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Purpose: The authors sought to investigate the influence of a comprehensive range of factors on the decision making of caregivers of children with hearing loss regarding the use of speech, the use of sign, spoken language multilingualism, and spoken language choice. This is a companion article to the qualitative investigation described in Crowe, Fordham, McLeod, and Ching (2014). Method: Through a questionnaire, 177 caregivers of 157 Australian children with hearing loss (ages 3;5 to 9;4 [years;months], Mage = 6;6) rated the importance of a range of potential influences on their decision making regarding their children's communication. The majority of children were reported to use speech (96.6%) as part or all of their communication system, with fewer children reported to use sign (20.9%). Few children used more than one spoken language (8.3%). Results: Proportional analyses and exploratory factor analyses were conducted. Overall, caregivers' decisions were influenced by their children's audiological and intervention characteristics, communication with those around them, community participation, access to intervention and education services in English, and concerns about their children's future lives. The advice of speech-language pathologists, audiologists, and specialist teachers was more important to caregivers than advice from medical practitioners and nonprofessionals. Conclusion: Caregivers' decision making regarding communication mode and language use is influenced by factors that are not equally weighted and that relate to child, family, community, and advice from others. Knowledge of these factors can assist professionals in supporting caregivers making choices regarding communication. [ABSTRACT FROM AUTHOR]

Background: The provision of effective feedback on clinical performance for medical students is important for their continued learning. Written feedback is an underutilised medium for linking clinical performances over time. Aims: The aim of this study is to investigate how clinical supervisors construct performance orientated written feedback and learning goals for medical students in a geographically distributed medical education (GDME) programme. Methods: This qualitative study uses textual analysis to examine the structure and content of written feedback statements in 1000 mini-CEX records from 33 Australian undergraduate medical students during their 36 week GDME programme. The students were in their second clinical year. Results: Forty percent of mini-CEX records contained written feedback statements. Within these statements, 80% included comments relating to student clinical performance. The way in which written feedback statements were recorded varied in structure and content. Only 16% of the statements contained student learning goals focused on improving a student's clinical performance over time. Very few of the written feedback statements identified forward-focused learning goals. Conclusion: Training clinical supervisors in understanding how their feedback contributes to a student's continuity of learning across their GDME clinical placements will enable more focused learning experiences based on student need. To enhance student learning over time and place, effective written feedback should contain focused, coherent phrases that help reflection on current and future clinical performance. It also needs to provide enough detail for other GDME clinical supervisors to understand current student performance and plan future directions for their teaching. [ABSTRACT FROM AUTHOR]

The article discusses aspects of mental health nursing in Australian Aboriginal remote communities. It tackles the critical role of mental health interviews in the provision of treatment and mental health services for Aboriginal clients due to linguistic barriers and limitations in communication process. Moreover, it mentions the significance of educating nurses on Aboriginal history to help them understand the psychological impact of social issues including inequality, loss, and racism.

Commercial dog health programs in Australian Indigenous communities are a relatively recent occurrence. Health promotion for these programs is an even more recent development, and lacks data on effective practices. This paper analyses 38 resources created by veterinary-community partnerships in Indigenous communities, to 71 resources available through local veterinary service providers. On average, community-produced resources used significantly more of the resource area as image, more imagery as communicative rather than decorative images, larger fonts and smaller segments of text and used images of people with a range of skin tones. As well as informal registers of Standard Australian English, community-produced resources used Aboriginal English and/or Creole languages in their text, while extra-community (EC)-produced resources did not. The text of EC resources had Flesh–Kincaid reading grade levels that excluded a large proportion of community recipients. Also, they did not cover some topics of importance in communities, used academic, formal and technical language, and did not depict people of a representative range of skin tones. As such, community-produced resources were more relevant to the unique situations in remote communities, while EC resources were often inappropriate and in some cases could even distance recipients by using inappropriate language, formats and imagery. [ABSTRACT FROM AUTHOR]

Participatory processes are effective for digital video production that promotes health and wellbeing with communities from diverse cultural and linguistic backgrounds, including migrants and refugees. Social media platforms YouTube, Vimeo, Flickr and others demonstrate potential for extending and enhancing this production approach. However, differences within and between communities in terms of their quality of participation online suggest that social media risk becoming exclusive online environments and a barrier to health and wellbeing promotion. This article examines the literature and recent research and practice in Australia to identify opportunities and challenges when using social media with communities from diverse cultural and linguistic backgrounds. It proposes a hybrid approach for digital video production that integrates ‘online’ and ‘offline’ participation and engages with the differences between migrants and refugees to support more inclusive health and wellbeing promotion using digital technology. [ABSTRACT FROM AUTHOR]

Background: Coordination of care is considered a key component of patient-centered health care systems, but is rarely defined or operationalised in health care policy. Continuity, an aspect of coordination, is the patient's experience of care over time, and is often described in terms of three dimensions: information, relational and management continuity. With the current health policy focus on both the use of information technology and care coordination, this study aimed to 1) explore how information continuity supports coordination and 2) investigate conditions required to support information continuity. Methods: Four diverse Australian primary health care initiatives were purposively selected for inclusion in the study. Each has improved coordination as an aim or fundamental principle. Each organization was asked to identify practitioners, managers and decision makers who could provide insight into the use of information for care coordination to participate in the study. Using in-depth semi-structured interviews, we explored four questions covering the scope and use of information, the influence of governance, data ownership and confidentiality and the influence of financial incentives and quality improvement on information continuity and coordination. Data were thematically analyzed using NVivo 8. Results: The overall picture that emerged across all four cases was that whilst accessibility and continuity of information underpin effective care, they are not sufficient for coordination of care for complex conditions. Shared information reduced unnecessary repetition and provided health professionals with the opportunity to access records of care from other providers, but participants described their role in coordination in terms of the active involvement of a person in care rather than the passive availability of information. Complex issues regarding data ownership and confidentiality often hampered information sharing. Successful coordination in each case was associated with responsiveness to local rather than system level factors. Conclusions: The availability of information is not sufficient to ensure continuity for the patient or coordination from the systems perspective. Policy directed at information continuity must give consideration to the broader 'fit' with management and relational continuity and provide a broad base that allows for local responsiveness in order for coordination of care to be achieved. [ABSTRACT FROM AUTHOR]

Background: Aphasia affects family members in addition to the individuals with the communication disorder. In order to develop appropriate services for the relatives of people with aphasia post-stroke, their rehabilitation goals need to be identified. Aim: The aim of the current investigation was to identify the rehabilitation goals that family members of individuals with aphasia have for themselves. Methods & Procedures: Forty-eight family members of adults with aphasia post-stroke participated in in-depth semi-structured interviews to identify the rehabilitation goals they had for themselves. All the interviews were transcribed verbatim and analysed using qualitative content analysis. Outcomes & Results: Analysis revealed seven categories of goals that the family members had for themselves: to be included in rehabilitation, to be provided with hope and positivity, to be able to communicate and maintain their relationship with the person with aphasia, to be given information, to be given support, to look after their own well-being, and to be able to cope with new responsibilities. A few participants reported that, at certain times during the rehabilitation process, they did not have any goals for themselves. Conclusions & Implications: This study highlights that family members of individuals with aphasia have a number of aphasia-related rehabilitation goals for themselves. In order to provide a family-centred approach to rehabilitation, health professionals, including speech-language pathologists, need systematically to identify and address family members' goals in light of the categories revealed in this investigation. [ABSTRACT FROM AUTHOR]

The aim of this research was to work collaboratively with an urban Aboriginal community to understand meanings of food and food insecurity and strengthen responses to this issue. The project took place at the Wathaurong Aboriginal Cooperative in Geelong, South Eastern Australia in 2009-2010. Photo-voice research methods were used to explore meanings of food and food insecurity. This identified that food selections were influenced by family harmony, collectivism and satiation of hunger with cheap high carbohydrate and fat foods. People were also proud of their hunter-gatherer heritage and saw the Wathaurong Aboriginal Cooperative as leaders in healthy food provision. Action research cycles were used to develop responses including plates depicting healthy food portions, social cooking opportunities, development of a cooking television series and a specialised cook-book. The partnership required researchers to listen carefully to respond to needs of the Wathaurong Aboriginal Cooperative, and this meant adapting research plans to suit the local environment and community partner needs. There is potential for Aboriginal organisations to provide further leadership for healthy eating and food security through workplace food policies and partnerships with food security agencies. Use of Aboriginal nutrition knowledge to provide nutrition education may be useful in health promotion approaches. [ABSTRACT FROM AUTHOR]

Background: An implantable cardioverter defibrillator (ICD) is a device used in the treatment of individuals with life-threatening cardiac conditions. These include genetic disorders such as long QT syndrome, hypertrophic cardiomyopathy, and Brugada syndrome, all of which have the propensity to cause sudden cardiac death. Adults with ICDs consistently report elevated levels of anxiety and depression, as well as negative lifestyle changes associated with the device. Compared to older ICD recipients, young patients face decades of life with the device and the long-term impact and implications are important to consider. This research explores the experiences of adolescents living with an ICD. Parents of these adolescents were also included to explore the impact on them as the primary caregivers. Methods: A qualitative approach was chosen to explore the lived experience; semistructured interviews with six adolescents and six parents were conducted from which a number of key themes emerged. Results: The experiences described by participants included the restrictions adolescents face, the ICD shock experience, and ongoing challenges post-ICD implantation. However, both adolescents and parents were able to adjust to life after receiving an ICD and described several benefits associated with having the device. Findings also emerged relating to communication between health professionals and adolescents, and the limitations adolescents impose on themselves post-ICD implantation. Conclusion: These findings have important implications for clinical practice and may help guide medical management for adolescents with ICDs and their families. (PACE 2012; 35:62-72) [ABSTRACT FROM AUTHOR]

The many Aboriginal and non Aboriginal social workers who work with Aboriginal communities to address health and socioeconomic disadvantage have a key role to play in reducing the continuing inequalities experienced by many Aboriginal clients in Australia. The need for more culturally-responsive practice is well recognised, as historic barriers to effective practice and relationships persist. This paper describes the views of Aboriginal people about the knowledge that social workers need to possess for effective work with Aboriginal clients, and the ways that this might be learned. Four focus groups with 30 urban Aboriginal community members identified three key areas of knowledge: Aboriginal history and its impact; cultural knowledge (including family and community structures); and the impact of social work interventions. Suggested methods for learning include building consultation and community connections, and field-education placements. The paper recommends that social work education prepares students for more effective practice with Aboriginal client groups by incorporating these content areas and methods into the core curricula. [ABSTRACT FROM AUTHOR]

Dietitian and general practitioner collaboration in the nutrition care of a patient is important to assist patients to achieve their nutrition goals. This paper aims to review the published literature on dietitians' correspondence practices with recipient general practitioners regarding nutrition interventions recommended to patients. A literature search was conducted of publications from 1995 to December 2009. Key words were used to search the electronic databases Medline, CINAHL Plus, ProQuest, PsycINFO and Google Scholar. Twenty papers that addressed this topic were selected by two authors for inclusion in the review. There is evidence that dietitians often fail to provide general practitioners with formalised correspondence that describes dietitians' nutrition interventions with patients. Doctors report they lack patient information via dietitians' correspondence. Information about nutrition care of hospital patients often remains within hospital records. Doctors prefer standardised letter formats with content presented succinctly. The letter should include a nutrition diagnosis, agreed goals, a plan for ongoing dietetic visits and instructions for a general practitioner's supportive actions. Dietitians need skill in drafting reports or letters useful for general practitioners by selecting content of value to doctors and using a suitable style. Implementation of shared electronic records in Australia will facilitate information transfer to help realise collaborative patient care. Further investigations of dietitian-general practitioner correspondence are warranted to determine best practice. [ABSTRACT FROM AUTHOR]

Background: Exploring the concept of living successfully with aphasia challenges researchers and clinicians to identify positive rather than negative adaptive processes and factors that may inform clinical interventions and other community-based services for people with aphasia. Previous research on this topic has focused on the perspectives of individuals with aphasia, and identified a number of core components of living successfully with aphasia, including doing things, meaningful relationships, striving for a positive way of living, and communication. As service providers, speech-language pathologists may also contribute valuable insights regarding components of living successfully with aphasia and factors influencing individuals' abilities to achieve this goal. Aims: This research aimed to explore speech-language pathologists' perspectives about the meaning of living successfully with aphasia, and factors they perceive to influence individuals' abilities to live successfully with aphasia. Methods & Procedures: Twenty-five speech-language pathologists from around Australia participated in semi-structured in-depth interviews on the topic of living successfully with aphasia. All interviews were transcribed verbatim and analysed using interpretative phenomenological analysis to identify themes of relevance. Outcomes & Results: Through the analysis of speech-language pathologist participant transcripts, the following themes emerged as components of living successfully with aphasia: participation and community engagement; communication; meaningful relationships; autonomy or independence; acceptance and embracement of aphasia; self-esteem; happiness; and purpose or meaningfulness. A wide variety of factors were perceived to influence individuals' abilities to live successfully with aphasia. These included support, acceptance, and understanding; personal factors; and speech-language pathology services. Conclusions & Implications: Further research is required to extend findings by investigating how speech-language pathologists address identified themes in clinical practice. To improve service provision, continued reflection by speech-language pathologists on how services provided align with client's values and priorities is a necessity. A commitment by speech-language pathologists to work in partnership with people with aphasia and their families and friends to achieve successful living with aphasia is one way to translate this research into practice. [ABSTRACT FROM AUTHOR]

For question-answer sequences in Australian Aboriginal talk, it has been claimed that answers are not necessarily a required response. This would contrast with findings reported in recent cross-linguistic work on such sequences. In a corpus of 62 question sequences from conversations in two Garrwa communities on the west side of the Gulf of Carpentaria in northern Australia, 34 questions were answered, and a further 12 dealt with the question in some other way. Sixteen received no response in the proximally subsequent talk. Whilst most of these questions were answered, the offset time between question and response was long compared to previous studies. There was also a higher rate of non-answers and non-responses. For some cases of non-responses, contingent factors easily explained the lack, but in a few the reasons were not so apparent. It is argued that a significant factor in the relatively long silence between question and answer, and the relatively high rate of non-answers or non-responses, is that the parties in the talk spend much of the time in 'continuing states of incipient talk', rather than in tightly focused and temporally bound conversation, which may help to account for the apparent relaxation of gap minimization and response mobilization. [ABSTRACT FROM AUTHOR]

The authors reflect on increased involvement of emergency physicians in international emergency medicine (IEM) activities. It states that the Australasian College for Emergency Medicine created an IEM Secretariat for International Programs and lists the duties of the Secretariat. It mentions the journal will support IEM information-sharing by publishing IEM manuscripts and presents special Instructions for Authors with recommendations for submission of IEM manuscripts.

The paper examines deaf people's knowledge of modern Internet communication technologies and the possible benefits they could obtain from them. We found that organisations for deaf people were active in informing their members but a very large number of people deafened by ageing were not so aware of possible benefits. Signing deaf people benefit from video communication by telephone and the Internet. Signing avatars are also of considerable benefit in making available text and voice sites on the Internet. Methods of promoting awareness for better access and suggestions for their implementation are examined. [ABSTRACT FROM AUTHOR]

Previous research on oppositional discourse has pointed out the need in the turn-by-turn analysis of conflict and disagreements. Work on cros-scultural disagreements and conflict is also imperative in the current age of globalization and international movement. This paper examines the negotiation of disagreements and differences between three generations of Greek-Australian women during their participation in interview-narratives. The paper first discusses the structural ways with which the women build their disagreements and negotiate their arguments in an interview setting and how they turn the interview into a place of dispute. Three disagreement strategies are discussed in this section: the participants' questioning the opponent's arguments, appealing to logic, and calling for defense. This paper also discusses the function of the disagreements in intergenerational conflict. Through the disagreements, participants display their cross-cultural and intergenerational differences. It is also revealed that disagreements are a means for the women to display and account for their competence as mothers and daughters in the presence of the interviewer and for the ‘record of the interview’. The study of disagreements provides useful insight into the areas of cross-cultural communication and intergenerational interaction. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Have Medical Journals Missed the Web 2.0 Roller Coaster?" by A. Buck, which appeared in the June 2012 issue.

A letter to the editor is presented assessing the effectiveness of newsletters as a method of disseminating information needs among hospital staff.