Indigenous Australia is deadly – and Leah Purcell shows it (Documentary review)

Urban skyline, as seen from inside a medium-density apartment block, opens Australian director Leah Purcell’s Who We Are: Brave New Clan (2014), which was broadcast on Foxtel’s Bio Channel last night. The one-off documentary – which deserves another run – follows the lives of six Indigenous Australians (not connected in real life but our “clan” for the sake of the documentary). Does it work? Oh yes...

Psychometric properties of an Australian supportive care needs assessment tool for Indigenous patients with cancer

BACKGROUND There are significant disparities in cancer outcomes between Indigenous and non-Indigenous Australians. Identifying the unmet supportive care needs of Indigenous Australians with cancer is imperative to improve their cancer care. The purpose of this study was to test the psychometric properties of a supportive care needs assessment tool for Indigenous Australian (SCNAT-IP) cancer patients. METHODS The SCNAT-IP was administered to 248 Indigenous Australians diagnosed with a range of cancer types and stages, and received treatment in one of four Queensland hospitals. All 39 items were assessed for ceiling and floor effects and analysed using exploratory factor analysis (EFA) to determine construct validity. Identified factors were assessed for internal consistency and convergent validity to validated psychosocial tools. RESULTS EFA revealed a four-factor structure (physical and psychological, hospital care, information and communication, and practical and cultural needs) explaining 51% of the variance. Internal consistency of four subscales was good, with Cronbach Alpha reliability coefficients ranging from 0.70-0.89. Convergent validity was supported by significant correlations between the SCNAT-IP with the Distress Thermometer (r=0.60, p<0.001), and The Cancer Worry Chart (r=0.58, p<0.001) and a moderately strong negative correlation with Assessment of Quality of Life questionnaire (r=-0.56, p<0.001). CONCLUSION These data provide initial support for the SCNAT-IP a measure of multiple supportive care needs domains specific to Indigenous Australian cancer patients undergoing treatment.

Health care consumers’ perspectives on pharmacist integration into private general practitioner clinics in Malaysia: A qualitative study

Background Pharmacists are considered medication experts but are underutilized and exist mainly at the periphery of the Malaysian primary health care team. Private general practitioners (GPs) in Malaysia are granted rights under the Poison Act 1952 to prescribe and dispense medications at their primary care clinics. As most consumers obtain their medications from their GPs, community pharmacists’ involvement in ensuring safe use of medicines is limited. The integration of a pharmacist into private GP clinics has the potential to contribute to quality use of medicines. This study aims to explore health care consumers’ views on the integration of pharmacists within private GP clinics in Malaysia. Methods A purposive sample of health care consumers in Selangor and Kuala Lumpur, Malaysia, were invited to participate in focus groups and semi-structured interviews. Sessions were audio recorded and transcribed verbatim and thematically analyzed using NVivo 10. Results A total of 24 health care consumers participated in two focus groups and six semi-structured interviews. Four major themes were identified: 1) pharmacists’ role viewed mainly as supplying medications, 2) readiness to accept pharmacists in private GP clinics, 3) willingness to pay for pharmacy services, and 4) concerns about GPs’ resistance to pharmacist integration. Consumers felt that a pharmacist integrated into a private GP clinic could offer potential benefits such as to provide trustworthy information on the use and potential side effects of medications and screening for medication misadventure. The potential increase in costs passed on to consumers and GPs’ reluctance were perceived as barriers to integration. Conclusion This study provides insights into consumers’ perspectives on the roles of pharmacists within private GP clinics in Malaysia. Consumers generally supported pharmacist integration into private primary health care clinics. However, for pharmacists to expand their capacity in providing integrated and collaborative primary care services to consumers, barriers to pharmacist integration need to be addressed.

Perspectives on global nursing leadership: International experiences from the field

AIM Nursing leaders from six countries engaged in a year-long discussion on global leadership development. The purpose of these dialogues was to strengthen individual and collective capacity as nursing leaders in a global society. Field experiences in practice and education were shared. Perspectives on global leadership can strengthen nurses' contributions to practice, workplace and policy issues worldwide. BACKGROUND Transformational leadership empowers nurses' increasing confidence. Mentoring is needed to stimulate leadership development but this is lacking in many settings where nurses practice, teach and influence policy. Organizations with global mission provide opportunity for nurses' professional growth in leadership through international dialogues. PROCEDURES Dialogues among participants were held monthly by conference calls or videoconferences. Example stories from each participant illustrated nursing leadership in action. From these exemplars, concepts were chosen to create a framework. Emerging perspectives and leadership themes represented all contexts of practice, education, research and policy. The cultural context of each country was reflected in the examples. RESULTS Themes emerged that crossed global regions and countries. Themes were creativity, change, collaboration, community, context and courage. IMPLICATIONS FOR NURSING AND HEALTH POLICY Relationships initially formed in professional organizations can be extended to intentionally facilitate global nursing leadership development. Exemplars from the dialogues demonstrated nursing leadership in health policy development within each cultural context. Recommendations are given for infrastructure development in organizations to enhance future collaborations.

Spatiotemporal analysis of indigenous and imported dengue fever cases in Guangdong province, China

Background Dengue fever has been a major public health concern in China since it re-emerged in Guangdong province in 1978. This study aimed to explore spatiotemporal characteristics of dengue fever cases for both indigenous and imported cases during recent years in Guangdong province, so as to identify high-risk areas of the province and thereby help plan resource allocation for dengue interventions. Methods Notifiable cases of dengue fever were collected from all 123 counties of Guangdong province from 2005 to 2010. Descriptive temporal and spatial analysis were conducted, including plotting of seasonal distribution of cases, and creating choropleth maps of cumulative incidence by county. The space-time scan statistic was used to determine space-time clusters of dengue fever cases at the county level, and a geographical information system was used to visualize the location of the clusters. Analysis were stratified by imported and indigenous origin. Results 1658 dengue fever cases were recorded in Guangdong province during the study period, including 94 imported cases and 1564 indigenous cases. Both imported and indigenous cases occurred more frequently in autumn. The areas affected by the indigenous and imported cases presented a geographically expanding trend over the study period. The results showed that the most likely cluster of imported cases (relative risk = 7.52, p < 0.001) and indigenous cases (relative risk = 153.56, p < 0.001) occurred in the Pearl River Delta Area; while a secondary cluster of indigenous cases occurred in one district of the Chao Shan Area (relative risk = 471.25, p < 0.001). Conclusions This study demonstrated that the geographic range of imported and indigenous dengue fever cases has expanded over recent years, and cases were significantly clustered in two heavily urbanised areas of Guangdong province. This provides the foundation for further investigation of risk factors and interventions in these high-risk areas.

Barriers to entering affordable home ownership for young people: A preliminary study from university students’ perspectives

Over the last two decades, housing affordability has been a problem for young people, and identified as factor leading to youth homelessness. The National Youth Commission Inquiry into Youth Homelessness developed a roadmap for preventing this problem (National Youth Commission, 2008). The roadmap recommends increasing the supply of affordable housing for young people as an important strategy to reduce the risk of homelessness problems. In addition, understanding the barriers and the needs of young people is a significant part of the development of a national affordable housing strategy. This paper explores issues encountered by young people when they enter the housing market as first home buyers. A short survey was conducted to review the barriers to entry, classified by income levels, housing cost and availability of affordable housing. In the current competitive job market, young people have minimal work experience, relatively low job security and low income. In addition to these barriers, participants also suggested other barriers towards the purchase of their first home, such as lack of knowledge of legal issues and lack of government funding. This study suggests the need for both government and educational support for young people around housing choices and the development of financial strategies to manage barriers towards owning their first home.

The respiratory health of urban Indigenous children aged less than 5 years: Study protocol for a prospective cohort study

Background Despite the burden of acute respiratory illnesses (ARI) among Aboriginal and Torres Strait Islander children being a substantial cause of childhood morbidity and associated costs to families, communities and the health system, data on disease burden in urban children are lacking. Consequently evidence-based decision-making, data management guidelines, health resourcing for primary health care services and prevention strategies are lacking. This study aims to comprehensively describe the epidemiology, impact and outcomes of ARI in urban Aboriginal and Torres Strait Islander children (hereafter referred to as Indigenous) in the greater Brisbane area. Methods/design A prospective cohort study of Indigenous children aged less than five years registered with a primary health care service in Northern Brisbane, Queensland, Australia. Children are recruited at time of presentation to the service for any reason. Demographic, epidemiological, risk factor, microbiological, economic and clinical data are collected at enrolment. Enrolled children are followed for 12 months during which time ARI events, changes in child characteristics over time and monthly nasal swabs are collected. Children who develop an ARI with cough as a symptom during the study period are more intensely followed-up for 28(±3) days including weekly nasal swabs and parent completed cough diary cards. Children with persistent cough at day 28 post-ARI are reviewed by a paediatrician. Discussion Our study will be one of the first to comprehensively evaluate the natural history, epidemiology, aetiology, economic impact and outcomes of ARIs in this population. The results will inform studies for the development of evidence-based guidelines to improve the early detection, prevention and management of chronic cough and setting of priorities in children during and after ARI.

Crossing lines: Sport history, transformative narratives, and Aboriginal Australia

In this collaborative article, we seek to unsettle the dominance of Western, reconstructionist accounts of Indigenous Australian sport history through reflections on our past research in the Queensland Aboriginal community of Cherbourg. That research focussed on a statue of legendary 1930s cricketer, Eddie Gilbert, and on sport exhibitions in Cherbourg's Ration Shed Museum. Here, we are less concerned with unveiling the ‘true’ account of Australian Aboriginal sporting history, or even a ‘true’ Indigenous representation of events. Rather, we are interested in analysing various perspectives in order to generate a more inclusive and complete account of Aboriginal sport history and the narrative implications of these for Indigenous and non-Indigenous Australia. Central to this endeavour is the positioning of Indigenous knowledge and understanding at the centre of history-making. The article is in two sections: reflections on our past work from the perspectives of the researchers themselves and an Aboriginal academic colleague, followed by a discussion of how those experiences and reflections will inform our pending project on the 1950s and 1960s Cherbourg marching girls teams.

Unlocking the learning potential of incarcerated Indigenous and low SES young people; Mathematics outcomes for future success: a discussion paper

This presentation provides a beginning discussion about what the literature reports about incarcerated young people. Incarcerated Indigenous and low SES young people typically have very low literacy and mathematics skills which precludes them from future education and or employment opportunities, thus continuing the cycle of disadvantage, exclusion and despair(Payne, 2007). Being locked out of learning, they are stuck in a cycle of underachievement, a scenario which contributes to unacceptably high levels of recidivism(ACER, 2014). Success at education is considered an important protective factor against delinquent behaviours such as offending, substance abuse and truancy. Youth education and training centres provide educational opportunities for the incarcerated Indigenous youth but achievement continues to be lower than expected, particularly in mathematics. This presentation provides an introductory literature review focusing on incarcerated young people and education. It is also the preliminary writing for a small pilot project currently being conducted in one Youth Education and Training Centre in Australia.

Multiple perspectives on quality of life for residents with dementia in long term care facilities: Protocol for a comprehensive Australian study

Background Dementia is a chronic illness without cure or effective treatment, which results in declining mental and physical function and assistance from others to manage activities of daily living. Many people with dementia live in long term care facilities, yet research into their quality of life (QoL) was rare until the last decade. Previous studies failed to incorporate important variables related to the facility and care provision or to look closely at the daily lives of residents. This paper presents a protocol for a comprehensive, multi-perspective assessment of QoL of residents with dementia living in long term care in Australia. A secondary aim is investigating the effectiveness of self-report instruments for measuring QoL. Methods The study utilizes a descriptive, mixed methods design to examine how facility, care staff, and resident factors impact QoL. Over 500 residents with dementia from a stratified, random sample of 53 facilities are being recruited. A sub-sample of 12 residents is also taking part in qualitative interviews and observations. Conclusions This national study will provide a broad understanding of factors underlying QoL for residents with dementia in long term care. The present study uses a similar methodology to the US-based Collaborative Studies of Long Term Care (CS-LTC) Dementia Care Study, applying it to the Australian setting.

Archival analysis of service desk research: New perspectives on design and delivery

ur analysis of service desk studies shows the extent to which researchers have neglected important aspects of service desk design and delivery. The observations are made through an archival analysis of 58 peer reviewed publications in top tier outlets. Our analysis led to the development of a generic framework which identified three themes in service desk design: (1) user groups, (2) support models, and; (3) technology types And two themes in service desk delivery: (1) direction of delivery, and; (2) executive support level. This paper makes a twofold contribution to service desk research. First, it provides an understanding of service desk functions and the challenges faced by organisations in delivering those functions. Second, it identifies established and emerging areas in the service desk field. This archival analysis is the first attempt to systematically analyse the service desk literature.

Toward making inroads in reducing the disparity of lung health in Australian Indigenous and New Zealand Maori children

Globally, Indigenous populations, which include Aboriginal and Torres Strait islanders in Australia and Māori people in New Zealand (NZ), have poorer health than their non-Indigenous counterparts (1). Indigenous peoples worldwide face substantial challenges in poverty, education, employment, housing, and disconnection from ancestral lands (1). While addressing social determinants of health is a priority, solving clinical issues is equally important. Indeed, ignoring the latter until social issues improve risks further disparity as this may take generations. A systematic overview of interventions addressing social determinants of health found a striking lack of reliable evaluations (2). Where evidence was available, health improvement associated with interventions was modest or uncertain (2). Thus, advances in healthcare remain essential and these require the best evidence available in preventing and managing common illnesses, including respiratory illnesses

Ubuntu and business ethics: Problems, perspectives and prospects

The African philosophy of Ubuntu is typically characterised as a communitarian philosophy that emphasises virtues such as compassion, tolerance and harmony. In recent years there has been growing interest in this philosophy, and in how it can be applied to a variety of disciplines and issues. Several authors have provided useful introductions of Ubuntu in the field of business ethics and suggested theoretical ways in which it could be applied. The purpose of this paper is to extend this discussion by providing a more critical analysis of Ubuntu and business ethics with the aim of clarifying the role that Ubuntu can play, and providing guidance for further research in this area. The analysis consists of three sections. In the first, certain problems are identified within the existing literature. This is followed by a consideration of alternative perspectives and interpretations of Ubuntu. The last section, following from the first two, identifies specific areas requiring further research, both empirical and non-empirical, as well as ways in which Ubuntu could be fruitfully applied.

Alternative education engaging Indigenous young people: Flexi schooling in Queensland

This article will discuss some of the findings from a qualitative research project that explored the connections between alternative education and Indigenous learners. This study investigated how flexi school leaders reported they were supporting Indigenous young people to remain engaged in education. The results of the survey provide demographic data focusing on Indigenous participation in this sample of flexi schools. The results revealed that a high number of Indigenous young people are participating in flexi schools within this sample. Furthermore, a high number of Indigenous staff members are working in multiple roles within these schools. The implications of these findings are twofold. First, the current Indigenous education policy environment is focused heavily on ‘Closing the Gap’, emphasising the urgent need for significant improvement of educational outcomes for Indigenous young people. The findings from this study propose that flexi schools are playing a significant role in supporting Indigenous young people to remain engaged in education, yet there remains a limited focus on this within the literature and education policy. Second, the high participation rates of Indigenous young people and staff suggest an urgent need to explore this context through research. Further research will assist in understanding the culture of the flexi school context. Research should also explore why a high number of Indigenous young people and staff members participate in this educational context and how this could influence the approach to engagement of Indigenous young people in conventional school settings.