Background Currently, over 300 languages are spoken in Australian homes. People without proficient English from non-English speaking countries may not receive equitable care if their health care workers do not speak their primary language. Use of professional interpreters is considered the gold standard; however, for a variety of reasons, it is often limited to key aspects of care such as diagnosis and consent. With the emergence of mobile technologies, health care workers are increasingly using digital translation tools to fill this gap. However, many of these technologies have not been developed for health care settings and their use has not been evaluated. Objective This study aimed to evaluate iPad-compatible language translation apps to determine their suitability for enabling everyday conversations in health care settings. Methods Translation apps were identified by searching the Apple iTunes Store and published and grey literature. Criteria for inclusion were that the apps were available at no cost, able to translate at least one of the top 10 languages spoken in Australia, and available for use on iPad. Apps that met inclusion criteria were reviewed in 2 stages. Stage 1 was the feature analysis conducted by 2 independent researchers, where apps were evaluated for offline use, input and output methods, and number of languages. Stage 2 was the analysis of suitability for everyday communication in the health care setting, conducted by 2 independent professionals with expertise in translation and cross-cultural communication. Apps that enabled key aspects of care normally within the realm of professional interpreters, such as assessment, treatment and discharge planning, and seeking consent for medical treatments, were considered unsuitable. Results In total, 15 apps were evaluated. Of these, 8 apps contained voice-to-voice and voice-to-text translation options. In addition, 6 apps were restricted to using preset health phrases, whereas 1 app used a combination of free input and preset phrases. However, 5 apps were excluded before stage 2. In addition, 6 of the 10 remaining apps reviewed in stage 2 were specifically designed for health care translation purposes. Of these, 2 apps were rated as suitable for everyday communication in the health care setting—culturally and linguistically diverse Assist and Talk To Me. Both apps contained simple and appropriate preset health phrases and did not contain conversations that are normally within the realm of professional interpreters. Conclusions All iPad-compatible translation apps require a degree of caution and consideration when used in health care settings, and none should replace professional interpreters. However, some apps may be suitable for everyday conversations, such as those that enable preset phrases to be translated on subject matters that do not require a professional interpreter. Further research into the use of translati...

The importance of family’s involvement in care planning has been stressed to cater individualized, person-centered care in residential aged care. However, in reality, there are numerous structural obstacles and barriers that limit opportunities for their involvement. The aim of this article is to explore what they are. The findings based on the 12 focus groups, six groups of care professionals and six groups of family/relatives, reveal that the narrow pathway of communication between staff and families, which is hierarchically structured, one-directional, and clinically driven, enables the former to maintain and control professional boundaries between formal and informal care-giving. Such communication style delimits an opportunity for families to engage in quality discussion about care planning for their loved ones with care staff. Communication within residential aged care facilities embodies complex dynamics of care expectations and responsibilities held by care staff and families.

Background The evidence for the clinical utility of pharmacogenomic (PGx) testing is growing, and guidelines exist for the use of PGx testing to inform prescribing of 13 antidepressants. Although previous randomised controlled trials of PGx testing for antidepressant prescribing have shown an association with remission of depression in clinical psychiatric settings, few trials have focused on the primary care setting, where most antidepressant prescribing occurs. Methods The PRESIDE Trial is a stratified double-blinded randomised controlled superiority trial that aims to evaluate the impact of a PGx-informed antidepressant prescribing report (compared with standard prescribing using the Australian Therapeutic Guidelines) on depressive symptoms after 12 weeks, when delivered in primary care. Six hundred seventy-two patients aged 18–65 years of general practitioners (GPs) in Victoria with moderate to severe depressive symptoms, measured using the Patient Health Questionnaire-9 (PHQ-9), will be randomly allocated 1:1 to each arm using a computer-generated sequence. Participants and GPs will be blinded to the study arm. The primary outcome is a difference between arms in the change of depressive symptoms, measured using the PHQ-9 after 12 weeks. Secondary outcomes include a difference between the arms in change in PHQ-9 score at 4, 8 and 26 weeks, proportion in remission at 12 weeks, a change in side effect profile of antidepressant medications, adherence to antidepressant medications, change in quality of life and cost-effectiveness of the intervention. Discussion This trial will provide evidence as to whether PGx-informed antidepressant prescribing is clinically efficacious and cost-effective. It will inform national and international policy and guidelines about the use of PGx to select antidepressants for people with moderate to severe depressive symptoms presenting in primary care. Trial registration Australian and New Zealand Clinical Trial Registry ACTRN12621000181808. Registered on 22 February 2021.

Background: Currently, over 300 languages are spoken in Australian homes. People from non-English speaking (NES) countries without proficient English may not receive equitable care if their health care workers do not speak the same language. Use of professional interpreters is considered the gold standard, but, for a variety of reasons, is often limited to specific aspects of care (e.g. diagnosis and consent). People from NES backgrounds may be disadvantaged when health care workers try to "get by" with minimal means of communication. With the emergence of mobile technologies, health care workers are increasingly using digital translation tools to fill this gap. However, many of these technologies were not developed for or evaluated in health care settings, and may pose a risk if used for certain situations and conversations. Objective: The aim of this study was to evaluate language translation applications that have the potential to be used in health care settings. The applications will be analysed for their capabilities and potential risks. Methods: Translation applications were identified by searching the Apple iTunes Store, and published and grey literature. Applications that met inclusion criteria were reviewed in two stages. Stage 1: was conducted by two independent researchers who evaluated technology features (e.g. input and output methods, languages available). Stage 2: was conducted by two independent experts in translation and cross-cultural communication, who evaluated the potential risk when used in a health care setting. Highrisk health care conversations involved clinical assessment, provision of diagnoses, conversations about treatment and care planning, discharge planning, and medico-legal information such as seeking consent for medical treatments. Results: Fifteen applications were evaluated. Eight of the 15 applications contained voice to voice and voice to text translation options. Six applications were restricted to using pre-set health phrases only, while one application used a combination of free input and pre-set phrases. Five applications were excluded prior to Stage 2. Six of the 10 remaining applications reviewed in Stage 2 were specifically designed for health care translation purposes. Of these, two applications were rated as low risk for use in the health care setting -CALD Assist and Talk To Me. Both of these applications contained simple and appropriate pre-set health phrases and did not enable free input. Conclusions: No translation application was without risk and none should replace professional interpreters. However, some applications may be suitable for low risk everyday conversations, such as those that enable pre-set health phrases to be translated on subject matters that pose little to no risk in the continuum of care. Further research into the use of translation technology for these types of conversations is needed and clinicians should use translation technology cautiously and consider the risks before use.