Aboriginal community control and decolonizing health policy : a yarn from Australia

This chapter outlines: a brief history of Australian Aboriginal health and health policy and then moves on to demonstrate how the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) undertakes its work and is an example of 'decolonizing policy in action'. Moreover, it highlights how Aboriginal participation in the development of policy and in the planning, delivery, management and evaluation of health programs enables policies and programs to respond effectively to the needs of Aboriginal people and to change future health outcomes for them. It showcases how Aboriginal decision-making has gone some way to decolonizing policymaking and has addressed the power imbalance - both of which have been critical in the improvement in Aboriginal health outcomes.

Aboriginal public health and education : has it made a difference in practice?

Over the years, public health in relation to Australian Aboriginal people has involved many individuals and groups including health professionals, governments, politicians, special interest groups and corporate organisations. Since colonisation commenced until the1980s, public health relating to Aboriginal and Torres Strait Islander people was not necessarily in the best interests of Aboriginal and Torres Strait Islander people, but rather in the interests of the non-Aboriginal population. The attention that was paid focussed more generally around the subject of reproduction and issues of prostitution, exploitation, abuse and venereal diseases (Kidd, 1997). Since the late 1980s there has been a shift in the broader public health agenda (see Baum, 1998) along with public health in relation to Aboriginal and Torres Strait Islander people (NHMRC, 2003). This has been coupled with increasing calls to develop appropriate tertiary curriculum and to educate, train, and employ more Aboriginal and Torres Strait Islander and non-Aboriginal people in public health (Anderson et al., 2004; Genat, 2007; PHERP, 2008a, 2008b). Aboriginal and Torres Strait Islander people have been engaged in public health in ways in which they are in a position to influence the public health agenda (Anderson 2004; 2008; Anderson et al., 2004; NATSIHC, 2003). There have been numerous projects, programs and strategies that have sought to develop the Aboriginal and Torres Strait Islander Public Health workforce (AHMAC, 2002; Oldenburg et al., 2005; SCATSIH, 2002). In recent times the Aboriginal community controlled health sector has joined forces with other peak bodies and governments to find solutions and strategies to improve the health outcomes of Aboriginal and Torres Strait Islander peoples (NACCHO & Oxfam, 2007). This case study chapter will not address these broader activities. Instead it will explore the activities and roles of staff within the Public Health and Research Unit (PHRU) at the Victorian Aboriginal Community Controlled Health Organisation (VACCHO). It will focus on their experiences with education institutions, their work in public health and their thoughts on gaps and where improvements can be made in public health, research and education. What will be demonstrated is the diversity of education qualifications and experience. What will also be reflected is how people work within public health on a daily basis to enact change for equity in health and contribute to the improvement of future health outcomes of the Victorian Aboriginal community.

How I became the first Aboriginal person in Australia to lead a national education organisation

In this paper, Bronwyn Fredericks reflects on how, in 1997, she became the National President of the Council of Australian Postgraduate Associations Inc. (CAPA). The paper describes the election process faced by Fredericks, and identifies some of her key achievements during her time as National President. In becoming the National President, Bronwyn became the first Aboriginal person in Australia to lead a national education organisation. The story within this paper is told from the author’s autobiographical memory, drawing on the cultural, social and political context in which the story and the author were (and are) situated (Wojecki 2007). In this way the story teller reveals story lines which have not previously been articulated (Wojecki 2007). Throughout this paper, Fredericks ‘re-stories’ her experiences of leadership.

Teaching to the middle in Australia : four teachers tell their stories

This chapter explores the perceptions of middle years specialist teachers in the contemporary Australian schools context. Written narratives were obtained from 4 Australian teachers. Each has followed distinctly different paths to teaching in the middle years. However, each has a high leadership profile in the general schooling sector assumed relatively early in their professional careers. These teachers were asked about their entry into teaching, the pathways they pursued to teaching at the middle level, opportunities and limitations experienced for them in schools, and their conceptions of the future of middle years reforms in Australia.

Paediatric spinal deformity research at the Mater Children's Hospital, Brisbane, Australia.

The Paediatric Spine Research group was formed in 2002 to perform high quality research into the prevention and management of spinal deformity, with an emphasis on scoliosis. The group has successfully built collaborative bridges between the scientific and research expertise at QUT, and the clinical skills and experience of the spinal orthopaedic surgeons at the Mater Children’s Hospital in Brisbane. Clinical and biomechanical research is now possible as a result of the development of detailed databases of patients who have innovative and unique surgical interventions for spinal deformity such as thoracoscopic scoliosis correction, thoracoscopic staple insertion for juvenile idiopathic scoliosis and minimally invasive growing rods. The Mater in Brisbane provides these unique datasets of spinal deformity surgery patients, whose procedures are not being performed anywhere else in the Southern Hemisphere. The most detailed is a database of thoracoscopic scoliosis correction surgery which now contains 180 patients with electronic collections of X-Rays, photographs and patient questionnaires. With ethics approval, a subset of these patients has had CT scans, and a further subset have had MRI scans with and without a compressive load to simulate the erect standing position. This database has to date contributed to 17 international refereed journal papers, a further 7 journal papers either under review or in final preparation, 53 national conference presentations and 35 international conference presentations. Major findings from selected journal publications will be presented. It is anticipated that as the surgical databases grow they will continue to provide invaluable clinical data which will feed into clinically relevant projects driven by both medical and engineering researchers whose findings will benefit spinal deformity patients and scientific knowledge worldwide.

A policy case study of blood in Australia

In 2008 the Australian government decided to remove white blood cells from all blood products. This policy of universal leucodepletion was a change to the existing policy of supplying leucodepleted products to high risk patients only. The decision was made without strong information about the cost-effectiveness of universal leucodepletion. The aims for this policy analysis are to generate cost-effectiveness data about universal leucodepletion, and to add to our understanding of the role of evidence and the political reality of healthcare decision-making in Australia. The cost-effectiveness analysis revealed universal leucodepletion costs $398,943 to save one year of life. This exceeds the normal maximum threshold for Australia. We discuss this result within the context of how policy decisions are made about blood, and how it relates to the theory and process of policy making. We conclude that the absence of a strong voice for cost-effectiveness was an important omission in this decision.

Public participation, values and interests in the procurement of infrastructure projects in Australia : a review and future research direction

In many countries, the main providers for major infrastructure projects are government or public agencies. Public infrastructure projects includes economic and social infrastructure such as transportation, education and health facilities. Most decision-making models for delivery of public infrastructure projects are heavily weighted towards financial/economic factors. In Australia, public participation is an essential instrument in the procurement of infrastructure and development within Australia. This study reviews the public participation, values and interests in the procurement of infrastructure projects in Australia, and identifies the research direction in this research area in order to improve the decision-making models that capture stakeholder social, economical and environmental concerns in infrastructure projects.

Householder experiences with resource monitoring technology in sustainable homes

The use of feedback technologies, in the form of products such as Smart Meters, is increasingly seen as the means by which 'consumers' can be made aware of their patterns of resource consumption, and to then use this enhanced awareness to change their behaviour to reduce the environmental impacts of their consumption. These technologies tend to be single-resource focused (e.g. on electricity consumption only) and their functionality defined by persons other than end-users (e.g. electricity utilities). This paper presents initial findings of end-users' experiences with a multi-resource feedback technology, within the context of sustainable housing. It proposes that an understanding of user context, supply chain management and market diffusion issues are important design considerations that contribute to technology 'success'.

Geographical information systems : an effective planning and decision-making platform for community health coalitions in Australia

The development of locally-based healthcare initiatives, such as community health coalitions that focus on capacity building programs and multi-faceted responses to long-term health problems, have become an increasingly important part of the public health landscape. As a result of their complexity and the level of investment, it has become necessary to develop innovative ways to help manage these new healthcare approaches. Geographical Information Systems (GIS) have been suggested as one of the innovative approaches that will allow community health coalitions to better manage and plan their activities. The focus of this paper is to provide a commentary on the use of GIS as a tool for community coalitions and discuss some of the potential benefits and issues surrounding the development of these tools.

Biomass burning influenced particles characteristics in Northern Territory Australia based on airborne measurements

Airborne measurements of particle number concentrations from biomass burning were conducted in the Northern Territory, Australia, during June and September campaigns in 2003, which is the early and the late dry season in that region. The airborne measurements were performed along horizontal flight tracks, at several heights in order to gain insight into the particle concentration levels and their variation with height within the lower boundary layer (LBL), upper boundary layer (UBL), and also in the free troposphere (FT). The measurements found that the concentration of particles during the early dry season was lower than that for the late dry season. For the June campaign, the concentration of particles in LBL, UBL, and FT were (685 ± 245) particles/cm3, (365 ± 183) particles/cm3, and (495 ± 45) particle/cm3 respectively. For the September campaign, the concentration of particles were found to be (1233 ± 274) particles/cm3 in the LBL, (651 ± 68) particles/cm3 in the UBL, and (568 ± 70) particles/cm3 in the FT. The particle size distribution measurements indicate that during the late dry season there was no change in the particle size distribution below (LBL) and above the boundary layer (UBL). This indicates that there was possibly some penetration of biomass burning particles into the upper boundary layer. In the free troposphere the particle concentration and size measured during both campaigns were approximately the same.

On-board mass monitoring of heavy vehicles : results of testing program

The Transport Certification Australia on-board mass feasibility project is testing various on-board mass devices in a range of heavy vehicles (HVs). Extensive field tests of on-board mass measurement systems for HVs have been conducted during 2008. These tests were of accuracy, robustness and tamper-evidence of heavy vehicle on-board mass telematics. All the systems tested showed accuracies within approximately +/- 500 kg of gross combination mass or approximately +/- 2% of the attendant weighbridge reading. Analysis of the dynamic data also showed encouraging results and has raised the possibility of use of such dynamic information in tamper evidence in two areas. This analysis was to determine if the use of averaged dynamic data could identify potential tampering or incorrect operating procedures as well as the possibility of dynamic measurements flagging a tamper event by the use of metrics including a tampering index (TIX). Technical and business options to detect tamper events will now be developed during implementation of regulatory OBM system application to Australian heavy vehicles (HVs).