The focus of this article is an examination of translation dilemmas in qualitative research. Specifically it explores three questions: whether methodologically it matters if the act of translation is identified or not; the epistemological implications of who does translation; and the consequences for the final product of how far the researcher chooses to involve a translator in research. Some of the ways in which researchers have tackled language difference are discussed. The medium of spoken and written language is itself critically challenged by considering the implications of similar ‘problems of method’ but in situations where the translation and interpretation issues are those associated with a visual spatial medium, in this case Sign Language. The authors argue that centring translation and how it is dealt with raises issues of representation that should be of concern to all researchers.

This article presents results from an interview study of 45 parents/caregivers (representing 27 families) whose infants were correctly identified as deaf during the first phase of the implementation of the national universal Newborn Hearing Screening Programme in England. Average age of children when parents were interviewed was 25 weeks. Two issues are explored: (a) how parents talk about significance of knowing early that their child is deaf and (b) parents' expectations of their child's development in light of early identification. Although results demonstrate clear support from parents’ perspective of knowing early, they also identify the psychological complexities of recognizing both the grief and reassurance that early knowledge brings; the risks of early knowledge-inducing timetables of expectations that create distress when not met speedily; the extent to which parental models of the developmental advantages of early identification are underpinned by notions of normal speech and the possibility of being like hearing children; and the pervasiveness of deficit and illness models associated with having identified deafness early. Implications for parental support and professional responses are also discussed.

Objective To assess the effectiveness of enhanced communication therapy in the first four months after stroke compared with an attention control (unstructured social contact). Design Externally randomised, pragmatic, parallel, superiority trial with blinded outcome assessment. Setting Twelve UK hospital and community stroke services. Participants 170 adults (mean age 70 years) randomised within two weeks of admission to hospital with stroke (December 2006 to January 2010) whom speech and language therapists deemed eligible, and 135 carers. Interventions Enhanced, agreed best practice, communication therapy specific to aphasia or dysarthria, offered by speech and language therapists according to participants’ needs for up to four months, with continuity from hospital to community. Comparison was with similarly resourced social contact (without communication therapy) from employed visitors. Outcome measures Primary outcome was blinded, functional communicative ability at six months on the Therapy Outcome Measure (TOM) activity subscale. Secondary outcomes (unblinded, six months): participants’ perceptions on the Communication Outcomes After Stroke scale (COAST); carers’ perceptions of participants from part of the Carer COAST; carers’ wellbeing on Carers of Older People in Europe Index and quality of life items from Carer COAST; and serious adverse events. Results Therapist and visitor contact both had good uptake from service users. An average 22 contacts (intervention or control) over 13 weeks were accepted by users. Impairment focused therapy was the approach most often used by the speech and language therapists. Visitors most often provided general conversation. In total, 81/85 of the intervention group and 72/85 of the control group completed the primary outcome measure. Both groups improved on the TOM activity subscale. The estimated six months group difference was not statistically significant, with 0.25 (95% CI –0.19 to 0.69) points in favour of therapy. Sensitivity analyses that adjusted for chance baseline imbalance further reduced this difference. Per protocol analyses rejected a possible dilution of treatment effect from controls declining their allocation and receiving usual care. There was no added benefit of therapy on secondary outcome measures, subgroup analyses (such as aphasia), or serious adverse events, although the latter were less common after intervention (odds ratio 0.42 (95% CI 0.16 to 1.1)). Conclusions Communication therapy had no added benefit beyond that from everyday communication in the first four months after stroke. Future research should evaluate reorganised services that support functional communication practice early in the stroke pathway. This project was funded by the NIHR Health Technology Assessment programme (project No 02/11/04) and is published in full in Health Technology Assessment 2012;16(26):1-160. Trial registration ISRCTN78617680

This article concerns the first stage of a research and development project that aimed to produce both parent and professional guidelines on the promotion and provision of informed choice for families with deaf children. It begins with a theoretical discussion of the problems associated with the concept of informed choice and deaf child services and then focuses specifically on why a metastudy approach was employed to address both the overcontextualized debate about informed choice when applied to deaf children and the problems associated with its investigation in practice with families and professionals. It presents a detailed analysis of the conceptual relevance of a range of identified studies “outside” the field of deafness. These are ordered according to 2 main conceptual categories and 7 subcategories—(a) the nature of information: “information that is evaluative, not just descriptive”; “the difficulties of information for a purpose”; “the origins and status of information”; and “informed choice and knowledge, not informed choice and information” and (b) parameters and definitions of choice: “informed choice as absolute and relative concept”, “preferences and presumptions of rationality”, and “informed choice for whom?” Relevant deaf child literature is integrated into the discussion of each conceptual debate in order both to expand and challenge current usage of informed choice as applied to deaf children and families and to delineate possible directions in the planning of the next stage of the main project aimed at producing parent/professional guidelines.

Using selected, contemporaneous illustrations from the reflective journal of a doctoral student undertaking data analysis for the first time, this article examines the relationship between journaling as a learning process when undertaking computer-assisted qualitative data analysis and establishing quality and validity in interpretative phenomenological analysis. The writing of the journal is shown both to enact some potential validity criteria (e.g. in producing an audit trail) whilst also recording and reflectively prompting the process of learning, interpretation and bracketing, thus evidencing transparency. By using a journal inside the software package and alongside the stages of the interpretative phenomenological analysis, analysis within the software package, it is argued that quality and validity become dynamic, not static constructs. These constructs are intimately linked to the researcher-learning-process and permit a critical stance to be taken.