Strengthening cardiac rehabilitation and secondary prevention for Aboriginal and Torres Strait Islander peoples

This article summarises the findings of a project funded and supported by a principal committee of the National Health and Medical Research Council, the Health Advisory Committee, chaired by Professor Adele Green.

The epistemology that maintains white race privilege, power and control of Indigenous Studies and Indigenous peoples' participation in universities

This paper represents my attempt to turn the gaze and demonstrate how Indigenous Studies is controlled in some Australian universities in ways that witness Indigenous peoples being further marginalised, denigrated and exploited. I have endeavoured to do this through sharing an experience as a case study. I have opted to write about it as a way of exposing the problematic nature of racism, systemic marginalisation, white race privilege and radicalised subjectivity played out within an Australian higher education institution and because I am dissatisfied with the on-going status quo. In bringing forth analysis to this case study, I reveal the relationships between oppression, white race privilege and institutional privilege and the epistemology that maintains them. In moving from the position of being silent on this experience to speaking about it, I am able to move from the position of object to subject and to gain a form of liberated voice (hooks 1989:9). Furthermore, I am hopeful that it will encourage others to examine their own practices within universities and to challenge the domination that continues to subjugate Indigenous peoples.

Book review : Indigenous peoples : self-determination knowledge indigeneity

This is a book review of Indigenous Peoples: Self-Determination Knowledge Indigeneity. Edited by Henry Minde in collaboration with Harald Gaski, Svein Jentoft and Georges Midre. Published by Eburon Academic Publishers in Delft, the Netherlands. Paperback, 382 pages, no index. AUD. $79.99. ISBN 978-90-5972-204-0.

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.

Knowing and teaching the indigenous other : teachers’ engagement with Aboriginal and Torres Strait Islander cultures

This is the first empirical study of teacher knowledge and classroom practice in Aboriginal and Torres Strait Islander education. It describes the construction of a survey instrument to measure non-Indigenous Australian teachers’ knowledge of Indigenous culture and place, frequency of everyday intercultural exchanges, and attempts to integrate Indigenous knowledge into classroom practice. Many teachers reported low levels of knowledge of Indigenous cultures, and limited encounters outside of school. While the cohort expressed dissatisfaction with pre-service training, exposure to pre- and in-service courses in Indigenous education correlated with higher levels of cultural knowledge and cultural engagement. Teachers with higher levels of cultural engagement were more likely to attempt to integrate Indigenous knowledges in curriculum and pedagogy.

Diabetes health program development for Aboriginal and Torres Strait Islander women

According to Australian Health (2008), the area of endocrine, nutritional and metabolic disorders (mainly diabetes) yields the highest cause of death for Indigenous Australian women at 10.1%. Indigenous Brisbane North women’s results reiterate this with slightly higher percentages and are a cause for concern and action due to the noted levels of undiagnosed/unaware Indigenous Brisbane North women with abnormal blood glucose levels, whom participated in the research. A sub-sample of the group (N=17) were piloted to test the feasibility of method of eliciting health information on Indigenous Women within this community. This pilot study revealed the following health information regarding this group of women. 41.2% of Indigenous Brisbane North women were found to have blood glucose levels that were outside normal ranges, however only 29.4% had been diagnosed with diabetes and or endocrine abnormalities. These findings highlight that 11.8% of participants have signs indicating that they may have undiagnosed diabetes or/and pre diabetes juxtaposed to unacceptable endocrine levels compatible with health and wellness. The percentages of Indigenous Brisbane North Women whom have indicated that they have a diagnosis of diabetes have been compared to both National Indigenous peoples percentages and the national percentages for the wider Australian community (all Australians). The rate of diabetes within this population is 9 times that of the wider Australian community and 5 times that of the wider Australian Indigenous community. Data was collected from Indigenous participants on arrival and the attendance numbers of 112 women was recorded for comparison with other current health prevention wellness programs being delivered. Data was also collected through the use of specially designed culturally safe questionnaires undertaken in conjunction with health checks and health service information given to participants.

‘We don’t leave our identities at the city limits’ : Aboriginal and Torres Strait Islander people living in urban localities

Aboriginal and Torres Strait Islander people who live in cities and towns are often thought of as ‘less Indigenous’ than those who live ‘in the bush’, as though they were ‘fake’ Aboriginal people — while ‘real’ Aboriginal people live ‘on communities’ and ‘real’ Torres Strait Islander people live ‘on islands’. Yet more than 70 percent of Australia’s Indigenous peoples live in urban locations (ABS 2007), and urban living is just as much part of a reality for Aboriginal and Torres Strait Islander people as living in remote discrete communities. This paper examines the contradictions and struggles that Aboriginal and Torres Strait Islander people experience when living in urban environments. It looks at the symbols of place and space on display in the Australian cities of Melbourne and Brisbane to demonstrate how prevailing social, political and economic values are displayed. Symbols of place and space are never neutral, and this paper argues that they can either marginalise and oppress urban Aboriginal and Torres Strait Islander people, or demonstrate that they are included and engaged.

Lung health care for Aboriginal and Torres Strait Islander Queenslanders : breathing easy is not so easy

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.

Editorial : Global 21st century professionals : developing capability to work with Indigenous and other traditionally-oriented peoples

International agreement on the framework for protecting the rights of Indigenous populations within nation states has occurred alongside unprecedented levels of globalisation of other previously nation-based activities such as economic and social provision and planning. As the idea of the postcolonial democratic state emerges, this collection undertakes an international and comparative examination of the role of higher education in educating globally aware professionals who are able to work effectively and in cultural safety with Indigenous Peoples...

Practices of alternative schools in Queensland in supporting Aboriginal and Torres Strait Islander young people to remain engaged in education

Alternative schools are an emerging model of education offered to young people who have been disenfranchised from conventional schooling opportunities. The body of literature on alternative schools in Australia has not identified how many Indigenous young people are engaged with alternative schools and how alternative schools are supporting Indigenous young people to remain engaged in education. It is well documented that Aboriginal and Torres Strait Islander people experience significant disadvantage including poorer educational outcomes than their non-Indigenous peers. This study seeks to contribute to improving educational outcomes for Aboriginal and Torres Strait Islander young people through exploring Aboriginal and Torres Strait Islander interactions with alternative schools in Queensland and investigating the practices of alternative school leaders in terms of how they are supporting Indigenous young people to remain engaged in education. Critical race theory informed the development of this study. An Aboriginal researcher sought to shift the focus of this study away from Indigenous young people to Principals; to explore their perspective of their own knowledge and practices in supporting Aboriginal and Torres Strait Islander young people at their school. Using survey methodology, a web-based questionnaire was developed to survey Principals’ providing data on alternative schools in Queensland including the demographics of the alternative school; self-reported knowledge of Indigenous cultures and communities and practices that support Aboriginal and Torres Strait Islander young people at their alternative school. There are nine key findings that emerged through the analysis of this study: key finding one is the high percentage of Aboriginal and Torres Strait Islander young people enrolled in schools surveyed; key finding two is there is a high percentage of Aboriginal and Torres Strait Islander staff employed in the schools; key finding three is the majority of the schools are located in low socio-economic areas; key finding four is the strong willingness of Principals’ in this study to engage in self-directed learning in relation to Aboriginal and Torres Strait Islander cultures; key finding five is the limited demonstration of understandings of Aboriginal and Torres Strait Islander cultures and communities; key finding six is the most prevalent practice of Principals’ in this study is the celebration of cultural events and cultural activities; key finding seven is the limited Principal engagement with Aboriginal and Torres Strait Islander young people, their families and the local community; key finding eight is the practice of alternative schools provides limited support and nurturing of Aboriginal and Torres Strait Islander young person’s cultural identity and key finding nine is that Principals’ are relying heavily on informal discussions with staff to know what their staff’s knowledge and skills are in relation to supporting Aboriginal and Torres Strait Islander young people. There are multiple implications that have arisen from this study. The data demonstrated high numbers of Aboriginal and Torre Strait Islander students and staff. The data also revealed that Principal’s demonstration of knowledge in relation to Indigenous cultures and communities was limited, as well as limited Principal engagement with Indigenous young peoples, families and communities. Therefore a major practical implication of this study is the urgent need for quality cultural learning opportunities for leaders of alternative schools to improve practices. Additionally, the implications of this study support an urgent need for further research on the role alternative schools are playing in supporting Indigenous young people to remain engaged in education.

Runs of homozygosity and a cluster of vulvar cancer in young Australian Aboriginal women

Objective A cluster of vulvar cancer exists in young Aboriginal women living in remote communities in Arnhem Land, Australia. A genetic case–control study was undertaken involving 30 cases of invasive vulvar cancer and its precursor lesion, high-grade vulvar intraepithelial neoplasia (VIN), and 61 controls, matched for age and community of residence. It was hypothesized that this small, isolated population may exhibit increased autozygosity, implicating recessive effects as a possible mechanism for increased susceptibility to vulvar cancer. Methods Genotyping data from saliva samples were used to identify runs of homozygosity (ROH) in order to calculate estimates of genome-wide homozygosity. Results No evidence of an effect of genome-wide homozygosity on vulvar cancer and VIN in East Arnhem women was found, nor was any individual ROH found to be significantly associated with case status. This study found further evidence supporting an association between previous diagnosis of CIN and diagnosis of vulvar cancer or VIN, but found no association with any other medical history variable. Conclusions These findings do not eliminate the possibility of genetic risk factors being involved in this cancer cluster, but rather suggest that alternative analytical strategies and genetic models should be explored.