84 resultados para Non-Indigenous Patients


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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.

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This brief presentation will commence to address a number of emerging questions that are underpinned by the current NCCARF research project: Understanding Urban and Peri‐urban Indigenous People’s vulnerability and adaptive capacity to Climate Change. In terms of climate change adaptation barriers, options and priorities, what are the major considerations for indigenous communities residing in coastal peri-urban and urban places that may differ from those of their non-indigenous counterparts and possibly from Indigenous communities living away from the coasts? It will speculate on whether these considerations can be addressed through existing planning and management frameworks.

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This introductory essay situates this special issue's concerns in the context of Indigenous cultural centre design in settler-colonial Australia. Given the very small number of Indigenous architects in Australia, architectural facilities for Indigenous communities are routinely designed by non-indigenous architects. The implications of this are significant. Given the often complex social, historical and political ambitions that are invested in the construction of Indigenous cultural centres, and their frequent intention to represent a broad Indigenous constituency, can non-indigenous architectural and spatial practice ever realize these? As a way into this question, the essay surveys postcolonial and architectural scholarship that explores the spatialization of setter-colonial politics and the distinct place-making traditions of Indigenous and non-indigenous Australians. The making of place in the Australian city is an ongoing force of conflict, assertion, exclusion and forgetting, but it is also central to the realization of a possible post-colonial state in which no one ‘centre’ can ever stabilize and resolve questions of legitimacy and power. Instead, such a centre might hold these questions in tension and as questions in common, which would mean a new foundation for the making of place.

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This research discerned and analysed the politics of non-Indigenous solidarity with Indigenous struggles in southeast Australia, producing a valuable resource for present and future generations of non-Indigenous activists. The research responds to Indigenous people’s challenges and attempts to draw non-Indigenous people into consideration of self-understanding, interests and complicity.

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Kunib-dji live in Maningrida, a remote community in the Northern Territory and speak Ndj-bbana as their preferred language of communication. Kunib-dji are one of many groups of Indigenous Australian languages who speak a minority language. Very little has been documented about the social practices of literacy with speakers of such languages, particularly with the texts that mediate these languages. Knowing about the beliefs and attitudes towards enacted by these speakers towards these texts is useful for understanding the process of learning of minority and majority languages. This paper presents a middle approach to literacy as distinct form top-down and bottom-up approaches, that has emerged from the minority Indigenous Australian language context in Maningrida. The proposed middle approach to literacy incorporates non-indigenous intervention in Indigenous social practices and technological transform of Indigenous texts. The methodological aspects of such intervention and transformation together with the implications of a middle approach to literacy are presented in this paper. Throughout the paper references are made to Kunib-dji children's access to digital Ndj-bbana texts and their engagement with these texts in a home environment.

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Increasingly planning practice and research are having to engage with Indigenous communities in Australia to empower and position their knowledge in planning strategies and arguments. But also to act as articulators of their cultural knowledge, landscape aspirations and responsibilities and the need to ensure that they are directly consulted in projects that impact upon their ‘country’ generally and specifically. This need has changed rapidly over the last 25 years because of land title claim legal precedents, state and Commonwealth legislative changes, and policy shifts to address reconciliation and the consequences of the fore-going precedents and enactments. While planning instruments and their policies have shifted, as well as research grant expectations and obligations, many of these Western protocols do not recognise and sympathetically deal with the cultural and practical realities of Indigenous community management dynamics, consultation practices and procedures, and cultural events much of which are placing considerable strain upon communities who do not have the human and financial resources to manage, respond, co-operate and inform in the same manner expected of non-Indigenous communities in Australia. This paper reviews several planning formal research, contract research and educational engagements and case studies between the authors and various Indigenous communities, and highlights key issues, myths and flaws in the way Western planning and research expectations are imposed upon Indigenous communities that often thwart the quality and uncertainty of planning outcomes for which the clients, research agencies, and government entities were seeking to create.

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The health outcomes for Indigenous peoples are well publicised as being poorer than that of the rest of the Australian population. The importance of physical activity as part of a balanced approach to health and wellbeing are well documented. Physical inactivity is a significant risk factor for many preventable diseases that many non-Indigenous, but specifically more Indigenous peoples die from. A recent report on Indigenous health indicated that only 23% of adults living in remote and very remote areas, such as Cape York, participated in regular physical activity. Physical activity initiatives in remote Indigenous communities on Cape York are commonly delivered by external agencies that ‘fly in and fly out’. While members of Indigenous communities may engage with the initiatives while they are being provided once the external agencies leave some of the benefits made may be quickly lost. There is no current published literature on the variety, prevalence and outcomes of ‘fly-in fly-out’ physical activity programs, or on the agencies that provide them. An understanding of these factors would facilitate a better understanding of the opportunities available to Indigenous communities on Cape York and provide important foregrounding to an investigation of community capacity for physical activity. The purpose of this study was to investigate the range of physical activity programs being offered by external agencies to Indigenous Cape York communities.

Methods: Five physical activity agencies that routinely engaged with Indigenous communities on Cape York were interviewed. The semi-structured interviews focussed on what activities were being conducted; by whom; when; and their concomitant outcomes. Interviews were recorded and professionally transcribed. Transcriptions were then analysed using content analysis to identify themes.

Results: Each physical activity agency had a variety of ways of engaging with community. The key initial focus point for each provider was the local school. Contacts within the school and opportunities to provide workshop opportunities for the students then facilitated wider community engagement.

Discussion: There were limited opportunities for these agencies to build community capacity to maintain their physical activities due to a variety of reasons that included: resources (both human and material); transient populations and an entrenched culture of ‘having things done to’ rather than with Indigenous people. In order to improve the physical activity outcomes of Indigenous people on Cape York community’s strategies that engage and empower the local population to take control of their needs should be employed.

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Background
Indigenous Australians suffer a disproportionate burden of preventable chronic disease compared to their non-Indigenous counterparts – much of it diet-related. Increasing fruit and vegetable intakes and reducing sugar-sweetened soft-drink consumption can reduce the risk of preventable chronic disease. There is evidence from some general population studies that subsidising healthier foods can modify dietary behaviour. There is little such evidence relating specifically to socio-economically disadvantaged populations, even though dietary behaviour in such populations is arguably more likely to be susceptible to such interventions.

This study aims to assess the impact and cost-effectiveness of a price discount intervention with or without an in-store nutrition education intervention on purchases of fruit, vegetables, water and diet soft-drinks among remote Indigenous communities.

Methods/Design
We will utilise a randomised multiple baseline (stepped wedge) design involving 20 communities in remote Indigenous Australia. The study will be conducted in partnership with two store associations and twenty Indigenous store boards. Communities will be randomised to either i) a 20% price discount on fruit, vegetables, water and diet soft-drinks; or ii) a combined price discount and in-store nutrition education strategy. These interventions will be initiated, at one of five possible time-points, spaced two-months apart. Weekly point-of-sale data will be collected from each community store before, during, and for six months after the six-month intervention period to measure impact on purchasing of discounted food and drinks. Data on physical, social and economic factors influencing weekly store sales will be collected in order to identify important covariates. Intervention fidelity and mediators of behaviour change will also be assessed.

Discussion
This study will provide original evidence on the effectiveness and cost-effectiveness of price discounts with or without an in-store nutrition education intervention on food and drink purchasing among a socio-economically disadvantaged population in a real-life setting.

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This paper reports on the preliminary investigations of an emerging program of research in which the authors are engaged. The program aims to generate new understandings for effective teacher education drawing on data from non-Indigenous pre-service teachers who undertook a teaching placement in remote Indigenous schools in Australia. The overall goals of this research gather around the notion of ‘building belonging’. The initial stage of this project sought to enable pre-service teachers to increase their awareness of the places and institutional practices operating within and between remote Indigenous communities and themselves. The twelve participants were interviewed while on three-week placements around Katherine and in Maningrida in the Northern Territory, Australia, during 2012. The paper elaborates various ways in which the remote placement experience began to challenge, positively disrupt, question and even (re) shape their professional learning and identities. Existing literature reporting on the experiences of largely white, middle class pre-service teachers in unfamiliar cultural contexts draws attention to themes of disruption, and the potential for meaningful and transformative professional learning experiences in such contexts (eg Gannon, 2010; Marble, 2012; Phillips, 2011; Ryan & Healy, 2009). Drawing on some of these insights from the literature, our preliminary reading of the data reveal the variety of ways and differing extents to which participants experienced disruptive, or potentially transformative professional learning moments during the placement. We conclude the paper by pointing towards some key areas for further investigation, in order to progress our research program around building belonging between pre-service teachers and remote Indigenous communities.

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This article introduces the Indigenous Media Practice special issue through a discussion of the aims and scope of the edition. It identifies three major currents in contemporary international research on media and indigeneity, which are reflected in the suite of scholarship presented here. The first is the importance of continuing to critically analyse media systems, institutions and policies that enable and constrain the production and dissemination of information for, by and about Indigenous populations. The second emphasises media-related practices in specific media production and social policy contexts, and the third underlines the importance of interrogating underlying and pervasive societal discourses in understanding Indigenous media practice. The contributions to this themed issue highlight that there is a vibrant body of research among a group of Indigenous and non-Indigenous scholars, typically working in teams in the pursuit of better understanding the relationships between media and indigeneity in both global and local contexts.

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The need to address the substantial inequities that exist between Indigenous and non-Indigenous Australians in higher education is widely recognised. Those factors that affect the performance of Indigenous students in tertiary education have been reasonably well documented across different institutions, disciplines, and programme levels but there has, to date, been less consideration of the processes by which Indigenous students either persist or desist in higher education. This paper aims to present a conceptual understanding of academic persistence that can inform the delivery of tailored academic support interventions to Indigenous students who are at high risk of leaving higher education.

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Racism toward Indigenous people remains a social problem in Australian culture, and racial abuse is part of that social problem. In this research, we investigated whether internal and external motivations, being open-minded, and having racist attitudes predicted the intention to engage in bystander action in support of Indigenous Australians in situations deemed low- and high-risk to personal safety. A total of 168 non-Indigenous community participants completed an anonymous online survey in Perth, Western Australia. In the low-risk scenario, low levels of racism, high internal motivation, and openness predicted the intention to engage in bystander action. In the high-risk scenario, participants with lower levels of racism and being female were more likely to engage in bystander action in support of Indigenous Australians. Coupled with previous research in the field, our findings suggest that internalized values relating to antiracist sentiments are significant predictors of antiracist bystander action.

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Listening… can involve the listener in an intense, efficacious, and complex set of communicative acts in which one is not speaking, discussing, or disclosing, but sitting quietly, watching, and feeling-the-place, through all the senses…. In the process, one becomes a part of the scene, hearing and feeling with it (Carbaugh 1999: 259).To listen this way involves much more than providing a chance for words to be spoken; it includes tuning in and getting the listening frequency clear. As a non-Indigenous person seeking to conduct qualitative research that listens to Aboriginal people, I need to ask how I can tune into the “active attentiveness” described by Carbaugh (1999) in order to listen in a manner that is appropriate, respectful and minimises my inherent white privilege. In addressing this question I draw on the work of Indigenous authors and academics, critical whiteness studies and my own experiences learning from Aboriginal people in a number of contexts over the past ten to fifteen years.History in Australia since colonization has created a situation where Aboriginal voices are white noise to the ears of many non-Indigenous people. This paper proposes that white privilege and the resulting white noise can be minimised and greater clarity given to Aboriginal voices by privileging Indigenous knowledge and ways of working when addressing Indigenous issues. To minimise the interference of white noise, non-Indigenous people would do well to adopt a position that recognises, acknowledges and utilises some of the strengths that can be learned from Aboriginal culture and Indigenous authors.This paper outlines a model of apprentice, allied listening for non-Indigenous researchers to adopt when preparing to conduct research alongside Indigenous people. Such an approach involves Re-learning of history, Reviewing of the researcher’s beliefs and placing Relating at the centre of the listening approach. Each of these aspects of listening is based on privileging of Indigenous voices.

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Introduction: The causal link between chemotherapy treatments and subsequent cardiotoxicity is well established, particularly for children with hematological malignancies. Little information exists on the characteristics and outcomes for patients with heart failure (HF) after chemotherapy. This study aimed to describe the characteristics, survival and mortality of patients who received chemotherapy for hematological cancer (leukemias, lymphomas and related disorders) before 18 years old and subsequently developed HF compared to those who did not.

Methods: Linked health data (1996-2009) from the Queensland Cancer Registry, Death Registry and Hospital Administration records for HF and chemotherapy admissions were reviewed. From all breast and hematological cancers patients (n=73,158), 15,987 received chemotherapy, including 819 patients aged ≤18 years at time of cancer diagnosis. Patients were categorized as those with an index HF admission (occurred after cancer diagnosis) and those without an index HF admission (non HF).

Results: Of the 819 patients, 3.7% (n=30) had an index HF admission. Median age of HF patients at time of cancer diagnosis was 5 years (IQR 3-12) compared to 7 years (IQR 3-14) in the non HF group (p=0.503). Median follow up from cancer diagnosis was 2.5 years in the HF group compared to 5.42 years in the non HF group (p<0.01). Of those who developed HF, 70% (n=21) had the index admission within 12 months of their cancer diagnosis. Of those with HF, 53.3% (n=16) died (all cause) compared to 14.6% (n=115) with no HF. On adjustment for age, sex and chemotherapy admissions, HF patients had an almost 5 fold increased mortality risk compared to non HF patients (HR 4.91 [95% CI, 2.88-8.36]) (Figure 1).

Conclusions: This study demonstrated that in children with hematological cancers the onset of HF occurred soon after chemotherapy and mortality risk is almost 5 times that of children who do not develop HF. Innovative strategies are still needed for the prevention and management of cardiotoxicity in this population.

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PURPOSE: Little is known about the prevalence of refractive error, binocular vision, and other visual conditions in Australian Indigenous children. This is important given the association of these visual conditions with reduced reading performance in the wider population, which may also contribute to the suboptimal reading performance reported in this population. The aim of this study was to develop a visual profile of Queensland Indigenous children. METHODS: Vision testing was performed on 595 primary schoolchildren in Queensland, Australia. Vision parameters measured included visual acuity, refractive error, color vision, nearpoint of convergence, horizontal heterophoria, fusional vergence range, accommodative facility, AC/A ratio, visual motor integration, and rapid automatized naming. Near heterophoria, nearpoint of convergence, and near fusional vergence range were used to classify convergence insufficiency (CI). RESULTS: Although refractive error (Indigenous, 10%; non-Indigenous, 16%; p = 0.04) and strabismus (Indigenous, 0%; non-Indigenous, 3%; p = 0.03) were significantly less common in Indigenous children, CI was twice as prevalent (Indigenous, 10%; non-Indigenous, 5%; p = 0.04). Reduced visual information processing skills were more common in Indigenous children (reduced visual motor integration [Indigenous, 28%; non-Indigenous, 16%; p < 0.01] and slower rapid automatized naming [Indigenous, 67%; non-Indigenous, 59%; p = 0.04]). The prevalence of visual impairment (reduced visual acuity) and color vision deficiency was similar between groups. CONCLUSIONS: Indigenous children have less refractive error and strabismus than their non-Indigenous peers. However, CI and reduced visual information processing skills were more common in this group. Given that vision screenings primarily target visual acuity assessment and strabismus detection, this is an important finding as many Indigenous children with CI and reduced visual information processing may be missed. Emphasis should be placed on identifying children with CI and reduced visual information processing given the potential effect of these conditions on school performance.