Torres Strait Islander Heritage Research Articles

Impact of socioeconomic status on presentation, care quality and outcomes of patients attended by emergency medical services for dyspnoea: a population-based cohort study

BackgroundLow socioeconomic status (SES) has been linked to poor outcomes in many conditions. It is unknown whether these disparities extend to individuals presenting with dyspnoea. We aimed to evaluate the...

Hepatitis B genotypes in Aboriginal and Torres Strait Islander Australians: correlation with clinical course and implications for management.

The prevalence of chronic hepatitis B (CHB) in Aboriginal and Torres Strait Islander Australians in Far North Queensland (FNQ) is greater than twice that of the general Australian population. CHB is common in Torres Strait Islanders diagnosed with hepatocellular carcinoma (HCC) - and in Aboriginals with HCC living in the Northern Territory - however, Aboriginals diagnosed with HCC in FNQ very rarely have CHB. Theexplanation for this apparent disparity is uncertain. To determine the HBV genotypes in the FNQ Aboriginal and Torres Strait Islander population and their correlation with clinical phenotype. We determined the HBV genotype of Aboriginal and Torres Strait Islander Australians living with CHB in FNQ and correlated this with demographic and clinical findings. 134/197 (68%) enrolled individuals had a sufficient viral load for genotyping. All 40 people with HBV/D genotype had Aboriginal heritage, whereas 85/93 (91%) with HBV/C had Torres Strait Islander heritage (P < 0.0001). Individuals with HBV/D were younger than those with HBV/C (median (interquartile range) age: 43 (39-48) vs 53 (42-66) years, P = 0.0002). However, they were less likely to be HBeAg positive (1/40 (3%) vs 23/93 (25%), P = 0.001). All three HCCs developed in Torres Strait Islanders; two-thirds were infected with HBV/C14; genotyping was not possible in the other individual. All 10 diagnoses of cirrhosis occurred in Torres Strait Islanders, 6/10 were infected with HBV/C14, genotyping was not possible in the other four individuals. HBV genotypes in Aboriginal and Torres Strait Islander Australians in FNQ differ markedly, which could explain the significant differences in the clinical phenotype in the two populations and might be used to inform cost-effective CHB care in the region.

Students as co-creators of an Aboriginal &amp; Torres Strait heritage garden and interactive maps

Over the last decade in response to the Universities Australia National Best Practice Framework for Indigenous Cultural Competency (2011), Australian Higher Education curricula have become increasingly permeable to First Nations ways of knowing being and doing. Online Campus Floras ("Turning campus grounds into botanical learning and teaching spaces,"Quinnell, The University of Sydney, 2020) can offer valuable teaching resources for biology and for experiential place-based learning beyond biology (e.g., in ecology, human geography, storytelling) as Aboriginal and Torres Strait Islander heritage walking trails (Muecke &amp; Eadie, 2020), and as portals to translate intergenerational knowledge by offering cultural, experiential learning for everyone (Muecke &amp; Eadie, 2020). Partnerships between schools, two Australian universities (one in Brisbane and one in Sydney) and respectful working practices with First Nations knowledge holders in use of co-designed citizenship science projects to create, curate and disseminate location and information about Indigenous Knowings in plants by incorporating learning objects (photos, videos) derived from observations of campus flora at a university in Brisbane, Queensland, is the first of its kind to create a distinctive learning environment celebrating co-creation alongside Indigenous Knowings in curriculum via use of technology. The value of outdoor learning in the context of First Nations’ cultural connections to the living worlds is well-documented, with most botanical gardens and universities offering Aboriginal heritage trails (e.g., Royal Melbourne Institute of Technology("RMIT Keelbundoora scarred trees and heritage trail," 2020), Murdoch University ("Murdoch University: Ngoolak, Poolgala and Koorloo Walk Trail," 2020), Monash University ("Monash University:Aboriginal Trail," 2020)), The University of Sydney (“Patyegarang Language Trail, 2016). In addition, citizen science approaches offered the means for students and knowledge experts to collaborate in an online environment whilst working outdoors (e.g., Pettit et al., 2014; Struwe et al., 2014). Citizen science applications like iNaturalist App, resolve the challenges for collaborators (students and knowledge experts) when unable to physically meet due to remote locations and COVID-19 restrictions, to meet online and work in equal partnership to develop their digital literacies and resources. Here, First Nations plant knowledge was gathered in partnership from an external Indigenous plants/garden local consultant for Brisbane with students from our school collaborators via regular guidance and consultation. Learning objects (i.e. plants, yarning circles, native beehives) were crafted into a virtual educational tour using an online mapping system iNaturalist App to facilitate blended learning experiences. Students follow up by participating in development of appropriate inclusion of this information in the curriculum. Use of these online resources can widen participation outcomes and deeply embed Aboriginal and Torres Strait Islander perspectives into school and university curricula leading to preservation and promotion of Indigenous Knowings both to a national and international audience. Permission to disseminate and share this information as a teaching resource between First Nations, participating schools and the two participating universities was secured. Implications for further practice include co-creation and development of online Aboriginal &amp; Torres Strait Islander heritage walking trails at other universities, linking to local and national botanical gardens and Aboriginal and Torres Strait Islander resource websites.

Past, present and future challenges for Australia's indigenous heritage management national policy

PurposeAustralia appears to be encountering a crisis in the protection of certain heritage places, despite its strong reputation in heritage conservation built up since the 1970s. Consequently, this paper examines changes to national cultural heritage management policy over the last few decades to understand more about this crisis.Design/methodology/approachIndigenous (Aboriginal and Torres Strait Islander heritage) was selected as the key focus. This paper applies a cultural heritage management framework tested first in Hong Kong to measure Australian paradigm change over 45 years.FindingsIt found the 1990s shift away from the provision of independent technical advice on national heritage policy has had a major impact. This shift is based on a change in ethos away from the earlier Whitlam/National Estate broader vision of heritage responsibilities towards a narrower more conservative one at the national level. Also, it found that studies and policymaking should allow for Indigenous voices. More Indigenous input in heritage policy formulation at all levels of government would further decolonise Indigenous heritage governance to deal justly with Indigenous Australians and their heritage.Research limitations/implicationsResources did not allow for comparative studies of the non-Indigenous (historic) and natural heritage as part of the current study.Practical implicationsThe study also included a consultation paper and an online conference presentation that have raised questions about the efficacy of current national policy on Indigenous places, on which a national conversation is urgently needed. The recent review of the National Heritage Strategy by the Australian Commonwealth Government based some of its proposed options on those listed in the consultation paper to initiate this conversation in a limited way.Social implicationsOne finding is that attention to heritage policy and protection must be ongoing at all levels of government and inclusive of First People's human rights, particularly those concerning their heritage. In regard to Australia, most Aboriginal and Torres Strait Islander respondents in this study would like to see targeted funding return for more than just iconic Indigenous places and for the creation of a more independent heritage body that allows them more self-determination in the care of their heritage.Originality/valueThe paper's value is that it investigates the Australian Heritage Commission's impact in the development of Australian cultural heritage management and associated national policy. Also, it provides insights for other postcolonial or New World settler societies dealing with the same issues or any decision-makers considering establishing a national independent body to oversee heritage protection and policymaking.

Chronic hepatitis B in remote, tropical Australia; successes and challenges.

Aboriginal and Torres Strait Islander Australians living in remote locations suffer disproportionately from chronic hepatitis B (CHB). Defining the temporospatial epidemiology of the disease-and assessing the ability of local clinicians to deliver optimal care-is crucial to improving patient outcomes in these settings. The demographic, laboratory and radiology findings in all patients diagnosed with CHB after 1990, and presently residing in remote Far North Queensland (FNQ), tropical Australia, were correlated with their management and clinical course. Of the 602 patients, 514 (85%) identified as Aboriginal and Torres Strait Islander Australians, 417 (69%) of whom had Torres Strait Islander heritage. Among the 514 Aboriginal and Torres Strait Islander Australians, there were only 61 (12%) born after universal postnatal vaccination was introduced in 1985. Community CHB prevalence varied significantly across the region from 7/1707 (0.4%) in western Cape York to 55/806 (6.8%) in the Eastern Torres Strait Islands. Although 240/602 (40%) are engaged in care, with 65 (27%) meeting criteria for antiviral therapy, only 43 (66%) were receiving this treatment. Among 537 with complete data, 32 (6%) were cirrhotic, of whom 15 (47%) were engaged in care and 10 (33%) were receiving antiviral therapy. Only 64/251 (26%) in whom national guidelines would recommend hepatocellular carcinoma (HCC) surveillance are receiving screening, however, only 20 patients have been diagnosed with HCC since 1999. Vaccination has had a dramatic effect on CHB prevalence in FNQ in only a generation. However, although engagement in care is the highest in Australia, this is not translating into initiation of antiviral therapy in all those that should be receiving it, increasing their risk of developing cirrhosis and HCC. New strategies are necessary to improve the care of Indigenous Australians living with CHB to reduce the morbidity and mortality of this preventable disease.

The Destruction and Revival of Indigenous Heritage in Australia

The chapter canvasses the deterioration and destruction of Australian Aboriginal and Torres Strait Islander heritage since British colonisation. While much of the history of Indigenous heritage in Australia is associated with decline and destruction, and although much has been lost, the chapter records that over the past four decades, since the 1967 federal referendum, there has been a resurgence and revival that heritage, due to the efforts of individuals and groups in demanding change, both through political fora and in the courts. That rejuvenation has been promoted by international laws and declarations and through Australian federal, state and territory legislative initiatives and policy. However, legislative mechanisms for dealing with the protection of Aboriginal and Torres Strait Islander heritage remain inconsistent in their robustness across the Australian legal landscape.

Clinical and histological features of immune-mediated necrotising myopathy: A multi-centre South Australian cohort study

Immune-mediated necrotising myopathy (IMNM) is a recently described entity. We describe a cohort of South Australian IMNM patients in order to define the spectrum of disease, characterise features that distinguish IMNM from other idiopathic inflammatory myopathy (IIM) subtypes and identify factors associated with clinically severe disease. Subjects were identified from the South Australian Myositis Database (SAMD), a histologically defined registry. Consecutive muscle sections from patients with IMNM (n = 62), other forms of IIM (n = 60) and histologically normal muscle (n = 17) were stained using immunohistochemistry and graded. Clinical information was collected from the SAMD and through retrospective chart review. IMNM patients displayed clinical and histological heterogeneity. While most (67%) were profoundly weak at presentation, 24% exhibited mild to moderate weakness and 9% had normal power. Histological myonecrosis ranged from minor to florid. The amount of myofibre complement deposition was closely associated with clinical severity. Patients of Aboriginal and Torres Strait Islander heritage and those with anti-SRP autoantibodies present with a severe phenotype. Despite intense immunotherapy, few IMNM patients recovered full power at one year follow up. The identification of clinical, serological and histological features which are associated with severe forms of the disease may have diagnostic and therapeutic utility.

Developmental vulnerability of Australian school-entry children with hearing loss.

National data from the Australian Early Development Census (AEDC) was used to describe the sociodemographic and developmental characteristics of a cohort of Australian children entering their first year of primary school in 2012. Results, together with sociodemographic variables were reported for two groups: children with and without reported hearing loss. Data on 285232 children were analysed, with just over 1% of these children identified with hearing loss. Logistic regression analysis found that children with reported hearing loss had over double the odds than their hearing peers of being developmentally 'vulnerable' on one or more domains of the AEDC. Covariates of interest included Aboriginal and Torres Strait Islander heritage, as well as high rates of school absenteeism. Retrospective longitudinal research linking developmental outcomes with intervention efforts, such as newborn hearing screening, would be beneficial in future research.

A scoping review of Aboriginal and Torres Strait Islander health promotion programs focused on modifying chronic disease risk factors

Issue addressedNoncommunicable chronic disease underlies much of the life expectancy gap experienced by Aboriginal and Torres Strait Islander people. Modifying contributing risk factors; tobacco smoking, nutrition, alcohol consumption, physical activity, social and emotional wellbeing (SNAPS) could help close this disease gap. This scoping review identified and describes SNAPS health promotion programs implemented for Aboriginal and Torres Strait Islander people in Australia.MethodsDatabases PubMed, CINAHL, Informit (Health Collection and Indigenous Peoples Collection), Scopus, Trove and relevant websites and clearing houses were searched for eligible studies until June 2015. To meet the inclusion criteria the program had to focus on modifying one of the SNAPS risk factors and the majority of participants had to identify as being of Aboriginal and/or Torres Strait Islander heritage.ResultsThe review identified 71 health promotion programs, described in 83 publications. Programs were implemented across a range of health and community settings and included all Australian states and territories, from major cities to remote communities. The SNAPS factor addressed most commonly was nutrition. Some programs included the whole community, or had multiple key audiences, whilst others focused solely on one subgroup of the population such as chronic disease patients, pregnant women or youth. Fourteen of the programs reported no outcome assessments.ConclusionsHealth promotion programs for Aboriginal and Torres Strait Islander people have not been adequately evaluated. The majority of programs focused on the development of individual skills and changing personal behaviours without addressing the other health promotion action areas, such as creating supportive environments or reorienting health care services.So What?This scoping review provides a summary of the health promotion programs that have been delivered in Australia for Aboriginal and Torres Strait Islander people to prevent or manage chronic disease. These programs, although many are limited in quality, should be used to inform future programs. To improve evidence‐based health promotion practice, health promotion initiatives need to be evaluated and the findings published publicly.

Professional Pathways of Aboriginal Early Childhood Teachers: Intersections of Community, Indigeneity, and Complexity

Abstract: Little information is available about the employment trajectories of Aboriginal and Torres Strait islander peoples pursuing university professional qualifications. This article describes a context in which cultural space, issues of identity, pragmatics of employment, family and community and a bureaucratic regulatory environment intersect to create scenarios that are multi-facetted and layered in complexity. As has been demonstrated clearly in other arenas (Richardson & Watt, 2006), the move towards professional teacher education qualification is not linear or straightforward. To add to the knowledge base in this area, the focus in this study is on university graduates of a teacher education degree targeting people of Aboriginal and Torres Strait Islander heritage. This landscape of professional pathways offers material for educators and policy-makers to consider in the drive to ‘close the gap’ in Indigenous educational opportunity in Australia and in related circumstances elsewhere. Note that terms such as ‘Aboriginal’ and ‘Indigenous peoples’ are used as general signifiers and may not be the group terms favoured by the people to whom they refer, but have been accepted as place-holders for complex identifications of lineage and personal identification. Aboriginal peoples should also be aware that this paper may refer to people who are no longer with us.

Successfully managing Aboriginal cultural heritage—LNG and other stories

The various LNG projects in Queensland presented industry and traditional owners with a unique set of circumstances. On the one hand, LNG proponents were required to engage individually with traditional owner groups regarding cultural heritage. On the other hand, traditional owner groups were dealing with a variety of LNG proponents each seeking agreement about the same thing but in different ways. The paper examines this issue, considers a number of the pitfalls, and asks whether there is a case for standardising the management of cultural heritage. The current review of the Commonwealth Aboriginal and Torres Strait Islander Heritage Protection Act 1984 appears to support this approach. This paper will also look at the various ways cultural heritage has been managed in Queensland, as well as in other states and territories, and assesses whether there really is a better way for proponents in the oil and gas industry to manage this issue. Paul Travers was responsible for developing Queensland’s Aboriginal Cultural Heritage Act 2003. He also drafted the Aboriginal cultural heritage duty of care and cultural heritage management guidelines under the legislation. He has worked with LNG proponents and traditional owners in relation to LNG projects in Queensland. He brings an interesting and unique take on the essential elements of successful cultural heritage management.

Douglas Husak on Dispensing With the malum prohibitum Offense of Money Laundering

There are currently more than 2,000,000 inmates in jails and prisons in the United States, or about 1 person in every 138 of the population (to say nothing of the large number on probation and on parole). By contrast, in Australia, for example, only about one person in every 1,500 of the population is currently in prison. The two prison populations do share at least one significant feature in common, namely, a massive over-representation of a minority group within the total population. In the of the U.S., it is those with an African-American heritage (who constitute about 13% of the nation's population but make up almost half of the total prison population), and in Australia it is those with an Aboriginal or Torres Strait Islander heritage (who, despite constituting less than 3% of the total population, account for about 40% of the nation's--and an appalling 80% of the Northern Territory's--prison population). However, in the present context, it is not this shared feature on which I wish to focus attention; rather, it is the discrepancy in the rates of incarceration. The enormity of the discrepancy cries out for explanation given the many cultural and socio-economic similarities that the two nations share. In his stimulating book Overcriminalization: The Limits of the Criminal Law, (1) Douglas Husak claims that, at least in the U.S., a major (even if not the only) factor contributing to the high numbers in prison is what he terms 'overcriminalization' on the part of legislatures, namely, the enactment by them of too many criminal laws. To oversimplify his argument somewhat, his bold thesis is that this excess of laws has contributed to an increase in the number of violations of criminal laws, which, in turn, has resulted in the meting out of too much criminal punishment (in particular, too much imprisonment). Furthermore, this overcriminalization has caused serious injustices to become endemic within the criminal law system (because of problems in fairly enforcing the excessive numbers of laws). He advances what he terms a presumptive and intuitive case (2) in support of these contentions and then argues that one way of reducing overcriminalization is to require that criminal laws be subject to a series of constraints that would serve to limit the sorts of conduct that justifiably expose offenders to punishment by the state. He proposes four constraints that he characterizes as internal to the criminal law and three that are external to it, though he acknowledges that the distinction is somewhat artificial because the categories will sometimes overlap. (Since details of the constraints have been set out in the Introduction to this symposium, (3) I will not restate them here.) According to Husak, the seven constraints are individually and severally necessary if overcriminalization is to be reined in. In addition to mounting powerful arguments for the plausibility of each of the constraints, he contends that requiring their satisfaction would do much to rid the criminal law of some of its more egregious injustices. In particular, he claims that requiring the satisfaction of his seven constraints would lead to the proscription of indefensible strict liability and criminal paternalism offenses, and to a dramatic reduction in the number of mala prohibita (4) and risk-creation offenses presently authorized in statutes. As regards these latter, Husak does not want to deny a place among justifiable criminal law statutes to all mala prohibita and risk-creation offenses, (5) but his detailed consideration of specific examples of such offenses is aimed at showing that the onus should be shouldered by those who advocate their retention within the criminal law. Thus, for instance, he contends that the mandatory imposition of criminal punishment on persons who engage in consensual sexual intercourse with minors (which in U.S. jurisdictions constitutes statutory rape) would be unjustifiable in light of his proposed constraints because in instances involving minors who are capable of giving consent their consensual participation would afford the defendant a complete defense. …

The Law, Politics, and “Historical Wounds”: The Dja Dja Warrung Bark Etchings Case in Australia

Last year, in volume 13 of this journal, Lyndel Prott published a Case Note entitled, “The Dja Dja Warrung Bark Etchings Case.” Prott, “The Dja Dja Warrung Bark Etchings Case.” In it she set out the background to a court case in Melbourne in 2004 to 2005 under the federal Administrative Decisions (Judicial Review) Act 1977. The case related to three nineteenth-century bark items made by Aboriginal people in northern Victoria, items now held in the collections of two London museums. The items had been borrowed by Museum Victoria and brought to Australia for an exhibition in the Melbourne Museum. During the exhibition, an inspector under the Aboriginal and Torres Strait Islander Heritage Protection Act 1984 had imposed a series of successive emergency declarations. The effect of these declarations had been to prevent Museum Victoria from fulfilling its contracts to return the three items to the overseas museums who had lent them for exhibition. The case went to court after several months of unsuccessful negotiations when Museum Victoria successfully challenged the legality of continuous emergency declarations. The inspector then failed in a request to the Victorian Minister for Aboriginal Affairs to make a permanent declaration to keep the objects in Australia, or to acquire the items compulsorily under the Heritage Protection Act. The objects were then returned to Britain. I was the curator of the exhibition, Etched on Bark 1854: Kulin barks from Northern Victoria , which was held within the Aboriginal Gallery of Melbourne Museum between March and June 2004. This paper is a discussion of some of the issues raised by the exhibition and its aftermath, and it is written from the perspective of a curator and a historian. The first part of the paper sets out the historical provenance of the three items, and discusses how the items came to be collected and sent overseas in the 1850s. I then describe how the debates at the time of the emergency declarations largely ignored this historical background, suggest some reasons why this occurred, and draw out some implications for the future. Last, I consider issues arising from the claims of ‘ownership’ that were made before and during the court case. This paper builds on two conference papers, one presented to the Museums Australia Conference in Brisbane in May 2006 and the second given to the Conference of the Australian Registrar's Committee in Hobart in November 2006. An expanded version of the first paper, “History, Strong Stories and New Traditions” appears in History Australia , June 2007.

An introduction to the KidneyCheck Australia Taskforce

SUMMARY: The KidneyCheck Australia program has been launched with the aim of reducing the incidence of end‐stage renal disease (ESRD) in Australia by an early detection and prevention program aimed at high risk groups. A multidisciplinary taskforce has been established to guide the process. The target groups for the program are the general public (particularly those in high risk groups), general practitioners, nephrologists, renal nurses, students, government and industry. Six risk factors have been identified: hypertension, diabetes, a family history of renal disease, smoking, age (over 50 years) and an Aboriginal or Torres Strait Islander heritage. This new public health awareness campaign will deliver several key messages. These include the message that kidney failure can be prevented, that urine protein is a useful early indicator of renal disease and general vascular risk, that early treatment with ACE inhibitors can be renal protective, and that general practitioners should think in terms of glomerular filtration rate (GFR) rather than creatinine levels when assessing renal function.

An introduction to the Kidney Check Australia Taskforce

SUMMARY: The KidneyCheck Australia program has been launched with the aim of reducing the incidence of end‐stage renal disease (ESRD) in Australia by an early detection and prevention program aimed at high risk groups. A multidisciplinary taskforce has been established to guide the process. the target groups for the program are the general public (particularly those in high risk groups), general practitioners, nephrologists, renal nurses, students, government and industry. Six risk factors have been identified: hypertension, diabetes, a family history of renal disease, smoking, age (over 50 years) and an Aboriginal or Torres Strait Islander heritage. This new public health awareness campaign will deliver several key messages. These include the message that kidney failure can be prevented, that urine protein is a useful early indicator of renal disease and general vascular risk, that early treatment with ACE inhibitors can be renal protective, and that general practitioners should think in terms of glomerular filtration rate (GFR) rather than creatinine levels when assessing renal function.

Notes For A Code Of Ethics For Australian Archaeologists Working With Aboriginal And Torres Strait Islander Heritage

At the annual conference of the Australian Archaeological Association (AAA), held at the Wilderness Lodge, Burdekin Dam, outside Townsville in December 1990, there were discussions about the adoption of a Code of Ethics for Australian archaeologists working with Aboriginal heritage.

The Inclusion of Studies about Aborigines in the Curriculum

In its first report to the Director-General of Education, QATSICC stated that -It is important the Aboriginal and Torres Strait Islander people should be encouraged to develop and retain a pride in their own cultural heritage…There is also a need for the wider Australian society to be encouraged to appreciate and become aware of Aboriginal and Torres Strait Islander heritage in this state.