Lost in translation, found in translation : A case study of working psychodynamically in an interpreter-assisted setting

Effective use of psychotherapeutic treatment in interpreter-assisted settings is well established; however, there has been little discussion of the use of psychodynamically-informed treatments in such settings. The literature suggests that therapy facilitated by interpreters is not conducive to psychodynamic approaches due to the presence of a third person, the perceived lack of intimacy, and the difficulties of working with translated material. However, transference, countertransference and other unconscious communications and responses necessarily occur in every therapeutic setting, including triadic therapy using interpreters. This paper describes a short-term (12 session) psychodynamically-oriented intervention with a 52-year old Cantonese-speaking man suffering from depression. A female, Chinese-born interpreter assisted in every session. The integral role of supervision in supporting a containing relationship between the therapist and the patient and the difficult emotional responses experienced by the interpreter is highlighted. The paper attempts to trace some of the unconscious communications that occurred during the therapy and demonstrates the feasibility of working psychodynamically in an interpreter-assisted setting.

Grunt language versus accent : the perceived communication barriers between international medical graduates and patients in Central Wheatbelt catchments

Due to the chronic shortages of GPs in Australian rural and remote regions, considerable numbers of international medical graduates (IMG) have been recruited. IMG experience many difficulties when relocating to Australia with one of the most significant being effective GP-patient communication. Given that this is essential for effective consultation it can have a substantial impact on health care. A purposive sample of seven practising GPs (five IMG, two Australian-trained doctors (ATD)) was interviewed using a semistructured face-to-face interviewing technique. GPs from Nigeria, Egypt, United Kingdom, India, Singapore and Australia participated. Interviews were transcribed and then coded. The authors used qualitative thematic analysis of interview transcripts to identify common themes. IMG-patient communication barriers were considered significant in the Wheatbelt region as identified by both IMG and ATD. ATD indicated they were aware of IMG-patient communication issues resulting in subsequent consults with patients to explain results and diagnoses. Significantly, a lack of communication between ATD and IMG also emerged, creating a further barrier to effective communication. Analysis of the data generated several important findings that rural GP networks should consider when integrating new IMG into the community. Addressing the challenges related to cross-cultural differences should be a priority, in order to enable effective communication. More open communication between ATD and IMG about GP-patient communication barriers and education programs around GP-patient communication would help both GP and patient satisfaction.

Folk opera : stories crossing borders in Papua New Guinea

The Life Drama project is a drama-based sexual health promotion project, developed by a cross-cultural research team in Papua New Guinea (PNG) over the past four years. Recognising the limitations of established theatre-in-education and theatre-for-development approaches when working across cultures, the research team explored ways of tapping into the everyday performativity of PNG participants and their communities in order to communicate more powerfully about the personal and social issues involved in sexual health. Through the Folk Opera form, developed by PNG theatre company Raun Raun Theatre around the time of national Independence, the research explored the importance of ‘story’ in identity formation, maintenance and change, the communication of meaning, and the transmission of tacit local knowledges. In a highly diverse and rapidly-changing country like PNG, enacted stories inherently compel the exchange and exploration of different knowledges, and promote the dialogue and ownership that drives social change. The paper will present and unpack the folk opera form as developed in the Life Drama program, drawing conclusions which may apply to other programs which to promote health and social justice across cultures.

“Yarning” as a method for community-based health research with indigenous women : the indigenous women's wellness research program

This project explores yarning as a methodology for understanding health and wellness from an indigenous woman's perspective. Previous research exploring indigenous Australian women's perspectives have used traditional Western methodologies and have often been felt by the women themselves to be inappropriate and ineffective in gathering information and promoting discussion. This research arose from the indigenous women themselves, and resulted in the exploration of using yarning as a methodology. Yarning is a conversational process that involves the sharing of stories and the development of knowledge. It prioritizes indigenous ways of communicating, in that it is culturally prescribed, cooperative, and respectful. The authors identify different types of yarning that are relevant throughout their research, and explain two types of yarning—family yarning and cross-cultural yarning—which have not been previously identified in research literature. This project found that yarning as a research method is appropriate for community-based health research with indigenous Australian women. This may be an important finding for health professionals and researchers to consider when working and researching with indigenous women from other countries.

A gender comparison of food shopper typologies

This research segments male and female food shoppers based on store and product attribute evaluations, enjoyment, planning, and shopping responsibility. A rich profile for each segment is developed from a sample of 580 primary food shoppers. Gender comparisons are operationalized and these developed food shopper typologies are contrasted against earlier works. Factor analysis, cluster analysis, and ANOVA were employed to develop specific segments of shoppers. This is the first study to identify specific groups of male food shoppers and contrast these to traditional female shoppers and earlier typographical works. The research provides the basis for further cross-cultural, cross-contextual comparative studies.

Transitions in taste in Vietnam and the diaspora

This paper argues that food and styles of eating have become the predominant markers of social change for the Vietnamese in both Vietnam and in the diaspora. In post-socialist Vietnam the transition to a market economy has allowed for a huge growth in the number of restaurants and cafes, and in the north, a return to an earlier style of cooking. The intense interest and emphasis on food as embodied pleasure has meant that it has come to stand for the transition away from a heavily state-controlled economy. The new configurations of family and friendship are being framed by newly available ways of ‘eating out’, which are both a means of social display and distinction as well as an indicator of the tensions between reform and festivity within an authoritarian nation-state struggling to define itself in a globalising world. At the same time as food in Vietnam is undergoing rapid transformation so too has the Vietnamese diaspora enerationally changed its eating patterns. Although there as been a focus in the literature on food in the diaspora that emphasises the nostalgic and recuperative elements of ‘migrant food’, I argue that food is the prime mechanism of intercultural engagement for each diasporic generation. For older Vietnamese, Vietnamese restaurants and barbecues have been the sites of interplay between cultural tradition’ and innovation, and between Australianness and Vietnameseness, and these interstitial places continue to be important for younger Vietnamese. Within this established framework of cross-cultural interaction, for Vietnamese youth, the social settings of ‘ethnic food’, eaten at home and shared with family, have been grafted onto a sociality of eating fast food. This melding together of both invention and convention, of transgression and ordinariness provides the background against which young people from migrant backgrounds are reinvigorating the social spaces of food consumption and in the process both e-enchanting and destabilising the notion of migrant food.

Women from refugee backgrounds and their experiences of attending a specialist antenatal clinic : narratives from an Australian setting

Problem: In response to an identified need, a specialist antenatal clinic for women from refugee backgrounds was introduced in 2008, with an evaluation planned and completed in 2010. Question: Can maternity care experiences for women from refugee backgrounds, attending a specialist antenatal clinic in a tertiary Australian public hospital, be improved? Methods: The evaluation employed mixed methods, generating qualitative and quantitative data from two hospital databases, a chart audit, surveys and interviews with service users, providers and stakeholders. Contributions were received from 202 participants. Findings: The clinic was highly regarded by all participants. Continuity of care throughout the antenatal period was particularly valued by newly arrived women as it afforded them security and support to negotiate an unfamiliar Western maternity system. Positive experiences decreased however; as women transitioned from the clinic to labour and postnatal wards where they reported that their traditional birthing and recuperative practices were often interrupted by the imposition of Western biomedical notions of appropriate care. The centrally located clinic was problematic, frequently requiring complex travel arrangements. Appointment schedules often impacted negatively on traditional spousal and family obligations. Conclusions: Providing comprehensive and culturally responsive maternity care for women from refugee backgrounds is achievable, however it is also resource intensive. The production of translated information which is high quality in terms of production and content, whilst also taking account of languages which are only rarely encountered, is problematic. Cultural competency programmes for staff, ideally online, require regular updating in light of new knowledge and changing political sensitivities.

Intercultural residential care in New Zealand

Along with other Organization for Economic Cooperation and Development (OECD) countries, New Zealand’s society is aging such that an increase in the number of older people requiring residential care is predicted. What cannot be foreseen is how culturally defined health beliefs affect the care given to older people in residential care. In this article, the authors describe and discuss the culturally based health beliefs of some Pacific Islands caregivers and predominately European (Pakeha) older people resident at one long-term care facility in Auckland, New Zealand. The delivery of care is influenced by culturally related beliefs about “being old.” Racism is evident in residential care, and the authors discuss the reactions of caregivers, residents, and management. This research extends the discussion of caregiving and receiving into the cross-cultural setting, and the findings highlight a number of elements in cultural differences between carer and cared-for that might affect care practices at the residential facility studied.

Folk opera : stories crossing borders in Papua New Guinea

The Life Drama project is a drama-based sexual health promotion project, developed by a cross-cultural research team in Papua New Guinea (PNG) over the past four years. Recognising the limitations of established theatre-in-education and theatre-for-development approaches when working across cultures, the research team explored ways of tapping into the everyday performativity of PNG participants and their communities in order to communicate more powerfully about the personal and social issues involved in sexual health. Through the Folk Opera form, developed by PNG theatre company Raun Raun Theatre around the time of national Independence, the research explored the importance of "story" in identity formation, maintenance and change, the communication of meaning, and the transmission of tacit local knowledges. In a highly diverse and rapidly-changing country like PNG, enacted stories inherently compel the exchange and exploration of different knowledges, and promote the dialogue and ownership that drives social change. The paper will present and unpack the Folk Opera form as developed in the Life Drama program, drawing conclusions which may apply to other programs which to promote health and social justice across cultures.

The supervision tango : perceptions of supervisors of international graduate students in Engineering and IT

This paper, which was part of a larger study, reports on a survey that explored the perceptions of 69 graduate supervisors regarding issues in supervision from three higher education institutions in Australia. Factors that contribute to student success in higher education research degrees are many and diverse, including a complex dance of student factors, supervisor factors, and their supervisory context factors, and those informed by cultural and language differences. Therefore, a complex system approach using Bayesian network modelling was used to explore how student and/or supervisor factors influence the success of culturally and linguistically diverse (CALD) graduate students in Engineering and IT. Findings suggest that key factors include the experience of supervisors in terms of experience with the Australian higher education system, personal cross-cultural experience.

Towards growing Indigenous culturally competent legal professionals in Australia

The Review of Australian Higher Education (Bradley Review: 2008) identified the need for tertiary institutions to incorporate Indigenous knowledges into curriculum to improve educational outcomes for Indigenous Australians and to increase the cultural competency of all students. It recommended that higher education providers ensure that the institutional culture, the cultural competence of staff and the nature of the curriculum supports the participation of Indigenous students, and that Indigenous knowledge be embedded into curriculum so that all students have an understanding of Indigenous culture. While cultural competency has been recognised as an essential element of professional practice in health services internationally, and legal practice in the United States, very little work has been done to promote the cultural competency of legal professionals in the Australian context. This paper will discuss a pilot cultural competency professional development program for legal academics at Queensland University of Technology (Brisbane) developed with the assistance of a Faculty of Law Teaching and Learning Grant in 2011-2012, and tell one Murri’s journey to foster Indigenous cultural competency in an Australian law school.

Prevalence of depressive symptoms as elicited by Patient Health Questionnaire (PHQ-9) among medical trainees in Oman

Background Despite the increasing recognition that medical training tends to coincide with markedly high levels of stress and distress, there is a dearth of validated measures that are capable of gauging the prevalence of depressive symptoms among medical residents in the Arab/Islamic part of the world. Objective The aim of the present study is two-fold. First is to examine the diagnostic validity of the Patient Health Questionnaire (PHQ-9) using an Omani medical resident population in order to establish a cut-off point. Second is to compare gender, age, and residency level among Omani Medical residents who report current depressive symptomatology versus those who report as non-depressed according to PHQ-9 cut-off threshold. Results A total of 132 residents (42 males and 90 females) consented to participate in this study. The cut-off score of 12 on the PHQ-9 revealed a sensitivity of 80.6% and a specificity of 94.0%. The rate of depression, as elicited by PHQ-9, was 11.4%. The role of gender, age, and residency level was not significant in endorsing depression. Conclusion This study indicated that PHQ-9 is a reliable measure among this cross-cultural population. More studies employing robust methodology are needed to confirm this finding.

The inaccuracy of national character stereotypes

Consensual stereotypes of some groups are relatively accurate, whereas others are not. Previous work suggesting that national character stereotypes are inaccurate has been criticized on several grounds. In this article we (a) provide arguments for the validity of assessed national mean trait levels as criteria for evaluating stereotype accuracy and (b) report new data on national character in 26 cultures from descriptions (N= 3323) of the typical male or female adolescent, adult, or old person in each. The average ratings were internally consistent and converged with independent stereotypes of the typical culture member, but were weakly related to objective assessments of personality. We argue that this conclusion is consistent with the broader literature on the inaccuracy of national character stereotypes