Clinicians and patients have varying degrees of comfort in discussing prognosis. Patients can swing between worry or understanding that death is near and hope or optimism that lets them live life. This prognostication awareness pendulum may require a clinician negotiate the discussion over time. The cognitive roadmap for prognosis discussion is ADAPT (Ask what they know about their medical condition, Discover what they want to know about prognosis, Anticipate ambivalence, Provide information about what to expect, and Track emotion and respond with empathy). Some patients want prognostic information, some don’t, and some are ambivalent. While respecting their wishes, exploring why in each of these scenarios may be helpful to understand their concerns and how best to address them. Be aware that patients and their family members may have different prognostic information needs. Having separate conversations (with permission) may be in order. When they are concerned about destroying hope or prognosis is uncertain, using the frame of “hope and worry” can be helpful. Finally, when patients or family members don’t believe our prognosis, be curious as to why and focus on the relationship.

Central to our argument is that “representation gaps” may be filled to some extent by alliances being built by actors at different points in the supply chain and based on the two different logics of representation: representation as structure and representation as claim. Using the Accord as the empirical context, Chapter 5 analyses how and when representation as claim and representation as structure can become complementary: labour rights NGOs can use their power to agitate and mobilise in ways that empower trade unions to negotiate with global brands, while trade unions provide the legitimacy and access to negotiation with global brands. This complementarity is illustrated by the Bangladesh Accord. The Accord emerged as a negotiated and legally binding agreement between Global Union Federations, NGOs and over 200 brands, providing an unprecedented mechanism of transnational co-determination at the supply chain level between representatives of labour and capital.

This chapter explores Japanese EFL learners’ responses to poems of different levels of familiarity. The aim of the project was to try to uncover learners’ interactions with poetry and then to consider the benefits of speaking about poetry for second language learning. A Japanese poem by Kenji Miyazawa in English translation was used as a familiar text, and a Dylan Thomas poem as an unfamiliar poem. Four pairs of learners were asked to talk together about the poems and report on what they understood the poems to mean. They were also asked to give a personal response to the poems. It was anticipated that in speaking about the familiar poem, learners’ background knowledge of the Japanese text would support a more detailed interpretation, while the unfamiliarity of the new poem would present barriers to understanding of meaning but could present opportunities for co-constructed meaning creation through speaking. Three sources of data are used in the chapter: (1) a bilingual questionnaire which identified learners’ poetry-reading backgrounds; (2) the learners’ conversations, used to explore spoken responses to the two poems; and (3) follow-up interviews. The results indicate that poetry-reading processes such as noticing, questioning and interpreting meaning occur with both types of poem. The results also suggest that speaking about poetry could be useful for the development of speaking skills such as elaborating, negotiating and also practising specific spoken language such as use of discourse markers and conversation skills. The results also suggest that poetry discussions may help learners to express their feelings in English, which could develop their familiarity with conversational strategies when using their speaking skills in future situations.