- Conclusion. This dissertation explores contemporary Aboriginal spatial practices in Yamatji country, Western Australia, within the context of rural service provision by the State government. The central themes with which it engages are a) historical and contemporary conceptualisations of Aboriginal spatialities; b) the lived experiences of Aboriginal mobilities in the region; and c) the dialectical, and often contentious, relationship between Aboriginal spatial practices and public health, housing, and education services. Drawing primarily on a range of field interviews, the thesis opens up a discursive space for examining the cultural content and hidden assumptions in constructions of 'appropriate' models of spatial mobility. In taking a policy-oriented focus, it argues that the appropriate provision of basic government services requires a shift away from overly simplistic assumptions and discourses of Aboriginal mobility. Until the often subtle practices of rendering particular Aboriginal mobilities as irrational, deviant, and/​or mysterious are challenged and replaced, deep-colonising practices in rural and remote Australia will persist. --The thesis reconceptualises contemporary Aboriginal spatial practices in Yamatji country based upon an examination of dynamics and circumstances that undergird Aboriginal mobilities in the region. With this empirical focus, it argues that Aboriginal spatial practices are fashioned by the processes of procuring, cultivating and contesting a sense of security and belonging. Case study material presented suggests that two primary considerations inform these processes. A post-settlement history of contested alienation from family and country (both sources from which belonging and security were traditionally derived), and a changing engagement with mainstream social and economic institutions, have produced a context in which security and belonging are iteratively derived from a number of sources. Contemporary Aboriginal spatial practices therefore take a complex variety of forms. The thesis concludes that adopting the framework of security and belonging for interpreting contemporary Aboriginal mobilities provides a starting point for engaging more effectively and intentionally with dynamic Aboriginal spatial practices in service delivery policy and practice.

UFO beliefs exist around the world yet they have been almost exclusively analysed within the context of urban American society. This article seeks to understand the ways in which people from differing social and cultural backgrounds also engage in UFO narratives. In a remote Aboriginal desert community in Central Australia, descriptions of UFOs merge popular and media portrayals of extraterrestrials with elements and themes found in local Aboriginal cosmology. Consequently, Aboriginal narratives regarding extraterrestrial beings are able to both reflect the local social environment of race relations and affirm Aboriginal identity.

This article explores how a remote Aboriginal-owned and -run art centre, Ikuntji Artists in Haasts Bluff, has developed grassroots-level cultural tourism. While not many remote Indigenous art centres engage with the tourism industry, Aboriginal tourism engagement has only recently been identified by the Northern Territory Government as a major business development area. Steered by the member artists and the board, the art centre has been able to create a range of workshops and activities that can be offered to small-scale tour operators. Over the past five years, an arts festival and various workshops for university field students and other small tour operators have been hosted. Member artists, staff and the board as well as the community see cultural tourism as an opportunity to share their culture by way of teaching visitors about the Luritja language, culture and country. Thus, this article argues that art centres can engage meaningfully in cultural tourism and support remote Indigenous communities in the sustainable development of cultural tourism.

Objective Research has found that otitis media (OM) is highly prevalent in Australian Indigenous children, and repeated bouts of OM is often associated with minimal-to-moderate hearing loss. However, what is not yet clear is the extent to which OM with hearing loss impacts auditory signal processing specifically, but also binaural listening, listening in noise, and the potential impact on phonological awareness (PA) – an important, emergent literacy skill. The goal of this study was to determine whether auditory abilities, especially binaural processing, were associated with PA in children from populations with a high incidence of OM, living in a remote Australian Indigenous community in the Northern Territory (NT). Methods Forty-seven 5-12-year-olds from a bilingual school participated in the study. All were tested to determine hearing sensitivity (pure tone audiometry and tympanometry), with PA measured on a test specifically developed in the first language of the children. OM often results in a hearing loss that can affect binaural processing: the Dichotic Digit difference Test (DDdT) was used to evaluate the children's dichotic listening and the Listening in Spatialized Noise-sentences test (LiSN-S) was used to evaluate their abilities to listen to speech-in-noise. Results Seventeen (36%) and 16 (34%) had compromised middle ear compliance (combined Type-B and –C) in the right and left ear respectively. Six children demonstrated a bilateral mild hearing loss, and another five children demonstrated a unilateral mild hearing loss. Thirty-one children were able to complete the DDdT listening task, whereas only 24 completed the speech in noise task (LiSN-S). Forty-four children (94%) were able to complete the letter identification subtask, comprising part of the PA task. The findings revealed that age was significantly correlated with all tasks such that the older children performed better across the board. Once hearing thresholds were controlled for, PA also correlated significantly with both binaural processing tasks of dichotic listening (r = 0.59, p < 0.001) and listening to speech in noise (r = −0.56, p = 0.005); indicating a potential association between early, emergent literacy and listening skills. Conclusions The significant correlations between phonological awareness and dichotic listening as well as phonological awareness with listening to speech-in-noise skills suggests auditory processing, rather than hearing thresholds per se, are associated to phonological awareness abilities of this cohort of children. This suggests that the ability to process the auditory signal is critical.