Respiratory Exacerbations in Indigenous Children From Two Countries With Non-Cystic Fibrosis Chronic Suppurative Lung Disease/Bronchiectasis

BACKGROUND: Acute respiratory exacerbations (AREs) cause morbidity and lung function decline in children with chronic suppurative lung disease (CSLD) and bronchiectasis. In a prospective longitudinal cohort study, we determined the patterns of AREs and factors related to increased risks for AREs in children with CSLD/bronchiectasis. METHODS: Ninety-three indigenous children aged 0.5 to 8 years with CSLD/bronchiectasis in Australia (n = 57) and Alaska (n = 36) during 2004 to 2009 were followed for > 3 years. Standardized parent interviews, physical examinations, and medical record reviews were undertaken at enrollment and every 3 to 6 months thereafter. RESULTS: Ninety-three children experienced 280 AREs (median = 2, range = 0-11 per child) during the 3-year period; 91 (32%) were associated with pneumonia, and 43 (15%) resulted in hospitalization. Of the 93 children, 69 (74%) experienced more than two AREs over the 3-year period, and 28 (30%) had more than one ARE in each study year. The frequency of AREs declined significantly over each year of follow-up. Factors associated with recurrent (two or more) AREs included age < 3 years, ARE-related hospitalization in the first year of life, and pneumonia or hospitalization for ARE in the year preceding enrollment. Factors associated with hospitalizations for AREs in the first year of study included age < 3 years, female caregiver education, and regular use of bronchodilators. CONCLUSIONS: AREs are common in children with CSLD/bronchiectasis, but with clinical care and time AREs occur less frequently. All children with CSLD/bronchiectasis require comprehensive care; however, treatment strategies may differ for these patients based on their changing risks for AREs during each year of care.

An Aboriginal nurse-led working model for success in graduating Indigenous Australian nurses

Australia needs more Indigenous nurses. This is widely recognised in both academic literature and government policy. In 2012, only 0.8 percent of the Australian nursing workforce was Indigenous (AIHW, 2012). In spite of the clear need, there is little discussion about how to successfully recruit, retain and graduate Indigenous nursing students. This paper describes a successful program being implemented at the University of Southern Queensland (USQ). Between 2000 and 2012, USQ graduated 80 Indigenous nurses and midwives, at both undergraduate and postgraduate levels. In this paper, the authors outline the journey they undertook to develop the successful program at USQ: the Indigenous Nursing Support (INS) Model: Helping Hands. They argue that four elements underpin success for Indigenous nursing students: the availability of Indigenous academics, Indigenous health content in the nursing curriculum, Indigenous-specific recruitment materials, and individual mentoring and nurturing of Indigenous students.

Lung disease in indigenous children

Children in indigenous populations have substantially higher respiratory morbidity than non-indigenous children. Indigenous children have more frequent respiratory infections that are, more severe and, associated with long-term sequelae. Post-infectious sequelae such as chronic suppurative lung disease and bronchiectasis are especially prevalent among indigenous groups and have lifelong impact on lung function. Also, although estimates of asthma prevalence among indigenous children are similar to non-indigenous groups the morbidity of asthma is higher in indigenous children. To reduce the morbidity of respiratory illness, best-practice medicine is essential in addition to improving socio-economic factors, (eg household crowding), tobacco smoke exposure, and access to health care and illness prevention programs that likely contribute to these issues. Although each indigenous group may have unique health beliefs and interfaces with modern health care, a culturally sensitive and community-based comprehensive care system of preventive and long term care can improve outcomes for all these conditions. This article focuses on common respiratory conditions encountered by indigenous children living in affluent countries where data is available.

Ad hoc communities on the road: Serendipitous social encounters to enhance tourist experiences

Driving can be a lonely activity. While there has been a lot of research and technical inventions concerning car-to-car communication and passenger entertainment, there is still little work concerning connecting drivers. Whereas tourism is very much a social activity, drive tourists and road trippers have few options to communicate with fellow travelers. Our study is placed at the intersection of tourism and driving. It aims to enhance the trip experience during driving through social interaction. This paper explores how a mobile application that allows instant messaging between travelers sharing similar context can establish a temporary, ad hoc community and enhance the road trip experience. A prototype was developed and evaluated in various user and field studies. The study’s outcomes are relevant for the design of future mobile tourist guides that benefit from community design, social encounters and recommendations.

Valuing Indigenous heritage through multimodal literacy

The study on which this presentation is based focuses on the particular ways in which students’ counter-narratives about race were embedded in multimodal and digital design in the development of a digital cultural heritage. The multimodal texts were analysed as a site for students’ views of Indigenous oppression in relation to the colonial powers and ownership of the land in Australian history. In this presentation, Kathy will demonstrate how pedagogies that explore counter-narratives of cultural heritage in the official curriculum can encourage students to reframe their own racial identity, while challenging dominant white, historical narratives of colonial conquest, race, and power. In the second part of this session, Indigenous Principal, John Davis and teachers from HymbaYumba Community Hub will provide a school-based, Indigenous panel to inspire educators with authentic ways to embed Indigenous knowledge in the curriculum.

The ultimate edge: The case for planning media for sustaining space communities

Governments and intergovernmental organisations have long recognised that space communities – the ultimate ‘settlements at the edge’ – will exist one day and have based their first plans for these on another region ‘at the edge’, the Antarctic. United States President Eisenhower proposed to the United Nations in 1960 that the principles of the Antarctic Treaty be applied to outer space and celestial bodies (State Department, n.d.). Three years later the UN adopted the Declaration of Legal Principles Governing the Activities of States in the Exploration and Use of Outer Space and in 1967 that became the Outer Space Treaty. According to the UN Office for Outer Space Affairs, ‘the Treaty was opened for signature by the three depository Governments (the Russian Federation, the United Kingdom and the United States of America) in January 1967, and it entered into force in October 1967’ (Office for Outer Space Affairs, n.d). The status of the treaty (at time of writing) was 89 signatories and 102 parties (Office for Disarmament Affairs, n.d.). Other related instruments include the Rescue Agreement, the Liability Convention, the Registration Convention and the Moon Agreement (Office for Outer Space Affairs, n.d.-a). Jumping to the present, a newsagency reported in July 2014 (Reuters, 2014) that the British Government had shortlisted eight aerodromes in its search for a potential base for the UK’s first spaceplane flights which Ministers want to happen by 2018 (UK Space Agency, 2014). The United States already has a spaceport, in New Mexico (Cokley, Rankin, Heinrich, & McAuliffe, 2013)...

Design-driven digital futures: The role of design-led innovation in the creation of online connected communities for new mobility solutions

Online communities have fundamentally changed how humans connected and are now so common they are fundamental to the human experience. As the Internet developed for Web 1.0 to Web 2.0, the functionality of these communities has far exceeded initial expectations. These communities have shifted from simply places to share information to ways to access products and services that bridge the online and offline worlds. This shift has led to the disruption of many industries with the transportation industry being one such sector. Both private transport providers and public transport systems face competition from online communities who are able to link services providers and customers more effectively and innovatively. These types of communities fall under what has been popularised as collaborative consumption or the sharing economy. The aim of this study is to explore the role of Design-led Innovation in the creation of digital futures, specifically online connected communities for successful new mobility solutions. To explore this proposition multiple data collection methods are proposed;Content Analysis, ii) A Comparative Qualitative Study consisting of Qualitative Interviews and Focus Groups / Design Workshops and iii) An Action Research Cycle of Embedded Practice. The multidisciplinary nature of this study grounds this research in a novel position contributing to new knowledge in both the field of design, and also a deeper understanding of the larger fast-growing online community phenomena.

Nutrition in remote Aboriginal communities: Lessons from Mai Wiru and the Anangu Pitjantjatjara Yankunytjatjara Lands

Objective To examine the impact of efforts to improve nutrition on the Anangu Pitjantjatjara Yankunytjatjara (APY) Lands from 1986, especially in Mai Wiru stores. Methods Literature was searched in a systematic manner. In 2012, the store-turnover method was used to quantify dietary intake of the five APY communities that have a Mai Wiru (good food) store. Results were compared with those available from 1986. Prices of a standard market basket of basic foods, implementation of nutrition policy requirements and healthy food checklists were also assessed in all seven APY community stores from 2008 and compared with available data from 1986. Results Despite concerted efforts and achievements decreasing intake of sugar and increasing the availability and affordability of healthy foods, particularly fruit and vegetables, and consequent improvements in some nutrient indicators, the overall effect has been a decrease in diet quality as indicated primarily by the increased supply and proportion of energy intake from discretionary foods, particularly sugar-sweetened beverages, convenience meals and take-away foods. Conclusions The study findings reinforce the notion that, in the absence of supportive regulation and market intervention, adequate and sustained resources are required to improve nutrition and prevent diet-related chronic disease on the APY Lands. Implications This study also provides insights into food supply/security issues affecting other remote Aboriginal communities and wider Australia.

Cough and ARI outcomes in urban Indigenous Children

Aim To identify cough epidemiology and outcomes in urban Indigenous children Methods An ongoing prospective cohort study of Indigenous children aged <5 years registered with at an urban Indigenous primary health care centre, Brisbane. Detailed baseline data are collected and, children are followed monthly for 12 months to capture ARI events. Children who develop cough as a symptom at any time over the 12 months have weekly follow-up for four weeks to ascertain cough outcomes. Results To date, 118 children have been enrolled (535 child-months of observation); Respiratory illnesses accounted for 23 (19 %) of overall reported reasons for presentation, however respiratory symptoms were present in 41 (35%) of all visits; a dry cough in 22 (18%), wet cough in 31 (26%). To date, 99 ARI’s have been recorded with an incidence of 18.4 episodes/100 child months. Seventeen children (14.4%) had persistent cough at day 28. Conclusion This is the first study to comprehensively describe the incidence and outcomes of cough in urban Indigenous children. Early data suggest respiratory illnesses are the most common illnesses for which these children seek medical advice and there is a high prevalence of wet cough.

“It puts a human face on the researched”: A qualitative evaluation of an Indigenous research governance model

Objective This study aimed to describe the Inala Aboriginal and Torres Strait Islander Community Jury for Health Research, and evaluate its usefulness as a model of Indigenous research governance within an urban Indigenous primary health care service from the perspectives of Jury members and researchers. Methods Informed by a phenomenological approach and using narrative inquiry, a focus group was conducted with Jury members and key informant interviews were undertaken with researchers who had presented to the Community Jury in its first year of operation. Results The Jury was a site of identity work for researchers and Jury members, providing an opportunity to observe and affirm community cultural protocols. Although researchers and Jury members had differing levels of research literacy, the Jury processes enabled respectful communication and relationships to form which positively influenced research practice, community aspirations and clinical care. Discussion The Jury processes facilitated transformative research practice among researchers, and resulted in transference of power from researchers to the Jury members to the mutual benefit of both. Conclusion Ethical Indigenous health research practice requires an engagement with Indigenous peoples and knowledges at the research governance level, not simply as subjects or objects of research.

Family violence in culturally and linguistically diverse communities: An evaluation of a family relationship centre

Federal legislative changes in Australia have sought to improve how family relationship centres (FRCs) can be more responsive to culturally and linguistically diverse (CALD) communities when addressing family disputes and family violence. Research on the prevalence of family violence against women from CALD backgrounds is sparse. This article seeks to contribute to the understanding of this issue by describing findings of an evaluation of the FRC at Broadmeadows conducted by the authors. The findings focus on family violence and the appropriateness of the services offered to three CALD community groups, namely Iraqi, Lebanese and Turkish. The final section provides reflections on these findings and offers suggestions about how FRC services might better cater to the family violence needs of CALD communities by developing more extensive partnerships with community groups and by expanding the range of processes they offer beyond mediation.

Recognising change and seeking affirmation: Themes for embeddding Indigenous knowledges on teaching practicum

The imperative for Indigenous education in Australia is influenced by national political, social and economic discourses as Australian education systems continue to grapple with an agreed aspiration of full participation for Aboriginal and Torres Strait Islander students. Innovations within and policies guiding our education systems are often driven by agendas of reconciliation, equity, equality in participation and social justice. In this paper, we discuss key themes that emerged from a recent Australian Office for Learning and Teaching (OLT) research project which investigated ways in which preservice teachers from one Australian university embedded Indigenous knowledges (IK) on teaching practicum . Using a phenomenological approach, the case involved 25 preservice teacher and 23 practicum supervisor participants, over a 30 month investigation. Attention was directed to the nature of subjective (lived) experiences of participants in these pedagogical negotiations and thus preservice and supervising teacher voice was actively sought in naming and analysing these experiences. Findings revealed that change, knowledge, help and affirmation were key themes for shaping discourses around Indigenous knowledges and perspectives in the Australian curriculum and defined the nature of the pedagogical relationships between novice and experienced teachers. We focus particularly on the need for change and affirmation by preservice teachers and their teaching practicum supervisors as they developed their pedagogical relationships whilst embedding Indigenous knowledges in learning and teaching.

A visual profile of Queensland Indigenous children

Purpose Little is known about the prevalence of refractive error, binocular vision, and other visual conditions in Australian Indigenous children. This is important given the association of these visual conditions with reduced reading performance in the wider population, which may also contribute to the suboptimal reading performance reported in this population. The aim of this study was to develop a visual profile of Queensland Indigenous children. Methods Vision testing was performed on 595 primary schoolchildren in Queensland, Australia. Vision parameters measured included visual acuity, refractive error, color vision, nearpoint of convergence, horizontal heterophoria, fusional vergence range, accommodative facility, AC/A ratio, visual motor integration, and rapid automatized naming. Near heterophoria, nearpoint of convergence, and near fusional vergence range were used to classify convergence insufficiency (CI). Results Although refractive error (Indigenous, 10%; non-Indigenous, 16%; p = 0.04) and strabismus (Indigenous, 0%; non-Indigenous, 3%; p = 0.03) were significantly less common in Indigenous children, CI was twice as prevalent (Indigenous, 10%; non-Indigenous, 5%; p = 0.04). Reduced visual information processing skills were more common in Indigenous children (reduced visual motor integration [Indigenous, 28%; non-Indigenous, 16%; p < 0.01] and slower rapid automatized naming [Indigenous, 67%; non-Indigenous, 59%; p = 0.04]). The prevalence of visual impairment (reduced visual acuity) and color vision deficiency was similar between groups. Conclusions Indigenous children have less refractive error and strabismus than their non-Indigenous peers. However, CI and reduced visual information processing skills were more common in this group. Given that vision screenings primarily target visual acuity assessment and strabismus detection, this is an important finding as many Indigenous children with CI and reduced visual information processing may be missed. Emphasis should be placed on identifying children with CI and reduced visual information processing given the potential effect of these conditions on school performance

Productivity, carbon assimilation and intra-annual change in tropical reef platform seagrass communities of the Torres Strait, north-eastern Australia

Detailed data on seagrass distribution, abundance, growth rates and community structure information were collected at Orman Reefs in March 2004 to estimate the above-ground productivity and carbon assimilated by seagrass meadows. Seagrass meadows were re-examined in November 2004 for comparison at the seasonal extremes of seagrass abundance. Ten seagrass species were identified in the meadows on Orman Reefs. Extensive seagrass coverage was found in March (18,700 ha) and November (21,600 ha), with seagrass covering the majority of the intertidal reef-top areas and a large proportion of the subtidal areas examined. There were marked differences in seagrass above-ground biomass, distribution and species composition between the two surveys. Major changes between March and November included a substantial decline in biomass for intertidal meadows and an expansion in area of subtidal meadows. Changes were most likely a result of greater tidal exposure of intertidal meadows prior to November leading to desiccation and temperature-related stress. The Orman Reef seagrass meadows had a total above-ground productivity of 259.8 t DW day-1 and estimated carbon assimilation of 89.4 t C day-1 in March. The majority of this production came from the intertidal meadows which accounted for 81% of the total production. Intra-annual changes in seagrass species composition, shoot density and size of meadows measured in this study were likely to have a strong influence on the total above-ground production during the year. The net estimated above-ground productivity of Orman Reefs meadows in March 2004 (1.19 g C m-2 day-1) was high compared with other tropical seagrass areas that have been studied and also higher than many other marine, estuarine and terrestrial plant communities.

Indigenous legal education at UNSW: A work in progress

Since the 1970s Australian law schools have provided alternative entry routes and, since the 1980s, pre-law programs and bridging programs. On-going support, once Indigenous students reach university law schools, has been an issue that has not been formally or appropriately addressed in most university law schools. In this way Indigenous students’ chances of entry are disguised as chances of success. Thus once Indigenous students start their law school studies, they are often expected to perform on a level playing field – their success or failure then depends on ‘gifts, merits or skills’ which are culturally appropriate for law school. This attitude fails to recognise the privilege which allows the development of such gifts, merits or skills...