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Objective: Vaccine hesitancy is a persistent barrier to vaccination uptake, and health professionals report interactions with such parents to be difficult. Using discourse analytic techniques, we examine the foundation of a therapeutic relationship: the display of empathy and attempts to build rapport, in consultations between immunisation specialists and vaccine reluctant parents.Methods: Consultations between consenting clinicians and parents in two Specialist Immunisation Clinics in Australia were recorded. Twelve conversations between the clinicians and parents were analysed using interactional sociolinguistic (IS) discourse analytic methods.Results: This paper takes a case study approach by citing two interactions that exemplify the interactional work of the consultants as they strive to engender mutual understanding and goodwill, noting examples of discursive choices that demonstrate empathy and the building of rapport.Conclusion: Awareness of discourse strategies that interweave relational and clinical goals enable a more nuanced understanding of communication skills that support a guiding partnership in vaccine related decisions with parents.Practical Implications: Through highlighting the strategic interactional work that displays empathy and builds rapport, we can inform educational approaches and build a repertoire of communication choices that strengthen the communication skills of health professionals. [ABSTRACT FROM AUTHOR]

Since 2018 the Australian government has displayed anxiety about its apparently declining influence in the Pacific Islands region due to the growing presence of China, a power with potentially inimical interests. The government has long been anxious about threats to its physical security that may arise from the Pacific Islands region. But reports in April 2018 that China was in talks to build a military base in Vanuatu were a wake-up call that its ability to influence the actions of Pacific Island countries (PICs) was limited. In response to its anxiety, the government has engaged in 'worldmaking' by seeking physical and ontological security through a discursive and practical 'geopolitical project'. This project has tried to enclose PICs through a 'domestication strategy' that has aimed at normalising Australia's presence in the Pacific Islands region. Yet despite these efforts at worldmaking through enclosure, the government has simultaneously made a parallel world that excludes Pacific peoples from Australia. To unpack this apparent contradiction, this article draws on ontological security scholarship and uses discourse analysis techniques to analyse the government's discursive efforts at enclosure by framing the Pacific as its 'family' and 'home', and practical efforts at enclosure through two schemes within which bordering practices are evident: labour mobility and scholarships. Drawing on criticisms of the exclusionary consequences of those schemes, this article then analyses how the government's migration rules seek to exclude Pacific peoples from Australia. Based on this analysis, it argues that the contradiction between the two worlds made by the government's foreign and security discourse and policy represent its longstanding ambivalence about its proximity to, and relationship with, PICs and Pacific peoples. [ABSTRACT FROM AUTHOR]

Environmental issues are becoming more urgent. Biodiversity loss, climate change, extreme events and global pressures on resources place increasing importance on decision making about how natural resources should be managed. Natural capital accounting (NCA) is gaining popularity as a systematic approach to recognise the full value of natural resources such as soil, vegetation, animals, water, and biodiversity. To understand perceptions and opportunities for awareness and behaviour change relating to the use of NCA, we conducted a discourse analysis of 57 interviews with stakeholders across Australia. Our aim is to promote discussion and reflection about perceptions of natural resources as forms of capital, and the role of NCA to underpin management practice change and support sustainability. We identify four key areas of contestation that relate to values, complexity, digital technology, and the desired future vision of NCA in society. Findings include conflicting views around whether NCA should have a diversity of tailored approaches or a consistent approach for all and that digital technology has and will continue to shape the way NCA is conducted. To our knowledge, this is the first paper to take a discourse analysis approach to perceptions of natural capital accounting. [Display omitted] [ABSTRACT FROM AUTHOR]

Across the globe, people are not equitably included or respected by health services. This results in some people being 'hardly reached' and having less access to safe and appropriate care. While some health services have adopted specific agendas to increase inclusion, these services can struggle to implement such strategies because the underlying reasons for exclusion have not been addressed. This calls for preparation prior to implementation of inclusion approaches that deconstructs discourses and practices of exclusion. This paper presents a pre-inclusion framework that seeks to deconstruct exclusion in health services. Authors developed this framework from action research in four 'mainstream' regional health services in southeast Australia over five years. Research identified dominant discourses of exclusion among staff in these services. The study also identified common experiences of residents hardly reached by these services. Following, a range of change activities were undertaken within these services to deconstruct exclusion. Researchers also kept journals, reflected on their impact, and identified lessons learned from trying to deconstruct exclusion. Triangulating these analyses, researchers developed an interdisciplinary framework that weaves together Foucauldian theory on power/discourse with continuous quality improvement processes to embed cultural humility and voices of the hardly reached in health care. The framework outlines five foundational concepts (power as productive, deconstruction, use of continuous quality improvement processes, cultural humility and voices of service users), followed by six principles (a journey, expect resistance, whole of service approach, make visible the reasons for change, we are all cultural beings and people centred care) and six actions undertaken within health services (commitment, assessment of exclusion, action plans, structural change, reflective discussions and engagement). Until such approaches to deconstruct exclusion are implemented, inclusive agendas are likely to be ineffective. • Before inclusion can be achieved, reasons for exclusion must be challenged. • Pre-inclusion readies a health service for engagement with those hardly reached. • This framework weaves Foucault, cultural humility, those hardly reached and CQI. • The framework aims to rupture power relations to privilege discourses of service users. • Health practitioners learn about their privilege and actions of exclusion. [ABSTRACT FROM AUTHOR]