Caroline Nilson

Aboriginal and Torres Strait Islander people have some of the highest rates of infant death in Australia, including Sudden Unexpected Death in Infancy (SUDI) and Sudden Infant Death Syndrome (SIDS). In 2018, data from the Australian Mothers and Babies report (Australian Institute of health and Welfare, 2020) reported that 1 in 18 or 5.7% of all babies born in Australia were Aboriginal and/or Torres Strait Islander. While the proportion of Aboriginal infant deaths occurring out-of-hospital is not reported, there has been an identified need to address the issues of community competence and awareness in cardiopulmonary resuscitation (CPR) and first aid in Western Australia, for many years (Celenza et al., 2002; Lynch et al., 2005)…

Objectives:
Among Aboriginal children, the year between birth and 1 year of age has the highest mortality rate compared with any other age. Prompt administration of cardiopulmonary resuscitation (CPR) leads to better outcomes and a lower likelihood of ongoing sequalae. Current education on infant CPR is not provided to parents except in certain circumstances in a neonatal intensive care unit. Currently, there are no identified CPR education courses specifically available for Aboriginal or Torres Strait Islander people, meaning that current infant CPR education courses are not culturally responsive.

Design:
Partnering with an Aboriginal community from the Bindjareb region of the Western Australian Noongar nation, the researchers used a co-design approach and an Aboriginal Participatory Action Research (APAR) design to explore how to deliver culturally safe and responsive infant CPR community education. This resulted in the development of the Koolangka Infant Life Saving Education Framework (KILSEF), which can be used to guide future planning and delivery of culturally safe and responsive community level infant CPR education.

Results:
The study findings identified that members of the Aboriginal community were very interested in receiving infant CPR education, but the barriers identified from mainstream CPR course delivery need to be removed for the community to benefit from culturally responsive ways of learning. Culturally responsive community CPR education should be provided in culturally safe places and the focus of learning should be on the practical applications of CPR and less on the academic pre-reading and written requirements. Explanations should be provided in lay terms and patience is required to communicate ideas in ways that facilitate understanding, and the course may need to be delivered over several days to accommodate community participant availability.

Conclusion:
Addressing Aboriginal community concerns and barriers allowed for the implementation of culturally responsive infant resuscitation education which was highly valued by community members and led to increased community confidence and participation in CPR education.

Research on transformative learning (Mezirow, 1991), particularly within the context of higher education, has demonstrated the significant impact university learning can have on a wide range of cohorts across diverse learning contexts. However, the extensive body of literature pertaining to transformative learning remains largely silent on the experiences of Aboriginal and Torres Strait Islander university students and the extent to which their engagement with academia can be transformative. Nevertheless, Nakata’s (2007b) cultural interface theory has shaped policy, practice and thought in Indigenous higher education, elucidating the nuances, complexities and challenges that confront Indigenous students in their journey through university. In bringing together these two critical theories, this study investigated the journeys of three undergraduate Indigenous university students finding that university can indeed be a site of positive personal transformation. Such changes were fostered through critical peer support relationships, relationships with family and loved ones as well as a growing confidence and pride in their cultural identities. These findings have important implications for the way institutions support and teach Aboriginal and Torres Strait Islander students and provides a nuanced insight into their university journeys at the cultural interface.

Aim:
To critically appraise the literature to determine availability and identify the cultural responsiveness of infant resuscitation education for Aboriginal and Torres Strait Islander populations.

Background:
Despite overall reductions in infant mortality in the last two decades, Aboriginal people have some of the highest rates of infant mortality of any developed nation. One of the key factors that has attributed to improvements in infant mortality rates is parent and carer education around risk factors and actions of first responders. Identifying gaps in the current basic first-aid initiatives available to Aboriginal communities may contribute to developing resources to contribute to reductions in Aboriginal neonatal mortality rates.

Method:
The review used key terms and Boolean operators across an 11-month time frame searching for research articles utilising the databases of CINAHL, Scopus, Ovid Emcare, Informit, Pubmed and Proquest. After review, 39 articles met the inclusion criteria, 25 articles were discarded due to irrelevant material and 14 articles were included in the structured literature review. The search process was developed using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Articles were assessed for validity and inclusion using the Critical Appraisal Skills Program checklist.

Results:
Research literature relating to First Nation community-based CPR and first-aid education programmes in Canada, USA, India, UK and Europe, Asia and Africa were identified; however, none pertaining specifically to CPR and first-aid education in Australian Aboriginal communities were found.

Discussion:
Despite the lack of research evidence relating to infant cardiopulmonary resuscitation (CPR) education for Australian Aboriginal populations, the reviewed studies noted the importance of culturally responsive education designed in collaboration with First Nation peoples, using novel ways of teaching CPR, that align with the language, culture and needs of the communities it is intended for.

Conclusion:
Further research is required to create a framework for the delivery of culturally responsive infant resuscitation education for Australian Aboriginal parents and communities.

Many formalised breastfeeding supports have been implemented in Australia, however breastfeeding duration still falls well short of national and global targets. A re-exploration of how women currently seek, interact with and respond to the support provided them can assist in informing further change. We used 'narrative inquiry' to examine the stories of seven women's lived experiences of support whilst establishing breastfeeding and collected data through audio-recorded conversations, transcribed verbatim stories, retold narratives, and researcher reflexive journaling. Clandinin and Connelly's framework (2000) was used to inform analysis by enabling an understanding of the relational aspects and the changeable nature of mothers' experiences. Thematic data analysis revealed four themes: 'trusting in the "natural"', 'navigating the complexity of the breastfeeding journey', 'battling others' assumptions', and 'finding strength in supportive environments'. All mothers found strength in the supportive interactions they experienced from professional, peer and family support. However, mothers also encountered many barriers, indicating remaining deficits in the support offered to breastfeeding mothers. The support experienced could be improved by encouraging more positive societal attitudes and developing a more knowledgeable, non-judgemental health system that delivers anticipatory, rather than reactive support responses. This will encourage the recognition of individuality, and support breastfeeding self-efficacy and the role of family support in overcoming breastfeeding difficulties.

In 2011 the Pinjarra Murray District Aboriginal Association in Western Australia approached Caroline Nilson at Murdoch University for ideas to promote better understanding of health and nutrition. They wanted a way of getting children involved, and a program based at a new community centre. Caroline raised funds and developed a children’s cooking course giving kids the skills to cook for a family. It was wildly popular. Caroline Nilson tells the story.

Aboriginal and Torres Strait Islander infants currently have one of the highest rates of Sudden Unexpected Death in Infancy (SUDI) and infant death of any population in a developed nation. Prompt initiation of cardiopulmonary resuscitation (CPR) is crucial for survival in an emergency situation. This is particularly relevant in remote communities where delayed response times from trained personnel could affect survival and parents are likely to be the first responders in these instances. In the neonatal intensive care unit (NICU) and special care nursery (SCN) health-related education is offered to parents prior to discharge, which includes Sudden Infant Death Syndrome (SIDS) and safe sleeping guidelines; however, it rarely includes infant cardiopulmonary resuscitation. Although some health-related education is also offered in maternity units, infant CPR is generally not included. By talking with Aboriginal parents in Western Australia who were discharged from the NICU/SCN or the maternity units within the first 12 months of the infant’s life, this study aims to determine what they understand about infant resuscitation and their perspectives on learning the skills to perform it. This will also include the views of grandparents, aunties and extended family of the participants. Using community participatory action research (CPAR), this study will utilise a well-established Indigenous research practice of yarning to gain a detailed understanding of Aboriginal parents’ perspectives and understanding of infant cardiopulmonary resuscitation. Whether these perspectives differ depending on if the mother and baby spent time in the NICU/SCN or the maternity unit in the postnatal period will also be identified. It is anticipated that a culturally responsive infant CPR education program and framework could result from the findings of the research.

Introduction/background: ePortfolio practice using PebblePad was first introduced into the Murdoch University Bachelor of Nursing course in 2015 into a first year theoretical unit. The initial success of PebblePad in strategic units of the course acted as a driver for change for both academics and students alike. Aim/objectives: To discuss eportfolio as a learning and teaching tool in nursing education. Discussion: The Murdoch University Discipline of Nursing has taken a pedagogical leadership role by introducing eportfolio learning into the MU BN course through a whole-of-course mapping approach. This blended learning strategy uses the PebblePad platform where students own their individual eportfolio learning space to record, reflect, self-audit, and undertake assessment. Assessment and feedback are supported by the learning design and the platform, so learners work in partnership with educational guides, whether they be students, university educators, or clinical facilitators. Learners also engage in the more ‘traditional’ types of eportfolio activities of collecting, collating, organising and presenting their achievements and experiences. In this context, the eportfolio space becomes a platform for ‘real world’ learning through experience, which supports students in the self-management of their developing knowledge and understanding. Issues/questions for exploration or ideas for discussion: What does eportfolio practice look like when approached through a ‘learning experience’ lens? What kinds of activities, possibly seen as ‘atypical’ in an eportfolio platform, empower students to own their learning and engage meaningfully with authentic experiences? How can this type of learning experience framework support learners to construct, explore and discuss real-world problems in contexts that are relevant to their nursing knowledge and skills development?