Suchergebnisse

Abstract
Aboriginal and Torres Strait Islanders have suffered violence and extreme prejudice in every walk of life as a result of the European colonisation of Australia. We acknowledge the ongoing colonial legacy to this suffering and discuss how cultural safety is a solution to overcoming some elements of the disadvantages that still beset Aboriginal and Torres Strait Islander people in terms of accessing health care. Accessible and culturally safe health services are critical in reducing health inequalities for First Nations' people because of the burden of ill-health they experience. 'Cultural safety' in this context refers to approaches that strengthen and respectfully engage with Aboriginal and Torres Strait Islander cultures in mainstream services. Alongside holistic Indigenous health and primary prevention approaches, a broad range of medical, socio-cultural and allied health support is needed to alleviate these inequalities. In this article, we describe how the working relationship between Aboriginal Hospital Liaison Officers and Social Workers in public hospitals in Victoria, Australia, contributes to cultural safety, and thereby improves the quality of care and a reduction in discharges against medical advice by Aboriginal patients. We conclude that elements of this model may be applicable to improving care for First Nation peoples in other countries.

The following report documents the growing up stories provided by people in the Torres Strait and Northern Peninsula Area during the trial phase of the Longitudinal Study of Indigenous Children. The trial is designed to assist the Australian Government Department of Families, Community Services and Indigenous Affairs (FaCSIA) develop a national 'Footprints in Time' Longitudinal Study of Indigenous Children. 'Footprints in Time' is the name FaCSIA has given to the Longitudinal Study of Indigenous Children. The study will work in partnership with a number of Aboriginal and Torres Strait Islander families all over the country, to collect information on the things that impact on Indigenous children's lives, and the things that help them to grow up strong. There will be two groups of children in the study—babies under one year, and children aged 4 to 5 years. 'Longitudinal' means the study will go back to these same children over a long period of time to see how they develop and grow. To get the big picture, families and carers of Indigenous children living in remote and very remote areas, in regional (country) areas, and in urban (city) areas will be asked to participate.

In recent years, Torres Strait Islanders have made a number of calls for greater governmental autonomy within the Australian federal system. This paper examines a number of these calls and government responses to them. It observes that progress towards greater autonomy has been slow and difficult and relates this to unresolved issues pertaining to three underlying analytic questions: from whom, for whom and for or over what is autonomy being sought? The paper argues that there have been, and still are, difficult unresolved issues relating to all three questions which Torres Strait Islanders need to address if autonomy is to be progressed. It also argues that the Australian federal system can accommodate greater autonomy in Torres Strait, though it will require some real innovation in Australian federal governance.

Emerging research indicates that more and more Indigenous peoples will be forced to migrate due to climate change. Current responses focus on mitigation and adaptation strategies. One such group, Torres Strait Islander people are already moving for other reasons and existing vulnerabilities compound levels of disadvantage when moving. It will be important to understand Torres Strait Islander people's experiences of contemporary movements in order to inform policy development and facilitate the process of migration and resettlement as movement increases. A synthesis of existing studies would allow the development of sensitising concepts that could inform future research in the Torres Strait Islander context. This article presents a metasynthesis of six qualitative studies of the experiences of different Indigenous and minority groups at various stages of migration, displacement and resettlement. Articles were selected on contemporary movements (2001-2011) and importantly the inclusion of first person voice. Reciprocal translation was used to synthesise common themes and a core construct. The overarching construct that became apparent from the metasynthesis was 'continuity of being' through staying connected to self, family and culture. Three themes emerged: 'freedom to be', 'staying close' and 'forming anchor'. These were enacted through people valuing their personal, social, religious and political freedom and recognising the importance of maintaining or forming strong social and family networks. When researching the experiences of Torres Strait Islanders it will be necessary to focus on motivations for moving, and understand the processes for staying connected to kin and homeland in order to achieve the desired outcomes of successful resettlement under conditions of uncertainty.

In his 1993 Boyer lecture, Getano Lui (Jnr) called for a change in the status of Torres Strait governance structures within the Australian federation, nominating the Centenary of Federation on January 1, 2001 as a possible time for change. In 1996, the Commonwealth Minister for Aboriginal and Torres Strait Islander Affairs initiated a Parliamentary Committee inquiry into greater autonomy for the people of Torres Strait, which reported favourably in 1997. This report was not, however, greeted all that favourably by Torres Strait Islanders and it now seems unlikely that any significantly new governance structures for Torres Strait will be in place by the Centenary of Federation. This paper attempts to explain why. The paper begins with a review of existing Torres Strait governance structures and the processes of political change taking place within them during the 1990s. It then considers the recommendations of the Parliamentary Committee's report and reactions to those recommendations. It argues that the Parliamentary Committee made some ill-conceived and inappropriate recommendations because it did not understand processes of political change occurring in Torres Strait during the 1990s and did not come to grips with the strength and depth of Islander feelings of distinctiveness from Aboriginal Australians. It examines government responses to the Parliamentary Committee inquiry and further Islander reactions in the light of these. In its final section, the paper argues that while there have been missed opportunities along the way, the Centenary of Federation was, in fact, always an ambitious timetable for the reform of Torres Strait governance structures. There are significant unresolved issues still to be addressed among Islanders and there have, in recent years, been other more pressing issues to attend to, such as native title. The Centenary of Federation has proven to be not so much a missed opportunity for Torres Strait governance structures as just bad timing.

In his 1993 Boyer lecture, Getano Lui (Jnr) called for a change in the status of Torres Strait governance structures within the Australian federation, nominating the Centenary of Federation on January 1, 2001 as a possible time for change. In 1996, the Commonwealth Minister for Aboriginal and Torres Strait Islander Affairs initiated a Parliamentary Committee inquiry into greater autonomy for the people of Torres Strait, which reported favourably in 1997. This report was not, however, greeted all that favourably by Torres Strait Islanders and it now seems unlikely that any significantly new governance structures for Torres Strait will be in place by the Centenary of Federation. This paper attempts to explain why. The paper begins with a review of existing Torres Strait governance structures and the processes of political change taking place within them during the 1990s. It then considers the recommendations of the Parliamentary Committee's report and reactions to those recommendations. It argues that the Parliamentary Committee made some ill-conceived and inappropriate recommendations because it did not understand processes of political change occurring in Torres Strait during the 1990s and did not come to grips with the strength and depth of Islander feelings of distinctiveness from Aboriginal Australians. It examines government responses to the Parliamentary Committee inquiry and further Islander reactions in the light of these. In its final section, the paper argues that while there have been missed opportunities along the way, the Centenary of Federation was, in fact, always an ambitious timetable for the reform of Torres Strait governance structures. There are significant unresolved issues still to be addressed among Islanders and there have, in recent years, been other more pressing issues to attend to, such as native title. The Centenary of Federation has proven to be not so much a missed opportunity for Torres Strait governance structures as just bad timing.

Issue addressed: Australia has succeeded in lowering the overall prevalence of tobacco smoking in the last four decades and has enjoyed a worldwide reputation for innovative policy. However, this success has not extended to Indigenous Australians. Method: Narrative review and critique of literature from government, public health, health promotion, marketing and communication on smoking cessation in Australia. Main points: We first consider the history of government anti-smoking measures including legislation and communication initiatives including advertising and sponsorship bans, health warnings and 'no smoking' rules affecting anti-smoking norms, culminating in the banning of branding and the advent of tobacco plain packaging. We also review the effects of excise increases and smoking cessation aids such as quit lines and nicotine replacement therapy. For each type of intervention, both population-wide and those specifically directed at Indigenous people, we consider the probable reasons for the failure to reach Aboriginal and Torres Strait Islander people or alter their smoking patterns, and make suggestions for improvements in interventions and their evaluation. Conclusion: The history of anti-smoking initiatives in Australia suggests that community-based health initiatives are likely to be more effective in addressing Indigenous people and helping smokers to quit.

This thesis concerns the relationship between ideology, values, beliefs, politics, language, discourses, public policy and health outcomes. By examining the origins of federal health policy concerning Aboriginal and Torres Strait Islander Peoples 1972-2001 I have explored the idea that the way a problem is constructed through language determines solutions enacted to solve that problem, and subsequent outcomes. Despite three decades of federal policy activity Aboriginal and Torres Strait Islander children born at the start of the 21st Century could expect to live almost 20 years less than non-Indigenous Australians. Explanations for the gap include that the colonial legacy of dispossession and disease continues to wreak social havoc and that both health policy and structures for health services have been fundamentally flawed. The research described in this thesis focuses on the role of senior Federal politicians in the health policy process. The research is grounded in theory which suggests that the values and beliefs of decision makers are perpetuated through language. Using critical discourse analysis the following hypotheses were tested: 1. That an examination of the language of Federal politicians responsible for the health of Aboriginal and Torres Strait Islander Peoples over three decades would reveal their beliefs, values and discourses concerning Aboriginal and Torres Strait Islander Peoples and their health 2. That the discourses of the Federal politicians contributed to policy discourses and frames in the Aboriginal and Torres Strait Islander health policy environment, and 3. That there is a relationship between the policy discourses of the Aboriginal and Torres Strait Islander health policy environment and health outcomes for Aboriginal and Torres Strait Islander Peoples. The hypotheses were proven. I concluded that there was a relationship between the publicly-expressed values and beliefs of politicians responsible for health, subsequent health policy and resulting health outcomes. However, a model in ...