Academic literature on the topic 'Aboriginal and Torres Strait Islander Victorians'

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Journal articles on the topic "Aboriginal and Torres Strait Islander Victorians"

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Costa, Nadia, Mary Sullivan, Rae Walker, and Kerin M. Robinson. "Emergency Department Presentations of Victorian Aboriginal and Torres Strait Islander People." Health Information Management Journal 37, no. 3 (October 2008): 15–25. http://dx.doi.org/10.1177/183335830803700303.

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This paper explains how routinely collected data can be used to examine the emergency department attendances of Victorian Aboriginal and Torres Strait Islander people. The data reported in the Victorian Emergency Minimum Dataset (VEMD) for the 2006/2007 financial year were analysed. The presentations of Aboriginal and Torres Strait Islander and non-Aboriginal people were compared in terms of age, gender, hospital location (metropolitan and rural) and presenting condition. Aboriginal and Torres Strait Islander people were found to attend the emergency department 1.8 times more often than non-Aboriginal people. While the emergency department presentation rates of metropolitan Aboriginal and Torres Strait Islander and non-Aboriginal people were similar, rural Aboriginal and Torres Strait Islander people presented to the emergency department 2.3 times more often than non-Aboriginal people. The injuries or poisonings, respiratory conditions and mental disorders presentation rates of the Aboriginal and Torres Strait Islander and non-Aboriginal population were compared. No previous studies have assessed the accuracy of the Indigenous status and diagnosis fields in the VEMD; therefore the quality of this data is unknown.
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Kennedy, Michelle, Tess Bright, Simon Graham, Christina Heris, Shannon K. Bennetts, Renee Fiolet, Elise Davis, et al. "“You Can’t Replace That Feeling of Connection to Culture and Country”: Aboriginal and Torres Strait Islander Parents’ Experiences of the COVID-19 Pandemic." International Journal of Environmental Research and Public Health 19, no. 24 (December 13, 2022): 16724. http://dx.doi.org/10.3390/ijerph192416724.

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This Aboriginal-led study explores Aboriginal and Torres Strait Islander parents’ experiences of COVID-19. 110 Aboriginal and Torres Strait Islander parents were interviewed between October 2020 and March 2022. Participants were recruited through community networks and partner health services in South Australia, Victoria, and Northern Territory, Australia. Participants were predominantly female (89%) and based in Victoria (47%) or South Australia (45%). Inductive thematic analysis identified three themes: (1) Changes to daily living; (2) Impact on social and emotional wellbeing; and (3) Disconnection from family, community, and culture. COVID-19 impacted Aboriginal and Torres Strait Islander families. Disruption to cultural practice, and disconnection from country, family, and community was detrimental to wellbeing. These impacts aggravated pre-existing inequalities and may continue to have greater impact on Aboriginal and Torres Strait Islander parents and communities due to intergenerational trauma, stemming from colonisation, violence and dispossession and ongoing systemic racism. We advocate for the development of a framework that ensures an equitable approach to future public health responses for Aboriginal and Torres Strait Islander people.
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Wotherspoon, Craig, and Cylie M. Williams. "Exploring the experiences of Aboriginal and Torres Strait Islander patients admitted to a metropolitan health service." Australian Health Review 43, no. 2 (2019): 217. http://dx.doi.org/10.1071/ah17096.

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Objective There continue to be disparate health outcomes for people who are Aboriginal and Torres Strait Islander. The aim of the present study was to measure whether there were any differences in in-patient experiences between Aboriginal and Torres Strait Islander people and those without an Aboriginal or Torres Strait Islander background. Methods Random samples of people were invited to complete a survey following admission at the hospitals at Peninsula Health, Victoria, Australia. This survey was based on the Victorian Patient Satisfaction Monitor. Open-ended questions were also asked to gauge perspectives on how the services could better meet needs of Aboriginal and Torres Strait Islander patients. Results A total of 154 responses was obtained. There were differences between the two groups of participants in the following variables: respect of privacy, representation of culture, assistance with meals and access to a culturally specific worker if needed. This was reflected in thematic analysis, with three main themes identified: (1) interactions with staff; (2) the challenging environment; and (3) not just about me, but my family too. Conclusion There were systemic differences in in-patient experiences. Healthcare services have a responsibility to make systemic changes to improve the health care of all Australians by understanding and reforming how services can be appropriately delivered. What is known about the topic? There is a disparity in health outcomes between Aboriginal and Torres Strait Islander Australians and those who do not identify as Aboriginal and/or Torres Strait Islander. In addition, Aboriginal and Torres Strait Islanders have different interactions within healthcare services. Many rural health services have models that aim to deliver culturally appropriate services, but it is unknown whether the same challenges apply for this group of Australians within metropolitan health services. What does this paper add? This paper identifies the structural supports that are required to help close the gap in health care provision inequality. Many of the key issues identified are not people but system based. Healthcare administrators should consider the factors identified and address these at a whole-of-service level. What are the implications for practitioners? Many practitioners are aware of the challenges of providing culturally appropriate services. This research raises awareness of how traditional healthcare is not a one size fits all and flexibility is required to improve health outcomes.
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Kennedy, Michelle, Amanual Getnet Mersha, Raglan Maddox, Catherine Chamberlain, Sian Maidment, Peter O'Mara, Cathy Segan, et al. "Koori Quit Pack mailout smoking cessation support for Aboriginal and Torres Strait Islander people who smoke: a feasibility study protocol." BMJ Open 12, no. 10 (October 2022): e065316. http://dx.doi.org/10.1136/bmjopen-2022-065316.

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IntroductionSmoking remains the leading preventable cause of death for Aboriginal and Torres Strait Islander people in Australia. Aboriginal and Torres Strait Islander people who smoke are more likely to make a quit attempt than their non-Aboriginal counterparts but less likely to sustain the quit attempt. There is little available evidence specifically for and by Indigenous peoples to inform best practice smoking cessation care.The provision of a free Koori Quit Pack with optional nicotine replacement therapy sent by mail may be a feasible, acceptable and effective way to access stop smoking support for Aboriginal and Torres Strait Islander peoples.Methods and analysisAn Aboriginal-led, multisite non-randomised single-group, pre–post feasibility study across three states in Australia will be conducted. Participants will be recruited via service-targeted social media advertising and during usual care at their Aboriginal Community Controlled Health Services. Through a process of self-referral, Aboriginal and Torres Strait Islander people who smoke daily will complete a survey and receive mailout smoking cessation support. Data will be collected over the phone by an Aboriginal Research Assistant. This pilot study will inform the development of a larger, powered trial.Ethics and disseminationEthics approval has been obtained from the Aboriginal Health & Medical Research Council Ethics Committee of New South Wales (NSW) (#1894/21) and the University of Newcastle (#H-2022-0174). Findings will be reported through peer-reviewed journals and presentations at relevant local, national and international conferences. The findings will be shared with the NSW and Victoria Quitline, Aboriginal Health and Medical Research Council and Victorian Aboriginal Community Controlled Organisation and the National Heart Foundation.Trial registration numberACTRN12622000654752.
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Phelan, Péta, and Robyn Oxley. "Understanding the Social and Emotional Wellbeing of Aboriginal LGBTIQ(SB)+ Youth in Victoria’s Youth Detention." Social Inclusion 9, no. 2 (April 15, 2021): 18–29. http://dx.doi.org/10.17645/si.v9i2.3770.

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Aboriginal youth are overrepresented within Victoria’s criminal justice system (Cunneen, 2020). Aboriginal and Torres Strait Islander youth are diverse people with diverse needs: It is imperative to understand what those needs are and how they can be supported within Victoria’s youth justice centres. Research has identified that Aboriginal youth in Victoria’s justice system have higher rates of psychopathology (Shepherd et al., 2018), higher rates of recidivism (Cunneen, 2008), higher pre-custody rates and post-release rates of substance abuse (Joudo, 2008) and lower rates of rehabilitation (Thompson et al., 2014) than non-Indigenous counterparts. It is critical to explore how the Victorian youth justice system identifies and implements the provision of services that consider lesbian, gay, bisexual, transgender, intersex, queer, sistergirl and brotherboy (LGBTIQSB+) identities of Aboriginal youth in custody. This is because additional levels of systemic disadvantage, discrimination, stigma, and social exclusion that impact LGBTIQ+ youth specifically (Cunneen, Goldson, & Russell, 2016) as well as Aboriginal identity, further compound and jeopardize the social and emotional wellbeing of those embodying intersectional identities. This article will examine the services available to Aboriginal LGBTIQSB+ youth in the Victorian criminal justice system. Aboriginal, Torres Strait Islander, Indigenous and First Nations People will be used interchangeably throughout this document.
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Armstrong, Gregory, Georgina Sutherland, Eliza Pross, Andrew Mackinnon, Nicola Reavley, and Anthony Jorm. "Effects of an Aboriginal and Torres Strait Islander Mental Health First Aid training programme for non-suicidal self-injury on stigmatising attitudes, confidence in ability to assist, and intended and actual assisting actions: an uncontrolled trial with precourse and postcourse measurement and 6-month follow-up." BMJ Open 13, no. 1 (January 2023): e066043. http://dx.doi.org/10.1136/bmjopen-2022-066043.

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ObjectivesNon-suicidal self-injury (NSSI) is a complex issue affecting Aboriginal and/or Torres Strait Islander Peoples in Australia. We evaluated the effects of an Aboriginal and Torres Strait Islander Mental Health First Aid (AMHFA) training course on assisting an Aboriginal and/or Torres Strait Islander person engaging in NSSI, including the effects on stigmatising attitudes, confidence in ability to assist, and intended and actual assisting actions.DesignUncontrolled trial with precourse and postcourse measurement (n=49) and 6-month follow-up (n=17).SettingParticipants attended courses that were run in Queensland and Victorian communities and through one national organisation.ParticipantsParticipants were 49 adults who worked directly with Aboriginal and/or Torres Strait Islander Peoples.InterventionThe 5-hour ‘Talking About Non-Suicidal Self-Injury’ course was delivered by accredited AMHFA instructors and teaches people how to support an Aboriginal and/or Torres Strait Islander person who is engaging in NSSI.Primary and secondary outcome measuresThe outcome measures were stigmatising attitudes, confidence in ability to assist, and intended and actual actions to assist a person engaging in NSSI.ResultsImprovements were observed in stigmatising attitudes, with significant changes from precourse in both the ‘weak-not-sick’ (postcourse p<0.0623; follow-up p=0.0058) and ‘dangerous/unpredictable’ (postcourse p<0.0001; follow-up p=0.0036) subscales. Participants’ confidence in ability to assist increased significantly both postcourse (p<0.0001) and at follow-up (p<0.0001). Despite a high level of endorsement for the nine recommended assisting actions at precourse, significant improvements (p<0.05) were observed in endorsement for six and four of the assisting actions postcourse and at follow-up, respectively. Course content was rated as being somewhat (3.4%), mostly (13.8%) or very (82.7%) culturally appropriate by participants who identified as Aboriginal and/or Torres Strait Islander.ConclusionsThe results of this uncontrolled trial were encouraging, suggesting that the Talking About Non-Suicidal Self-Injury course was able to improve participants’ attitudes, confidence and intended assisting actions.
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Battams, Samantha, Toni Delany-Crowe, Matt Fisher, Lester Wright, Anthea Krieg, Dennis McDermott, and Fran Baum. "Applying Crime Prevention and Health Promotion Frameworks to the Problem of High Incarceration Rates for Aboriginal and Torres Strait Islander Populations: Lessons from a Case Study from Victoria." International Indigenous Policy Journal 12, no. 2 (May 14, 2021): 1–29. http://dx.doi.org/10.18584/iipj.2021.12.2.10208.

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This article examines what kinds of policy reforms are required to reduce incarceration rates of Aboriginal and Torres Strait Islander people through a case study of policy in the Australian state of Victoria. This state provides a good example of a jurisdiction with policies focused upon, and developed in partnership with, Aboriginal communities in Victoria, but which despite this has steadily increasing incarceration rates of Indigenous people. The case study consisted of a qualitative analysis of two key justice sector policies focused upon the Indigenous community in Victoria and interviews with key justice sector staff. Case study results are analysed in terms of primary, secondary, and tertiary crime prevention; the social determinants of Indigenous health; and recommended actions from the Ottawa Charter for Health Promotion. Finally, recommendations are made for future justice sector policies and approaches that may help to reduce the high levels of incarceration of Aboriginal and Torres Strait Islander people.
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Chynoweth, J., B. Daveson, M. McCambridge, J. Coutts, H. Zorbas, and K. Whitfield. "A National Priority: Improving Outcomes for Aboriginal and Torres Strait Islander People With Cancer Through an Optimal Care Pathway." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 243s. http://dx.doi.org/10.1200/jgo.18.97700.

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Background and context: Cancer survival rates in Australia are among the best in the world, yet Aboriginal and Torres Strait Islander (indigenous) people continue to experience disparities in the distribution and burden of cancer, and unwarranted variations in outcomes. Indigenous Australians are 40% more likely to die of cancer than non-Indigenous Australians. Cancer Australia developed the National Aboriginal and Torres Strait Islander Cancer Framework (the framework), which identified 7 national priorities to address disparities in cancer outcomes experienced by indigenous Australians. An ongoing collaboration with indigenous Australians was integral to developing this shared agenda. Priority 5 in the framework highlights the need to ensure indigenous Australians affected by cancer receive optimal and culturally appropriate treatment, services, and supportive and palliative care. Aim: To improve cancer outcomes for indigenous Australians through the development and national endorsement of a population-specific Optimal Care Pathway (OCP) to guide the delivery of consistent, safe, high-quality, culturally appropriate and evidence-based care. Strategy/Tactics: Cancer Australia formed a partnership with the Victorian Department of Health and Human Services (DHHS) to address Priority 5 and develop the OCP. The approach to development was underpinned by Cancer Australia's Model of Engagement for Aboriginal and Torres Strait Islander People and guided by the national Leadership Group on Aboriginal and Torres Strait Islander Cancer Control (Leadership Group). Program/Policy process: Cancer Australia, in collaboration with DHHS: • reviewed experiences of care and the framework's comprehensive evidence base • developed a draft OCP to complement tumor-specific pathways • facilitated an Expert Working Group, comprising indigenous health sector leaders and consumers to refine and validate the draft OCP • undertook national public consultation, including with the indigenous health sector and community, health professionals and professional colleges • received an indication of support to proceed to endorsement from the Leadership Group. Outcomes: The first population-specific OCP for Aboriginal and Torres Strait Islander people with cancer received national endorsement. It will guide the delivery of consistent, safe, high-quality, culturally appropriate and evidence-based care. What was learned: Key elements of optimal care include: addressing the cultural appropriateness of the healthcare environment; improving cross-cultural communication; relationship building with local community; optimizing health literacy; recognition of men's and women's business; and the need to use culturally appropriate resources. The national priority in the framework informed and unified high-level direction, which was integral to effective OCP development and endorsement. The evidence-based, step-wise development approach contributed to its relevance, utility and quality.
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Hobbs, Harry. "A Queensland treaty: Current steps and potential challenges." Alternative Law Journal 45, no. 1 (November 28, 2019): 25–30. http://dx.doi.org/10.1177/1037969x19891709.

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Last year Queensland joined Victoria and the Northern Territory in formally committing to a conversation about a treaty with Aboriginal and Torres Strait Islander peoples. This article explains what a treaty is, outlines the processes undertaken thus far, situates it within the broader national context, and explores several challenges moving forward.
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Briskman, Linda. "Beyond apologies: The Stolen Generations and the Churches." Children Australia 26, no. 3 (2001): 4–8. http://dx.doi.org/10.1017/s1035077200010282.

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The complicity of state and church in the removal and placement of Aboriginal children in Australia has been well documented. Since the investigation by the National Inquiry into the Separation of Aboriginal and Torres Strait Islander Children from their Families, a number of churches have apologised for their participation in these practices. Alongside the apologies, churches have engaged in activities of reconciliation. This paper documents a research project, commissioned by the Minajalku Aboriginal Corporation, to explore the role of churches and church agencies in Victoria.
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Dissertations / Theses on the topic "Aboriginal and Torres Strait Islander Victorians"

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Hall, Kerry K. "Acute respiratory illness in urban Aboriginal and Torres Strait Islander children." Thesis, Queensland University of Technology, 2017. https://eprints.qut.edu.au/110528/1/Kerry_Hall_Thesis.pdf.

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This thesis is the first to comprehensively evaluate Acute Respiratory Illness with Cough (ARIwC) in urban, predominantly Aboriginal and Torres Strait Islander, children. It identified a community experiencing significant disadvantage and a concerning burden of ARIwC. Positive findings include the frequent presentation to primary health care, continuity of primary health care provider, and knowledge of when cough is abnormal; factors that are all critical to the success of interventions and further research to reduce the burden of disease.
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Hodes, Jeremy. "Torres Strait Islander migration to Cairns before World War II." [S.l. : s.n.], 1998. http://catalog.hathitrust.org/api/volumes/oclc/44839600.html.

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Thesis (Master of Letters)--Central Queensland University, 1998.
"A dissertation submitted in partial fulfilment of the requirements for the Degree of Letters in History. Central Queensland University." Cover title.
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Adams, Michael John. "Sexual and reproductive health problems among Aboriginal and Torres Strait Islander males." Thesis, Queensland University of Technology, 2007. https://eprints.qut.edu.au/16599/1/Michael_John_Adams_Thesis.pdf.

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Compared to males in almost any social group in all affluent nations, Australia's Aboriginal and Torres Strait Islander men suffer from substantially more serious illnesses and early death. To date, research done by or in collaboration with Indigenous communities has revealed the extent of the problems that arise from diabetes, heart disease, hypertension, cancers, respiratory diseases, psychological disorders, accidental injuries, violence and other causes. Reproductive health, however, rarely has been studied among Indigenous men. To date, research in this field has been limited mainly to studies of sexually transmitted infections. No data has been published on Aboriginal men's symptoms of prostate disease or erectile dysfunction, nor has the clinical screening and treatment of these disorders among these men been assessed. In-depth search of the worldwide web demonstrated that little information on these issues was available from other Indigenous populations. It does appear that Indigenous men in Australia, New Zealand and North America are less likely than European-ancestry men to die from prostate cancer, or for living cases to be recorded on cancer registries. This may arise because Indigenous men genuinely have a lower risk, or because they are not captured by official statistics, or because they do not live long enough to develop severe prostate disease. We also know very little about other reproductive health problems such as sexual dysfunction and specifically erectile difficulties. One reason for our scant knowledge is that research mainly relies on self-report of sensitive information. The aim of the research study was to improve the understanding of sexual and reproductive health problems experienced by Indigenous men. This is best gathered by Aboriginal males who are inside the culture of middleaged and older Indigenous men, but until now this has not been attempted. In this study we adopted the World Health Organization (WHO) definitions for Reproductive and Sexual Health (WHO, 2001). Thus, we consider reproductive system disorders (prostate disease, erectile dysfunction) and related health care-seeking, and also men's perceptions about a "satisfying and safe sexual life". The methodology was framed within an Aboriginal and Torres Strait Islander research protocol that advocates respect for cultural, social and community customs. A mixed method design combined qualitative inquiry (4 focus groups and 18 in-depth interviews) and quantitative survey (n=301) involving men living in remote, rural and urban communities (Tiwi Islands, Darwin and north and south-east Queensland). Survey data were compared to recently published self-reports from 5990 randomly selected men aged over 40 years in Australia (Holden et al., 2005, The Lancet, 366, 218-224. The qualitative interviews revealed that most men were silent about reproductive health. They were unwilling to reveal their inner feelings to wives or partners, and they were unwilling to discuss such issues with doctors and other health care workers. Men's reaction to sexual difficulties included shame, denial, substance abuse and occasionally violence. On a positive note many men said they want to learn about it, so they understand how to cope with such problems. The Indigenous men reported symptoms of erectile dysfunction at least as much as non-Indigenous men in other Australian studies. Bivariate analysis showed that erectile dysfunction was correlated with many health and lifestyle variable. However multivariate analysis revealed that only three factors significantly predicted ED: presence of chronic disease, presence of pain when working, and living in a remote geographic location The quantitative survey data indicate that Indigenous men have more symptoms of prostate disease than non-Indigenous men. The syndrome appears to be poorly managed in clinical practice (e.g. rates of PSA testing and digital-rectal examination are only one-third the rate reported by non-Aboriginal men, despite equivalent likelihood of GP visits). The research study adds to the literature by providing better insight and depth into the issues impacting on Aboriginal and Torres Strait Islander males experiencing reproductive and sexual health difficulties. It also provides a platform to undertake comprehensive research with Aboriginal and Torres Strait Islander men to explore a wider spectrum of questions in this important but neglected area. Implications for education of primary healthcare workers and community-based awareness campaigns for Indigenous males are discussed. Most of all, this study revealed "layers" of silence around sexual and reproductive health of Indigenous men. This includes silence in the scientific establishments in health services, and in the community. It is hoped that this study puts the voices of the men forward to help to break down this silence.
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Adams, Michael John. "Sexual and reproductive health problems among Aboriginal and Torres Strait Islander males." Queensland University of Technology, 2007. http://eprints.qut.edu.au/16599/.

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Compared to males in almost any social group in all affluent nations, Australia's Aboriginal and Torres Strait Islander men suffer from substantially more serious illnesses and early death. To date, research done by or in collaboration with Indigenous communities has revealed the extent of the problems that arise from diabetes, heart disease, hypertension, cancers, respiratory diseases, psychological disorders, accidental injuries, violence and other causes. Reproductive health, however, rarely has been studied among Indigenous men. To date, research in this field has been limited mainly to studies of sexually transmitted infections. No data has been published on Aboriginal men's symptoms of prostate disease or erectile dysfunction, nor has the clinical screening and treatment of these disorders among these men been assessed. In-depth search of the worldwide web demonstrated that little information on these issues was available from other Indigenous populations. It does appear that Indigenous men in Australia, New Zealand and North America are less likely than European-ancestry men to die from prostate cancer, or for living cases to be recorded on cancer registries. This may arise because Indigenous men genuinely have a lower risk, or because they are not captured by official statistics, or because they do not live long enough to develop severe prostate disease. We also know very little about other reproductive health problems such as sexual dysfunction and specifically erectile difficulties. One reason for our scant knowledge is that research mainly relies on self-report of sensitive information. The aim of the research study was to improve the understanding of sexual and reproductive health problems experienced by Indigenous men. This is best gathered by Aboriginal males who are inside the culture of middleaged and older Indigenous men, but until now this has not been attempted. In this study we adopted the World Health Organization (WHO) definitions for Reproductive and Sexual Health (WHO, 2001). Thus, we consider reproductive system disorders (prostate disease, erectile dysfunction) and related health care-seeking, and also men's perceptions about a "satisfying and safe sexual life". The methodology was framed within an Aboriginal and Torres Strait Islander research protocol that advocates respect for cultural, social and community customs. A mixed method design combined qualitative inquiry (4 focus groups and 18 in-depth interviews) and quantitative survey (n=301) involving men living in remote, rural and urban communities (Tiwi Islands, Darwin and north and south-east Queensland). Survey data were compared to recently published self-reports from 5990 randomly selected men aged over 40 years in Australia (Holden et al., 2005, The Lancet, 366, 218-224. The qualitative interviews revealed that most men were silent about reproductive health. They were unwilling to reveal their inner feelings to wives or partners, and they were unwilling to discuss such issues with doctors and other health care workers. Men's reaction to sexual difficulties included shame, denial, substance abuse and occasionally violence. On a positive note many men said they want to learn about it, so they understand how to cope with such problems. The Indigenous men reported symptoms of erectile dysfunction at least as much as non-Indigenous men in other Australian studies. Bivariate analysis showed that erectile dysfunction was correlated with many health and lifestyle variable. However multivariate analysis revealed that only three factors significantly predicted ED: presence of chronic disease, presence of pain when working, and living in a remote geographic location The quantitative survey data indicate that Indigenous men have more symptoms of prostate disease than non-Indigenous men. The syndrome appears to be poorly managed in clinical practice (e.g. rates of PSA testing and digital-rectal examination are only one-third the rate reported by non-Aboriginal men, despite equivalent likelihood of GP visits). The research study adds to the literature by providing better insight and depth into the issues impacting on Aboriginal and Torres Strait Islander males experiencing reproductive and sexual health difficulties. It also provides a platform to undertake comprehensive research with Aboriginal and Torres Strait Islander men to explore a wider spectrum of questions in this important but neglected area. Implications for education of primary healthcare workers and community-based awareness campaigns for Indigenous males are discussed. Most of all, this study revealed "layers" of silence around sexual and reproductive health of Indigenous men. This includes silence in the scientific establishments in health services, and in the community. It is hoped that this study puts the voices of the men forward to help to break down this silence.
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Grootjans, John, of Western Sydney Hawkesbury University, and of Health Humanities and Social Ecology Faculty. "Both ways and beyond : in Aboriginal and Torres Strait Islander health worker education." THESIS_FHHSE_SEL_Grootjans_J.xml, 1999. http://handle.uws.edu.au:8081/1959.7/445.

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During 1987 my essential beliefs about the nature of the world were challenged by a chance event which led to my arrival in Arnhemland. Working with Aboriginal people allowed me to see first hand the failings of Western ideas in Aboriginal education and health. This is how a 12 year collaboration with Aboriginal people began. The aim was to search for answers to the question, 'Why so many ideas that had been successfully used in the Western world, fail to meet the needs of aboriginal people? My experiences prior to 1995 had led me to believe that Both Ways, an education pedagogy developed in teacher education, was the best approach for empowering Aboriginal Health Workers. I believed Both Ways gave Aboriginal Health Workers a means to develop solutions to aboriginal health issues which valued and respected their aboriginal knowledge. I needed to describe and evaluate the practice of both ways with Aboriginal Health workers for the purpose of proving the benefit of this pedagogy for other educators in this field. This thesis describes how I came to think Both Ways was a good idea; how I defined Both ways; and how I put it into practice. It also provides a description of the issues raised in my critique of Both Ways and in my attempts to provide answers to these issues. Several years of collecting data, including records from action research group discussions, participant observation, interviews with peers and students, and formal evaluations left me with many concerns about Both Ways. As educators follow my journey of discovery I hope that they will recognise experiences and insights that they themselves have shared. The descriptions and discussions in this thesis will add significantly to the overall discourse about health worker education. Similarly, the exploration of ideas beyond Both Ways will add significantly to the overall body knowledge about the power relationships involved in teaching in a cross cultural setting
Doctor of Philosophy (PhD)
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Grootjans, John. "Both ways and beyond : in Aboriginal and Torres Strait Islander health worker education /." View thesis, 1999. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20030725.103057/index.html.

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Hogarth, Melitta Dorn. "A critical analysis of the Aboriginal and Torres Strait Islander Education Action Plan." Thesis, Queensland University of Technology, 2015. https://eprints.qut.edu.au/89754/1/Melitta_Hogarth_Thesis.pdf.

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This study involves the analysis of one of the most recent Indigenous Education policies, the Aboriginal and Torres Strait Islander Education Action Plan 2010-2014 (MCEECDYA, 2011). It examines how the language used within policy positions Aboriginal and Torres Strait Islander peoples. Articulating Rigney's (1999) Indigenist Research Principles with Fairclough's (2001) Critical Discourse Analysis provides a platform for critical dialogues about policy decision-making. In doing so, this articulation enables and emphasises the need for potential policy revision to contribute to the Aboriginal and Torres Strait Islander struggle for self-determination.
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Simone, Nicole R. "Teachers perspectives of embedding Aboriginal and Torres Strait Islander peoples' histories and cultures in mathematics." Thesis, Queensland University of Technology, 2022. https://eprints.qut.edu.au/227459/1/Nicole_Simone_Thesis.pdf.

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This thesis explored how six teachers of mathematics embedded Aboriginal and Torres Strait Islander Peoples’ Histories and Cultures into the core mathematics curriculum. Semi-structured interviews were conducted, then written transcripts were analysed through the use of Bernstein’s Theory of Pedagogic Discourse. Teachers shared their perspectives on how they have developed their cultural capabilities, and how this has informed culturally responsive teaching of mathematics. Recommendations are made for how to support in-service teachers with their personal cultural capabilities to authentically embed Aboriginal and Torres Strait Islander Peoples’ Histories and Cultures in mathematics curriculum.
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Shepherd, Carrington C. J. "The socioeconomic pattern of health and developmental outcomes among Aboriginal and Torres Strait Islander children." Thesis, Curtin University, 2012. http://hdl.handle.net/20.500.11937/712.

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The pervasive health and social disadvantage faced by Aboriginal and Torres Strait Islander peoples is an acknowledged part of Australian society. The contemporary data reveal striking inequalities between Indigenous and non-Indigenous Australians in most measurable aspects of wellbeing across the life cycle. This reflects a postcolonial history of marginalisation and exclusion from mainstream society, dispossession of traditional lands, forced separation from family and kinship networks, and racism. Despite an increased awareness and disapproval of these inequalities in health, the inequalities persist.The lack of progress in the face of public disapproval and progressive government support underscores the fact that we still do not adequately understand the fundamental causes of Indigenous ill health and disease. A small body of research in Australia has highlighted that socioeconomic status (SES) accounts for a portion of the gap in health but this does not imply that they account for health differences within Indigenous population groups. A robust international literature has consistently shown that socioeconomic factors influence population health. These factors reflect the way in which society is ordered according to wealth, prestige, power, social standing or one’s control over economic resources, and their pattern of association with health has almost always depicted better health for those who are better off— that is, the health of population groups normally follows a gradient pattern. Despite the ubiquity of this observation in the empirical literature, there is uncertainty as to whether it applies to Aboriginal and Torres Strait Islander populations in Australia.Accordingly, this thesis has aimed to assess the pattern of socioeconomic disparities in the health and development of Indigenous populations in Australia, with a specific focus on children. The three key objectives were to: • Describe the developmental status of Indigenous children and the mechanisms that influence this status; • Determine the pattern of association between socioeconomic factors and physical and mental health outcomes; and • Reveal the significant differences (and similarities) in the socioeconomic pattern of child health between Indigenous and non-Indigenous populations, and articulate these in terms of their direction, shape and magnitude.The objectives of the study were primarily assessed using a quantitative analytic framework applied to four existing population-representative datasets: the 2008 National Aboriginal and Torres Strait Islander Social Survey, the 2000–2002 Western Australian Aboriginal Child Health Survey, the 2004–05 National Aboriginal and Torres Strait Islander Health Survey and 2004–05 National Health Survey. Simple univariate and cross-tabulation data were used to describe population characteristics, while the relationships between socioeconomic indicators and health outcomes were assessed using a range of regression techniques. Multilevel models are an important feature of this study, and have enabled a more accurate estimation of the effects of individual and area-level measures of SES on health. Generalised Additive Models were used to account for the possible non-linear nature of associations between continuous SES variables and physical health outcomes, with results presented as non-parametric spline curves. The mechanisms linking SES and mental health were explored using a stepwise approach to the regression analysis. All data in all chapters were weighted to reflect population benchmarks.The findings highlighted that there were significant socioeconomic disparities in the health of Indigenous children in Australia, although the direction, shape and magnitude varied, by both socioeconomic measure and health outcome. While the socioeconomic patterns of Indigenous child health are not universal, they are more consistent for mental than physical health. In addition, the thesis has shown that both conventional and alternative notions of SES can influence health patterns. The largest disparities in child physical health were observed for area-level SES indicators, while housing characteristics and area-level SES both had a strong direct effect on child mental health.The thesis has demonstrated that the patterns of socioeconomic disparities in child health differ markedly in Indigenous and non-Indigenous populations—at least in non-remote settings. It was not uncommon for the magnitude of disparity to be larger in the Indigenous population. These findings lend support to the notion that socioeconomic factors have a differential impact on the health of Indigenous and non-Indigenous populations. The implication of this for policy is that a single approach to stimulating socioeconomic conditions will not have equal benefits to child health outcomes in Indigenous and non-Indigenous populations. While the evidence here underscores the validity of the well-worn edict that “one size does not fit all” in Indigenous health policy, it also reinforces the need to examine health disparities within and across Indigenous and other population groups in order to better inform policy and practiceCollectively, the results have provided clear evidence that socioeconomic factors matter to both the physical and mental health of Aboriginal and Torres Strait Islander children. The diversity of findings implies that SES factors are one facet of the unique and complex set of factors that influence Aboriginal child health and wellbeing.This thesis has made several original contributions to the literature on social inequalities in Indigenous health in Australia and the broader field of social determinants of health. It is one of the few studies internationally to explicitly look at the socioeconomic patterning of health in an Indigenous population, and the first to examine these patterns among Indigenous children using population-representative data. In doing so, the study has begun to bridge the knowledge gap on social inequalities in Aboriginal health in Australia, and will facilitate a better grasp of the complex underlying mechanisms that determine Aboriginal health.For policy, this knowledge can lead to more effective government decision-making in terms of targeting social determinants of health that are of particular significance for Aboriginal populations. It is hoped that the findings of the thesis can provide directions for future research and insights to policy that will, ultimately, increase the pace of change toward health equity in Australia.
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Miller, Melinda G. "Action for change? Embedding Aboriginal and Torres Strait Islander perspectives in early childhood education curricula." Thesis, Queensland University of Technology, 2013. https://eprints.qut.edu.au/60905/5/60905.pdf.

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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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Books on the topic "Aboriginal and Torres Strait Islander Victorians"

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curator), Ryan Judith (Museum, ed. Aboriginal and Torres Strait Islander art in the collection of the National Gallery of Victoria. Melbourne, Victoria, Australia: National Gallery of Victoria, 2015.

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Healey, Justin. Aboriginal and Torres Strait Islander health. Thirroul, NSW, Australia: Spinney Press, 2014.

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Moorcroft, Heather. Aboriginal and Torres Strait Islander thesaurus. Canberra: National Library of Australia, 1997.

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Price, Kaye, ed. Aboriginal and Torres Strait Islander Education. Cambridge: Cambridge University Press, 2012. http://dx.doi.org/10.1017/cbo9781139519403.

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Naylor, Tonia. Teaching aboriginal & Torres Strait Islander university students. Mt. Lawley, W.A: Kurongkurl Katitjin Books, 1998.

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Author, Slade Lisa, ed. Highlights: Aboriginal and Torres Strait Islander collection. Adelaide: Art Gallery of South Australia, 2014.

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McLennan, W. 1994 National aboriginal and torres strait islander survey: Victoria. [Canberra, Australia]: Australian Bureau of Statistics, 1996.

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McLennan, W. 1994 National Aboriginal and Torres Strait Islander survey: Tasmania. [Canberra, Australia]: Australian Bureau of Statistics, 1996.

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McLennan, W. 1994 National aboriginal and torres strait islander survey: Queensland. [Canberra, Australia]: Australian Bureau of Statistics, 1996.

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Trewin, Dennis. Population distribution, Aboriginal and Torres Strait Islander Australians, 2001. [Canberra]: Australian Bureau of Statistics, 2002.

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Book chapters on the topic "Aboriginal and Torres Strait Islander Victorians"

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McMillan, Faye, Linda Deravin, and Glenda McDonald. "Aboriginal and Torres Strait Islander health." In Nursing in Australia, 53–64. Milton Park, Abingdon, Oxon; New York, NY: Routledge, 2021.: Routledge, 2020. http://dx.doi.org/10.4324/9781003120698-7.

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Johnston, Michelle, and Simon Forrest. "Education and Aboriginal and Torres Strait Islander Students." In Working Two Way, 125–51. Singapore: Springer Singapore, 2020. http://dx.doi.org/10.1007/978-981-15-4913-7_7.

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Tubex, Hilde, and Dorinda Cox. "Aboriginal and Torres Strait Islander Women in Australian Prisons." In Neo-Colonial Injustice and the Mass Imprisonment of Indigenous Women, 133–54. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-44567-6_7.

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Kildea, Sue, and M. Wardaguga. "Childbirth in Australia: Aboriginal and Torres Strait Islander Women." In Science Across Cultures: the History of Non-Western Science, 275–86. Dordrecht: Springer Netherlands, 2009. http://dx.doi.org/10.1007/978-90-481-2599-9_26.

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O’Rourke, Timothy. "Aboriginal and Torres Strait Islander Domestic Architecture in Australia." In The Handbook of Contemporary Indigenous Architecture, 25–56. Singapore: Springer Singapore, 2018. http://dx.doi.org/10.1007/978-981-10-6904-8_2.

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Akbar, Skye, and Freya Higgins-Desbiolles. "Critical perspectives on Aboriginal and Torres Strait Islander tourism." In Inclusive Place Branding, 23–36. Abingdon, Oxon ; New York, NY : Routledge, 2018.: Routledge, 2017. http://dx.doi.org/10.4324/9781315620350-3.

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Lewis, Ben. "Empowering Aboriginal and Torres Strait Islander students in schools." In Flip the System Australia, 133–36. Abingdon, Oxon; New York, NY : Routledge, [2019]: Routledge, 2018. http://dx.doi.org/10.4324/9780429429620-19.

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Pyle, Elizabeth, Deanna Grant-Smith, and Robyn Mayes. "Deficit Discourses and Aboriginal and Torres Strait Islander Disadvantage." In The Management of Wicked Problems in Health and Social Care, 148–59. New York, NY : Routledge, 2019. | Series: Routledge studies in health management: Routledge, 2018. http://dx.doi.org/10.4324/9781315102597-14.

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Bodkin-Andrews, Gawaian, Treena Clark, and Shannon Foster. "Aboriginal and Torres Strait Islander Secondary Students’ Experiences of Racism." In The Palgrave Handbook of Ethnicity, 1–24. Singapore: Springer Singapore, 2019. http://dx.doi.org/10.1007/978-981-13-0242-8_106-1.

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Austin, Jon. "Aboriginal and Torres Strait Islander Students as Effective Numeracy Learners." In Numeracy in Authentic Contexts, 75–89. Singapore: Springer Singapore, 2017. http://dx.doi.org/10.1007/978-981-10-5736-6_5.

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Conference papers on the topic "Aboriginal and Torres Strait Islander Victorians"

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Blake, Tamara, Mark Chatfield, Anne Chang, Helen Petsky, and Margaret Mcelrea. "Spirometry reference values for Australian Aboriginal and Torres Strait Islander (Indigenous) children and young adults." In ERS International Congress 2018 abstracts. European Respiratory Society, 2018. http://dx.doi.org/10.1183/13993003.congress-2018.oa3777.

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Blake, Tamara, Mark Chatfield, Anne Chang, Helen Petsky, and Margaret Mcelrea. "Self-reported and medical chart histories of Australian Aboriginal and Torres Strait Islander (Indigenous) children and young adults." In ERS International Congress 2018 abstracts. European Respiratory Society, 2018. http://dx.doi.org/10.1183/13993003.congress-2018.pa4682.

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Crump, Vanessa, and Yvonne C. Davila. "UNDERSTANDING STUDENTS’ EXPERIENCES AFTER INCORPORATING INDIGENOUS PERSPECTIVES IN A POSTGRADUATE SCIENCE COMMUNICATION." In International Conference on Education and New Developments. inScience Press, 2022. http://dx.doi.org/10.36315/2022v2end005.

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"Many Australian universities have recently incorporated Indigenous graduate attributes into their programs, and the University of Technology Sydney (UTS) is no exception. This project aimed to investigate students’ perceptions and experiences of learning about Indigenous Knowledge systems and culture while developing science communication skills. Advanced Communication Skills in Science is a core subject in the Master of Science program at UTS. An existing assessment task, a three-minute thesis style oral presentation, was reworked to include the Indigenous Graduate Attribute (IGA) developed for the Faculty of Science. Students researched an aspect of Indigenous Science, an area of emerging interest for cultural and scientific understanding, and a mechanism for empowering Australia’s diverse first nations peoples. They then presented their key message in three minutes using a single PowerPoint slide. This task allowed students to demonstrate an awareness and appreciation of multiple ways of developing understandings of nature while enhancing their ability to understand the role of science communication in the modern world. Students were surveyed at the beginning and end of the semester to establish their Indigenous Science conceptions and reflect on their experiences. Students demonstrated an outstanding ability to integrate appropriate Aboriginal and Torres Strait Islander knowledges, experience, and analysis into a key message. Most students reported greater familiarity with concepts such as Indigenous Science and provided richer definitions of what this means. When asked if understanding Aboriginal and Torres Strait Islander knowledges and cultural practices might impact their practice as a scientist, many felt their perspective had changed and that reflecting on their cultural values and beliefs had improved their cultural capability. Most students responded that this subject challenged (at least to a degree) some firmly held assumptions, ideas, and beliefs."
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Finlay, E., and J. Kidd. "16 Unpacking the ‘truth’ about the health gap: decolonising methodologies, cultural archives and the national aboriginal and torres Strait Islander health plan 2013–2023." In Negotiating trust: exploring power, belief, truth and knowledge in health and care. Qualitative Health Research Network (QHRN) 2021 conference book of abstracts. British Medical Journal Publishing Group, 2021. http://dx.doi.org/10.1136/bmjopen-2021-qhrn.54.

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Reports on the topic "Aboriginal and Torres Strait Islander Victorians"

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Go-Sam, Carroll, Kelly Greenop, Kali Marnane, and Theresa Bower. Campuses on Countries: Aboriginal and Torres Strait Islander Design Framework at The University of Queensland. Brisbane, Australia: The University of Queensland, January 2021. http://dx.doi.org/10.14264/955791e.

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Rogers, Jessa, Kate E. Williams, Kristin R. Laurens, Donna Berthelsen, Emma Carpendale, Laura Bentley, and Elizabeth Briant. Footprints in Time: Longitudinal Study of Indigenous Children. Queensland University of Technology, October 2022. http://dx.doi.org/10.5204/rep.eprints.235509.

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The Longitudinal Study of Indigenous Children (LSIC; also called Footprints in Time) is the only longitudinal study of developmental outcomes for Aboriginal and Torres Strait Islander children globally. Footprints in Time follows the development of Australian Aboriginal and Torres Strait Islander children to understand what Indigenous children need to grow up strong. LSIC involves annual waves of data collection (commenced in 2008) and follows approximately 1,700 Aboriginal and Torres Strait Islander children living in urban, regional, and remote locations. This LSIC Primary School report has been produced following the release of the twelfth wave of data collection, with the majority of LSIC children having completed primary school (Preparatory [aged ~5 years] to Year 6 [aged ~12 years]). Primary schools play a central role in supporting student learning, wellbeing, and connectedness, and the Footprints in Time study provides a platform for centring Indigenous voices, connecting stories, and exploring emerging themes related to the experience of Indigenous children and families in the Australian education system. This report uses a mixed-methods approach, analysing both quantitative and qualitative data shared by LSIC participants, to explore primary school experiences from the perspective of children, parents and teachers. Analyses are framed using a strengths-based approach and are underpinned by the understanding that all aspects of life are related. The report documents a range of topics including teacher cultural competence, racism, school-based Aboriginal and Torres Strait Islander education activities, parental involvement, engagement, attendance, and academic achievement.
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Marnane, Kali, and Theresa Bower. Campuses on Countries: Aboriginal and Torres Strait Islander Design Framework Engagement Report at The University of Queensland. St Lucia, QLD Australia: The University of Queensland, January 2021. http://dx.doi.org/10.14264/c684e38.

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Ward, Jeanette E., Seham Girgis, Kathryn Thorburn, Stefanie Oliver, Charles Weijer, and Monica Taljaard. A systemic review of self-reported ethical practices in publications of cluster randomised trials conducted in Aboriginal and Torres Strait Islander settings. Edited by Melissa Marshall, Gillian Kennedy, Anna Dwyer, and Sandra Wooltorton. Nulungu Research Institute, The University of Notre Dame Australia, 2021. http://dx.doi.org/10.32613/nrp/2021.4.

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Rankin, Nicole, Deborah McGregor, Candice Donnelly, Bethany Van Dort, Richard De Abreu Lourenco, Anne Cust, and Emily Stone. Lung cancer screening using low-dose computed tomography for high risk populations: Investigating effectiveness and screening program implementation considerations: An Evidence Check rapid review brokered by the Sax Institute (www.saxinstitute.org.au) for the Cancer Institute NSW. The Sax Institute, October 2019. http://dx.doi.org/10.57022/clzt5093.

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Background Lung cancer is the number one cause of cancer death worldwide.(1) It is the fifth most commonly diagnosed cancer in Australia (12,741 cases diagnosed in 2018) and the leading cause of cancer death.(2) The number of years of potential life lost to lung cancer in Australia is estimated to be 58,450, similar to that of colorectal and breast cancer combined.(3) While tobacco control strategies are most effective for disease prevention in the general population, early detection via low dose computed tomography (LDCT) screening in high-risk populations is a viable option for detecting asymptomatic disease in current (13%) and former (24%) Australian smokers.(4) The purpose of this Evidence Check review is to identify and analyse existing and emerging evidence for LDCT lung cancer screening in high-risk individuals to guide future program and policy planning. Evidence Check questions This review aimed to address the following questions: 1. What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? 2. What is the evidence of potential harms from lung cancer screening for higher-risk individuals? 3. What are the main components of recent major lung cancer screening programs or trials? 4. What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Summary of methods The authors searched the peer-reviewed literature across three databases (MEDLINE, PsycINFO and Embase) for existing systematic reviews and original studies published between 1 January 2009 and 8 August 2019. Fifteen systematic reviews (of which 8 were contemporary) and 64 original publications met the inclusion criteria set across the four questions. Key findings Question 1: What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? There is sufficient evidence from systematic reviews and meta-analyses of combined (pooled) data from screening trials (of high-risk individuals) to indicate that LDCT examination is clinically effective in reducing lung cancer mortality. In 2011, the landmark National Lung Cancer Screening Trial (NLST, a large-scale randomised controlled trial [RCT] conducted in the US) reported a 20% (95% CI 6.8% – 26.7%; P=0.004) relative reduction in mortality among long-term heavy smokers over three rounds of annual screening. High-risk eligibility criteria was defined as people aged 55–74 years with a smoking history of ≥30 pack-years (years in which a smoker has consumed 20-plus cigarettes each day) and, for former smokers, ≥30 pack-years and have quit within the past 15 years.(5) All-cause mortality was reduced by 6.7% (95% CI, 1.2% – 13.6%; P=0.02). Initial data from the second landmark RCT, the NEderlands-Leuvens Longkanker Screenings ONderzoek (known as the NELSON trial), have found an even greater reduction of 26% (95% CI, 9% – 41%) in lung cancer mortality, with full trial results yet to be published.(6, 7) Pooled analyses, including several smaller-scale European LDCT screening trials insufficiently powered in their own right, collectively demonstrate a statistically significant reduction in lung cancer mortality (RR 0.82, 95% CI 0.73–0.91).(8) Despite the reduction in all-cause mortality found in the NLST, pooled analyses of seven trials found no statistically significant difference in all-cause mortality (RR 0.95, 95% CI 0.90–1.00).(8) However, cancer-specific mortality is currently the most relevant outcome in cancer screening trials. These seven trials demonstrated a significantly greater proportion of early stage cancers in LDCT groups compared with controls (RR 2.08, 95% CI 1.43–3.03). Thus, when considering results across mortality outcomes and early stage cancers diagnosed, LDCT screening is considered to be clinically effective. Question 2: What is the evidence of potential harms from lung cancer screening for higher-risk individuals? The harms of LDCT lung cancer screening include false positive tests and the consequences of unnecessary invasive follow-up procedures for conditions that are eventually diagnosed as benign. While LDCT screening leads to an increased frequency of invasive procedures, it does not result in greater mortality soon after an invasive procedure (in trial settings when compared with the control arm).(8) Overdiagnosis, exposure to radiation, psychological distress and an impact on quality of life are other known harms. Systematic review evidence indicates the benefits of LDCT screening are likely to outweigh the harms. The potential harms are likely to be reduced as refinements are made to LDCT screening protocols through: i) the application of risk predication models (e.g. the PLCOm2012), which enable a more accurate selection of the high-risk population through the use of specific criteria (beyond age and smoking history); ii) the use of nodule management algorithms (e.g. Lung-RADS, PanCan), which assist in the diagnostic evaluation of screen-detected nodules and cancers (e.g. more precise volumetric assessment of nodules); and, iii) more judicious selection of patients for invasive procedures. Recent evidence suggests a positive LDCT result may transiently increase psychological distress but does not have long-term adverse effects on psychological distress or health-related quality of life (HRQoL). With regards to smoking cessation, there is no evidence to suggest screening participation invokes a false sense of assurance in smokers, nor a reduction in motivation to quit. The NELSON and Danish trials found no difference in smoking cessation rates between LDCT screening and control groups. Higher net cessation rates, compared with general population, suggest those who participate in screening trials may already be motivated to quit. Question 3: What are the main components of recent major lung cancer screening programs or trials? There are no systematic reviews that capture the main components of recent major lung cancer screening trials and programs. We extracted evidence from original studies and clinical guidance documents and organised this into key groups to form a concise set of components for potential implementation of a national lung cancer screening program in Australia: 1. Identifying the high-risk population: recruitment, eligibility, selection and referral 2. Educating the public, people at high risk and healthcare providers; this includes creating awareness of lung cancer, the benefits and harms of LDCT screening, and shared decision-making 3. Components necessary for health services to deliver a screening program: a. Planning phase: e.g. human resources to coordinate the program, electronic data systems that integrate medical records information and link to an established national registry b. Implementation phase: e.g. human and technological resources required to conduct LDCT examinations, interpretation of reports and communication of results to participants c. Monitoring and evaluation phase: e.g. monitoring outcomes across patients, radiological reporting, compliance with established standards and a quality assurance program 4. Data reporting and research, e.g. audit and feedback to multidisciplinary teams, reporting outcomes to enhance international research into LDCT screening 5. Incorporation of smoking cessation interventions, e.g. specific programs designed for LDCT screening or referral to existing community or hospital-based services that deliver cessation interventions. Most original studies are single-institution evaluations that contain descriptive data about the processes required to establish and implement a high-risk population-based screening program. Across all studies there is a consistent message as to the challenges and complexities of establishing LDCT screening programs to attract people at high risk who will receive the greatest benefits from participation. With regards to smoking cessation, evidence from one systematic review indicates the optimal strategy for incorporating smoking cessation interventions into a LDCT screening program is unclear. There is widespread agreement that LDCT screening attendance presents a ‘teachable moment’ for cessation advice, especially among those people who receive a positive scan result. Smoking cessation is an area of significant research investment; for instance, eight US-based clinical trials are now underway that aim to address how best to design and deliver cessation programs within large-scale LDCT screening programs.(9) Question 4: What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Assessing the value or cost-effectiveness of LDCT screening involves a complex interplay of factors including data on effectiveness and costs, and institutional context. A key input is data about the effectiveness of potential and current screening programs with respect to case detection, and the likely outcomes of treating those cases sooner (in the presence of LDCT screening) as opposed to later (in the absence of LDCT screening). Evidence about the cost-effectiveness of LDCT screening programs has been summarised in two systematic reviews. We identified a further 13 studies—five modelling studies, one discrete choice experiment and seven articles—that used a variety of methods to assess cost-effectiveness. Three modelling studies indicated LDCT screening was cost-effective in the settings of the US and Europe. Two studies—one from Australia and one from New Zealand—reported LDCT screening would not be cost-effective using NLST-like protocols. We anticipate that, following the full publication of the NELSON trial, cost-effectiveness studies will likely be updated with new data that reduce uncertainty about factors that influence modelling outcomes, including the findings of indeterminate nodules. Gaps in the evidence There is a large and accessible body of evidence as to the effectiveness (Q1) and harms (Q2) of LDCT screening for lung cancer. Nevertheless, there are significant gaps in the evidence about the program components that are required to implement an effective LDCT screening program (Q3). Questions about LDCT screening acceptability and feasibility were not explicitly included in the scope. However, as the evidence is based primarily on US programs and UK pilot studies, the relevance to the local setting requires careful consideration. The Queensland Lung Cancer Screening Study provides feasibility data about clinical aspects of LDCT screening but little about program design. The International Lung Screening Trial is still in the recruitment phase and findings are not yet available for inclusion in this Evidence Check. The Australian Population Based Screening Framework was developed to “inform decision-makers on the key issues to be considered when assessing potential screening programs in Australia”.(10) As the Framework is specific to population-based, rather than high-risk, screening programs, there is a lack of clarity about transferability of criteria. However, the Framework criteria do stipulate that a screening program must be acceptable to “important subgroups such as target participants who are from culturally and linguistically diverse backgrounds, Aboriginal and Torres Strait Islander people, people from disadvantaged groups and people with a disability”.(10) An extensive search of the literature highlighted that there is very little information about the acceptability of LDCT screening to these population groups in Australia. Yet they are part of the high-risk population.(10) There are also considerable gaps in the evidence about the cost-effectiveness of LDCT screening in different settings, including Australia. The evidence base in this area is rapidly evolving and is likely to include new data from the NELSON trial and incorporate data about the costs of targeted- and immuno-therapies as these treatments become more widely available in Australia.
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