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‘Lucy Ngarbal Marshall Oration by the Nulungu Chair of Indigenous Studies’
Get PDFIn the second Lucy Ngarbal Marshall Oration, Chair of Indigenous Studies, Steve Kinnane, will explore the historical context leading up to the Crocodile Hole Meeting in 1991 at Rugan in the East Kimberley, and intervening historical arc of self-determination over the past 30 plus years. Following the 1967 referendum and the resultant 1972 Aboriginal Affairs Planning Authority Act, Kimberley Aboriginal leaders pivoted to Canberra as they sought a regional voice beyond the colonial frame of Western Australia. These hopeful beginnings of speaking as a region beyond the often-empty promises of bilateral entanglements that characterised the Kimberley’s relationship with the nation state have shifted and changed across ‘fronts’ of action, sometimes responsive, sometimes strategic, but always regionally grounded. In 1989 Nugget H.C. Coombs’ (et al) book, Land of Promises, quoted Miriwoong Elder, Pearly Gordon’s statement that, ‘The Aboriginal people in Western Australia think this is the promised land because we have promises and broken promises. That’s all we have.’ Interweaving personal, historical and political narratives, Steve will reflect on the long Kimberley journey to move Beyond the Land of Promises, set against the need to recognise, value and generate outcomes based on community assets of cultural governance, cultural authority and Indigenous Knowledge, and the outcome of the 2023 Australian Indigenous Voice Referendum
A scoping review examining patient experience and what matters to people experiencing homelessness when seeking healthcare
No full textBackground: Homelessness is associated with signifcant health disparities. Conventional health services often fail to address the unique needs and lived experience of homeless individuals and fail to include participatory design when planning health services. This scoping review aimed to examine areas of patient experience that are most frequently reported by people experiencing homelessness when seeking and receiving healthcare, and to identify existing surveys used to measure patient experience for this cohort.
Methods: A scoping review was undertaken reported according to the PRISMA-ScR 2020 Statement. Databases were searched on 1 December 2022: MEDLINE, EMBASE, APA PsychINFO and CINAHL. Included studies focused on peo‑ ple experiencing homelessness, healthcare services and patient experience, primary research, published in English from 2010. Qualitative papers and fndings were extracted and synthesized against a modifed framework based on the National Institute for Health and Care Excellence guidelines for care for people experiencing homelessness, the Institute of Medicine Framework and Lachman’s multidimensional quality model. People with lived experience of homelessness were employed as part of the research team.
Results: Thirty-two studies were included. Of these, 22 were qualitative, seven quantitative and three mixed methods, from the United States of America (n=17), United Kingdom (n=5), Australia (n=5) and Canada (n=4). Health services ranged from primary healthcare to outpatient management, acute care, emergency care and hospital based health‑ care. In qualitative papers, the domains of ‘accessible and timely’, ‘person-centred’, and values of‘dignity and respect’ and‘kindness with compassion’ were most prevalent. Among the three patient experience surveys identifed, ‘acces‑ sible and timely’ and‘person-centred’ were the most frequent domains. The least frequently highlighted domains and values were ‘equitable’ and‘holistic’. No questions addressed the ‘safety’ domain.
Conclusions: The Primary Care Quality-Homeless questionnaire best refected the priorities for healthcare provi‑ sion that were highlighted in the qualitative studies of people experiencing homelessness. The most frequently cited domains and values that people experiencing homelessness expressed as important when seeking healthcare were refected in each of the three survey tools to varying degrees. Findings suggest that the principles of‘Kindnes
Yawardani Jan-ga – How horses are writing a new story with Aboriginal young people in the Kimberley
Get PDFEquine Assisted Learning (EAL) is an experiential learning approach that simultaneously engages sensory, neuromotor and cognitive systems to promote wellbeing outcomes. EAL is very different to office-based social and emotional wellbeing interventions and seems particularly suited to support the wellbeing of Aboriginal young people due to their flexibility, their non-confrontational non-verbal methods for feedback, and importantly, the historical ties to horses through working and living on country.
The Yawardani Jan-ga (Horses doing Healing) EAL intervention responds to the urgent needs of Aboriginal young people across the Kimberley. This study aims to evaluate the impact of the EAL intervention on the social and emotional wellbeing of Aboriginal young people
Postoperative hypothermia is associated with reduced length of stay in adult acute burn survivors
No full textBackground: The hypermetabolic response after a burn predisposes patients to hypothermia due to dysfunction of thermoregulation. Traditionally, hypothermia is avoided actively in burn care due to reported complications associated with low body temperature. The likelihood of hypothermia with acute burn surgery is compounded by general anesthesia, exposure of wound areas and prolonged operation times. However, we find limited studies exploring the effects of perioperative hypothermia on length of stay in the adult burn population.
Objective: To determine associations between postoperative hypothermia and hospital length of stay in adult burns patients.
Method: This retrospective cohort study involved patients admitted to the State Adult Burn Unit in Western Australia between 1st January 2015 to 28th February 2021. All adults who underwent surgery for acute burn, and had postoperative recovery room body temperature recorded, were included in the study. In this study, we defined normothermia as \u3e 36.5C and hypothermia as \u3c 36.0 °C with mild, moderate, and severe hypothermia being 35.0–35.9 °C, 34.0–34.9 °C and \u3c 34.0 °C, respectively. Patients with hyperthermia were excluded. Multivariable general linear models explored if hypothermia was independently associated with length of stay.
Results: Among 1486 adult patients, 1338 (90%) were normothermic postoperatively, with temperatures \u3e 36.0C. We included 148 (10%) patients with hypothermia (temperature \u3c 36.0 °C) postoperatively. Most burns in the study population were minor: 96% had burns \u3c 15% TBSA. Data modelling demonstrated that hypothermia was associated with a shorter length of hospital stay (coefficient = −0.129, p = 0.041). Conclusion: In adult acute burn patients, postoperative hypothermia was associated with reduced length of stay after surgery. The positive results of this study indicate that a review of the core temperature targets with acute burn surgery, and timing of burn patient cooling practices in general is warranted
Registered nurses confidence related to undertaking a leadership role in residential aged care: A clinical leadership self-assessment survey
No full textBackground: The Australian Royal Commission emphasizes the importance of registered nurse leadership in providing safe, high-quality care to older adults in Residential aged care. Nurse leadership has important ramifications for effective multidisciplinary care as well as recruitment and retention of the aged care workforce. Registered nurse leadership plays a crucial role in enhancing resident outcomes in Residential aged care, however there are limited studies examining self-perceptions of confidence and competence of nurses running Residential aged care, particularly after hours.
Aim: To examine registered nurse leadership via self-reported confidence and competence in Residential aged care.
Methods: A cross-sectional research design with ten facilities in Western Australia was used, including a survey tool that relied on the Clinical Leadership Competency Framework. Cronbach’s alpha test was used to ascertain internal reliability and replicability. The Strengthening the Reporting of Observational studies in Epidemiology guidelines was used to guide the study. Inferential statistics were used for data analysis. Data collection occurred over a six-month period, involving registered nurses employed by a single Residential aged care provider in Perth, Western Australia. Participants rated their leadership confidence on a 5-point Likert-type scale ranging from 1 (never) to 5 (all the time). Findings: From a sample of 100 registered nurses working in aged care after-hours, 90% reported high levels of self-confidence. The survey results showed that those who have more than 10 years of experience reported highest confidence in managing services. Registered nurses over 50 years old self-reported highest confidence in personal qualities, managing, and improving service domains.
Discussion: Registered nurses run residential aged care, and this time of aged care reform provides an opportunity to examine associations between registered nurse leadership and resident outcomes and provide avenues for improvements in working environments and resident experiences. Conclusion: The findings have important implications for Residential aged care providers in establishing effective leadership mentoring programs to support registered nurses in improving their confidence and ability
The Archaeology of the Spiritual and Working Lives of the Muslim Cameleers of Western Australia in the Late Nineteenth and Early Twentieth Centuries
Get PDFThis thesis describes the lifeways of cameleers (also identifiable as males, Muslims, Asians, ‘Afghans’) who worked in Western Australia’s transport industry in the period 1887 to 1920. With their camels’ unique capabilities in the dry and sandy terrain of Western Australia’s arid and semi-arid areas, they provided a critical service in the early mining and settlement history of Western Australia. This research has been done through the archaeological record of their campgrounds, other sites, and the historical record. The research’s four aims were to gather and compile archaeological evidence associated with the Afghans and their religious lives as Muslims; describe their lives in permanent campgrounds; their working lives; and the collapse of their industry. Research on this topic has minimal precedent in Western Australia.
Seven sites comprising campgrounds, burial grounds and mosques were surveyed. Two other sites provided criteria to distinguish Afghan and European Australian occupation. The physical remains of mosques show both traditional Asian practices plus modification to Australian conditions. The archaeology of campgrounds reveals a complex society and economy with an intricate relationship with European Australians. Mosques and other religious symbols with varying functions reveal a complex Islamic life. Historical data showed that some transplanted cultural elements, such as purdah, seclusion of women, were imported unmodified. Food cans were the dominant artefact but have been greatly disturbed by contemporaneous campground clearing and metal recycling. However, outside of the camps, artefacts related to their working lives on the road were sparse. Almost all artefacts and features dated from the period 1887 to 1920, with very little post-dating this period, indicating a clear decline in activity. Declining output from mining and the introduction of railways limited Afghans’ work in Western Australia, and eventually ended it