Building Relationships with Aboriginal People: A Cultural Mapping Toolbox

This article describes a cultural mapping tool developed specifically for working with Aboriginal people experiencing mental health problems. The tool has broad scope, drawing from ecological and systems approaches. It will assist social workers to understand cultural and family obligations and build relationships with Aboriginal service users. Students learning about cultural diversity have expressed concern about asking culturally-sensitive questions. Australian human service workers typically state they feel inadequate in addressing Aboriginal culture in their practice approaches. The three components of the cultural mapping toolbox, (a) the social and emotional wellbeing cluster map, (b) the community and cultural diversity map, and (c) the migration map, provide social workers with a way of supporting a culturally connected lifestyle in contemporary society

A Hard Road: Driving Local Action against Alcohol Related Problems in a Rural Town

Context is important in developing strategies to address alcohol related violence. Knowledge of local conditions is critical to action in rural areas. The aim of this study was to gather information about context specific alcohol related problems experienced by frontline workers in a regional centre to inform the local alcohol action plan. Frontline workers were invited to participate in one of five focus group discussions that investigated problems experienced as a result of other people’s alcohol use. Alcohol related problems were more frequently associated with time periods than any single group in the community. Social media was used to incite arguments between groups in different venues during the lock-out periods. The focus groups identified that the location of licensed premises and a taxi rank; and previous relationships between protagonists were the key contextual factors causing alcohol related problems. A second taxi rank was identified as a useful local management strategy. Supply reduction was suggested as a key factor in long term solutions to alcohol related problems in rural towns. The local liquor accord did not want to reduce supply of alcohol by closing late night venues earlier. Local action to reduce alcohol related problems will be limited to pragmatic solutions because supply reduction is unacceptable to those in the business of selling alcohol

The process of change for people with cognitive impairment in a residential rehabilitation program for substance problems: A phenomenographical analysis

2019 The Author(s). Cognitive impairment is prevalent among people with substance problems and a factor affecting retention in treatment. Empirical phenomenography was used to systematically explore how people with cognitive impairment viewed a novel residential rehabilitation program - Project RE PIN - designed with cognitive compensatory behaviour change activities and from a strengths-based approach. Twelve participants took part in semi-structured interviews and cross-case analysis identified the overarching theme of change. Key program elements were the safe environment, structured routines, modified psycho-educational material and staff support. Critical changes that participants attributed to the program were in dealing with their own and others\u27 emotions, experiencing daily life without drugs or alcohol and reframing their self-view. Fear and anxiety about relapse were common and few participants had strategies or support to cope in the future. This study demonstrates that program activities changed participants\u27 thoughts, feelings and behaviours about themselves and their substance use. The results indicate that RE-PIN\u27s modified content and processes can benefit people with cognitive impairments in treatment. The study highlights that some treatment users may be vulnerable to resumption of drug use despite gains made during a residential program and their desire to remain substance-free

Leading wellness in healthcare:A qualitative study of leadership practices for wellness in hospital settings

Ways of dealing with workplace stress and enhancing healthcare workers wellness are sought globally. The aim of this study was to explore healthcare leaders\u27 practice in relation to the implementation of a workplace wellness program called SEED in the context of multiple crises (bushfires and COVID-19) affecting a local health district in New South Wales, Australia. Practice theory informed interviews (n = 23), focus groups (n = 2) and co-analysis reflexive discussions (n = 2) that were conducted with thirteen leaders and twenty healthcare workers. A pragmatic approach to program implementation for healthcare workers\u27 wellness explored the process and actions that resulted from leadership practice in an inductive thematic analysis. Preliminary themes were presented in the co-analysis sessions to ensure the lived experiences of the SEED program were reflected and co-interpretation of the data was included in the analysis. Three key themes were identified. 1) Leading change-implementing a wellness program required leaders to try something new and be determined to make change happen. 2) Permission for wellness-implicit and explicit permission from leaders to engage in wellness activities during worktime was required. 3) Role-modelling wellness-leaders viewed SEED as a way to demonstrate leadership in supporting and caring for healthcare workers. SEED provided a platform for leaders who participated to demonstrate their leadership practices in supporting wellness activities. Leadership practices are critical to the implementation of healthcare wellness programs. The implementation of SEED at a time of unprecedented crisis gave leaders and healthcare workers opportunities to experience something new including leadership that was courageous, responsive and authentic. The study highlighted the need for workplace wellness programs to intentionally include leaders rather than only expect them to implement them. The practices documented in this study provide guidance to others developing, implementing and researching workplace wellness programs

The 6-minute walk test and other endpoints in Duchenne muscular dystrophy: longitudinal natural history observations over 48 weeks from a multicenter study.

IntroductionDuchenne muscular dystrophy (DMD) subjects ≥5 years with nonsense mutations were followed for 48 weeks in a multicenter, randomized, double-blind, placebo-controlled trial of ataluren. Placebo arm data (N = 57) provided insight into the natural history of the 6-minute walk test (6MWT) and other endpoints.MethodsEvaluations performed every 6 weeks included the 6-minute walk distance (6MWD), timed function tests (TFTs), and quantitative strength using hand-held myometry.ResultsBaseline age (≥7 years), 6MWD, and selected TFT performance are strong predictors of decline in ambulation (Δ6MWD) and time to 10% worsening in 6MWD. A baseline 6MWD of <350 meters was associated with greater functional decline, and loss of ambulation was only seen in those with baseline 6MWD <325 meters. Only 1 of 42 (2.3%) subjects able to stand from supine lost ambulation.ConclusionFindings confirm the clinical meaningfulness of the 6MWD as the most accepted primary clinical endpoint in ambulatory DMD trials

The SEED Wellness Model: A Workplace Approach to Address Wellbeing Needs of Healthcare Staff During Crisis and Beyond

Workplace wellness has gained new meaning and significance in the healthcare workforce in the face of the COVID-19 pandemic. Healthcare workers across the world have carried the burden of responding to the public health crisis by having to work under new pressures and constantly changing environments, take on additional shifts, risk their own health and lives, and cope with the ongoing psychological and emotional strain. The purpose of this paper is to articulate a workplace wellness model applied across hospitals in the Illawarra Shoalhaven Local Health District, a regional area in New South Wales, Australia. The description of the development, components, and lessons learned from the SEED Wellness Model illustrates one possible solution about how to provide better care for the staff thus not only preventing staff burnout and turnover, but also creating lasting organizational benefits. The detailed model description can assist in developing a larger and more rigorous evidence-base to improve staff wellness in healthcare settings, both within Australia and internationally