815 resultados para Non-Indigenous Patients
Resumo:
The overrepresentation of students from minority ethnic groups in separate special education settings has been extensively documented in North America, yet little research exists for Australian school systems. To address this gap, we systematically analyzed 13 years of enrolment data from the state of New South Wales. Stark differences are seen in patterns of enrolment between Indigenous students, students from a Language Background Other than English (LBOTE), and non-Indigenous English speaking students. Moreover, these differences are increasing. While enrollments of Indigenous students in separate settings increased faster across time than did enrollments of Indigenous students in mainstream, enrollments of LBOTE students in mainstream increased faster than did enrollments of LBOTE students in separate settings.
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OBJECTIVE: To better understand help-seeking behaviours and reproductive health disorders among Aboriginal and Torres Strait Islander men. DESIGN, SETTING AND PARTICIPANTS: A cross-sectional mixed-methods study conducted from 1 May 2004 to 30 April 2005 of 293 Aboriginal and Torres Strait Islander men aged 18 years and over from urban, rural and remote communities in the Northern Territory and Queensland. MAIN OUTCOME MEASURES: Subscale of the International Index of Erectile Function, self-reported help-seeking behaviours for erectile dysfunction (ED) and prostate disease, thematic analysis of semi-structured interviews and focus groups. RESULTS: The prevalence of moderate-to-severe ED increased across age groups, from about 10% in younger men (under 35 years) to 28% in men aged 55-74 years. Moderate-to-severe ED was strongly associated with reporting a chronic condition (odds ratio [OR], 3.67) and residing in a remote area (OR, 2.94). Aboriginal and Torres Strait Islander men aged 40-59 years showed similar low levels of help-seeking behaviours compared with non-Indigenous men from a comparable population-based study. About half of the men with ED saw a doctor or received treatment for ED in each population. While prostate cancer rates were low in both studies, testing for prostate problems was less frequent in Aboriginal and Torres Strait Islander men (11.4%) than in non-Indigenous men (34.1%, P < 0.001), despite similar levels of concern about prostate cancer. Barriers to help-seeking included shame, culturally inappropriate services and lack of awareness. CONCLUSION: This study, the first to investigate reproductive health of Aboriginal and Torres Strait Islander men, found low levels of help-seeking behaviours for reproductive health disorders, with implications for missing a predictor of chronic disease and late diagnosis of prostate disease.
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This thesis focuses on non-Indigenous educators’ work around embedding Indigenous perspectives in early childhood education curricula. In place of reporting examples of ‘good’ educational practice, the study questions how whiteness and racism continue to operate in diversity work that is seen to be productive and inclusive. The thesis argues for a more comprehensive framework for embedding Indigenous perspectives in before-school contexts to support educators’ efforts. New strategies for professional development are also suggested to support changes in disciplinary knowledge and pedagogy.
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This article is a call to literacy teachers and researchers to embrace the possibility of attending more consciously to the senses in digital media production. Literacy practices do not occur only in the mind, but involve the sensoriality, embodiment, co-presence, and movement of bodies. This paper theorises the sensorial and embodied dimension of children’s filmmaking about place in two communities in Australia. The films were created by pre-teen Indigenous and non-Indigenous children in Logan, Queensland, and by Indigenous teenagers at the Warralong campus of the Strelley Community School in remote Western Australia. The films were created through engagement in cross-curricular units that sensitised the students’ experience of local places, gathering corporeal information through their sensing bodies as they interacted with the local ecology. The analysis highlights how the sensorial and bodily nature of literacy practice through documentary filmmaking was central to the children’s formation and representation of knowledge, because knowledge and literacy practices are not only acquired through the mind, but are also reliant on embodiment, sensoriality, co-presence, and kinesics of the body in place.
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This thesis examines the role of social enterprises in regional development and is based on comparative case studies of two regions in NSW. With a specific focus on 10 social enterprises, including both Indigenous and non-Indigenous organisations, 63 interviews were conducted with a wide range of community stakeholders. Utilising a decolonising methodological approach, the study examined the social and financial needs of these organisations, as well as their contributions as regional development actors.
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This article explores the strengths and limitations of settler colonial theory (SCT) as a tool for non-Indigenous scholars seeking to disturb rather than re-enact colonial privilege. Based on an examination of recent Australian academic debates on settler colonialism and the Northern Territory intervention, we argue that SCT is useful in dehistoricizing colonialism, usually presented as an unfortunate but already transcended national past, and in revealing the intimate connections between settler emotions, knowledges, institutions and policies. Most importantly, it makes settler investments visible to settlers, in terms we understand and find hard to escape. However, as others have noted, SCT seems unable to transcend itself, in the sense that it posits a structural inevitability to the settler colonial relationship. We suggest that this structuralism can be mobilized by settler scholars in ways that delegitimize Indigenous resistance and reinforce violent colonial relationships. But while settlers come to stay and to erase Indigenous political existence, this does not mean that these intentions will be realized or must remain fixed. Non-Indigenous scholars should challenge the politically convenient conflation of settler desires and reality, and of the political present and the future. This article highlights these issues in order to begin to unlock the transformative potential of SCT, engaging settler scholars as political actors and arguing that this approach has the potential to facilitate conversations and alliances with Indigenous people. It is precisely by using the strengths of SCT that we can challenge its limitations; the theory itself places ethical demands on us as settlers, including the demand that we actively refuse its potential to re-empower our own academic voices and to marginalize Indigenous resistance.
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Background Despite bronchiectasis being increasingly recognised as an important cause of chronic respiratory morbidity in both indigenous and non-indigenous settings globally, high quality evidence to inform management is scarce. It is assumed that antibiotics are efficacious for all bronchiectasis exacerbations, but not all practitioners agree. Inadequately treated exacerbations may risk lung function deterioration. Our study tests the hypothesis that both oral azithromycin and amoxicillin-clavulanic acid are superior to placebo at improving resolution rates of respiratory exacerbations by day 14 in children with bronchiectasis unrelated to cystic fibrosis. Methods We are conducting a bronchiectasis exacerbation study (BEST), which is a multicentre, randomised, double-blind, double-dummy, placebo-controlled, parallel group trial, in five centres (Brisbane, Perth, Darwin, Melbourne, Auckland). In the component of BEST presented here, 189 children fulfilling inclusion criteria are randomised (allocation-concealed) to receive amoxicillin-clavulanic acid (22.5 mg/kg twice daily) with placebo-azithromycin; azithromycin (5 mg/kg daily) with placebo-amoxicillin-clavulanic acid; or placebo-azithromycin with placebo-amoxicillin-clavulanic acid for 14 days. Clinical data and a paediatric cough-specific quality of life score are obtained at baseline, at the start and resolution of exacerbations, and at day 14. In most children, blood and deep nasal swabs are also collected at the same time points. The primary outcome is the proportion of children whose exacerbations have resolved at day 14. The main secondary outcome is the paediatric cough-specific quality of life score. Other outcomes are time to next exacerbation; requirement for hospitalisation; duration of exacerbation; and spirometry data. Descriptive viral and bacteriological data from nasal samples and blood markers will also be reported. Discussion Effective, evidence-based management of exacerbations in people with bronchiectasis is clinically important. Yet, there are few randomised controlled trials (RCTs) in the neglected area of non-cystic fibrosis bronchiectasis. Indeed, no published RCTs addressing the treatment of bronchiectasis exacerbations in children exist. Our multicentre, double-blind RCT is designed to determine if azithromycin and amoxicillin-clavulanic acid, compared with placebo, improve symptom resolution on day 14 in children with acute respiratory exacerbations. Our planned assessment of the predictors of antibiotic response, the role of antibiotic-resistant respiratory pathogens, and whether early treatment with antibiotics affects duration and time to the next exacerbation, are also all novel.
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Objectives In Aboriginal and Torres Strait Islander peoples in Queensland, to (a) determine the disease burden of common chronic lung diseases and (b) identify areas of need with respect to lung health services. Methods Literature reviews and analyses of hospitalisation and mortality data were used to describe disease epidemiology and available programs and services. Key stakeholder interviews and an online survey of health professionals were used to evaluate lung health services across the state and to identify services, needs and gaps. Results Morbidity and mortality from respiratory diseases in the Indigenous population is substantially higher than the non-Indigenous population across all age groups and regions. There are inadequate clinical services and resources to address disease prevention, detection, intervention and management in an evidence-based and culturally acceptable fashion. There is a lack of culturally appropriate educational resources and management programs, insufficient access to appropriately engaged Indigenous health professionals, a lack of multi-disciplinary specialist outreach teams, fragmented information systems and inadequate coordination of care. Conclusions Major initiatives are required at all levels of the healthcare system to adequately address service provision for Indigenous Queenslanders with lung diseases, including high quality research to investigate the causes for poor lung health, which are likely to be multifactorial.
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OBJECTIVE: We present and analyze long-term outcomes following multimodal therapy for esophageal cancer, in particular the relative impact of histomorphologic tumor regression and nodal status. PATIENTS AND METHODS: A total of 243 patients [(adenocarcinoma (n = 170) and squamous cell carcinoma (n = 73)] treated with neoadjuvant chemoradiotherapy in the period 1990 to 2004 were followed prospectively with a median follow-up of 60 months. Pathologic stage and tumor regression grade (TRG) were documented, the site of first failure was recorded, and Kaplan-Meier survival curves were plotted. RESULTS: Thirty patients (12%) did not undergo surgery due to disease progression or deteriorated performance status. Forty-one patients (19%) had a complete pathologic response (pCR), and there were 31(15%) stage I, 69 (32%) stage II, and 72 (34%) stage III cases. The overall median survival was 18 months, and the 5-year survival was 27%. The 5-year survival of patients achieving a pCR was 50% compared with 37% in non-pCR patients who were node-negative (P = 0.86). Histomorphologic tumor regression was not associated with pre-CRT cTN stage but was significantly (P < 0.05) associated with ypN stage. By multivariate analysis, ypN status (P = 0.002) was more predictive of overall survival than TRG (P = 0.06) or ypT stage (P = 0.39). CONCLUSION: Achieving a node-negative status is the major determinant of outcome following neoadjuvant chemoradiotherapy. Histomorphologic tumor regression is less predictive of outcome than pathologic nodal status (ypN), and the need to include a primary site regression score in a new staging classification is unclear. © 2007 Lippincott Williams & Wilkins, Inc.
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This paper explores the reception of Indigenous perspectives and knowledges in university curricula and educators’ social responsibility to demonstrate cultural competency through their teaching and learning practices. Drawing on tenets of critical race theory, Indigenous standpoint theory and critical pedagogies, this paper argues that the existence of Indigenous knowledges in Australian university curricula and pedagogy demands personal and political activism (Dei, 2008) as it requires educators to critique both personal and discipline-based knowledge systems. The paper interrogates the experiences of non-Indigenous educators involved in this contested epistemological space (Nakata, 2002), and concludes by arguing for a political and ethical commitment by educators towards embedding Indigenous knowledges towards educating culturally competent professionals.
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The monstrous landscape and the revenge of nature are recurring motifs in Australian cinema. In the horror genre, the idea of the monstrous landscape emerges from, and builds upon, an established tradition in Australian cinema in which landscape functions not just as a setting for action, but also as a character in its own right. Rather than a picturesque wilderness or countryside, or a serene natural world untainted by civilisation – representations common in landscape cinema celebrating positive aspects of the Australian ‘outback’ – the monstrous landscape is a dangerous, malevolent and threatening force. Drawing upon themes also common in Australian Gothic narratives such as entrapment in a hostile environment, isolation and fear of the unknown (Turcotte, 1988, see also Jonathan Rayner’s essay in this volume), the monstrous landscape acts according to its own logic indecipherable to non-Indigenous Australians and is represented in terms of its alien-ness and inhuman horror.
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This project involved writing Turrwan (great man), a novel set in Queensland in the nineteenth century, and an investigation into the way historical novels portray the past. Turrwan tells the story of Tom Petrie, who was six when he arrived with his family at the notorious Moreton Bay Penal Colony in 1837. The thesis examines historical fiction as a genre with particular focus on notions of historical authenticity. It analyses the complexities involved in a non-Indigenous person writing about the Australian Aboriginal people, and reflects on the process of researching, planning and writing a historical novel.
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Research background: Cungelela is an intercultural music project undertaken in collaboration with William ‘Dura Danje’ Leisha and Shem ‘Curan Danje’ Leisha. The project contributes to cultural maintenance for Australian First Nations peoples, and is informed by prior work in this area by scholars including Peter Dunbar-Hall, Chris Gibson and Karl Neuenfeldt. These existing studies have discussed the complexities of intercultural collaboration, and the types of cultural politics that are involved when Indigenous and non-Indigenous musicians and scholars work together on projects of cultural significance. Critical race theory has also informed the creative work, as a means of interpreting the implicit and explicit discourses of race that arise through intercultural creative practice. The project asked the research question, in what ways can collaborative music making contribute to intercultural understanding and support cultural maintenance for Australian First Nations people affected by the Stolen Generations? Research contribution: This project has identified that collaborative production of recorded popular music can produce shared affective, embodied and transformative forms of knowledge about the impact of the Stolen Generations on Australian First Nations peoples. Research significance: The compact disc was presented by Aunty Anne Leisha as part of an invited presentation at the World Indigenous Nations Higher Education Consortium in New Mexico, 2013. The work also formed part of a refereed conference presentation at the 2013 conference of the International Association for the Study of Popular Music held at the University of Oviedo, Gijon, Spain.
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Research background: Ananyi (Going) is an intercultural music project with lyrics sung in Luritja and English, undertaken in collaboration with the Tjupi Band and producer Jeffrey McLaughlin. The project contributes to cultural maintenance for Australian First Nations peoples, and is informed by prior work in this area by scholars including Peter Dunbar-Hall, Chris Gibson and Karl Neuenfeldt. These existing studies have discussed the complexities of intercultural collaboration, and the types of cultural politics that are involved when Indigenous and non-Indigenous musicians and scholars work together on projects of cultural significance. Critical race theory has also informed the creative work, as a means of interpreting the implicit and explicit discourses of race that arise through intercultural creative practice. The project asked the research question, how can collaborative music making contribute to intercultural understanding and the maintenance of Australian First Nations languages and cultures? Research contribution: The project has identified that recorded popular music is important in the maintenance of Luritja language and culture, and that intercultural collaboration in the areas of digital sound production and distribution can assist with cultural maintenance in both local and national contexts. Research significance: The compact disc was released on the CAAMA Music label, and supported through competitive grants from the Australian Government’s Contemporary Music Touring Grant and the Arnhem Land Progress Association (ALPA). The research context of the work is detailed in Brydie-Leigh Bartleet and Gavin Carfoot 2013. "Desert harmony: Stories of collaboration between Indigenous musicians and university students." International Education Journal: Comparative Perspectives 12 (1): 180-196.
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This paper presents the findings from a conversation between an Aboriginal educator and a non-Indigenous pre-service educator about the importance and complexities of building productive partnerships. Although the participants focused on the challenges and benefits of building relationships between Aboriginal and Torres Strait Islander educators and non-Indigenous educators in Australian early years settings, the more significant outcome of the meeting was the personal connection two young women were able to make when a friendship began to develop. The project was intended to enable an opportunity for the participants ‘to engage in reflexivity on their pedagogic work’, something Mills (2012) understands as crucial to the support of social justice and transformation in the classroom.