Document analysis: The regulatory and policy framework for the delivery of community transport programs in the New England region

Government considers volunteer involvement as civic participation or social capital, yet little is known about the experience of volunteer drivers in community transport services in rural communities. This paper describes a study that examined policy framework that fosters sustainable and safe work practices for volunteer drivers in community transport programs. The study analysed policy documents of four major rural community transport organisations. Rural Community Transport services are non government organisations and operate in a highly regulated environment. They deliver a range of services including driving disadvantaged clients to health appointments. These trips often require long distances and long days for the drivers. In these situations volunteers and their passengers are exposed to increased levels of risk. Document analysis was undertaken of volunteer policies of four community transport services. These policies were assessed against the Home and Community Care National Service Standards. The key finding was that operational policies lacked consistency, and the role of the volunteers was variable across services located in the same region. Two governance models were identified in the analysis; those auspice by a local council with an advisory committee and incorporated bodies with a management committee. The governance type was not found to be a major influence on the operationalised performance of policy. This study provided the foundation for ongoing research into the impact of the policy environment on the community transport volunteers who provide this valuable community service. Evidence is required to inform government understanding of the experience of volunteer drivers and to give consideration to the occupation health and safety implications for volunteers in providing this service

Culture, communication and child health

Cultural beliefs and values implicitly and explicitly shape every aspect of the way we parent our children and how we communicate about parenting. To support parents appropriately in this new and challenging role, child health services for parents in Australia need to do more than acknowledge a diverse range of cultural practices. While many health professionals believe they act in culturally sensitive ways, we need to closely examine this belief, question the cultural assumptions implicit in the information we give, and assess the extent to which our interactions are culturally appropriate. In this paper, we present a critical review of the literature on health care provision for migrant women and families. We then suggest a need to re-examine the values, beliefs and attitudes within cultural frameworks that inform how child health professionals communicate. Specifically, communication between child health professionals and migrant parents requires further analysis. We suggest that professionals need to reflect on the cultural self rather than solely on the culture of others

My Children Matter: An Autoethnography on Becoming a Childless Mother

My three children died of unrelated causes in 1971, 1983, and 2005. This thesis is an autoethnography in which I reclaim my identity as a mother, change my gaze to my children's lives rather than their deaths and explore how the culture of the last four decades influenced my experience. As I research my life, I seek answers from the academic literature to create meaning from my experience. At the core of this research are three stories about mothering each child within the culture in which they lived and died. Although the generalizability of my experiences is problematic, I hope that my writing resonates with the experience of readers

Crafting Practice in Trauma Therapy: A dialogical and relational engagement with ethics and poetic, sacred, spiritual and unnamed moments in therapeutic relationships

This study utilised narrative inquiry to explore trauma therapists' engagement with poetic, sacred, spiritual and unnamed moments in therapy. The research focuses on therapists, their therapeutic relationships and the ways they make their therapy practice and their practice ethics through the making and doing of their therapy. The thesis presents a poetic conceptual frame for the analysis of therapist's experiences of making (poiésis) and the generative discoveries produced within their therapeutic relationships. Interviews were designed as dialogical and relational conversations with colleagues. The study explored: therapist's practices in violence and abuse contexts and poetic, sacred, spiritual and unnamed moments in therapy; whether therapists deliberately include practices to evoke unnamed moments in therapy, and how do therapists make sense of and interpret their experience with vicarious traumatisation. Using Polkinghorne (1995), the analysis produced three configured plots related to: resonance and transformation in the therapeutic relationship; therapy as threshold experience: narratives of self-discovery, practice and identity; and a relational and dialogical engagement with vicarious traumatisation: therapists and their practices. This study has been intimately concerned with the making and doing of therapy practice and identified three practice components from the findings of the research, they are: In the making and doing of authentic therapy practices transformation occurs for both therapist and client and this leads to the emergence of unnamed moments in therapeutic relationships; unnamed moments offer therapist's threshold experiences of self-discovery related to their sense of self, identity and their therapy practices; and therapists' engagement with their ethical commitments and therapy practices are an integral part of the way they account for and live out their relationship to vicarious traumatisation

Troublesome breasts: older women living in the liminal state of being 'at risk' of breast cancer

It is almost unthinkable to consider any condition of the breast without simultaneously evoking the dread of breast cancer. The ways in which women's experience of 'benign breast disease' and 'risk' disrupt the notion of a previously predictable and familiar relationship with the self/body form the subject of this paper. A discursive analysis of both terms is followed by a case study which illustrates and analyses the subject positions one woman takes up as she lives the everyday/every night embodiment of troublesome breasts.Troublesome breasts are experienced as enduring, and simultaneously immediate, embodied reminders of uncertainty. A diagnosis of 'benign breast disease' may offer a sense of relief and reassurance for women because it is not, in this moment, breast cancer. But it is a slippery and difficult position to hold because of the embodied fear that it may, at any time, become cancer. Thus closure is always partial. Women's very engagement with ongoing surveillance ensures that the body remembers; and the ongoing bodily production of memory reaches beyond any physical symptom or particular encounter with the clinic

Assessing

Australian nurses have used the nursing process since the 1980s as a way of systematically thinking about what to do for patients they provide care for. Over time expert clinical nurses and nurse scholars have described the basic process and the terms that name its components in a number of different ways. Yet the nursing process remains a dynamic, cyclic and ongoing process of problem solving in practice. The purpose of the nursing process is to identify a patient's health status and actual or potential health care problems/needs/strengths, to establish plans to meet the identified needs, and to deliver specific nursing interventions to meet those needs. The nurse's evaluation of care will lead to changes in the implementation of care, as the patient's needs change during their stay in hospital with improvement or deterioration in their health status. The nursing process not only focuses on ways to improve the patient's physical needs, but also on social, cultural, emotional and spiritual needs as well. Accordingly, the nursing process is: • cyclic and dynamic • goal directed and patient centred • interpersonal and collaborative • universally applicable • systematic. In this chapter, the patient may be an individual, a family or a group

Assessing Clients with Bowel Elimination Disorders

After foods are eaten and broken down into usable elements, nutrients are absorbed and indigestible materials are eliminated. Bowel elimination is the end process in digestion. This chapter describes the structure and function of the large intestine, including the rectosigmoid region and the anus, as well as the assessment of bowel function. The anatomy and physiology of the small intestine are discussed in relation to nutrition in Chapter 21; the information in this chapter is provided as a base for understanding health problems from altered bowel function. In addition, this chapter discusses the function of the small intestine in the absorption of digested end products. Malabsorption (impaired absorption of nutrients) is discussed fully in Chapter 26

Intercultural communication in child and family health: insights from postcolonial feminist scholarship and three-body analysis

Londo

'Culture it's a big term isn't it'? An analysis of child and family health nurses' understandings of culture and intercultural communication

Understandings of culture and multiculture are broad and deeply embedded in every day talk and practices. In an increasingly globalised world, how we understand and work with these terms affects how parents and their families experience health care services and the support intended by health care professionals. This is particularly important for parents who are new to Australia. In this paper we report on findings from an ethnographic study undertaken across two community child and family health nursing sites in South Australia. Using examples, we explore how child and family health nurses appear to understand and use constructs of culture and multiculture during everyday, intercultural communication with parents who are new to Australia and Australian health services. By analysing these understandings through postcolonial and feminist theories we found pervading evidence that neo-colonial constructs of a white western monoculture shaped intercultural communication practice. We conclude by reflecting on how these constructs might be addressed to improve intercultural communication in child and family health settings