Journal articles on the topic 'CALD'
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Seman, Michael, Bill Karanatsios, Koen Simons, Roman Falls, Neville Tan, Chiew Wong, Christopher Barrington-Brown, Nicholas Cox, and Christopher J. Neil. "The impact of cultural and linguistic diversity on hospital readmission in patients hospitalized with acute heart failure." European Heart Journal - Quality of Care and Clinical Outcomes 6, no. 2 (July 23, 2019): 121–29. http://dx.doi.org/10.1093/ehjqcco/qcz034.
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Abstract Aims Health services worldwide face the challenge of providing care for increasingly culturally and linguistically diverse (CALD) populations. The aims of this study were to determine whether CALD patients hospitalized with acute heart failure (HF) are at increased risk of rehospitalization and emergency department (ED) visitation after discharge, compared to non-CALD patients, and within CALD patients to ascertain the impact of limited English proficiency (LEP) on outcomes. Methods and results A cohort of 1613 patients discharged from hospital following an episode of acute HF was derived from hospital administrative datasets. CALD status was based on both country of birth and primary spoken language. Comorbidities, HF subtype, age, sex and socioeconomic status, and hospital readmission and ED visitation incidences, were compared between groups. A Cox proportional hazard model was employed to adjust for potential confounders. The majority of patients were classified as CALD [1030 (64%)]. Of these, 488 (30%) were designated as English proficient (CALD-EP) and 542 (34%) were designated CALD-LEP. Compared to non-CALD, CALD-LEP patients exhibited a greater cumulative incidence of HF-related readmission and ED visitation, as expressed by an adjusted hazard ratio (HR) [1.27 (1.02–1.57) and 1.40 (1.18–1.67), respectively]; this difference was not significant for all-cause readmission [adjusted HR 1.03 (0.88–1.20)]. CALD-EP showed a non-significant trend towards increased rehospitalization and ED visitation. Conclusion This study suggests that CALD patients with HF, in particular those designated as CALD-LEP, have an increased risk of HF rehospitalization and ED visitation. Further research to elucidate the underlying reasons for this disparity are warranted.
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Eatt, Jodi, Stuart J. Watson, Helen L. Ball, Katherine Sevar, and Megan Galbally. "Maternal Depression and Early Parenting: A Comparison Between Culturally and Linguistically Diverse and Australian born Mothers." Australasian Psychiatry 30, no. 1 (January 6, 2022): 119–25. http://dx.doi.org/10.1177/10398562211052886.
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Objective: To examine the risk of perinatal depression, parenting stress and infant sleep practices in Australian culturally and linguistically diverse (CaLD) women. Method: Within the Mercy Pregnancy and Emotional Wellbeing Study, we examined 487 pregnant women of whom 52 were CaLD and 435 non-CaLD. Depression was measured using the Structured Clinical Interview for DSM-IV and the Edinburgh Postnatal Depression Scale. In addition, Parenting Stress Index and infant sleep measures were collected. Results: Fewer CaLD women had a depression diagnosis but there were no differences between CaLD and non-CaLD women for perinatal mental health symptoms. More mothers in the CaLD group were bed sharing with their infant during the night at six months; however, bedsharing was only associated with higher parenting stress for non-CaLD mothers. Conclusions: Findings suggest both differences in infant sleep parenting practices and in parenting stress but not general emotional wellbeing. Future research is required to replicate these findings.
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Ghafournia, Nafiseh, Peter Massey, Sunita J. Rebecca Healey, and Bhavi Ravindran. "Culturally and linguistically diverse voices and views in COVID-19 pandemic plans and policies." Western Pacific Surveillance and Response Journal 13, no. 2 (August 4, 2022): 43–45. http://dx.doi.org/10.5365/wpsar.2022.13.2.915.
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Objective: This paper presents a rapid assessment of coronavirus disease 2019 (COVID-19) pandemic plans and explores the representation of culturally and linguistically diverse (CALD) communities in such plans. Four levels of pandemic plans were reviewed: regional, state, national and international. Methods: Discussions with representatives from four CALD communities informed the development of search and selection criteria for the COVID-19 plans, which were gathered and assessed using a CALD lens. Six COVID-19 pandemic plans that met the inclusion criteria were critically assessed. Results: The reviewed plans did not report any CALD community voices, views or consultations with community groups in the development phase, nor did they acknowledge the diversity of CALD populations. A few plans noted the vulnerability of CALD communities, but none discussed the challenges CALD communities face in accessing health information or health services during the pandemic, or other structural barriers (social determinants of health). Discussion: Our analysis revealed major gaps in all pandemic plans in terms of engaging with immigrant or CALD communities. Policies and plans that address and consider the complex needs and challenges of CALD communities are essential. Collaboration between public health services, multicultural services and policy-makers is vital for the inclusion of this higher-risk population.
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Pham, Thi Thu Le, Janneke Berecki-Gisolf, Angela Clapperton, Kerry S. O’Brien, Sara Liu, and Katharine Gibson. "Definitions of Culturally and Linguistically Diverse (CALD): A Literature Review of Epidemiological Research in Australia." International Journal of Environmental Research and Public Health 18, no. 2 (January 16, 2021): 737. http://dx.doi.org/10.3390/ijerph18020737.
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Objective: To identify how Culturally and Linguistically Diverse (CALD) communities are defined in epidemiological research in Australia and provide a definition of CALD status that aids the consistency and interpretability of epidemiological studies. Methods: Peer-reviewed literature from January 2015 to May 2020 was searched via four databases (Ovid Medline combined with PubMed, Embase, Emcare, and CINAHL) to identify quantitative studies of CALD people in Australia. Results: A total of 108 studies met the criteria for inclusion in the review. Country of birth was the most commonly used CALD definition (n = 33, 30.6%), with combinations of two or more components also frequently used (n = 31, 28.7%). No studies used all the components suggested as core to defining CALD status. including country of birth, languages other than English spoken at home, English proficiency, and indigenous status. Conclusions: There was considerable inconsistency in how CALD status was defined. The review suggests that CALD status would best be defined as people born in non-English speaking countries, and/or who do not speak English at home. Additionally, indigenous peoples should be considered separately. This recommended definition will support the better identification of potential health disparity and needs in CALD and indigenous communities.
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Ayre, Julie, Carissa Bonner, Sian Bramwell, Sharon McClelland, Rajini Jayaballa, Glen Maberly, and Kirsten McCaffery. "Implications for GP endorsement of a diabetes app with patients from culturally diverse backgrounds: a qualitative study." Australian Journal of Primary Health 26, no. 1 (2020): 52. http://dx.doi.org/10.1071/py19062.
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Although many diabetes self-management apps exist, these are not tailored for people from culturally and linguistically diverse (CALD) backgrounds. This study aimed to explore GP perceptions of how diabetes app features could help GPs better support their patients from CALD backgrounds. Twenty-five semi-structured interviews with GPs in Western Sydney explored attitudes towards a proposed app’s suitability for CALD patients. Interviews were audio-recorded, transcribed and coded using Framework Analysis. Theme 1 explored the implications of perceptions that patients’ health literacy is dependent on the language used. Theme 2 explored the influence of messaging from sources that share the patient’s language and culture (including misinformation from community sources). Theme 3 described the suitability of the app platform for CALD patients, and its potential challenges in this group. GPs perceived that a diabetes app could be useful for providing support to patients from CALD backgrounds. Findings suggest app features should be optimised to address existing challenges that GPs face and carefully consider strategies for recruiting CALD patients. It is important that GPs feel comfortable promoting an app to their CALD patients to help increase participation rates by people in the CALD community.
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Wang, Hongge, Matthew D. Davison, Martin L. Kramer, Weiliang Qiu, Tatiana Gladysheva, Ruby M. S. Chiang, Can Kayatekin, et al. "Evaluation of Neurofilament Light Chain as a Biomarker of Neurodegeneration in X-Linked Childhood Cerebral Adrenoleukodystrophy." Cells 11, no. 5 (March 7, 2022): 913. http://dx.doi.org/10.3390/cells11050913.
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Cerebral adrenoleukodystrophy (CALD) is a devastating, demyelinating neuroinflammatory manifestation found in up to 40% of young males with an inherited mutation in ABCD1, the causative gene in adrenoleukodystrophy. The search for biomarkers which correlate to CALD disease burden and respond to intervention has long been sought after. We used the Olink Proximity Extension Assay (Uppsala, Sweden) to explore the cerebral spinal fluid (CSF) of young males with CALD followed by correlative analysis with plasma. Using the Target 96 Neuro Exploratory panel, we found that, of the five proteins significantly increased in CSF, only neurofilament light chain (NfL) showed a significant correlation between CSF and plasma levels. Young males with CALD had a 11.3-fold increase in plasma NfL compared with controls. Importantly, 9 of 11 young males with CALD who underwent HCT showed a mean decrease in plasma NfL of 50% at 1 year after HCT compared with pre-HCT levels. In conclusion, plasma NfL could be a great value in determining outcomes in CALD and should be scrutinized in future studies in patients prior to CALD development and after therapeutic intervention.
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Kaur, Jatinder. "Working with families from culturally and linguistically diverse communities in Queensland: An Australian exploratory study." Children Australia 32, no. 4 (2007): 17–24. http://dx.doi.org/10.1017/s1035077200011731.
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In Australia there is limited research and information regarding how Culturally and Linguistically Diverse (CALD) families are assessed within the child protection system. This paper explores assessment issues faced by child protection investigation officers when working with CALD families in the Queensland child protection system. The research examined the level of knowledge, training and experiences of child protection officers and whether they were ‘culturally competent’. The study found that entry level officers did not receive adequate training and resources, and lacked CALD-specific knowledge on how to deal with cross cultural issues when working with CALD families. Respondents indicated that interpreters‘ services were effective during investigation and assessment of CALD families. The findings of this study highlight key concerns in the provision of child protection assessments, practice, policy and service delivery when working with CALD families.
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Lwin, Zarnie, Alexander Broom, Rasha Cosman, Ann Livingstone, Kate Sawkins, Phillip Good, Emma Kirby, Eng-Siew Koh, and Elizabeth Hovey. "Culturally and linguistically diverse patient participation in glioma research." Neuro-Oncology Practice 1, no. 3 (June 25, 2014): 101–5. http://dx.doi.org/10.1093/nop/npu009.
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Abstract Marginal communities, such as culturally and linguistically diverse (CALD) patients, have significantly lower rates of recruitment, accrual, and retention in cancer clinical trials. A combination of language and cultural barriers means that trial participation from CALD communities remains at suboptimal levels, which in turn favors research findings that are biased towards therapeutic effects or toxicities within the context of non-CALD populations. Here we outline some key challenges and implications for CALD patient participation in glioma research in countries such as Australia, where English is the language of governance and health services implementation. We highlight multistakeholder interventions to improve both investigator recruitment and participation of CALD communities in future glioma research, particularly in this era when global migration has come of age. Enhancing research participation of CALD communities ensures not only wider understanding of genetic heterogeneity to improve glioma outcomes but also equity in access to care.
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Randon, Giulia, Paola Falloppi, Maria Chiara Costa, Anita Bevilacqua, Anna Brugnolli, Federica Canzan, Astrid Kustatscher, et al. "The Lived Experience of Nursing Students with Culturally and Linguistically Diverse (CALD) Backgrounds in Italy: A Descriptive Phenomenological Study." Journal of Transcultural Nursing 31, no. 5 (November 21, 2019): 519–28. http://dx.doi.org/10.1177/1043659619889118.
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Introduction: In recent decades, Italy has been exposed to significant migrant flows resulting from political and economic instability in neighbouring countries. As a result, there has been an increased amount of cultural and linguistic diversity (CALD) among nursing students. The aim of this study was to explore the experience of CALD nursing students as lived in the Italian nursing programmes. Method: A descriptive phenomenological method was used in 2017 with the involvement of a purposeful sample of 21 CALD nursing students in five Italian Bachelor of Nursing Science campuses. Data were collected using semistructured interviews; the subsequent content analysis was conducted by two independent researchers. Results: CALD nursing students reported having lived a transformative experience based on seven themes, from “living in the middle, between belonging and detachment” to “acquiring cultural awareness and cultural sensitivity.” Discussion: Dealing with linguistic and cultural differences can affected CALD students’ academic success, but also encourages them to develop awareness and cultural sensitivity by influencing their peers and the environment of the nursing programme. Therefore, having CALD students is a great value for nursing programmes. Nursing programmes should embody the values of cultural sensitivity and acceptance, including them as a nursing care value and as a concrete strategy to support CALD students. They should also develop strategies to promote the knowledge and responsibilities of nurses among CALD students and increase cultural sensitivity among faculty members at different levels.
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Ward, Bernadette, Julie Ellis, and Karen Anderson. "Barriers to the provision of home and community care services to culturally and linguistically diverse populations in rural Australia." Australian Journal of Primary Health 11, no. 2 (2005): 147. http://dx.doi.org/10.1071/py05033.
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In 2002, qualitative methods in the form of in-depth interviews and focus groups were used to gather data from culturally and linguistically diverse (CALD) population residents, service providers and key stakeholders across rural Victoria, to identify and describe barriers to the effective delivery of home services to people from CALD populations in rural Australia. Barriers to the provision of Home and Community Care (HACC) services to CALD populations in rural areas were not specific to HACC programs. For CALD residents, barriers included lack of information about the range of available services, cultural factors, and negative past and recent experiences in dealing with both the broader community and service providers. Service providers indicated lack of information about the profile of the local CALD population and lack of experience in working with these groups to be barriers. Communication was also an issue both for CALD residents and service providers, in terms of cultural factors and specific communication strategies such as inadequate printed material and under-utilisation of existing resources such as interpreter services. As one of the world?s most ethno-culturally diverse nations, Australia has a responsibility to provide health services that are culturally responsive and acceptable. Greater attention needs to be given to the needs of rural CALD population groups in accessing home services.
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Goris, Janny, Nera Komaric, Amanda Guandalini, Daniel Francis, and Ellen Hawes. "Effectiveness of multicultural health workers in chronic disease prevention and self-management in culturally and linguistically diverse populations: a systematic literature review." Australian Journal of Primary Health 19, no. 1 (2013): 14. http://dx.doi.org/10.1071/py11130.
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With a large and increasing culturally and linguistically diverse (CALD) population, the Australian health care system faces challenges in the provision of accessible culturally competent health care. Communities at higher risk of chronic disease include CALD communities. Overseas, multicultural health workers (MHWs) have been increasingly integrated in the delivery of culturally relevant primary health care to CALD communities. The objective of this systematic review was to examine the effectiveness of MHW interventions in chronic disease prevention and self-management in CALD populations with the aim to inform policy development of effective health care in CALD communities in Australia. A systematic review protocol was developed and computerised searches were conducted of multiple electronic databases from 1 January 1995 until 1 November 2010. Thirty-nine studies were identified including 31 randomised controlled trials. Many of the studies focussed on poor and underserved ethnic minorities. Several studies reported significant improvements in participants’ chronic disease prevention and self-management outcomes and meta-analyses identified a positive trend associated with MHW intervention. Australian Government policies express the need for targeted inventions for CALD communities. The broader systemic application of MHWs in Australian primary health care may provide one of the most useful targeted interventions for CALD communities.
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Guo, Xin Yue, Susan Woolfenden, Gordon McDonald, Aldo Saavedra, and Raghu Lingam. "Discharge against medical advice in culturally and linguistically diverse Australian children." Archives of Disease in Childhood 104, no. 12 (June 22, 2019): 1150–54. http://dx.doi.org/10.1136/archdischild-2019-317063.
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ObjectivesThis study quantifies the prevalence and rates of discharge against medical advice (DAMA) in culturally and linguistically diverse (CALD) children and assesses the independent association between CALD status and DAMA accounting for key demographic confounders in a large tertiary Australian hospital network.MethodsProspectively collected data between 2010 and 2018 were extracted from the hospital network electronic medical records system for admitted patients (n=192 037), outpatients (n=268 904) and between 2015 and 2018 for emergency department (ED) patients (n=158 903). CALD status was defined as ‘preferred language being not English’ and DAMA was measured as ‘discharge at own risk’ in admissions, ‘no show’ in outpatients, ‘left without being seen’ and ‘did not wait’ in ED. Data were analysed using χ² test, bivariate analysis and multivariate logistic regression.ResultsThe prevalence of DAMA was 1.34% in admitted patients, 19.31% in outpatients and 12.64% in ED patients. Rates of DAMA were higher among CALD children compared to non-CALD children (1.75% vs 1.29% in admitted patients, 26.53% vs 17.92% in outpatients and 18.74% vs 11.61% in ED patients). CALD status was independently associated with DAMA in admitted children (OR=1.30, 95% CI 1.15 to 1.44), outpatients (OR=1.55; 95% CI 1.51 to 1.58) and ED patients (OR=1.60; 95% CI 1.53 to 1.66).ConclusionBeing from a CALD background places children at increased risks to DAMA. Implementing appropriate health service responses may ensure equitable access and quality care for children from CALD backgrounds to reduce the rates of DAMA and its associated ramifications.
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Mallack, Eric J., Stephanie van de Stadt, Paul A. Caruso, Patricia L. Musolino, Reza Sadjadi, Marc Engelen, and Florian S. Eichler. "Clinical and radiographic course of arrested cerebral adrenoleukodystrophy." Neurology 94, no. 24 (June 1, 2020): e2499-e2507. http://dx.doi.org/10.1212/wnl.0000000000009626.
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ObjectiveTo gain insight into the natural history of arrested cerebral adrenoleukodystrophy (CALD) by quantifying the change in Neurologic Function Score (NFS) and Loes Score (LS) over time in patients whose cerebral lesions spontaneously stopped progressing.MethodsWe retrospectively reviewed a series of 22 patients with arrested CALD followed longitudinally over a median time of 2.4 years (0.7–17.0 years). Primary outcomes were change in radiographic disease burden (measured by LS) and clinical symptoms (measured by NFS) between patients who never developed a contrast-enhancing lesion (gadolinium enhancement (GdE)− subgroup) and those who did (GdE+ subgroup). Secondary analyses comparing patterns of neuroanatomic involvement and lesion number, and prevalence estimates, were performed.ResultsCerebral lesions were first detected at a median age of 23.3 years (8.0–67.6 years) with an initial LS of 4 (0.5–9). NFS was 0.5 (0–6). Overall change in NFS or LS per year did not differ between subgroups. No patients who remained GdE− converted to a progressive CALD phenotype. The presence of contrast enhancement was associated with disease progression (rs = 0.559, p < 0.001). Four patients (18.2%) underwent step-wise progression, followed by spontaneous resolution of contrast enhancement and rearrest of disease. Three patients (13.6%) converted to progressive CALD. Nineteen patients (86.4%) had arrested CALD at the most recent follow-up. The prevalence of arrested CALD is 12.4%.ConclusionArrested CALD lesions can begin in childhood, and patients are often asymptomatic early in disease. The majority of patients remain stable. However, clinical and MRI surveillance is recommended because a minority of patients undergo step-wise progression or conversion to progressive CALD.
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Henderson, Saras, and Elizabeth Kendall. "Culturally and linguistically diverse peoples' knowledge of accessibility and utilisation of health services: exploring the need for improvement in health service delivery." Australian Journal of Primary Health 17, no. 2 (2011): 195. http://dx.doi.org/10.1071/py10065.
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With 28% of Australia’s population having a culturally and linguistically diverse (CALD) background, the health system faces an increasing challenge to provide accessible and culturally competent health care. The view that all CALD communities are homogenous and solutions can be developed for the entire nation is detrimental. Despite available health services, CALD communities are reluctant to use them due to cultural differences, perceived racism and misunderstandings leading to the existing health disparities. Therefore, gathering data from four prominent CALD communities, such as the Sudanese, Afghani, Pacific Islander and Burmese communities in Logan, Queensland, about how they perceive and use health services can provide insightful information towards development of a service model that will better suit these CALD communities. The objective of the study was to examine the extent to which four prominent CALD communities (Sudanese, Afghani, Pacific Islander and Burmese) access and use health services in Logan, Queensland. Six focus group interviews using interpreters were conducted in English with Sudanese, Afghani, Pacific Islander and Burmese people. The results indicated that even long-standing CALD communities, such as the Pacific Islander people, were unfamiliar with health services and experienced difficulties accessing appropriate health care. Most wanted doctors to use traditional healing methods alongside orthodox medicine, but did not feel respected for their beliefs. Language difficulties impeded communication with health professionals who were hindered by ineffective use of interpreters. In conclusion, a clear role for bilingual community-based navigators was identified by CALD participants to address concerns about the health system, and to improve accessibility and health service usage.
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Sepulveda, Mercedes, Saras Henderson, Dana Farrell, and Gaby Heuft. "Needs-gap analysis on culturally and linguistically diverse grandparent carers’ ‘hidden issues’: a quality improvement project." Australian Journal of Primary Health 22, no. 6 (2016): 477. http://dx.doi.org/10.1071/py15051.
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In Australia, a significant number of culturally and linguistically diverse (CALD) grandparents are sole carers for their grandchildren. Available information on the impact of caring on CALD grandparents and the ability of service providers to respond to their needs is limited. Our needs-gap analysis quality improvement project aimed to uncover ‘hidden issues’ for CALD grandparent carers so that services can be improved. One hundred service providers, such as community and aged-care services, child and/or grandparent support services and CALD-specific services, were approached using six structured questions. Six consultative forums on the caring role, issues encountered, and what needed to be done, were conducted with African, Asian, Spanish, Middle Eastern, European, Pacific Island and Maori grandparent carers in Queensland. The data were qualitatively analysed. Six themes emerged: 1) service provider and grandparent carer perception that there was limited research on CALD grandparents; 2) inadequate legal and financial support; 3) barriers to accessing information; 4) lack of childcare options; 5) transport difficulties; and 6) inadequate technological skills. Our findings provide insight to health service providers on the ‘hidden issues’ so that they can better assist CALD grandparent carers by improving access to relevant information, referrals and resources.
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Karidakis, Maria, Robyn Woodward-Kron, Riccardo Amorati, Bei Hu, Anthony Pym, and John Hajek. "Enhancing COVID-19 public health communication for culturally and linguistically diverse communities: An Australian interview study with community representatives." Qualitative Health Communication 1, no. 1 (January 25, 2022): 61–83. http://dx.doi.org/10.7146/qhc.v1i1.127258.
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Background: Public health crises present challenges for providing accessible, timely, and accurate health information to culturally and linguistically diverse (CALD) communities. Aim: The aim of this qualitative project was to explore strategies used by CALD community organizations to improve communication about COVID-19 for their communities; we also aimed to identify gaps and challenges. Methods: We interviewed 16 representatives from Greek, Italian, and Chinese CALD organizations in Melbourne, Australia. The interviews were analyzed thematically. Results: Community leaders played a significant role in engaging their community members with accurate key health information. There were differences between language communities about preferred channels for receiving information. As the pandemic intensified, there was a shift from written communication to more interactive exchanges between authorities and community leaders. Discussion: The findings suggest effective public health communication is enhanced by the mediation and outreach strategies adopted by CALD community organizations; further, stakeholders need to be cognizant of heterogeneity of needs and preferences. This may optimize information dissemination to meet specific needs. Conclusions:The CALD organizations have developed communication strategies involving different kinds of mediation to reach specific sub-groups, especially the most vulnerable. These strategies can inform future public health engagement.
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Pierpont, Elizabeth, Julie Eisengart, Richard Ziegler, Gerald Raymond, Paul J. Orchard, Troy Lund, and Weston P. Miller. "Neurocognitive Trajectory of Patients with Childhood Cerebral Adrenoleukodystrophy Who Received Allogeneic Hematopoietic Cell Transplantation at an Early Stage of Cerebral Disease." Blood 128, no. 22 (December 2, 2016): 4682. http://dx.doi.org/10.1182/blood.v128.22.4682.4682.
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Abstract Adrenoleukodystrophy (ALD) is an X-linked disorder of very long chain fatty acid metabolism which may manifest with adrenal gland and/or central nervous system disease. Thirty-five percent of affected boys develop cerebral involvement (cALD) during childhood. Characterized by progressive cerebral demyelination and resulting in devastating neurological and cognitive decline, cALD is usually fatal within years of clinically-evident disease. The only treatment known to enhance long-term survival and stabilize cerebral disease for boys with cALD is hematopoietic cell transplantation (HCT). It is well-established that the risk for negative long-term outcomes is significantly lower when HCT occurs at an earlier stage of cerebral white matter disease (ALD MRI severity score [Loes score] < 10). Nevertheless, there is limited knowledge of broad-based neurocognitive outcomes of patients transplanted with early-disease cALD. We studied all patients who underwent HCT for cALD at the University of Minnesota between January 1, 1991 and October 20, 2014. HCT preparative regimens varied with time, although most patients underwent myeloablative conditioning. Transplant allograft sources varied. Neurocognitive data were available for 63 patients who had a pre-transplant Loes MRI severity score < 10. Within this cohort, patients with less extensive cerebral disease (Loes ≤ 4) at the time of HCT had significantly higher scores on baseline tests of intellectual functioning than those with more cerebral involvement (Loes >4). This difference was particularly apparent on measures of nonverbal (visual) reasoning and processing speed. Furthermore, patients with more MRI-evident white matter disease at HCT showed more dramatic declines in neurocognitive test performance over time. In a subset of 20 patients who were followed for at least 4 years post-transplant, 15 patients (75%) demonstrated significant neurocognitive deficits (>1.5 SD below the mean) in at least one of the following domains: overall intellectual functioning (30%), attention (39%), verbal memory (33%), visual-motor integration (40%) and fine motor skills (58%). Results of this study provide evidence that within this patient group (boys undergoing HCT for cALD with Loes score < 10), patients have better neurocognitive outcomes when minimal cerebral disease is evident on neuroimaging prior to transplant. These data represent the largest analysis of cognitive outcomes in patients with early-disease cALD who underwent HCT. Our findings provide a benchmark for comparison to alternative or additional interventions for patients with cALD. Opportunities to enhance standard methods of detecting early cerebral disease and to intervene at the earliest possible stage of cALD should be explored. The emergence of newborn screening for adrenoleukodystrophy will provide avenues for improved pre-transplant monitoring and timing of intervention to preserve cognitive functioning and quality of life among patients with cALD. Disclosures No relevant conflicts of interest to declare.
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Gide, Sene, Sandie Wong, Frances Press, and Belinda Davis. "Cultural diversity in the Australian early childhood education workforce: What do we know, what don’t we know and why is it important?" Australasian Journal of Early Childhood 47, no. 1 (December 6, 2021): 48–61. http://dx.doi.org/10.1177/18369391211057292.
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This paper reviews current literature and research relevant to the Culturally and Linguistically Diverse (CALD) Early Childhood Education (ECE) workforce in Australia, including data from the Australian Bureau of Statistics (ABS). Australia is a highly multicultural society, with one out of every three people born overseas. Anecdotally, the Australian early childhood sector is reported to have a highly multicultural workforce. Yet there is a noticeable lack of data and research concerning cultural diversity in the Australian ECE workforce. This paper reports on the data from the ABS-Census of Population and Housing (ABS-Census), the small body of literature on the CALD ECE workforce and literature pertaining to CALD in other Australian workforces to argue that more data and research is needed. Developing a richer understanding of the status, experience and contributions of CALD educators would enable the sector to recognise and support the potential benefits of such a workforce for children and families and social cohesion in Australia.
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Shepherd, Jeanette, and Kitty van Vuuren. "The Brisbane flood: CALD gatekeepers’ risk communication role." Disaster Prevention and Management 23, no. 4 (July 29, 2014): 469–83. http://dx.doi.org/10.1108/dpm-08-2013-0133.
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Purpose – The purpose of this paper is to present the results of an original research project that explored the experiences and actions of immigrant and refugee communities during the 2011 Brisbane flood. It specifically examines the role of culturally and linguistically diverse (CALD) community leaders who acted as “gatekeepers” in communicating emergency responses to the disaster to their communities. Design/methodology/approach – Semi-structured interviews were conducted with eight “gatekeepers” who met the study's selection criteria. Findings – The study found that the characteristics and demographics of CALD gatekeepers in Brisbane, their use of multiple sources related to their involvement in the community, their use of interpersonal sources for information-seeking and use of the mass media, is largely consistent with previous studies. Research limitations/implications – This study departed from previous research with respect to issues of trust in government sources, gender and warning confirmation behaviour. These differences affected the behaviour of the CALD gatekeepers, especially around risk perception, information dissemination and filtering. Although the study points to the potential challenges facing emergency management services in fully incorporating the needs of all CALD communities, implications are limited given the small number of gatekeepers who agreed to be interviewed. Practical implications – Despite its limitation, the study does indicate that a critical gap exists in understanding CALD community responses to natural disasters. Social implications – The paper concludes with suggestions for a research agenda to gain better knowledge of the ethnic, demographic and personal factors that influence gatekeeping behaviour. Originality/value – The study is original because no prior research has directed attention to Brisbane's CALD community responses to disasters.
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Jamal, Javeria, Freya MacMillan, and Kate A. McBride. "Barriers and Facilitators of Breast Cancer Screening amongst Culturally and Linguistically Diverse Women in South Western Sydney: A Qualitative Explorative Study." International Journal of Environmental Research and Public Health 18, no. 17 (August 30, 2021): 9129. http://dx.doi.org/10.3390/ijerph18179129.
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Breast cancer is the most common cause of cancer amongst Australian women and the second most common cause of cancer mortality. Despite the proven effectiveness of early intervention, screening rates remain subpar across many regions in New South Wales (NSW). Screening rates are particularly low within the culturally and linguistically diverse (CALD) area of South Western Sydney (SWS). The objective of this study was to qualitatively explore barriers and facilitators to breast screening from the perspectives of CALD women from SWS. CALD women aged ≥40 who resided in SWS were invited to participate in a semi-structured interview to explore barriers and facilitators to breast cancer screening. Interviews were recorded, transcribed verbatim and analysed thematically to identify recurring patterns in the data. Sixteen women from CALD backgrounds participated. Women in this study reported absence of symptoms, fatalistic beliefs and embarrassment during the procedure to be the primary reasons for reluctance to screen. Lack of general practitioner (GP) endorsement, transport issues and pain associated with the procedure were also reported as additional barriers to screening. Common facilitators to screening included encouragement from family and friends, family history of cancer and media adverts. CALD women have distinctive barriers to mammography, which lead to poor breast screening participation rates. Opportunistic health promotion in this area is warranted and may lead to better health outcomes amongst this population.
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Hamiduzzaman, Mohammad, Noore Siddiquee, and Helen McLaren. "COVID-19 risk perceptions and precautions among the elderly: A study of CALD adults in South Australia." F1000Research 11 (January 13, 2022): 43. http://dx.doi.org/10.12688/f1000research.74631.1.
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Background: Coping with COVID-19 is a challenge for culturally and linguistically diverse (CALD) older adults. In Australia, little attention has been given to understanding associations between cultural contexts, health promotion, and socio-emotional and mental health challenges of older CALD adults during the COVID-19 pandemic. Therefore, we have collected data from older CALD adults to examine their COVID-19 risk perceptions and its association with their health precautions, behavioural dimensions and emergency preparation. Methods: A cross-sectional survey was conducted in South Australia. The CALD population aged 60 years and above were approached through 11 South Australian multicultural NGOs. Results: We provide the details of 155 older CALD South Australians’ demographics, risk perceptions, health precautions (problem-and-emotion-focused), behavioural dimensions and emergency preparation. The explanatory variables included demographic characteristics (age, gender, education and ethnicity); and risk perception (cognitive [likelihood of being affected] and affective dimension [fear and general concerns], and psychometric paradigm [severity, controllability, and personal impact]. The outcome measure variables were health precautions (problem-focused and emotion-focused), behavioral adaptions and emergency preparation. Conclusions: This dataset may help the researchers who investigate multicultural health or aged care in the pandemic and or who may have interest to link with other datasets and secondary use of this primary dataset in order to develop culturally tailored pandemic-related response plan. The data set is available from Harvard Dataverse.
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Natoli, Riccardo. "Exploratory insights into the financial habits of CALD migrants." International Journal of Sociology and Social Policy 35, no. 11/12 (October 12, 2015): 795–811. http://dx.doi.org/10.1108/ijssp-12-2014-0118.
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Purpose – The purpose of this paper is to explore the financial habits and experience of culturally and linguistically diverse (CALD) migrants via a case study of first and second wave migrants from the Vietnamese community in Australia. Design/methodology/approach – This paper utilises a qualitative approach through semi-structured interviews. A thematic analysis was adopted when coding the interview data which led to the emergence of identified themes related to financial habits and experience. Findings – The findings reveal that first and second wave migrants shared similar views on seeking professional financial advice, but not on the use of community-based financial schemes. When asked about the potential benefits of attending financial education workshops to inform themselves of financial services, most were unwilling to attend. Research limitations/implications – Although the research targets first and second wave Vietnamese CALD migrants, no claims can be made regarding the representation of CALD migrants as a whole. The research has implications with respect to the perceived necessity of CALD migrants to utilise mainstream financial services. This paper provides recommendations for future research in this area. Originality/value – The paper provides one of the few studies of an Australian CALD migrant cohort with respect to financial habits. The paper also provides an understanding of the cultural barriers and challenges facing this specific cohort of the Vietnamese community in Australia with respect to potentially accessing financial services.
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Gibbs, Lisa, Alexander J. Thomas, Alison Coelho, Adil Al-Qassas, Karen Block, Niamh Meagher, Limya Eisa, et al. "Inclusion of Cultural and Linguistic Diversity in COVID-19 Public Health Research: Research Design Adaptations to Seek Different Perspectives in Victoria, Australia." International Journal of Environmental Research and Public Health 20, no. 3 (January 28, 2023): 2320. http://dx.doi.org/10.3390/ijerph20032320.
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Participation of people from culturally and linguistically diverse (CALD) communities in public health research is often limited by challenges with recruitment, retention and second-language data collection. Consequently, people from CALD communities are at risk of their needs being marginalised in public health interventions. This paper presents intrinsic case analyses of two studies which were adapted to increase the cultural competence of research processes. Both cases were part of the Optimise study, a major mixed methods research study in Australia which provided evidence to inform the Victorian state government’s decision-making about COVID-19 public health measures. Case study 1 involved the core Optimise longitudinal cohort study and Case study 2 was the CARE Victorian representative survey, an Optimise sub-study. Both case studies engaged cultural advisors and bilingual staff to adjust the survey measures and research processes to suit target CALD communities. Reflexive processes provided insights into the strengths and weaknesses of the inclusive strategies. Selected survey results are provided, demonstrating variation across CALD communities and in comparison to participants who reported speaking English at home. While in most cases a gradient of disadvantage was evident for CALD communities, some patterns were unexpected. The case studies demonstrate the challenge and value of investing in culturally competent research processes to ensure research guiding policy captures a spectrum of experiences and perspectives.
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Hughson, Jo-anne, Fiona Marshall, Justin Oliver Daly, Robyn Woodward-Kron, John Hajek, and David Story. "Health professionals' views on health literacy issues for culturally and linguistically diverse women in maternity care: barriers, enablers and the need for an integrated approach." Australian Health Review 42, no. 1 (2018): 10. http://dx.doi.org/10.1071/ah17067.
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Objective To identify health literacy issues when providing maternity care to culturally and linguistically diverse (CALD) women, and the strategies needed for health professionals to collaboratively address these issues. Methods A qualitative case study design was undertaken at one large metropolitan Australian hospital serving a highly CALD population. Semistructured interviews were conducted with a range of maternity healthcare staff. The data were analysed thematically. The study is informed by a framework of cultural competence education interventions for health professionals and a health literacy framework. Results Eighteen clinicians participated in the interviews (seven midwives, five obstetricians, five physiotherapists, one social worker, and one occupational therapist). Emergent themes of health literacy-related issues were: patient-based factors (communication and cultural barriers, access issues); provider-based factors (time constraints, interpreter issues); and enablers (cultural awareness among staff, technology). Conclusions There are significant health literacy and systemic issues affecting the hospital’s provision of maternity care for CALD women. These findings, mapped onto the four domains of cultural competence education interventions will inform a technology-delivered health literacy intervention for CALD maternity patients. This approach may be applied to other culturally diverse healthcare settings to foster patient health literacy. What is known about the topic? There are health inequities for pregnant women of culturally and linguistically diverse (CALD) backgrounds. Low health literacy compounded by language and cultural factors contribute to these inequities and access to interpreters in pregnancy care remains an ongoing issue. Pregnancy smart phone applications are a popular source of health information for pregnant women yet these apps are not tailored for CALD women nor are they part of a regulated industry. What does this paper add? This paper provides clinician and language service staff perspectives on key health literacy issues that are both patient-based and provider-based. This research confirms that the complex interplay of social and practical factors contributes to and perpetuates low health literacy, creating barriers to health access; it also highlights several enablers for increasing CALD health literacy and access. These include greater health practitioner awareness and accommodation of CALD women’s needs and the provision of culturally and linguistically appropriate eHealth resources. What are the implications for practitioners? eHealth resources are emerging as valuable enabling tools to address the health literacy and information needs of pregnant women. However, these resources need to be used adjunctively with health practitioner communication. Both resource developers and health practitioners need to understand issues affecting CALD patients and their needs. Developers need to consider how the resource addresses these needs. Training of health professionals about culture-specific issues may help to enhance communication with, and therefore health literacy among, individual cultural groups. Further, formalised language and interpreting training of bi- or multilingual health professionals is advised to ensure that they are able to interpret to a professional standard when called on to do so.
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Velasco Leon, Azucena, and Marilyn Campbell. "Assessment of academic difficulties in culturally and linguistically diverse school students." Journal of Psychologists and Counsellors in Schools 30, no. 1 (March 3, 2020): 25–42. http://dx.doi.org/10.1017/jgc.2020.5.
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AbstractThe increasing tendency of immigration and forced migration practices around the world has made countries’ populations culturally and linguistically diverse. Australia is considered one of the most culturally diverse countries in the world. Consequently, the proportion of school-aged children with different culture and language is also increasing. Thus, school psychologists and guidance counsellors face the challenge of designing fair assessment practices and sound interventions for culturally and linguistically diverse (CALD) students who experience difficulties with their learning. Although many multicultural countries have extensive research regarding the assessment of learning difficulties in CALD students, Australia lacks this research. This study explored the most common assessment strategies that school psychologists and guidance counsellors usually implement in their assessment of CALD students. These results were then compared to a best practice model from the literature. In order to understand the current practices of school psychologists and counsellors in Australia who have assessed CALD children, a survey was administered to 34 school psychologists and counsellors. It was found that the reported strategies and protocols were very close to the ones proposed by experts, which was an unexpected outcome of this study. Implications for school psychologists and counsellors are discussed.
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Greenstock, Louise, Robyn Woodward-Kron, Catriona Fraser, Amie Bingham, Lucio Naccarella, Kristine Elliott, and Michal Morris. "Telecommunications as a means to access health information: an exploratory study of migrants in Australia." Journal of Public Health Research 1, no. 3 (October 31, 2012): 34. http://dx.doi.org/10.4081/jphr.2012.e34.
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<em>Background</em>. Health policies increasingly promote e-health developments (e.g., consumers’ access to online health information) to engage patients in the health care. In order to make these developments available for culturally and socially diverse communities, not only do Internet accessibility, literacy and e-health literacy need to be taken into account, but consumers’ preferences and information seeking behaviours for accessing health information have also to be understood. These considerations are crucial when designing major new health policy directions, especially for migration destination countries with culturally diverse populations, such as Australia. The aim of this study was to examine how people from a culturally and linguistically diverse (CALD) community use telecommunications (phone, mobile, Internet) to access health information. <em>Design and Methods</em>. A case study was conducted using a questionnaire exploring the use of telecommunications to access health information among CALD people. The study was carried out at a community health centre in a socially and economically disadvantaged area of Melbourne, a city of 4 million people with a large CALD and migrant population. Questionnaires were translated into three languages and interpreters were provided. Fifty-nine questionnaires were completed by users of the community health centre. <em>Results</em>. Most of the CALD participants did not have access to the Internet at home and very few reported using telecommunications to access health information. <em>Conclusions</em>. The findings of the study suggest that telecommunications are not necessarily perceived to be an important channel for accessing health information by members of the CALD community.
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Buchholz, Udo, Doris Altmann, and Bonita Brodhun. "Differential Seasonality of Legionnaires’ Disease by Exposure Category." International Journal of Environmental Research and Public Health 17, no. 9 (April 28, 2020): 3049. http://dx.doi.org/10.3390/ijerph17093049.
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Legionnaires’ disease (LD) shows a seasonal pattern with most cases occurring in summer. We investigate if seasonality can be observed for all three exposure categories (community-acquired (CALD), travel-associated (TALD) and healthcare-associated (HCA)). Methods: LD cases (2005–2015) were classified by exposure categories and we calculated the relative case ratio for each month from February to December using January as reference. The TALD relative case ratio was compared with flight frequencies. Results: Overall case numbers in Germany (N = 7351) peaked in August. CALD had a curve similar to all cases. TALD displayed a bimodal curve with peaks in June/July and October. The latter was attributable to LD cases aged 60+. The relative case ratio of TALD surpassed clearly that of CALD. The curve was similar to that of the relative flight frequencies, but was shifted by about one month. HCA showed no apparent seasonality. Conclusions: Although the overall seasonality in LD is heavily influenced by CALD, seasonal differences are more pronounced for TALD which may reflect travel behavior. The bimodal pattern of TALD is attributable to the curve among those aged 60+ and may reflect their preference to travel outside school holiday periods. Heightened vigilance for HCA cases is necessary throughout the entire year.
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Khawaja, Nigar G., and Lakshmi Dhushyanthakumar. "Strengths and difficulties questionnaire-teacher: Investigating its factor structure and utility with culturally and linguistically diverse students." Journal of Psychologists and Counsellors in Schools 30, no. 1 (February 26, 2020): 43–57. http://dx.doi.org/10.1017/jgc.2019.23.
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AbstractThe Strengths and Difficulties Questionnaire (SDQ), with its three forms (youth, parent and teacher version), is widely used to assess emotional and behavioural disorders in children and adolescents. The present study examined the factor structure and psychometric properties of the teacher version of the scale (SDQ-T) with adolescents from culturally and linguistically diverse (CALD) background. It also explored the impact of demographic factors on the mental health outcomes of CALD adolescents in the school setting as indicated by SDQ-T. Teachers from a Special English language transitional school in Brisbane, Australia completed the SDQ-T for 175 culturally and linguistically diverse adolescents. The exploratory factor analysis indicated a 23-item scale with a four-factor structure: Prosocial Behaviour, Hyperactivity, Emotional Symptoms, and Behavioural Problems. The revised scale had sound internal consistency. Findings indicated that CALD adolescents from refugee backgrounds scored higher on Emotional Symptoms, Conduct and Peer Problems, and SDQ total difficulties. There were no differences on subscale scores based on gender or English language proficiency. SDQ-T emerged as a promising scale that can be used to understand CALD adolescents’ postmigration emotional experiences, risks and protective factors. The implications of the SDQ-T in schools with adolescents from migrant and refugee backgrounds are discussed.
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Hutchinson, Claire, Jenny Cleland, Ruth Walker, and Julie Ratcliffe. "What Quality-of-Life Dimensions Are Most Important to Older Adults from Culturally and Linguistically Diverse Backgrounds Receiving Aged Care Services? An Exploratory Study." Geriatrics 7, no. 6 (December 19, 2022): 144. http://dx.doi.org/10.3390/geriatrics7060144.
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There is little research on what aspects of quality of life (QoL) are most important to culturally and linguistically diverse (CALD) older adults. This study aimed to identify what QoL dimensions were most important to CALD older adults receiving aged care services, and therefore, how relevant a new six dimensions QoL instrument developed for use in aged care is to this population. A three-stage, mixed-methods study was undertaken. Stage 1: n = 3 focus groups with aged care providers. Stage 2: n = 30 semi-structured interviews with Italian-born older adults in ethno-specific residential aged care. Stage 3: survey of n = 63 older adults from mixed CALD backgrounds receiving community aged care services. Overall, older adults asserted the importance of the six dimensions of the new QoL instrument. The importance of ‘identity’ and ‘purpose and meaning’ were identified via the focus groups; however, the community-based CALD older adults identified these aspects of quality of life as more important than older Italians in residential care. Being in ethno-specific residential aged care where needs relating to language, food, and religion were met and they continued to live with others from their community may have meant that the meeting of cultural needs was more taken for granted.
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Michael, Jaklina, Tracy Aylen, and Rajna Ogrin. "Development of a Translation Standard to support the improvement of health literacy and provide consistent high-quality information." Australian Health Review 37, no. 4 (2013): 547. http://dx.doi.org/10.1071/ah13082.
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Australia has a high number of people from culturally and linguistically diverse (CALD) backgrounds whose primary language is not English. CALD population groups have comparatively lower levels of education and health literacy, and poorer health outcomes compared with the Australian-born population. The delivery of consumer health information to people from CALD backgrounds usually includes the use of translated resources. Unfortunately, the quality of translated resources available on health issues is highly variable and may impact efforts to address the disparities in health outcomes. Currently applied guides to translation focus on accuracy and literalness of the translation; however, for health translations, conveying meaning and incorporating culturally relevant information is essential. Minimum standards for developing translated resources are needed to provide an indication of quality for end users, including healthcare providers, the client and carer. This paper describes the development of a Translation Standard, led by a community nursing organisation in collaboration and consultation with CALD community members and peak community organisations in Melbourne, Australia. The Translation Standard includes 10 components that have been identified as necessary to ensure a minimum standard of translation that is of high quality and caters to the health literacy levels of the target audience. What is known about the topic? There are many people from CALD backgrounds who have worse health outcomes than people who are Australian born. There is a gap in guidance to health professionals on how to develop high-quality translations of consumer health information that consider culture and health literacy. Higher-quality translations are needed to better inform CALD groups about their health. What does this paper add? The description of a new Translation Standard to guide the development of culturally relevant consumer health translations, considering the cultural needs and health literacy level of the target audience. What are the implications for practitioners? The Translation Standard provides assurance to practitioners that any translation that has followed this Standard is of high quality and increases the likelihood that the target audience will find the information relevant and understandable. The Translation Standard can assist consumers to make more informed choices and decisions about their health. Future translations would benefit by using such a guide.
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Chandrakumar, Abira, Elizabeth Hoon, Jill Benson, and Nigel Stocks. "Barriers and facilitators to cervical cancer screening for women from culturally and linguistically diverse backgrounds; a qualitative study of GPs." BMJ Open 12, no. 11 (November 2022): e062823. http://dx.doi.org/10.1136/bmjopen-2022-062823.
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ObjectiveTo explore general practitioners’ (GPs) perspectives on the barriers and facilitators to cervical cancer screening (CCS) for women from culturally and linguistically diverse (CALD) backgrounds.DesignQualitative descriptive study involving semi-structured interviews, with interview guide informed by the Theoretical Domains Framework.SettingAdelaide, South Australia.ParticipantsTwelve GPs with experience in providing CCS to women from CALD backgrounds participated.ResultsFour main themes emerged: ‘importance of clinician–patient relationship’, ‘patients’ cultural understanding regarding health care and CCS’, ‘communication and language’ and ‘health system related’. Each theme had several subthemes. GPs’ professional relationship with their patients and repeated advice from other clinicians, together with the provision of opportunistic CCS, were described as facilitators, and encompassed the theme of ‘importance of clinician–patient relationship’. This theme also raised the possibility of self-collection human papilloma virus tests. Lack of awareness and knowledge, lower priority for cancer screening and patients’ individual circumstances contributed to the theme of ‘patients’ cultural understanding regarding health care and CCS’, and often acted as barriers to CCS. ‘Communication and language’ consisted of language difficulties, interpreter use and use of appropriate resources. Language difficulties were a barrier to the provision of CCS, and GPs used interpreters and written handouts to help overcome this. The theme of ‘health system related’ involved the increased time needed for CCS consults for CALD women, access to appointments, funding, health promotion and effective use of practice management software.ConclusionsThis study highlights that multiple, inter-related barriers and facilitators influence CALD women’s engagement with CCS, and that GPs needed to manage all of these factors in order to encourage CCS participation. More efforts are needed to address the barriers to ensure that GPs have access to appropriate resources, and CALD patients have access to GPs they trust.
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Maidment, Jane, Ronnie Egan, and Jane Wexler. "Social work with older people from culturally and linguistically diverse backgrounds: Using research to inform practice." Aotearoa New Zealand Social Work 23, no. 3 (July 8, 2016): 3–15. http://dx.doi.org/10.11157/anzswj-vol23iss3id156.
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This research investigated the views of older culturally and linguistically diverse (CALD) people, their families and paid workers about experiences of giving and receiving care services in the Barwon region of Victoria, Australia. The project was conducted in collaboration with Diversitat, Geelong. While the research process incorporated a range of qualitative techniques this article is confined to reporting selected findings from the individual interviews and a focus group discussion. These findings demonstrated that particular caregiver personal attributes strengthened the relationship between older people and caregivers; differing interpretations were offered up about the use of time; multiple barriers for older CALD people using health and social services were identified; and that experiences of ageism within the health services were reported along with infrequent use of interpreter services. The article concludes with a discussion about the implications for social work practice and education with older CALD people.
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Saltapidas, Helen, and Jennie Ponsford. "The Influence of Cultural Background on Experiences and Beliefs about Traumatic Brain Injury and their Association with Outcome." Brain Impairment 9, no. 1 (May 1, 2008): 1–13. http://dx.doi.org/10.1375/brim.9.1.1.
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AbstractThe aim of the study was to compare beliefs and experiences of traumatic brain injury (TBI) in patients with TBI from the dominant English-speaking culture in Australia versus those from minority culturally and linguistically diverse (CALD) backgrounds and examine the relative influence of beliefs, acculturation, along with demographic and injury-related variables on outcome. The primary measures included the Illness Perception Questionnaire-Revised (IPQ-R), and the Craig Handicap Assessment and Reporting Technique (CHART). Participants were 70 individuals with mild to severe TBI, including 38 of English-speaking background (ESB) and 32 from CALD backgrounds. Although similar to the ESB participants in education, preinjury employment status, injury severity and experience of TBI, the CALD participants differed significantly from ESB participants on acculturation variables. CALD participants also experienced greater negative emotions and were less likely to have internal locus of control causal beliefs than ESB participants. Regression analyses indicated that describing one's value system as other than Australian, poorer understanding of TBI and greater negative emotional reactions, along with fewer years of education were associated with poorer outcomes on the CHART. Thus, in treating patients from different cultural backgrounds it is important for health professionals to understand beliefs about and responses to TBI, as they could potentially impact on coping, emotional adjustment and long-term outcome.
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Zuhair, Segu, Guneratne Wickremasinghe, and Riccardo Natoli. "Migrants and self-reported financial literacy." International Journal of Social Economics 42, no. 4 (April 13, 2015): 368–86. http://dx.doi.org/10.1108/ijse-09-2013-0203.
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Purpose – The issue of migrant financial literacy remains largely unresolved despite the increasing focus on financial literacy in general. The purpose of this paper is to provide a migrant-based approach to provide a snapshot of the self-reported levels of financial literacy specifically for a group of newly arrived culturally and linguistically diverse (CALD) migrants. Design/methodology/approach – A questionnaire is employed to explore the financial literacy of selected migrant groups representing the regions of Africa, Asia and Europe. Findings – The findings reveal that: migrants are eager to seek further information to assist with their financial decision making; better access and utilisation of basic financial services seems to be an area where improvement is required; and self-reported financial literacy levels are influenced by education levels. Research limitations/implications – Although the research targets newly arrived CALD migrants, no claims can be made regarding the representation of CALD migrants as a whole. The research has implications with respect to the development of a more adequate provision of avenues for CALD migrants to utilise basic financial services. This paper provides recommendations for future research in this area. Originality/value – A migrant’s financial literacy is typically based on a “one-size-fits-all” questionnaire, which only provides a broad examination of financial literacy aspects. This study addresses this gap by undertaking a case study focused solely on newly arrived migrants.
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J Black, Kristen, Deborah N Osborne, and Melissa A Lindeman. "Access to Local Government HACC services for people speaking a language other than English at home." Australian Journal of Primary Health 10, no. 1 (2004): 9. http://dx.doi.org/10.1071/py04002.
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Home and Community Care (HACC) services are provided to frail older people, other people with disabilities, and their carers, to assist independent living. HACC policy acknowledges that certain groups within the population have greater difficulty accessing HACC services than others. This paper considers the equity of access issue for one of the groups that have difficulty - people from culturally and linguistically diverse (CALD) backgrounds. Language spoken at home is used as an indicator of CALD status. The 2001 Census data and HACC-user data from the Western Metropolitan Region (WMR) of Victoria was analysed. The proportion of the HACC user population that speaks a language other than English (LOTE) was compared with the proportion of the general population that speaks a language other than English for two age groups ?the total population and those 65 years and over. Chi square analyses were conducted to determine odds ratios to give an indication of the magnitude and direction of the association between CALD status and access to HACC services. Analyses indicated that people who spoke a LOTE at home were approximately a third as likely to access Local Government HACC services than those who spoke English (OR=0.35). The findings suggest that policy and service development initiatives to improve access to HACC services for people of CALD backgrounds have not yet effectively reached their targets.
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Saute, Jonas Alex Morales, Carolina Fischinger Moura de Souza, Fabiano de Oliveira Poswar, Karina Carvalho Donis, Lillian Gonçalves Campos, Adriana Vanessa Santini Deyl, Maira Graeff Burin, et al. "Neurological outcomes after hematopoietic stem cell transplantation for cerebral X-linked adrenoleukodystrophy, late onset metachromatic leukodystrophy and Hurler syndrome." Arquivos de Neuro-Psiquiatria 74, no. 12 (December 2016): 953–66. http://dx.doi.org/10.1590/0004-282x20160155.
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ABSTRACT Hematopoietic stem cell transplantation (HSCT) is the only available treatment for the neurological involvement of disorders such as late-onset metachromatic leukodystrophy (MLD), mucopolysaccharidosis type I-Hurler (MPS-IH), and X-linked cerebral adrenoleukodystrophy (CALD). Objective To describe survival and neurological outcomes after HSCT for these disorders. Methods Seven CALD, 2 MLD and 2 MPS-IH patients underwent HSCT between 2007 and 2014. Neurological examinations, magnetic resonance imaging, molecular and biochemical studies were obtained at baseline and repeated when appropriated. Results Favorable outcomes were obtained with 4/5 related and 3/6 unrelated donors. Two patients died from procedure-related complications. Nine transplanted patients were alive after a median of 3.7 years: neurological stabilization was obtained in 5/6 CALD, 1/2 MLD, and one MPS-IH patient. Brain lesions of the MPS-IH patient were reduced four years after HSCT. Conclusion Good outcomes were obtained when HSCT was performed before adulthood, early in the clinical course, and/or from a related donor.
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SCHEMBRI, NEVILLE. "Developing linguistic and cultural competence: participants' evaluation of a Maltese language and culture awareness program." Advances in Social Sciences Research Journal 8, no. 5 (May 23, 2021): 251–60. http://dx.doi.org/10.14738/assrj.85.10195.
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Malta is facing an increasing demand and decreasing supply of local nurses and engagement of culturally and linguistically diverse (CALD) personnel is becoming the main solution to mitigate such problems. The case study examines the perceptions of CALD nurses about the content and utility of a Maltese language and culture awareness program. A qualitative methodology was adopted and data collected through focus group interviews conducted with sixteen (16) participants. Qualitative content analysis using Framework Method was used to analyse the data.
Views on the training program have been divided between elements related to individual utility, service user utility, quality of delivery and areas for improvement. The results indicate that training can provide significant advantages in terms of enhancing cultural competence and cross-cultural encounters amongst CALD nurses working in elderly long term care and it is recommended that such programs are encouraged to be taken on board by organisations operating in similar health and social care services.
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Lambert, Sylvie, Ekaterina Loban, Jane Li, Tracy Nghiem, Jamie Schaffler, Christine Maheu, Sylvie Dubois, Nathalie Folch, Elisa Gélinas-Phaneuf, and Andréa Maria Laizner. "Chronic Illness Management in Culturally and Linguistically Diverse Patients: Exploring the Needs, Access, and Understanding of Information." Qualitative Health Research 31, no. 13 (October 12, 2021): 2426–39. http://dx.doi.org/10.1177/10497323211040769.
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In Canada, people from culturally and linguistically diverse (CALD) backgrounds are at a greater risk of developing a chronic illness, and are more likely to experience adverse health effects and challenges in accessing high-quality care compared with Canadian-born individuals. This, in part, has been attributed to having inadequate access to information and resources needed to manage their illness(es). A qualitative descriptive design and inductive content analysis were used to explore the information needs of 24 CALD patients with chronic illnesses. Participants identified medical, lifestyle, and psychosocial information needs. How much information was needed depended on such antecedents as illness trajectory, severity, and perception. Most information needs remained unmet. A number of communication strategies were identified to bridge language barriers that go beyond translation and are based on effective health education strategies. Findings can help health care professionals better identify CALD patients’ information needs and provide strategies that go beyond translation.
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Deadman, Lauren, and Vicki L. McKenzie. "More than play: The impact of playgroup participation on culturally and linguistically diverse parents’ and carers’ degree of social support, connectedness and self-efficacy." Educational and Developmental Psychologist 37, no. 1 (May 20, 2020): 75–82. http://dx.doi.org/10.1017/edp.2020.8.
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AbstractSupported playgroups are a common form of intervention offered in Australian early childhood education. This study used interviews and quantitative measures to examine whether attending supported playgroups benefits culturally and linguistically diverse (CALD) parents’ or carers’ social support, connectedness, and parental self-efficacy (PSE). Thirty-five playgroup attendees completed three validated measures assessing social support, isolation, and PSE. Seven mothers, two carers, and two playgroup staff participated in semistructured interviews. The quantitative and qualitative data indicated that CALD parents and carers show high levels of isolation and low social support. The qualitative data indicated that most parents or carers felt more supported and connected as a result of attending the playgroup, and just over half stated that the playgroup had improved their confidence. This study highlights the need to consider the social resources of CALD families when planning and delivering services, and calls for future longitudinal studies of the benefits of playgroups.
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Boughtwood, Desiree, Christopher Shanley, Jon Adams, Yvonne Santalucia, Helena Kyriazopoulos, Dimity Pond, and Jeffrey Rowland. "Dementia information for culturally and linguistically diverse communities: sources, access and considerations for effective practice." Australian Journal of Primary Health 18, no. 3 (2012): 190. http://dx.doi.org/10.1071/py11014.
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Providing information about dementia has been shown to produce immense benefits for people living with dementia and their carers. The dementia information needs of culturally and linguistically diverse (CALD) families have not been comprehensively investigated. Addressing this research gap, the current study examines the perspectives of a range of stakeholders – CALD family caregivers (Arabic, Chinese, Italian and Spanish speaking), bilingual and bicultural workers, bilingual general practitioners and geriatricians – about dementia-related information. The study focussed on sources of information, issues of access and considerations for improving information provision. The main findings that are relevant for improving policy and practice are: the need for a more strategic and coordinated approach to dissemination structures and processes, a greater emphasis on supporting and enhancing the interpersonal aspects of information provision, the need for a greater range of information for CALD communities and the need to ensure information resources and processes reflect the circumstances and needs of these communities.
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Ogbo, Felix Akpojene, Osita Kingsley Ezeh, Sarah Khanlari, Sabrina Naz, Praween Senanayake, Kedir Y. Ahmed, Anne McKenzie, et al. "Determinants of Exclusive Breastfeeding Cessation in the Early Postnatal Period among Culturally and Linguistically Diverse (CALD) Australian Mothers." Nutrients 11, no. 7 (July 16, 2019): 1611. http://dx.doi.org/10.3390/nu11071611.
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There are limited epidemiological data on exclusive breastfeeding (EBF) among culturally and linguistically diverse (CALD) Australian mothers to advocate for targeted and/or culturally-appropriate interventions. This study investigated the determinants of EBF cessation in the early postnatal period among CALD Australian mothers in Sydney, Australia. The study used linked maternal and child health data from two local health districts in Australia (N = 25,407). Prevalence of maternal breastfeeding intention, skin-to-skin contact, EBF at birth, discharge, and the early postnatal period (1–4 weeks postnatal), were estimated. Multivariate logistic regression models were used to investigate determinants of EBF cessation in the early postnatal period. Most CALD Australian mothers had the intention to breastfeed (94.7%). Skin-to-skin contact (81.0%), EBF at delivery (91.0%), and at discharge (93.0%) were high. EBF remained high in the early postnatal period (91.4%). A lack of prenatal breastfeeding intention was the strongest determinant of EBF cessation (adjusted odds ratio [aOR] = 23.76, 95% CI: 18.63–30.30, for mothers with no prenatal breastfeeding intention and aOR = 6.15, 95% CI: 4.74–7.98, for those undecided). Other significant determinants of EBF cessation included a lack of partner support, antenatal and postnatal depression, intimate partner violence, low socioeconomic status, caesarean birth, and young maternal age (<20 years). Efforts to improve breastfeeding among women of CALD backgrounds in Australia should focus on women with vulnerabilities to maximise the benefits of EBF.
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Truong, Mandy, Lisa Gibbs, Yin Paradies, Naomi Priest, and Maryanne Tadic. "Cultural competence in the community health context: ‘we don’t have to reinvent the wheel’." Australian Journal of Primary Health 23, no. 4 (2017): 342. http://dx.doi.org/10.1071/py16073.
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Health and social service agencies need to be responsive to the healthcare requirements of culturally and linguistically diverse (CALD) groups in the community. This is a challenging proposition, particularly due to shifting demographics in developed Western countries such as Australia. Organisations that strive for cultural competence can potentially reduce the barriers associated with inequitable access to services by CALD groups. Community health services play a vital role in the provision of culturally competent health services to people from CALD groups. Additional research related to cultural competence in the community health context is needed. Thus, the aim of this paper is to explore the positioning of cultural competence within community health from multiple perspectives using a qualitative case study of a community health service located in Victoria, Australia. The findings suggest that if the essential needs of clients are met, regardless of cultural background (e.g. able to communicate with staff, trust and a respectful and caring environment), then issues related to cultural background may be of less significance for some clients.
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Ogie, Robert, Juan Castilla Rho, Rodney J. Clarke, and Alison Moore. "Disaster Risk Communication in Culturally and Linguistically Diverse Communities: The Role of Technology." Proceedings 2, no. 19 (October 26, 2018): 1256. http://dx.doi.org/10.3390/proceedings2191256.
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Migrants, ethnic minorities and people from culturally and linguistically diverse (CALD) communities are often more vulnerable to natural disasters due to cultural barriers and limited proficiency in the dominant language, which sometimes undermine their ability to access, interpret and respond to warnings. Technology can assist in engendering culturally and linguistically appropriate communication with CALD communities if key challenges are identified. This study contributes by reviewing relevant literature with the aim of ascertaining the most pressing challenges requiring technological interventions. Three broad issues (i.e., trust, message tailoring, and message translation) are identified and discussed, and potential solutions for addressing these issues are recommended.
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McKinlay, Eileen, Stewart Graham, and Pauline Horrill. "Culturally and linguistically diverse patients' views of multimorbidity and general practice care." Journal of Primary Health Care 7, no. 3 (2015): 228. http://dx.doi.org/10.1071/hc15228.
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INTRODUCTION: It is recognised that patients who are culturally and linguistically diverse (CALD) have challenges in accessing health care and understanding health advice or instructions. Those with multimorbidity (MM) are likely to have additional difficulties. In New Zealand, little is known about how this patient group view their health and general practice health care. This study examined the views of multimorbid CALD patients about MM and the health care available in a Very Low Cost Access general practice. METHODS: This qualitative study recruited Samoan, Cook Island Maori, and Cambodian patients with diabetes and more than three other long-term conditions. Two individual interviews and two language-specific focus groups were undertaken to yield themes representing the experience of these CALD patients with MM. FINDINGS: Participants described MM as having considerable impact on their life. They reported feeling responsible for supporting their own health and many detailed self-management techniques. However, they also expressed confusion, lack of information and limited understanding of MM, in particular about managing medication. Not all patients were aware of the range of available general practice services and some described difficulties in accessing general practice care. CONCLUSION: Despite being motivated to self-manage, this patient group report challenges in understanding their conditions and how to manage them, which may also be influenced by health beliefs. Available general practice services are not well known by CALD patients with MM. There is likely to be value in developing a specific structured, yet patient-centred, model of care for this group of patients. KEYWORDS: Access to health care; ethnic groups; focus groups; general practice; health literacy; self care
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Henderson, Saras, and Elizabeth Kendall. "'Community navigators': making a difference by promoting health in culturally and linguistically diverse (CALD) communities in Logan, Queensland." Australian Journal of Primary Health 17, no. 4 (2011): 347. http://dx.doi.org/10.1071/py11053.
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A key component of the 2011 Australian National Health Reform, via the Access and Equity Policy, is to improve access to quality health services for all Australians including CALD communities. Awareness has been raised that certain CALD communities in Australia experience limited access to health care and services, resulting in poor health outcomes. To address this issue, the Community Navigator Model was developed and implemented in four CALD communities in Logan, Queensland, through a partnership between government and non-government organisations. The model draws on local natural leaders selected by community members who then act as a conduit between the community and health service providers. Nine ‘navigators’ were selected from communities with low service access including the Sudanese, Burmese, Afghan and Pacific Islander communities. The navigators were trained and employed at one of two local non-government organisations. The navigators’ role included assessing client needs, facilitating health promotion, supporting community members to access health services, supporting general practitioners (GPs) to use interpreters and making referrals to health services. This paper explores the ‘lived experience’ of the navigators using a phenomenological approach. The findings revealed three common themes, namely: (1) commitment to an altruistic attitude of servility allowing limitless community access to their services; (2) becoming knowledge brokers, with a focus on the social determinants of health; and (3) ‘walking the walk’ to build capacity and achieving health outcomes for the community. These themes revealed the extent to which the role of CALD community navigators has the potential to make a difference to health equity in these communities, thus contributing to the Australian National Health Reform.
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Miller, Weston P., Steven M. Rothman, David Nascene, Teresa Kivisto, Todd E. DeFor, Richard S. Ziegler, Julie Eisengart, et al. "Outcomes after allogeneic hematopoietic cell transplantation for childhood cerebral adrenoleukodystrophy: the largest single-institution cohort report." Blood 118, no. 7 (August 18, 2011): 1971–78. http://dx.doi.org/10.1182/blood-2011-01-329235.
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Abstract Cerebral adrenoleukodystrophy (cALD) remains a devastating neurodegenerative disease; only allogeneic hematopoietic cell transplantation (HCT) has been shown to provide long-term disease stabilization and survival. Sixty boys undergoing HCT for cALD from 2000 to 2009 were analyzed. The median age at HCT was 8.7 years; conditioning regimens and allograft sources varied. At HCT, 50% demonstrated a Loes radiographic severity score ≥ 10, and 62% showed clinical evidence of neurologic dysfunction. A total of 78% (n = 47) are alive at a median 3.7 years after HCT. The estimate of 5-year survival for boys with Loes score < 10 at HCT was 89%, whereas that for boys with Loes score ≥ 10 was 60% (P = .03). The 5-year survival estimate for boys absent of clinical cerebral disease at HCT was 91%, whereas that for boys with neurologic dysfunction was 66% (P = .08). The cumulative incidence of transplantation-related mortality at day 100 was 8%. Post-transplantation progression of neurologic dysfunction depended significantly on the pre-HCT Loes score and clinical neurologic status. We describe the largest single-institution analysis of survival and neurologic function outcomes after HCT in cALD. These trials were registered at www.clinicaltrials.gov as #NCT00176904, #NCT00668564, and #NCT00383448.
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Zheng, Feixia, Zhongdong Lin, Ying Hu, Xulai Shi, Qianlei Zhao, and Zhenlang Lin. "Identification of a Novel Non-Canonical Splice-Site Variant in ABCD1." Journal of Clinical Medicine 12, no. 2 (January 6, 2023): 473. http://dx.doi.org/10.3390/jcm12020473.
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Cerebral adrenoleukodystrophy (CALD) is a fatal genetic disease characterized by rapid, devastating neurological decline, with a narrow curative treatment window in the early stage. Non-canonical splice-site (NCSS) variants can easily be missed during genomic DNA analyses, and only a few of them in ABCD1 have been explored. Here, we studied a Chinese patient with clinical features similar to those of early-stage CALD but with a negative molecular diagnosis and a sibling who had presumably died of CALD. Trio-based whole-exome sequencing (trio-WES) and RNA sequencing (RNA-Seq) revealed a novel hemizygote NCSS variant c.901-25_901-9 del in ABCD1 intron 1, resulting in a complex splicing pattern. The in vitro minigene assay revealed that the c.901-25_901-9 del construct contained two aberrant transcripts that caused skipping of exon 2 and a small 48-bp deletion on left of the same exon. We identified a novel NCSS variant, that extends the spectrum of the known ABCD1 variants, and demonstrated the pathogenicity of this gene variant. Our findings highlight the importance of combining RNA-Seq and WES techniques for prompt diagnosis of leukodystrophy with NCSS variants.
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Nguyen, Tran. "Australian welfare workers and street-level discretion when working with clients from culturally and linguistically diverse (CALD) backgrounds." Current Sociology 68, no. 3 (June 13, 2019): 372–89. http://dx.doi.org/10.1177/0011392119853001.
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This article explores street-level discretion of Australian welfare workers when working with clients from culturally and linguistically diverse (CALD) backgrounds. The research is situated within the context of New Public Management (NPM) and neoliberalism in the welfare sector. Findings suggest that workers’ discretion oscillates between extra support for clients, or further scrutiny and sanction. Such contradictory patterns of discretion highlight workers’ capacity to resist neoliberalism while concurrently upholding it. The article argues that cultural understanding, recognition of the limitations in welfare-to-work policies and neoliberalism, and how those factors, together with ethnicity, may influence street-level discretion are necessary for welfare workers to support CALD clients effectively.
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McDougall, Jenny, and Caroline Henderson-Brooks. "Lessons Learnt: Reflections on the ‘Insider-Outsider Divide’ in Working With Culturally and Linguistically Diverse Students in a Participatory Action Research Project." International Journal of Qualitative Methods 20 (January 2021): 160940692110663. http://dx.doi.org/10.1177/16094069211066375.
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This paper explores the challenges and possibilities in research that involves students from Culturally and Linguistically Diverse (CALD) backgrounds, a group that tends to be overlooked in university settings and in the literature. We present a reflexive account of our experiences as researchers in a Participatory Action Research (PAR) study that explored the needs of CALD students from an enabling (access) program in a regional Australian university. PAR was chosen as a research method out of our desire to give these students a voice and to help break down any potential barriers because of our positioning as researchers. We draw on the concept of ‘researcher as insider-outsider’ (Merriam, 2016) to highlight these aspects in our analysis of the research process. Some of our democratic objectives were achieved, but we also found there were limitations. Our position as Caucasian, Australian-born English speakers meant that we remained ‘outsiders’ to the CALD experience in fundamental ways. Further, our ‘insider’ status as researchers and lecturers was difficult to ignore, and institutional expectations created additional barriers. Some aspects of our data collection had unintended negative consequences, thus necessitating a change of course. On the plus side, however, consulting with students at each stage of the research helped to create more equal, trusting relationships and fostered empathetic understandings. The continual cycle of reflection and action assisted in ensuring we were responsive to the needs of participants. Although there are no guarantees, our experiences suggest that collaborative methods can assist in blurring the researcher-researched divide and give vulnerable communities greater agency in research. Despite the complexities and risks, exploring the needs of CALD students remains a worthwhile research endeavour. Any attempts to achieve equitable outcomes should highlight the capacity and potential of these students and not just their vulnerabilities.
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Hilder, Jo, Ben Gray, and Maria Stubbe. "Health navigation and interpreting services for patients with limited English proficiency: a narrative literature review." Journal of Primary Health Care 11, no. 3 (2019): 217. http://dx.doi.org/10.1071/hc18067.
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ABSTRACT INTRODUCTIONCulturally and linguistically diverse populations (CALD) have significant health outcome disparities compared to dominant groups in high-income countries. The use of both navigators and interpreters are strategies used to address these disparities, but the intersections between these two roles can be poorly understood. AIMTo gain an overview of the literature on health navigation and similar roles, with particular reference to the New Zealand context, and to explore the interface between these roles and that of interpreters for CALD populations with limited English proficiency. METHODSA narrative review of the literature was conducted using a range of search strategies and a thematic analysis was conducted. RESULTSThere are several barriers to health-care access relating to health systems and CALD populations. For over 50 years, health workers who are members of these communities have been used to address these barriers, but there are many terms describing workers with wide-ranging roles. There is some evidence of efficacy in economic, psychosocial and functional terms. For health navigation services to work, they need to have staff who are well selected, trained and supported; are integrated into health-care teams; and have clearly defined roles. There may be a place for integrating interpreting more formally into the navigator role for members of communities who have limited English proficiency. CONCLUSIONTo achieve better access to health care for CALD populations, there is an argument for adding another member to the health team who combines clearly defined aspects of the roles of interpreter, community health worker and navigator. Organisations considering setting up such a position should have a clear target population, carefully consider the barriers they are trying to address and define a role, scope of practice and training requirements best suited to addressing those barriers.