Journal articles on the topic 'Community health services for children Victoria Melbourne'

Chlamydia is the most common notifiable infectious disease in Australia with the number of notifications increasing 92% over the past 5 years. The "Sex and Sport" Project is piloting a community based chlamydia testing and treatment program reaching young people in a specific community setting, sporting clubs. This multifaceted approach utilises health education, population screening and collection of data on risk taking behaviour as the first steps in enhancing health and shaping future service provisions. The project's primary aim is to assess the feasibility of an outreach testing and treatment program. Secondary aims are to measure the prevalence of chlamydia and assess sexual risk behaviour in this population. Strong community collaborations and integration into local health services through the Primary Care Partnerships is important in the project's sustainability; in particular key community members respected by sporting clubs needed to be identified, capacity developed to deliver effective health promotion messages and improve young people's access to sexual health services. Additionally, local knowledge has guided overall program implementation and provides opportunities for capacity building to regionally based services. For example, poor access to sexual health services is being addressed by the participants being able to access services via telephone consultation with Melbourne Sexual Health Centre. Approximately 1000 Victorians aged 16-25 years from the Loddon Mallee region of Victoria will be tested between June and September 2007. This paper will report on the feasibility, challenges and possible solutions in establishing a community based outreach testing and treatment program.

It is important to address the health needs of asylum seekers within the early stages of their arrival in Australia, as this impacts all aspects of their resettlement. However, asylum seekers face a range of barriers to accessing timely and appropriate health care in the community. In 2012, the increasing number of asylum seekers in Australia placed additional demand on health and social services in high-settlement regions. Health providers experienced a substantial increase in Medicare ineligible clients and avoidable presentations to Emergency Departments, and the health needs of new asylum seeker arrivals were not being fully addressed. In response, South Eastern Melbourne Medicare Local, Monash Health, the Australian Red Cross and local settlement support agencies collaborated to develop an integrated healthcare pathway in South Eastern Melbourne to facilitate healthcare access for asylum seekers released from detention. From September 2012 to December 2014, a total of 951 asylum seekers transitioned through the pathway. Seventy-eight percent required primary healthcare assistance, and were provided with a service appointment within 3 weeks of their arrival in Melbourne. This initiative has demonstrated the value of partnership and collaboration when responding to emergent asylum seeker health needs.

Anabolic steroid injectors are at risk of infection with blood-borne viruses (BBVs), but have received little attention from researchers, practitioners or agencies working in public health. In recognition of this gap, in early 1996 the Steroid Peer Education Project (SPEP) began providing part-time mobile needle and syringe distribution and health information and referral services to steroid injectors in north-eastern Melbourne. Demand repeatedly caused the project to expand, and its sole peer worker now operates Victoria-wide, five days per week. Basic information on injecting practices collected from SPEP clients showed that many were at risk of BBV infection. This led to the initiation of a collaborative research project, in which SPEP clients were tested for BBV antibodies and provided detailed information about their risk behaviours. Of 29 steroid injectors tested between May and August 1999, three (10%) had antibodies to the hepatitis C virus, and they described behaviour which could spread the virus to other steroid users. These results show that blood-borne viruses are present in the Victorian steroid injecting community, and reinforce the SPEP's commitment to reducing harm in this group.

Despite the best efforts and commitment of oral health programs, there is no evidence that the current surgical output-based model of oral health care is delivering better oral health outcomes to the community. In fact, Australian evidence indicates the oral health of the community could be getting worse. It is now well-understood that this traditional surgical model of oral health care will never successfully manage the disease itself. It is proposed that a health-promoting, minimally invasive oral disease management model of care may lead to a sustainable benefit to the oral health status of the individual and community groups. The aim of this paper is to describe such a model of oral health care (MoC) currently being implemented by the North Richmond Community Health Oral Health (NRCH-OH) program in Melbourne, Victoria, Australia; this model may serve as a template for other services to re-orient their healthcare delivery towards health promotion and prevention. The paper describes the guiding principles and theories for the model and also its operational components, which are: pre-engagement while on the waitlist; client engagement at the reception area; the assessment phase; oral health education (high-risk clients only); disease management; and reviews and recall.

The Families First Pilot Program in the then Outer East metropolitan region of Melbourne began in mid-1991 as an intensive family preservation and reunification service for children on the verge of state care. The service offered was brief (4-6 week), intensive (up to 20 hours per week), home-based and flexible (24 hour a day, 7 day a week availability) and all members of the household or family were the focus of service even though the goals were clearly grounded in the protection of the child. This paper begins with some of the apprehension expressed both in the field and in Children Australia in 1993, and reports upon the now completed evaluation of the pilot, which covered the first 18 months of operation. The evaluation examined implementation and program development issues and considered the client population of the service against comparative data about those children at risk who were not included. The paper concludes that there is room for Families First in the Victorian system of protective and family services and points to several developmental issues.

The care of people living with HIV/AIDS in the home and community can be complex and challenging, requiring high levels of knowledge, skill, preparedness and, importantly, the ability to engage with people belonging to marginalised groups. In 2003, the Royal District Nursing Service (RDNS) HIV/AIDS Team in Victoria, Australia, developed the new role of HIV Resource Nurse at two RDNS centres in Melbourne serving high numbers of people living with HIV/AIDS. Drawing from two case studies and interviews with two HIV Resource Nurses from one of the centres, this paper describes this practice innovation. Benefits (including a positive impact on client engagement with services, client care, relationships with other health care workers and job satisfaction) are outlined, along with challenges in the implementation and evolution of the role. Strategies to sustain and develop the HIV Resource Nurse role are proposed.

Increasingly, primary care services are required to use data to assess their local population's health needs and plan services. This paper reports focus group discussions of service providers' perceived current practice, issues and needs related to obtaining and using data for planning services in two local government areas of Melbourne. Six groups were conducted with nominees from two municipal councils, four divisions of general practice, three community health services, three hospital networks and eight community organizations. Two groups were conducted with planners and data providers from the Department of Human Services, Victoria. The 66 participants had a broad range of experience in using data to assess local population health needs. Participants reported that issues limiting the use of data related to: access to data (lack of awareness, contacting the right person, poor communication between data providers and users, resource constraints, lack of central access); gaps in data; quality of data (inconsistent definitions and collection, currency, ties to funding); applicability of data (unfriendly format, problems with aggregated versus small area data, non-matching data sets, lack of contextual information); and support for data use in local population health planning. If local population needs assessment is to lead to better health outcomes, service providers need access to high quality data presented in formats that are applicable to their communities. They also need practicable planning methods, skills training and support in using data for local population needs assessment and service planning.

Recently arrived older refugees in resettlement countries are a particularly vulnerable population who face many risks to their health and well‐being, and many challenges in accessing services. This paper reports on a project undertaken in Victoria, Australia to explore the needs of older people from 14 recently arrived refugee communities, and the barriers to their receiving health and aged care. Findings from consultations with community workers and service providers highlight the key issues of isolation, family conflict and mental illness affecting older refugees, and point to ways in which policy‐makers and service providers can better respond to these small but deserving communities.

The Australian Institute of Health and Welfare (AIHW) has recently released a report on the educational outcomes for children and young people on guardianship or custody orders. This report, four years in the making, represents one of the first comprehensive Australian assessments based on educational performance data from multiple jurisdictions for children on guardianship or custody orders. Developed for the National Child Protection and Support Services data group, the study was funded by the Community and Disability Services Ministers’ Advisory Council (AIHW 2007).This pilot study examines how children on guardianship/custody orders are performing compared with all Australian children in education department-based testing for reading and numeracy in years 3, 5 and 7. Mean test scores were examined in addition to the achievement of national benchmarks for reading and numeracy. These nationally agreed benchmarks are designed to assess whether children have achieved the minimum standards for years 3, 5 and 7 (AIHW 2007). Data on 895 children on guardianship or custody orders were collected from five jurisdictions - Queensland, Victoria, South Australia, Tasmania and the Australian Capital Territory - for August 2003 (AIHW 2007). The data were linked through collaborative efforts by state and territory education and community services departments.

The papers published in this special issue of Children Australia were originally presented at a two day symposium held in Melbourne on 26 and 27 November 2009. The symposium, Adoption, fostering, permanent care and beyond: Re-thinking policy and practice on out-of-home care for children in Australia, was jointly convened by the Department of Human Services (DHS), Victoria and the School of Political and Social Inquiry at Monash University in conjunction with the History of Adoption in Australia project (Monash University 2009).The event was a partnership between professionals working in this area and university researchers. Each group brought different perspectives and imperatives to the table. For DHS and the sector, the immediate frame of the symposium was the major policy statement Directions for out-of-home care, announced in May 2009 by the Victorian Minister for Community Services after consultation with community service organisations and young people living in care (DHS 2009a). It announces a framework for change which incorporates action on seven fronts or ‘reform directions’. These are to support children to remain at home with their families; to provide a better choice of care placement; to promote wellbeing; to prepare young people who are leaving care to make the transition into adult life; to improve the education of children in care; to develop effective and culturally appropriate responses to the high numbers of Aboriginal children in our care; and to create a child-focused system and processes (DHS 2009a). The driving principle informing the reforms is to ensure that policy and service provision are centred on the needs and interests of children and young people, and to ensure that young people are consulted as to what their needs are (rather than assumptions being made by adults as to their needs).

Objective Government policy and planning set the direction for community decisions related to resource allocation, infrastructure, services, programs, workforce and social environments. The aim of the present study was to examine the policy and planning context for oral health promotion in Victoria, Australia, over the period 2007–12. Methods Key Victorian policies and plans related to oral health promotion in place during the 2007–12 planning cycle were identified through online searching, and content analysis was performed. Inclusion of oral health (and oral health-related) promotion initiatives was assessed within the goals, objectives and strategies sections of each plan. Results Six of the 223 public health plans analysed (3%) included oral health ‘goals’ (including one plan representing nine agencies). Oral health was an ‘objective’ in 10 documents. Fifty-six plan objectives, and 70 plan strategies related to oral health or healthy eating for young children. Oral health was included in municipal plans (44%) more frequently than the other plans examined. Conclusion There is a policy opportunity to address oral health at a community level, and to implement population approaches aligned with the Ottawa Charter that address the social determinants of health. What is known about the topic? Poor oral health is a significant global health concern and places a major burden on individuals and the healthcare system, affecting approximately 50% of all children and 75%–95% of adults in Australia. The Ottawa Charter acknowledges the key role of policy in improving the health of a population; however, little is known about the policy emphasis placed on oral health by local government, primary care partnerships and community health agencies in Victoria, Australia. What does this paper add? This is a review of oral health content within local government (municipal) and community health plans in Victoria, Australia. What are the implications for practitioners? The findings identify several opportunities for public health and community health practitioners and policy makers to place greater emphasis on prevention and improvement of the oral health of Victorians through policy development.

IntroductionSystems science methodologies have been used in attempts to address the complex and dynamic causes of childhood obesity with varied results. This paper presents a protocol for the Reflexive Evidence and Systems interventions to Prevention Obesity and Non-communicable Disease (RESPOND) trial. RESPOND represents a significant advance on previous approaches by identifying and operationalising a clear systems methodology and building skills and knowledge in the design and implementation of this approach among community stakeholders.Methods and analysisRESPOND is a 4-year cluster-randomised stepped-wedge trial in 10 local government areas in Victoria, Australia. The intervention comprises four stages: catalyse and set up, monitoring, community engagement and implementation. The trial will be evaluated for individuals, community settings and context, cost-effectiveness, and systems and implementation processes. Individual-level data including weight status, diet and activity behaviours will be collected every 2 years from school children in grades 2, 4 and 6 using an opt-out consent process. Community-level data will include knowledge and engagement, collaboration networks, economic costs and shifts in mental models aligned with systems training. Baseline prevalence data were collected between March and June 2019 among >3700 children from 91 primary schools.Ethics and disseminationEthics approval: Deakin University Human Research Ethics Committee (HREC 2018-381) or Deakin University’s Faculty of Health Ethics Advisory Committee (HEAG-H_2019-1; HEAG-H 37_2019; HEAG-H 173_2018; HEAG-H 12_2019); Victorian Government Department of Education and Training (2019_003943); Catholic Archdiocese of Melbourne (Catholic Education Melbourne, 2019-0872) and Diocese of Sandhurst (24 May 2019). The results of RESPOND, including primary and secondary outcomes, and emerging studies developed throughout the intervention, will be published in the academic literature, presented at national and international conferences, community newsletters, newspapers, infographics and relevant social media.Trial registration numberACTRN12618001986268p.

Research conducted in 2018 documented the disaster experiences of 56 women and men in Australia aged between 18 and 93 years. This paper draws out the gendered factors that affected their resilience, and in so doing, begins to address the dearth of research related to gendered aspects of long-term disaster resilience. It is unique in capturing the voices of survivors who spoke of events 9 years after the 2009 Black Saturday fires and of earlier fires and floods in Victoria more than 50 years ago, including the 1983 Ash Wednesday fires. Over decades, gendered expectations of men and women significantly hindered resilience. Men spoke of the long-term cost to them of demands to ‘be strong’ in the worst of disasters and reasons they were reluctant to seek help afterwards. Women spoke of their contributions holding a lesser value and of discrimination. Discussions of violence against women and children after disaster, and suicide ideation in anticipation of future disasters offered critical insights. Protective factors identified by informants were not wholly intrinsic to their character but were also physical, such as essential resources provided in the immediate aftermath, and psychological and community support offered in the long-term. Factors that helped resilience departed from the ‘masculine’ model of coping post-disaster by moving away from a refusal to admit trauma and suffering, to community-wide resilience bolstered by widespread emotional, social and psychological support. Genuine community planning for disasters before they strike builds trust and offers insights for emergency management planners.

Childhood injury is a major health issue, with approximately 20,000 children under five hospitalised each year in Australia. The home is a common site for childhood injuries, with some of the more frequent episodes including falls, poisoning, burns, cuts and crush injuries. A regional initiative to develop a coordinated approach towards minimising injuries sustained by children between 0-4 years, resulted in the development of 'Childsafe Now', a health promotion program which involved training of child care providers, and the establishment of several home safety displays in the Eastern metropolitan region of Victoria. One of the home safety displays was developed in a Community Health Centre, utilising a pre-existing child care facility and the multidisciplinary skills of the staff. Community Health Centres were established with a focus on health promotion - encouraging illness and injury prevention through a holistic combination of education, community involvement, behavioural and social modification and multi-disciplinary primary health care services - yet the opportunity to establish a permanent, functional display which combines all of these aspects of health promotion is becoming increasingly rare. However, the skills and knowledge which have traditionally been nurtured within the Community Health Program make Community Health Centres a particularly appropriate location for establishing a Home Safety Display.

A study on perceptions, attitudes and treatment-seeking practices related to schistosomiasis was conducted among the Wasukuma in the rural Magu district of Tanzania at the shore of Lake Victoria where Schistosoma haematobium and mansoni infections are endemic. The study applied in-depth interviews, focus group discussions and a questionnaire survey among adults and primary school children. The perceived symptoms and causes were incongruous with the biomedical perspective and a number of respondents found schistosomiasis to be a shameful disease. Lack of diagnostic and curative services at the government health care facilities was common, but there was a willingness from the biomedical health care services to collaborate with the traditional healers. Recommendations to the District Health Management Team were: that collaboration between biomedical and traditional health care providers should be strengthened and that the government facilities’ diagnostic and curative capacity with regard to schistosomiasis should be upgraded. Culturally compatible health education programmes should be developed in collaboration with the local community.

Introduction:On November 21 and 22 of 2016, Victoria witnessed an unprecedented epidemic thunderstorm asthma emergency event in size acuity and impact. This scenario was never exercised nor contemplated. The event resulted in a 73% increase in calls to the Emergency Services Telecommunications Authority and 814 ambulance cases in the six hours from 6 pm on November 21, 2016. A 58% increase in people presented to public hospital emergency departments in Melbourne and Geelong on November 21 and 22, 2016 (based on the three-year average). 313 calls were made to the nurse on call from people with breathing, respiratory, and allergy problems (compared to an average of 63 calls for the previous month). Tragically, ten deaths are linked to this event.Methods:A substantial amount of work has been completed, much of which goes towards addressing the Inspector-General for Emergency Management recommendations following a review of the event, including: Release of an epidemic thunderstorm asthma campaign and education programs which were rolled out across Victoria for the community and health professionals from September through November 2017;Development of a new epidemic thunderstorm asthma forecasting system on 1 October 2017 and updated warning protocols during the 2017 grass pollen season;Implementation of a Real-time Health Emergency Monitoring System to alert the department of demands on public hospital emergency departments on the system; andIntroduction of a new State Health Emergency Response Plan in October 2017 to improve coordination and communications before and during a health emergency.Discussion:The presentation will concentrate on the lessons learned more than two years down the track from the event in November 2016.

An increasing number of Australians are being admitted to hospitals and day procedure centers to have dental treatment under a dental general anesthetic (DGA). Children younger than 2 y are having DGAs. These operations are costly and, although there have been improvements in safety, are not without risk. Most DGAs in children are to treat dental caries and have been defined as potentially preventable dental hospitalizations (PPDHs). This article reports on an analysis of the impact of access to community water fluoridation (CWF), availability of oral health professionals (OHPs), and socioeconomic status (SES) on PPDHs of 0- to 4-y-olds in 2012–2013 in Victoria, Australia. Data on these variables were obtained at the community (postcode) level. From the negative binomial multivariate analysis, each of the 3 independent variables was independently significantly associated with PPDHs at the postcode level. Children residing in postcodes without CWF on average had 59% higher rates than those with access (incident rate ratio [IRR], 1.59; P < 0.0001), children in postcodes with the lowest level of availability of OHPs had 65% higher rates than those with the highest access (IRR, 1.65; P < 0.0001), and children living in the most disadvantaged SES quintiles had 57% higher rates than children in the most advantaged quintiles (IRR, 1.57; P < 0.0001). There was a stepwise social gradient by SES quintile. In analysis of access to CWF and SES status, children without access to CWF had 86% higher PPDH rates than children with access (IRR, 1.86; P < 0.0001). In summary, no access to CWF, poor availability of OHPs, and lower SES status were independently associated with higher PPDH rates among 0- to 4-y-olds in Victoria at the postcode level. The study highlights the importance of considering 3 interacting factors—access to CWF, access to OHPs, and SES—in efforts to reduce PPDH rates in young children. Knowledge Transfer Statement: Extending access to water fluoridation, increasing the availability of dental services, and raising disadvantaged families’ socioeconomic status are each likely to decrease the rate of dental general anesthetics in young children.

Purpose The purpose of this paper is to examine the service accessibility of Somali Australians suffering Autism Spectrum Disorder (ASD) by using both quantitative and qualitative methods. Design/methodology/approach Using Geographic Information System (GIS) and the 2011 census data a total of 19,178 people reporting Somali ancestry were mapped to SA1 level with most being in the three capital cities of original migration; Sydney, Melbourne and Perth. Findings Access to primary services pertinent to ASD was measured using the GIS software, some 15 per cent of these cities Somali children were within 500 m of a General practice and 89 per cent within 2,000 m. A quarter of children were within 2,000 m of a speech pathology service access point and nearly a third (31 per cent) within 2,000 m of a psychologist. Qualitative analysis found a quite negative perspective on mental illness and ASD within the community with 85 per cent of respondents reporting a “Bad” perception of ASD within the community. Research limitations/implications Clearly, the opportunity these data provide is to develop service models targeting need and changing perspectives of ASD within an at risk community. Originality/value This is the first time in Australia that issues of service access (health) for Autism suffers and their families has been analysed in a detailed geographic manner.

Integrated service delivery in the early childhood education and care sector is burgeoning as a direct result of government agendas in Australia that privilege services for young children and families, especially those considered most vulnerable and at risk. In many cases this means reviewing and revising current practice to work more collaboratively with other professionals. This paper reports the findings of one aspect of a larger Australian study entitled: ‘Developing and sustaining pedagogical leadership in early childhood education and care professionals’. The focus of this paper is the understandings and practices of professionals in both Queensland and Victoria working in integrated Children's Services across the education, care, community and health sectors. The notion of transdisciplinary practice is also explored as a way to sustain practice. Qualitative data collection methods, including the ‘Circles of Change’ process, the ‘Significant Change’ method and semi-structured interviews were used. The findings indicate concerns around professional identity, feeling valued, role confusion and the boundaries imposed by funding regulations. Working in a transdisciplinary way was generally considered a useful way to move practice forward in these settings, although the ramifications for leadership that this approach brings requires further consideration.

Background and context: The Bridge of Support Program (BOS) is adapting a successful community based model of peer support to an acute setting, at the Sunshine Hospital Breast Clinic, to meet the cultural and socioeconomic diverse needs of women with breast cancer. This two year project was funded by LUCRF Community Partnership Trust. Aim: To improve the experience of women undergoing treatment of breast cancer at Western Health. To improve access to psych-social, emotional and practical support for women by extending the reach of CounterPart- a state-wide service of women´s Health Victoria, funded by the Victorian Department of Health and Human Services to provide peer support and information to people affected by breast or a gynecologic cancer. Program/Policy process: Peer support volunteers actively guided women to current and credible evidence-based information, support decision making and provide emotional support. Peer support volunteers are rostered once a week at Sunshine Hospital to coincide with breast clinic and include access to the day oncology unit and radiotherapy center. Detailed contact information is recorded and women receive follow-up contact (with consent) from the peer support volunteers at the CounterPart Resource Centre in Melbourne. A CounterPart staff member oversees the project and provides direct support and supervision to the volunteers on site at the hospital. Women can self refer. Outcomes: Between February and December 2016 the BOS program had 159 separate contacts with patients and their families. 82 contacts were with men and women who were new to CounterPart and 77 were follow-up contacts. 90 individuals treated for breast cancer at Western Health accessed the program, which represent 53% of the women seen by the breast service. 48% of the contacts were follow-up contacts with the CounterPart volunteers indicating that once engaged with the service many men and women continue to make contact. 38% of contacts were with women diagnosed with metastatic disease, a group who often have higher levels of unmet or more complex needs. 49% were born in a nonmain English speaking country (compared with the overall state of Victoria average of 19.6%) thus reflecting an accessible service to the non-English speaking community. What was learned: At a time when peer support is being increasingly recognized as a key part of effective supportive care in cancer services, the BOS program offers a model of integrated peer support that is respected, reliable, well supported and safe within the acute setting. This acute-community sector partnership demonstrates how the medical and social models of health care can work together to provide a connected and quality service for men and women diagnosed with breast cancer. An active research approach is enabling the project to be responsive to issues and challenges as they arise including the ongoing recruitment of women as volunteers from the local community to work within the acute setting.

ObjectivesTimely access to outpatient services is a major issue for public health systems. To address this issue, we aimed to establish the return on investment to the health system of the implementation of an alternative model for access and triage (Specific Timely Appointments for Triage: STAT) compared with a traditional waitlist model.DesignUsing a prospective pre–post design, an economic analysis was completed comparing the health system costs for participants who were referred for community outpatient services post-implementation of STAT with a traditional waitlist comparison group.SettingEight community outpatient services of a health network in Melbourne, Australia.ParticipantsAdults and children referred to community outpatient services.InterventionsSTAT combined targeted activities to reduce the existing waiting list and direct booking of patients into protected assessment appointments. STAT was compared with usual care, in which new patients were placed on a waiting list and offered appointments as space became available.OutcomesHealth system costs included STAT implementation costs, outpatient health service use, emergency department presentations and hospital admissions 3 months before and after initial outpatient appointment. Waiting time was the primary outcome. Incremental cost-effectiveness ratios (ICERs) were estimated from the health system perspective.ResultsData from 557 participants showed a 16.9 days or 29% (p<0.001) reduction in waiting time for first appointment with STAT compared with traditional waitlist. The ICER showed a cost of $A10 (95% CI −19 to 39) per day reduction in waiting time with STAT compared with traditional waitlist. Modelling showed the cost reduced to $A4 (95% CI −25 to 32) per day of reduction in waiting, if reduction in waiting times is sustained for 12 months.ConclusionsThere was a significant reduction in waiting time with the introduction of STAT at minimal cost to the health system.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12615001016527).

ObjectiveThis study investigated the associations between maternal symptoms of attention deficit hyperactivity disorder (ADHD) and child functional outcomes in a community-based sample of children with and without ADHD.Design and settingIn this cohort study, children with ADHD and healthy controls were recruited through schools in Melbourne, Australia, using a combined screening (Conners 3 ADHD Index) and case confirmation (Diagnostic Interview Schedule for Children Version IV) procedure.Patients117 children with ADHD and 149 control children were included in the analyses.Main outcome measuresMaternal ADHD symptoms (Conners Adult ADHD Rating Scale) and child outcomes (ADHD severity, quality of life (QoL), academic competence, social-emotional functioning) were measured at a mean child age of 8.9 years.ResultsMothers of children with ADHD had clinically elevated ADHD symptoms compared with mothers of control children (adjusted analysis: 18.0% vs 2.0%, P<0.001). Elevated maternal ADHD symptoms were associated with greater child ADHD symptom severity and lower QoL by maternal report for children with (severity P=0.01; QoL P=0.003) and without (severity P=0.003; QoL P=0.003) ADHD. Elevated maternal ADHD symptoms were additionally associated with increased parent-rated emotional problems, peer problems and total impairment scores in children without ADHD (all P<0.01).ConclusionsMaternal ADHD symptoms are associated with increased ADHD symptom severity and reduced QoL by maternal report in offspring with or without ADHD, and have broader negative associations with emotional and social functioning in children without ADHD. In the evaluation of the referred children, maternal ADHD symptoms should be considered and referral made to adult services where indicated.

The effectiveness of current support services for families who have a child with a progressive life-threatening illness seems to be a frequently overlooked issue. This paper, which is based on the findings of a recently conducted study, attempts to elucidate the critical issues in supporting this unique group of families. The study examined the perceptions of families regarding the value and effectiveness of the social supports available in the community for families caring for a child with a life-threatening illness in Victoria. Attention has been drawn to perceived gaps in support for these families. Also considered is the effectiveness of supports available for bereaved families who have lost children with life-threatening illnesses. The study was based on information provided by families who had been involved with a family support agency known as Very Special Kids.

Health literacy courses for health professionals have emerged in response to health professionals’ perceived lack of understanding of health literacy issues, and their failure to routinely adopt health literacy practices. Since 2013 in Victoria, Australia, the Centre for Culture, Ethnicity and Health has delivered an annual health literacy demonstration training course that it developed. Course development and delivery partners included HealthWest Partnership and cohealth. The courses are designed to develop the health literacy knowledge, skills and organisational capacity of the health and community services sector in the western metropolitan region of Melbourne. This study presents key learnings from evaluation data from three health literacy courses using Wenger’s professional educational learning design framework. The framework has three educational learning architecture components (engagement, imagination and alignment) and four educational learning architecture dimensions (participation, emergent, local/global, identification). Participatory realist evaluation approaches and qualitative methods were used. The evaluations revealed that the health literacy courses are developing leadership in health literacy, building partnerships among course participants, developing health literacy workforce knowledge and skills, developing ways to use and apply health literacy resources and are serving as a catalyst for building organisational infrastructure. Although the courses were not explicitly developed or implemented using Wenger’s educational learning design pedagogic features, the course structure (i.e. facilitation role of course coordinators, providing safe learning environments, encouraging small group work amongst participants, requiring participants to conduct mini-projects and sponsor organisation buy-in) provided opportunities for engagement, imagination and alignment. Wenger’s educational learning design framework can inform the design of future key pedagogic features of health literacy courses. What is known about the topic? Health professionals are increasingly participating in health literacy professional development courses. What does this paper add? This paper provides key lessons for designing health literacy professional development courses by reflecting upon Wenger’s professional educational learning design framework. What are the implications for practitioners? To ensure health professionals are receiving evidence-informed health literacy professional education, we encourage future health literacy courses be designed, implemented and evaluated using existing professional educational learning design frameworks.

Background: Despite evidence for early integration of palliative care for people with advanced cancer and their families, patterns of late engagement continue. Prior research has focused on health professionals’ attitudes to palliative care with few studies exploring the views of patients and their carers. Aim: To explore initial perceptions of palliative care when this is first raised with patients with advanced cancer and their families in Australian settings. Design: Cross-sectional, prospective, exploratory qualitative design, involving narrative-style interviews and underpinned by an interpretative phenomenological framework. Setting/participants: Purposively sampled, English-speaking, adult patients with advanced cancer ( n = 30) and their nominated family caregivers ( n = 25) recruited from cancer services at a tertiary metropolitan hospital in Melbourne, Victoria, Australia. Results: Three major themes evolved which represent the common initial perceptions of palliative care held by patients with advanced cancer and their carers when this concept is first raised: (1) diminished care, (2) diminished possibility and (3) diminished choice. Palliative care was negatively associated with a system of diminished care which is seen as a ‘lesser’ treatment alternative, diminished possibilities for hope and achievement of ambitions previously centred upon cure and diminished choices for the circumstances of one’s care given all other options have expired. Conclusion: While there is an increasing move towards early integration of palliative care, this study suggests that patient and caregiver understandings have not equally progressed. A targeted public health campaign is warranted to disentangle understandings of palliative care as the ‘institutional death’ and to reframe community rhetoric surrounding palliative care from that of disempowered dying to messages of choice, accomplishment and possibility.

IntroductionOptimal early childhood development is an international priority. Risks during pregnancy and early childhood have lasting effects because growth is rapid. We will test whether a complex intervention addressing multiple modifiable risks: maternal nutrition, mental health, parenting capabilities, infant health and development and gender-based violence, is effective in reducing deficient cognitive development among children aged two in rural Vietnam.Methods and analysisThe Learning Clubs intervention is a structured programme combining perinatal stage-specific information, learning activities and social support. It comprises 20 modules, in 19 accessible, facilitated groups for women at a community centre and one home visit. Evidence-informed content is from interventions to address each risk tested in randomised controlled trials in other resource-constrained settings. Content has been translated and culturally adapted for Vietnam and acceptability and feasibility established in pilot testing.We will conduct a two-arm parallel-group cluster-randomised controlled trial, with the commune as clustering unit. An independent statistician will select 84/112 communes in Ha Nam Province and randomly assign 42 to the control arm providing usual care and 42 to the intervention arm. In total, 1008 pregnant women (12 per commune) from 84 clusters are needed to detect a difference in the primary outcome (Bayley Scales of Infant and Toddler Development Cognitive Score <1 SD below standardised norm for 2 years of age) of 15% in the control and 8% in the intervention arms, with 80% power, significance 0.05 and intracluster correlation coefficient 0.03.Ethics and disseminationMonash University Human Research Ethics Committee (Certificate Number 20160683), Melbourne, Victoria, Australia and the Institutional Review Board of the Hanoi School of Public Health (Certificate Number 017-377IDD- YTCC), Hanoi, Vietnam have approved the trial. Results will be disseminated through a comprehensive multistranded dissemination strategy including peer-reviewed publications, national and international conference presentations, seminars and technical and lay language reports.Trial registration numberACTRN12617000442303; Pre-results.

Background Approximately 80% of the population residing in sub-Saharan Africa relies on Traditional Medicine (TM). However, literature on factors motivating the use of TM for children under the age of five in these settings is limited. Such information can guide policy formulation for integration of TM into mainstream health care services. This study aimed to describe the motivation on use of TM among caregivers of children residing in rural and urban communities in western Kenya. Methods The socio-behavioral sciences (SBS) arm of the Child Health and Mortality Prevention Surveillance (CHAMPS) program in western Kenya, conducted a cross-sectional qualitative study in Manyatta—an urban informal settlement located in Kisumu town and Karemo—a rural setting in Siaya County. We performed 29 in-depth interviews, 5 focus group discussions and 11 semi-structured interviews with community representatives (n = 53), health workers (n = 17), and community leaders (n = 18). All the participants were purposively sampled. We performed thematic analysis using both inductive and deductive approaches. Data management was completed on Nvivo 11.0 software (QSR International, Melbourne, Australia). Results Our findings reveal that some caregivers prefer TM to treat some childhood diseases. Use of TM was informed by illness beliefs about etiology of disease. We observed an appreciation from the study participants that malaria can effectively be treated by Conventional Medicine (CM) while TM was preferred to treat measles and diseases believed to be associated with supernatural etiology such as witchcraft, evil spirit or breaching cultural taboos. TM was also used in instances where CM failed to provide a diagnosis or when CM was ‘slow’. TM in such cases was used as a last resort. Conclusion We observed varied beliefs that motivate caregivers’ choice of TM use among children in western Kenya. It is therefore crucial to consider perceptions and socio-cultural beliefs about illnesses when formulating interventions that are geared towards child health.

IntroductionPoverty and deprivation can harm children’s future health, learning, economic productivity and societal participation. The Australian Healthier Wealthier Families project seeks to reduce the childhood inequities caused by poverty and deprivation by creating a systematic referral pathway between two free, community-based services: universal, well-child nursing services, which provide health and development support to families with children from birth to school entry, and financial counselling. By adapting the successful Scottish ‘Healthier Wealthier Children’ model, the objectives of this Australian pilot are to test the (1) feasibility of systematising the referral pathway, and (2) short-term impacts on household finances, caregiver health, parenting efficacy and financial service use.Methods and analysisThis pilot randomised controlled trial will run in three sites across two Australian states (Victoria and New South Wales), recruiting a total of 180 participants. Nurses identify eligible caregivers with a 6-item, study-designed screening survey for financial hardship. Caregivers who report one or more risk factors and consent are randomised. The intervention is financial counselling. The comparator is usual care plus information from a government money advice website. Feasibility will be evaluated using the number/proportion of caregivers who complete screening, consent and research measures, and access financial counselling. Though powered to assess feasibility, impacts will be measured 6 months post-enrolment with qualitative interviews and questionnaires about caregiver-reported income, loans and costs (adapted from national surveys, for example, the Household, Income and Labour Dynamics in Australia Survey); health (General Health Questionnaire 1, EuroQol five-dimensional questionnaire, Depression, Anxiety, Stress Scale short-form); efficacy (from the Longitudinal Study of Australian Children); and financial service use (study-designed) compared between arms.Ethics and disseminationEthics committees of the Royal Children’s Hospital (HREC/57372/RCHM-2019) and South West Sydney Local Health District (2019/ETH13455) have approved the study. Participants and stakeholders will receive results through regular communication channels comprising meetings, presentations and publications.Trial registration numberACTRN12620000154909; prospectively registered. Pre-results.

IntroductionChildren entering out-of-home care have high rates of health needs across all domains of health. To identify these needs early and optimise long-term outcomes, routine health assessment on entry to care is recommended by child health experts and included in policy in many jurisdictions. If effective, this ought to lead to high rates of health service use as needs are addressed. Victoria (Australia) has no state-wide approach to deliver routine health assessments and no data to describe the timing and use of health service visits for children in out-of-home care. This retrospective cohort data linkage study aims to describe the extent and timeliness of health service use by Victorian children (aged 0–12 years) who entered out-of-home care for the first time between 1 April 2010 and 31 December 2015, in the first 12 months of care.Methods and analysisThe sample will be identified in the Victorian Child Protection database. Child and placement variables will be extracted. Linked health databases will provide additional data: six state databases that collate data about hospital admissions, emergency department presentations and attendances at dental, mental and community health services and public hospital outpatients. The federal Medicare Benefits Schedule claims dataset will provide information on visits to general practitioners, specialist physicians (including paediatricians), optometrists, audiologists and dentists. The number, type and timing of visits to different health services will be determined and benchmarked to national standards. Multivariable logistic regression will examine the effects of child and system variables on the odds of timely health visits, and proportional-hazards regression will explore the effects on time to first health visits.Ethics and disseminationEthical and data custodian approval has been obtained for this study. Dissemination will include presentation of findings to policy and service stakeholders in addition to scientific papers.

Despite past geo-political turbulence, Nepal has made significant progress in societal and economic initiatives, particularly in relation to social determinants of health. These improvements, however, belie the suffering of those with life-limiting disease due to pain, stigma, social and financial distress, consequent upon low patient, caregiver and health professional awareness of the need for, and availability of, appropriate care and support. Two Worlds Cancer Collaboration (INCTR-Canada) has been working with partners in Nepal to build capacity for palliative care by: (a) organizational and administrative support – establishing the Nepal Association of Palliative Care (NAPCare), and the creation of the Nepal Strategy for Palliative Care, approved by government in 2017; (b) “twinning” between 2 hospital palliative care units in Nepal and the Nanaimo Hospice and Victoria Hospice, BC, Canada; (c) sustainable growth of palliative care according to WHO foundational measures, implementing facility-based clinical programs, and home-based care aligned with the cultural, social, and economic environment of Nepal; (d) training of health professionals in adult and paediatricpalliative carethrough interactive on-line “distance learning” (Extension of Community Healthcare Outcomes, ECHO);(e) leveraging palliative care training and expertise across the government health system, and (f) local and international support to build a newfacility for Hospice Nepal to provide more support for more patients in a rural ambience on the outskirts of Kathmandu. Palliative care needs to become standard-of-care, providing peace, comfort and dignity for adults and children. Working collaboratively with partners in Nepal, the collective vision is a capable professional Nepali community leading palliative care services for all in need, wherever in need.

The objectives of this study were to perform an economic evaluation of a targeted school-based dental checkup program in northern metropolitan Melbourne, Victoria. A 12-mo retrospective case-control cohort analysis using the decision tree method evaluated the incremental cost-utility and cost-effectiveness ratio (ICUR/ICER) for passive standard care dental services and an outreach pilot intervention completed in 2013. A societal perspective was adopted. A total of 273 children ( n = 273) aged between 3 and 12 y met the inclusion/exclusion criteria: 128 in the standard care group and 145 in the intervention group. The total society costs included health sector costs, patient/family costs, and productivity losses in 2014 Australian dollars. Outcome measures were evaluated using quality-adjusted tooth years (QATY) and the combined deciduous and permanent decayed, missing, and filled teeth prevented (DMFT-prevented). A generic outcome variable was created to determine the impact of the intervention to reach underserved populations based on government concession eligibility (cardholder status). Uncertainties were incorporated using 95% confidence intervals. The mean total society cost per child is $463 and $291 ( P = 0.002), QATY utility difference is 0.283 and 0.293 ( P = 0.937), effectiveness difference is 0.16 and 0.10 ( P = 0.756), and cardholder status is 50.0% and 66.2% ( P = 0.007), respectively, for the standard care and intervention groups. On average per child, there was a cost saving of $172 and improvement of 0.01 QATY, with an additional proportion of 16.2% of cardholder children reached. The calculated ICER was $3,252 per DMFT-prevented. The intervention dominates standard care for QATY and per 1% cardholder reached outcome measures. Our study found the pilot checkup program was largely less costly and more effective compared with the current standard care. Further research is needed to quantify the value of outreach interventions to prevent dental caries development and progression in populations from low socioeconomic status. Knowledge Transfer Statement: The findings of this research demonstrated that an outreach dental program can be less costly and more effective than standard models of dental care. It showed that a school-based dental checkup program is beneficial despite other opinions that dental screening is ineffective as a method to improve public dental health. There is fiscal economic evidence to support broader expansion of similar programs locally and internationally to reduce dental caries for children from low-income families.

Water is an essential resource required for various human activities such as drinking, cooking, growing food, and personal hygiene. As a key infrastructure of public services, access to clean and safe drinking water is an essential factor for local socio-economic development. Despite various national and international efforts, water supply is often not guaranteed, especially in rural areas of Africa. Although many water resources are theoretically available in these areas, bodies of water are often contaminated with dangerous pathogens and pollutants. As a result, people, often women and children, have to travel long distances to collect water from taps and are exposed to dangers such as physical violence and accidents on their way. In this article, we present a socio-economic case study for rural development. We describe a drinking water treatment plant with an annual capacity of 10,950 m3 on Kibumba Island in Lake Victoria (Tanzania). The plant is operated by a photovoltaic mini-grid system with second-life lithium-ion battery storage. We describe the planning, the installation, and the start of operation of the water treatment system. In addition, we estimate the water prices achievable with the proposed system and compare it to existing sources of drinking water on Kibumba Island. Assuming a useful life of 15 years, the installed drinking water system is cost-neutral for the community at a cost price of 0.70 EUR/m3, 22% less than any other source of clean water on Kibumba Island. Access to safe and clean drinking water is a major step forward for the local population. We investigate the socio-economic added value using social and economic key indicators like health, education, and income. Hence, this approach may serve as a role model for community-owned drinking water systems in sub-Saharan Africa.

IntroductionImproving mental healthcare for adolescents is a global policy priority. Despite demands for community-based services, many adolescents require more intensive interventions, such as an inpatient admission. This is typically at a point of crisis, often accompanied by intense emotional dysregulation, impairment of coping function and impulsivity. However, limited evidence exists on how best to support this group while they are in inpatient care, aside from pharmacological treatments which have a limited role in adolescents. Little is known about the models of care (MoC) offered in inpatient units, whether adolescents perceive these as helpful and the perspectives of caregivers and clinicians. Here, we describe a protocol which aims to explore and evaluate an inpatient MoC.Methods and analysisWe designed a longitudinal, mixed-methods, case study. The population consists of adolescents, caregivers and clinicians at a single inpatient unit in Melbourne, Australia. Standardised outcome measures, including semi- structured interviews, will be administered to adolescents at three time-points, T1 (admission), T2 (discharge) and T3 (6 months post discharge). Caregivers will also be interviewed at T1, T2 and T3. Clinicians will be interviewed once. The measures include: Life Problems Inventory, Quick Inventory of Depressive Symptomatology, Kessler Psychological Distress Scale and the Youth Self-Report. Health of the Nation Outcome Scales for Children and Adolescents will be collected at T1 and T2. Quantitative analysis will include descriptive statistics and paired t-tests summarising adolescents admitted to the unit, clinical characteristics and longitudinal data on symptomatology. Qualitative data will be analysed using both thematic and trajectory analysis. Data collection began in May 2017 and will cease with T3 interviews by October 2018.Ethics and dissemination

Education in Oceania continues to reflect the embedded implicit and explicit colonial practices and processes from the past. This paper conceptualises a cultural approach to education and leadership appropriate and relevant to the Republic of the Marshall Islands. As elementary school leaders, we highlight Kanne Lobal, a traditional Marshallese navigation practice based on indigenous language, values and practices. We conceptualise and develop Kanne Lobal in this paper as a framework for understanding the usefulness of our indigenous knowledge in leadership and educational practices within formal education. Through bwebwenato, a method of talk story, our key learnings and reflexivities were captured. We argue that realising the value of Marshallese indigenous knowledge and practices for school leaders requires purposeful training of the ways in which our knowledge can be made useful in our professional educational responsibilities. Drawing from our Marshallese knowledge is an intentional effort to inspire, empower and express what education and leadership partnership means for Marshallese people, as articulated by Marshallese themselves. Introduction As noted in the call for papers within the Waikato Journal of Education (WJE) for this special issue, bodies of knowledge and histories in Oceania have long sustained generations across geographic boundaries to ensure cultural survival. For Marshallese people, we cannot really know ourselves “until we know how we came to be where we are today” (Walsh, Heine, Bigler & Stege, 2012). Jitdam Kapeel is a popular Marshallese concept and ideal associated with inquiring into relationships within the family and community. In a similar way, the practice of relating is about connecting the present and future to the past. Education and leadership partnerships are linked and we look back to the past, our history, to make sense and feel inspired to transform practices that will benefit our people. In this paper and in light of our next generation, we reconnect with our navigation stories to inspire and empower education and leadership. Kanne lobal is part of our navigation stories, a conceptual framework centred on cultural practices, values, and concepts that embrace collective partnerships. Our link to this talanoa vā with others in the special issue is to attempt to make sense of connections given the global COVID-19 context by providing a Marshallese approach to address the physical and relational “distance” between education and leadership partnerships in Oceania. Like the majority of developing small island nations in Oceania, the Republic of the Marshall Islands (RMI) has had its share of educational challenges through colonial legacies of the past which continues to drive education systems in the region (Heine, 2002). The historical administration and education in the RMI is one of colonisation. Successive administrations by the Spanish, German, Japanese, and now the US, has resulted in education and learning that privileges western knowledge and forms of learning. This paper foregrounds understandings of education and learning as told by the voices of elementary school leaders from the RMI. The move to re-think education and leadership from Marshallese perspectives is an act of shifting the focus of bwebwenato or conversations that centres on Marshallese language and worldviews. The concept of jelalokjen was conceptualised as traditional education framed mainly within the community context. In the past, jelalokjen was practiced and transmitted to the younger generation for cultural continuity. During the arrival of colonial administrations into the RMI, jelalokjen was likened to the western notions of education and schooling (Kupferman, 2004). Today, the primary function of jelalokjen, as traditional and formal education, it is for “survival in a hostile [and challenging] environment” (Kupferman, 2004, p. 43). Because western approaches to learning in the RMI have not always resulted in positive outcomes for those engaged within the education system, as school leaders who value our cultural knowledge and practices, and aspire to maintain our language with the next generation, we turn to Kanne Lobal, a practice embedded in our navigation stories, collective aspirations, and leadership. The significance in the development of Kanne Lobal, as an appropriate framework for education and leadership, resulted in us coming together and working together. Not only were we able to share our leadership concerns, however, the engagement strengthened our connections with each other as school leaders, our communities, and the Public Schooling System (PSS). Prior to that, many of us were in competition for resources. Educational Leadership: IQBE and GCSL Leadership is a valued practice in the RMI. Before the IQBE programme started in 2018, the majority of the school leaders on the main island of Majuro had not engaged in collaborative partnerships with each other before. Our main educational purpose was to achieve accreditation from the Western Association of Schools and Colleges (WASC), an accreditation commission for schools in the United States. The WASC accreditation dictated our work and relationships and many school leaders on Majuro felt the pressure of competition against each other. We, the authors in this paper, share our collective bwebwenato, highlighting our school leadership experiences and how we gained strength from our own ancestral knowledge to empower “us”, to collaborate with each other, our teachers, communities, as well as with PSS; a collaborative partnership we had not realised in the past. The paucity of literature that captures Kajin Majol (Marshallese language) and education in general in the RMI is what we intend to fill by sharing our reflections and experiences. To move our educational practices forward we highlight Kanne Lobal, a cultural approach that focuses on our strengths, collective social responsibilities and wellbeing. For a long time, there was no formal training in place for elementary school leaders. School principals and vice principals were appointed primarily on their academic merit through having an undergraduate qualification. As part of the first cohort of fifteen school leaders, we engaged in the professional training programme, the Graduate Certificate in School Leadership (GCSL), refitted to our context after its initial development in the Solomon Islands. GCSL was coordinated by the Institute of Education (IOE) at the University of the South Pacific (USP). GCSL was seen as a relevant and appropriate training programme for school leaders in the RMI as part of an Asia Development Bank (ADB) funded programme which aimed at “Improving Quality Basic Education” (IQBE) in parts of the northern Pacific. GCSL was managed on Majuro, RMI’s main island, by the director at the time Dr Irene Taafaki, coordinator Yolanda McKay, and administrators at the University of the South Pacific’s (USP) RMI campus. Through the provision of GCSL, as school leaders we were encouraged to re-think and draw-from our own cultural repository and connect to our ancestral knowledge that have always provided strength for us. This kind of thinking and practice was encouraged by our educational leaders (Heine, 2002). We argue that a culturally-affirming and culturally-contextual framework that reflects the lived experiences of Marshallese people is much needed and enables the disruption of inherent colonial processes left behind by Western and Eastern administrations which have influenced our education system in the RMI (Heine, 2002). Kanne Lobal, an approach utilising a traditional navigation has warranted its need to provide solutions for today’s educational challenges for us in the RMI. Education in the Pacific Education in the Pacific cannot be understood without contextualising it in its history and culture. It is the same for us in the RMI (Heine, 2002; Walsh et al., 2012). The RMI is located in the Pacific Ocean and is part of Micronesia. It was named after a British captain, John Marshall in the 1700s. The atolls in the RMI were explored by the Spanish in the 16th century. Germany unsuccessfully attempted to colonize the islands in 1885. Japan took control in 1914, but after several battles during World War II, the US seized the RMI from them. In 1947, the United Nations made the island group, along with the Mariana and Caroline archipelagos, a U.S. trust territory (Walsh et al, 2012). Education in the RMI reflects the colonial administrations of Germany, Japan, and now the US. Before the turn of the century, formal education in the Pacific reflected western values, practices, and standards. Prior to that, education was informal and not binded to formal learning institutions (Thaman, 1997) and oral traditions was used as the medium for transmitting learning about customs and practices living with parents, grandparents, great grandparents. As alluded to by Jiba B. Kabua (2004), any “discussion about education is necessarily a discussion of culture, and any policy on education is also a policy of culture” (p. 181). It is impossible to promote one without the other, and it is not logical to understand one without the other. Re-thinking how education should look like, the pedagogical strategies that are relevant in our classrooms, the ways to engage with our parents and communities - such re-thinking sits within our cultural approaches and frameworks. Our collective attempts to provide a cultural framework that is relevant and appropriate for education in our context, sits within the political endeavour to decolonize. This means that what we are providing will not only be useful, but it can be used as a tool to question and identify whether things in place restrict and prevent our culture or whether they promote and foreground cultural ideas and concepts, a significant discussion of culture linked to education (Kabua, 2004). Donor funded development aid programmes were provided to support the challenges within education systems. Concerned with the persistent low educational outcomes of Pacific students, despite the prevalence of aid programmes in the region, in 2000 Pacific educators and leaders with support from New Zealand Aid (NZ Aid) decided to intervene (Heine, 2002; Taufe’ulungaki, 2014). In April 2001, a group of Pacific educators and leaders across the region were invited to a colloquium funded by the New Zealand Overseas Development Agency held in Suva Fiji at the University of the South Pacific. The main purpose of the colloquium was to enable “Pacific educators to re-think the values, assumptions and beliefs underlying [formal] schooling in Oceania” (Benson, 2002). Leadership, in general, is a valued practice in the RMI (Heine, 2002). Despite education leadership being identified as a significant factor in school improvement (Sanga & Chu, 2009), the limited formal training opportunities of school principals in the region was a persistent concern. As part of an Asia Development Bank (ADB) funded project, the Improve Quality Basic Education (IQBE) intervention was developed and implemented in the RMI in 2017. Mentoring is a process associated with the continuity and sustainability of leadership knowledge and practices (Sanga & Chu, 2009). It is a key aspect of building capacity and capabilities within human resources in education (ibid). Indigenous knowledges and education research According to Hilda Heine, the relationship between education and leadership is about understanding Marshallese history and culture (cited in Walsh et al., 2012). It is about sharing indigenous knowledge and histories that “details for future generations a story of survival and resilience and the pride we possess as a people” (Heine, cited in Walsh et al., 2012, p. v). This paper is fuelled by postcolonial aspirations yet is grounded in Pacific indigenous research. This means that our intentions are driven by postcolonial pursuits and discourses linked to challenging the colonial systems and schooling in the Pacific region that privileges western knowledge and learning and marginalises the education practices and processes of local people (Thiong’o, 1986). A point of difference and orientation from postcolonialism is a desire to foreground indigenous Pacific language, specifically Majin Majol, through Marshallese concepts. Our collective bwebwenato and conversation honours and values kautiej (respect), jouj eo mour eo (reciprocity), and jouj (kindness) (Taafaki & Fowler, 2019). Pacific leaders developed the Rethinking Pacific Education Initiative for and by Pacific People (RPEIPP) in 2002 to take control of the ways in which education research was conducted by donor funded organisations (Taufe’ulungaki, 2014). Our former president, Dr Hilda Heine was part of the group of leaders who sought to counter the ways in which our educational and leadership stories were controlled and told by non-Marshallese (Heine, 2002). As a former minister of education in the RMI, Hilda Heine continues to inspire and encourage the next generation of educators, school leaders, and researchers to re-think and de-construct the way learning and education is conceptualised for Marshallese people. The conceptualisation of Kanne Lobal acknowledges its origin, grounded in Marshallese navigation knowledge and practice. Our decision to unpack and deconstruct Kanne Lobal within the context of formal education and leadership responds to the need to not only draw from indigenous Marshallese ideas and practice but to consider that the next generation will continue to be educated using western processes and initiatives particularly from the US where we get a lot of our funding from. According to indigenous researchers Dawn Bessarab and Bridget Ng’andu (2010), doing research that considers “culturally appropriate processes to engage with indigenous groups and individuals is particularly pertinent in today’s research environment” (p. 37). Pacific indigenous educators and researchers have turned to their own ancestral knowledge and practices for inspiration and empowerment. Within western research contexts, the often stringent ideals and processes are not always encouraging of indigenous methods and practices. However, many were able to ground and articulate their use of indigenous methods as being relevant and appropriate to capturing the realities of their communities (Nabobo-Baba, 2008; Sualii-Sauni & Fulu-Aiolupotea, 2014; Thaman, 1997). At the same time, utilising Pacific indigenous methods and approaches enabled research engagement with their communities that honoured and respected them and their communities. For example, Tongan, Samoan, and Fijian researchers used the talanoa method as a way to capture the stories, lived realities, and worldviews of their communities within education in the diaspora (Fa’avae, Jones, & Manu’atu, 2016; Nabobo-Baba, 2008; Sualii-Sauni & Aiolupotea, 2014; Vaioleti, 2005). Tok stori was used by Solomon Islander educators and school leaders to highlight the unique circles of conversational practice and storytelling that leads to more positive engagement with their community members, capturing rich and meaningful narratives as a result (Sanga & Houma, 2004). The Indigenous Aborigine in Australia utilise yarning as a “relaxed discussion through which both the researcher and participant journey together visiting places and topics of interest relevant” (Bessarab & Ng’andu, 2010, p. 38). Despite the diverse forms of discussions and storytelling by indigenous peoples, of significance are the cultural protocols, ethics, and language for conducting and guiding the engagement (Bessarab & Ng’andu, 2010; Nabobo-Baba, 2008; Sualii-Sauni & Aiolupotea, 2014). Through the ethics, values, protocols, and language, these are what makes indigenous methods or frameworks unique compared to western methods like in-depth interviews or semi-structured interviews. This is why it is important for us as Marshallese educators to frame, ground, and articulate how our own methods and frameworks of learning could be realised in western education (Heine, 2002; Jetnil-Kijiner, 2014). In this paper, we utilise bwebwenato as an appropriate method linked to “talk story”, capturing our collective stories and experiences during GCSL and how we sought to build partnerships and collaboration with each other, our communities, and the PSS. Bwebwenato and drawing from Kajin Majel Legends and stories that reflect Marshallese society and its cultural values have survived through our oral traditions. The practice of weaving also holds knowledge about our “valuable and earliest sources of knowledge” (Taafaki & Fowler, 2019, p. 2). The skilful navigation of Marshallese wayfarers on the walap (large canoes) in the ocean is testament of their leadership and the value they place on ensuring the survival and continuity of Marshallese people (Taafaki & Fowler, 2019; Walsh et al., 2012). During her graduate study in 2014, Kathy Jetnil-Kijiner conceptualised bwebwenato as being the most “well-known form of Marshallese orality” (p. 38). The Marshallese-English dictionary defined bwebwenato as talk, conversation, story, history, article, episode, lore, myth, or tale (cited in Jetnil Kijiner, 2014). Three years later in 2017, bwebwenato was utilised in a doctoral project by Natalie Nimmer as a research method to gather “talk stories” about the experiences of 10 Marshallese experts in knowledge and skills ranging from sewing to linguistics, canoe-making and business. Our collective bwebwenato in this paper centres on Marshallese ideas and language. The philosophy of Marshallese knowledge is rooted in our “Kajin Majel”, or Marshallese language and is shared and transmitted through our oral traditions. For instance, through our historical stories and myths. Marshallese philosophy, that is, the knowledge systems inherent in our beliefs, values, customs, and practices are shared. They are inherently relational, meaning that knowledge systems and philosophies within our world are connected, in mind, body, and spirit (Jetnil-Kijiner, 2014; Nimmer, 2017). Although some Marshallese believe that our knowledge is disappearing as more and more elders pass away, it is therefore important work together, and learn from each other about the knowledges shared not only by the living but through their lamentations and stories of those who are no longer with us (Jetnil-Kijiner, 2014). As a Marshallese practice, weaving has been passed-down from generation to generation. Although the art of weaving is no longer as common as it used to be, the artefacts such as the “jaki-ed” (clothing mats) continue to embody significant Marshallese values and traditions. For our weavers, the jouj (check spelling) is the centre of the mat and it is where the weaving starts. When the jouj is correct and weaved well, the remainder and every other part of the mat will be right. The jouj is symbolic of the “heart” and if the heart is prepared well, trained well, then life or all other parts of the body will be well (Taafaki & Fowler, 2019). In that light, we have applied the same to this paper. Conceptualising and drawing from cultural practices that are close and dear to our hearts embodies a significant ontological attempt to prioritize our own knowledge and language, a sense of endearment to who we are and what we believe education to be like for us and the next generation. The application of the phrase “Majolizing '' was used by the Ministry of Education when Hilda Heine was minister, to weave cultural ideas and language into the way that teachers understand the curriculum, develop lesson plans and execute them in the classroom. Despite this, there were still concerns with the embedded colonized practices where teachers defaulted to eurocentric methods of doing things, like the strategies provided in the textbooks given to us. In some ways, our education was slow to adjust to the “Majolizing '' intention by our former minister. In this paper, we provide Kanne Lobal as a way to contribute to the “Majolizing intention” and perhaps speed up yet still be collectively responsible to all involved in education. Kajin Wa and Kanne Lobal “Wa” is the Marshallese concept for canoe. Kajin wa, as in canoe language, has a lot of symbolic meaning linked to deeply-held Marshallese values and practices. The canoe was the foundational practice that supported the livelihood of harsh atoll island living which reflects the Marshallese social world. The experts of Kajin wa often refer to “wa” as being the vessel of life, a means and source of sustaining life (Kelen, 2009, cited in Miller, 2010). “Jouj” means kindness and is the lower part of the main hull of the canoe. It is often referred to by some canoe builders in the RMI as the heart of the canoe and is linked to love. The jouj is one of the first parts of the canoe that is built and is “used to do all other measurements, and then the rest of the canoe is built on top of it” (Miller, 2010, p. 67). The significance of the jouj is that when the canoe is in the water, the jouj is the part of the hull that is underwater and ensures that all the cargo and passengers are safe. For Marshallese, jouj or kindness is what living is about and is associated with selflessly carrying the responsibility of keeping the family and community safe. The parts of the canoe reflect Marshallese culture, legend, family, lineage, and kinship. They embody social responsibilities that guide, direct, and sustain Marshallese families’ wellbeing, from atoll to atoll. For example, the rojak (boom), rojak maan (upper boom), rojak kōrā (lower boom), and they support the edges of the ujelā/ujele (sail) (see figure 1). The literal meaning of rojak maan is male boom and rojak kōrā means female boom which together strengthens the sail and ensures the canoe propels forward in a strong yet safe way. Figuratively, the rojak maan and rojak kōrā symbolise the mother and father relationship which when strong, through the jouj (kindness and love), it can strengthen families and sustain them into the future. Figure 1. Parts of the canoe Source: https://www.canoesmarshallislands.com/2014/09/names-of-canoe-parts/ From a socio-cultural, communal, and leadership view, the canoe (wa) provides understanding of the relationships required to inspire and sustain Marshallese peoples’ education and learning. We draw from Kajin wa because they provide cultural ideas and practices that enable understanding of education and leadership necessary for sustaining Marshallese people and realities in Oceania. When building a canoe, the women are tasked with the weaving of the ujelā/ujele (sail) and to ensure that it is strong enough to withstand long journeys and the fierce winds and waters of the ocean. The Kanne Lobal relates to the front part of the ujelā/ujele (sail) where the rojak maan and rojak kōrā meet and connect (see the red lines in figure 1). Kanne Lobal is linked to the strategic use of the ujelā/ujele by navigators, when there is no wind north wind to propel them forward, to find ways to capture the winds so that their journey can continue. As a proverbial saying, Kanne Lobal is used to ignite thinking and inspire and transform practice particularly when the journey is rough and tough. In this paper we draw from Kanne Lobal to ignite, inspire, and transform our educational and leadership practices, a move to explore what has always been meaningful to Marshallese people when we are faced with challenges. The Kanne Lobal utilises our language, and cultural practices and values by sourcing from the concepts of jouj (kindness, love), kautiej (respect), and jouj eo mour eo (reciprocity). A key Marshallese proverb, “Enra bwe jen lale rara”, is the cultural practice where families enact compassion through the sharing of food in all occurrences. The term “enra” is a small basket weaved from the coconut leaves, and often used by Marshallese as a plate to share and distribute food amongst each other. Bwe-jen-lale-rara is about noticing and providing for the needs of others, and “enra” the basket will help support and provide for all that are in need. “Enra-bwe-jen-lale-rara” is symbolic of cultural exchange and reciprocity and the cultural values associated with building and maintaining relationships, and constantly honouring each other. As a Marshallese practice, in this article we share our understanding and knowledge about the challenges as well as possible solutions for education concerns in our nation. In addition, we highlight another proverb, “wa kuk wa jimor”, which relates to having one canoe, and despite its capacity to feed and provide for the individual, but within the canoe all people can benefit from what it can provide. In the same way, we provide in this paper a cultural framework that will enable all educators to benefit from. It is a framework that is far-reaching and relevant to the lived realities of Marshallese people today. Kumit relates to people united to build strength, all co-operating and working together, living in peace, harmony, and good health. Kanne Lobal: conceptual framework for education and leadership An education framework is a conceptual structure that can be used to capture ideas and thinking related to aspects of learning. Kanne Lobal is conceptualised and framed in this paper as an educational framework. Kanne Lobal highlights the significance of education as a collective partnership whereby leadership is an important aspect. Kanne Lobal draws-from indigenous Marshallese concepts like kautiej (respect), jouj eo mour eo (reciprocity), and jouj (kindness, heart). The role of a leader, including an education leader, is to prioritise collective learning and partnerships that benefits Marshallese people and the continuity and survival of the next generation (Heine, 2002; Thaman, 1995). As described by Ejnar Aerōk, an expert canoe builder in the RMI, he stated: “jerbal ippān doon bwe en maron maan wa e” (cited in Miller, 2010, p. 69). His description emphasises the significance of partnerships and working together when navigating and journeying together in order to move the canoe forward. The kubaak, the outrigger of the wa (canoe) is about “partnerships”. For us as elementary school leaders on Majuro, kubaak encourages us to value collaborative partnerships with each other as well as our communities, PSS, and other stakeholders. Partnerships is an important part of the Kanne Lobal education and leadership framework. It requires ongoing bwebwenato – the inspiring as well as confronting and challenging conversations that should be mediated and negotiated if we and our education stakeholders are to journey together to ensure that the educational services we provide benefits our next generation of young people in the RMI. Navigating ahead the partnerships, mediation, and negotiation are the core values of jouj (kindness, love), kautiej (respect), and jouj eo mour eo (reciprocity). As an organic conceptual framework grounded in indigenous values, inspired through our lived experiences, Kanne Lobal provides ideas and concepts for re-thinking education and leadership practices that are conducive to learning and teaching in the schooling context in the RMI. By no means does it provide the solution to the education ills in our nation. However, we argue that Kanne Lobal is a more relevant approach which is much needed for the negatively stigmatised system as a consequence of the various colonial administrations that have and continue to shape and reframe our ideas about what education should be like for us in the RMI. Moreover, Kannel Lobal is our attempt to decolonize the framing of education and leadership, moving our bwebwenato to re-framing conversations of teaching and learning so that our cultural knowledge and values are foregrounded, appreciated, and realised within our education system. Bwebwenato: sharing our stories In this section, we use bwebwenato as a method of gathering and capturing our stories as data. Below we capture our stories and ongoing conversations about the richness in Marshallese cultural knowledge in the outer islands and on Majuro and the potentialities in Kanne Lobal. Danny Jim When I was in third grade (9-10 years of age), during my grandfather’s speech in Arno, an atoll near Majuro, during a time when a wa (canoe) was being blessed and ready to put the canoe into the ocean. My grandfather told me the canoe was a blessing for the family. “Without a canoe, a family cannot provide for them”, he said. The canoe allows for travelling between places to gather food and other sources to provide for the family. My grandfather’s stories about people’s roles within the canoe reminded me that everyone within the family has a responsibility to each other. Our women, mothers and daughters too have a significant responsibility in the journey, in fact, they hold us, care for us, and given strength to their husbands, brothers, and sons. The wise man or elder sits in the middle of the canoe, directing the young man who help to steer. The young man, he does all the work, directed by the older man. They take advice and seek the wisdom of the elder. In front of the canoe, a young boy is placed there and because of his strong and youthful vision, he is able to help the elder as well as the young man on the canoe. The story can be linked to the roles that school leaders, teachers, and students have in schooling. Without each person knowing intricately their role and responsibility, the sight and vision ahead for the collective aspirations of the school and the community is difficult to comprehend. For me, the canoe is symbolic of our educational journey within our education system. As the school leader, a central, trusted, and respected figure in the school, they provide support for teachers who are at the helm, pedagogically striving to provide for their students. For without strong direction from the school leaders and teachers at the helm, the students, like the young boy, cannot foresee their futures, or envisage how education can benefit them. This is why Kanne Lobal is a significant framework for us in the Marshall Islands because within the practice we are able to take heed and empower each other so that all benefit from the process. Kanne Lobal is linked to our culture, an essential part of who we are. We must rely on our own local approaches, rather than relying on others that are not relevant to what we know and how we live in today’s society. One of the things I can tell is that in Majuro, compared to the outer islands, it’s different. In the outer islands, parents bring children together and tell them legends and stories. The elders tell them about the legends and stories – the bwebwenato. Children from outer islands know a lot more about Marshallese legends compared to children from the Majuro atoll. They usually stay close to their parents, observe how to prepare food and all types of Marshallese skills. Loretta Joseph Case There is little Western influence in the outer islands. They grow up learning their own culture with their parents, not having tv. They are closely knit, making their own food, learning to weave. They use fire for cooking food. They are more connected because there are few of them, doing their own culture. For example, if they’re building a house, the ladies will come together and make food to take to the males that are building the house, encouraging them to keep on working - “jemjem maal” (sharpening tools i.e. axe, like encouraging workers to empower them). It’s when they bring food and entertainment. Rubon Rubon Togetherness, work together, sharing of food, these are important practices as a school leader. Jemjem maal – the whole village works together, men working and the women encourage them with food and entertainment. All the young children are involved in all of the cultural practices, cultural transmission is consistently part of their everyday life. These are stronger in the outer islands. Kanne Lobal has the potential to provide solutions using our own knowledge and practices. Connie Joel When new teachers become a teacher, they learn more about their culture in teaching. Teaching raises the question, who are we? A popular saying amongst our people, “Aelon kein ad ej aelon in manit”, means that “Our islands are cultural islands”. Therefore, when we are teaching, and managing the school, we must do this culturally. When we live and breathe, we must do this culturally. There is more socialising with family and extended family. Respect the elderly. When they’re doing things the ladies all get together, in groups and do it. Cut the breadfruit, and preserve the breadfruit and pandanus. They come together and do it. Same as fishing, building houses, building canoes. They use and speak the language often spoken by the older people. There are words that people in the outer islands use and understand language regularly applied by the elderly. Respect elderly and leaders more i.e., chiefs (iroj), commoners (alap), and the workers on the land (ri-jerbal) (social layer under the commoners). All the kids, they gather with their families, and go and visit the chiefs and alap, and take gifts from their land, first produce/food from the plantation (eojōk). Tommy Almet The people are more connected to the culture in the outer islands because they help one another. They don’t have to always buy things by themselves, everyone contributes to the occasion. For instance, for birthdays, boys go fishing, others contribute and all share with everyone. Kanne Lobal is a practice that can bring people together – leaders, teachers, stakeholders. We want our colleagues to keep strong and work together to fix problems like students and teachers’ absenteeism which is a big problem for us in schools. Demetria Malachi The culture in the outer islands are more accessible and exposed to children. In Majuro, there is a mixedness of cultures and knowledges, influenced by Western thinking and practices. Kanne Lobal is an idea that can enhance quality educational purposes for the RMI. We, the school leaders who did GCSL, we want to merge and use this idea because it will help benefit students’ learning and teachers’ teaching. Kanne Lobal will help students to learn and teachers to teach though traditional skills and knowledge. We want to revitalize our ways of life through teaching because it is slowly fading away. Also, we want to have our own Marshallese learning process because it is in our own language making it easier to use and understand. Essentially, we want to proudly use our own ways of teaching from our ancestors showing the appreciation and blessings given to us. Way Forward To think of ways forward is about reflecting on the past and current learnings. Instead of a traditional discussion within a research publication, we have opted to continue our bwebwenato by sharing what we have learnt through the Graduate Certificate in School Leadership (GCSL) programme. Our bwebwenato does not end in this article and this opportunity to collaborate and partner together in this piece of writing has been a meaningful experience to conceptualise and unpack the Kanne Lobal framework. Our collaborative bwebwenato has enabled us to dig deep into our own wise knowledges for guidance through mediating and negotiating the challenges in education and leadership (Sanga & Houma, 2004). For example, bwe-jen-lale-rara reminds us to inquire, pay attention, and focus on supporting the needs of others. Through enra-bwe-jen-lale-rara, it reminds us to value cultural exchange and reciprocity which will strengthen the development and maintaining of relationships based on ways we continue to honour each other (Nimmer, 2017). We not only continue to support each other, but also help mentor the next generation of school leaders within our education system (Heine, 2002). Education and leadership are all about collaborative partnerships (Sanga & Chu, 2009; Thaman, 1997). Developing partnerships through the GCSL was useful learning for us. It encouraged us to work together, share knowledge, respect each other, and be kind. The values of jouj (kindness, love), kautiej (respect), and jouj eo mour eo (reciprocity) are meaningful in being and becoming and educational leader in the RMI (Jetnil-Kijiner, 2014; Miller, 2010; Nimmer, 2017). These values are meaningful for us practice particularly given the drive by PSS for schools to become accredited. The workshops and meetings delivered during the GCSL in the RMI from 2018 to 2019 about Kanne Lobal has given us strength to share our stories and experiences from the meeting with the stakeholders. But before we met with the stakeholders, we were encouraged to share and speak in our language within our courses: EDP05 (Professional Development and Learning), EDP06 (School Leadership), EDP07 (School Management), EDP08 (Teaching and Learning), and EDP09 (Community Partnerships). In groups, we shared our presentations with our peers, the 15 school leaders in the GCSL programme. We also invited USP RMI staff. They liked the way we presented Kannel Lobal. They provided us with feedback, for example: how the use of the sail on the canoe, the parts and their functions can be conceptualised in education and how they are related to the way that we teach our own young people. Engaging stakeholders in the conceptualisation and design stages of Kanne Lobal strengthened our understanding of leadership and collaborative partnerships. Based on various meetings with the RMI Pacific Resources for Education and Learning (PREL) team, PSS general assembly, teachers from the outer islands, and the PSS executive committee, we were able to share and receive feedback on the Kanne Lobal framework. The coordinators of the PREL programme in the RMI were excited by the possibilities around using Kanne Lobal, as a way to teach culture in an inspirational way to Marshallese students. Our Marshallese knowledge, particularly through the proverbial meaning of Kanne Lobal provided so much inspiration and insight for the groups during the presentation which gave us hope and confidence to develop the framework. Kanne Lobal is an organic and indigenous approach, grounded in Marshallese ways of doing things (Heine, 2002; Taafaki & Fowler, 2019). Given the persistent presence of colonial processes within the education system and the constant reference to practices and initiatives from the US, Kanne Lobal for us provides a refreshing yet fulfilling experience and makes us feel warm inside because it is something that belongs to all Marshallese people. Conclusion Marshallese indigenous knowledge and practices provide meaningful educational and leadership understanding and learnings. They ignite, inspire, and transform thinking and practice. The Kanne Lobal conceptual framework emphasises key concepts and values necessary for collaborative partnerships within education and leadership practices in the RMI. The bwebwenato or talk stories have been insightful and have highlighted the strengths and benefits that our Marshallese ideas and practices possess when looking for appropriate and relevant ways to understand education and leadership. Acknowledgements We want to acknowledge our GCSL cohort of school leaders who have supported us in the development of Kanne Lobal as a conceptual framework. A huge kommol tata to our friends: Joana, Rosana, Loretta, Jellan, Alvin, Ellice, Rolando, Stephen, and Alan. References Benson, C. (2002). Preface. In F. Pene, A. M. Taufe’ulungaki, & C. Benson (Eds.), Tree of Opportunity: re-thinking Pacific Education (p. iv). Suva, Fiji: University of the South Pacific, Institute of Education. Bessarab, D., Ng’andu, B. (2010). Yarning about yarning as a legitimate method in indigenous research. International Journal of Critical Indigenous Studies, 3(1), 37-50. Fa’avae, D., Jones, A., & Manu’atu, L. (2016). Talanoa’i ‘a e talanoa - talking about talanoa: Some dilemmas of a novice researcher. AlterNative: An Indigenous Journal of Indigenous Peoples,12(2),138-150. Heine, H. C. (2002). A Marshall Islands perspective. In F. Pene, A. M. Taufe’ulungaki, & C. 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Abstract Background The Melbourne Genomics Health Alliance (the Alliance) is a collaboration of leading hospitals, research and academic organisations, supported by its member organisations and the Victorian Government. The Alliance was set up by its members in 2013 to steer the translation of genomics, making it an integral part of health care in Victoria, Australia. The Community Advisory Group (CAG) was formed soon after, to give input and advice across the program. This was to ensure consideration of community values, perspectives and priorities, and knowledge translation for patient care. The CAG was charged with providing a strong community voice for the duration of the program. Appointed members were experienced consumer advocates with developed connections to the community. Main body The Alliance progressed from an initial Demonstration Project (2013–2015) to a multifaceted program (2016–2020). The CAG worked strategically to help address complex issues, for example, communication, privacy, informed consent, ethics, patient experience, measurement and evaluation standards and policies, data storage and re-use of genomic data. Many aspects of translating genomics into routine care have been tackled, such as communicating with patients invited to have genomic testing, or their caregivers, and obtaining informed consent, clinical questions across 16 areas of health care, training and education of health and laboratory professionals, genomic data management and data-sharing. Evidence generated around clinical utility and cost-effectiveness led to government funding of testing for complex genetic conditions in children. Conclusion The CAG activities, recorded in a CAG-inspired Activity register, span the full spectrum of information sharing and consultation to co-design and partnership. The CAG were involved at multiple levels of participation and in all tiers of activity including governance, development of policies and procedures, program planning and evaluation. Working relationships were built up and a level of trust instilled to advance the Alliance work program in ensuring an effective patient-care model of delivery of genomics. CAG input into project deliverables has been tangible. Less tangible contributions included presentations at external meetings and conferences, direct interactions at meetings with Alliance members, interactions with visitors and external experts, taking part in consultations with experts, state and federal government.

Australians in rural and remote locations have worse health outcomes compared to that of their metropolitan counterparts and this is due in part to poor access to health services. Public specialist dental services in Victoria, Australia are predominantly offered in the capital city Melbourne. For rural patients this can mean considerable travel, out of pocket costs and delays due to long wait-times. In 2015 Dental Health Service Victoria (DHSV) embarked on a pilot project to enable access to rural clients by linking community dental clinics with the Royal Dental Hospital Melbourne using a Telehealth platform. Aim: The objectives of the pilot were to develop specialist care pathways and enable patient access, support community clinicians to work to full scope through a peer education approach and to identify the appropriate equipment and telehealth platform to support this model of care. Method: DHSV launched its pilot project June 2015 collaborating with four Community Dental sites. The specialties trialled during the pilot project were Oral Medicine, Oral Surgery, Endodontics and Orthodontics. An action based research framework was adopted so that improvements to the operational framework and clinical pathways could be made throughout the life of the pilot. Results: By the end of the pilot programme, DHSV was satisfied the program objectives had been met and the modality was accepted by specialists, community dentists, and patients as a satisfactory substitution for a traditional face-to-face referral and consult mode. Conclusion: Based on this outcome, the programme was endorsed and implemented across the state of Victoria in January 2018.

Objectives: This narrative paper describes the influences behind the development of, and key components of a specialist younger-onset dementia service located in metropolitan Victoria, Australia. Conclusion: The Melbourne Young-Onset Dementia Service was established in 2013 and provides diagnosis and ongoing care for people with younger-onset dementia and their families, through collaboration with other medical units, allied health and community services. It is potentially a model for other younger-onset dementia services nationally and internationally.

Purpose Following deaths and hospitalisations in Melbourne, Victoria, Australia, related to the unwitting consumption of a combination of 25C-NBOMe and 4-FA, a community-led unauthorised drug checking service was rapidly established at a subsequent music festival. We aim to demonstrate the value of community-led drug checking, even when conducted in less-than-ideal conditions, by describing this service and reporting on its outcomes. Design/methodology/approach In all, 131 samples were tested with between 1 and 4 (M = 2.24 and SD = 0.61) reagents (Mandelin, Marquis, Mecke and Simons), and behavioural intentions of service users were reported. Findings People whose results indicated that the drug tested was what they expected, or was a drug familiar to them, were more likely to report an intention to take the drug compared to those whose results indicated that the drug was not what they had expected. For example, in 11 cases where the expected substance was not identified and novel substances including 2 C-X (including the NBOMe series), methylone, mephedrone, PMA and MXE were indicated, most reported an intention to discard (8/11). Practical implications The guerrilla service appeared to dissuade some people from consuming substances with higher risk profiles. It was also quick to identify substances of concern consistent with the NBOMe/4-FA combination for broader community action. The authors urge governments in Australia and elsewhere to reconsider their opposition to drug checking services, given their utility as vital health services during times of volatile drug market shifts. Originality/value While these data are five years old, it has only been in the past year that the Coroners Court of Victoria finalised their report on the deaths associated with this drug outbreak, providing context for the rapid peer response.

Abstract Introduction 'No Jab, No Play' and 'No Jab, No Pay' mandatory immunisation policies were introduced in the state of Victoria and Australia nationally in January 2016. They restrict access to childcare/kindergarten and family assistance payments respectively, for under-vaccinated children. We aimed to describe the proportion of attendees to immunisation services of a tertiary hospital, the Royal Children's Hospital Melbourne (RCH), who were motivated by the policies to discuss or catch up vaccination. We also explored the association between policy motivation, vaccine hesitancy (VH) and intent to seek medical exemption, with vaccine-uptake. Referrals to the Specialist Immunisation Clinic (SIC) were also reviewed. Methods Parents/Guardians and clinicians completed surveys October 2016-May 2017 from the nurse-led immunisation Drop in Centre (DIC) or physician-led SIC. Vaccine-uptake was measured using the Australian Immunisation Register at baseline, 1 and 7 months post-attendance. The association between vaccine-uptake, policy motivation and VH was explored by logistic regression. Results Of 607 children included, 393 (65%) were from the DIC and 214 (35%) SIC. 74 (12%) of parents were motivated by the policies to attend immunisation services and 19% were VH. Only 50% of VH parents planned to catch-up vaccination for enrolment to childcare/kindergarten. Fewer children were fully immunised at 7 months if their parents were VH (difference 18%; OR 0.24, CI 0.1-0.54,p&lt;0.001) or seeking medical exemption (difference 33%, OR 0.08, CI 0.01-0.6, p 0.015). Conclusions The 'No Jab' policies motivated attendance to a tertiary immunisation service but children of vaccine hesitant parents and those seeking medical exemption to immunisation were less likely to be fully immunised post attendance, compared to baseline. These data will be used to inform a comprehensive evaluation of the impact of the policies, particularly the educational impact from loss of early childhood education.

Joanne Holmes was a respected and valued colleague, a champion for her people, a dearly loved wife, mother and grandmother, and a woman who met challenges with style. Joanne was born in Wynyard, Tasmania, a Palawa woman whose father died in the Hobart bushfires and whose mother subsequently moved to Melbourne. Joanne met and married Kevin Holmes in 1974 and, in the 1980s after having her first son, Matthew, decided to train as a teacher. After undertaking a number of teaching roles, Joanne had a second son, Jeremy, but 1992 brought ill health following a dental procedure and Joanne became the first Aboriginal woman to receive a liver transplant. Poor health dogged her footsteps on and off from this time on, but Joanne was unstoppable. She enrolled and completed a Bachelor of Social Work degree graduating with Honours in Social Work from the Institute of Koori Education at Geelong (Deakin University), and until her death maintained her determination to advocate passionately for services to children, young people and their families throughout the northern regions of Victoria and beyond.

Introduction Most developed countries, including Australia, have a strong focus on national, state and local strategies for emergency management and response in the face of disasters and crises. This framework can include coping with catastrophic dislocation, service disruption, injury or loss of life in the face of natural disasters such as major fires, floods, earthquakes or other large-impact natural events, as well as dealing with similar catastrophes resulting from human actions such as bombs, biological agents, cyber-attacks targeting essential services such as communications networks, or other crises affecting large populations. Emergency management frameworks for crisis and disaster response are distinguished by their focus on the domestic context for such events; that is, how to manage and assist the ways in which civilian populations, who are for the most part inexperienced and untrained in dealing with crises and disasters, are able to respond and behave in such situations so as to minimise the impacts of a catastrophic event. Even in countries like Australia that demonstrate a strong public commitment to cultural pluralism and social cohesion, ethno-cultural diversity can be seen as a risk or threat to national security and values at times of political, natural, economic and/or social tensions and crises. Australian government policymakers have recently focused, with increasing intensity, on “community resilience” as a key element in countering extremism and enhancing emergency preparedness and response. In some sense, this is the result of a tacit acknowledgement by government agencies that there are limits to what they can do for domestic communities should such a catastrophic event occur, and accordingly, the focus in recent times has shifted to how governments can best help people to help themselves in such situations, a key element of the contemporary “resilience” approach. Yet despite the robustly multicultural nature of Australian society, explicit engagement with Australia’s cultural diversity flickers only fleetingly on this agenda, which continues to pursue approaches to community resilience in the absence of understandings about how these terms and formations may themselves need to be diversified to maximise engagement by all citizens in a multicultural polity. There have been some recent efforts in Australia to move in this direction, for example the Australian Emergency Management Institute (AEMI)’s recent suite of projects with culturally and linguistically diverse (CALD) communities (2006-2010) and the current Australia-New Zealand Counter-Terrorism Committee-supported project on “Harnessing Resilience Capital in Culturally Diverse Communities to Counter Violent Extremism” (Grossman and Tahiri), which I discuss in a longer forthcoming version of this essay (Grossman). Yet the understanding of ethno-cultural identity and difference that underlies much policy thinking on resilience remains problematic for the way in which it invests in a view of the cultural dimensions of community resilience as relic rather than resource – valorising the preservation of and respect for cultural norms and traditions, but silent on what different ethno-cultural communities might contribute toward expanded definitions of both “community” and “resilience” by virtue of the transformative potential and existing cultural capital they bring with them into new national and also translocal settings. For example, a primary conclusion of the joint program between AEMI and the Australian Multicultural Commission is that CALD communities are largely “vulnerable” in the context of disasters and emergency management and need to be better integrated into majority-culture models of theorising and embedding community resilience. This focus on stronger national integration and the “vulnerability” of culturally diverse ethno-cultural communities in the Australian context echoes the work of scholars beyond Australia such as McGhee, Mouritsen (Reflections, Citizenship) and Joppke. They argue that the “civic turn” in debates around resurgent contemporary nationalism and multicultural immigration policies privileges civic integration over genuine two-way multiculturalism. This approach sidesteps the transculturational (Ortiz; Welsch; Mignolo; Bennesaieh; Robins; Stein) aspects of contemporary social identities and exchange by paying lip-service to cultural diversity while affirming a neo-liberal construct of civic values and principles as a universalising goal of Western democratic states within a global market economy. It also suggests a superficial tribute to cultural diversity that does not embed diversity comprehensively at the levels of either conceptualising or resourcing different elements of Australian transcultural communities within the generalised framework of “community resilience.” And by emphasising cultural difference as vulnerability rather than as resource or asset, it fails to acknowledge the varieties of resilience capital that many culturally diverse individuals and communities may bring with them when they resettle in new environments, by ignoring the question of what “resilience” actually means to those from culturally diverse communities. In so doing, it also avoids the critical task of incorporating intercultural definitional diversity around the concepts of both “community” and “resilience” used to promote social cohesion and the capacity to recover from disasters and crises. How we might do differently in thinking about the broader challenges for multiculturalism itself as a resilient transnational concept and practice? The Concept of Resilience The meanings of resilience vary by disciplinary perspective. While there is no universally accepted definition of the concept, it is widely acknowledged that resilience refers to the capacity of an individual to do well in spite of exposure to acute trauma or sustained adversity (Liebenberg 219). Originating in the Latin word resilio, meaning ‘to jump back’, there is general consensus that resilience pertains to an individual’s, community’s or system’s ability to adapt to and ‘bounce back’ from a disruptive event (Mohaupt 63, Longstaff et al. 3). Over the past decade there has been a dramatic rise in interest in the clinical, community and family sciences concerning resilience to a broad range of adversities (Weine 62). While debate continues over which discipline can be credited with first employing resilience as a concept, Mohaupt argues that most of the literature on resilience cites social psychology and psychiatry as the origin for the concept beginning in the mid-20th century. The pioneer researchers of what became known as resilience research studied the impact on children living in dysfunctional families. For example, the findings of work by Garmezy, Werner and Smith and Rutter showed that about one third of children in these studies were coping very well despite considerable adversities and traumas. In asking what it was that prevented the children in their research from being negatively influenced by their home environments, such research provided the basis for future research on resilience. Such work was also ground-breaking for identifying the so-called ‘protective factors’ or resources that individuals can operationalise when dealing with adversity. In essence, protective factors are those conditions in the individual that protect them from the risk of dysfunction and enable recovery from trauma. They mitigate the effects of stressors or risk factors, that is, those conditions that predispose one to harm (Hajek 15). Protective factors include the inborn traits or qualities within an individual, those defining an individual’s environment, and also the interaction between the two. Together, these factors give people the strength, skills and motivation to cope in difficult situations and re-establish (a version of) ‘normal’ life (Gunnestad). Identifying protective factors is important in terms of understanding the particular resources a given sociocultural group has at its disposal, but it is also vital to consider the interconnections between various protective mechanisms, how they might influence each other, and to what degree. An individual, for instance, might display resilience or adaptive functioning in a particular domain (e.g. emotional functioning) but experience significant deficits in another (e.g. academic achievement) (Hunter 2). It is also essential to scrutinise how the interaction between protective factors and risk factors creates patterns of resilience. Finally, a comprehensive understanding of the interrelated nature of protective mechanisms and risk factors is imperative for designing effective interventions and tailored preventive strategies (Weine 65). In short, contemporary thinking about resilience suggests it is neither entirely personal nor strictly social, but an interactive and iterative combination of the two. It is a quality of the environment as much as the individual. For Ungar, resilience is the complex entanglements between “individuals and their social ecologies [that] will determine the degree of positive outcomes experienced” (3). Thinking about resilience as context-dependent is important because research that is too trait-based or actor-centred risks ignoring any structural or institutional forces. A more ecological interpretation of resilience, one that takes into a person’s context and environment into account, is vital in order to avoid blaming the victim for any hardships they face, or relieving state and institutional structures from their responsibilities in addressing social adversity, which can “emphasise self-help in line with a neo-conservative agenda instead of stimulating state responsibility” (Mohaupt 67). Nevertheless, Ungar posits that a coherent definition of resilience has yet to be developed that adequately ‘captures the dual focus of the individual and the individual’s social ecology and how the two must both be accounted for when determining the criteria for judging outcomes and discerning processes associated with resilience’ (7). Recent resilience research has consequently prompted a shift away from vulnerability towards protective processes — a shift that highlights the sustained capabilities of individuals and communities under threat or at risk. Locating ‘Culture’ in the Literature on Resilience However, an understanding of the role of culture has remained elusive or marginalised within this trend; there has been comparatively little sustained investigation into the applicability of resilience constructs to non-western cultures, or how the resources available for survival might differ from those accessible to western populations (Ungar 4). As such, a growing body of researchers is calling for more rigorous inquiry into culturally determined outcomes that might be associated with resilience in non-western or multicultural cultures and contexts, for example where Indigenous and minority immigrant communities live side by side with their ‘mainstream’ neighbours in western settings (Ungar 2). ‘Cultural resilience’ considers the role that cultural background plays in determining the ability of individuals and communities to be resilient in the face of adversity. For Clauss-Ehlers, the term describes the degree to which the strengths of one’s culture promote the development of coping (198). Culturally-focused resilience suggests that people can manage and overcome stress and trauma based not on individual characteristics alone, but also from the support of broader sociocultural factors (culture, cultural values, language, customs, norms) (Clauss-Ehlers 324). The innate cultural strengths of a culture may or may not differ from the strengths of other cultures; the emphasis here is not so much comparatively inter-cultural as intensively intra-cultural (VanBreda 215). A culturally focused resilience model thus involves “a dynamic, interactive process in which the individual negotiates stress through a combination of character traits, cultural background, cultural values, and facilitating factors in the sociocultural environment” (Clauss-Ehlers 199). In understanding ways of ‘coping and hoping, surviving and thriving’, it is thus crucial to consider how culturally and linguistically diverse minorities navigate the cultural understandings and assumptions of both their countries of origin and those of their current domicile (Ungar 12). Gunnestad claims that people who master the rules and norms of their new culture without abandoning their own language, values and social support are more resilient than those who tenaciously maintain their own culture at the expense of adjusting to their new environment. They are also more resilient than those who forego their own culture and assimilate with the host society (14). Accordingly, if the combination of both valuing one’s culture as well as learning about the culture of the new system produces greater resilience and adaptive capacities, serious problems can arise when a majority tries to acculturate a minority to the mainstream by taking away or not recognising important parts of the minority culture. In terms of resilience, if cultural factors are denied or diminished in accounting for and strengthening resilience – in other words, if people are stripped of what they possess by way of resilience built through cultural knowledge, disposition and networks – they do in fact become vulnerable, because ‘they do not automatically gain those cultural strengths that the majority has acquired over generations’ (Gunnestad 14). Mobilising ‘Culture’ in Australian Approaches to Community Resilience The realpolitik of how concepts of resilience and culture are mobilised is highly relevant here. As noted above, when ethnocultural difference is positioned as a risk or a threat to national identity, security and values, this is precisely the moment when vigorously, even aggressively, nationalised definitions of ‘community’ and ‘identity’ that minoritise or disavow cultural diversities come to the fore in public discourse. The Australian evocation of nationalism and national identity, particularly in the way it has framed policy discussion on managing national responses to disasters and threats, has arguably been more muted than some of the European hysteria witnessed recently around cultural diversity and national life. Yet we still struggle with the idea that newcomers to Australia might fall on the surplus rather than the deficit side of the ledger when it comes to identifying and harnessing resilience capital. A brief example of this trend is explored here. From 2006 to 2010, the Australian Emergency Management Institute embarked on an ambitious government-funded four-year program devoted to strengthening community resilience in relation to disasters with specific reference to engaging CALD communities across Australia. The program, Inclusive Emergency Management with CALD Communities, was part of a wider Australian National Action Plan to Build Social Cohesion, Harmony and Security in the wake of the London terrorist bombings in July 2005. Involving CALD community organisations as well as various emergency and disaster management agencies, the program ran various workshops and agency-community partnership pilots, developed national school education resources, and commissioned an evaluation of the program’s effectiveness (Farrow et al.). While my critique here is certainly not aimed at emergency management or disaster response agencies and personnel themselves – dedicated professionals who often achieve remarkable results in emergency and disaster response under extraordinarily difficult circumstances – it is nevertheless important to highlight how the assumptions underlying elements of AEMI’s experience and outcomes reflect the persistent ways in which ethnocultural diversity is rendered as a problem to be surmounted or a liability to be redressed, rather than as an asset to be built upon or a resource to be valued and mobilised. AEMI’s explicit effort to engage with CALD communities in building overall community resilience was important in its tacit acknowledgement that emergency and disaster services were (and often remain) under-resourced and under-prepared in dealing with the complexities of cultural diversity in emergency situations. Despite these good intentions, however, while the program produced some positive outcomes and contributed to crucial relationship building between CALD communities and emergency services within various jurisdictions, it also continued to frame the challenge of working with cultural diversity as a problem of increased vulnerability during disasters for recently arrived and refugee background CALD individuals and communities. This highlights a common feature in community resilience-building initiatives, which is to focus on those who are already ‘robust’ versus those who are ‘vulnerable’ in relation to resilience indicators, and whose needs may require different or additional resources in order to be met. At one level, this is a pragmatic resourcing issue: national agencies understandably want to put their people, energy and dollars where they are most needed in pursuit of a steady-state unified national response at times of crisis. Nor should it be argued that at least some CALD groups, particularly those from new arrival and refugee communities, are not vulnerable in at least some of the ways and for some of the reasons suggested in the program evaluation. However, the consistent focus on CALD communities as ‘vulnerable’ and ‘in need’ is problematic, as well as partial. It casts members of these communities as structurally and inherently less able and less resilient in the context of disasters and emergencies: in some sense, as those who, already ‘victims’ of chronic social deficits such as low English proficiency, social isolation and a mysterious unidentified set of ‘cultural factors’, can become doubly victimised in acute crisis and disaster scenarios. In what is by now a familiar trope, the description of CALD communities as ‘vulnerable’ precludes asking questions about what they do have, what they do know, and what they do or can contribute to how we respond to disaster and emergency events in our communities. A more profound problem in this sphere revolves around working out how best to engage CALD communities and individuals within existing approaches to disaster and emergency preparedness and response. This reflects a fundamental but unavoidable limitation of disaster preparedness models: they are innately spatially and geographically bounded, and consequently understand ‘communities’ in these terms, rather than expanding definitions of ‘community’ to include the dimensions of community-as-social-relations. While some good engagement outcomes were achieved locally around cross-cultural knowledge for emergency services workers, the AEMI program fell short of asking some of the harder questions about how emergency and disaster service scaffolding and resilience-building approaches might themselves need to change or transform, using a cross-cutting model of ‘communities’ as both geographic places and multicultural spaces (Bartowiak-Théron and Crehan) in order to be more effective in national scenarios in which cultural diversity should be taken for granted. Toward Acknowledgement of Resilience Capital Most significantly, the AEMI program did not produce any recognition of the ways in which CALD communities already possess resilience capital, or consider how this might be drawn on in formulating stronger community initiatives around disaster and threats preparedness for the future. Of course, not all individuals within such communities, nor all communities across varying circumstances, will demonstrate resilience, and we need to be careful of either overgeneralising or romanticising the kinds and degrees of ‘resilience capital’ that may exist within them. Nevertheless, at least some have developed ways of withstanding crises and adapting to new conditions of living. This is particularly so in connection with individual and group behaviours around resource sharing, care-giving and social responsibility under adverse circumstances (Grossman and Tahiri) – all of which are directly relevant to emergency and disaster response. While some of these resilient behaviours may have been nurtured or enhanced by particular experiences and environments, they can, as the discussion of recent literature above suggests, also be rooted more deeply in cultural norms, habits and beliefs. Whatever their origins, for culturally diverse societies to achieve genuine resilience in the face of both natural and human-made disasters, it is critical to call on the ‘social memory’ (Folke et al.) of communities faced with responding to emergencies and crises. Such wellsprings of social memory ‘come from the diversity of individuals and institutions that draw on reservoirs of practices, knowledge, values, and worldviews and is crucial for preparing the system for change, building resilience, and for coping with surprise’ (Adger et al.). Consequently, if we accept the challenge of mapping an approach to cultural diversity as resource rather than relic into our thinking around strengthening community resilience, there are significant gains to be made. For a whole range of reasons, no diversity-sensitive model or measure of resilience should invest in static understandings of ethnicities and cultures; all around the world, ethnocultural identities and communities are in a constant and sometimes accelerated state of dynamism, reconfiguration and flux. But to ignore the resilience capital and potential protective factors that ethnocultural diversity can offer to the strengthening of community resilience more broadly is to miss important opportunities that can help suture the existing disconnects between proactive approaches to intercultural connectedness and social inclusion on the one hand, and reactive approaches to threats, national security and disaster response on the other, undermining the effort to advance effectively on either front. This means that dominant social institutions and structures must be willing to contemplate their own transformation as the result of transcultural engagement, rather than merely insisting, as is often the case, that ‘other’ cultures and communities conform to existing hegemonic paradigms of being and of living. In many ways, this is the most critical step of all. A resilience model and strategy that questions its own culturally informed yet taken-for-granted assumptions and premises, goes out into communities to test and refine these, and returns to redesign its approach based on the new knowledge it acquires, would reflect genuine progress toward an effective transculturational approach to community resilience in culturally diverse contexts.References Adger, W. Neil, Terry P. Hughes, Carl Folke, Stephen R. Carpenter and Johan Rockström. “Social-Ecological Resilience to Coastal Disasters.” Science 309.5737 (2005): 1036-1039. ‹http://www.sciencemag.org/content/309/5737/1036.full> Bartowiak-Théron, Isabelle, and Anna Corbo Crehan. “The Changing Nature of Communities: Implications for Police and Community Policing.” Community Policing in Australia: Australian Institute of Criminology (AIC) Reports, Research and Policy Series 111 (2010): 8-15. Benessaieh, Afef. “Multiculturalism, Interculturality, Transculturality.” Ed. A. Benessaieh. Transcultural Americas/Ameriques Transculturelles. Ottawa: U of Ottawa Press/Les Presses de l’Unversite d’Ottawa, 2010. 11-38. Clauss-Ehlers, Caroline S. “Sociocultural Factors, Resilience and Coping: Support for a Culturally Sensitive Measure of Resilience.” Journal of Applied Developmental Psychology 29 (2008): 197-212. Clauss-Ehlers, Caroline S. “Cultural Resilience.” Encyclopedia of Cross-Cultural School Psychology. Ed. C. S. Clauss-Ehlers. New York: Springer, 2010. 324-326. Farrow, David, Anthea Rutter and Rosalind Hurworth. Evaluation of the Inclusive Emergency Management with Culturally and Linguistically Diverse (CALD) Communities Program. Parkville, Vic.: Centre for Program Evaluation, U of Melbourne, July 2009. ‹http://www.ag.gov.au/www/emaweb/rwpattach.nsf/VAP/(9A5D88DBA63D32A661E6369859739356)~Final+Evaluation+Report+-+July+2009.pdf/$file/Final+Evaluation+Report+-+July+2009.pdf>.Folke, Carl, Thomas Hahn, Per Olsson, and Jon Norberg. “Adaptive Governance of Social-Ecological Systems.” Annual Review of Environment and Resources 30 (2005): 441-73. ‹http://arjournals.annualreviews.org/doi/pdf/10.1146/annurev.energy.30.050504.144511>. Garmezy, Norman. “The Study of Competence in Children at Risk for Severe Psychopathology.” The Child in His Family: Children at Psychiatric Risk. Vol. 3. Eds. E. J. Anthony and C. Koupernick. New York: Wiley, 1974. 77-97. Grossman, Michele. “Resilient Multiculturalism? Diversifying Australian Approaches to Community Resilience and Cultural Difference”. Global Perspectives on Multiculturalism in the 21st Century. Eds. B. E. de B’beri and F. Mansouri. London: Routledge, 2014. Grossman, Michele, and Hussein Tahiri. Harnessing Resilience Capital in Culturally Diverse Communities to Counter Violent Extremism. Canberra: Australia-New Zealand Counter-Terrorism Committee, forthcoming 2014. Grossman, Michele. “Cultural Resilience and Strengthening Communities”. Safeguarding Australia Summit, Canberra. 23 Sep. 2010. ‹http://www.safeguardingaustraliasummit.org.au/uploader/resources/Michele_Grossman.pdf>. Gunnestad, Arve. “Resilience in a Cross-Cultural Perspective: How Resilience Is Generated in Different Cultures.” Journal of Intercultural Communication 11 (2006). ‹http://www.immi.se/intercultural/nr11/gunnestad.htm>. Hajek, Lisa J. “Belonging and Resilience: A Phenomenological Study.” Unpublished Master of Science thesis, U of Wisconsin-Stout. Menomonie, Wisconsin, 2003. Hunter, Cathryn. “Is Resilience Still a Useful Concept When Working with Children and Young People?” Child Family Community Australia (CFA) Paper 2. Melbourne: Australian Institute of Family Studies, 2012.Joppke, Christian. "Beyond National Models: Civic Integration Policies for Immigrants in Western Europe". West European Politics 30.1 (2007): 1-22. Liebenberg, Linda, Michael Ungar, and Fons van de Vijver. “Validation of the Child and Youth Resilience Measure-28 (CYRM-28) among Canadian Youth.” Research on Social Work Practice 22.2 (2012): 219-226. Longstaff, Patricia H., Nicholas J. Armstrong, Keli Perrin, Whitney May Parker, and Matthew A. Hidek. “Building Resilient Communities: A Preliminary Framework for Assessment.” Homeland Security Affairs 6.3 (2010): 1-23. ‹http://www.hsaj.org/?fullarticle=6.3.6>. McGhee, Derek. The End of Multiculturalism? Terrorism, Integration and Human Rights. Maidenhead: Open U P, 2008.Mignolo, Walter. Local Histories/Global Designs: Coloniality, Subaltern Knowledges, and Border Thinking. Princeton: Princeton U P, 2000. Mohaupt, Sarah. “Review Article: Resilience and Social Exclusion.” Social Policy and Society 8 (2009): 63-71.Mouritsen, Per. "The Culture of Citizenship: A Reflection on Civic Integration in Europe." Ed. R. Zapata-Barrero. Citizenship Policies in the Age of Diversity: Europe at the Crossroad." Barcelona: CIDOB Foundation, 2009: 23-35. Mouritsen, Per. “Political Responses to Cultural Conflict: Reflections on the Ambiguities of the Civic Turn.” Ed. P. Mouritsen and K.E. Jørgensen. Constituting Communities. Political Solutions to Cultural Conflict, London: Palgrave, 2008. 1-30. Ortiz, Fernando. Cuban Counterpoint: Tobacco and Sugar. Trans. Harriet de Onís. Intr. Fernando Coronil and Bronislaw Malinowski. Durham, NC: Duke U P, 1995 [1940]. Robins, Kevin. The Challenge of Transcultural Diversities: Final Report on the Transversal Study on Cultural Policy and Cultural Diversity. Culture and Cultural Heritage Department. Strasbourg: Council of European Publishing, 2006. Rutter, Michael. “Protective Factors in Children’s Responses to Stress and Disadvantage.” Annals of the Academy of Medicine, Singapore 8 (1979): 324-38. Stein, Mark. “The Location of Transculture.” Transcultural English Studies: Fictions, Theories, Realities. Eds. F. Schulze-Engler and S. Helff. Cross/Cultures 102/ANSEL Papers 12. Amsterdam and New York: Rodopi, 2009. 251-266. Ungar, Michael. “Resilience across Cultures.” British Journal of Social Work 38.2 (2008): 218-235. First published online 2006: 1-18. In-text references refer to the online Advance Access edition ‹http://bjsw.oxfordjournals.org/content/early/2006/10/18/bjsw.bcl343.full.pdf>. VanBreda, Adrian DuPlessis. Resilience Theory: A Literature Review. Erasmuskloof: South African Military Health Service, Military Psychological Institute, Social Work Research & Development, 2001. Weine, Stevan. “Building Resilience to Violent Extremism in Muslim Diaspora Communities in the United States.” Dynamics of Asymmetric Conflict 5.1 (2012): 60-73. Welsch, Wolfgang. “Transculturality: The Puzzling Form of Cultures Today.” Spaces of Culture: City, Nation World. Eds. M. Featherstone and S. Lash. London: Sage, 1999. 194-213. Werner, Emmy E., and Ruth S. Smith. Vulnerable But Invincible: A Longitudinal Study of\ Resilience and Youth. New York: McGraw Hill, 1982. NotesThe concept of ‘resilience capital’ I offer here is in line with one strand of contemporary theorising around resilience – that of resilience as social or socio-ecological capital – but moves beyond the idea of enhancing general social connectedness and community cohesion by emphasising the ways in which culturally diverse communities may already be robustly networked and resourceful within micro-communal settings, with new resources and knowledge both to draw on and to offer other communities or the ‘national community’ at large. In effect, ‘resilience capital’ speaks to the importance of finding ‘the communities within the community’ (Bartowiak-Théron and Crehan 11) and recognising their capacity to contribute to broad-scale resilience and recovery.I am indebted for the discussion of the literature on resilience here to Dr Peta Stephenson, Centre for Cultural Diversity and Wellbeing, Victoria University, who is working on a related project (M. Grossman and H. Tahiri, Harnessing Resilience Capital in Culturally Diverse Communities to Counter Violent Extremism, forthcoming 2014).

Findings from longitudinal research, globally, repeatedly emphasise the importance of a taking an early life course approach to mental health promotion; one that invests in the formative years of development, from early childhood to young adulthood, just prior to the transition to parenthood for most. While population monitoring systems have been developed for this period, they are typically designed for use within discrete stages (i.e., childhood or adolescent or young adulthood). No system has yet captured development across all ages and stages (i.e., from infancy through to young adulthood). Here we describe the development, and pilot implementation, of a new Australian Comprehensive Monitoring System (CMS) designed to address this gap by measuring social and emotional development (strengths and difficulties) across eight census surveys, separated by three yearly intervals (infancy, 3-, 6-, 9- 12-, 15-, 18 and 21 years). The systems also measures the family, school, peer, digital and community social climates in which children and young people live and grow. Data collection is community-led and built into existing, government funded, universal services (Maternal Child Health, Schools and Local Learning and Employment Networks) to maximise response rates and ensure sustainability. The first system test will be completed and evaluated in rural Victoria, Australia, in 2022. CMS will then be adapted for larger, more socio-economically diverse regional and metropolitan communities, including Australian First Nations communities. The aim of CMS is to guide community-led investments in mental health promotion from early childhood to young adulthood, setting secure foundations for the next generation.

Abstract We aimed to understand support needs for Aboriginal and Torres Strait Islander parents experiencing complex trauma.Becoming a parent is an exciting yet challenging transition, particularly for parents who have experienced past hurt in their own childhood which can have long lasting effects, including complex trauma. Complex trauma-related distress can make it harder to care for a baby, but the parenting transition offers unique opportunities for recovery. This formative research is part of a community-based participatory action research project which aims to co-design perinatal awareness, recognition, assessment and support strategies for Aboriginal and Torres Strait Islander parents experiencing complex trauma. We used an Indigenist approach and grounded theory methods. Aboriginal and Torres Strait Islander parents who were pregnant and/or have children up to two years old were recruited through perinatal care services and community networks in three Australian sites (Alice Springs, Adelaide and Melbourne). Parents were offered a group discussion or individual interview, facilitated by Aboriginal researchers. Third-person scenarios and visual tools were used to facilitate reflections about the impact of past experiences, what keeps parents strong, hopes and dreams, and what is needed to achieve those dreams. Parents were also shown themes from a previous systematic review of parents’ experiences as a prompt to identify any additional key issues. Seventeen Aboriginal and Torres Strait Islander parents participated in August to September 2019. Most were mothers (n = 15). The study’s grounded theory methods provided the foundation of a theoretical supposition that positions the transformation of the compounding cycle of trauma, to a reinforcing cycle of nurturing at the intersection of: 1) parents’ connectedness; 2) social and emotional wellbeing; and 3) the transition to parenting. Unique opportunities and challenges situated at the interface are bound to the compounding or reinforcing nature of the intersecting factors. Findings reveal complexity, differing experiences by gender and age, as well as within and between communities.

It seems clear that people who are deaf ... struggle continually against the meanings that others impose on their experience, and the way that this separates them from others. They struggle for acknowledgement of the way they see their lives and wish to live them, and aspire to connection?with other people, to share and belong. (David Moorhead. Knowing Who I Am. 1995. 85.) Nga Tapuwae and Before I am deaf but, before that part of my life started, I was hearing and worked for many years as a librarian in New Zealand. My first job was in a public library located within a secondary school Nga Tapuwae Secondary College in South Auckland. Its placement was a 1970’s social experiment to see if a public library could work within the grounds of a community college (and the answer was no, it could not). The experience was a great introduction for me to the Maori and Polynesian cultures that I had not previously encountered. Until then, I was wary of both groups, and so it was a revelation to realise that although there were many social problems in the area including low literacy, many of the children and teenagers were bright, talented individuals. They simply did not connect to the Anglo-Saxon reading materials we offered. Years later, my interest in the social dynamics of literacy led to my enrolment in a post-graduate literacy degree in Melbourne. This action may have saved my life because at the end of this course, a minor ailment resulted in a visit to the university doctor who diagnosed me with the life-threatening medical condition, Neurofibromatosis Type 2 (NF 2). NF2 is a late onset genetic condition in which one’s body grows tumours, always on both hearing nerves, sometimes elsewhere as well. The tumours usually cause deafness and can cause death. I was told I needed to have my tumours removed and would probably become fully deaf as a result. This is how my life as I knew it changed direction and I started the long journey towards becoming deaf. Diagnosis and Change Predictably, once diagnosed, friends and colleagues rallied to comfort me. I was told things probably weren’t as bad as they sounded. Helen Keller was mentioned several times as an example of someone who had succeeded despite being deaf and blind. ‘Really,’ my friends asked, ‘how bad can it be? ‘Inside myself however, it couldn’t have been worse. A day later the enormity of it all hit me and I became inconsolable. A friend drove me back to the doctor and she did two things that were to change my life. She referred me to the University’s counselling services where, happily, I was counselled by Elizabeth Hastings who later went on to become Australia’s first Disability Services Commissioner. Secondly, the doctor organised for me to visit the HEAR Service at the Victorian Deaf Society (VDS). Again by happy accident, my friend and I stumbled into the ‘wrong building’ where I ended up meeting John Lovett, who was Deaf and the CEO there, via an interpreter. When I met John Lovett I was distraught but, unlike other people, he made no attempt to stop me crying. He simply listened carefully until I realised he understood what I was saying and stopped crying myself. He said my fears that I could end up alone and lonely were valid and he suggested the best thing I could do for myself was to join the ‘Deaf community’; a community. I had never heard of. He explained it was made up of people like him who used Australian sign language (Auslan) to communicate. He was so engaging and supportive that this plan sounded fine to me. By the time we finished talking and he walked me over to the HEAR Service, I was so in his thrall that I had enrolled for a Deaf awareness workshop, an Auslan class, and had plans to join the Deaf community. Had I stayed on and learned Auslan, my life may well have followed a different path, but this was not to be at that time. Becoming Hearing Impaired (HI) Across at the HEAR service, an alternate view of my potential future was put to me. Instead of moving away from everything familiar and joining the Deaf community, I could learn to lip-read and hopefully use it to stay in the workforce and amongst my hearing friends. I had a cousin and aunt who were late deafened; my cousin in particular was doing well communicating with lip-reading. I discussed this with friends and the idea of staying with the people I already knew sounded far less confronting than joining the Deaf community and so I chose this path. My surgeon was also optimistic. He was confident he could save some of my hearing. Suddenly learning Auslan seemed superfluous. I phoned John Lovett to explain, and his response was that I should do what suited me, but he asked me to remember one thing: that it was me who decided to leave the Deaf Community, not that the Deaf community had not wanted me. He told me that, if I changed my mind, I could always go back because the door to the Deaf community would always be open and he would be still be there. It would be a decade before I decided that I wanted to go back through that door, and around that time this great man passed away, but I never forgot my promise to remember our conversation. It, and a few other exchanges I had with him in the following years, stayed at the back of my mind, especially as my residual hearing sank over the years, and the prospect of total deafness hung over me. When I had the surgery, my surgeon’s optimism proved unfounded. He could not save any hearing on my left side and my facial and balance nerves were damaged as well. The hospital then decided not to operate again, and would only attempt to remove the second tumour if it grew and threatened my health again. Consequently, for close to a decade, my life was on hold in many ways. I feared deafness—for me it signalled that my life as I knew it would end and I would be isolated. Every hearing test was a tense time for me as I watched my remaining hearing decline in a slow, relentless downward path on the graph. It was like watching the tide go out knowing it was never going to come in as fully again. My thinking started to change too. Within a week of my diagnosis I experienced discrimination for the first time. A library school that had offered me a place in its post graduate librarianship course the following year made it clear that they no longer wanted me. In the end it did not matter as I was accepted at another institution but it was my first experience of being treated less favourably in the community and it was a shock. After the surgery my life settled down again. I found work in public libraries again, rekindled an old relationship and in 1994 had a baby boy. However, living with a hearing loss is hard work. Everything seemed tiring, especially lip-reading. My ears rejected my hearing aid and became itchy and inflamed. I became aware that my continual hearing problems were sometimes seen as a nuisance in work situations. Socialising lost a lot of its appeal so my social world also contracted. Around this time something else started happening. Outside work, people started expressing admiration for me—words like ‘role model’ and ‘inspiring’ started entering the conversation. Any other time I might have enjoyed it but for me, struggling to adapt to my new situation, it felt odd. The whole thing reminded me of being encouraged to be like Helen Keller; as if there is a right way to behave when one is deaf in which you are an inspiration, and a wrong way in which one is seen as being in need of a role model. I discussed this with Elizabeth Hastings who had helped me prepare mentally for the surgery and afterwards. I explained I felt vulnerable and needy in my new situation and she gave me some useful advice. She thought feeling needy was a good thing as realising one needs people keeps one humble. She observed that, after years of intellectualising, educated people sometimes started believing they could use intellectualisation as a way to avoid painful emotions such as sadness. This behaviour then cut them off from support and from understanding that none of us can do it alone. She believed that, in always having to ask for help, people with disabilities are kept aware of the simple truth that all people depend on others to survive. She said I could regard becoming deaf as a disability, or I could choose to regard it as a privilege. Over the years the truth of her words became increasingly more evident to me as I waded through all the jargon and intellectualisation that surrounds discussion of both deafness and the disability arena, compared to the often raw emotion expressed by those on the receiving end of it. At a personal level I have found that talking about emotions helps especially in the face of the ubiquitous ‘positive thinking’ brigade who would have us all believe that successful people do not feel negative emotions regardless of what is happening. The Lie Elizabeth had initially sympathised with my sadness about my impending deafness. One day however she asked why, having expressed positive sentiments both about deaf people and people with disabilities, I was saying I would probably be better off dead than deaf? Up until that conversation I was unaware of the contradictions between what I felt and what I was saying. I came to realise I was living a lie because I did not believe what I was telling myself; namely, that deaf people and people with disabilities are as good as other people. Far from believing this, what I really thought was that being deaf, or having a disability, did lessen one’s worth. It was an uncomfortable admission, particularly sharing it with someone sitting in a wheelchair, and especially as up until then I had always seen myself as a liberal thinker. Now, faced with the reality of becoming deaf, I had been hoist by my own petard, as I could not come to terms with the idea of myself as a deaf person. The Christian idea of looking after the ‘less fortunate’ was one I had been exposed to, but I had not realised the flip side of it, which is that the ‘less fortunate’ are also perceived as a ‘burden’ for those looking after them. It reminded me of my initial experiences years earlier at Nga Tapuwae when I came face to face with cultures I thought I had understood but did not. In both cases it was only when I got to know people that I began to question my own attitudes and assumptions and broadened my thinking. Unfortunately for deaf people, and people with disabilities, I have not been the only person lying to myself. These days it is not common for people to express their fears about deaf people or people with disabilities. People just press on without fully communicating or understanding the other person’s attitude or perspectives. When things then do not work out, these failures reinforce the misconceptions and these attitudes persist. I believe it is one of the main reasons why true community inclusion for deaf and people with disabilities is moving so slowly. Paying for access is another manifestation of this. Everyone is supportive of access in principle but there is continuous complaint about paying for things such as interpreting. The never-ending discussions between deaf people and the wealthy movie industry about providing more than token access to captioned cinema demonstrate that the inclusion lie is alive and well. Until it can be effectively addressed through genuine dialogue, deaf people, hard of hearing people and people with disabilities will always be largely relegated to life outside the mainstream. Collectively we will also continue to have to endure this double message that we are of equal value to the community while simultaneously being considered a financial burden if we try to access it in ways that are meaningful to us. Becoming Deaf In 2002 however all this thinking still lay ahead of me. I still had some hearing and was back living in New Zealand to be close to my family. My relationship had ended and I was a solo mother. My workplace had approved leave of absence, and so I still had my job to go back to in Melbourne if I wanted it. However, I suspected that I would soon need the second tumour removed because I was getting shooting pains down my face. When my fears were confirmed I could not decide whether to move back to Melbourne or let the job go, and risk having trouble finding one if I went back later. I initially chose to stay longer as my father was sick but eventually I decided Melbourne was where I wanted to be especially if I was deaf. I returned, found temporary employment, and right up to the second surgery I was able to work as I could make good use of the small amount of hearing I still had. I thought that I would still be able to cope when I was made fully deaf as a result of the surgery. It was, after all, only one notch down on the audiogram and I was already ‘profoundly deaf’ and still working. When I woke up after the surgery completely deaf, it felt anti-climactic. The world seemed exactly the same, just silent. At home where I was surrounded by my close family and friends everything initially seemed possible. However, when my family left, it was just my seven-year-old son and myself again, and on venturing back into the community, it quickly became clear to me that at some level my status had changed. Without any cues, I struggled to follow speech and few people wanted to write things down. Although my son was only seven, people communicated with him in preference to me. I felt as if we had changed roles: I was now the child and he was the adult. Worse was soon to follow when I tried to re-enter the workforce. When I had the surgery, the hospital had installed a gadget called an auditory brainstem implant, (ABI) which they said would help me hear. An ABI is similar to a cochlear implant but it is attached to the brainstem instead of the cochlear nerve. My cochlear nerve was removed. I hoped my ABI would enable me to hear enough to find work but, aside from clinical conditions in which there was no background noise and the staff knew how to assist, it did not work. My most humiliating moment with it came when it broke down mid job interview and I spent half the time left trying to get it going again in full view of the embarrassed interview panel, and the other half trying to maintain my composure whilst trying to lip-read the questions. The most crushing blow came from the library where I had happily worked for seven years at middle management level. This library was collaborating with another institution to set up a new library and they needed new staff. I hopefully applied for a job at the same level I had worked at prior to becoming deaf but was unsuccessful. When I asked for feedback, I was told that I was not seen as having the skills to work at that level. My lowest point came when I was refused a job unpacking boxes of books. I was told I did not have experience in this area even though, as any librarian will attest, unpacking boxes is part of any librarian’s work. When I could not find unskilled work, it occurred to me that possibly I would never work again. While this was unfolding, my young son and I went from being comfortable financially to impoverished. My ex-partner also decided he would now make childcare arrangements directly with my son as he was annoyed at being expected to write things down for me. My relationship with him, some family members, and my friends were all under strain at that time. I was lost. It also became clear that my son was not coping. Although he knew the rudiments of Auslan, it was not enough for us to communicate sufficiently. His behaviour at school deteriorated and one night he became so frustrated trying to talk to me that he started to pull out his own hair. I calmed him and asked him to write down for me what he was feeling and he wrote down ‘It is like you died. It is like I don’t have a Mum now’. It was now clear to me that although I still had my friends, nobody including myself knew what to do. I realised I had to find someone who could understand my situation and I knew now it had to be a Deaf person. Fortunately, by this stage I was back learning Auslan again at La Trobe University. The week after the conversation with my son, I told my Auslan teacher what had happened. To my relief she understood my situation immediately. She told me to bring my son to class, at no cost, and she would teach him herself. I did and my life started to turn around. My son took to Auslan with such speed and application that he was able to not only converse with her in one month but immediately started using Auslan with me at home to get the things he wanted. We were able to re-establish the mother/son relationship that we both needed. I was also able to help my son talk through and deal with all the changes that me becoming deaf had foisted upon him. He still uses Auslan to talk to me and supplements it using speech, copious finger spelling, notes and diagrams. More than anything else, this relationship has kept me anchored to my long-term goal of becoming a clear signer. Encouraged by my son’s success, I put all my energy into learning Auslan and enrolled in a full time TAFE Auslan course. I also joined a chat group called ‘Here to Hear’ (H2H). The perspectives in the group ranged from strongly oral to strongly Deaf but for me, trying to find a place to fit in any of it, it was invaluable. Almost daily I chatted with the group, asking questions and invariably someone responded. The group acted as a safety net and sounding board for me as I worked out the practicalities of living life deaf. The day of my fateful interview and the ABI humiliation, I came home so shaken that I used the Irish remedy of a couple of swigs of whisky, and then went online and posted an account of it all. I can still remember the collective indignation of the group and, as I read the responses, beginning to see the funny side of it . . . something I could not have done alone. I also made use of easy access to Deaf teachers at TAFE and used that to listen to them and ask advice on situations. I found out for example, that if I instructed my son to stand behind me when people in shops insisted on addressing him, they had no alternative but to talk to me; it was a good clear message to all concerned that my son was the child in this relationship. About this time, I discovered the Disability Discrimination Act (DDA) that Elizabeth Hastings had worked so hard on, filed my first DDA complaint, and received my first apology at the mediation session that followed. My personal life also improved, relationship by relationship as everyone adjusted. Slowly the ice melted in most of my relationships; some relationships faded and were replaced with new ones with signing people, and eventually hearing people again. My life moved forward. Through a member of ‘Here to Hear’, I was invited to apply for my first post deaf job—covering holiday leave at a Deaf sports organisation. I practically finger-spelt my way through the interview but not only did they offer me the job, they were delighted to have me. I was able to buy a few things with the money I earned, and suddenly it felt as if everything was possible again. This acceptance of me by Deaf people had a profound impact on me. I mixed with people more, and it was not too long before I was able to use my basic signing skills to use Auslan interpreters and re-enter the workplace. I have discovered over time that living in silence also has advantages—no more noisy parties or rubbish trucks clanging at dawn and in its place a vastly heightened visual awareness that I enjoy. Before I was deaf I thought it would be lonely in the silence but in fact many of life’s best moments—watching rain hit and then run down a window, swimming in the sea, cooking and being with good friends—do not rely upon sound at all; they feel the same way they always did. Sometimes I have felt somewhat of an outsider in the Deaf community. I have sometimes been taken aback by people’s abruptness but I have learned over time that being succinct is valued in Auslan, and some people like to come straight to the point. At crisis points, such as when I asked for help at the Victorian Deaf Society and my Auslan class, it has been a huge relief to talk to Deaf people and know immediately that they understand just from reading their eyes. Having access to an additional world of deaf people has made my life more enjoyable. I feel privileged to be associated with the Deaf community. I can recall a couple of Christmases ago making dinner for some signing friends and suddenly realising that, without noticing, everything had become alright in my world again. Everyone was signing really fast – something I still struggle with; but every now and then someone would stop and summarise so I felt included. It was really relaxed and simply felt like old times, just old times without the sound thrown in. Le Page and Tabouret-Keller, two ethnographers, have this to say about why people communicate the ways they do: The individual ... creates for himself the patterns of his linguistic behaviour so as to resemble those of the group or groups with which from time to time he wishes to be identified, or so as to be unlike those from whom he wishes to be distinguished ... . We see speech acts as acts of projection; the speaker is projecting his inner universe, implicitly with the invitation to others to share it ... he is seeking to reinforce his models of the world, and hopes for solidarity from those with whom he wishes to identify. (181) This quote neatly sums up why I choose to communicate the ways I do. I use Auslan and speech in different situations because I am connected to people in both groups and I want them in my life. I do not feel hugely different from anyone these days. If it is accepted that I have as much to contribute to the community as anyone else, becoming deaf has also meant for me that I expect to see other people treated well and accepted. For me that means contributing my time and thoughts, and advocating. It also means expecting a good level of access to interpreters, to some thought provoking captioned movies in English, and affordable assistive technologies so I can participate. I see this right to participate and engage in genuine dialogue with the rest of the community as central to the aspirations and identity of us all, regardless of who we are or where others think we belong. References Le Page, R.B., and Andree Tabouret-Keller. Acts of Identity: Creole-Based Approaches to Language and Ethnicity. London: Cambridge University Press, 1985. Moorhead, D. “Knowing Who I Am.” In S. Gregory, ed., Deaf Futures Revisited. Block 3, Unit 10, D251 Issues in Deafness. Open University, 1995.

IntroductionThe National School Chaplaincy and Student Welfare Program (NSCSWP) has been one of the most controversial Australian news topics in the past eight years. Newspaper representations of the NSCSWP have been prolific since the Program began in 2006/07. In my previous research into the NSCSWP, I found that initially the Program was well received. Following the High Court Challenge campaign, however, which began in late 2010, newspaper reports portrayed the NSCSWP in a predominantly negative light. These negative portrayals of the NSCSWP persisted in the lead up to the second High Court Challenge from 2013 until June 2014. During this time, newspaper representations portrayed the Program as an illegitimate form of counseling for state school students. However, I would argue that it was the newspaper representations of the NSCSWP that were in fact illegitimate. In this article, I contend that illegitimate representations of the NSCSWP became hegemonic because of a lack of evidence-based research conducted into the Program’s operation within state schools. Evidence-based research would have appropriately evaluated the Program’s progress and contributed to a legitimate and fair representation of chaplains in online newspapers. My analysis acknowledges the overwhelming prejudice against the NSCSWP. Whether chaplains were indeed a legitimate or illegitimate form of counseling is not my argument. My argument is that newspaper representations of the NSCSWP were illegitimate because news articles were presenting biased and incomplete information to the Australian community. Defining IllegitimacyIllegitimacy as a term has a long history dating back to early modern England, when it was commonly used to refer to children born out of wedlock (Pritchard 19). However, the definition of illegitimacy extends beyond this social phenomenon. Katie Pritchard states:The understanding of illegitimacy encompasses a kind of theoretical illegitimacy that is nothing to do with birth, referring to a kind of falseness or unsuitability that can be applied in many circumstances. (21)For this article, I will be using the term ‘illegitimate’ to describe how the newspaper representations of the NSCSWP were unsuitable because they were biased and lacked valuable information. Newspaper reports, which can be accessed online via the newspaper company’s website, include important authoritative voices. However, these voices expressed a certain opinion or concern, rather than delivering information that contributed to society’s understanding of the NSCSWP. Therefore, newspapers did not present legitimate facts, but instead a range of subjective opinions.The Illegitimacy of Newspaper ReportingThe ideological bias of newspapers has been recently examined regarding News Corp, the owner of national title The Australian, and many of the major Australian state newspapers: The Daily Telegraph; The Courier Mail, Herald Sun; The Advertiser; and Sunday Times. This organisation has recently been accused of showing bias in its newspaper articles (Meade). Meade quotes Mark Scott, the ABC Managing Director, who states:Given the aggressive editorial positioning of some of their mastheads and their willingness to adopt and pursue an editorial position, an ideological position and a market segmentation, you could argue that News Corporation newspapers have never been more assertive in exercising media power. (1)The market domination enjoyed by large organisations such as News Corp, and even Fairfax Media, leads to consistency in journalists’ writing on political, social, religious, and economic issues, which may predominate over the articles published by smaller newspapers. There is the concern that over time a particular point of view will be favoured. According to Mark Scott “a range of influential voices [is] essential to ensure a fair and open media” (Meade 1). Scott cites Rupert Murdoch who stated, back in 1967, that “freedom of the press mustn’t be one-sided just for a publisher to speak as he pleases, to try and bully the community” (Meade 1). Therefore, it has been acknowledged that a biased news article is illegitimate, and national news articles are to present facts, not the opinions of the newspaper.A Methodological Framework For this article I will utilise Norman Fairclough’s theory of Critical Discourse Analysis. Fairclough states:By ‘critical’ discourse analysis I mean discourse analysis which aims to systematically explore often opaque relationships of causality and determination between (a) discursive practices, events and texts and (b) wider social and cultural structures, relations and processes. (132-133)This method of analysis examines three assumptions: Existential, Propositional and Value. Existential assumptions make claims about what exists with regards to the problem, and refers to social phenomena such as globalisation or social cohesion (56). Propositional assumptions make predictions about what is or will be (55). Value assumptions simply evaluate things as good or bad, needed or not needed (57). These assumptions can be identified through analysis of the various direct quotes included within online newspaper articles.Direct quotations in newspaper articles available online often represent polarised views demonstrating whether people agree or disagree with the topic being discussed. The selection, or framing, of dominant voices within an article can be used to construct or re-present certain ideologies (Entman, 165). Entman explains that “we can define framing as the process of culling a few elements of perceived reality and assembling a narrative that highlights connections among them to promote a particular interpretation” (164). The framing of direct quotes within an article, therefore, assists the reader in identifying the article’s bias. The National School Chaplaincy and Student Welfare ProgramThe National School Chaplaincy Program was first established in 2006 by the Howard Government, and in 2011 Julia Gillard included secular youth workers, expanding it from 2012 to become the National School Chaplaincy and Student Welfare Program. According to the National School Chaplaincy and Student Welfare Guidelines, the Program aimed to “assist school communities to provide pastoral care and general spiritual, social and emotional comfort to all students, irrespective of their faith or beliefs” (6). Chaplaincy in Australia has been a predominantly Christian counseling service with Christianity being the most commonly practiced religion in Australia (Australian Bureau of Statistics). However, there have been chaplains representing other faiths such as Islam, Judaism and Buddhism (Australian Government 8). Chaplains were chosen by their respective schools and were partly funded by the Government to provide support to students and staff.State Newspaper Articles Online: Representations 2013-2014My sample of articles came from nine state newspapers with an online presence: The Sydney Morning Herald, Brisbane Courier Mail, Adelaide Advertiser, Melbourne Age, Northern Times, The Australian, The West Australian, The Daily Telegraph, and The Mercury. A total of 36 articles were collected, from the newspaper’s Website, for 2013 and 2014, and were divided into two categories.The two categories are Supportive (of the Program) and Unsupportive (of the Program). In 2013, two articles were supportive of the Program, whereas in 2014 there were four. In 2013 three articles were unsupportive of the Program, whereas in 2014 there were 27 unsupportive articles, representing the growing interest in the scheme in the final lead up to the High Court Challenge in 2014. An online newspaper article from 2013, which portrays the NSCSWP and in particular chaplains as illegitimate, is Call for Naked School Chaplain to Be Defrocked (Domjen). This article explains how an off-duty school chaplain was preaching naked in the main street of a country town in NSW. The NSW Teachers Federation President Maurie Mulheron, and Parents and Citizens Association publicity officer Rachael Sowden were quoted in this article. It is through their direct quotes that the illegitimacy of chaplaincy is framed. President Mulheron states:We believe the chaplaincy program is wrong and that money should be used for an increase in school-based counsellors. Obviously the right checks and balances are not in place. (1)When President Mulheron states “We” it is unclear to the reader as to whether he is referring to all NSW Teachers or the organisation’s administrators. The reader is left to make their own assumptions about whom he is referring to. The President also makes a value assumption that the money would be better spent on school-based counselors, thus expressing his own opinion that they are a better option. A propositional assumption is made when he claims that the “right checks and balances are not in place”, but is he basing his claim on this one incident or is there other research to support this assumption?Perhaps this naked chaplain appeared fine when the school hired him, perhaps he does not have a previous record of inappropriate behaviour, perhaps it was an isolated incident. The reader is not given any background information on this chaplain and is therefore meant to take the President’s assumptions as legitimate fact. Ms Sowden, representing the Parents’ and Citizens’ Association, also expresses the same assumptions and concerns. Ms Sowden states:We have great concerns about the chaplain scheme - many parents do. We are concerned about whether they go through the same processes as teachers in terms of working with children checks and their suitability to the position, and this case highlights that.Ms Sowden makes a propositional assumption that many parents and citizens are concerned about the Program. It would be interesting to know what the Parents and Citizens Association was doing about this, considering the choice to have a chaplain is a decision made by the school community? Ms Sowden also asks whether chaplains “go through the same processes as teachers in terms of working with children checks and their suitability to the position”. Chaplains do not go through the same process as teachers in their training as they have a different role in the school. However, chaplains do require a Certificate IV in Pastoral Care as well as a Working with Children Check because they are in close proximity to children, and are being paid for their school counseling service (Working with Children Check). Ms Sowden’s value assumption that chaplains are unsuitable for the position is based on her own limited understanding of their qualifications, which she admits to not knowing. In fact, to be appointed to represent parents and citizens and to even voice their concerns, but not know the qualifications of chaplains in her community, is an interesting area of ignorance.This article has been framed to evaluate the actions of all chaplains through the example of a publicly-naked chaplain, discussed without context in this article. The Program is portrayed as hiring unsuitable and thus illegitimate chaplains. However, the quotes are based on concerns and assumptions that are unfounded, and are fears presented as facts. Therefore the representation is illegitimate because it does not report any information that the public can use to better understand the NSCSWP, or even to understand the circumstances surrounding the chaplain who preached naked in the street. Another article from 2014, which represents chaplains as illegitimate, is Push to Divert Chaplain Cash to School Councillors (Paine). This article focuses on the comments of the Tasmanian Association of State School Organisations President Jenny Eddington, and the Australian Education Union President Angelo Gavrielatos. These dominant voices within the Tasmanian and Australian communities are chosen to express their opinion that the money once used for chaplains should now be used to fund psychologists in schools. AEU President Angelo Gavrielatos states: Apart from undermining our secular traditions, this additional funding should have been allocated to schools to better meet the educational needs of students with trained, specialist staff.Mr Gavrielatos makes a propositional assumption that chaplains are untrained staff and are thus illegitimate staff. However, chaplains are trained and specialise in providing counseling services. Thus, through his call for “trained, specialist staff” he aims to delegitimize the training of chaplains. Mr Gavrielatos also makes a value assumption when he claims that the funding put towards the NSCSWP undermines “our secular traditions”. “Secular traditions” is an existential assumption in positioning that Australians have secular traditions, and that these do not involve chaplaincy because the Australian Government is not supposed to support religion. The Australian Bureau of Statistics states:Enlightenment principles promoted a secular government, detached from the church, that encouraged tolerance and supported religious pluralism, including the right to practice no religion. By Federation, this diversity was enshrined in the Australian Constitution, which says that the Commonwealth shall not make any law for establishing any religion, or for imposing any religious observance, or for prohibiting the free exercise of any religion. (1)The funding of the Program was a contentious issue from the time of its inception; although it could be argued that it was the prerogative of the Government to support the practice of diverse cultural and religious beliefs by allowing schools to hire religious counselors of their choice. Given that not every student is Christian some would perhaps benefit from chaplains or counselors representing other faiths.These news articles have selected dominant voices to construct and promote an ideology of chaplains as an illegitimate resource for school communities. In these newspaper reports existential, propositional and value assumptions were expressed by dominant voices who expressed concern about the role and behaviour of chaplains in schools. However, research into the Program and its operation within each state may have avoided the representation of unfounded and illegitimate assumptions.Evidence-Based Research: Avoiding Illegitimacy Over the course of the Chaplaincy Program various resources, such as reports and journal articles attempted to provide evidence of how the NSCSWP was funded and operated within state schools.The Department of Education received frequent progress reports by state schools who hired chaplains, although this information was not made available to the public. However, in 2011 then Education Minister Peter Garrett released a discussion paper informing Australians about the current set up of the Program and how the community could have their say on the Program’s fulfillment from 2012-2014. The discussion paper was reported on by The Australian, which portrayed the Program as not catering to the needs of Australian youth because chaplains are predominantly Christian (Ferrari). The newspaper report focuses on the concerns of Australian communities regarding the funding, and qualifications of chaplains, and the cost of the Program. Thus, the Program appeared illegitimate and as though it could not cater to the Australian community’s expectations.Reports conducted by organisations external to the Education Department tried to examine schools communities’ expectations and experiences of the Program. One such report was written in 2009 by Dr Philip Hughes and Professor Margaret Sims from Edith Cowan University who aimed to examine how Australian schools evaluated the Program, and the role of chaplains, but their report excluded the state of NSW.Hughes and Sims state that chaplains’ “contribution was widely appreciated” by schools (6). This report attempted to provide a legitimate and independent account of the Program, however, the report was deemed biased by NSW Greens MLC, Dr John Kaye who remarked that the study was “deeply flawed” and lacked independence (Thielking & MacKenzie 1). According to critics, the study focussed on the positive benefits of chaplains, but the only benefit that was unique to them was that they were religious (The Greens). The study also neglected to report that Hughes was an employee of the Christian Research Association and that his background could impede his objectivity. In the same year, 2009, ACCESS ministries published a report titled: The value of chaplains in Victorian schools. The independent research conducted by Social Compass covers: “the value of chaplains; their social, spiritual and academic impacts; the difference made to the health, well being and quality of life of students; and the contributions made to strengthen communities” (2).This study promoted a positive view of chaplaincy within schools and tried to report on a portion of the community’s experiences with chaplains. However, it was limited in that it pertains only to Victorian schools and received very little media attention online. Even if this information were available online it would have only related to Victoria. Further research conducted into chaplaincy has been published in the Journal of Christian Education. This journal contains many articles on chaplaincy, but these are not easily available online as they require a subscription. The findings from these articles have not been published in newspaper articles online and have therefore not been made available to the general public. The Christian bias of the journal may have also contributed to its contents being neglected by news articles made available online, although they might have assisted in providing a more balanced representation of the NSCSWP.The extent of the research conducted into The National School Chaplaincy and Student Welfare Program has not been entirely delineated here, but these are some of the prominent resources. Nonetheless, the rigorous evaluation of the contribution of the NSCSWP was minimal, and the quality of its evaluation predominantly biased.Robert Slavin states that school program evaluations must “produce reliable, unbiased, and meaningful information on the strength of evidence behind each program” (1). Unfortunately, the research conducted into the Chaplaincy Program was not free from bias, consistent or properly designed in a way that legitimately evaluated the NSCSWP. According to Monica Thielking and David MacKenzie:The fact is that the provision of support services for students in Australian schools has never been subjected to serious research and evaluation, and any analysis is made more difficult by the fact that the various states and territories deploy somewhat different models. (1)Thus, the information on the Chaplaincy Program’s progress and the responsibilities of chaplains in schools was not comprehensive or accurate enough to be appropriately reported in newspapers available online. Therefore, newspaper articles used quotes and information based on a limited understanding of the Program, which in turn produced illegitimate representations of the NSCSWP.ConclusionNewspaper reports available online drew conclusions about the Program’s effectiveness, which had not been appropriately tested. If research had been made available to the public, or published within state-based media online, Australians would have had a more legitimate understanding of the Program’s operation within state education, even if that understanding could not have changed the High Court ruling.The Chaplaincy Program demonstrates how a lack of evidence-based research allows the media to construct illegitimate representations based on promoting the assumptions of dominant, and I would argue the loudest, voices, in society. The bias represented in a consistent approach adopted by newspapers owned by dominant media companies, is a factor in the re-presentation and promotion of certain ideologies. This was made evident by the fact that, in 2014, across nine state newspapers available online, 27 articles were unsupportive of the Program as opposed to only four articles that were supportive. Audiences need to be presented with facts rather than opinions, which are based on very little research. Hopefully newspaper reporting will change in the future to offer audiences a more legitimate representation of news events. ReferencesACCESS Ministries. The Value of Chaplains in Victorian Schools. NSW, 2009. Australian Bureau of Statistics. "Reflecting a Nation: Stories from the 2011 Census, 2012–2013." 2012. Australian Government. National School Chaplaincy Program: A Discussion Paper. Australia: Commonwealth of Australian, 2011. Chaplaincy Australia. "Training." n.d. Commonwealth of Australia. National School Chaplaincy and Student Welfare Program Guidelines. Australia: Australian Government, 2012. Domjen, Briana. “Call for Naked School Chaplain to Be Defrocked.” The Australian 3 Feb. 2013: 1.Entman, Robert. "Framing Bias: Media in the Distribution of Power." Journal of Communications 1 (2007): 163-73.Fairclough, Norman. Analysing Discourse: Textual Analysis for Social Research. London: Longman, 2003.Ferrari, Justine. "School Chaplains Not Representative." The Australian 12 Feb. 2011: 1.Hughes, Philip, and Margaret Sims. The Effectivess of Chaplaincy: As Provided by the National School Chaplaincy Association to Government Schools in Australia. Perth: Edith Cowan University, 2009.Meade, Amanda. "Mark Scott: News Corp Papers Never More Aggressive than Now." The Guardian 3 Oct. 2014: 1.Paine, Michelle. “Push to Divert Chaplain Cash to School Councillors.” The Mercury 21 Jun. 2014: 1.Pritchard, Katie. "Legitimacy, Illegitimacy and Sovereignty in Shakespeare’s British Plays." U of Manchester, 2011.Slavin, Robert. "Perspectives on Evidence-Based Research in Education: What Works? Issues in Synthesizing Educational Program Evaluations." Educational Researcher 37.1 (2008): 5-14. The Greens. "Chaplaincy Program Study 'Flawed and Biased': Conclusions Not Justified." n.d. Thielking, Monica, and David MacKenzie. “School Chaplains: Time to Look at the Evidence.” 2011. Working with Children Check. "Categories of Work." 2008.

Introduction As social-distancing mandates in response to COVID-19 restricted in-person data collection methods such as participant observation and interviews, researchers turned to socially distant methods such as interviewing via video-conferencing technology (Lobe et al.). These were not new tools nor methods, but the pandemic muted any bias towards face-to-face data collection methods. Exemplified in crowd-sourced documents such as Doing Fieldwork in a Pandemic, researchers were encouraged to pivot to digital methods as a means of fulfilling research objectives, “specifically, ideas for avoiding in-person interactions by using mediated forms that will achieve similar ends” (Lupton). The benefits of digital methods for expanding participant cohorts and scope of research have been touted long before 2020 and COVID-19, and, as noted by Murthy, are “compelling” (“Emergent” 172). Research conducted by digital methods can expect to reap benefits such as “global datasets/respondents” and “new modalities for involving respondents” (Murthy, “Emergent” 172). The pivot to digital methods is not in and of itself an issue. What concerns us is that in the dialogues about shifting to digital methods during COVID-19, there does not yet appear to have been a critical consideration of how participant samples and collected data will be impacted upon or skewed towards recording the experiences of advantaged cohorts. Existing literature focusses on the time-saving benefits for the researcher, reduction of travel costs (Fujii), the minimal costs for users of specific platforms – e.g. Skype –, and presumes ubiquity of device access for participants (Cater). We found no discussion on data costs of accessing such services being potential barriers to participation in research, although Deakin and Wakefield did share our concern that: Online interviews may ... mean that some participants are excluded due to the need to have technological competence required to participate, obtain software and to maintain Internet connection for the duration of the discussion. In this sense, access to certain groups may be a problem and may lead to issues of representativeness. (605) We write this as a provocation to our colleagues conducting research at this time to consider the cultural and material capital of their participants and how that capital enables them to participate in digitally-mediated data gathering practices, or not, and to what extent. Despite highlighting the potential benefits of digital methods within a methodological tool kit, Murthy previously cautioned against the implications posed by digital exclusion, noting that “the drawback of these research options is that membership of these communities is inherently restricted to the digital ‘haves’ ... rather than the ‘have nots’” (“Digital” 845). In this article, we argue that while tools such as Zoom have indeed enabled fieldwork to continue despite COVID disruptions, this shift to online platforms has important and under-acknowledged implications for who is and is not able to participate in research. In making this argument, we draw on examples from the Connected Students project, a study of digital inclusion that commenced just as COVID-19 restrictions came into effect in the Australian state of Victoria at the start of 2020. We draw on the experiences of these households to illustrate the barriers that such cohorts face when participating in online research. We begin by providing details about the Connected Students project and then contextualising it through a discussion of research on digital inclusion. We then outline three areas in which households would have experienced (or still do experience) difficulties participating in online research: data, devices, and skills. We use these findings to highlight the barriers that disadvantaged groups may face when engaging in data collection activities over Zoom and question how this is impacting on who is and is not being included in research during COVID-19. The Connected Students Program The Connected Students program was conducted in Shepparton, a regional city located 180km north of Melbourne. The town itself has a population of around 30,000, while the Greater Shepparton region comprises around 64,000 residents. Shepparton was chosen as the program’s site because it is characterised by a unique combination of low-income and low levels of digital inclusion. First, Shepparton ranks in the lowest interval for the Australian Bureau of Statistics’ Socio-Economic Indexes for Areas (SEIFA) and the Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD), as reported in 2016 (Australian Bureau of Statistics, “Census”; Australian Bureau of Statistics, “Index”). Although Shepparton has a strong agricultural and horticultural industry with a number of food-based manufacturing companies in the area, including fruit canneries, dairies, and food processing plants, the town has high levels of long-term and intergenerational unemployment and jobless families. Second, Shepparton is in a regional area that ranks in the lowest interval for the Australian Digital Inclusion Index (Thomas et al.), which measures digital inclusion across dimensions of access, ability, and affordability. Funded by Telstra, Australia’s largest telecommunications provider, and delivered in partnership with Greater Shepparton Secondary College (GSSC), the Connected Students program provided low-income households with a laptop and an unlimited broadband Internet connection for up to two years. Households were recruited to the project via GSSC. To be eligible, households needed to hold a health care card and have at least one child attending the school in year 10, 11, or 12. Both the student and a caregiver were required to participate in the project to be eligible. Additional household members were invited to take part in the research, but were not required to. (See Kennedy & Holcombe-James; and Kennedy et al., "Connected Students", for further details regarding household demographics.) The Australian Digital Inclusion Index identifies that affordability is a significant barrier to digital inclusion in Australia (Thomas et al.). The project’s objective was to measure how removing affordability barriers to accessing connectivity for households impacts on digital inclusion. By providing participating households with a free unlimited broadband internet connection for the duration of the research, the project removed the costs associated with digital access. Access alone is not enough to resolve the digital exclusion confronted by these low-income households. Digital exclusion in these instances is not derived simply from the cost of Internet access, but from the cost of digital devices. As a result, these households typically lacked sufficient digital devices. Each household was therefore provided both a high speed Internet connection, and a brand new laptop with built-in camera, microphone, and speakers (a standard tool kit for video conferencing). Data collection for the Connected Students project was intended to be conducted face-to-face. We had planned in-person observations including semi-structured interviews with household members conducted at three intervals throughout the project’s duration (beginning, middle, and end), and technology tours of each home to spatially and socially map device locations and uses (Kennedy et al., Digital Domesticity). As we readied to make our first research trip to commence the study, COVID-19 was wreaking havoc. It quickly became apparent we would not be travelling to work, much less travelling around the state. We thus pivoted to digital methods, with all our data collection shifting online to interviews conducted via digital platforms such as Zoom and Microsoft Teams. While the pivot to digital methods saved travel hours, allowing us to scale up the number of households we planned to interview, it also demonstrated unexpected aspects of our participants’ lived experiences of digital exclusion. In this article, we draw on our first round of interviews which were conducted with 35 households over Zoom or Microsoft Teams during lockdown. The practice of conducting these interviews reveals insights into the barriers that households faced to digital research participation. In describing these experiences, we use pseudonyms for individual participants and refer to households using the pseudonym for the student participant from that household. Why Does Digital Inclusion Matter? Digital inclusion is broadly defined as universal access to the technologies necessary to participate in social and civic life (Helsper; Livingstone and Helsper). Although recent years have seen an increase in the number of connected households and devices (Thomas et al., “2020”), digital inclusion remains uneven. As elsewhere, digital disadvantage in the Australian context falls along geographic and socioeconomic lines (Alam and Imran; Atkinson et al.; Blanchard et al.; Rennie et al.). Digitally excluded population groups typically experience some combination of education, employment, income, social, and mental health hardship; their predicament is compounded by a myriad of important services moving online, from utility payments, to social services, to job seeking platforms (Australian Council of Social Service; Chen; Commonwealth Ombudsman). In addition to challenges in using essential services, digitally excluded Australians also miss out on the social and cultural benefits of Internet use (Ragnedda and Ruiu). Digital inclusion – and the affordability of digital access – should thus be a key concern for researchers looking to apply online methods. Households in the lowest income quintile spend 6.2% of their disposable income on telecommunications services, almost three times more than wealthier households (Ogle). Those in the lowest income quintile pay a “poverty premium” for their data, almost five times more per unit of data than those in the highest income quintile (Ogle and Musolino). As evidenced by the Australian Digital Inclusion Index, this is driven in part by a higher reliance on mobile-only access (Thomas et al., “2020”). Low-income households are more likely to access critical education, business, and government services through mobile data rather than fixed broadband data (Thomas et al., “2020”). For low-income households, digital participation is the top expense after housing, food, and transport, and is higher than domestic energy costs (Ogle). In the pursuit of responsible and ethical research, we caution against assuming research participants are able to bear the brunt of access costs in terms of having a suitable device, expending their own data resources, and having adequate skills to be able to complete the activity without undue stress. We draw examples from the Connected Students project to support this argument below. Findings: Barriers to Research Participation for Digitally Excluded Households If the Connected Students program had not provided participating households with a technology kit, their preexisting conditions of digital exclusion would have limited their research participation in three key ways. First, households with limited Internet access (particularly those reliant on mobile-only connectivity, and who have a few gigabytes of data per month) would have struggled to provide the data needed for video conferencing. Second, households would have struggled to participate due to a lack of adequate devices. Third, and critically, although the Connected Students technology kit provided households with the data and devices required to participate in the digital ethnography, this did not necessarily resolve the skills gaps that our households confronted. Data Prior to receiving the Connected Students technology kit, many households in our sample had limited modes of connectivity and access to data. For households with comparatively less or lower quality access to data, digital participation – whether for the research discussed here, or in contemporary life – came with very real costs. This was especially the case for households that did not have a home Internet connection and instead relied solely on mobile data. For these households, who carefully managed their data to avoid running out, participating in research through extended video conferences would have been impossible unless adequate financial reimbursement was offered. Households with very limited Internet access used a range of practices to manage and extend their data access by shifting internet costs away from the household budget. This often involved making use of free public Wi-Fi or library internet services. Ellie’s household, for instance, spent their weekends at the public library so that she and her sister could complete their homework. While laborious, these strategies worked well for the families in everyday life. However, they would have been highly unsuitable for participating in research, particularly during the pandemic. On the most obvious level, the expectations of library use – if not silent, then certainly quiet – would have prohibited a successful interview. Further, during COVID-19 lockdowns, public libraries (and other places that provide public Internet) became inaccessible for significant periods of time. Lastly, for some research designs, the location of participants is important even when participation is occurring online. In the case of our own project, the house itself as the site of the interview was critical as our research sought to understand how the layout and materiality of the home impacts on experiences of digital inclusion. We asked participants to guide us around their home, showing where technologies and social activities are colocated. In using the data provided by the Connected Students technology kit, households with limited Internet were able to conduct interviews within their households. For these families, participating in online research would have been near impossible without the Connected Students Internet. Devices Even with adequate Internet connections, many households would have struggled to participate due to a lack of suitable devices. Laptops, which generally provide the best video conferencing experience, were seen as prohibitively expensive for many families. As a result, many families did not have a laptop or were making do with a laptop that was excessively slow, unreliable, and/or had very limited functions. Desktop computers were rare and generally outdated to the extent that they were not able to support video conferencing. One parent, Melissa, described their barely-functioning desktop as “like part of the furniture more than a computer”. Had the Connected Students program not provided a new laptop with video and audio capabilities, participation in video interviews would have been difficult. This is highlighted by the challenges students in these households faced in completing online schooling prior to receiving the Connected Students kit. A participating student, Mallory, for example, explained she had previously not had a laptop, reliant only on her phone and an old iPad: Interviewer: Were you able to do all your homework on those, or was it sometimes tricky?Mallory: Sometimes it was tricky, especially if they wanted to do a call or something ... . Then it got a bit hard because then I would use up all my data, and then didn’t have much left.Interviewer: Yeah. Right.Julia (Parent): ... But as far as schoolwork, it’s hard to do everything on an iPad. A laptop or a computer is obviously easier to manoeuvre around for different things. This example raises several common issues that would likely present barriers to research participation. First, Mallory’s household did not have a laptop before being provided with one through the Connected Students program. Second, while her household did prioritise purchasing tablets and smartphones, which could be used for video conferencing, these were more difficult to navigate for certain tasks and used up mobile data which, as noted above, was often a limited resource. Lastly, it is worth noting that in households which did already own a functioning laptop, it was often shared between several household members. As one parent, Vanessa, noted, “yeah, until we got the [Connected Students] devices, we had one laptop between the four of us that are here. And Noel had the majority use of that because that was his school work took priority”. This lack of individuated access to a device would make participation in some research designs difficult, particularly those that rely on regular access to a suitable device. Skills Despite the Connected Students program’s provision of data and device access, this did not ensure successful research participation. Many households struggled to engage with video research interviews due to insufficient digital skills. While a household with Internet connectivity might be considered on the “right” side of the digital divide, connectivity alone does not ensure participation. People also need to have the knowledge and skills required to use online resources. Brianna’s household, for example, had downloaded Microsoft Teams to their desktop computer in readiness for the interview, but had neglected to consider whether that device had video or audio capabilities. To work around this restriction, the household decided to complete the interview via the Connected Students laptop, but this too proved difficult. Neither Brianna nor her parents were confident in transferring the link to the interview between devices, whether by email or otherwise, requiring the researchers to talk them through the steps required to log on, find, and send the link via email. While Brianna’s household faced digital skills challenges that affected both parent and student participants, in others such as Ariel’s, these challenges were focussed at the parental level. In these instances, the student participant provided a vital resource, helping adults navigate platforms and participate in the research. As Celeste, Ariel’s parent, explained, it's just new things that I get a bit – like, even on here, because your email had come through to me and I said to Ariel "We're going to use your computer with Teams. How do we do this?" So, yeah, worked it out. I just had to look up my email address, but I [initially thought] oh, my god; what am I supposed to do here? Although helpful in our own research given its focus on school-aged young people, this dynamic of parents being helped by their dependents illustrates that the adults in our sample were often unfamiliar with the digital skills required for video conferencing. Research focussing only on adults, or on households in which students have not developed these skills through extended periods of online education such as occurred during the COVID-19 lockdowns, may find participants lacking the digital skills to participate in video interviews. Participation was also impacted upon by participants' lack of more subtle digital skills around the norms and conventions of video conferencing. Several households, for example, conducted their interviews in less ideal situations, such as from both moving and parked cars. A portion of the household interview with Piper’s household was completed as they drove the 30 minutes from their home into Shepperton. Due to living out of town, this household often experienced poor reception. The interview was thus regularly disrupted as they dropped in and out of range, with the interview transcript peppered with interjections such as “we’re going through a bit of an Internet light spot ... we’re back ... sorry ...” (Karina, parent). Finally, Piper switched the device on which they were taking the interview to gain a better connection: “my iPad that we were meeting on has worse Internet than my phone Internet, so we kind of changed it around” (Karina). Choosing to participate in the research from locations other than the home provides evidence of the limited time available to these families, and the onerousness of research participation. These choices also indicate unfamiliarity with video conferencing norms. As digitally excluded households, these participants were likely not the target of popular discussions throughout the pandemic about optimising video conferences through careful consideration of lighting, background, make-up and positioning (e.g. Lasky; Niven-Phillips). This was often identified by how participants positioned themselves in front of the camera, often choosing not to sit squarely within the camera lens. Sometimes this was because several household members were participating and struggled to all sit within view of the single device, but awkward camera positioning also occurred with only one or two people present. A number of interviews were initially conducted with shoulders, or foreheads, or ceilings rather than “whole” participants until we asked them to reposition the device so that the camera was pointing towards their faces. In noting this unfamiliarity we do not seek to criticise or apportion responsibility for accruing such skills to participating households, but rather to highlight the impact this had on the type of conversation between researcher and participant. Such practices offer valuable insight into how digital exclusion impacts on individual’s everyday lives as well as on their research participation. Conclusion Throughout the pandemic, digital methods such as video conferencing have been invaluable for researchers. However, while these methods have enabled fieldwork to continue despite COVID-19 disruptions, the shift to online platforms has important and under-acknowledged implications for who is and is not able to participate in research. In this article, we have drawn on our research with low-income households to demonstrate the barriers that such cohorts experience when participating in online research. Without the technology kits provided as part of our research design, these households would have struggled to participate due to a lack of adequate data and devices. Further, even with the kits provided, households faced additional barriers due to a lack of digital literacy. These experiences raise a number of questions that we encourage researchers to consider when designing methods that avoid in person interactions, and when reviewing studies that use similar approaches: who doesn’t have the technological access needed to participate in digital and online research? What are the implications of this for who and what is most visible in research conducted during the pandemic? Beyond questions of access, to what extent will disadvantaged populations not volunteer to participate in online research because of discomfort or unfamiliarity with digital tools and norms? When low-income participants are included, how can researchers ensure that participation does not unduly burden them by using up precious data resources? And, how can researchers facilitate positive and meaningful participation among those who might be less comfortable interacting through mediums like video conferencing? In raising these questions we acknowledge that not all research will or should be focussed on engaging with disadvantaged cohorts. Rather, our point is that through asking questions such as this, we will be better able to reflect on how data and participant samples are being impacted upon by shifts to digital methods during COVID-19 and beyond. As researchers, we may not always be able to adapt Zoom-based methods to be fully inclusive, but we can acknowledge this as a limitation and keep it in mind when reporting our findings, and later when engaging with the research that was largely conducted online during the pandemic. Lastly, while the Connected Students project focusses on impacts of affordability on digital inclusion, digital disadvantage intersects with many other forms of disadvantage. Thus, while our study focussed specifically on financial disadvantage, our call to be aware of who is and is not able to participate in Zoom-based research applies to digital exclusion more broadly, whatever its cause. Acknowledgements The Connected Students project was funded by Telstra. This research was also supported under the Australian Research Council's Discovery Early Career Researchers Award funding scheme (project number DE200100540). References Alam, Khorshed, and Sophia Imran. “The Digital Divide and Social Inclusion among Refugee Migrants: A Case in Regional Australia.” Information Technology & People 28.2 (2015): 344–65. Atkinson, John, Rosemary Black, and Allan Curtis. “Exploring the Digital Divide in an Australian Regional City: A Case Study of Albury”. Australian Geographer 39.4 (2008): 479–493. 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Introduction: The Creative Arts and Regional Well-BeingThe relationship between regionalism, well-being, and the creative arts has enjoined significant attention from community activists, commercial entrepreneurs, policy analysts, artists, and researchers over recent years (Australia Council for the Arts, “Living Culture”; Australia Council for the Arts, “The Arts in Regional Australia;” Drummond, Keane, and West; Elg; Warren, and West; Woodward, Bremner, and Cahalan). Underpinning most of the activity and research in this area is the understanding (occasionally bordering on an un-critical presumption) that the creative arts make a positive contribution to regional well-being. Commenting on the Live. Love. Life. creative-arts wellness festival in Daylesford, Victoria, Mary-Anne Thomas (Member of Parliament for the state seat of Macedon) stated that the festival will “reinforce Daylesford and the Macedon Ranges’ status as one of the nation’s leading wellness destinations” (Elg). For Thomas, it would appear that the linkage of the creative arts to regional well-being is never in doubt; which is to say, always already available for reinforcement. According to university-based researchers Margaret Woodward, Craig Bremner, and Anthony Cahalan, writing in a more scholarly and critical register, “there is a growing body of research which shows that thriving creative industries and cultural activities are crucial for the health and vitality of a region and its communities” (3). Qualifying this, they add that: “Achieving high levels of community well being through thriving creative activity is not however without its challenges in regional Australia” (3). Similarly, Rozaline Drummond, Jondi Keane, and Patrick West present their work as a test of the efficacy of the creative arts in aiding regional well-being: The opportunity to work collaboratively with a community like the one at Lake Bolac [Victoria] provided an occasion to gauge our discerning and initiating skills within creative-arts research and to test the argument that the combination of our different approaches adds to community and individual well-being. Our approach is informed by Gilles Deleuze’s ethical proposition that the health of a community is directly influenced by the richness of the composition of its parts. (n.p.)Deleuzean philosophy aside, quantitative data indicates that people in regional Australia are increasingly optimistic about the positive impact of the creative arts on their well-being. In 2016, 57% believed the arts impacted their sense of well-being and happiness, up from 52% in 2013 (Australia Council for the Arts, “The Arts in Regional Australia”). Given this article’s emphasis on place and well-being in relation to located creative-arts production, it is worth citing another dataset from the same Australia Council for the Arts publication, which details the “Location of Professional Artists”:There continues to be a concentration of artists in urban areas. Three quarters (74%) live in cities, compared to two thirds of the Australian population. This urban concentration […] may in part be related to concentration of cultural infrastructure in cities.1 in 6 Australian artists live in regional cities or towns (16%) and around 1 in 10 live in rural, remote or very remote areas (11%). (n.p.)Regional artists are a minority voice in the Australian creative arts. But the ways in which a minority voice is constructed, and the (potential) impact a minoritarian position has within the wider debate about regional well-being and the creative arts, requires careful unpacking. Ironically, creative artists themselves have been relatively neglected actors in this space. Working with Tony Birch’s short story, “The Red House”, as a neglected text of regionalism, this article exposes oversights in current understandings of the connection between well-being and regionalism. The Voice of the Regional Artist and “Resistant Speech” It is important to recognise that the “concentration of artists in urban areas” may sometimes lead to situations where non-regional artists, in the undoubtedly well-meaning pursuit of regional well-being, drown out the voices of regional artists in regional places (Australia Council for the Arts, “The Arts in Regional Australia”). Drummond, Keane, and West, all city-based artists, show sensitivity to this problem in their observation that: “It is not for the artists to presume that they can empower a [regional] community.” Certainly, regional artists and communities should take the lead in the development of regional well-being through the creative arts. The problem of (not) speaking for the other is, however, not so easily dealt with (Spivak). While urban artists might adopt the strategy of consciously allowing regional artists a voice, making such allowance could itself be viewed as a play of privilege and power by the city-based practitioner, resourced by their greater “concentration of cultural infrastructure” (Australia Council for the Arts, “The Arts in Regional Australia”). It is notoriously difficult to give the slip to the relatively invisible operations of entitlement. Furthermore, even if the regional artist is given a voice, there are many different ways of being heard or not heard. Gayatri Chakravorty Spivak’s distinction between “speaking” and “talking” is useful here. Discussing “Can the Subaltern Speak?” in an interview with Bulan Lahiri, Spivak notes that: “It was not about talking. It was about: when the subaltern speaks there is not enough infrastructure for people to recognise it as resistant speech. That’s what it means.” In this crucial move, Spivak refines understanding of the issues at stake around the minoritarian position of regional artists. It is not enough for regional artists merely to “talk”; rather, they must be heard with the full impact of “resistant speech” (Lahiri). Obviously, what Spivak means by the “infrastructure” of “resistant speech” differs from the meaning the word “infrastructure” has in the Australia Council for the Arts publication referred to above, which employs the term as part of a governmental and technocratic discourse (“The Arts in Regional Australia”). The distance separating these two usages of “infrastructure” indicates the difference between the quantitative and the qualitative. Working with Spivak, this article’s focus is on the gap or failing in the infrastructure of qualitative research that has led to the relative neglect of Tony Birch’s short story “The Red House” as a significant text of regionalism. The Australia Council for the Arts, with its quantitative and empirical methodology, would not count Birch as a regional writer (to the best of the author’s knowledge, Birch lives and works in Melbourne). Its definition of a regional artist undermines the possibilities of a qualitative research infrastructure. However, recognizing the powerful regional concerns within a text by a primarily city-based writer like Birch is a key move, not only in expanding the definition of who counts as a minoritarian regional writer, but in giving voice to the “resistant speech” of women and children, subalterns on Spivak’s terms, within the regional-urban flux (Lahiri). The aim of this article is to give voice to Tony Birch as a regional writer, at least insofar as he is the author of “The Red House”, while also addressing the issue of well-being (as linked to the curse of domestic violence), through attention to Birch’s artistic re-creation of regionalism. In this way, working with Spivak’s reference to “infrastructure,” the aim is to nurture the growth of a research infrastructure open to a more productive engagement with regionalism, which begins by nuancing the definition of regional. It is not that regional artists, defined either by their demography or (as with Birch) by their creative concerns, are not “talking” rather, what they are saying is not being recognised in Spivak’s strong sense of “speaking”. Indeed, the very fact that Birch is not a regional writer in an empirical sense, and that, as will be explored later in this article, “The Red House” is not even primarily set in a regional location, has at least one important consequence. Potentially, it increases the value of Birch’s short story to an engagement with regionalism, given that “The Red House” unfolds regionalism as a concept always already in productive dialogue with other frameworks of place (such as the urban and the international). To the extent that Birch is a city-based writer of regionalism, and thus on the (urban) margin of the (regional) margin, he enlivens an exquisite position of minoritarian power. Furthermore, “The Red House” contains a diversity of acute insights into the nexus of regionalism and well-being that, to date, critics have overlooked. “The Red House” and the Well-Being of Places Comparatively little scholarly attention has been paid to creative work that itself dramatises and interrogates the issue of regional well-being. Tony Birch’s short story “The Red House” (2006), from his collection of linked stories (which is sometimes referred to as a novel) Shadowboxing, is a particularly interesting candidate to fill this gap in the literature, given how delicately it ranges across, and problematises, the division between the urban and the regional.“The Red House” is the opening story of Shadowboxing. Covering a period of close to a decade, loosely overlapping with the 1960s, and set in different parts of Victoria and Melbourne, it is told in the voice of Michael, who recounts the story of a peripatetic family under stress and struggling to survive. The first sentence reads: “We moved to the red house in the winter after my younger sister, May, died of meningitis” (1). The first page also establishes the place-based coordinates of the story: “In the weeks following our move from Clunes back to Fitzroy, our new house was almost submerged by a rising flood” (1). Birch’s interrogation of regionalism will henceforth operate largely along the Clunes-Fitzroy axis. Fitzroy is an inner-city suburb of Melbourne while Clunes is a small regional town (present population: approximately 2000) about 140 kilometres north-west of Melbourne (Clunes). A flashback section of three pages or so, early on in the story, fills in the events leading up to the return to Melbourne after May’s death in Clunes. Apart from this, the story has a linear structure. The various spatial shifts of “The Red House”, both within Melbourne and between Clunes and Melbourne, are all triggered by threats against, or the pursuit of, multiple modes of well-being. The first move reflects the promise of a fresh romantic union: “It was only after he [Michael’s father] had met my mother and moved with her to my [maternal] grandmother’s house over in Carlton that he had left Fitzroy for the first time in his life” (4–5). This move from Fitzroy to Carlton is followed by a much bigger one: Carlton to Clunes. Implicated in this move are at least two modes of well-being: “The eventual move to the bush had come on the advice of a doctor at the public hospital. He said that the fresh air would help my dad recover from [his] asthma” (5); however, “My grandmother told me years later that the move did not really have all that much to do with his asthma. It was the drink” (5). The context is the husband’s assault of “his six months’ pregnant wife” with “a straight right on the end of her nose” (5). The decision to move to Clunes is made by Michael’s mother: “He fought with her so much that my mother eventually decided that she would have to move away from her mother’s house, for both their sakes. Clunes was a drastic move. But it worked, for a time […]. They appeared happy” (6). This part of “The Red House” unpacks the complexities of how well-being and (physical and mental) health are linked in a social matrix; a physical ailment (asthma) elides an addiction to alcohol, until a doctor’s discourse (validated by the authority of a medical establishment) is subverted by the subalternate voice of Michael’s grandmother. This passage also dramatises the abject scenario of a victim (Michael’s mother) attending to the well-being of her persecutor (Michael’s father) by moving to Clunes “for both their sakes” (6).Subsequently, May is born in Clunes, “a ‘special baby’. She was magical even…” (6). Indeed, “My father’s habit of explosive anger melted before May. He was truly besotted with her” (6). Just before what would have been her second birthday, May dies. “My father wanted to bring May back to Melbourne for burial, but my mother stood up to him and demanded that she be buried in the town where she was born” (6). This is the most powerful enduring connection of Michael’s family to regional Clunes. Significantly, well-being (in the sense of survival and the rebuilding of happiness after the tragic death of a daughter) is dispersed differently, through place, by mother and father, along gendered lines. While the mother wants her daughter’s birthplace and place of death to coincide, the father wants to possess his daughter, almost as if she were an object, by returning her to the city for burial. (Space restrictions preclude further exploration here of the many issues raised by May’s death, including those around the gendered nexus between well-being [happiness] and the proximity or otherwise to a child’s burial place.) After May’s death, Michael’s father’s behaviour deteriorates once more. The domestic violence continues: “It was difficult for my mother to find anything safe to say to him […]. She tried to talk about May with him several times, but he either responded with silence, or swore and yelled at her uncontrollably. He also found his way back to the pubs” (7). The decision to return to Melbourne is made by Michael’s father, against his wife’s wishes: And then one night after he had walked in from the pub he sat down at the table and just said to her, ‘Fuck all this fresh-air bullshit, we’re going back to Melbourne.’ She tried persuading him to stay, talked about his job and my school, but he would not listen. He got sick of her talking and slammed a fist into his heavy palm. ‘We’re fucken going. That’s it. We’re going.’ And that was it.She looked across the table that night and saw once again the man she had married six years earlier, the man who she had deceived herself had faded and eventually disappeared with the move away from the city. (7)In this passage, well-being (even if only imagined rather than real) is explicitly linked to place. Shortly afterwards, the family moves into the red house, where they will remain. The flashback section of the text has already sketched out the chain of events that leads to the return to the city, while also commenting on the agency Michael’s mother exercises in dealing with what, to her, is an unwelcome situation: “Mum […] had argued against coming back to the city. She sensed the looming danger in my father moving back both to his old streets and his old habits. But on realising that she had no real say in the matter, she was determined to ensure that she at least have some say in the house she was moving into” (4). Specifically, Michael’s mother turns her Fitzroy house into the regional house left behind in Clunes. Under her influence, “It wasn’t long before the inside of the house came to life and began to resemble the old place at Clunes” (11). Again: she brings a portrait of May, along with assorted baby belongings, into the Fitzroy house, keeping this secret from her husband. Thus, Michael’s mother infiltrates regional place into urban place as a strategy of (subalternate) well-being. In summary, “The Red House” unpacks well-being as an expansive category shaped by domestic violence, in a negative sense, but also more positively by the actuality or promise of happiness. It also interrogates the fine-grained links between well-being in its incarnations as medical and emotional health. At the same time, it maps the rise and fall of well-being against a human geography of regional and urban places, refusing any simplistic connection of place to well-being (more faintly, there is even the problematising presence of international place, in the character of the Italian landlord, Mr Carboni, and the reference to “the local Italian community [2]). Thus, the text’s regionalism suggests a strategic model, reliant on human intervention in the (re-)creation of place; this is most evident in Michael’s mother’s actions. “The Red House” rewards interpretation as a text of how regional place (Clunes) is re-made in urban place (Fitzroy) through the rehabilitation of a house in the interests of well-being. Well-Being and Domestic Violence across Places It is hard to imagine a greater threat to the well-being of women and children than domestic violence. This makes it all the more surprising that “The Red House” is one of relatively few texts (to the author’s knowledge) to offer a detailed outline of the territory of well-being, in its many forms stretching from the health-based to the emotional, while also including a direct and unflinching consideration of domestic violence. (One cognate text is Kathryn Heyman’s novel The Breaking, which merges medical disability and domestic violence within a broader consideration of regional well-being.) Even more unusual is the way Birch’s story of well-being and domestic violence is mapped in relation to regional and non-regional places. “The Red House” is rare and valuable for its triangulation of well-being, domestic violence, and place; above all, in its refusal to resort to any comforting notion that regional places have essential qualities that make them necessarily better for well-being than the experience of cities. This is perhaps the meaning of the colour of the red house, a colour Michael’s father hates. According to a local know-all, Emu Bailey, the red was originally a form of protest by Ettie Rogers, “‘some sort of communist’” (10). “‘Most everyone around here back then was DLP [Democratic Labour Party]. Still is, some of them. Ettie wasn’t in agreement with the others in the street, so she let them know all about it. Redone it every summer too, the same colour, red’” (10). When Michael’s mother responds to her husband’s injunction to re-paint the house “‘any colour but that fucken red’” (13) by preparing to re-paint it, subversively, “a deep red splash of colour” (19) it is not difficult to discern a silent protest, passed down from woman to woman, against the domestic violence suffered by Michael and his mother. Indeed, Birch comes very close to describing the red of the house as blood-like, labelling it “a rich congealed red” (2). “Congealed” is often used to describe blood. In this way, through a colour that evokes the body, a house becomes a visible and metaphorical protest against the bodily violence (but also emotional and mental torment) that is domestic violence. As Meg Mundell argues, “the body is integral to how literary sense of place is produced” (8). This bodily, coloured protest folds back into the special sort of place the Fitzroy home becomes. If Michael’s mother cannot keep living in Clunes, she can at least paint her city house red. Perhaps attesting to the success of this female protest, there is, towards the end of “The Red House”, a fascinating moment when, as if influenced by the domestic circumstances of transplanted place (from regional Clunes) created by Michael’s mother, domestic violence threatens, but is thwarted. Michael’s mother has just told her husband that she is going to have another baby: “He spun around and moved towards her. I thought that maybe he was going to hit her. But he didn’t. He stopped in front of her. They were toe to toe” (17). Place and (pregnant) body, in an intensified combination (or even, to riff on Spivak’s terminology, as an “infrastructure”), allow the subaltern to “speak” against her oppression. Conclusion: Re-Defining Regionalism through the Literary Creative Arts Tony Birch’s “The Red House” re-creates the regional as something other than a pre-determined place. Regionalism is “activated,” in a strategic mode, within the flux of the urban and the regional. This is particularly evident in the actions of Michael’s mother. She preserves her well-being (located in Clunes, as it were, where her daughter is buried) even after she is forced by her husband to return to Melbourne (the place she left to escape from his domestic violence). The picture of May acts as a talisman of well-being (aptly, given Clunes is described by Michael as “a town where old superstitions held sway over logic” [6]), which Michael’s mother smuggles from regional Clunes into her Melbourne house. “The Red House” is thus a vital literary rejoinder to the conceptualisation of well-being, and regional areas employed by government bodies and commercial entities, which instrumentalizes a binary opposition of the regional/non-regional. By extension, it contests the naïve linkage of regional place to well-being through a nuanced investigation into the complex links between place (regional, urban, even international) and multi-faceted well-being. Birch’s story is a valuable, fine-grained creative analysis of well-being (extending from happiness, comfort and security through to what might be called the “ill-being” of domestic violence), which is matched to an equally fine-grained engagement with multiple modalities of place. It challenges the reader to creatively re-think how regionalism and well-being might align. References Australia Council for the Arts. “Living Culture: First Nations Arts Participation and Wellbeing.” Sydney: Australia Council for the Arts, 2017. 10 Mar. 2019 <https://www.australiacouncil.gov.au/research/living-culture/>.———. “The Arts in Regional Australia: A Research Summary.” Sydney: Australia Council for the Arts, 2017. 10 Mar. 2019 <https://www.australiacouncil.gov.au/research/regional-arts-summary/>.Birch, Tony. “The Red House.” Shadowboxing. Melbourne: Scribe, 2006. 1–19. Clunes, Victoria. Wikipedia. <https://en.wikipedia.org/wiki/Clunes,_Victoria>.Drummond, Rozalind, Jondi Keane, and Patrick West. “Zones of Practice: Embodiment and Creative Arts Research.” M/C Journal 15.4 (2012). 1 Mar. 2019 <http://journal.media-culture.org.au/index.php/mcjournal/article/view/528>.Elg, Hayley. “New Wellness Festival for Daylesford.” The Advocate 22 Jan. 2018. 1 Mar. 2019 <https://www.hepburnadvocate.com.au/story/5182322/the-live-love-life-festival-is-coming-to-daylesford-this-november/>.Heyman, Kathryn. “When I First Wrote about Domestic Violence, No One Talked about It. Now the Shame has Lifted.” The Guardian. 21 May 2017. 10 Mar. 2019 <https://www.theguardian.com/books/2017/may/21/when-i-first-wrote-about-domestic-violence-no-one-talked-about-it-now-the-shame-has-lifted>.Lahiri, Bulan. “In Conversation: Speaking to Spivak.” The Hindu 5 Feb. 2011. 1 Mar. 2019 <https://www.thehindu.com/books/In-Conversation-Speaking-to-Spivak/article15130635.ece>.Mundell, Meg. “Crafting ‘Literary Sense of Place’: The Generative Work of Literary Place-Making.” JASAL: Journal of the Association for the Study of Australian Literature 18.1 (2018): 1–17. 10 Mar. 2019 <https://openjournals.library.sydney.edu.au/index.php/JASAL/article/view/12375>.Spivak, Gayatri Chakravorty. “Can the Subaltern Speak?” Colonial Discourse and Post-Colonial Theory: A Reader. New York: Harvester Wheatsheaf, 1993: 66–111. Warren, Brad, and Patrick West. “From Ecological Creativity to an Ecology of Well-Being: ‘Flows & Catchments’ as a Case Study of NVivo.” Landscapes: The Journal of the International Centre for Landscape and Language 5.2 (2013): 1–15. 1 Mar. 2019 <https://ro.ecu.edu.au/landscapes/vol5/iss2/21/>.Woodward, Margaret, Craig Bremner, and Anthony Cahalan. “Defining the Geography of Creativity in a Regional Australian University.” Proceedings of the 2012 Australian Council of University Art and Design Schools (ACUADS) Conference: Region and Isolation: The Changing Function of Art & Design Education within Diasporic Cultures and Borderless Communities. Australian Council of University Art and Design Schools (ACUADS) Conference 2012. Perth: Australian Council of University Art and Design Schools (ACUADS), 2012: 1–13. 1 Mar. 2019 <https://acuads.com.au/conference/article/defining-the-geography-of-creativity-in-a-regional-australian-university/>.

The term “coffee palace” was primarily used in Australia to describe the temperance hotels that were built in the last decades of the 19th century, although there are references to the term also being used to a lesser extent in the United Kingdom (Denby 174). Built in response to the worldwide temperance movement, which reached its pinnacle in the 1880s in Australia, coffee palaces were hotels that did not serve alcohol. This was a unique time in Australia’s architectural development as the economic boom fuelled by the gold rush in the 1850s, and the demand for ostentatious display that gathered momentum during the following years, afforded the use of richly ornamental High Victorian architecture and resulted in very majestic structures; hence the term “palace” (Freeland 121). The often multi-storied coffee palaces were found in every capital city as well as regional areas such as Geelong and Broken Hill, and locales as remote as Maria Island on the east coast of Tasmania. Presented as upholding family values and discouraging drunkenness, the coffee palaces were most popular in seaside resorts such as Barwon Heads in Victoria, where they catered to families. Coffee palaces were also constructed on a grand scale to provide accommodation for international and interstate visitors attending the international exhibitions held in Sydney (1879) and Melbourne (1880 and 1888). While the temperance movement lasted well over 100 years, the life of coffee palaces was relatively short-lived. Nevertheless, coffee palaces were very much part of Australia’s cultural landscape. In this article, I examine the rise and demise of coffee palaces associated with the temperance movement and argue that coffee palaces established in the name of abstinence were modelled on the coffee houses that spread throughout Europe and North America in the 17th and 18th centuries during the Enlightenment—a time when the human mind could be said to have been liberated from inebriation and the dogmatic state of ignorance. The Temperance Movement At a time when newspapers are full of lurid stories about binge-drinking and the alleged ill-effects of the liberalisation of licensing laws, as well as concerns over the growing trend of marketing easy-to-drink products (such as the so-called “alcopops”) to teenagers, it is difficult to think of a period when the total suppression of the alcohol trade was seriously debated in Australia. The cause of temperance has almost completely vanished from view, yet for well over a century—from 1830 to the outbreak of the Second World War—the control or even total abolition of the liquor trade was a major political issue—one that split the country, brought thousands onto the streets in demonstrations, and influenced the outcome of elections. Between 1911 and 1925 referenda to either limit or prohibit the sale of alcohol were held in most States. While moves to bring about abolition failed, Fitzgerald notes that almost one in three Australian voters expressed their support for prohibition of alcohol in their State (145). Today, the temperance movement’s platform has largely been forgotten, killed off by the practical example of the United States, where prohibition of the legal sale of alcohol served only to hand control of the liquor traffic to organised crime. Coffee Houses and the Enlightenment Although tea has long been considered the beverage of sobriety, it was coffee that came to be regarded as the very antithesis of alcohol. When the first coffee house opened in London in the early 1650s, customers were bewildered by this strange new drink from the Middle East—hot, bitter, and black as soot. But those who tried coffee were, reports Ellis, soon won over, and coffee houses were opened across London, Oxford, and Cambridge and, in the following decades, Europe and North America. Tea, equally exotic, entered the English market slightly later than coffee (in 1664), but was more expensive and remained a rarity long after coffee had become ubiquitous in London (Ellis 123-24). The impact of the introduction of coffee into Europe during the seventeenth century was particularly noticeable since the most common beverages of the time, even at breakfast, were weak “small beer” and wine. Both were safer to drink than water, which was liable to be contaminated. Coffee, like beer, was made using boiled water and, therefore, provided a new and safe alternative to alcoholic drinks. There was also the added benefit that those who drank coffee instead of alcohol began the day alert rather than mildly inebriated (Standage 135). It was also thought that coffee had a stimulating effect upon the “nervous system,” so much so that the French called coffee une boisson intellectuelle (an intellectual beverage), because of its stimulating effect on the brain (Muskett 71). In Oxford, the British called their coffee houses “penny universities,” a penny then being the price of a cup of coffee (Standage 158). Coffee houses were, moreover, more than places that sold coffee. Unlike other institutions of the period, rank and birth had no place (Ellis 59). The coffee house became the centre of urban life, creating a distinctive social culture by treating all customers as equals. Egalitarianism, however, did not extend to women—at least not in London. Around its egalitarian (but male) tables, merchants discussed and conducted business, writers and poets held discussions, scientists demonstrated experiments, and philosophers deliberated ideas and reforms. For the price of a cup (or “dish” as it was then known) of coffee, a man could read the latest pamphlets and newsletters, chat with other patrons, strike business deals, keep up with the latest political gossip, find out what other people thought of a new book, or take part in literary or philosophical discussions. Like today’s Internet, Twitter, and Facebook, Europe’s coffee houses functioned as an information network where ideas circulated and spread from coffee house to coffee house. In this way, drinking coffee in the coffee house became a metaphor for people getting together to share ideas in a sober environment, a concept that remains today. According to Standage, this information network fuelled the Enlightenment (133), prompting an explosion of creativity. Coffee houses provided an entirely new environment for political, financial, scientific, and literary change, as people gathered, discussed, and debated issues within their walls. Entrepreneurs and scientists teamed up to form companies to exploit new inventions and discoveries in manufacturing and mining, paving the way for the Industrial Revolution (Standage 163). The stock market and insurance companies also had their birth in the coffee house. As a result, coffee was seen to be the epitome of modernity and progress and, as such, was the ideal beverage for the Age of Reason. By the 19th century, however, the era of coffee houses had passed. Most of them had evolved into exclusive men’s clubs, each geared towards a certain segment of society. Tea was now more affordable and fashionable, and teahouses, which drew clientele from both sexes, began to grow in popularity. Tea, however, had always been Australia’s most popular non-alcoholic drink. Tea (and coffee) along with other alien plants had been part of the cargo unloaded onto Australian shores with the First Fleet in 1788. Coffee, mainly from Brazil and Jamaica, remained a constant import but was taxed more heavily than tea and was, therefore, more expensive. Furthermore, tea was much easier to make than coffee. To brew tea, all that is needed is to add boiling water, coffee, in contrast, required roasting, grinding and brewing. According to Symons, until the 1930s, Australians were the largest consumers of tea in the world (19). In spite of this, and as coffee, since its introduction into Europe, was regarded as the antidote to alcohol, the temperance movement established coffee palaces. In the early 1870s in Britain, the temperance movement had revived the coffee house to provide an alternative to the gin taverns that were so attractive to the working classes of the Industrial Age (Clarke 5). Unlike the earlier coffee house, this revived incarnation provided accommodation and was open to men, women and children. “Cheap and wholesome food,” was available as well as reading rooms supplied with newspapers and periodicals, and games and smoking rooms (Clarke 20). In Australia, coffee palaces did not seek the working classes, as clientele: at least in the cities they were largely for the nouveau riche. Coffee Palaces The discovery of gold in 1851 changed the direction of the Australian economy. An investment boom followed, with an influx of foreign funds and English banks lending freely to colonial speculators. By the 1880s, the manufacturing and construction sectors of the economy boomed and land prices were highly inflated. Governments shared in the wealth and ploughed money into urban infrastructure, particularly railways. Spurred on by these positive economic conditions and the newly extended inter-colonial rail network, international exhibitions were held in both Sydney and Melbourne. To celebrate modern technology and design in an industrial age, international exhibitions were phenomena that had spread throughout Europe and much of the world from the mid-19th century. According to Davison, exhibitions were “integral to the culture of nineteenth century industrialising societies” (158). In particular, these exhibitions provided the colonies with an opportunity to demonstrate to the world their economic power and achievements in the sciences, the arts and education, as well as to promote their commerce and industry. Massive purpose-built buildings were constructed to house the exhibition halls. In Sydney, the Garden Palace was erected in the Botanic Gardens for the 1879 Exhibition (it burnt down in 1882). In Melbourne, the Royal Exhibition Building, now a World Heritage site, was built in the Carlton Gardens for the 1880 Exhibition and extended for the 1888 Centennial Exhibition. Accommodation was required for the some one million interstate and international visitors who were to pass through the gates of the Garden Palace in Sydney. To meet this need, the temperance movement, keen to provide alternative accommodation to licensed hotels, backed the establishment of Sydney’s coffee palaces. The Sydney Coffee Palace Hotel Company was formed in 1878 to operate and manage a number of coffee palaces constructed during the 1870s. These were designed to compete with hotels by “offering all the ordinary advantages of those establishments without the allurements of the drink” (Murdoch). Coffee palaces were much more than ordinary hotels—they were often multi-purpose or mixed-use buildings that included a large number of rooms for accommodation as well as ballrooms and other leisure facilities to attract people away from pubs. As the Australian Town and Country Journal reveals, their services included the supply of affordable, wholesome food, either in the form of regular meals or occasional refreshments, cooked in kitchens fitted with the latest in culinary accoutrements. These “culinary temples” also provided smoking rooms, chess and billiard rooms, and rooms where people could read books, periodicals and all the local and national papers for free (121). Similar to the coffee houses of the Enlightenment, the coffee palaces brought businessmen, artists, writers, engineers, and scientists attending the exhibitions together to eat and drink (non-alcoholic), socialise and conduct business. The Johnson’s Temperance Coffee Palace located in York Street in Sydney produced a practical guide for potential investors and businessmen titled International Exhibition Visitors Pocket Guide to Sydney. It included information on the location of government departments, educational institutions, hospitals, charitable organisations, and embassies, as well as a list of the tariffs on goods from food to opium (1–17). Women, particularly the Woman’s Christian Temperance Union (WCTU) were a formidable force in the temperance movement (intemperance was generally regarded as a male problem and, more specifically, a husband problem). Murdoch argues, however, that much of the success of the push to establish coffee palaces was due to male politicians with business interests, such as the one-time Victorian premiere James Munro. Considered a stern, moral church-going leader, Munro expanded the temperance movement into a fanatical force with extraordinary power, which is perhaps why the temperance movement had its greatest following in Victoria (Murdoch). Several prestigious hotels were constructed to provide accommodation for visitors to the international exhibitions in Melbourne. Munro was responsible for building many of the city’s coffee palaces, including the Victoria (1880) and the Federal Coffee Palace (1888) in Collins Street. After establishing the Grand Coffee Palace Company, Munro took over the Grand Hotel (now the Windsor) in 1886. Munro expanded the hotel to accommodate some of the two million visitors who were to attend the Centenary Exhibition, renamed it the Grand Coffee Palace, and ceremoniously burnt its liquor licence at the official opening (Murdoch). By 1888 there were more than 50 coffee palaces in the city of Melbourne alone and Munro held thousands of shares in coffee palaces, including those in Geelong and Broken Hill. With its opening planned to commemorate the centenary of the founding of Australia and the 1888 International Exhibition, the construction of the Federal Coffee Palace, one of the largest hotels in Australia, was perhaps the greatest monument to the temperance movement. Designed in the French Renaissance style, the façade was embellished with statues, griffins and Venus in a chariot drawn by four seahorses. The building was crowned with an iron-framed domed tower. New passenger elevators—first demonstrated at the Sydney Exhibition—allowed the building to soar to seven storeys. According to the Federal Coffee Palace Visitor’s Guide, which was presented to every visitor, there were three lifts for passengers and others for luggage. Bedrooms were located on the top five floors, while the stately ground and first floors contained majestic dining, lounge, sitting, smoking, writing, and billiard rooms. There were electric service bells, gaslights, and kitchens “fitted with the most approved inventions for aiding proficients [sic] in the culinary arts,” while the luxury brand Pears soap was used in the lavatories and bathrooms (16–17). In 1891, a spectacular financial crash brought the economic boom to an abrupt end. The British economy was in crisis and to meet the predicament, English banks withdrew their funds in Australia. There was a wholesale collapse of building companies, mortgage banks and other financial institutions during 1891 and 1892 and much of the banking system was halted during 1893 (Attard). Meanwhile, however, while the eastern States were in the economic doldrums, gold was discovered in 1892 at Coolgardie and Kalgoorlie in Western Australia and, within two years, the west of the continent was transformed. As gold poured back to the capital city of Perth, the long dormant settlement hurriedly caught up and began to emulate the rest of Australia, including the construction of ornately detailed coffee palaces (Freeman 130). By 1904, Perth had 20 coffee palaces. When the No. 2 Coffee Palace opened in Pitt Street, Sydney, in 1880, the Australian Town and Country Journal reported that coffee palaces were “not only fashionable, but appear to have acquired a permanent footing in Sydney” (121). The coffee palace era, however, was relatively short-lived. Driven more by reformist and economic zeal than by good business sense, many were in financial trouble when the 1890’s Depression hit. Leading figures in the temperance movement were also involved in land speculation and building societies and when these schemes collapsed, many, including Munro, were financially ruined. Many of the palaces closed or were forced to apply for liquor licences in order to stay afloat. Others developed another life after the temperance movement’s influence waned and the coffee palace fad faded, and many were later demolished to make way for more modern buildings. The Federal was licensed in 1923 and traded as the Federal Hotel until its demolition in 1973. The Victoria, however, did not succumb to a liquor licence until 1967. The Sydney Coffee Palace in Woolloomooloo became the Sydney Eye Hospital and, more recently, smart apartments. Some fine examples still survive as reminders of Australia’s social and cultural heritage. The Windsor in Melbourne’s Spring Street and the Broken Hill Hotel, a massive three-story iconic pub in the outback now called simply “The Palace,” are some examples. Tea remained the beverage of choice in Australia until the 1950s when the lifting of government controls on the importation of coffee and the influence of American foodways coincided with the arrival of espresso-loving immigrants. As Australians were introduced to the espresso machine, the short black, the cappuccino, and the café latte and (reminiscent of the Enlightenment), the post-war malaise was shed in favour of the energy and vigour of modernist thought and creativity, fuelled in at least a small part by caffeine and the emergent café culture (Teffer). Although the temperance movement’s attempt to provide an alternative to the ubiquitous pubs failed, coffee has now outstripped the consumption of tea and today’s café culture ensures that wherever coffee is consumed, there is the possibility of a continuation of the Enlightenment’s lively discussions, exchange of news, and dissemination of ideas and information in a sober environment. 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