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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.

Introduction: There is a global agenda towards shared culture and practices between clinicians and a shift to integrated and more community-based healthcare. A crucial context in this agenda is clinicians’ practice with referral of vulnerable populations to community programs, as referral practices address necessary dimensions of integrated care (e.g. professional and normative integration). This study investigates clinicians’ referral practices for people attending diabetes outpatient clinics from culturally and linguistically diverse (CALD) backgrounds to identify possible challenges with making referrals to CALD specific programs.   Methods: The study was conducted in four diabetes outpatient facilities in South Western Sydney Local Health District in Sydney, Australia. Fifty-three clinicians, including medical specialists, diabetes nurse educators and allied health professionals (e.g. dietitian, psychologist) participated by completing a questionnaire in June 2018. The response rate for the questionnaire was 75%. Data were analysed for frequency of health professional’s referral and rationale for referral and non-referral to three CALD specific programs.  Results: Only twenty-five percent (13/53) of clinicians had referred to CALD specific education programs in the past 12 months. There were 10 referrals for the NSW Health Get Healthy Program (including an interpreter), three referrals for the community-based diabetes support group and nil referrals to the bilingual community educator diabetes education program run by the Health Promotion Department. The most common reason for non- referrals was clinician’s lack of awareness of the programs. Other rationales for non-referral were: inconvenience of the referral process (1 clinician), other health issues taking priority over making the referral (1 clinician) and the programs not being beneficial for the patient (1 clinician). Discussion: Clinicians’ lack of awareness of available community programs can be a bottleneck to integrating care for the vulnerable diabetes outpatients from CALD background.  This situation is characteristic of lack of awareness of services outside of one’s own setting and indicate inadequacies in professional, functional and normative integration. As the study finds clinicians doubting benefits from CALD specific programs and not prioritising the referral, it is possible that multidisciplinary professionals in this setting are not convinced of the shared value of the CALD specific programs.  Conclusions: Clinician’s referral to CALD specific community programs for diabetes outpatients of CALD background is not at a satisfactory level. The challenges are clinician’s lack of awareness of the program and vision of shared value of the programs. Shared culture and practices between the diabetes outpatient departments and providers of CALD specific education programs are necessary for integrating care for this cohort. Lessons learned: Clinician’s referral to CALD specific community programs was not at a satisfactory level, despite the programs being in operation for 3 or more years. Appropriate referral mechanisms and integration of care in multidisciplinary setting requires a long-term approach, addressing clinical governance, shared culture and practices of different professions.  Limitations: This study was limited to the context of an outpatient service for people with type 2 diabetes. Suggestions for future research: Future research may investigate whether similar challenges in referral mechanisms occur in the case of other chronic conditions.

Background People from ethnically diverse backgrounds living with HIV are susceptible to adverse health and wellbeing outcomes, particularly as a consequence of HIV-related stigma and discrimination (HSD), though relatively little is known about experiences in Australia. Methods This paper reports on HSD in ethnically diverse communities in South Australia and impacts on health and wellbeing. Interviews and focus groups were conducted with 10 individuals living with HIV from ethnically diverse backgrounds, 14 ethnically diverse community leaders, and 50 service providers. Data were analysed thematically. Results Findings indicated that HIV is a highly stigmatised condition in ethnically diverse communities due to fear of moral judgment and social isolation, and was experienced at the intersections of gender, sexual orientation, religion, culture, and immigration status. Experiences of HSD were damaging to health and wellbeing through non-disclosure, reduced social support, delayed testing, service access barriers, impacts on treatment adherence, and directly to mental health. Conclusions Actions addressing the impacts of HSD on people from ethnically diverse backgrounds are crucial.

In contemporary multicultural societies, understanding how culturally and linguistically diverse (CALD) individuals navigate organisational and educational contexts is crucial for fostering inclusive leadership. This article provides a comprehensive theoretical discussion, encompassing the nature of culture, individual acculturation strategies, acculturation processes, and the interplay between organisational culture and leadership acculturation in schools, to illuminate the challenges and opportunities faced by CALD middle-level leaders in school contexts across Australia.

The growing number of students who are culturally and linguistically diverse (CALD) relative to the host university undertaking fieldwork placements raises questions about how to best support their needs and the needs of their fieldwork supervisors so as to maximize the experience for both parties. This research aims to quantify and compare fieldwork supervisors’ perceptions of CALD versus non-CALD students’ performance during placements, the areas and levels of concern they experience in providing this supervision. Placement supervisors from health and non-health courses affiliated with an Australian University were randomly assigned to a survey containing question sets relating to their experiences in supervising CALD (n = 153) or non-CALD students (n = 168). The survey comprised Likert scale questions assessing “pressure points” to supervision and open-ended questions including strategies fieldwork supervisors typically used to assist students. Using univariate ordinal logistic regression analyses, “speaking” (coefficient, 95% CI 2.1 (1.56, 2.65)), “writing” in English (1.69 (1.17, 2.20)), and “adapting to culture of workplaces” (1.20 (0.71, 1.69)) were perceived by placement supervisors as the top “pressure points” in supervising CALD students. Interaction effects demonstrated that “difficulties in assessing CALD students’ competency” (coefficient, 95% CI-1.14 (-2.27,-0.01), “feeling competent in supervising students for placements” (1.35 (0.26, 2.45)), and the “perception of lack of support” from either the university or employing organization (-1.70 (-2.83, 0.56)) were evident within fieldwork placement of health courses only. These results can assist universities and placement organizations to prioritize resources to address the key areas affecting CALD students’ performance on placements, and to improve supervisors’ experience in supervising CALD students on placements in health courses.

The under-representation of culturally and linguistically diverse participants in clinical trials is an ongoing concern for medical researchers and the community. The aim of this review is to examine the complex issue of recruiting culturally and linguistically diverse (CALD) older people to medical research and to examine responses to these issues. The review focuses on (1) trends in the existing literature on barriers to and strategies for recruiting CALD and older people to clinical research, (2) issues with informed consent for CALD populations, and (3) the efficacy of innovative approaches, including approaches incorporating multimedia in research and consent processes. The literature indicates that predominant barriers to greater involvement of CALD patients in clinical trials are communication, including literacy and health literacy considerations; English language competence; and cultural factors in the research setting such as mistrust of consent processes, as well as considerable practical and logistical barriers, including mobility considerations. Some evidence exists that incorporating multimedia resources into the informed consent process can improve patient understanding and is preferred by patients, yet these findings are inconclusive. A multi-methodological approach, including the use of culturally and linguistically sensitive multimedia tools, may help address the issue of low inclusion of CALD groups in clinical research. Researcher education needs to be taken into account to address preconceptions about CALD resistance to research participation and to raise awareness of cultural concerns in regard to research participation.

This work simulated a modified three-dimensional single-track finite element model and a temperature discrimination mechanism in order to investigate the variation of temperature field in stainless steel and the effect of technological parameters on the coating. Through theoretical calculation, the distinction between the thermal characteristics of CoCrCuFeNi powders and CoCrCuFeNi alloys was made to improve the precision of simulation findings. In addition, to more precisely represent the heat transfer, an asymmetric Gaussian was used to distributed heat source and exponentially change the laser energy to account for the attenuation of laser power along the z-axis. The absorption rate of the laser beam at different temperatures of the material was also considered. The data was curve-fitted to examine the impact of laser power and scanning speed on the cladding layer morphologies. The laser power was found to be proportional to the width and depth of the clad layer, whereas the laser scanning speed was found to be inversely related to the width and depth of the clad layer. The simulation results were basically matched to the experiment.

How can songwriting show us the meaning of music and language for health and wellbeing in culturally and linguistically diverse mothers? This article examines the artistic processes in music-cum-health workshops involving new and expectant mothers and their midwives. The voices of the mothers of colour have been silenced historically and systemically. To give them social justice in a health context, singing is a powerful tool and songwriting links this tool to useful health messages. Through this article, the formation of a song on the placenta, a key part of the womb in childbearing, is traced through the stories of a music facilitator, a mother and a midwife. The storying highlights the importance of artistic processes for understanding the person within and their cultural identity. The article argues that cultural understanding of the participants in such arts-in-health programmes is important for socially just models of health care for those at the margins. From being instrumentalized as interventions that are 'administered' with an aim to garner health outcomes, art-based participatory approaches are now recognized as capable of activating culturally founded wellbeing in individuals. Through this article, I propose that as the focus shifts from what art does for health to what art means for a healthy life, the cultural vitality inherent in individuals and societies can be better championed in arts-in-health discourses. I discuss the artistic processes in singing and songwriting in a perinatal context involving mothers from culturally and linguistically diverse backgrounds and their midwives. I argue for lenses to better understand the role of cultural practices in health research involving migrant and refugee communities. Using narrative inquiry, I trace intersecting trajectories wherein the storied life of a coloured mother is intercepted by that of a midwife, and of myself, a coloured female mother-researcher and facilitator. At the intersection emerges a song, as a process and product. This article advances that it is when artmaking processes are centred that the voices from the margins become heard, and it is when their voices are amplified that health research design becomes equitable and ethically sound.

Endometriosis affects one in seven women in Australia and is a significant public health concern. Access to appropriate health information is essential for informed decision-making and quality of life, especially for culturally and linguistically diverse (CALD) women who may face additional communication and health literacy barriers. This study explored the information-seeking behaviours and experiences of CALD women living with endometriosis using semi-structured interviews. Through convenience and snowball sampling via social media, eleven women were recruited. Data were analysed using thematic analysis. The results showed that although women often did not view their cultural background as influential, taboos and stigma can shape information-seeking behaviours. Women primarily relied on healthcare professionals, online resources, and other women with endometriosis as information resources. Healthcare professionals were appreciated for providing tailored information, but some were perceived to have limited knowledge of endometriosis, reducing their usefulness. Online information was abundant and easily accessible but often overwhelming and difficult to navigate. Information from other women with lived experience provided both practical insights and validation, though participants recognised its limited transferability to their own circumstances. These findings highlight the need for information pathways, including better patient education through healthcare providers, as well as accessible and evidence-based online resources.

Australian schools are experiencing an increase in enrolments for students from culturally and linguistically diverse backgrounds. Many of these students, who are frequently from migrant, refugee or asylum-seeker backgrounds, progress academically, but a small number experience learning challenges. In these circumstances, practitioners (school psychologists and guidance counsellors) assess the students to determine underlying factors contributing to limited academic progress, and ways in which the student’s learning can be supported and enhanced. However, formal assessment can be challenging due to language and cultural barriers. Considering the gaps in the research and training, the present article proposes an assessment framework and highlights strategies that can be adopted by practitioners at schools to enrich their decision-making and assessment process. Two case studies are used to highlight factors that can impact students’ academic difficulties. Further interview protocols and assessment measures that can be used to assist these students and their families are discussed. Ways in which school authorities can guide and support these students in the classroom and in the school are examined.