Avondale Research Publications
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Item Protocol to Establish Standards for the Elements Infection Prevention and Control Programs and Competencies for Infection Control Professionals in Australian Residential Aged Care Homes(PLoS ONE, 2025) Shaban, Ramon Z.; Curtis, Kate; Fry, Margaret; McCormack, Brendan; Parker, Deborah; Macbeth, Deborough; Mitchell, Brett G.; Russo, Phillip L.; Friedman, N. Deborah; Bennett, Noleen; Thompson, Lucy; Dalton, Jo-Ann; Dempsey, Kathy; Henderson, Belinda; Considine, Julie; Bowes, Rachel; Campbell, Elise; Powell, Merrick; Viengkham, CatherineThe COVID-19 pandemic elucidated the importance of infection prevention and control (IPC) in residential aged care homes (RACHs), both on the health and wellbeing of its residents, and the staff and clinicians who care for them. While considerable efforts have been made in Australia to improve IPC both during and in the aftermath of the COVID-19 pandemic, many of these resources remain reliant on evidence originating from hospitals and acute healthcare settings. This research aims to establish the core minimum components that will populate standards for IPC programs and governance (Stream A) and for professional practice and competencies (Stream B) in RACHs. This research will be completed using a sequential three-phase design. In Phase 1, two integrative literature reviews will be completed to synthesise the elements of current global IPC programs and professional competencies in RACHs. In Phase 2, a qualitative analysis of IPC programs and professional practice in Australian RACHs using a combination of surveys and interviews will be completed. Finally, in Phase 3, an e-Delphi will be conducted to collate expert opinion and generate consensus on the minimum components of the IPC program and professionals who administer them in RACHs. The final standards and resources will be collaboratively designed with aged care partners, industry leaders, professional bodies and key Australian health policymakers. These standards seek to empower IPC and aged care staff, not only by ensuring that they are well-equipped with the knowledge and skills to implement effective IPC programs themselves, but also that the organisation is adequately prepared to provide the resources and governance systems.Item Thanks for Not Asking: Samoan Social Practitioner Experiences of Racism and Exclusion in Decision-Making(Springer, 2024) Scanlan, Jack; Mafileo, TracieItem Managing the Tidal Wave of Diabetes: Barriers to Effective Management of the Disease in Fiji(United Nations, 2024-12-04) Ravono, Akisi; Carryer, Jenny; Stewart-Withers, Rochelle; Mafileo, TracieDiabetes, as a disease of global concern, has drawn an immense amount of literature. The present paper contains a review on what is known about diabetes among the iTaukei (Indigenous people) in Fiji. It also provides an explanation on how people living with diabetes in Fiji manage their status and highlights the barriers that affect how patients suffering from the disease self-manage their illness.Item “It’s not a Pain you can fix”: A Qualitative Exploration of Working with Vulnerably Positioned Current and Bereaved Carers across Sectors of Health and Social Care(Taylor & Francis, 2025) Bindley, Kristin; Lewis, Joanne; DiGiacomo, MichelleCaring for someone with a life-limiting illness is associated with complex psychosocial sequelae; amplified for carers experiencing structural vulnerability. Workers across sectors of health and social care provide support for vulnerably positioned carers, yet exploration of the impacts of this work has predominantly focused on health professionals directly engaged with death and dying. This qualitative study explored ways in which palliative care and welfare workers experience work with current and bereaved carers of people with life-limiting illness, in a region associated with socioeconomic disadvantage. Work in this landscape involved: (1) navigation of evocative content, (2) encountering limits of grief literacy, (3) negotiating effects of policy constraints, (4) meaning-making for system survival, and (5) varied utilization of resources and strategies. Findings indicate the need for cross-sectoral recognition of consequences of this work, reflected through initiatives to cultivate grief literacy, acknowledgement of harmful consequences of policy, and structural approaches to workforce well-being.Item Determining Timeframes to Death for Imminently Dying Patients: A Retrospective Cohort Study(BioMed Central, 2025-01-13) O'Connor, Tricia; Liu, Wai-Man; Samara, Juliane; Lewis, Joanne; Strickland, Karen; Paterson, CatherineBackground Clinicians are frequently asked ‘how long’ questions at end-of-life by patients and those important to them, yet predicting timeframes to death remains uncertain, even in the last weeks and days of life. Patients and families wish to know so they can ask questions, plan, make decisions, have time to visit and say their goodbyes, and have holistic care needs met. Consequently, this necessitates a more accurate assessment of empirical data to better inform prognostication and reduce uncertainty around time until death. The aims of this study were to determine the timeframes for palliative care patients (a) between becoming comatose and death, and (b) between being totally dependent and bedfast, and then comatose, or death, using Australia-modified Karnofsky Performance Status (AKPS) scores. The secondary aim was to determine if covariates predicted timeframes. Method This is a large retrospective cohort study of 2,438 patients, 18 years and over, cared for as hospice inpatients or by community palliative care services, died between January 2017 and December 2021, and who collectively had 49,842 AKPS data points. An Interval-Censored Cox Proportional Hazards regression model was used. Results Over 53% (n = 1,306) were comatose (AKPS 10) for longer than one day before death (mean = 2 days, median = 1, SD = 2.0). On average, patients were found to be totally dependent and bedfast (AKPS 20) for 24 days, before progressing to being comatose. A difference in life expectancy was observed at AKPS 20 among people with cancer (mean = 14.4, median = 2, SD = 38.8) and those who did not have cancer (mean = 53.3, median = 5, SD = 157.1). Conclusion Results provide clinicians with validated data to guide communication when answering ‘how long’ questions at end-of-life. Knowledge of projected time to death can prompt timely conversations while the patient can understand and engage in meaningful conversations. The importance of considering covariates such as location and diagnosis in determining timeframes has been highlighted. Shared decision-making and essential person-centered end-of-life care can be planned.Item How Long do you Think? Unresponsive Dying Patients in a Specialist Palliative Care Service: A Consecutive Cohort Study(SAGE, 2024-05-01) O'Connor, Tricia; Liu, Wai-Man; Samara, Juliane; Lewis, Joanne; Paterson, CatherineBackground: Predicting length of time to death once the person is unresponsive and deemed to be dying remains uncertain. Knowing approximately how many hours or days dying loved ones have left is crucial for families and clinicians to guide decision-making and plan end-of-life care. Aim: To determine the length of time between becoming unresponsive and death, and whether age, gender, diagnosis or location-of-care predicted length of time to death. Design: Retrospective cohort study. Time from allocation of an Australia-modified Karnofsky Performance Status (AKPS) 10 to death was analysed using descriptive narrative. Interval-censored survival analysis was used to determine the duration of patient’s final phase of life, taking into account variation across age, gender, diagnosis and location of death. Setting/participants: A total of 786 patients, 18 years of age or over, who received specialist palliative care: as hospice in-patients, in the community and in aged care homes, between January 1st and October 31st, 2022. Results: The time to death after a change to AKPS 10 is 2 days (n = 382; mean = 2.1; median = 1). Having adjusted for age, cancer, gender, the standard deviation of AKPS for the 7-day period prior to death, the likelihood of death within 2 days is 47%, with 84% of patients dying within 4 days. Conclusion: This study provides valuable new knowledge to support clinicians’ confidence when responding to the ‘how long’ question and can inform decision-making at end-of-life. Further research using the AKPS could provide greater certainty for answering ‘how long’ questions across the illness trajectory.Item Chaplaincy and Spiritual Care in Australian Ambulance Services: An Exploratory Cross-Sectional Study(Taylor & Francis, 2024) Tunks Leach, Katie; Demant, Daniel; Simpson, Paul; Lewis, Joanne; Levett-Jones, TracyAmbulance staff wellbeing programs aim to support the bio-psycho-social and sometimes spiritual needs of paramedics. While evidence demonstrates strong connections between spirituality and/or religion to wellbeing outcomes, little is known about spiritual care in ambulance services or its impact. The aim of this study was to investigate paramedics’ perspectives on the role and value of Australian ambulance chaplains. A cross-sectional online study of registered paramedics in Australia was conducted between November and December 2022. Analysis of the 150 responses identified that paramedics viewed the chaplain’s role as one built on professional caring relationships that provided proactive and reactive care in paramedic workplaces. Chaplains were perceived to promote wellbeing by incorporating emotional, psychological, social and spiritual care, and assisting paramedics to access additional support. Perceived religiousness of chaplains and organisational factors were barriers to paramedics accessing chaplains, while pre-existing relationships and shared experiences positively influenced paramedics decision to seek chaplain support.Item Daniel’s Seventy Weeks in Luke 1–2: Allusion or Illusion? Fulfilment or Prefiguration?(New Testament Society of Southern Africa, 2023-06-01) MacPherson, AnthonyIn the early 20th century, Eric Burrows (1940) and René Laurentin (1957) made the argument that Luke 1–2 features a 490-day period which is a deliberate allusion to Dan 9’s seventy weeks prophecy. This view has received some support but suffered its most significant pushback when Raymond Brown in 1977 dismissed it in his major work on the infancy narratives of Matthew and Luke. Brown’s criticisms have influenced later commentators (e.g., Bock 1994). This may account for the tentativeness of support, if it is mentioned at all, in contemporary Lucan commentaries. This article will first revisit the earlier view of Burrows and Laurentin and will offer a general defence of their basic position against Brown’s objections. However, limitations and problems in their position are recognised and discussed, and a new modified understanding of Luke’s allusion to Daniel’s seventy weeks will be advanced. It will be argued that Luke is not seeking to indicate that Daniel’s seventy weeks are being fulfilled in the birth of Jesus. Rather, Luke is showing that a complementary 490-day period in the infancy of John and Jesus prefigures their future work, and this parallels Daniel’s seventy-week prophecy. Luke either designs or discerns in the infancy of John and Jesus a miniaturised Daniel-like 490-day period which is also a prefiguration of the future of John and Jesus. The result is that Luke’s 490 days helps prepare the reader for the fulfilment in history of Daniel’s seventy-week prophecy in Luke 3–4.Item 1 Samuel, 2 Samuel(Pacific Press, 2023) Turner, Laurence; Magyarosi, Barna; Frey, Mathilde; Gelbrich, DanielA comprehensive commentary based on the Hebrew text written from a narrative-critical perspective.Item The Experiences of Archie Royce, YMCA Representative in the AIF 1916-18(Evangelical History Association, 2024-12-01) Reynaud, DanielThe YMCA was one of the most effective support organisations for the Australian Imperial Force (AIF) during World War One, its evangelical orientation motivating it to heights of influence on hundreds of thousands of soldiers. This paper explores the experiences of Archie Royce, YMCA Representative in the Australian Imperial Force (AIF) from late 1916 to the end of the war. Royce served on a troopship, then at AIF bases around Weymouth in England, finally completing a short period of service in the front lines late in the war. It examines his diary and letters, which detail his work in social welfare and religious activities on behalf of the soldiers and his relationships to the various military and civilian personnel connected to his work. His papers also capture his relationship with his wife and children in Australia, his son serving in the AIF, and the friendships he cultivated, in particular with several women who provided him with considerable emotional support. The discussion offers an evaluation of his contribution, using it as an example of the influence that the evangelically-minded YMCA had on servicemen in World War One.