ORCID Profile
0000-0002-0525-8516
Current Organisations
National Ageing Research Institute
,
Beijing Information Science & Technology University
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Publisher: Elsevier BV
Date: 09-2021
Publisher: SAGE Publications
Date: 16-07-2023
DOI: 10.1177/14713012231190578
Abstract: There is a growing demand for interpreter-mediated cognitive assessments for dementia. However, most interpreters lack specialist knowledge of dementia and cognitive assessment tools. This can negatively affect the way instructions and responses are conveyed between clinicians and patients, undermining clinicians’ ability to accurately assess for cognitive impairment. This article reports on the co-design of an online dementia training package, MINDSET, which aims to address this gap. Two iterative online co-design workshops were conducted in October and November 2021, using a World Café approach. Sixteen clinicians, interpreters, and multilingual family carers of a person with dementia participated. Based on these workshops, training and assessment materials were developed and tested with 12 interpreters from April to June 2022. The training package comprises online modules: 1) Knowledge of Dementia and Australia’s Aged Care System, 2) Briefings and Introductions, 3) Interpreting Skills, 4) Interpreting Ethics, and 5) Cross-cultural Communication. The codesign process highlighted ergent perspectives between clinicians and interpreters on an interpreter’s role during a cognitive assessment, but it also facilitated negotiation and consensus building, which enriched the training content. The training is now developed and will be evaluated in a randomized control trial and subsequent implementation study.
Publisher: Elsevier BV
Date: 08-2019
DOI: 10.1016/J.SOCSCIMED.2019.112359
Abstract: This article explores whether this extension of treatment and medication possibilities, owing to greater transnational movement of goods and people, presents increasing challenges for maintaining patients' trust within nationally-bound healthcare systems, such as in Australia. We ran focus groups in Melbourne from June 2012 to June 2013 with 34 Indian migrants to Australia. Our findings illustrate discrepancies between the symbolic mediation of trust within Indian and Australian healthcare encounters. We find that Indian participants associated authoritative and decisive self-presentation by doctors with medical competence, conflicting with Western patient choice models which exalt patient autonomy and agency. We also find that trust in Indian healthcare encounters is mediated through the symbolic deployment of "strong medication" and the engendering of "hope" in patients. Australian doctors' failure to deploy these symbols in the same way contributes to distrust that Indian participants express towards Australian health professionals and healthcare systems. We conclude that in situations where patients have less familiarity with the symbolic repertoire shared by the majority of users of a national healthcare system, such as can be the case with recent migrants, difficulties and misunderstandings may arise in negotiating trust, providing a potential motivator for seeking alternatives transnationally.
Publisher: Routledge
Date: 03-01-2023
Publisher: Oxford University Press (OUP)
Date: 29-04-2022
Abstract: Providers who work closely with ethnic minority people with dementia and their families are pivotal in helping them access services. However, few studies have examined how these providers actually do this work. Using the concept of “boundary crossers,” this article investigates the strategies applied by these providers to facilitate access to dementia services for ethnic minority people with dementia and their families. Between 2017 and 2020, in-depth video-recorded interviews were conducted with 27 health, aged care, and community service providers working with ethnic minority people living with dementia across Australia. Interviews were conducted in one of seven languages and/or in English, then translated and transcribed verbatim into English. The data were analyzed thematically. Family and community stigma associated with dementia and extra-familial care were significant barriers to families engaging with services. To overcome these barriers, participants worked at the boundaries of culture and dementia, community and systems, strategically using English and other vernaculars, clinical and cultural terminology, building trust and rapport, and assisting with service navigation to improve access. Concurrently, they were cognizant of familial boundaries and were careful to provide services that were culturally appropriate without supplanting the families’ role. In negotiating cultural, social, and professional boundaries, providers undertake multidimensional and complex work that involves education, advocacy, negotiation, navigation, creativity, and emotional engagement. This work is largely undervalued but offers a model of care that facilitates social and community development as well as service integration across health, aged care, and social services.
Publisher: SAGE Publications
Date: 06-2022
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 09-2023
Publisher: Informa UK Limited
Date: 27-07-2023
DOI: 10.1080/07317115.2022.2101968
Abstract: 40% of dementia cases can be prevented by addressing 12 lifestyle factors. These risk factors have increased presence in ethnic minorities, yet dementia prevention messages have not reached these communities. This article investigates the experience of co-designing a dementia prevention animated film with 9 ethnic groups in Australia. Evidence-based recommendations were adapted through an iterative process involving workshops with a stakeholder advisory committee and nine focus groups with 104 participants from the Arabic-, Hindi-, Tamil-, Cantonese-, Mandarin-, Greek-, Italian-, Spanish-, and Vietnamese-speaking communities. Data were analyzed using the Normalization Process Theory. Cultural adaptation involves consideration of the mode of delivery, imagery and tone of the resource being developed ensuring cultural adequacy anticipating the need of the end-users and managing linguistic challenges associated with working across multiple languages. Learnings from this co-design process offer valuable insights for researchers and program developers who work with ethnic minority groups. • Adaptation across cultures and languages is a negotiation not a consensus building exercise• Linguistic adaptation requires consideration of the education levels, and linguistic and intergenerational preferences of community members• Co-designing across multiple languages and cultures risks "flattening out" key aspects of cultural specificity.
Publisher: Wiley
Date: 31-05-2021
DOI: 10.1111/JOCN.15842
Abstract: As places of both residence and work, what constitutes “good quality care” in residential aged care requires consideration of staffs’ perspectives. A meta‐synthesis of the qualitative literature was conducted exploring residential aged care staff perspectives on “quality of care.” Six electronic databases were searched for articles that met the screening inclusion criteria. This meta‐synthesis was informed by the Preferred Reporting Items for Systematic reviews and Meta‐Analyses guidelines, and included studies were critically appraised using JBI SUMARI. Two independent reviewers conducted thematic network mapping and analysis of included articles, with oversight from three additional reviewers. Forty‐seven articles were included, with findings summarised into four organising themes and nine basic themes. The four organising themes about quality care from staff perspectives include direct care, professional values and competence, the care environment and organisational/regulatory factors. Staff describe a wide range of factors that they perceived to influence the quality of care. Some may feel motivated to leave employment in aged care, due to organisational pressures that make staff unable to uphold what they perceive as an acceptable standard of care. There is tension between professional values and organisation/regulatory factors—regulation should be enacted at a level that supports good practice and staff's moral integrity. This review found that while person‐centred care is now well established as the benchmark of quality care in residential aged care homes, achieving it in reality remains challenged by limitations on staff members’ time, resources and sometimes their competencies and the regularity of their employment.
Publisher: SAGE Publications
Date: 02-09-2021
Publisher: SAGE Publications
Date: 24-08-2023
DOI: 10.1177/14713012231181167
Abstract: This study was conducted to assess Vietnam’s dementia service delivery. Using WHO methodology, website searches of key organisations focused on three aspects of Vietnam’s healthcare system: (1) Health and social workforce (2) Services, supports and treatment programs and (3) Promotion of awareness and understanding. Data were analysed using content analysis. While key members of the healthcare workforce receive some education in dementia competencies during their training, the skill-mix of staff in the current workforce appears inadequate to address the complex needs of people with dementia. Although Vietnam’s general healthcare system comprises a good variety of service types, there is a lack of dementia-specific services. Available diagnosis and treatment services are concentrated in the hospital system and are mainly located in metropolitan areas, impacting their accessibility. While both community-based and institutional long-term care is available, institutional care is not universally accessible and home-based care is mainly provided by family carers who don’t have access to dementia care training. There is no active dementia prevention or public awareness c aign. To improve the ability of Vietnam’s service delivery to meet the needs of people with dementia and their carers, the skill-mix of the healthcare workforce should be strengthened by ensuring that dementia core competencies are embedded within undergraduate and graduate education programs and making post-qualification dementia care training available. The capacity of existing community-level health and social services should be expanded to ensure that integrated, specialised and comprehensive health and social services are accessible to all people with dementia. Expanding access to institutional long-term care and making dementia education available to family and other informal carers could increase choice and improve quality of care. Finally, Vietnam could look to other countries in the region with regards to the development of a dementia prevention and public awareness c aign.
Publisher: Elsevier BV
Date: 12-2023
Publisher: SAGE Publications
Date: 10-2013
Abstract: Daniel Bell’s The Cultural Contradictions of Capitalism lies at the intersection of the three main theoretical currents of sociological thought, those of Karl Marx, Émile Durkheim and Max Weber. His ‘three realms’ methodology moves away from deterministic accounts that subordinate the political and cultural to the economic realm. By granting each realm an autonomy and principles of their own, Bell locates the contradictions of capitalism in the friction between them. With constant innovation, in idual expressiveness and libertarian social values becoming forces in-and-of-themselves, prevailing social structures and the roles within them are left looking increasingly incoherent, illegitimate and meaningless. Likewise, the shift from Protestant asceticism to modernist hedonism creates a sharp tension between the demand for a disciplined and responsible workforce and the demand for economic growth through unrestrained and instantly gratifying consumerism. The result is a complex of crisis scenarios which were manifest with the end of the post-war boom. However, as other commentators have pointed out, Bell’s prophetic theses often seem to fail under the light of subsequent history.
Publisher: Faculty of Humanities and Social Sciences, University of Zagreb
Date: 2021
DOI: 10.17234/ZGB.29.1
Publisher: SAGE Publications
Date: 06-2018
Abstract: This article explores some of the concerns which are being raised about algorithms with recourse to Habermas’s theory of communicative action. The intention is not to undertake an empirical examination of ‘algorithms’ or their consequences but to connect critical theory to some contemporary concerns regarding digital cultures. Habermas’s ‘colonization of life-worlds’ thesis gives theoretical expression to two different trends which underlie many current criticisms of the insidious influence of digital algorithms: the privatization of communication, and the particularization of knowledge and experience. Habermas’s social theory therefore offers a useful framework for exploring some of the normative and political problems that are attributed to ‘algorithmic culture’ and ‘big data’.
Publisher: SAGE Publications
Date: 22-04-2020
Publisher: Hindawi Limited
Date: 22-05-2022
DOI: 10.1111/HSC.13853
Publisher: SAGE Publications
Date: 23-11-2020
Abstract: The ‘family crisis’ narrative is frequently used in dementia studies to explain ethnic minority families’ pathways to health and aged care and why there is delayed dementia diagnoses in ethnic minority communities. Such narratives may obscure the family carers’ agency in negotiating services and managing personal, social and structural burdens in the lead up to diagnosis. To illuminate agency, this article describes ethnic minority families’ pathways to a dementia diagnosis using the concept of sense-making. Three case studies were drawn from 56 video interviews with family carers of older adults with dementia from Chinese, Arab and Indian backgrounds. Interviews were conducted across Australia from February to August 2018, then translated, transcribed and thematically analysed. Findings suggest families did not enter into formal care because of a crisis, instead navigating fragmented systems and conflicting advice to obtain a dementia diagnosis and access to relevant care. This experience was driven by sense-making (a search for plausible explanations) that involved family carers interpreting discrepant cues in changes to the behaviour of the person with dementia over time, managing conflicting (medical) advice about these discrepancies and reinterpreting their relationships with hindsight. The sense-making concept offers a more constructive hermeneutic than the ‘family crisis’ narrative as it illuminates the agency of carers’ in understanding changed behaviours, negotiating services and managing personal, social and structural barriers pre-diagnosis. The concept also demonstrates the need for a multimodal approach to promoting timely diagnosis of dementia in ethnic minority communities through dementia awareness and literacy c aigns as well as initiatives that address structural inequities.
Publisher: Informa UK Limited
Date: 11-09-2023
Publisher: Informa UK Limited
Date: 02-09-2019
Publisher: Informa UK Limited
Date: 26-12-2022
Publisher: SAGE Publications
Date: 30-03-2020
Abstract: Evidence in the literature demonstrates the reliability of cognitive screening assessments using video technology in English-speaking older populations. However, this has not been tested in older culturally and linguistically erse (CALD) populations who require an interpreter, and what the associated costs would be. The aim was to determine if the Rowland Universal Dementia Assessment Scale (RUDAS) and the Geriatric Depression Scale (GDS) could be reliably administered over video-interpreting methods compared with face-to-face interpreting. In addition, the study aims to compare the costs of video-interpreting with the costs of face-to-face interpreting. We compared similarity of the RUDAS and GDS scores when administered face-to-face and via video-interpreting. The similarity of scores between methods was analysed using paired t-tests and Bland–Altman plots. A costing analysis was done using a micro-costing approach to estimate the costs of video-interpreting compared with face-to-face, extrapolated to a national level. Analysis found no significant differences in the mean assessment scores between video-interpreting and face-to-face (RUDAS mean difference: −0.36 95% confidence interval (CI): −1.09, 0.38, GDS mean difference: 0.22 95% CI: −0.38, 0.83). Bland–Altman plots demonstrated that 71% of RUDAS scores and 82% of GDS scores were within the maximum allowed difference of ±2 units. Costing analysis showed a A$7 saving per assessment when using video-interpreting compared with face-to-face, with a total national saving of A$247,350. Video-interpreting was found to be as reliable as face-to-face interpreting for both RUDAS and GDS assessments. Cost analysis indicates that video-interpreting is cheaper than face-to-face interpreting.
Publisher: Springer Nature Singapore
Date: 2022
Publisher: La Trobe
Date: 2020
Publisher: John Benjamins Publishing Company
Date: 11-08-2021
Abstract: Many health and social care services are implementing video remote interpreting (VRI) to deal with supply shortages and high costs of language interpreting for linguistically erse clients. This qualitative study examines stakeholders’ perspectives on using VRI for home-based cognitive assessments, which are routinely performed with older people during aged care assessments in Australia. We conducted 25 semi-structured interviews with clients, assessors and interpreters in Melbourne and a regional Victorian city. We found that across stakeholder groups participants usually regard VRI as an acceptable alternative to face-to-face interpreting when the latter is not possible. Freelance interpreters said VRI saved on travel time and expenditure and afforded them financial and practical benefits that enabled them to better meet the high demand for their work. However, stakeholders also pointed to the limitations of VRI, including technical challenges, sound and video quality, and difficulties with positioning equipment optimally during interviews. The assessors and interpreters agreed that VRI was inappropriate when clients are known to be cognitively impaired, and that face-to-face interpreting is necessary to support these clients and ensure assessment accuracy. We suggest that plans by health or social care services to replace face-to-face interpreting with VRI should be balanced against the needs of clients and any impacts on professional practice.
Publisher: Springer International Publishing
Date: 2019
Publisher: Wiley
Date: 2022
DOI: 10.1002/TRC2.12349
Abstract: The number of Australian residents with dementia is projected to double by 2058, with 28% currently being migrants from non‐Anglophone countries. There will be growing demand for professional interpreters for cognitive assessments and dementia‐related health consultations in the future. Interpreting cognitive assessments can be challenging for interpreters inaccurate interpreting can influence assessment outcomes. The Improving Interpreting for Dementia Assessments (MINDSET) project will upskill interpreters through an online training course in dementia and cognitive assessments. The training has been co‐designed with key stakeholders from the interpreting sector, dementia‐related services, and family caregivers, and has been user‐tested with 12 interpreters. The training aims to improve the quality of interpreter‐mediated communication during cognitive assessments, and thereby improve the accuracy and acceptability of cognitive assessments with older people who have limited English proficiency. We are conducting a single‐blinded randomized controlled trial to evaluate the effectiveness of the training. We aim to enroll 150 interpreters, and allocate them to equal parallel groups. The intervention group will receive access to the MINDSET training, which comprises 4 hours of resources covering five domains: dementia knowledge, cross‐cultural communication, briefings and debriefings, interpreting skills, and interpreting ethics. The control group will be assigned to a wait list, and will receive access to the training after the trial. Participants will be assessed according to the five domains, via the Dementia Knowledge and Assessment Scale, multiple‐choice questions, video‐simulated assessments, and ethical scenarios. Assessments will occur at baseline (prior to the intervention group completing the training), 3 months after enrollment, and 6 months after enrollment. The trial is ongoing. Recruitment began in June 2022. This is the first time a training resource for interpreters in dementia has been trialed. If successful it may represent a technologically innovative way to offer training to both trainee and practicing interpreters. Interpreters are crucial in facilitating cognitive assessments for allophone speakers. Interpreters would benefit from training to improve assessment accuracy. Our study has co‐designed specialized dementia training for interpreters. This is a protocol to evaluate the training's efficacy in a randomized controlled trial.
Publisher: SAGE Publications
Date: 26-01-2016
Abstract: Recent scholarship has drawn on Koselleck’s methods of conceptual history and his diagnosis of ‘crisis’ in modernity to make sense of 21st-century developments in political, social and economic life and thought. This review essay looks at two texts that, in different ways, test Koselleck’s ideas in challenging and innovative ways. Lara’s use of conceptual history to shed light on the debates over secularization demonstrates how concepts become central to struggles over the definition of politics – definitions which thereafter disclose the possibilities and set the agenda for future political action. Roitman continues Koselleck’s interest in the concept of crisis and shows how conceptual history can be used to sharpen our awareness of undisclosed content and theoretical blind spots. Both show how conceptual history serves as a ‘semantic check’ on political concepts, demanding greater reflexivity and the setting of realistic political goals.
Publisher: Springer Science and Business Media LLC
Date: 08-02-2017
Publisher: SAGE Publications
Date: 22-01-2021
Abstract: There is increasing interest in harnessing aged care residents’ perspectives to drive quality improvement in aged care homes. We conducted a systematic review of qualitative evidence including literature examining residents’ descriptions of “quality of care” in aged care homes, using database searches and screening records according to eligibility criteria. Three independent reviewers conducted quality assessment of forty-six eligible articles and performed thematic synthesis of articles’ findings. We distinguish nine key themes describing factors influencing quality care: staffing levels, staff attitude, continuity, routine, environment, decision-making and choice, dignity of risk, activities, and culture and spirituality. While many themes were consistent across studies, residents’ prioritization of them varied. Aged care home residents have differing conceptions of quality care as well as heterogeneous and dynamic needs and preferences. Care providers are best able to facilitate quality care when intentional efforts are made to recognize this and tailor delivery of services the in idual residents.
Publisher: Cambridge University Press (CUP)
Date: 19-03-2021
DOI: 10.1017/S0144686X20000318
Abstract: This article calls for a sociological understanding of the importance of trust to aged care. It connects existing theories of trust to empirical evidence from gerontology and nursing research. Trust is defined as a response to and management of social vulnerability. It is argued this makes trust a fundamental concept for understanding human service and social care institutions, including aged care. In light of Australia's Royal Commission into Aged Care Quality and Safety, as well as generational shifts in consumer expectations and care ethics, the article highlights four distinct yet interrelated forms of trust: interpersonal, institutional, organisational and public trust. All of these forms are shown to be critical in conceptualising and evaluating the perceived trust deficit facing contemporary aged-care systems, and existing evidence shows how these forms of trust can reinforce, conflict and misalign with each other. Efforts to rebuild trust in aged care at an organisational and institutional level should ensure mechanisms facilitate rather than hinder the formation of interpersonal trust relations between in idual service users, their families and aged care staff. Broader social policy reforms must also consider and address the way cultural understandings of ageing, and media representations of aged care, have diminished the public's trust in the sector, and how the cycle of scandals, reviews and piecemeal reforms contributes to this.
No related grants have been discovered for Andrew Gilbert.