Coronary heart disease is the single greatest contributor to mortality within developed countries in our time. Type 2 diabetes mellitus and obesity, both of which are potent risk factors for coronary heart disease, are common conditions with rapidly rising rates of prevalence both globally and in Australia. Within Australia, Indigenous Australians suffer from disproportionately high rates of diabetes, obesity and coronary heart disease, the reason for which lies, in part, with changes in dietary intake and decreased levels of physical activity over the past 200 years. These disease trends have led to a substantially reduced life expectancy from an increase in excess cardiovascular deaths in Indigenous Australians. Assessment of cardiovascular risk in Indigenous Australians is complicated by ethnic differences in cardiovascular risk factors and their prevalence. There is also evidence that Indigenous Australians are genetically predisposed to diabetes. Current cardiovascular risk stratification algorithms are suboptimal, significantly underestimating risk in Indigenous Australians. This thesis aimed to address these issues. Firstly, to evaluate the efficacy of a lifestyle intervention programme to sustainably improve markers of health outcome in a cohort of Indigenous Australians who were overweight or had type 2 diabetes mellitus by improving diet and physical activity levels. Secondly, to evaluate the utility of anthropometric markers of obesity, ultrasound markers of atherosclerotic burden and serum C-reactive protein as additional cardiovascular risk stratification tools. The Healthy Lifestyle Programme (HELP) was a two year prospective intervention study designed and implemented with substantial input from the Indigenous community. The primary intervention consisted of a series of educational workshops delivered predominantly by Indigenous health workers advocating improving diet and increasing physical activity. To complement these workshops, facilities were established within the community to support dietary improvement and increased physical activity. Sustainable changes to markers of cardiovascular outcome, including significant reductions in central obesity and blood pressure were demonstrated over time. A slowing in the deterioration of renal function as marked by albuminuria was also detected. These beneficial changes were accompanied by increased physical activity and improved dietary intake. In a substudy, individuals with the apolipoprotein E4 genotype, who were dyslipidaemic at baseline, benefited from lipid profiles that improved significantly during the course of the study. Changes in blood pressure and central obesity detected during the course of the project are likely to have significant clinical impact on health outcomes considering their sustained nature. Evaluating ultrasound imaging based markers of cardiovascular risk, carotid artery intimal medial thickness was a more reliable measure of risk based on its firm correlation with established cardiovascular risk factors compared to brachial artery flow mediated vasodilatation. Carotid artery intimal medial thickness may be the better surrogate marker to improve cardiovascular risk stratification in the Indigenous population. Examining anthropometric markers of obesity, body mass index and waist circumference but not waist hip ratio correlated well with traditional cardiovascular risk factors. Furthermore, both body mass index and waist circumference predicted insulin resistance fairly well using threshold values derived from receiver operating characteristics curve analyses. Both body mass index and waist circumference were simple to perform with a high degree of reproducibility between observers and will likely be valuable additional cardiovascular risk stratification tools. Raised inflammatory stress, as marked by elevated serum C-reactive protein levels, was found in individuals with diabetes or obesity. C-reactive protein levels did not correlate with carotid artery intimal medial thickness, suggesting that C-reactive protein raises cardiovascular risk by means other than increasing atherosclerotic burden. Genotyping a small random sample of our the C-reactive protein gene promoter region. This SNP was found to independently increase serum C-reactive protein in the Framingham cohort. A genetic basis for increased inflammatory stress may contribute to coronary heart disease in Indigenous Australians. In summary, a community centred lifestyle intervention programme was efficacious in producing sustainable improvement in markers of health outcome. Examination of additional cardiovascular risk markers in the Indigenous community have provided evidence for using carotid artery intimal medial thickness, waist circumference, body mass index and serum C-reactive protein levels to improve cardiovascular risk stratification. These additional tools would allow for more specific resource allocation to target individuals at highest cardiovascular risk for preventative management. C-reactive protein gene polymorphisms, their contribution to circulating C-reactive protein levels and cardiovascular outcomes warrants further investigation in the Indigenous population. A more proactive risk management plan, which includes a lifestyle intervention component, may yield the greatest improvement in long term health outcomes if targeted at younger members of the Indigenous community.

France and Australia possess such distinctive national traits that they are not habitually compared in relation to their history, identity and culture. However, their national cinemas reveal that they have much in common. A significant number of recent films from both nations bear the mark of a similar obsessional quest for national identity that is linked to the exploration of a troubled colonial past. This shared preoccupation constitutes the starting point for this thesis, which compares the representation of colonial history in the cinema of France and Australia since 1970. It is of course evident that the two nations have had widely differing experiences of colonisation. Modern France is among the ranks of the major empire builders, and Australia is the product of one of Great Britain's most successful colonies. If neither nation can forget its colonial past, it is also for different reasons: France is the principal destination of migrants from her former colonies, and Australia faces landrights claims from her indigenous populations. If these differences provide the distinct social, political and geographical contexts of French and Australian cinema, they do not, however, impinge upon the stylistic and ideological analysis of their colonial thematics. For the purposes of this thesis, three fundamental criteria determine the inclusion of a film in the corpus: it must have an historical colonial setting; its narrative must focus principally on aspects of the colonisation process; and its director must be a descendant of the former colonisers. Around a dozen films released since 1970 in each country have been identified as matching these criteria and, for the purposes of the thesis, have been called postcolonial films. The content and structures of the films dictate the analytical approach and theories are drawn upon as tools when needed. These theories are widely varied across the disciplines and the theorists include Pierre Sorlin, Edward Saïd and Albert Memmi. The approach to representing colonial issues varies widely, with the majority of the films in the corpus neither appearing to confront openly nor to support the ideology of colonialism. Two exceptions are Coup de torchon (Tavernier, France, 1981) and The Chant of Jimmie Blacksmith (Schepisi, Australia, 1978). More typical of the ambivalent treatment of colonialism are the popularly attended films such as Indochine (Wargnier, France, 1991) and Picnic at Hanging Rock (Weir, Australia, 1975). In the first chapter an analysis of the relationship of the films to documented history demonstrates that French films are frequently set during the period between 1910 and 1950, and Australian films during the last half of the nineteenth century. The following chapter examines the relationship of the colonisers to their colonised lands and asks if the exceptional attention paid in all the films to the colonial geography has the effect of assimilating an alien landscape into the Western settlers’ culture and mythology. The following two chapters address the core element of colonial life - in Franz Fanon's terms - its division into two worlds. The first of these chapters examines the interaction between the coloniser and the colonised through individual relationships between the two, and addresses the problem that all of these relationships end in permanent separation. The following chapter explores the interaction between coloniser and colonised as social groups that are divided by notions of race and discusses the general epistemological problem of the representation of the Other. The fifth chapter analyses the symbolic mechanisms being used to structure the films and manipulate the unconscious effect on the viewer. For example, there are a number of films with journeys of some kind, orphan-like characters and characters with strong noble savage qualities. Finally, the sixth chapter compares two of the films to the books from which they are derived. The object of this double comparison is to isolate differences in the films which are better explained by changing colonial politics than by inherent differences between cinema and literature. In the conclusion, it is argued that there appear to be few sustained attempts at confronting and resolving the problematic aspects of colonialism’s legacy. This is especially evident from the predominance of fictitious stories over the depiction of actual documented events. This tendency in both the French and Australian cinemas to contain the representation of the colonial past within a fictional framework has the inevitable consequence of masking history and thus avoiding the necessity of dealing with it. A further notable tendency was the preference for selecting certain periods and avoiding others, hence stripping the colonial past of its most embarrassing aspects. For example, no film could be found which showed the initial phase of the establishment of a colony. Despite the rarity of films released in France and Australia that openly challenge colonialism as a whole, many signs are evident throughout these films that the practices and values defending or justifying colonisation are nevertheless being questioned. / Thesis (Ph.D) -- School of Humanities, 2003

Coronary heart disease is the single greatest contributor to mortality within developed countries in our time. Type 2 diabetes mellitus and obesity, both of which are potent risk factors for coronary heart disease, are common conditions with rapidly rising rates of prevalence both globally and in Australia. Within Australia, Indigenous Australians suffer from disproportionately high rates of diabetes, obesity and coronary heart disease, the reason for which lies, in part, with changes in dietary intake and decreased levels of physical activity over the past 200 years. These disease trends have led to a substantially reduced life expectancy from an increase in excess cardiovascular deaths in Indigenous Australians. Assessment of cardiovascular risk in Indigenous Australians is complicated by ethnic differences in cardiovascular risk factors and their prevalence. There is also evidence that Indigenous Australians are genetically predisposed to diabetes. Current cardiovascular risk stratification algorithms are suboptimal, significantly underestimating risk in Indigenous Australians. This thesis aimed to address these issues. Firstly, to evaluate the efficacy of a lifestyle intervention programme to sustainably improve markers of health outcome in a cohort of Indigenous Australians who were overweight or had type 2 diabetes mellitus by improving diet and physical activity levels. Secondly, to evaluate the utility of anthropometric markers of obesity, ultrasound markers of atherosclerotic burden and serum C-reactive protein as additional cardiovascular risk stratification tools. The Healthy Lifestyle Programme (HELP) was a two year prospective intervention study designed and implemented with substantial input from the Indigenous community. The primary intervention consisted of a series of educational workshops delivered predominantly by Indigenous health workers advocating improving diet and increasing physical activity. To complement these workshops, facilities were established within the community to support dietary improvement and increased physical activity. Sustainable changes to markers of cardiovascular outcome, including significant reductions in central obesity and blood pressure were demonstrated over time. A slowing in the deterioration of renal function as marked by albuminuria was also detected. These beneficial changes were accompanied by increased physical activity and improved dietary intake. In a substudy, individuals with the apolipoprotein E4 genotype, who were dyslipidaemic at baseline, benefited from lipid profiles that improved significantly during the course of the study. Changes in blood pressure and central obesity detected during the course of the project are likely to have significant clinical impact on health outcomes considering their sustained nature. Evaluating ultrasound imaging based markers of cardiovascular risk, carotid artery intimal medial thickness was a more reliable measure of risk based on its firm correlation with established cardiovascular risk factors compared to brachial artery flow mediated vasodilatation. Carotid artery intimal medial thickness may be the better surrogate marker to improve cardiovascular risk stratification in the Indigenous population. Examining anthropometric markers of obesity, body mass index and waist circumference but not waist hip ratio correlated well with traditional cardiovascular risk factors. Furthermore, both body mass index and waist circumference predicted insulin resistance fairly well using threshold values derived from receiver operating characteristics curve analyses. Both body mass index and waist circumference were simple to perform with a high degree of reproducibility between observers and will likely be valuable additional cardiovascular risk stratification tools. Raised inflammatory stress, as marked by elevated serum C-reactive protein levels, was found in individuals with diabetes or obesity. C-reactive protein levels did not correlate with carotid artery intimal medial thickness, suggesting that C-reactive protein raises cardiovascular risk by means other than increasing atherosclerotic burden. Genotyping a small random sample of our the C-reactive protein gene promoter region. This SNP was found to independently increase serum C-reactive protein in the Framingham cohort. A genetic basis for increased inflammatory stress may contribute to coronary heart disease in Indigenous Australians. In summary, a community centred lifestyle intervention programme was efficacious in producing sustainable improvement in markers of health outcome. Examination of additional cardiovascular risk markers in the Indigenous community have provided evidence for using carotid artery intimal medial thickness, waist circumference, body mass index and serum C-reactive protein levels to improve cardiovascular risk stratification. These additional tools would allow for more specific resource allocation to target individuals at highest cardiovascular risk for preventative management. C-reactive protein gene polymorphisms, their contribution to circulating C-reactive protein levels and cardiovascular outcomes warrants further investigation in the Indigenous population. A more proactive risk management plan, which includes a lifestyle intervention component, may yield the greatest improvement in long term health outcomes if targeted at younger members of the Indigenous community.

No description available.

Master of Philosophy / As Australia’s leading agency for funding health research (expending over $400 million in 2006), the National Health and Medical Research Council (NHMRC) has a major responsibility to improve the evidence base for health policy and practice. There is an urgent need for better evidence to guide policy and programs that improve the health of Indigenous peoples. In 2002, NHMRC endorsed a series of landmark policy changes to acknowledge its ongoing role and responsibilities in Indigenous health research—adopting a strategic Road Map for research, improving Indigenous representation across NHMRC Council and Principal Committees, and committing 5% of its annual budget to Indigenous health research. This thesis examines how these policies evolved, the extent to which they have been implemented, and their impact on agency expenditure in relation to People Support. Additionally, this thesis describes the impact of NHMRC policies in reshaping research practices among Indigenous populations.

Master of Philosophy / As Australia’s leading agency for funding health research (expending over $400 million in 2006), the National Health and Medical Research Council (NHMRC) has a major responsibility to improve the evidence base for health policy and practice. There is an urgent need for better evidence to guide policy and programs that improve the health of Indigenous peoples. In 2002, NHMRC endorsed a series of landmark policy changes to acknowledge its ongoing role and responsibilities in Indigenous health research—adopting a strategic Road Map for research, improving Indigenous representation across NHMRC Council and Principal Committees, and committing 5% of its annual budget to Indigenous health research. This thesis examines how these policies evolved, the extent to which they have been implemented, and their impact on agency expenditure in relation to People Support. Additionally, this thesis describes the impact of NHMRC policies in reshaping research practices among Indigenous populations.

澳洲原住民已經生存在澳洲大陸長達四萬年。他們有著自成一套的宗教系統、神話、風俗習慣、語言和藝術，遵循著使人和自然都共榮的生存方式。但是，由於白人的入侵，企圖強占他們的土地，使得澳洲原住民幾乎要絕滅。在大規模的屠殺和白人從歐洲帶來的傳染病流行之下，原住民的人口急遽減少，連他們的文化都受到威脅。因此，原住民成為澳洲社會中被邊緣化的少數族群。 因此，此篇論文要援引巴赫汀（Mikhail Bakhtin）提出的「時空型」的概念、法國史學家納拉（Pierre Nora）對於記憶的看法及相關的原住民文化，去探討傑克•戴維斯在《頭生兒三部曲》中，顯示出白澳社會對於原住民的壓迫及原住民在重建文化記憶和原住民本質的強化之下，所表現出來生存的毅力。第一章包含了白人和澳洲原住民接觸的歷史背景、傑克•戴維斯及其劇作的簡介，其他評論家對於《頭生兒三部曲》的評論。第二章中，我要援引巴赫汀的「時空型」的概念來討論在白人政府的壓迫之下，原住民所處嚴酷的社會環境及原住民弱勢的社會地位給原住民帶來的影響。第三章則援用納拉對於記憶的論點來分析戴維斯藉由說故事、舞蹈和夢境來創造「記憶場域」（lieux de mémoire）以保留原住民對於其文化的記憶。第四章則是探討原住民本質所帶來的能力增強。藉由此能力強化，原住民得到了對抗白人迫害的力量，且可以為自己發聲。第五章則是為前四章所論做總結。 / Indigenous Australians have lived in Australia for 40,000 years. They develop their own system of religion and mythology, social conventions, language and arts, observing a life that can make both the environment and human beings prosperous. But Aboriginals are driven to extinction by the White who intend to possess their land. Because of large scale of massacres and diseases, both the number of Aboriginal population and their culture are endangered. Indigenous Australians become the marginalized minority in Australian society. Therefore, with the reference to Mikhail Bakhtin’s idea of the chronotope, Pierre Nora’s concept of memory and related Aboriginal culture, this thesis aims to discuss that Jack Davis, in The First Born trilogy, presents the oppression of White Australian society to Aboriginal people and displays Aboriginals’ persistence in survival through the reconstruction of Aboriginal memory and the empowerment of Aboriginality. Chapter One includes the general historical background of the contact between the White and Aboriginals, the introduction to Jack Davis and his plays, and the criticism on Davis’s trilogy. In Chapter Two, I take advantage of Bakhtin’s idea of the chronotope to discuss the severe social environment of indigenous Australians who are oppressed by the White Australian government and the social consequences of Aboriginals’ disadvantaged position in society. Chapter Three aims to utilize Pierre Nora’s concept of memory to analyze that Davis, through stories, dances, and dream visions, creates lieux de mémoire to preserve Aboriginal memory. Chapter Four concentrates on the empowerment of Aboriginality, which offers a subversive force for Aboriginals to fight against the White persecution and have their voice heard. Chapter Five is the concluding chapter to wrap up these three plays.

En Australie du Nord, une nouvelle catégorie d'acteurs sociaux aborigènes a émergé dans les années 1990 : les « rangers ». Fondés sur la professionnalisation et la formalisation de responsabilités « traditionnelles » envers la terre et la mer, leurs emplois et programmes sont présentés comme des mécanismes de « gestion des ressources naturelles » et de conservation de la biodiversité contrôlés par les communautés autochtones, tout comme un support de « développement » local. Cette thèse propose un regard critique sur le système des rangers en partant de la question suivante : constitue-t-il une manifestation « d'impérialisme écologique » ? L'ethnographie (2009-2010) des interactions sociales mises en jeu par les activités du groupe de rangers de la communauté de Ngukurr (Terre d'Arnhem, Territoire du Nord) y est associée à une contextualisation et à une analyse articulant échelles locale, régionale et nationale et discours international. Le système des rangers reflète diverses logiques endogènes et exogènes qui dépassent ses objectifs affichés de résilience environnementale et socio-économique. Il repose sur des rapports de pouvoir et des négociations complexes entre les différents acteurs impliqués (dont l'État australien), entre « savoirs écologiques traditionnels » et science, et entre rapports sociaux locaux et bureaucratiques. Cette étude met au jour le processus de bureaucratisation et les multiples ingérences et ambivalences inhérents à ce système, qui (re)produit des distinctions et tensions sociales. Elle souligne également la fonction de médiateurs qu'endossent les rangers ainsi que l'ambiguïté de la position de chercheur dans un tel contexte. / In Northern Australia, a new category of Indigenous social actors emerged in the 1990s: “rangers”. Their jobs and programmes are based on the professionalization and formalization of “traditional” responsibilities for the land and sea. They are presented as natural resource management and biodiversity conservation mechanisms controlled by Indigenous communities and as a basis for local “development”.This thesis proposes a critical view of the ranger system, starting from the following question: is this system a form of “ecological imperialism”? The ethnography (2009-2010) of the social interactions at work in the activities of the Ngukurr community's ranger group (Arnhem Land, Northern Territory) is combined with a contextualization and an analysis linking local, regional and national levels with the international discourse.The ranger system reflects various endogenous and exogenous logics that go beyond its stated aims of environmental and socioeconomic resilience. It is based on complex power relations and negotiations between the different actors involved (including the Australian State), between “traditional ecological knowledge” and science, and between local and bureaucratic social relationships. This study reveals the bureaucratization process and the many external interventions and ambivalences inherent in this system which (re)produces social distinctions and tensions. It also highlights the mediator or broker role played by the rangers as well as the ambiguous position of the researcher in such a context.