Cardiac ARIA Index: Measuring Accessibility to Cardiovascular Services in Rural and Remote Australia via Applied Geographic Spatial Technology

Cardiovascular disease (CVD) continues to impose a heavy burden in terms of cost, disability and death in Australia. Evidence suggests that increasing remoteness, where cardiac services are scarce, is linked to an increased risk of dying from CVD. Fatal CVD events are reported to be between 20% and 50% higher in rural areas compared to major cities. The Cardiac ARIA project, with its extensive use of geographic Information Systems (GIS), ranks each of Australia’s 20,387 urban, rural and remote population centres by accessibility to essential services or resources for the management of a cardiac event. This unique, innovative and highly collaborative project delivers a powerful tool to highlight and combat the burden imposed by cardiovascular disease (CVD) in Australia. Cardiac ARIA is innovative. It is a model that could be applied internationally and to other acute and chronic conditions such as mental health, midwifery, cancer, respiratory, diabetes and burns services. Cardiac ARIA was designed to: 1. Determine by expert panel, what were the minimal services and resources required for the management of a cardiac event in any urban, rural or remote population locations in Australia using a single patient pathway to access care. 2. Derive a classification using GIS accessibility modelling for each of Australia’s 20,387 urban, rural and remote population locations. 3. Compare the Cardiac ARIA categories and population locations with census derived population characteristics. Key findings are as follows: • In the event of a cardiac emergency, the majority of Australians had very good access to cardiac services. Approximately 71% or 13.9 million people lived within one hour of a category one hospital. • 68% of older Australians lived within one hour of a category one hospital (Principal Referral Hospital with access to Cardiac Catheterisation). • Only 40% of indigenous people lived within one hour of the category one hospital. • 16% (74000) of indigenous people lived more than one hour from a hospital. • 3% (91,000) of people 65 years of age or older lived more than one hour from any hospital or clinic. • Approximately 96%, or 19 million, of people lived within one hour of the four key services to support cardiac rehabilitation and secondary prevention. • 75% of indigenous people lived within one hour of the four cardiac rehabilitation services to support cardiac rehabilitation and secondary prevention. Fourteen percent (64,000 persons) indigenous people had poor access to the four key services to support cardiac rehabilitation and secondary prevention. • 12% (56,000) of indigenous people were more than one hour from a hospital and only had access one the four key services (usually a medical service) to support cardiac rehabilitation and secondary prevention.

Philanthropic capacity to support Indigenous causes : the journey to improvement

The role of philanthropy in addressing Indigenous causes is still conceptually emerging in Australia despite many years of practice. This paper reports on a qualitative study with grantmakers and grantseekers to better understand the issues affecting the philanthropic grantmaking system for Indigenous causes in Australia. An attitudinal emphasis on human rights for politically, economically and socially disadvantaged groups and an impetus for structural change emerged that has yet to deliver real funding equity. The way forward is still largely focussed on ‘improving’ Indigenous community capacity in organisational governance systems. In contrast, this study points to strategic leverage points within philanthropic organisations which could be used to first assess and then develop policies, processes and their underlying attitudes which impact on cross-cultural work i.e. the ‘cultural competence ’ of philanthropic organisations. It is argued such an approach would support improved social justice practice in the sector and subsequently Indigenous outcomes.

Enhancing resilience in indigenous people: The integration of individual, family and community interventions

This paper describes a number of interventions being developed to address the emotional, social and behavioural problems experienced by Aboriginal people in Australia. These are: the We-Al-Li program to help people deal with the impact of transgenerational trauma; and the RAP Indigenous Parenting Program. It is argued that the emotional well being of indigenous people will be enhanced through the integration of interventions targeting the individual, family and community.

Exploring health information use by older Australians within everyday life

Exploring information use within everyday or community contexts is a recent area of interest for information literacy research endeavors. Within this domain, health information literacy (HIL) has emerged as a focus of interest due to identified synergies between information use and health status. However, while HIL has been acknowledged as a core ingredient that can assist people to take responsibility for managing and improving their own health, limited research has explored how HIL is experienced in everyday community life. This article will present the findings of ongoing research undertaken using phenomenography to explore how HIL is experienced among older Australians within everyday contexts. It will also discuss how these findings may be used to inform policy formulation in health communication and as an evidence base for the design and delivery of consumer health information resources and services.

Informed for healthy ageing : exploring how ageing Australians experience health information use

Exploring information use within everyday or community contexts is a recent area of interest for information literacy research endeavours. Within this domain, health information literacy (HIL) has emerged as a focus of interest due to identified synergies between information use and health status. However, while HIL has been acknowledged as a core ingredient that can assist people to take responsibility for managing and improving their own health, limited research has explored how HIL is experienced in everyday community life. This article will present the findings of ongoing research undertaken using phenomenography to explore how HIL is experienced among older Australians within everyday contexts. It will also discuss how these findings may be used to inform policy formulation in health communication and as an evidence base for the design and delivery of consumer health information resources and services.

Indigenous knowledge and effective parent–school partnerships : issues and insights

Towards the last decade of the last millennium, Indigenous knowledge was central to international scholarly debates relating to decolonising knowledge. Indigenous scholars, particularly those from Australia, New Zealand, Canada, and the United States, advanced many of these debates. They argued for Indigenous knowledge to be used as the epistemological standpoint for intellectual engagements and the methodology for resisting colonial constructions of the colonised other (Rigney 1997; Smith 1999, 2005). However, the challenge of engaging Indigenous knowledge to inform research and educational processes, in many respects, is still a contested debate in Western-oriented universities and institutions of higher education. This chapter discusses findings of the Parent–School Partnership Initiative (hereafter referred to as PSPI) project conducted by the Oodgeroo Unit staff and the Aboriginal and Torres Strait Islander Education Focus Group for the Caboolture Shire, in South East Queensland. The state government sponsored initiative examined factors that promote and enhance parent–school engagement with students’ schooling, and contributed to Aboriginal and Torres Strait Islander students’ learning and completion of secondary schooling within the participating schools. We argue in this chapter for the importance of recognising Indigenous knowledge and its place in enhancing parent–school partnerships.

Fear of Crime in Expatriate Australians in Ho Chi Minh City Vietnam

This is an analytical report of a qualitative study of fear of crime in six Australian expatriates living in Ho Chi Minh City (HCMC) Vietnam. Addressing the primary question of what changes, or impacts upon, fear of crime in Australian expatriates in HCMC Vietnam, the research paid particular attention to studying the differences in fear of crime when respondents became expatriates, and the impact of incivilities and access to media. Each of the respondents indicated that they felt safer in Vietnam than in Australia. An analysis of the respondents’ responses indicates that this feeling of safety did not occur on arrival but after a short period of adjustment. The findings of this research support the existing theories on fear of crime and highlight the importance of context in predicting the impact of such factors as media and incivilities. The study has practical applications for both private and public sector organisations seeking to deploy staff to HCMC and adds to the current significant body of fear of crime research by specifically examining the issue of fear of crime amongst expatriates.

Towards designing digital noticeboards with a remote indigenous community

This position paper reflects upon the opportunities and challenges of designing a digital noticeboard system with a remote indigenous community that supports their aspirations for both internal and external communication. The project itself has evolved from a relationship built through ecological work between scientists and the local community on the Groote Eylandt archipelago to study native populations of animal species over the long term. In the course of this work the aspiration has emerged to explore how digital noticeboards might promote and communicate aspects of work and life on the island through both the web and touchscreen noticeboards. This paper introduces the community, the context and the history of the project. We then reflect upon the science project and its outcomes, in order to draw lessons for extending what we see as a pragmatic and relationship based approach towards design.

Valuing diversity : a multiliteracies project in a remote Indigenous community

This chapter draws attention to the complex nature of teachers’ work when working with linguistically and culturally diverse students and their communities in an era of new literacies. One multiliteracies project undertaken within a remote Indigenous community in the Torres Straits, Far North Queensland, Australia, is presented. The discussion considers understandings of student diversity as articulated in the Australian Curriculum documents, designs of meaning for written and visual text and the various components of pedagogy introduced into a multiliteracies project. The chapter concludes by highlighting the usefulness of the ‘wide, but not vague’ multiliteracies approach and the importance of an explicit grammar for written and visual text, for meeting the literacy learning needs of one group of 21st century learners.

Introductory Indigenous Studies in Education : Reflection and the Importance of Knowing

Although the demand for pre-service teachers to be better informed about Indigenous issues in Australia has been broadly articulated, it is reasonably new for universities to make Indigenous studies a compulsory area of study, or to define what is meant by 'Indigenous education'. This book was motivated by the growing necessity for an approach to Indigenous education that would include more than just a summarising of Indigenous history and traditional culture. It is useful for anyone with an interest in challenging their ideas about culture, identity and history in Australia.

Re/presenting readings of the indigenous literary terrain

In this study I investigate the spectrum of authoring, publishing and everyday reading of three texts - My Place (Morgan 1987), Jandamarra and the Bunuba Resistance (Pedersen and Woorunmurra 1995) and Carpentaria (Wright 2006). I have addressed this study within the field of production and consumption, utilising amongst others the work of Edward Said (1978, 1983) and Stanley Fish (1980). I locate this work within the holism of Kombu-merri philosopher, Mary Graham's 'Aboriginal Inquiry' (2008), which promotes self-reflexivity and a concern for others as central tenets of such inquiry. I also locate this work within a postcolonial framework and in recognition of the dynamic nature of that phenomenon I use Aileen MoretonRobinson's (2003) adoption of the active verb, "postcolonising"(38). In apprehending selected texts through the people who make them and who make meaning from them - authors, publishers and everyday readers, I interviewed members of each cohort within a framework that recognises the exercise of agency in their respective practices as well as the socio-historical contexts to such textual practices. Although my research design can be applied to other critical arrangements of texts, my interest here lies principally in texts that incorporate the subjects of Indigenous worldview and Indigenous experience; and in texts that are Indigenous authored or Indigenous co-authored.