This study, completed in 2008, aims to address gaps in the literature on caring concerning the reluctance of CALD communities in Australia to use formal care. It hypothesises that broader cultural considerations, rather than merely language barriers and lack of information, are responsible for the preference of CALD communities for informal care. The literature on caring, mediated by certain aspects of Bourdieu??s habitus, is employed as a conceptual framework to analyse the informal and formal strategies employed by carers from the Italian and Greek speaking communities. The study concludes that habitus, informed by cultural factors, influences both the means of access to formal care and the type of formal care acceptable to these communities but differs between communities and between generations within each community. However,second and third order influences can lead to modification of habitus and caring strategies

This study, completed in 2008, aims to address gaps in the literature on caring concerning the reluctance of CALD communities in Australia to use formal care. It hypothesises that broader cultural considerations, rather than merely language barriers and lack of information, are responsible for the preference of CALD communities for informal care. The literature on caring, mediated by certain aspects of Bourdieu??s habitus, is employed as a conceptual framework to analyse the informal and formal strategies employed by carers from the Italian and Greek speaking communities. The study concludes that habitus, informed by cultural factors, influences both the means of access to formal care and the type of formal care acceptable to these communities but differs between communities and between generations within each community. However,second and third order influences can lead to modification of habitus and caring strategies

Bakgrund: I dagens samhälle med globalisering och en ökad invandring från andra länder så interagerar olika individer och grupper som inte har samma livsåskådning, tro ellervärderingar. Detta skapar ett ökat behov för en palliativ vård som är betydligt mer kulturkänslig, där sjuksköterskan och det multidisciplinära teamet kan bemöta både patienter från en annan kulturell etnicitet i ett palliativt skede och deras närstående på ett icke-dömande sätt. Konflikter och etiska svårigheter i omvårdnaden av dessa patienter kan riskera att påverka livets sista tid negativt. Syfte: Syftet är att belysa sjuksköterskan och det multidisciplinära teamets utmaningar i mötet med patienter från en annan kulturell etnicitet i palliativt skede. Metod: Studien är genomförd som en induktiv litteraturöversikt. Femton artiklar inkluderades och en tematisk innehållsanalysen utfördes enligt Bettany-Saltikov och McSherry. Resultat: Fyra huvudteman utformades i resultatet. Resultatet visade på utmaningar i det palliativa mötet, i kommunikationen, kulturell kompetens och kulturella utmaningar med patienter från en annan kulturell etnicitet. I det palliativa mötet framkom det att ordet palliativ inte har någon tydlig översättning inom flera olika språk och kulturer, vilket försvårade för sjuksköterskan och teamets i deras arbete. Kommunikation visade att det var svårt att göra ett bra arbete när man multidisciplinärt team varken kunde förmedla eller få korrekt tolkad information gällande sjukdomen, symtom eller förlopp till patienten. En kulturell medvetenhet var av stor betydelse samt vikten av att en god kulturell kompetens inom hela teamet var av stor vikt för att kunna bemöta och ge dessa patienter från en annan kulturell etnicitet i palliativt skede och deras närstående en god vård. Slutsats: Det framkom att både sjuksköterskan och teamet upplevde svårigheter med att möta och vårda patienter från en annan kulturell etnicitet och deras närstående på grund av kommunikationshinder och kulturella skillnaderna. Resultatet påvisade också att det fanns stora brister i kommunikationen både gällande den språkliga delen och uttrycksdelen men att även den kulturella delen brister. Kunskaper gällande religion och kultur hos personalen samt teamet runt omkring patienten är otillräcklig. / Background: In society today with the globalization and increased immigration from other countries, different individuals and groups who do not have the same outlook on life, beliefs or values interact. This creates an increased need for palliative care that is significantly more culturally sensitive, where the nurse and the multidisciplinary team can respond to both patients from another cultural ethnicity at a palliative stage and their relatives in a nonjudgmental way. Conflicts and ethical difficulties in the care of these patients may have a negative effect on the last days of life. Aim: The purpose is to shed light on the nurse and the multidisciplinary team's challenges in the meeting with patients from another cultural ethnicity in a palliative phase. Method: The study is conducted as an inductive literature review. Fifteen articles were included, and a thematic content analysis was performed according to Bettany-Saltikov and McSherry. Results: Four main themes were formulated in the result. The result showed challenges in the palliative encounter, in communication, cultural competence and cultural challenges with patients from another cultural ethnicity. In the palliative meeting, it emerged that the word palliative doesn`t have a clear translation in several different languages and cultures, which made it difficult for the nurse and the team in their work. Communication showed that it was difficult to do a good job when a multidisciplinary team could neither convey nor get correctly interpreted information regarding the disease, symptoms or course to the patient. A cultural awareness was of great importance and the importance of good cultural competence within the entire team was of great importance to be able to meet and give these patients from another cultural ethnicity in the palliative care stage and their relatives a good care. Conclusion: It emerged that both the nurse and the team experienced difficulties in meeting and caring for patients from another cultural ethnicity and their relatives due to communication barriers and cultural differences. The results also showed that there were major shortcomings in the communication, in terms of the linguistic part and the expressive part, but that the cultural part was also short. Knowledge regarding religion and culture of the staff and the team around the patient is insufficient.

Abstract The original intention for the Partnership Community Worker (PCW) project in 2006 was for it to be an extension of the Pegasus Health General Practice and furthermore to be a bridge between the community and primary healthcare. It was believed that a close working relationship between the Practice Nurse and the PCW would help the target population of Māori, Pacifica and low income people to address and overcome their perceived barriers to healthcare which included: finance, transport, anxiety, cultural issues, communication, or lack of knowledge. Seven years later although the PCW project has been deemed a success in the Canterbury District Health Board annual reports (2013-14) and community and government agencies, including the Christchurch Resettlement Service (2012), many of the Pegasus Health General Practices have not utilised the project to its full extent, hence the need for this research. I was interested in finding out in the first instance if the model had changed and, if so why, and in the second instance if the promotional material currently distributed by Pegasus Health Primary Health Organisation reflected the daily practice of the PCW. A combination of methods were used including: surveys to the Pegasus Health General Practices, interviews with PCWs, interviews with managers of both the PCW host organisations and referring agencies to the PCW project. All the questions asked of all the participants in this research were focussed on their own perception of the role of the PCW. Results showed that the model has changed and although the publications were not reflecting the original intention of the project they did reflect the daily practice of the PCWs who are now struggling to meet much wider community expectations and needs. Key Results: Partnership Community Worker (PCW) interviews: Seventeen PCWs of the 19 employed were interviewed face to face. A number expressed interest in more culturally specific training and some are pursuing qualifications in social work; for many pay parity is an issue. In addition, many felt overwhelmed by the expectations around clients with mental health issues and housing issues now, post-earthquakes. Medical Practice surveys: Surveys were sent to eighty-two Pegasus Health medical practices and of these twenty five were completed. Results showed the full capacity of the PCW role was not clearly understood by all with many believing it was mostly a transport service. Those who did understand the full complexity of the role were very satisfied with the outcomes. PCW Host Community Manager Interviews: Of the ten out of twelve managers interviewed, some wished for more communication with Pegasus Health management because they felt aspects of both the PCW role and their own role as managers had become blurred over time. Referring organisations: Fifteen of the fifty referring community or government organisations participated. The overall satisfaction of the service was high and some acknowledged the continuing need for PCWs to be placed in communities where they were well known and trusted. Moreover results also showed that both the Canterbury earthquakes 2010-2011 and the amalgamation of Partnership Health PHO and Pegasus Health Charitable Limited in 2013 have contributed to the change of the model. Further future research may also be needed to examine the long term effects on the people of Canterbury involved in community work during the 2011-2014 years.

Doctor of Public Health / For many years the major cause of infant mortality in NSW has been the result of Sudden Infant Death Syndrome (SIDS). Statistics show the area defined as 'Western Sydney' is no exception, and in 2002, a report prepared by the Epidemiology, Indicators, Evaluation and Research Unit (EIRE) in Western Sydney presented data indicating SIDS rates in the area were higher than the state average. In particular, two Local Government Areas (LGAs) had clusters of SIDS deaths. Previous Australian research identified a higher risk of SIDS and other causes of infant mortality in Aboriginal and Torres Strait Islander populations. The areas of Western Sydney where SIDS rates were higher than expected were home to Aboriginal, Torres Strait Islander and Pacific Island residents. The number of SIDS deaths in Aboriginal infants did not explain the higher than expected rate of SIDS in the areas under investigation. Studies undertaken in New Zealand and the Pacific Islands have identified higher than expected risk of SIDS in Maori and Pacific Island communities in those countries, although this has never been studied in Pacific Island residents living in Australia. The reasons for these communities exhibiting a higher than normal SIDS rate is not completely understood, but can be partially explained by behavioural practices which are known to impact adversely on the risk of SIDS. This study sought to investigate the level of knowledge concerning the prevention of sudden and unexpected death in infants (SUDI) in three key groups of infant caregivers: general practitioners, nurses and parents living or working in the area geographically defined by Sydney West Area Health Service (WSAHS). In addition, the study sought to identify any variation in knowledge of SIDS reduction strategies in the three groups under study, and to investigate factors influencing knowledge and practice in these participants. The study findings were then used as a basis on which to develop strategies and recommendations to enhance the delivery of safe sleeping messages through the health care system. Using a combination of qualitative and quantitative methods, this cross-sectional study highlights a number of issues around infant care practices and the major influences on new parents living in a multicultural community. Results of the study showed there is a large variation in knowledge around safe sleeping practices (including SIDS reduction strategies) in all the groups studied. Although educational campaigns are conducted regularly, many general practitioners and parents are confused about the key SIDS reduction messages and still place infants in sleeping positions considered unsafe. While nurses and midwives were aware of the SIDS reduction strategies, they still occasionally used infant sleeping positions considered unsafe. General practitioners born overseas in a country where English is not the first language were less likely to be familiar with safe sleeping messages, including SIDS reduction strategies. Families from a Culturally and Linguistically Diverse (CALD) background were less likely to have seen SIDS information in their own language than families who spoke English, and as a result were more likely to use traditional methods of infant care, including co-sleeping with siblings and parents and side or tummy sleeping. CALD parents were more likely to rely on herbal remedies and friends and family for assistance, than English speaking parents who accessed health professionals as the first point of call when infants were unwell. The study identified a relatively recent practice, which until reported in this study, has not been documented in the literature. The practice of draping infant prams with blankets originated from the Cancer Council of Australia guidelines which recommend covering a pram with a light muslin wrap to protect infants’ skin from the sun. It appears parents have misinterpreted this message and are covering infant prams with blankets to encourage sleep, even when sun exposure is not an issue. Research suggests that poor air quality around the head of an infant may affect an infant’s arousal response. While no research has been conducted on the air quality around an infants head when covered by a heavy blanket in a pram, it is possible based on research into air quality around infants, that that this practice may increase the risk of sudden and unexpected death in an infant. In conclusion, this study found that multiple changes to the SIDS reduction messages since the initial ‘Reduce the Risks’ Campaign have led to confusion about ways of preventing SIDS in GPs, nurses and parents in Western Sydney. The study makes seven recommendations aimed at improving knowledge of safe sleeping practices in these groups, and optimizing health outcomes for infants using a collaborative approach to service delivery and future initiatives.

Prevailing research presents evidence that links language proficiency to fundamental literacy acquisition. However, when language and literacy acquisition are simultaneous, as is the case with young (4-6 years) English language learners (ELL’s), who acquire literacy in a language not spoken at home in B.C. Canada, the research is limited. The aim of the study was to explore and compare the language and literacy profiles (LLP) of ELL’s and monolingual learners. The normative processes as elucidated in the theoretical frameworks of Bronfenbrenner’s ecosystemic model, Vygotsky’s sociocultural model and the Critical Theory (CT) model informed the comparative framework. In addition, the second language acquisition (SLA) theoretical frameworks purported by Chomsky, Vygotsky and Krashen are elaborated upon. A causal comparative approach to the mixed model research design and a complementary mixed methods approach is applied to the study. The study interactively investigated the cultural and linguistic diversity (CALD) of ELL’s and sought statistically significant differences between the language and literature profiles (LLP) of 25 ELL’s and his/her parent - whose home language is other than English during first time literacy acquisition - and 25 monolingual learners and his/her parent (selected via a simple, purposive, random sample strategy) when English is the language medium used in the inclusive classroom. The qualitative findings delineated the LLP of the ELL’s with regard to CALD, biographic and background details; the quantitative findings, delineated the at risk educationally vulnerable minority by virtue of their limited English proficiency (LEP) and limited emergent literacy and language profile (LLP). The identification of the at risk educationally vulnerable minority, informed the proposed theoretical framework for the study, namely, namely, LLP - Semiotic Scaffolding-From Theory to Practice and the attendant curriculum. Findings are discussed comparatively with the classic and current theoretical frameworks pertaining to child development, language acquisition for both first and second language acquisition (SLA) in addition to globalisation, inclusive education and social justice. The implication of the findings for policy makers, curriculum planners, schools, teachers, classrooms, parents and the learners are discussed. Opportunities for further research are noted. / Psychology of Education / D. Ed. (Psychology of Education)

Prevailing research presents evidence that links language proficiency to fundamental literacy acquisition. However, when language and literacy acquisition are simultaneous, as is the case with young (4-6 years) English language learners (ELL’s), who acquire literacy in a language not spoken at home in B.C. Canada, the research is limited. The aim of the study was to explore and compare the language and literacy profiles (LLP) of ELL’s and monolingual learners. The normative processes as elucidated in the theoretical frameworks of Bronfenbrenner’s ecosystemic model, Vygotsky’s sociocultural model and the Critical Theory (CT) model informed the comparative framework. In addition, the second language acquisition (SLA) theoretical frameworks purported by Chomsky, Vygotsky and Krashen are elaborated upon. A causal comparative approach to the mixed model research design and a complementary mixed methods approach is applied to the study. The study interactively investigated the cultural and linguistic diversity (CALD) of ELL’s and sought statistically significant differences between the language and literature profiles (LLP) of 25 ELL’s and his/her parent - whose home language is other than English during first time literacy acquisition - and 25 monolingual learners and his/her parent (selected via a simple, purposive, random sample strategy) when English is the language medium used in the inclusive classroom. The qualitative findings delineated the LLP of the ELL’s with regard to CALD, biographic and background details; the quantitative findings, delineated the at risk educationally vulnerable minority by virtue of their limited English proficiency (LEP) and limited emergent literacy and language profile (LLP). The identification of the at risk educationally vulnerable minority, informed the proposed theoretical framework for the study, namely, namely, LLP - Semiotic Scaffolding-From Theory to Practice and the attendant curriculum. Findings are discussed comparatively with the classic and current theoretical frameworks pertaining to child development, language acquisition for both first and second language acquisition (SLA) in addition to globalisation, inclusive education and social justice. The implication of the findings for policy makers, curriculum planners, schools, teachers, classrooms, parents and the learners are discussed. Opportunities for further research are noted. / Psychology of Education / D. Ed. (Psychology of Education)