The ideas of Frantz Fanon and culturally safe practices for aboriginal and Torres Strait Islander people in Australia.

Mainstream mental health services in Australia have failed to provide culturally appropriate care for Aboriginal and Torres Strait Islander people despite several national reports and policies that have attempted to promote positive service development in response to the calls for change from the Aboriginal and Torres Strait Islander communities. In light of this situation, this article considers the ideas of Frantz Fanon and their potential for promoting cultural safety (Ramsden, 2002) in mainstream mental health services. This article argues that Fanon's ideas provide a conceptual strategy for nurses that prompts reflection and establishes a critical theoretical perspective linking power imbalance and inequitable social relationships in health care, thus complementing the aims of cultural safety. The purpose of this critical reflection is to guide nurses' understanding of the relationship between colonization and health status in order to change their attitudes from those that continue to support current hegemonic practices and systems of health care to those that support the health of Aboriginal and Torres Strait Islander people.

Collaboration: developing integration in multi-purpose services in rural New South Wales, Australia.

INTRODUCTION: The Multi-purpose Service (MPS) Program was introduced to rural Australia in 1991 as a solution to poor health outcomes in rural compared with metropolitan populations, difficulty in attracting healthcare staff and a lack of viability and range of health services in rural areas. The aim of this study was to describe the main concerns of participants involved in the development of multi-purpose services in rural New South Wales (NSW). This article is abstracted from a larger study and discusses the extent to which collaboration occurred within the new multi-purpose service. METHODS: A constructivist grounded theory methodology was used. Participants were from 13 multi-purpose services in rural NSW and 30 in-depth interviews were conducted with 6 community members, 11 managers and 13 staff members who had been involved in the process of developing a multi-purpose service. RESULTS: The main concern of all participants was their anticipation of risk. This anticipation of risk manifested itself in either trust or suspicion and explained their progression through a phase of collaborating. Participants who had trust in other stakeholders were more likely to embrace an integrated health service identity. Those participants, who were suspicious that they would lose status or power, maintained that the previous hospital services provided a better health service and described a coexistence of services within the multi-purpose service. CONCLUSIONS: This study provided an insight into the perceptions of community members, staff members and managers involved in the process of developing a multi-purpose service. It revealed that the anticipation of risk was intrinsic to a process of changing from a traditional hospital service to collaborating in a new model of health care provided at a multi-purpose service.

The development of nurse practitioners via flexible learning: toward an innovative Masters degree curriculum in Thailand.

The changing health system in Thailand has provided Thai people with more equitable opportunities in accessing health care services. As a result of medical practitioner shortages and a strong desire for nurses to expand their scope of practice, the Thailand Nursing and Midwifery Council (TNC) plans to increase the number of nurse practitioners at master degree level to staff primary care units (PCUs) and Health Centres around the country. Nursing master degree curricula in Thailand are currently offered using the traditional on-campus face-to-face mode of delivery and have low numbers of student enrolments. Furthermore, research indicates that many graduate nurses in Thailand are seeking entry to master degree curricula, but accessibility, convenience and availability of curricula locally are limiting enrolments. Nursing education globally is a dynamic and iterative process. Educational curricula are based on the principles of adult learning, continuing professional education and life-long learning, which advocate flexible and learner-oriented education. Flexible learning, which has the ability to closely match the professional and academic needs of the learner, has the potential to lead nursing education toward meeting the TNC policy and health system reform in Thailand. It is essential that nursing education in Thailand be revolutionised, embracing flexible delivery modes by traditional higher education providers. This paper presents a new model of health care service delivery and the mechanism used to integrate the principles of flexible learning into a new master degree curriculum for nurse practitioners (NPs) in Thailand.

The application of ecological thinking to better understand the needs of communities of older people.

AIM: This research applied ecological thinking to develop a more integrated or ecological understanding of the needs and aspirations of communities of older people. METHODS: A three-stage methodology was utilised. Stage one entailed the thematic analysis of resident satisfaction surveys collected from 1000 residents of aged living and care facilities to identify issues impacting upon their lives. In stage two these findings were critiqued through a key stakeholder forum. In stage three findings were authenticated through resident interviews and workshops. RESULTS: The findings suggest that an ecological framework for the well-being of older people living in residential communities can be conceptualised as the four domains of the physical environment, social environment, governance and active living. CONCLUSIONS: This framework for the ecology of resident well-being developed through this research informs an ecological approach to service providers' planning to promote the health and well-being of residents of communities of older people.

An interprofessional learning module on asthma health promotion.

OBJECTIVE: To develop, implement, and evaluate a new interprofessional learning module that focused on asthma health promotion called Taking Action Together for Asthma. DESIGN: Faculty members in medicine, nursing, and pharmacy courses recruited 10 students each to participate in a 3-day interprofessional learning module. Students received extensive materials including a workbook to document their expectations and experience; completed a 1-day interprofessional workshop; received training in the Triple A (Adolescent Asthma Action) program; and went into high schools and taught the Triple A program to students in interprofessional teams. ASSESSMENT: Before and after participating in the module, students completed a questionnaire consisting of 3 previously validated instruments: the Asthma Knowledge for Health Professionals Scale, Attitudes Toward Health Care Teams Scale, and Readiness for Interprofessional Learning Scale (RIPLS). Seventeen students completed both the pre- and post-module scales and significant changes were seen only in means scores for the Attitude Toward Healthcare Teams (81.0 ± 4.7 to 85.2 ± 5.9) and the Teamwork and Collaboration subscale of the RIPLS (41.4 ± 2.7 to 43.2 ± 2.7). CONCLUSION: Health promotion activities offer a viable mechanism for fostering interprofessional learning among health professions students.

Ecological aging: the settings approach in aged living and care accommodation.

As the proportion of older people increases within populations, financial demands related to the cost of health service delivery threaten global stability. This population trend challenges the traditional approach to health service delivery to older populations. This article presents the Australian context as a case study to argue that the application of a health promoting settings approach to aged care may lead to improved well-being for older people to the extent that the periods of chronic morbidity often associated with aging can be compressed into an ever shorter period of time. Promoting an ecological perspective to aged care suggests that there is no need to manage older people in isolation, as is common practice, but as integral to the way society lives, works, and plays. The article maps parallels between characteristics of health promoting settings such as Health Promoting Schools and the aged living and care industry, arguing that the setting encompassing services for the elderly is a prime location for the establishment of a new health promotion setting. Supporting life opportunities for our aged is central to such an approach. More broadly, an ecological approach orients us toward the connection between environment and health, and encourages increased attention and action within the aged living and care sector on reducing environmental impacts of this growing population. As such, the application of this approach to the aged living and care sector has the potential to reduce the threat that a dependant older population has on global sustainability.

Exploration of self-identified education needs of alcohol and other drug workers.

OBJECTIVE: It is well established that people who work with clients who are dependent on substances need to be well equipped to deal with challenging and complex situations. Our research explores the experience of alcohol and other drug workers (AODW) in order to identify how successful Australia's teaching institutions are at preparing AODWs to meet this challenge. DESIGN: Interviews were conducted to ascertain the perceived gaps in existing training programs and the perceived training needs of AODW. Using a qualitative research approach in-depth interviews were conducted with more than 20 counsellors working in six AODW rehabilitation centres in regional New South Wales. RESULTS: There was a perception among all workers that their training had been inadequate and that the preparation for employment in AODW settings had not meet the felt needs of grass-roots workers leaving them to learn through experience. CONCLUSION: Considering the recommendations of both national and state policies on AODWs in Australia there is an urgent need to develop courses relevant to the needs of workers as suggested by respondents to this research.