Gotowa bibliografia na temat „Aboriginal Australia”

In recent years Aboriginalia, defined here as souvenir objects depicting Aboriginal peoples, symbolism and motifs from the 1940s—1970s and sold largely to tourists in the first instance, has become highly sought after by both Aboriginal and non-Aboriginal collectors and has captured the imagination of Aboriginal artists and cultural commentators. The paper seeks to understand how and why Aboriginality came to brand Australia and almost every tourist place and centre at a time when Aboriginal people and culture were subject to policies (particularly the White Australia Polic(ies)) that effectively removed them from their homelands and sought in various ways to assimilate them (physiologically and culturally) into mainstream white Australian culture. In addition the paper suggests that this Aboriginalia had an unintended social life as an object of tourism and nation. It is argued that the mass-produced presence of many reminders of Aboriginal culture came to be ‘repositories of recognition’ not only of the presence of Aborigines but also of their dispossession and repression. As such they emerge today recoded as politically and culturally charged objects with (potentially) an even more radical role to play in the unfolding of race relations in Australia.

There can be no ethnic group in Australia that displays as much diversity as the Australian Aborigines. Their lifestyles range from hunting and gathering in the most remote corners of Australia, through a more settled existence in outback country towns and on the fringes of towns and cities, to an ongoing struggle to survive in the hearts of Australia’s biggest cities. What is it that unites all Aboriginal people regardless of where they live? Many people, white Australians especially, seem to think that it is the racial characteristics, skin colour and “blood”, which makes an Aborigine. To these people, the darker a person’s skin is, the more Aboriginal they are. When this sort of thinking predominates, as it so often does, many Aboriginal people start finding themselves robbed of their Aboriginality. People tell them that they are only half or a quarter Aborigine, or a “part Aborigine”.

When the Australian Governor General, Sir William Deane, referred in a speech in 1996 to the “appalling problems relating to Aboriginal health” he was not exaggerating. The Australia Bureau of Statistics report on The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples (McLennan & Madden, 1997) outlines the following statistics. The life expectancy for Aboriginal Australians is 15 to 20 years lower than for non-Aboriginal Australians, and is lower than for most countries of the world with the exception of central Africa and India. Aboriginal babies are two to three times more likely to be of lower birth weight and two to four times more likely to die at birth than non-Aboriginal babies. Hospitalisation rates are two to three times higher for Aboriginal than non-Aboriginal Australians. Death rates from infectious diseases are 15 times higher among Aboriginal Australians than non-Aboriginal Australians. Rates for heart disease, diabetes, injury and respiratory diseases are also all higher among Aboriginals – and so the list goes on. It is fair to say that Aboriginal people have higher rates for almost every type of illness for which statistics are currently recorded.

In the 20 years before the Second World War the frontier war dragged to a close in remote parts of north Australia with the 1926 Daly River massacre and the 1928 Coniston massacre. There was a rapid decline in the Aboriginal population, giving rise to the idea of the ‘dying race’ which had found policy expression in the State ‘Protection’ Acts. Aboriginal and Islander labour was exploited under scandalous rates of pay and conditions in the struggling north Australian beef industry and the pearling industry. In south east Australia, Aborigines endured repressive white control on government reserves and mission stations described by some historians as being little better than prison farms. A largely ineffectual Aboriginal political movement with a myriad of organisations, none of which had a pan-Aboriginal identity, struggled to make headway against white prejudice. Finally, in 1939, John McEwen's ‘assimilation policy’ was introduced and, though doomed to failure, it at least recognised that Aborigines had a place in Australia in the long term.

The long history of Asian contact with Australian Aborigines began with the early links with seafarers, Makassan trepang gatherers and even Chinese contact, which occurred in northern Australia. Later contact through the pearling industry in the Northern Territory and Kimberley, Western Australia, involved Filipinos (Manilamen), Malays, Indonesians, Chinese and Japanese. Europeans on the coastal areas of northern Australia depended on the work of indentured Asians and local Aborigines for the development and success of these industries. The birth of the Australian Federation also marked the beginning of the “White Australia Policy” designed to keep non-Europeans from settling in Australia. The presence of Asians in the north had a significant impact on state legislation controlling Aborigines in Western Australia in the first half of the 20th century, with implications to the present. Oral and archival evidence bears testimony to the brutality with which this legislation was pursued and its impact on the lives of Aboriginal people.

A review of Eric Michaels' report Aboriginal Invention of Television: Central Australia 1982–1986, Australian Institute of Aboriginal Studies, Canberra, 1986, 159p, gratis; and policy considerations for Aboriginal broadcasting in remote Australia.

Different from their ancestors, most of the Australian Aborigines currently live outside their native land but in a multicultural society under the major influence of Western culture. The assimilation policy, the White Australian policy etc. partly deprived Australian aborigines of their traditional culture. The young generations tend to adopt the western style of living, leaving behind their ancestors’ culture without any heir! However, they now are aware of this loss, and in spite of the modern trend of western culture, they are striving for their traditional preservation. In “Multicultural Australia: United in Diversity” announced on 13 May 2003, Australian government stated guidelines for the 2003-2006 development strategies. The goals are to build a successful Australia of diverse cultures, ready to be tolerant to other cultures; to build a united Australia with a shared future of devoted citizens complying with the law. As for Aboriginal culture, the multicultural policy is a recognition of values and significance of the most original features of the country’s earliest culture. It also shows the government’s great concern for the people, especially for the aborigines. All this displays numerous advantages for the preservation of Australian aboriginal culture.

Abstract In recent decades, the popularity of Australian Aboriginal dot painting overseas has exploded, with works by some of Australia's leading artists selling for millions of dollars at auction, as well as featuring in major international exhibitions like the Venice Biennale and documenta. While this carries with it the risk of Aboriginal art and culture becoming diluted or commodified, this essay explores the origins and use of the ‘dotting’ typical of much Australian Aboriginal art of the Western and Central Deserts of Australia, as well as Aboriginal dot painting's circulation internationally, to consider how Aboriginal art's entry into the global art world might also represent an act of Indigenous self-determination. By leveraging the Western fascination with the ‘secret/sacred’ content often assumed to be hidden by these dots, Aboriginal artists have been able to generate an international market for their works. While Aboriginal communities remain among the most economically disadvantaged in Australia, Aboriginal art nevertheless provides a critical means by which Indigenous communities can support themselves, and, more importantly, operates as a form of cultural preservation and a tool by which Aboriginal peoples can assert their sovereignty.

Advancing Aboriginal participation in the workplace comes with its challenges, and those experienced in the oil and gas industry are unique. Barriers to participation need to be regularly evaluated and addressed for success. Although Chevron Australia's focus on Aboriginal employment is fairly recent, it receives strong internal support from senior and corporate leadership. It will be important in the future to further this commitment and build ownership throughout the organisation to achieve long-term results and meet business needs and skills gaps. Camis Smith, Chevron Australia's Aboriginal Employment Strategy Manager, will share Chevron's experiences, lessons and challenges in advancing Aboriginal participation in the workplace, and reinforce its reputation as an employer of choice. Chevron is one of the world's leading integrated energy companies and through its Australian subsidiaries, has been present in Australia for more than 60 years. With the ingenuity and commitment of more than 4,000 people, Chevron Australia leads the development of the Gorgon and Wheatstone natural gas projects, and has been operating Australia's largest onshore oilfield on Barrow Island for more than 45 years.

Aboriginal, Historical and Maritime archaeology have been taught in Australian universities since the 1960s, and archaeology has made major contributions to our understanding of Australia's past. Yet many Australians are still more interested in archaeology overseas than in Australia itself. This partly reflects Australia's history as a former British colony which currently has a minority of indigenous Aboriginal and Torres Strait Islander people, many of whom regard archaeology as yet another colonial imposition which at best is largely irrelevant to their own understanding of their history. Present government policies empower Aboriginal people to veto certain kinds of archaeological research they do not agree with. At minimum this may require archaeologists to engage in what can become protracted consultation, with uncertain outcomes.

This thesis is an inquiry into the possibility of Aboriginal autonomy under the regime of a state policy which commands self determination. Debate about policy has been dominated by Western scientific, political and professional knowledge, which is challenged by indigenous paradigms grounded in the Dreaming. A recognition of the role of paradox leads me to an attempt at reconciliation between the old and the new Australian intellectual traditions. The thesis advances the theory of internal colonialism by identifying self-determination as its current phase. During more than 200 years of colonial history the relationship between Aborigines and the state has been increasingly contradictory. The current policy of self-determination is a political paradox. Aboriginal people must either conform to the policy by disobeying it, or reject the policy in obedience to it. Through the policy of self-determination the state constructs a relationship of dependent autonomy with Aboriginal people. In a two-year (1994-95) action research project Kitya Aboriginal Health Action Group was set up to empower a local community to establish an Aboriginal health service despite opposition from the Government Health Service. In collaboration with local general practitioners and volunteers the action group opened a health centre. After the end of formal field work government funding and support for the health service was granted. The project illustrated the paradox of dependent autonomy. What appeared as successful community development was not development, and what appeared as destructive factionalism was empowering. Strategies for change made use of contradictions and paradoxes within the state. As an innovation in the practice of social change, the thesis begins the construction of a model for indigenous community action for self-determination in health.

Much academic work concerned with social and cultural processes in Australia takes as its field of inquiry how the lives of Aboriginal Australians have been changed and impacted on by colonisation. Rarely has scholarship attempted to uncover some of the ways Aboriginality and Aboriginal people have become integral in the shaping of the lives of non-Aboriginal Australians. Ths thesis takes to heart the challenge of subjecting oneself and one's own social and cultural position to the rigours of sociological scrutiny and sets out to examine how crucial Aboriginality and Aboriginal people have been in shaping the lives, identities and economies of non-Aboriginal Australians. Drawing on the work of Homi Bhabha the thesis argues that ambivalence, whch underlies much of colonial discourse, can have a tremendously disruptive and unsettling effect on the authority, identities and everyday social lives of non-Aboriginal people. The thesis explores something of the diversity of this ambivalence by focusing attention on five groups of people (One Nation Supporters, retired tourists, 'alternative lifestylers', governmental workers and early colonists); two historical moments(early colonial times and the late 1990s); and two regions (the south-west and Kimberley of Western Australia). The thesis argues that one of the effects of ths ambivalence is that the social worlds of non- Aboriginal Australians are often subjected to challenge and change. In early colonial times many 'settlers' were tom between the will to colonise and economic and cultural reliance on the efforts and knowledge of Aboriginal people. More recently, One Nation supporters attempt to distance themselves from Aboriginal people by constituting them as the barbaric and parasitical other. At the same time, Hansonites indirectly position Aboriginality as central to their own identity and political future. Another group, retired tourists, regularly perpetuate old colonial tropes and publicly express their disdain of Aboriginal people. At the same time, these people yearn for and engage in social practices otherwise associated with Aborigrnal culture. Behind both groups' public attacks on Aborigines as cannibals and the 'Aboriginal Industry' as spongers lies a deep political and cultural reliance on Aboriginality. Romantics and others who aspire to consume and mimic Aboriginal culture are likewise regularly ambivalent and contradictory in their treatment of Aboriginality. It is arguable that many are selfinterested and seek to plunder Aboriginal cultural. However, the very romance that prompts their mimicry can and does act to unsettle the certainty of non-Aboriginal dominance. This prompts people to re-examine their identities and social practices. Ambivalence and complexity is also central to the lives of those involved in the business of Aboriginal governance. On the one hand, these people are clearly implicated in the government and regulation of Aboriginal people. On the other hand, liberal discourse on fairness and equality of opportunity force governmental workers to increase their contact and reliance on Aboriginal people. This often has the effect of provoking changes in non-Aboriginal people's personal and working lives. The thesis concludes that the engagement of colonial discourse with Aboriginalities inevitably leads to an ambivalence that disables the monolithic dominance of non-Aboriginal Australians. In a range of ways this ambivalence can and does produce conditions whch undermine and transform the cultural lives and identities of non-Aboriginal Australians.

Much academic work concerned with social and cultural processes in Australia takes as its field of inquiry how the lives of Aboriginal Australians have been changed and impacted on by colonisation. Rarely has scholarship attempted to uncover some of the ways Aboriginality and Aboriginal people have become integral in the shaping of the lives of non-Aboriginal Australians. Ths thesis takes to heart the challenge of subjecting oneself and one's own social and cultural position to the rigours of sociological scrutiny and sets out to examine how crucial Aboriginality and Aboriginal people have been in shaping the lives, identities and economies of non-Aboriginal Australians. Drawing on the work of Homi Bhabha the thesis argues that ambivalence, whch underlies much of colonial discourse, can have a tremendously disruptive and unsettling effect on the authority, identities and everyday social lives of non-Aboriginal people. The thesis explores something of the diversity of this ambivalence by focusing attention on five groups of people (One Nation Supporters, retired tourists, 'alternative lifestylers', governmental workers and early colonists); two historical moments(early colonial times and the late 1990s); and two regions (the south-west and Kimberley of Western Australia). The thesis argues that one of the effects of ths ambivalence is that the social worlds of non- Aboriginal Australians are often subjected to challenge and change. In early colonial times many 'settlers' were tom between the will to colonise and economic and cultural reliance on the efforts and knowledge of Aboriginal people. More recently, One Nation supporters attempt to distance themselves from Aboriginal people by constituting them as the barbaric and parasitical other. At the same time, Hansonites indirectly position Aboriginality as central to their own identity and political future. Another group, retired tourists, regularly perpetuate old colonial tropes and publicly express their disdain of Aboriginal people. At the same time, these people yearn for and engage in social practices otherwise associated with Aborigrnal culture. Behind both groups' public attacks on Aborigines as cannibals and the 'Aboriginal Industry' as spongers lies a deep political and cultural reliance on Aboriginality. Romantics and others who aspire to consume and mimic Aboriginal culture are likewise regularly ambivalent and contradictory in their treatment of Aboriginality. It is arguable that many are selfinterested and seek to plunder Aboriginal cultural. However, the very romance that prompts their mimicry can and does act to unsettle the certainty of non-Aboriginal dominance. This prompts people to re-examine their identities and social practices. Ambivalence and complexity is also central to the lives of those involved in the business of Aboriginal governance. On the one hand, these people are clearly implicated in the government and regulation of Aboriginal people. On the other hand, liberal discourse on fairness and equality of opportunity force governmental workers to increase their contact and reliance on Aboriginal people. This often has the effect of provoking changes in non-Aboriginal people's personal and working lives. The thesis concludes that the engagement of colonial discourse with Aboriginalities inevitably leads to an ambivalence that disables the monolithic dominance of non-Aboriginal Australians. In a range of ways this ambivalence can and does produce conditions whch undermine and transform the cultural lives and identities of non-Aboriginal Australians.

Thesis (Ph.D.) (Economics and Finance)-- University of Western Sydney, 2002.
A thesis submitted for the award of Ph.D. (Economics and Finance), September 2002, University of Western Sydney. Bibliography : leaves 325-342.

Thesis (Ph.D.) -- La Trobe University, 2006.
Research. "A thesis submitted in total fulfilment of the requirements for the degree of Doctor of Philosophy, La Trobe Law, Faculty of Law and Management, La Trobe University, Bundoora, Victoria". Includes bibliographical references (leaves 318-338). Also available via the World Wide Web.

This thesis aims to shed some lights on the actual conditions of Aboriginal Australians throughout history and today. Many stereotypes are commonly known about them and many of them are incorrect, starting from the notion that Captain Cook discovered Australia. Australia was not discovered by the British, it already hosted a multitude of cultures before the Europeans arrived.

The Nabarlek uranium mine is located in the Alligator Rivers Region of the Northern Territory of Australia. The site lies in the wet/dry topics with an annual rainfall of about 1400mm, which falls between October and April. The site operated as a “no release” mine and mill between 1979 and 1988 after which time the facility was mothballed until decommissioning was required by the Supervising Authorities in 1994. The dismantling of the mill and rehabilitation earthworks were completed in time for the onset of the 1995–96 wet season. During the operational phase accumulation of excess water resulted in irrigation of waste water being allowed in areas of natural forest bushland. The practice resulted in adverse impacts being observed, including a high level of tree deaths in the forest and degradation of water quality in both ground and surface waters in the vicinity. A comprehensive environmental monitoring programme was in place throughout the operating and rehabilitation phases of the mine’s life, which continues, albeit at a reduced level. Revegetation of the site, including the former irrigation areas, is being observed to ascertain if the site can be handed back to the Aboriginal Traditional Owners. A comprehensive review of proximal water sampling points was undertaken in 2001 and the data used to provide a snapshot of water quality to assist with modelling the long term prognosis for the water resources in the area. While exhibiting detectable effects of mining activities, water in most of the monitoring bores now meets Australian drinking water guideline levels. The paper reviews the history of the site and examines the accumulated data on water quality for the site to show how the situation is changing with time. The paper also presents an assessment of the long term future of the site in respect of water quality.

13 uranium mines operated in the South Alligator Valley of Australia’s Northern Territory between 1953 and 1963. At the end of operations the mines, and associated infrastructure, were simply abandoned. As this activity preceded environmental legislation by about 15 years there was neither any obligation, nor attempt, at remediation. In the 1980s it was decided that the whole area should become an extension of the adjacent World Heritage, Kakadu National Park. As a result the Commonwealth Government made an inventory of the abandoned mines and associated facilities in 1986. This established the size and scope of the liability and formed the framework for a possible future remediation project. The initial program for the reduction of physical and radiological hazards at each of the identified sites was formulated in 1989 and the works took place from 1990 to 1992. But even at this time, as throughout much of the valley’s history, little attention was being paid to the long term aspirations of traditional land owners. The traditional Aboriginal owners, the Gunlom Land Trust, were granted freehold Native Title to the area in 1996. They immediately leased the land back to the Commonwealth Government so it would remain a part of Kakadu National Park, but under joint management. One condition of the lease required that all evidence of former mining activity be remediated by 2015. The consultation, and subsequent planning processes, for a final remediation program began in 1997. A plan was agreed in 2003 and, after funding was granted in 2005, works implementation commenced in 2007. An earlier paper described the planning and consultation stages, experience involving the cleaning up of remant uranium mill tailings and other mining residues; and the successful implementation of the initial remediation works. This paper deals with the final planning and design processes to complete the remediation programme, which is due to occur in 2009. The issues of final containment design and long term stewardship are addressed in the paper as well as some comments on lessons learned through the life of the project.

Although the catchment - the topographically defined edge where “all rainfall… drains naturally … or is directed to by human intervention towards … the catchment outlet [which may be immediately a creek, but ultimately is the ocean] ” – is the most significant boundary for ecological function of landscapes, Raxworthy has argued that property boundaries and land tenure make it such that “landscape pattern is as much an emergent quality of capitalism as it is propensity[y] of [the landscape.” Despite its role in establishing the pattern of the landscape, landscape architects tend to treat property boundary as a given that is almost invisible when every act they do reacts to it in some way, necessitating, Raxworthy continues, a theorising of land tenure in landscape architecture. I hope to continue Raxworthy’s project in this paper by examining the celebrated model of contemporary land titling – the Torrens System – in its place of origination – Adelaide – and explore the relationship between landscape, people and land titling. Two of the things Adelaide is most famous for might seem complimentary but are actually contradictory: the Torrens System of title (which Atkinson, quoting Greg Taylor, calls ““South Australia’s most successful intellectual export.”” ) and the first successful determination Native Title in a capital city of Australia. Developed by Robert Richard Torrens, the “Real Property Act (1858)” (which subsequently became known as Torrens Title, or the Torrens System) and “simplify[ied] the Laws relating to the transfer and encumbrance of freehold and other interests in land,” by creating a centralised registration system of actual land ownership, rather than simply deeds, removing potentials for contestation. In the developing world the Torrens System has been a very important tool in helping secure land title in post-colonial countries “[becoming] the norm in both Anglophone and Francophone colonial Africa,” yet, as Leonie Kelleher has argued, the Torrens System effectively eclipsed the previous sovereignty of Aboriginal people in the very place of its creation.

Professor Leslie R. Marchant was a Western Australian historian of international renown. Richly educated as a child in political philosophy and critical reason, Marchant’s understandings of western political philosophies were deepened in World War Two when serving with an international crew of the merchant navy. After the war’s end, Marchant was appointed as a Protector of Aborigines in Western Australia’s Depart of Native Affairs. His passionate belief in Enlightenment ideals, including the equality of all people, was challenged by his experiences as a Protector. Leaving that role, he commenced his studies at The University of Western Australia where, in 1952, his Honours thesis made an early case that genocide had been committed in the administration of Aboriginal people in Western Australia. In the years that followed, Marchant became an early researcher of modern China and its relationship with the West, and won respect for his archival research of French maritime history in the Asia-Pacific. This work, including the publication of France Australe in 1982, was later recognised with the award of a French knighthood, the Chevalier d’Ordre National du Mèrite, and his election as a fellow to the Royal Geographical Society. In this festschrift, scholars from The University of Notre Dame Australia appraise Marchant’s work in such areas as Aboriginal history and policy, Westminster traditions, political philosophy, Australia and China and French maritime history.

This paper examines renewable energy developments on Aboriginal lands in North-West Western Australia at three scales. It first examines the literature developing in relation to large scale renewable energy projects and the Native Title Act (1993)Cwlth. It then looks to the history of small community scale standalone systems. Finally, it examines locally adapted approaches to benefit sharing in remote utility owned networks. In doing so this paper foregrounds the importance of Aboriginal agency. It identifies Aboriginal decision making and economic inclusion as being key to policy and project development in the 'scaling up' of a transition to renewable energy resources in the North-West.

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

Geelong and the Surf Coast are treated here as one entity although there are marked differences between the two communities. Sitting on the home of the Wathaurong Aboriginal group, this G21 region is geographically diverse. Geelong serviced a wool industry on its western plains, while manufacturing and its seaport past has left it as a post-industrial city. The Surf Coast has benefitted from the sea change phenomenon. Both communities have fast growing populations and have benefitted from their proximity to Melbourne. They are deeply integrated with this major urban centre. The early establishment of digital infrastructure proved an advantage to certain sectors. All creative industries are represented well in Geelong while many creatives in Torquay are embedded in the high profile and economically dominant surfing industry. The Geelong community is serviced well by its own creative industries with well-established advertising firms, architects, bookshops, gaming arcades, movie houses, music venues, newspaper headquarters, brand new and iconic performing and visual arts centres, libraries and museums, television and radio all accessible in its refurbished downtown area. Co-working spaces, collective practices and entrepreneurial activity are evident throughout the region.

Coffs Harbour on the north coast of NSW is a highway city sandwiched between the Great Dividing Range and the Pacific Ocean. For thousands of years it was the traditional land of the numerous Gumbaynggirr peoples. Tourism now appears to be the major industry, supplanting agriculture and timber getting, while a large service sector has grown up around a sizable retirement community. It is major holiday destination. Located further away from the coast in the midst of a dairy farming community, Bellingen has become a centre of alternative culture which relies heavily on a variety of festivals activated by energetic tree changers and numerous professionals who have relocated from Sydney. Both communities rely on the visitor economy and there have been considerable changes to how local government in this region approach strategic planning for arts and culture. The newly built Coffs Harbour Education Campus (CHEC) is an experiment in encouraging cross pollination between innovative businesses and education and incorporates TAFE NSW, Coffs Harbour Senior College and Southern Cross University as well as the Coffs Harbour Technology Park and Coffs Harbour Innovation Centre all on one site. The 250 seat Jetty Memorial Theatre is the main theatre in Coffs Harbour for local and touring productions while local halls and converted theatres are the mainstay of smaller communities in the region. As peak body Arts Mid North Coast reports, there is a good record of successful arts related events which range across all genres of music, art, sculpture, Aboriginal culture, street art, literature and even busking and opera. These are mainly managed by passionate local volunteers.

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