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The Let's Start Parent-Child Program is a manualised parent-child program which aims to improve educational, social and emotional outcomes for Aboriginal parents and their four- to seven-year-old children. It has been implemented in the Northern Territory, Australia on the Tiwi Islands and in Darwin since 2005. This paper outlines the adaptation of the program to include narrative approaches, the sharing of stories and the use of expressive arts as a way to build understanding between program leaders and participating families. An example from a recent program is used to illustrate how the sharing of stories and expressive use of art engages and binds group participants together. It supports parents to tell their own stories, to speak about their lived experience, to reconsider aspects of their own and their children's experiences and to achieve an increased awareness of their personal resources and a sense of self-empowerment. The program is designed and delivered with sensitivity to individual parents, children and families, where cultural and interpersonal differences and different developmental and family situations can be taken into account.

Resource management systems such as national parks are complex and dynamic with strong interdependencies between their human and ecological components. Their management has become more difficult as scale, impacts and consequences have increased and local communities have become increasingly involved. Increasing pressures from tourism have added to this management complexity. Complex adaptive systems thinking, and especially the metaphor of the adaptive cycle (Holling 2001), can potentially enhance our understanding of these resource systems, including national parks. The concept of the adaptive cycle can help understand changes over time in a system such as a national park. In this study, the concept of capital helped to understand the relationships, changes and interactions (Walker and Salt 2006) between tourism associated with Purnululu National Park and the Warmun community. Specific objectives of the study were to describe the opportunities and barriers to local involvement in protected area tourism, and analyse these using the concept of ‘capital’. An ethnographic approach emphasising ‘lived-in’ experience and the explicit consideration of context guided the inquiry (Tedlock 2000). Repeat semi-structured interviews were used to investigate local community perceptions of tourism in Purnululu and their place in it. Geographical ideas of community – occupying a discrete spatial location and centred on the Park – were adopted as the most appropriate unit of analysis for this research. The rationale behind this choice was the localised nature of Park tourism and the assumption that communities adjacent to Purnululu would be well placed to engage with Park tourism. For cultural reasons the sample consisted of sixteen elders and their immediate family members with authority to discuss the Purnululu area. Questions sought local Aboriginal perceptions of the importance of and ways in which the Park and tourism were beneficial or had a negative impact on the community. This ethnographic approach revealed that tourism created opportunities for local people through patronage of local businesses, including a community-owned roadhouse and art gallery. These two venues hosted most of the interactions between locals and tourists. Passing tourist trade was a crucial source of income for many community members, representing a key benefit afforded by Park tourism. Direct employment within the Park was a further benefit. Tourist patronage and direct employment represent an opportunity for enhancing the financial, social and human capital of local people. However, both of these were limited in extent. Respondents recognised the potential but unrealised opportunities available to them through cultural tourism, such as guided Park tours or welcome to country ceremonies. Barriers to local involvement in Park tourism included the lack of money for the Park managers to employ local people (i.e. inadequate financial capital) as well as limited skills (i.e. inadequate human and social capital). Many respondents, however, appeared content to remain separate from Park tourism. This was often linked to a ‘lack of motivation’. Lack of motivation may be viewed in two ways. Firstly, in terms of limited human and social capital, which includes the skills, knowledge and networks needed to successfully engage in Park tourism. Secondly, lack of engagement is a cultural choice and should not be interpreted as a lack of motivation or a concern related to social capital. Results indicated that several avenues existed through which locals engaged with Park tourism, leading to increased income. Social and human capital was also built to some degree. However, the ability to develop relations further was constrained by limits in local human, social and financial capital. These limited stores of capital potentially translate into a reduced capacity to adapt. Overall, findings suggest that the local Aboriginal community lacks adaptive capacity and is stuck in a ‘poverty trap’ (Carpenter and Brock 2008). External inputs, such as investments in skills development and education, are potentially important means for building local human and financial capital. Such investments could increase the capacity of local Aboriginal people to adapt to change, thereby breaking the poverty trap.

'Yuta Gonydjuy (The New Wax)' is a children's story written by Kathy Guthadjaka, an Indigenous Elder from Gawa, Elcho Island, northeast Arnhem Land in the Northern Territory. 'Yuta Gonydjuy' has been illustrated and published in both Warramiri and English via the bilingual Literature Production Centre at Galiwin'ku, in 1998. There is also a digital, interactive version of the story, and it is available online (as alphabetic text only) as part of the 'Living Archive of Aboriginal Languages' (2015). 'Yuta Gonydjuy' is an allegorical parable with both traditional Yolnju and Christian themes, and considering the 'transculturation' history and ontological priorities of the Warramiri Yoltu, 'Yuta Gonydjuy' is a most appropriate text. Furthermore, the potential for 'Yuta Gonydjuy' to be utilised within a 'Lonydju'yirr' (aligning side-by-side) multiliteracy approach at Gawa is compelling and offers fresh insight into a generative, 'bothways' Yoltu pedagogy.

The Australian Broadcasting Corporation's Country Hour radio programmes are produced regionally and promote specific understandings of rurality. This article presents an analysis that shows Indigenous people and issues are rarely sources or topics in Country Hour, and that stories about Indigenous land use are generally broadcast only if the land is used in a way that is seen as 'productive' through settler colonial eyes. It also argues the programme should include Indigenous voices and understandings of the land in imagining this space. It makes a theoretical contribution to media studies by extending on concepts of the 'rural imaginary' and 'settler common sense' to argue that the programme perpetuates a discourse that legitimates and valorises the use of 'rural' space for non-Indigenous people, concepts and activities. Indigenous people are noticeably absent and silent. Country Hour is therefore conceptualised as a media space that continues to transmit settler colonialism and its attendant myths.

Summary Background Remote Australian Aboriginal communities have among the highest diagnosed rates of sexually transmissible infections (STIs) in the world. We did a trial to assess whether continuous improvement strategies related to sexual health could reduce infection rates. Methods In this stepped-wedge, cluster-randomised trial (STIs in remote communities: improved and enhanced primary health care [STRIVE]), we recruited primary health-care centres serving Aboriginal communities in remote areas of Australia. Communities were eligible to participate if they were classified as very remote, had a population predominantly of Aboriginal people, and only had one primary health-care centre serving the population. The health-care centres were grouped into clusters on the basis of geographical proximity to each other, population size, and Aboriginal cultural ties including language connections. Clusters were randomly assigned into three blocks (year 1, year 2, and year 3 clusters) using a computer-generated randomisation algorithm, with minimisation to balance geographical region, population size, and baseline STI testing level. Each year for 3 years, one block of clusters was transitioned into the intervention phase, while those not transitioned continued usual care (control clusters). The intervention phase comprised cycles of reviewing clinical data and modifying systems to support improved STI clinical practice. All investigators and participants were unmasked to the intervention. Primary endpoints were community prevalence and testing coverage in residents aged 16–34 years for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. We used Poisson regression analyses on the final dataset and compared STI prevalences and testing coverage between control and intervention clusters. All analyses were by intention to treat and models were adjusted for time as an independent covariate in overall analyses. This study was registered with the Australia and New Zealand Clinical Trials Registry, ACTRN12610000358044. Findings Between April, 2010, and April, 2011, we recruited 68 primary care centres and grouped them into 24 clusters, which were randomly assigned into year 1 clusters (estimated population aged 16–34 years, n=11 286), year 2 clusters (n=10 288), or year 3 clusters (n=13 304). One primary health-care centre withdrew from the study due to restricted capacity to participate. We detected no difference in the relative prevalence of STIs between intervention and control clusters (adjusted relative risk [RR] 0·97, 95% CI 0·84–1·12; p=0·66). However, testing coverage was substantially higher in intervention clusters (22%) than in control clusters (16%; RR 1·38; 95% CI 1·15–1·65; p=0·0006). Interpretation Our intervention increased STI testing coverage but did not have an effect on prevalence. Additional interventions that will provide increased access to both testing and treatment are required to reduce persistently high prevalences of STIs in remote communities. Funding Australian National Health and Medical Research Council.

Storytelling is central to Aboriginal and Torres Strait Islander cultures in Australia. Aboriginal stories are communicated through various mediums; they are spoken in language, performed in dance and music, and communicated through visual arts. For Aboriginal people, the stories passed from generation to generation serve many purposes, including the sharing of spiritual narratives, cultural practices and landscapes, collective histories and life histories. Aboriginal stories are unique to country and nation and, prior to ‘the invasion’ (Langton 1996), there were between 200 to 500 different language groups around Australia with distinctive and unique cultures, identities, and beliefs. Given that only around 50 Aboriginal languages remain in contemporary Australia, the preservation of oral histories and traditional knowledges is essential to sustaining Aboriginal cultures and teachings. Tourism is one avenue through which Aboriginal stories can be shared. In this presentation, we tell the story of why an Aboriginal community in remote Australia sought to be involved in tourism, and how they engaged academic researchers to guide the development of a locally and culturally appropriate Indigenous tourism product. The Wagiman people of Pine Creek, a remote town in the Katherine region of the Northern Territory of Australia, possess distinct representations of culture, identity, and knowledge of country. Elders of the Wagiman community asked the researchers to initiate a project that recorded their stories, for the dual purpose of preserving Wagiman knowledges for future generations of Wagiman people, and to provide Wagiman interpretation of country for both non-Aboriginal residents of Pine Creek, and domestic and international visitors to the town. To this end, the Wagiman community worked closely with the researchers to create digital recordings of country, histories, language and culture over a series of extended fieldwork visits (McGinnis, Young and Harvey, 2016). Methodologically, an overarching goal of the Wagiman research project was to engage the Indigenous method of storytelling (Tuhiwai-Smith, 2012) in order to provide authentic interpretations of local knowledge. In particular, we engaged the practice of ‘yarning’ with Wagiman Elders to record their stories ‘on country’. Indigenising methodologies allowed for the sharing of stories in ways that can foster community identity, pride and empowerment (Foley 2015; Russell-Mundine 2012; Tuhiwai-Smith 2012). We report on the learnings of the researchers in working with Wagiman people, particularly the importance of relationship building and the formation of trust for engaging in culturally-appropriate tourism research that can educate and empower all stakeholders. The Aboriginal-led research resulted in digital options for Indigenous engagement in tourism, including websites, digital maps and mobile apps. The collection of local stories resulting from the research partnership with the community seeks to ensure the continuation of Wagiman teachings for the long-term. The tourism venture provides a case study of community driven research collaboration focused on self-determination for the Wagiman people in the sharing of their stories and the development of Indigenous tourism in Pine Creek.

Thesis (Ph.D.) -- New York University, 2005. Includes bibliographical references.

INTRODUCTION:Skin infections including scabies and impetigo have a high burden and cause significant morbidity in remote Aboriginal communities in Australia. Nevertheless, there is limited knowledge about community, healthcare practitioner and service provider perspectives on skin infections and treatment preferences. An increased understanding of their respective knowledge, attitudes and practices will contribute to improving healthcare seeking behaviour, improved diagnosis, treatment acceptability and quality of care within remote Aboriginal communities. The aim of this study was to explore Aboriginal parent/carer, healthcare practitioner, and service provider attitudes and practices regarding skin infections in Aboriginal communities in remote communities in the Pilbara, Western Australia. The study documents their perspectives and preferences regarding treatments for skin infections, as well as the perceived barriers and enablers to treatment uptake for scabies and impetigo amongst Aboriginal families in this region. METHODS:A qualitative study consisting of semi-structured interviews and focus group discussions was conducted with parents/carers, healthcare practitioners and community service providers in four remote communities in Western Australia. All interviews and focus group discussions were voice recorded and data were analysed using NVivo software and thematic analysis. RESULTS:Despite the high burden, skin infections were considered normal in these communities, and their impact on child health was under-recognised. Common themes identified by all participants included the inadequacy of health services, the pain of the benzathine penicillin G injection, uncertainty regarding the use of oral antibiotics and topical creams, and the need for health practitioner training and improved communication and resources. CONCLUSION:Documenting carer, service provider and healthcare practitioner perspectives on skin infections provides a more informed understanding of the context in which treatment decisions are made. The ongoing need for culturally appropriate targeted, translational health education; improved treatment guidelines and feasible, painless treatments; and potential for the use of bush medicines for skin infections were themes that emerged.

This chapter interrogates mobility as a site of freedom, ambivalence and hybridity within the framework of colonial settler/ Indigenous relationships in Central Australia, which is located in the imposed jurisdiction of the Northern Territory of Australia. It emerges from a suite of research projects on law, policing and mobility in Central Australia. The first research phase coincided with the 2007 Northern Territory Emergency Intervention ('the Intervention') designed to eradicate a perceived epidemic of family violence and child abuse through a massive increase in police numbers on remote Aboriginal communities. The second, from 2014 to the present, has focused on what we call Indigenous counter- mobilities. The first counter-mobility relates to community law and justice and involves place-based mobility strategies by Warlpiri women Elders to 'patrol' their own communities in order to enhance social and cultural well- being and to reduce inter-personal harms, which we view as a form of place- based sovereignty. The second relates to the vehicle itself as a necessary part of life in remote Australia and how it is being 'hybridized' and 'Indigenised' to reflect the cultural and economic realities of life in the remote outback. We see both, in their different guises, as being engaged in what South American theorists with an interest in Amerindian liberation call the politics of 'decoloniality' (see Escobar 2010 ; Maldonado-Torres 2011 ).

Background Hospitalisation with skin infection in Western Australian (WA) Aboriginal children is common, with the highest rates in infants and children from remote WA. Objective We aimed to quantify infant, maternal, and sociodemographic risk factors for skin infection hospitalisation in WA children, focussing on Aboriginal children aged <17 years. Methods We conducted a retrospective population-based cohort study with linked perinatal and hospitalisation data on WA-born children (1996-2012), of whom 31 348 (6.7%) were Aboriginal. We used Cox regression to calculate adjusted hazard ratios and associated population attributable fractions (PAFs) for perinatal factors attributed to first hospitalisation with skin infection. To identify specific risk factors for early-onset infection, we further restricted the cohort to infants aged <1 year. Results Overall, 5439 (17.4%) Aboriginal and 6750 (1.5%) non-Aboriginal children were hospitalised at least once with a skin infection. Aboriginal infants aged <1 year had the highest skin infection hospitalisation rate (63.2 per 1000 child-years). The strongest risk factors in Aboriginal children aged <17 years were socio-economic disadvantage, very remote location at birth, and multi-parity (≥3 previous pregnancies) accounting for 24%, 23%, and 15% of skin infection hospitalisations, respectively. Other risk factors included maternal age <20 years, maternal smoking during pregnancy, and low birthweight. Conclusions We have quantified the relative influence of perinatal risk factors associated with skin infection hospitalisations in WA children, providing measures indicating which factors have the potential to reduce the most hospitalisations. Our evidence not only supports existing calls for substantial government investment in addressing underlying social and environmental barriers to healthy skin in WA Aboriginal children but also identifies potential areas to target health promotion messaging at individuals/families on maternal smoking during pregnancy and skin hygiene for families.

This article describes the needs analysis, implementation and outcomes of a pilot program aimed at creating books with families in ways that represent their language and culture. Creating Books in Communities is part of Better Beginnings, a state-wide program, developed by the State Library of Western Australia, for children and their families, that aims to develop literacy skills through fostering a love of books and language. Literature about the importance of recognising and valuing home languages and culture in supporting early literacy learning and the impact of family literacy programs is explored to provide a background to the program. The process of Creating Books in Communities is described in detail—it involves collaboration between librarians, early childhood partners, and community based artists working with families to produce a high-quality book. The impact of the program is explored through the voices of all the participants, revealing a number of positive family and community outcomes. We conclude the article by identifying six key factors related to the success of the program, which can be used as guidelines for implementation of the program both nationally and internationally.

In the 1980s, Indigenous Aboriginal women in Australia began to agitate against liquor outlets perceived as affecting the remote communities in which they lived, and mobilized in a series of fluid grassroots public demonstrations against alcohol availability. The women supported dry zones, local prohibition, and abstinence and were opposed to reforms designed to improve drinking places and promote ?social? drinking. In these and many other ways, Aboriginal women?s activism and ideology resembled that of the Woman?s Christian Temperance Union (WCTU) in Australia decades earlier, despite there being no direct influence from the WCTU. This article explores the commonalities in the tactics and strategies deployed by these ?old? and ?new? temperance movements and argues that for Aboriginal women, their dissent necessitated a complex negotiation around the social and cultural norms of their society.

This paper draws on our experience as evaluators of the Aboriginal Mental Health Worker Program that has been operating in eight remote communities across the Top End of the Northern Territory, Australia, for over four years. The program aimed to fund the placement of Aboriginal Mental Health Workers (AMHWs) in remote community health centres, to work under the clinical leadership of General Practitioners and to contribute to development of a culturally appropriate community based mental health care service for Indigenous people. In this paper, we examine the key features of the AMHW program and the originating partnership, the degree of integration of AMHWs in health centre processes and the provision of support for the development of the AMHW role in community mental health work. While there are many examples in this program of AMHWs providing highly valued services within their communities, the evaluation showed that the program did not achieve clear commitments to develop mental health practice around the AMHWs? role. In addition there was variability in levels of local managerial support for the AMHWs, vulnerability to staff turnover and other discontinuities, as well as tensions in views about what the role of the AMHWs should be. Should it be culturally informed, clinically-related mental health work or community ?wellbeing work?, and how should each role be supported? Together these factors undermined the sustainability of positive achievements within the program.

Australia is free of canine rabies, however northern regions – such as the Northern Peninsula Area (NPA), Queensland – are at risk of an incursion from nearby rabies-infected Indonesian islands. Early detection and reactive vaccination is the current Australian policy to eradicate an incursion. Early detection in this region is challenging, so pre-emptive vaccination might be an effective strategy. The NPA dog population also has a heterogenous contact structure, with three roaming categories previously characterised, which could be exploited in targeted pre-emptive vaccination strategies for more efficient use of limited resources. To evaluate the effectiveness of a pre-emptive vaccination program, an agent-based rabies spread simulation model was used to simulate outbreaks with a range of pre-emptive vaccination coverages. Increasing proportions (10% increments) of the dog population randomly vaccinated were modelled, and at the most efficient random vaccination coverage we then explored 10 pre-emptive vaccination strategies targeting different dog roaming categories (whilst maintaining the same overall population level vaccination coverage). All pre-emptive vaccination strategies were simulated 2000 times without and with a 70% random reactive vaccination strategy, following rabies detection. All random pre-emptive vaccination coverages reduced outbreak size and duration compared to no pre-emptive vaccination. A 40% random coverage was most efficient. Targeted strategies that pre-emptively vaccinated proportionally more roaming dogs were more effective than a random 40% vaccination coverage and strategies that targeted non-roaming dogs. The pre-emptive vaccination strategies that targeted non-roaming dogs produced significantly larger and longer outbreaks. These results suggest that pre-emptive vaccination can reduce potential rabies outbreaks in this region and that such a strategy should not just focus on easily accessible dogs that do not roam often or at all. A cost-benefit analysis is required to determine whether the implementation of such pre-emptive vaccination strategies is also cost-effective, which is essential in the resource-poor communities of this region.

INTRODUCTION:Despite being one of the most avoided topics of all time, death is a guaranteed eventuality for us all. However, quality psychosocial care as death approaches is not a guarantee. Where people reside is likely to impact a person's accessibility to quality psychological, emotional, social, spiritual and cultural support. Structural forces such as funding and resourcing will also be a contributing factor. Social workers have specific expertise in the psychosocial domain, yet enablers and inhibitors to social work referrals to support terminally ill clients in rural and remote communities have not been well explored. This study had two primary aims: to investigate the provision of psychosocial care for palliative clients in rural Australian communities and to identify barriers and facilitators of social work referrals to address psychosocial concerns for palliative care clients. METHODS:Qualitative interviews were conducted with 38 rural participants across 24 rural and remote communities in the state of Queensland, Australia. The researcher travelled 7500 km to conduct these interviews over a 5-week period. The Rural, Remote, Metropolitan Areas classifications provided guidance on determining which communities would be considered regional, rural or remote communities. To explore the aims of the study, four participant groups were selected to participate in semi-structured qualitative interviews: group 1, social workers; group 2, community health nurses; group 3, community workers; and group 4, palliative clients/carers. For a comprehensive analysis, it was important to not only hear the views of those addressing psychosocial needs, but also include the voices of those receiving psychosocial care, resulting in all perspectives being captured. A thematic analysis was utilised, from which prominent, recurring themes were identified to form the basis for recommendations for future psychosocial care provision. RESULTS:Findings revealed that psychosocial needs for terminally ill clients were addressed in an ad-hoc, inconsistent manner across rural and remote Queensland. Eligibility and access for palliative care program funding impacted service delivery and what support could be provided. Furthermore, social workers were limited in what they could offer due to the vast geographical distances, which inhibited quality face-to-face interventions and the capacity to address urgent psychosocial concerns. This resulted in community nurses assuming the role that social workers would usually undertake in more urban settings. In communities where a generalist social worker was employed, referrals were often impacted by the perceptions of other professionals of social work competencies. Finally, the results highlighted that a disparity exists between the perspectives of palliative care clients and their caregivers and understanding of healthcare professionals of what were identified as important psychosocial concerns. CONCLUSIONS:Palliative care funding in Queensland is insufficient to effectively address the existing demand. Resourcing for rural and remote palliative care in Queensland is inadequate to ensure holistic and quality approaches to psychosocial care in the end stages of life. Increased resourcing would result in better care, for longer time frames throughout a disease trajectory. Education and training for health practitioners to address skills and competencies in psychosocial care for terminally ill clients is a recommendation for professional development. Furthermore, there is a need for social work to develop national standards and competencies to enhance practitioner confidence to efficiently address psychosocial concerns for terminally ill clients. Whilst this study was undertaken in Queensland, Australia, the findings are echoed in other international rural communities.

Introduction Skin is important in Australian Aboriginal culture informing kinship and identity. In many remote Aboriginal communities, scabies and impetigo are very common. Untreated skin infections are painful, itchy and frequently go untreated due to under-recognition and lack of awareness of their potential serious complications. We hypothesise that the skin infection burden in remote Aboriginal communities can be reduced by implementing streamlined training and treatment pathways integrated with environmental health and health promotion activities, tested in the See, Treat, Prevent (SToP skin sores and scabies) trial.Methods and analysis SToP will evaluate a skin control programme using a stepped-wedge, cluster randomised trial design with three intervention components (the ‘SToP activities’): (1) seeing skin infections (development of training resources implemented within a community dermatology model); (2) treating skin infections (employing the latest evidence for impetigo, and scabies treatment); and (3) preventing skin infections (embedded, culturally informed health promotion and environmental health activities). Four community clusters in the remote Kimberley region of Western Australia will participate. Following baseline data collection, two clusters will be randomly allocated to the SToP activities. At 12 months, the remaining two clusters will transition to the SToP activities. The primary outcome is the diagnosis of impetigo in children (5–9 years) at school-based surveillance. Secondary outcome measures include scabies diagnosis, other child health indicators, resistance to cotrimoxazole in circulating pathogenic bacteria, determining the economic burden of skin disease and evaluating the cost effectiveness of SToP activities.Ethics and dissemination This study protocol was approved by the health ethics review committees at the Child and Adolescent Health Service (Approval number RGS0000000584), the Western Australian Aboriginal Health Ethics Committee (Reference number: 819) and the University of Western Australia (Reference RA/4/20/4123). Study findings will be shared with community members, academic and medical communities via publications and presentations, and in reports to funders. Authorship for all publications based on this study will be determined in line with the Uniform Requirements for Manuscripts Submitted to Biomedical Journals published by the International Committee of Medical Journal Editors. Sharing results with organisations and communities who contributed to the study is paramount. The results of the SToP trial will be shared with participants in a suitable format, such as a single summary page provided to participants or presentations to communities, the Kimberly Aboriginal Health Planning Forum Research Subcommittee and other stakeholders as appropriate and as requested. Communication and dissemination will require ongoing consultation with Aboriginal communities to determine appropriate formats.

This paper reports on the ethnobotany of Eucalyptus pachyphylla F.Muell. (Myrtaceae) (Pintupi name warrilyu), an understudied Eucalyptus species with a distribution largely restricted to the Gibson Desert region of Western Australia and the southern Northern Territory. Seeds of this and certain other Eucalyptus species were traditionally consumed as uncooked “seed pastes” by desert Aboriginal peoples (Cane 1987; Gillen 2017; Johnstone and Cleland 1943; Latz 2018; Roth 1897; Walsh and Douglas 2011). However, unfortunately, as with many other arid zone seed foods that were utilized intermittently depending on seasonal availability, there seems to be little or no written record of the specific techniques used to process E. pachyphylla seeds. Moreover, the nutritional status of the seeds is unknown.

Rural mental health outcomes have been persistently poorer than those in larger cities suggesting that the prevailing investments to improve matters are not working. Mental health researchers and service providers from New South Wales, Victoria, Western Australia and the Australian Capital Territory met in Orange in October 2018 to explore issues pertaining to rural mental health and well-being. The group recognised and acknowledged that rural residents experience a series of interconnected geographical, demographic, social, economic and environmental challenges which are not addressed adequately by the current mix of services. This declaration has been endorsed by those listed below and we welcome further support. We list ten interrelated problems and ten solutions. As a group, we take this declaration as an opportunity to invite discussion about how we can collectively improve the mental health of rural residents through research, service design and delivery. We invite the reader to consider endorsing this declaration. A short summary of supporting evidence is available online at https://www.crrmh.com.au/.

Fetal alcohol spectrum disorder (FASD) is a highly prevalent neurodevelopmental disorder associated with prenatal alcohol exposure. Early identification can improve functioning for individuals and reduce costs to society. Gold standard methods of diagnosing FASD rely on specialists to deliver intensive, multidisciplinary assessments. While comprehensive, prevalence rates highlight that this assessment model cannot meet demand, nor is it feasible in remote areas where specialist services are lacking. This project aims to expand the capabilities of remote practitioners in north Queensland, Australia, where 23–94% of the community identify as First Nations people. Integrating cultural protocols with the implementation science theories of Knowledge-To-Action, Experience-Based Co-Design, and RE-AIM, remote practitioners with varying levels of experience will be trained in a co-designed, culturally appropriate, tiered neurodevelopmental assessment process that considers FASD as a potential outcome. This innovative assessment process can be shared between primary and tertiary health care settings, improving access to services for children and families. This project aims to demonstrate that neurodevelopmental assessments can be integrated seamlessly with established community practices and sustained through evidence-based workforce development strategies.

Many small communities across the vast interior of Australia are under pressure from ongoing rural restructuring and a long-running drought. Socioeconomic indicators suggest that rural people are significantly disadvantaged by comparison with their urban counterparts. While these factors are evident, less well understood are the circumstances of rural and remote young people. In this article we draw on research conducted in 2001 and 2004 on the employment and educational experiences of young people in these communities. Using Reimer's typology of relations associated with social exclusion ? market, bureaucratic, associative and communal ? we indicate that rural and remote young people are experiencing rising levels of social exclusion. Their access to education and employment is restricted through no fault of their own, and is in fact, obstructed by government policy. The need for sensitive policy to increase the social inclusion of young people in rural and remote areas is evident.

In this chapter, I home in on the last issue of anticipated labour mobility for employment as the least likely option for the Aboriginal people with whom I have worked over the past four decades in very remote localities where there are few or no paid jobs. I know one place, an outstation in western Arnhem Land in the Northern Territory called Mumeka, extremely well. I lived there in 1979 and 1980 and have visited almost every year since. Much of my work as an anthropologist has been with people who constitute a community defined, in part, by their traditional ownership of the area around Mumeka and, in part, by their shared use of Kuninjku, a dialect of a regional pan-dialectical language called Bininj Kunwok.2 The only paid employment at Mumeka for a long time now has been for a teaching assistant. To get paid employment, Mumeka residents have either to migrate to the nearby township of Maningrida, where there are few available jobs, or further afield, or somehow economically develop their outstation and surrounds to generate jobs.I begin this chapter by revisiting some observations on a brief visit to Mumeka in July 2012 that, six years on, I interpret as a pivotal moment when I saw a particular form of economic development being introduced. I have made several presentations between 2012 and 2014 using this ethnographic material but, for a variety of reasons that will become apparent as the narrative unfolds, including disbelief at what I was observing, I have not published this material until now.3I commence with an observation about remote development for employment and then try to make some analytic sense of this. I look to provide some historical and regional contexts for what I saw. I then explore Kuninjku regimes of work under colonial conditions and in the postcolonial present, and examine some possible explanatory theories for interpreting a form of recolonisation that is occurring in the name of modernising development and employment creation. I end with a postscript that provides a brief update of the consequences that have unfolded since that pivotal moment to which I now turn.

Objective: The aim of this paper is to indicate how online cognitive behavioural therapy (CBT) training for rural and remote health professionals can enhance access to evidence-based treatments in rural communities and address psychotherapy training shortfalls for rural practitioners treating Australians with high prevalence psychological disorders.Conclusions: Issues of cost, distance and disruption to services have meant that, until now, it has been very difficult to provide really effective training in evidence-based therapies (in the main, CBT) for Australian rural and remote health professionals. The recent development of online CBT training provides new opportunities. Online training, supplemented by regular supervision, can fulfil many of the functions of face-to-face training at significantly reduced cost. While face-to-face residential workshops will still be necessary to embed new skills, we estimate that online training can reduce the face-to-face time required by at least 50%.

Increased focus and attention has been paid in recent years to providing remote Aboriginal and Torres Strait Islander students with access to high quality schooling opportunities. Often, this requires attendance at secondary schooling away from their hometowns or communities, through accessing boarding schools or residential programs. The stated intents of many of these boarding programs often follow themes of providing equitable opportunities for education, improving opportunities for year 12 completion, increasing participation in further and higher education, and improving employment prospects. However, despite a growing body of qualitative-based research on the expectations, transitions and experiences of Aboriginal and Torres Strait Islander students and families engaging with boarding schools, the outcomes of this education are largely unidentified or reported. This paper draws on the work and experiences of a number of authors who have had varied roles as researchers or practitioners in boarding schools and remote education systems. It aims to synthesise findings from studies conducted on boarding in the past 10 years, and through a collaborative process, explore a range of theoretical approaches that may aid in examining the causal pathways and accompanying mechanisms contributing to boarding school outcomes. In doing so, we propose key areas and directions for future research in this field to inform future and practice.

In the past decade growing numbers of privately operated child care centres have been established as a result of encouragement by government. Although extensive study about centre management and leadership issues has been undertaken there exists a gap in research about the performance of centres from a viability perspective.Therefore, this paper extends knowledge and understanding about successful centre operation and considers the obstacles that hinder performance. A theoretical business performance framework is utilised to discuss the findings from a research project conducted Australia-wide. The study serves to clarify relevant issues in an effort to inform centre managers and policy-makers about what is needed to support the development of viable child care services.

Roebourne, or what the Ngarluma people call Ieramugadu, is the oldest township established in 1866 as a ‘non-Aboriginal town’ in the remote Pilbara region of Western Australia (Edmunds 2012). It is some 1,500 kilometers north on the North West Coastal Highway from Perth, one of the most isolated large cities in the world.1 The Pilbara is home to about 50,000 people, most of whom live in and around small urban centers like Roeburne, Port Hedland, Karratha and Newman.