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Objective To quantitatively assess the factors associated with non-beneficial treatments (NBTs) in hospital admissions at the end of life.Conclusions This paper presents the first statistical modelling results to assess the factors associated with NBT in hospital, beyond an intensive care setting. Our findings highlight potential areas for intervention to reduce the likelihood of NBTs.

Objective: There is substantial evidence that refugees' employment experiences are marred by a range of hurdles as they settle in their host country. This study investigated the relationship between a range of independent variables such as, demographic factors, acculturation, acculturative stress, and resilience and the dependent variable that is the employment status of former refugees. Method: Questionnaire data were gathered from 169 participants from the Ethiopian, Congolese, and Myanmar communities settled in Brisbane, Australia. Hierarchical logistic regression was used to investigate the factors that predicted employment status. Results: Resilience and demographic variables such as age, education, gender, and country of origin were not associated with being employed. Length of stay and English proficiency increased the likelihood of being employed. Surprisingly, an increase in acculturation was associated with the likelihood of being unemployed, while an increase in acculturative stress was associated with the likelihood of being employed. Conclusions: These findings indicate that unemployed participants perceived themselves to be acculturated and integrated, while those who were employed reported more acculturative stress. Furthermore, employment despite its positive impact can also be stressful. The study has practical and theoretical implications for stakeholders involved in the employment of refugees.

Intergroup communication, given its interdisciplinary roots in communication and social psychology, has been eclectic in methodology. Earlier approaches tended to be quantitative and experimental. In the early 21st century, the full range of qualitative approaches—thematic analysis and grounded theory, discourse analysis, conversation analysis, and others—have come to prominence. A key issue has been how to reconcile the broad-brush aspects of surveys, tightly-controlled contexts in experiments, and very limited numbers of participants in qualitative research. In the past decade or so, rapid improvements to the capabilities of computational technologies have brought forth a new generation of computational methods for communication research. Broadly known as visual text analytics, these methods provide communication scholars new ways to model, visualize, and analyze intergroup communication processes. They also allow larger scale in the detailed analysis of texts and discourse. In spite of their great interest to intergroup communication, these new visual text analytic methods also present challenges. In presenting several newer visual text analytic methods, we articulate some ways to approach the tools to achieve maximum research benefit. In the past decade or so, rapid improvements to the capabilities of computational technologies have brought forth a new generation of computational methods for communication research. Broadly known as visual text analytics, these methods provide communication scholars new ways to model, visualize, and analyze intergroup communication processes. They also allow larger scale in the detailed analysis of texts and discourse. In spite of their great interest to intergroup communication, these new visual text analytic methods also present challenges. In presenting several newer visual text analytic methods, we articulate some ways to approach the tools to achieve maximum research benefit.

Taking a truly global perspective, this textbook presents concepts, theories and applications from the field of intercultural communication in a lively and easy-to-follow style. Covering all the essential topics, from immigration to intercultural conflict to the impact of mass media and technology, this cutting edge new edition features: A student-friendly structure with enhanced signposting to guide students through the book. Expanded coverage of ethics, digital communication and social media. A brand new set of international case studies to tie theory to real-world practices, including the European refugee crisis, Chinese food culture and Barbie dolls and beauty. A suite of student-friendly learning features, including ‘Do it!’ activity boxes, chapter summaries and applications of key theories in ‘Theory Corner’. Links to further reading and SAGE Video to help understanding. A host of online resources to reinforce students' learning, including multiple choice quizzes, discussion questions and exercises. Introducing Intercultural Communication is the ideal guide to becoming a critical consumer of information and an effective global citizen. It should be required reading for students in media and communications, business and management, linguistics and beyond.

In contemporary Western society, the concept of risk is mostly linked related to negative or undesirable outcomes and used to explain unusual or abnormal events that have harmful consequences. Working in a poststructuralist framework, in this article we examine how risk shapes interactions between midwives and pregnant women in the context of public hospitals in Australia. We draw on data from an observational study of clinical encounters in three Australian hospitals between October 2014 and July 2015. The research teams recorded 83 health encounters and in this paper we draw on data from the recordings of 10 clinical consultations between 8 midwives and 10 pregnant women at various stages of gestation. We used these data to explore how a discourse of risk was mobilised through rhetorical strategies and practices of ‘hunting’ for the abnormal and attempts to control the body. Our findings demonstrate how a discourse of pregnancy and birth as risky operates within public hospital midwifery consultations. We found that in the midwifery consultations we recorded, pregnancy was constructed as a period of vulnerability and unpredictability. It was normalised through discursive practices of hunting for the abnormal and rhetorical strategies of attempting to control the body. Within this discourse, midwives occupied conflicting positions. They asserted that women, with the right support, were capable of spontaneous and intervention-free (pregnancy and) birth. Yet, they acted to enable medical professionals to assess a woman’s ability to give birth (un)assisted, or the potential for an adverse event. The women, while positioned as passive within the public health system, were positioned as active in surveilling themselves and responsible for taking steps to mitigate against adverse events.

Objectives To estimate the incidence, duration and cost of futile treatment for end-of-life hospital admissions. Design Retrospective multicentre cohort study involving a clinical audit of hospital admissions. Setting Three Australian public-sector tertiary hospitals. Participants Adult patients who died while admitted to one of the study hospitals over a 6-month period in 2012. Main outcome measures Incidences of futile treatment among end-of-life admissions; length of stay in both ward and intensive care settings for the duration that patients received futile treatments; health system costs associated with futile treatments; monetary valuation of bed days associated with futile treatment. Results The incidence rate of futile treatment in end-of-life admissions was 12.1% across the three study hospitals (range 6.0%–19.6%). For admissions involving futile treatment, the mean length of stay following the onset of futile treatment was 15 days, with 5.25 of these days in the intensive care unit. The cost associated with futile bed days was estimated to be $AA12.4 million for the three study hospitals using health system costs, and $A988 000 when using a decision maker’s willingness to pay for bed days. This was extrapolated to an annual national health system cost of $A153.1 million and a decision maker’s willingness to pay of $A12.3 million. Conclusions The incidence rate and cost of futile treatment in end-of-life admissions varied between hospitals. The overall impact was substantial in terms of both the bed days and cost incurred. An increased awareness of these economic costs may generate support for interventions designed to reduce futile treatments. We did not include emotional hardship or pain and suffering, which represent additional costs.

The study had two goals: First, a 20-item “Refugee Parent-Child Relational Communication Scale” was developed for parents from refugee backgrounds. Former refugee parents from Ethiopia, Congo and Burma (N=221) completed this and other questionnaires measuring demographics, acculturation and acculturative stress. Exploratory factor analysis indicated three factors: “Engagement”, “Hope and Aspirations” and “Dissonance”. The sub-scales were internally consistent. Second, this newly-developed scale was used to explore whether the parents’ communication and relations with their children were associated with demographics, acculturation and acculturative stress. Results of multiple regressions indicated that mothers and parents with higher acculturation were more engaged with their children and also encouraged their children to aspire for higher goals in life. Though parents with higher acculturative stress were also developing aspirations and hopes in their children; they reported strained relations with their children. Parents from the Congo scored higher on dissonance, indicating some problematic communication with their children.

Free to Read Objective(s) To describe how doctors define and use the terms “futility” and “futile treatment” in end-of-life care. Design, Setting, Participants A qualitative study using semi-structured interviews with 96 doctors across a range of specialties who treat adults at the end of life. Doctors were recruited from three large Australian teaching hospitals and were interviewed from May to July 2013. Results Doctors’ conceptions of futility focused on the quality and chance of patient benefit. Aspects of benefit included physiological effect, weighing benefits and burdens, and quantity and quality of life. Quality and length of life were linked, but many doctors discussed instances when benefit was determined by quality of life alone. Most doctors described the assessment of chance of success in achieving patient benefit as a subjective exercise. Despite a broad conceptual consensus about what futility means, doctors noted variability in how the concept was applied in clinical decision-making. Over half the doctors also identified treatment that is futile but nevertheless justified, such as short-term treatment as part of supporting the family of a dying person. Conclusions There is an overwhelming preference for a qualitative approach to assessing futility, which brings with it variation in clinical decision-making. “Patient benefit” is at the heart of doctors’ definitions of futility. Determining patient benefit requires discussions with patients and families about their values and goals as well as the burdens and benefits of further treatment.

This is the finalreport of the ARC linkage research project Refugees’ employment aspirations and inter-generational communication about future occupational pathways.The project was based in South-eastQueensland and was conducted overthree years (2013, 2014, and 2015). The lead chief investigator was Dr Aparna Hebbani from the University of Queensland. The project had three overall aims. Aim 1: To investigate the employment experiences of recently arrived refugees. Aims2 and 3: Toinvestigate refugees’ aspirations for themselves and their children’s educational and occupational futures. Specifically, this study focused on the experiences of refugeesettlersfrom Burma, the Democratic Republic of Congo, and Ethiopia, which are among the top ten source countries for offshore humanitarian entrants (DIBP, 2013).

Full Text, Thesis (PhD Doctorate), Doctor of Philosophy in Organisational Psychology (PhD OrgPsych), School of Applied Psychology, Griffith Health, Understanding the psychological relationship between the individual and the organisation, and its effects on behaviour, continues to have strong theoretical and practical relevance for identification researchers (van Knippenberg & Sleebos, 2006). Indeed, it has been argued that an organisation can not be fully understood without understanding the identity dynamics that arise from the interactions between the organisation, its social environment, and the individual psychology of its members (Ashforth & Mael, 1989; Haslam, 2014; Hodgkinson, 2013; Tajfel, 1981). The goal of this thesis project was to undertake an indepth exploration of employee identifications in one organisation undergoing large-scale change. The first major aim was to illuminate the particular identities that were most salient for participants as they reflected on their experience of the changes. The second aim was to conduct an indepth exploration of those identities, to shed light on their origins and core features, and to understand why they were evoked during change. A third aim was to explore the relationship between the identities, and participants' perceptions and responses to change. Finally, a key aim was to illuminate any features of the organisational and social context that were related to the presence, development and effects of salient identities. The guiding methodology was interpretive qualitative research, chosen for its acute sensitivity to identity processes and associated contextual features (Yin, 2009). The advantage of this approach is that it allowed for indepth exploration of the nature, sources and effects of employee identifications, including contextual aspects involved in shaping and sustaining important identities.

Parents’ communication with their children is considered salient for their normal development and socialisation. Parents, from a refugee background, who enter Australia on humanitarian grounds, have the added responsibility of using communication to facilitate the acculturation of their children. Communication can be adaptive or maladaptive and can also include messages of hope, aspiration and support. The parents’ communication can be effected by their own acculturation process and challenges. In spite of the significance of these parents’ communication with their children, there has not been any attempt to measure their communication patterns with a valid scale. The present study developed a scale to measure the parents, from a refugee background, perception of their communication with their children. The impact of demographic variables, acculturation and acculturative stress on communication was also investigated. Items were generated by the research team after consulting literature and experts. Former refugees from Congo, Ethiopia and Burma were invited to participate in the study. Data were collected with the assistance of Access Community Services Ltd. a refugee settlement non-government organisation in Brisbane, Australia, and is part of a larger ARC Linkage project (LP12020076). Parents (N= 148), who had at least one child in school, participated in the study and completed a battery of questionnaires in their own respective language. Exploratory factor analysis identified a 20- item “Refugee Parents’ Communication Scale” with three factors. Engagement (factor1) measured the parent-child relationship evident by spending time together, common interests and mutual respect. Hopes/Aspirations (factor 2), reflected parents communication with their children about educational and employment goals of these youngsters. Dissonance (factor 3) was associated with parent-child conflict and perceived negative influence of living in Australia. A series of MANOVAS were condu

People with dementia living in residential care often face the dual disadvantage of increasing difficulty with communication and reduced opportunities for conversation. Social interaction is central to wellbeing of residents with dementia, so it is important that care staff have the skills to engage in conversation with them. We studied conversations in 20 care staff–resident dyads, to examine conversation structure and content, patterns of engagement within conversations, including the topics around which engagement occurred, and communication behaviours by care staff that appeared to facilitate (or impede) participation by residents. The transcripts were analysed using Discursis, a computational information visualisation tool that allows interactive visual inspection, in context, of the contributions by each speaker, the turn-taking dynamics, and the content recurring within and between speakers. We present case examples (a) where care staff did most of the talking, initiated topics and were responsible for most recurrence of content; (b) where talk was more evenly shared between partners, with some topics initiated and/or elaborated by participants with dementia; and (c) where participants with dementia talked most, with care staff supporting the conversation. We identified accommodative strategies used by care staff, such as reflecting back the other person's responses to sustain engagement. We also noted care staff behaviours that impeded communication, such as not listening attentively and not allowing sufficient time for responses. The results from this study highlight aspects of social communication within the aged care context and suggest ways in which rewarding interactions between staff and residents with dementia might be encouraged.

In this study, 3531 Queensland women, who had recently given birth, completed a questionnaire that included questions about their participation in decision making during pregnancy, their ratings of client centred care and perceived quality of care. These data tested a version of Street’s (2001) linguistic model of patient participation in care (LMOPPC), adapted to the maternity context. We investigated how age and education influenced women’s perceptions of their participation and quality of care. Hierarchical multiple regressions revealed that women’s perceived ability to make decisions, and the extent of client-centred communication with maternity care providers were the most influential predictors of participation and perceived quality of care. Participation in care predicted perceived quality of care, but the influence of client-centred communication by a care provider and a woman’s confidence in decision making were stronger predictors of perceived quality of care. Age and education level were not important predictors. These findings extend and support the use of LMOPPC in the maternity context.

Treatment that will not provide significant net benefit at the end of a person’s life (called futile treatment) is considered by many people to represent a major problem in the health sector, as it can waste resources and raise significant ethical issues. Medical treatment at the end of life involves a complex negotiation that implicates intergroup communication between health professionals, patients, and families, as well as between groups of health professionals. This study, framed by intergroup language theory, analyzed data from a larger project on futile treatment, in order to examine the intergroup language associated with futile treatment. Hospital doctors (N = 96) were interviewed about their understanding of treatment given to adult patients at the end of life that they considered futile. We conducted a discourse analysis on doctors’ descriptions of futile treatment provided by themselves and their in-group and out-group colleagues. Results pointed to an intergroup context, with patients, families, and colleagues as out-groups. In their descriptions, doctors justified their own decisions using the language of logic, ethics, and respect. Patients and families, however, were characterized in terms of wishing and wanting, as were outgroup colleagues. In addition, out-group doctors were described in strongly negative intergroup language.