Prehospital, Resuscitation and Emergency Care Research Unit

The role of religion for migrants in Australia has generated much interest in recent years. A growing area of scholarly inquiry is how religion can assist in migrant language maintenance. This thesis looks at the interaction between language and religion within the goal of heritage language maintenance and how this plays out in a particular migrant religious institution and for a particular ethnoreligious group, namely Sri Lankan Tamil Hindus. It is the result of an 18-month ethnographic study situated in a Tamil Hindu temple in Australia.

The study investigates the role of the Tamil language in the temple, the types of language practices that the second generation employ in the space, and the relevance of the Tamil language and Hindu religion in the lives of second-generation devotees. It provides an insight into how migrant youth skilfully use their heritage language and English to achieve communication and index their hybrid identifications as they grow up in Anglo-dominant, multicultural Australia. It also highlights the important role played by the temple in supporting these migrants.

At a macro-level, this study shows how the temple, as a religious institution, not only provides a space for Hindu worship, but one for socialising, cultural identification and the transmission of language, religion and culture. In Sri Lanka the Tamil language and Hindu religion are closely linked in a Tamil Hindu culture and this strong language-religion ideology is reflected in the language practices of the temple. However, in the Australian setting, the temple faces sociocultural change including an increasingly ethnically and linguistically diverse congregation and disengagement by the second generation. Therefore there is a tension between the extent to which the temple remains linked to its Tamil identity and to which it must change its policies to accommodate those who do not speak Tamil.

On the micro-level, as an insight into language practices for the second generation, the thesis focuses on one class in the temple’s Tamil-medium religious school. Naturalistic linguistic data collected from a small class of teenage devotees reveals that translanguaging is the usual code for interactions. While English is dominant in the students’ lives, practices in the classroom show that approximately 30 per cent of their speech contains Tamil, thus evidencing the language-religion ideology being transmitted to the next generation. English and Tamil features perform particular but also overlapping functions in the classroom. The students and teacher create a safe space where they can use their individual repertoires to explore and challenge their beliefs and positions in terms of their heritage culture and religion. Through the analysis of selected linguistic extracts, the multicompetence, creativity, criticality, cooperation and subversion of the students is evident in their language use.

While pure Tamil is not necessarily used in the class, the ways in which Tamil features are adopted to signal a connection to Tamil culture, the ethnoreligious community and to perform a Tamil Hindu identity are highly significant. It forms part of the picture of a group of second-generation migrants who can practice their heritage language, religion and culture with confidence in Australian society, and at the same time, bring their strong proficiency in English into these expressions of heritage, identity and faith.

This book is the first compilation of the experiences of the Sri Lankan Tamil diaspora in Australia. It explores the theme of home—from what is left behind to what is brought or (re)created in a new space—and all the complex processes that ensue as a result of leaving a land defined by conflict. The context of the book is unique since it focuses on the ten-year period since the Sri Lankan civil war ended in 2009. Although the war has officially come to an end, conflict continues in diverse and insidious forms, which we present from the point of view of those who have left Sri Lanka.

The multidisciplinary nature of the book means that various aspects of Sri Lankan Tamil experiences are documented including trauma, violence, resettlement, political action, cultural and religious heritage, and intergenerational transmission. This book draws on qualitative methods from the fields of history, geography, sociology, sociolinguistics, psychology and psychiatry. Methodological enquiries range from oral histories and in-depth interviews to ethnography and self-reflexive accounts. To complement these academic chapters, creative contributions by prominent Sri Lankan artists in Australia seek to provide personalised and alternative interpretations on the theme of home. These include works from playwrights, novelists and community arts practitioners who also identify as human rights activists.

“Tamil weekends” describe how second-generation migrants involved in an intensively packed mix of Tamil linguistic, cultural and activities, mostly on the weekends, as part of the first generation’s to (re)create home.

Drawing from an ethnographic study a Tamil Hindu temple, this chapter explores how adolescent students the transmission efforts of the first generation, and what it means their sense of belonging and their sense of Tamilness in the homeland Sri Lanka and the new home of Australia. I highlight how first- and -generation ideologies regarding Tamil identity and belonging are with time, largely due to new interpretations of “being Tamil” vary between and within generations. At the same time, as a result of threat to Tamil culture in Sri Lanka, there is an enduring sense of duty maintain the language, religion and culture outside of the homeland.

This study is located in a lesser-known educational context and investigates aspects of migration, religion and multilingualism. Focusing on the discourse of second-generation adolescent migrants in a Tamil Hindu temple school in urban Australia, I discuss how flexible language practices manifest in this migrant faith setting. I argue that the use of the heritage language is not always at the forefront, despite a monolingual Tamil language policy, because religious transmission is given priority over language transmission. At the same time, there are certain motivations that influence the use of Tamil: to index the close relationship between language and religious culture and to index one’s membership of the ethnoreligious community.

This paper draws on ethnographic data to provide both a macro and micro view of these motivations – what drives adolescents to use their heritage language, how it is deployed from their linguistic repertoires, and how it contrasts with the use of the students’ dominant language, English. The analysis takes a whole of conversation approach to understanding the relationship between religion and heritage language use for second-generation migrant students.

Transplanting non-Western religions to Western nations results in first-generation migrant attempts to transmit faith in vastly different contexts. Especially as adolescents, second-generation migrants tackle mediating their personal religious beliefs in a society with diverse religions and ideologies as well as negotiating membership of their ethnoreligious community.

This paper draws from an ethnography in a Tamil Hindu temple in Australia. I present Sri Lankan teenage migrants’ discourse from their faith classroom to elucidate processes of belief positioning. In working out their emergent, and provisional, faith identities, the students deploy mainly Tamil and English linguistic features in their belief narratives. Flexible languaging complements their “syncretic acts” – the practice of drawing on diverse ideologies and experiences (outside the boundaries of a particular religion) to form personalized beliefs. Translanguaging thus facilitates the expression of circumspect, nuanced, and non-traditional interpretations of their heritage religion. Understanding such processes of belief positioning can help societies and institutions to work towards migrant youth inclusion.

BACKGROUND: The defibrillator prompt, which directs callers to retrieve a defibrillator during out-of-hospital-cardiac arrest, is crucial to the emergency call because it can save lives. We evaluated communicative effectiveness of the prompt instated by the Medical Priority Dispatch System TM version 13, namely: if there is a defibrillator (AED) available, send someone to get it now, and tell me when you have it.
METHODS: Using Conversation Analysis and descriptive statistics, we examined linguistic features of the defibrillator sequences (call-taker prompt and caller response) in 208 emergency calls where non-traumatic out of hospital cardiac arrest was confirmed by the emergency medical services, and they attempted resuscitation, in the first six months of 2019. Defibrillator sequence durations were measured to determine impact on time to CPR prompt. The proportion of cases where bystanders retrieved defibrillators was also assessed.
RESULTS: There was low call-taker adoption of the Medical Priority Dispatch System TM version 13 prompt (99/208) compared to alternative prompts (86/208) or no prompt (23/208). Caller responses to the version 13 prompt tended to be longer, more ambiguous or unrelated, and have more instances of repair (utterances to address comprehension trouble). Defibrillators were rarely brought to the scene irrespective of defibrillator prompt utilised.
CONCLUSION: While the version 13 prompt aims to ensure the use of an available automatic external defibrillator, its effectiveness is undermined by the three-clause composition of the prompt and exclusion of a question structure. We recommend testing of a re-phrased defibrillator prompt in order to maximise comprehension and caller action.

Migration can affect the physical, mental, emotional, and social wellbeing of individuals and families. This study provides an overview of interventions aimed at improving the wellbeing of young migrants. It identifies knowledge gaps and provides direction for future research. The review process comprises a systematic search of six academic databases, and websites for relevant peer-reviewed and gray literature on the topic. A total of 2,911 records were identified, of which 28 studies met our eligibility criteria for inclusion. Thematic analysis comprised of the description of study characteristics and outcome themes. EPHPP and CASP tools were utilized to assess the methodological quality of studies. The review findings indicate a number of approaches with varying effectivity, however, arts, music, and sports programs showed good results for youth across all migrant groups. Our findings call for further and more high-quality evaluation research, with longitudinal designs that ideally include stakeholder collaboration.

Background: One-fifth of Australia's population do not speak English at home. International studies have found emergency calls with language barriers (LB) result in longer delays to out-of-hospital cardiac arrest (OHCA) recognition, and lower rates of bystander cardiopulmonary resuscitation (CPR) and survival. This study compared LB and non-LB OHCA call time intervals in an Australian emergency medical service (EMS). Methods: The retrospective cohort study measured time intervals from call commencement for primary outcomes: (1) address acquisition; (2) OHCA recognition; (3) CPR initiation; (4) telecommunicator CPR (t-CPR) compressions, in all identified LB calls and a 2:1 random sample of non-LB EMS calls from January to June 2019. Results for time intervals #1, 2, and 4 were benchmarked against the American Heart Association's (AHA) t-CPR minimal acceptable time standards. Patient survival outcomes were compared. Results: We identified 50 (14%) LB calls from a cohort of 353 calls. LB calls took longer than non-LB calls (n=100) for: address acquisition (median 29 vs 14 secs, p<0.001), OHCA recognition (103 vs 85 secs, p=0.02), and CPR initiation (206 vs 164 secs, p=0.01), but not for t-CPR compressions (292 vs 248 secs, p=0.12). Rates of OHCA recognition and 30-day-survival did not differ but smaller proportions of LB calls met the AHA standards. Conclusion: Time delays found in LB calls point to phases of the call which need further qualitative investigation to understand how to improve communication. Overall, training call-takers for LB calls may assist caller understanding and cooperation during OHCAs.

Due to the urgent, time-sensitive nature of interactions in emergency ambulance phone calls, dealing with repairs (communication trouble) can be challenging. We investigate a critical medical emergency known as out-of-hospital cardiac arrest (OHCA) and focus on how ambulance call-takers handle repairs during an interactive sequence concerning the retrieval of automatic external defibrillators (AED). Clear communication about AEDs is vital, because the device can deliver a life-saving shock to an OHCA patient’s heart. We examined repair initiations, and their subsequent trajectories, during the defibrillator sequences in 58 OHCA emergency calls. We found evidence of competing influences in resolving such repairs: (1) providing a repair solution (including ensuring caller comprehension of what a defibrillator is) to achieve intersubjectivity that could resolve the question of defibrillator availability; or (2) progressing the call as swiftly as possible to an immediately applicable life-saving intervention such as cardiopulmonary resuscitation. The findings suggest that in certain institutional contexts, such as emergency medical service dispatch, the resolution of repairs in communication can take varying trajectories in order to achieve the most feasible goal in immediate time. We suggest that emergency medical services consider these trajectories in helping ambulance call-takers anticipate repairs in OHCA calls.

When a person has an out-of-hospital cardiac arrest (OHCA), calling the ambulance for help is the first link in the chain of survival. Ambulance call-takers guide the caller to perform lifesaving interventions on the patient before the paramedics arrive at the scene, therefore, their actions, decisions and communication are integral to saving the patient's life. In 2021, we conducted open-ended interviews with 10 ambulance call-takers with the aim of understanding their experiences of managing these phone calls; and to explore their views on using a standardised call protocol and triage system for OHCA calls. We took a realist/ essentialist methodological approach and applied an inductive, semantic and reflexive thematic analysis to the interview data to yield four main themes expressed by the call-takers: 1) time-critical nature of OHCA calls; 2) the call-taking process; 3) caller management; 4) protecting the self. The study found that call-takers demonstrated deep reflection on their roles in, not only helping the patient, but also the callers and bystanders to manage a potentially distressing event. Call-takers expressed their confidence in using a structured call-taking process and noted the importance of skills and traits such as active listening, probing, empathy and intuition, based on experience, in order to supplement the use of a standardised system in managing the emergency. This study highlights the often under-acknowledged yet critical role of the ambulance call-taker in being the first member of an emergency medical service that is contacted in the event of an OHCA.

This article explores how language learning is an integral component of progressing linguistic reconciliation in contexts of war and conflict. Sri Lanka is a case where ethnolinguistic division and the devaluation of Tamil as a co-official language has led to linguistic injustice for Tamil people and users of Tamil. In the postwar landscape, government commitment towards addressing this injustice, and reconciliation for that matter, has been weak. We interviewed 12 adult students and teachers in a small, non-profit, Tamil language course to understand what motivates people to learn Tamil in this context. The language course was a space where both second language and heritage language learners came together. Thematic analysis of the interview data showed that language learning motivations extended beyond the norm of the instrumental/integrative dichotomy and revealed the role of social, historical, and political factors, and a shared vision for societal multilingualism in shaping learners' motivations. The results help to form a preliminary conceptualisation of linguistic reconciliation and to promote language learning "of the enemy" as an integral and impactful component.