93 research outputs found

    If You Knew the End of the Story, Would you Still Want to Hear It?: The Importance of Narrative Time for Mental Health Care

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    The origins of this paper lie in our experiences of having heard too many stories with the same outcome or ending in the field of inquiry and practice described as “Aboriginal Mental Health.” This paper was written in an attempt to make sense of these experiences. It does so by focussing on another type of outcome or story ending in mental health care/research contexts more widely known as [Recovery]. Not to be confused with the term recovery as it is used in addiction studies, the concept of [Recovery] currently underpinning mental health care policies and reform is at once a philosophy, a practice orientation, and a guiding value and principle. This paper emerged from a range of discussions about [Recovery] as a practice orientation and a particular type of story-ending told by those who receive and provide Aboriginal mental health care in North Queensland. Poetic inquiry was used as a way to respond to the questions that arose from these discussions. In the research projects and discussions that foreground and underpin this paper, the use of poetic reasoning and writing, evolved from using poetry as a reflective tool, to a being used as a method of data collection, data construction, analysis and interpretation (even though none of these words appropriately inscribe these aspects of research within Arts informed research practices). It is also posited as an aesthetic and ethical way of (re)presenting the results of inquiring. This paper (re)presents and unpacks a particular generated poem to demonstrate the approach (as it is and was) used. As an arts-informed approach to social inquiry and to writing, the purpose of this text is to open or introduce an awkward pause in an ongoing dialogue or conversation about Aboriginal people in mental health care and to amplify the Aboriginal voices informing the development of this text

    "It's all about relationships": the place of boarding schools in promoting and managing health and wellbeing of Aboriginal and Torres Strait Islander secondary school students

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    Introduction: In recent years, Australian government policies have promoted access to secondary education through boarding schools for Aboriginal and Torres Strait Islander (hereafter respectfully termed Indigenous) students from remote communities. These students experience the poorest health of any Australian adolescent group. This exploratory study examines how boarding schools across Queensland promote and manage healthcare and wellbeing support for Indigenous students. Methods: Qualitative grounded theory methods were used to sample and collect data from the healthcare and wellbeing support staff of eight Queensland boarding schools using semi-structured interviews. Data were coded using NVIVO software and compared to identify the context, conditions, core process, strategies and outcomes of boarding schools' healthcare and wellbeing support. Preliminary findings were fed back to school staff and students' family members for discussion and response at an annual Schools and Communities meeting. Results: Boarding school health staff support Indigenous student-centred healthcare and wellbeing by weaving a relational network with students, families, school staff and external healthcare providers. Either through on-site or school-linked centres, they provide students with access to healthcare services, support wellbeing, and offer health education. Through these strategies, they enable students' participation in education and learning, receive quality healthcare improvement, "move to a better head space", and become responsible for their own healthcare. Enabling conditions are the professional and cultural capabilities of school staff, school leadership and commitment, compatibility of intersectoral systems and resourcing of healthcare and wellbeing support. Conclusions: Boarding schools are doing considerable work to improve the promotion and management of healthcare and wellbeing support for Indigenous students, but there is considerable variation across schools, impacts are not formally monitored or reported, and there are many opportunities for improvement. Working towards a best practice framework, school staff identified a need for a multi-levelled relational model of healthcare and wellbeing support to be iteratively embedded at each stage of the school cycle: at intake; enrolment; term one; and throughout the school year (including in emergencies/crises)

    Building consensus in neuromesodermal research:Current advances and future biomedical perspectives

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    International audienceThe development of the vertebrate body axis relies on the activity of different populations of axial progenitors, including neuromesodermal progenitors. Currently, the term "Neuromesodermal progenitors'' is associated with various definitions. Here, we use distinct terminologies to highlight advances in our understanding of this cell type at both the single cell and population levels. We discuss how these recent insights prompt new opportunities to address a range of biomedical questions spanning cancer metastasis, congenital disorders, cellular metabolism, regenerative medicine, and evolution. Finally, we outline some of the major unanswered questions and propose future directions at the forefront of neuromesodermal research

    Reframing health promotion research and practice in Australia and the Pacific: the value of arts-based practices

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    In health promotion research, the arts can take many forms: as the focus of the research or evaluation; as a tool of inquiry; as an avenue of dissemination; or as a combination of each of these. Each art form occurs within a place-based or social and spatial context, and it is the interdependence of form and context that gives rise to ethical and methodological tensions. In this chapter, we argue that arts-based research (ABR) is an aesthetic, iterative, and organic research process and health promotion practice that brings to the fore ethical and methodological tensions inherent in participatory research. The value of ABR lies in how it advances and enhances scientific practices and methodologies. However, there are also tensions inherent in designing studies that respond to community-led research priorities because ABR provides opportunities for ethical and methodological development/advancement

    Quality management systems in Aboriginal Community Controlled Health Services: a review of the literature

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    Background A national accreditation policy for the Australian primary healthcare (PHC) system was initiated in 2008. While certification standards are mandatory, little is known about their effects on the efficiency and sustainability of organisations, particularly in the Aboriginal Community Controlled Health Service (ACCHS) sector. Aim The literature review aims to answer the following: to what extent does the implementation of the International Organisation for Standardization 9001:2008 quality management system (QMS) facilitate efficiency and sustainability in the ACCHS sector? Methods Thematic analysis of peer-reviewed and grey literature was undertaken from Australia and New Zealand PHC sector with a focus on First Nations people. The databases searched included Medline, Scopus and three Informit sites (AHB-ATSIS, AEI-ATSIS and AGIS-ATSIS). The initial search strategy included quality improvement, continuous quality improvement, efficiency and sustainability. Results Sixteen included studies were assessed for quality using the McMaster criteria. The studies were ranked against the criteria of credibility, transferability, dependability and confirmability. Three central themes emerged: accreditation (n=4), quality improvement (n=9) and systems strengthening (n=3). The accreditation theme included effects on health service expenditure and clinical outcomes, consistency and validity of accreditation standards and linkages to clinical governance frameworks. The quality improvement theme included audit effectiveness and value for specific population health. The theme of systems strengthening included prerequisite systems and embedded clinical governance measures for innovative models of care. Conclusion The ACCHS sector warrants reliable evidence to understand the value of QMSs and enhancement tools, particularly given ACCHS (client-centric) services and their specialist status. Limited evidence exists for the value of standards on health system sustainability and efficiency in Australia. Despite a mandatory second certification standard, no studies reported on sustainability and efficiency of a QMS in PHC

    Australian Public and Smallpox

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    A national survey of 1,001 Australians found that most were concerned about a bioterrorist attack and were ill-informed about smallpox prevention and response. Since general practitioners were commonly identified as the initial point of care, they should become a focus of bioterrorism response planning in Australia

    Public engagement on global health challenges

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    <p>Abstract</p> <p>Background</p> <p>Experience with public engagement activities regarding the risks and benefits of science and technology (S&T) is growing, especially in the industrialized world. However, public engagement in the developing world regarding S&T risks and benefits to explore health issues has not been widely explored.</p> <p>Methods</p> <p>This paper gives an overview about public engagement and related concepts, with a particular focus on challenges and benefits in the developing world. We then describe an Internet-based platform, which seeks to both inform and engage youth and the broader public on global water issues and their health impacts. Finally, we outline a possible course for future action to scale up this and similar online public engagement platforms.</p> <p>Results</p> <p>The benefits of public engagement include creating an informed citizenry, generating new ideas from the public, increasing the chances of research being adopted, increasing public trust, and answering ethical research questions. Public engagement also fosters global communication, enables shared experiences and methodology, standardizes strategy, and generates global viewpoints. This is especially pertinent to the developing world, as it encourages previously marginalized populations to participate on a global stage. One of the core issues at stake in public engagement is global governance of science and technology. Also, beyond benefiting society at large, public engagement in science offers benefits to the scientific enterprise itself.</p> <p>Conclusion</p> <p>Successful public engagement with developing world stakeholders will be a critical part of implementing new services and technologies. Interactive engagement platforms, such as the Internet, have the potential to unite people globally around relevant health issues.</p

    Suppression of Methylation-Mediated Transcriptional Gene Silencing by βC1-SAHH Protein Interaction during Geminivirus-Betasatellite Infection

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    DNA methylation is a fundamental epigenetic modification that regulates gene expression and represses endogenous transposons and invading DNA viruses. As a counter-defense, the geminiviruses encode proteins that inhibit methylation and transcriptional gene silencing (TGS). Some geminiviruses have acquired a betasatellite called DNA β. This study presents evidence that suppression of methylation-mediated TGS by the sole betasatellite-encoded protein, βC1, is crucial to the association of Tomato yellow leaf curl China virus (TYLCCNV) with its betasatellite (TYLCCNB). We show that TYLCCNB complements Beet curly top virus (BCTV) L2- mutants deficient for methylation inhibition and TGS suppression, and that cytosine methylation levels in BCTV and TYLCCNV genomes, as well as the host genome, are substantially reduced by TYLCCNB or βC1 expression. We also demonstrate that while TYLCCNB or βC1 expression can reverse TGS, TYLCCNV by itself is ineffective. Thus its AC2/AL2 protein, known to have suppression activity in other geminiviruses, is likely a natural mutant in this respect. A yeast two-hybrid screen of candidate proteins, followed by bimolecular fluorescence complementation analysis, revealed that βC1 interacts with S-adenosyl homocysteine hydrolase (SAHH), a methyl cycle enzyme required for TGS. We further demonstrate that βC1 protein inhibits SAHH activity in vitro. That βC1 and other geminivirus proteins target the methyl cycle suggests that limiting its product, S-adenosyl methionine, may be a common viral strategy for methylation interference. We propose that inhibition of methylation and TGS by βC1 stabilizes geminivirus/betasatellite complexes
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