Are We Teaching Nurses to Be Racist towards Aboriginal and Torres Strait Islander Peoples? A Critical Race Document Analysis of Discrete Aboriginal and Torres Strait Islander Health Courses

Background: Racism is responsible for health inequity and the harm perpetrated upon Aboriginal and Torres Strait Islander peoples by white institutions, building on attitudes and beliefs dominated by assumptions of white superiority. The National Aboriginal and Torres Strait Islander Health Curriculum Framework ‘Curriculum Framework’, released in 2014, was introduced to provide a framework for nursing programs and included the introduction of discrete Aboriginal and Torres Strait Islander health courses to draw attention to the relationship between racism health outcomes of Aboriginal and Torres Strait Islander peoples within health care settings.  Methods: Using an Indigenist research paradigm with Colonial Critical Race Theory as the methodology and framework, this study presents a document analysis of discrete Aboriginal and Torres Strait Islander health courses taught in undergraduate nursing programs at 31 Australian Universities.  Results: This work draws on the collective activism of Aboriginal and Torres Strait Islander nurses in challenging the systemic racism embedded in the Australian nursing curriculum. We demonstrate the utility of the Racial Segregation Audit Tool (RSAT), as an innovative approach to identify and respond to racism embedded in course learning outcomes.  Conclusions: This study explores and uncovers how the learning outcomes assert the social construction of race as a tool of oppressive segregation.</p

Culturally capable and culturally safe: Caseload care for Indigenous women by Indigenous midwifery students

BACKGROUND: Evidence is emerging of the benefits to students of providing continuity of midwifery care as a learning strategy in midwifery education, however little is known about the value of this strategy for midwifery students. AIM: To explore Indigenous students' perceptions of providing continuity of midwifery care to Indigenous women whilst undertaking a Bachelor of Midwifery. METHODS: Indigenous Bachelor of Midwifery students' experiences of providing continuity of midwifery care to Indigenous childbearing women were explored within an Indigenous research approach using a narrative inquiry framework. Participants were three Indigenous midwifery students who provided continuity of care to Indigenous women. FINDINGS: Three interconnected themes; facilitating connection, being connected, and journeying with the woman. These themes contribute to the overarching finding that the experience of providing continuity of care for Indigenous women creates a sense of personal affirmation, purpose and a validation of cultural identity in Indigenous students. DISCUSSION AND CONCLUSIONS: Midwifery philosophy aligns strongly with the Indigenous health philosophy and this provides a learning platform for Indigenous student midwives. Privileging Indigenous culture within midwifery education programs assists students develop a sense of purpose and affirms them in their emerging professional role and within their community. The findings from this study illustrate the demand for, and pertinence of, continuity of care midwifery experiences with Indigenous women as fundamental to increasing the Indigenous midwifery workforce in Australia. Australian universities should provide this experience for Indigenous student midwives

Informatics tools for scientific discovery and collaboration.

Informatics tools for scientific discovery and collaboration

Predictors of retention in a randomised trial of smoking cessation in low-socioeconomic status Australian smokers

Background and aims Little is known about the factors associated with retention in smoking cessation trials, especially for low-socioeconomic status (low-SES) smokers. This study examined the factors associated with retention of low-SES smokers in the Australian Financial Interventions for Smoking Cessation Among Low-Income Smokers (FISCALS) trial. Design A two-group parallel block randomised open-label trial with allocation concealment. Setting Australia. The study was conducted primarily by telephone-based interviews with nicotine replacement therapy delivered via mail. Participants 1047 low-SES smokers interested in quitting smoking were randomised. Measurements Participants completed computer assisted telephone interviews (CATIs) at baseline, 2-month and 8-month follow-up. Smoking-related, substance use, mental or physical health, general psychological constructs, sociodemographic and recruitment sources association with retention at 8-month follow-up were examined using binary logistic regression. Findings 946 participants (90%) completed the 2-month follow-up interview and 880 participants (84%) completed the 8-month follow-up interview. Retention at 8-months was associated with higher motivation to quit (OR: 1.15; 95% CI: 1.04, 1.27 p < 0.01), more recent quit attempts (OR: 1.20; 95% CI: 1.04, 1.40 p < 0.05), increasing age (OR: 1.05; 95% CI: 1.03, 1.07 p < 0.01), and higher level of education (OR: 2.24; 95% CI: 1.45, 3.46 p < 0.01). Lower retention at 8-months occurred for those participants recruited from posters placed in Department of Human Service Centrelink Offices (OR: 0.56; 95% CI: 0.35, 0.89, p < 0.05) compared to participants recruited from Quitline services. No significant differences in retention were found for participants recruited via newspaper advertisements or word of mouth compared to Quitline services. No significant associations were found between health-related or behavioural factors and retention. Conclusions In the context of high overall retention rates from disadvantaged smokers in a randomised trial, retention was greater in those smokers with higher motivation to quit, more recent quit attempts, increased age, higher level of education and for those recruited through Quitline or newspaper advertisements. © 2016 Elsevier Lt

The effectiveness, safety and cost-effectiveness of cytisine versus varenicline for smoking cessation in an Australian population: A study protocol for a randomized controlled non-inferiority trial

Background and aims: Smoking cessation medications are effective, but often underutilized because of costs and side effects. Cytisine is a plant-based smoking cessation medication with more than 50 years of use in central and eastern Europe. While cytisine has been found to be well-tolerated and more effective than nicotine replacement therapy, direct comparisons with varenicline have not been conducted. This study evaluates the effectiveness, safety and cost-effectiveness of cytisine compared with varenicline. Design: Two-arm, parallel group, randomized, non-inferiority trial, with allocation concealment and blinded outcome assessment. Setting: Australian population-based study. Participants: Adult daily smokers (n = 1266) interested in quitting will be recruited through advertisements and Quitline telephone-based cessation support services. Intervention and comparator: Eligible participants will be randomized (1 : 1 ratio) to receive either cytisine capsules (25-day supply) or varenicline tablets (12-week supply), prescribed in accordance with the manufacturer's recommended dosing regimen. The medication will be mailed to each participant's nominated residential address. All participants will also be offered standard Quitline behavioural support (up to six 10–12-minute sessions). Measurements: Assessments will be undertaken by telephone at baseline, 4 and 7 months post-randomization. Participants will also be contacted twice (2 and 4 weeks post-randomization) to ascertain adverse events, treatment adherence and smoking status. The primary outcome will be self-reported 6-month continuous abstinence from smoking, verified by carbon monoxide at 7-month follow-up. We will also evaluate the relative safety and cost-effectiveness of cytisine compared with varenicline. Secondary outcomes will include self-reported continuous and 7-day point prevalence abstinence and cigarette consumption at each follow-up interview. Comments: If cytisine is as effective as varenicline, its lower cost and natural plant-based composition may make it an acceptable and affordable smoking cessation medication that could save millions of lives world-wide. © 2018 Society for the Study of Addictio

Long-term variability of Jupiter's northern auroral 8-μm CH4 emissions

We present a study of the long term variability of Jupiter's mid-infrared CH4 auroral emissions. 7.7–7.9 μm images of Jupiter recorded by NASA's Infrared Telescope Facility, Subaru and Gemini-South over the last three decades were collated in order to quantify the magnitude and timescales over which the northern auroral hotspot's CH4 emission varies. These emissions predominantly sound the 10- to 1-mbar pressure range and therefore highlight the temporal variability of lower-stratospheric auroral-related heating. We find that the ratio of the radiance of the poleward northern auroral emissions to a lower-latitude zonal-mean, henceforth ‘Relative Poleward Radiance’ or RPR, exhibits variability over a 37% range and over a range of apparent timescales. We searched for patterns of variability in order to test whether seasonally varying solar insolation, the 11-year solar cycle, or short-term solar wind variability at Jupiter's magnetopause could explain the observed evolution. The variability of the RPR exhibits a weak (r < 0.2) correlation with both the instantaneous and phase-lagged solar insolation received at Jupiter's high-northern latitudes. This rules out the hypothesis suggested in previous work (e.g. Sinclair et al. 2017a, 2018) that shortwave solar heating of aurorally produced haze particles is the dominant auroral-related heating mechanism in the lower stratosphere. We also find the variability exhibits negligible (r < 0.18) correlation with both the instantaneous and phase-lagged monthly-mean sunspot number, which therefore rules out a long-term variability associated with the solar cycle. On shorter timescales, we find moderate correlations of the RPR with solar wind conditions at Jupiter in the preceding days before images were recorded. For example, we find correlations of r = 0.45 and r = 0.51 of the RPR with the mean and standard deviation solar wind dynamical pressure in the preceding 7 days. The moderate correlation suggests that either: (1) only a subset of solar wind compressions lead to brighter, poleward CH4 emissions and/or (2) a subset of CH4 emission brightening events are driven by internal magnetospheric processes (e.g. Io activity) and independent of solar wind enhancements.</p

Evolving beyond antiracism: Reflections on the experience of developing a cultural safety curriculum in a tertiary education setting

There is an inextricable link between cultural and clinical safety. In Australia high-profile Aboriginal deaths in custody, publicised institutional racism in health services and the international Black Lives Matter movement have cemented momentum to ensure culturally safe care. However, racism within health professionals and health professional students remains a barrier to increasing the number of Aboriginal and Torres Strait Islander Health professionals. The Australian Health Practitioner Regulation Agency's Aboriginal and Torres Strait Islander Health Strategy's objective to ‘eliminate racism from the health system’, and the recent adoption of the Aboriginal and Torres Strait Islander peoples led cultural safety definition, has instigated systems level reflections on decolonising practice. This article explores cultural safety as the conceptual antithesis to racism, examining its origins, and contemporary evolution led by Aboriginal and Torres Strait Islander peoples in Australia, including its development in curriculum innovation. The application of cultural safety is explored using in-depth reflection, and the crucial development of integrating critical consciousness theory, as a precursor to culturally safe practice, is discussed. Novel approaches to university curriculum development are needed to facilitate culturally safe and decolonised learning and working environments, including the key considerations of non-Indigenous allyship and collaborative curriculum innovations and initiatives

The Gravitational-wave Optical Transient Observer (GOTO): Prototype performance and prospects for transient science

The Gravitational-wave Optical Transient Observer (GOTO) is an array of wide-field optical telescopes, designed to exploit new discoveries from the next generation of gravitational wave detectors (LIGO, Virgo, and KAGRA), study rapidly evolving transients, and exploit multimessenger opportunities arising from neutrino and very high energy gamma-ray triggers. In addition to a rapid response mode, the array will also perform a sensitive, all-sky transient survey with few day cadence. The facility features a novel, modular design with multiple 40-cm wide-field reflectors on a single mount. In 2017 June, the GOTO collaboration deployed the initial project prototype, with 4 telescope units, at the Roque de los Muchachos Observatory (ORM), La Palma, Canary Islands. Here, we describe the deployment, commissioning, and performance of the prototype hardware, and discuss the impact of these findings on the final GOTO design. We also offer an initial assessment of the science prospects for the full GOTO facility that employs 32 telescope units across two sites

A unified call to action from Australian nursing and midwifery leaders: Ensuring that Black lives matter

Nurses and midwives of Australia now is the time for change! As powerfully placed, Indigenous and non-Indigenous nursing and midwifery professionals, together we can ensure an effective and robust Indigenous curriculum in our nursing and midwifery schools of education. Today, Australia finds itself in a shifting tide of social change, where the voices for better and safer health care ring out loud. Voices for justice, equity and equality reverberate across our cities, our streets, homes, and institutions of learning. It is a call for new songlines of reform. The need to embed meaningful Indigenous health curricula is stronger now than it ever was for Australian nursing and midwifery. It is essential that nursing and midwifery leadership continue to build an authentic collaborative environment for Indigenous curriculum development. Bipartisan alliance is imperative for all academic staff to be confident in their teaching and learning experiences with Indigenous health syllabus. This paper is a call out. Now is the time for Indigenous and non-Indigenous nurses and midwives to make a stand together, for justice and equity in our teaching, learning, and practice. Together we will dismantle systems, policy, and practices in health that oppress. The Black Lives Matter movement provides us with a ‘now window’ of accepted dialogue to build a better, culturally safe Australian nursing and midwifery workforce, ensuring that Black Lives Matter in all aspects of health care