Overcoming language barriers in healthcare: A protocol for investigating safe and effective communication when patients or clinicians use a second language

Background Miscommunication in the healthcare sector can be life-threatening. The rising number of migrant patients and foreign-trained staff means that communication errors between a healthcare practitioner and patient when one or both are speaking a second language are increasingly likely. However, there is limited research that addresses this issue systematically. This protocol outlines a hospital-based study examining interactions between healthcare practitioners and their patients who either share or do not share a first language. Of particular interest are the nature and efficacy of communication in language-discordant conversations, and the degree to which risk is communicated. Our aim is to understand language barriers and miscommunication that may occur in healthcare settings between patients and healthcare practitioners, especially where at least one of the speakers is using a second (weaker) language. Methods/Design Eighty individual interactions between patients and practitioners who speak either English or Chinese (Mandarin or Cantonese) as their first language will be video recorded in a range of in- and out-patient departments at three hospitals in the Metro South area of Brisbane, Australia. All participants will complete a language background questionnaire. Patients will also complete a short survey rating the effectiveness of the interaction. Recordings will be transcribed and submitted to both quantitative and qualitative analyses to determine elements of the language used that might be particularly problematic and the extent to which language concordance and discordance impacts on the quality of the patient-practitioner consultation. Discussion Understanding the role that language plays in creating barriers to healthcare is critical for healthcare systems that are experiencing an increasing range of culturally and linguistically diverse populations both amongst patients and practitioners. The data resulting from this study will inform policy and practical solutions for communication training, provide an agenda for future research, and extend theory in health communication.

Orientations to Critical Literacy for English as an Additional Language or Dialect (EAL/D) learners: A case study of four teachers of senior English

Recently, the debate around critical literacy has dissipated as literacy education agendas and attendant policies shift to embrace more hybrid approaches to the teaching of senior English. This paper reports on orientations towards critical literacy as expressed by four teachers of senior English who teach culturally and linguistically diverse learners. Teachers’ understandings of critical literacy are important given the emphasis on Critical and Creative Thinking as well as Literacy as General Capabilities underpinning the Australian Curriculum. Using critical discourse analysis and Janks' (2010) Synthesis Model of Critical Literacy, interview and classroom data from four teachers of English as an Additional Language or Dialect (EAL/D) learners in two high schools were analysed for the ways these teachers constructed critical literacy in their talk and practice. While all four teachers indicated significant commitment to critical literacy as an approach to English language teaching, their understandings varied. These ranged from providing access to powerful genres, to rationalist approaches to interrogating text, with less emphasis on multimodal design and drawing on learner diversity. This has significant implications for what kind of learning is being offered to EAL/D learners in the name of English teaching, for syllabus design, and for teacher professional development.

Negotiating Chineseness through learning Chinese as a Heritage Language in Australia: The role of habitus

While education researchers have drawn on the work of a wide diversity of theorists over the years, much contemporary theory building in these areas has revolved around the work of Pierre Bourdieu. Theory as Method in Research develops the capacity of students, researchers and teachers to successfully put Bourdieu’s ideas to work in their own research and prepare them effectively for conducting Masters and Doctoral scholarships. Structured around four core themes, this book provides a range of research case studies exploring educational identities, educational inequalities, school leadership and management, and research in teacher education. Issues as diverse as Chinese language learning and identity, school leadership in Australia and the school experience of Afro-Trinidadian boys, are covered, intertwined with a set of innovative approaches to theory application in education research. This collection brings together, in one comprehensive volume, a set of education researchers who place Pierre Bourdieu’s key concepts such as habitus, capital and field at the centre of their research methodologies. Full of insight and innovation, the book is an essential read for practitioners, student teachers, researchers and academics who want to harness the potential of Bourdieu’s core concepts in their own work, thereby helping to bridge the gap between theory and method in education research.

Learning Chinese as a Heritage Language: An Australian Perspective

Summary: This book explores the fascinating topic of heritage language learning, looking in particular at Chinese Australians' learning of Chinese. The author studies the investment, challenges and benefits of heritage language learning across varied contexts including school, work, home and in the community. The book investigates how Chinese Australians navigate and negotiate their Chineseness and how resources are used to support their learning. The book is based on a mixed methods study which uses Bourdieu's sociological theory, and offers implications for sociologists of language and education, Chinese heritage language learners and teachers, as well as language and cultural policy makers. Review: This book is a compelling account of the habitus of Chineseness in a world of mobility. It offers up a plethora of insights into the implication of heritage language learning in the constitution of Chinese identity; it makes available a sophisticated mixed methods approach for using the thinking tools of Pierre Bourdieu; it adds to these tools a nuanced cultural dimension. Karen Dooley, Queensland University of Technology, Australia In our increasingly trans-migratory world, language can be central to cultural identity. Dr Mu’s research breaks new ground by adapting Bourdieu’s insights to examine how cultural identity (‘Chinese-ness’) is linguistically learned and practiced in Australia. His remarkable book will interest educators and researchers grappling with how language pertains to identity. Tom Strong, University of Calgary, Canada A thought-provoking, highly engaging work that has deftly shown how Bourdieusian framework can be applied in the research field of literacy education and Heritage Language learning. A must-read for those interested in overseas Chinese communities and Heritage Language learning across various immigrant communities in general! Liang Du, Beijing Normal University, China

Introduction to "Learning Chinese as a Heritage Language : An Australia Perspective"

The book grapples with the complex entanglement of identity construction, language choice, cultural heritage, and social orders. Specifically, the book investigates how Chinese Australians negotiate their Chineseness and capitalise on resources through learning Chinese as a heritage language in Australia and beyond. Though the book is concerned with Chinese Australians, knowledge built and lessons learned can provide insight into other multicultural settings where people of Chinese descent are becoming increasingly prominent in representing the cultural and linguistic diversity of the society, and more recently, in contributing to the economic dynamics of the society. In addition, the focus on the potholes and distractions as well as the benefits and gains of heritage language learning is not restricted to Chinese diaspora, but relevant to ethnic minority individuals and communities elsewhere.

Using collaboration and technology to enhance Vietnamese students' English language writing skills

This action research study investigated face-to-face and wiki technology collaboration to enhance students' English writing skills in a second language (L2) class in Vietnam. The thesis is underpinned by socio-cultural theory and argues that collaborative learning using wikis led to an enhancement in L2 writing skills. The findings show that collaborating via wikis challenged traditional L2 writing pedagogy in the following ways: increased student autonomy; understanding formative feedback; and awareness of process writing, genre and audiences. This study contributes practical knowledge about affordances and constraints of collaborative writing using wikis in Vietnam and other countries where traditional pedagogies are prevalent.

Improving SEA procedures within Italian regions: Towards a more effective evaluation of urban sustainability

Sustainable urban development, a major issue at global scale, will become more relevant according to population growth predictions in developed and developing countries. Societal and international recognition of sustainability concerns led to the development of specific tools and procedures, known as sustainability assessments/appraisals (SA). Their effectiveness however, considering that global quality life indicators have worsened since their introduction, has promoted a re-thinking of SA instruments. More precisely, Strategic Environmental Assessment (SEA), – a tool introduced in the European context to evaluate policies, plans, and programmes (PPPs), – is being reconsidered because of several features that seem to limit its effectiveness. Over time, SEA has evolved in response to external and internal factors dealing with technical, procedural, planning and governance systems thus involving a shift of paradigm from EIA-based SEAs (first generation protocols) towards more integrated approaches (second generation ones). Changes affecting SEA are formalised through legislation in each Member State, to guide institutions at regional and local level. Defining SEA effectiveness is quite difficult. Its’ capacity-building process appears quite far from its conclusion, even if any definitive version can be conceptualized. In this paper, we consider some European nations with different planning systems and SA traditions. After the identification of some analytical criteria, a multi-dimensional cluster analysis is developed on some case studies, to outline current weaknesses.

Improving SEA prodedures within Italian regions: Towards a more effective evaluation of urban sustainability

Sustainable urban development, a major issue at global scale, will become more relevant according to population growth predictions in developed and developing countries. Societal and international recognition of sustainability concerns led to the development of specific tools and procedures, known as sustainability assessments/appraisals (SA). Their effectiveness however, considering that global quality life indicators have worsened since their introduction, has promoted a re-thinking of SA instruments. More precisely, Strategic Environmental Assessment (SEA), – a tool introduced in the European context to evaluate policies, plans, and programmes (PPPs), – is being reconsidered because of several features that seem to limit its effectiveness. Over time, SEA has evolved in response to external and internal factors dealing with technical, procedural, planning and governance systems thus involving a shift of paradigm from EIA-based SEAs (first generation protocols) towards more integrated approaches (second generation ones). Changes affecting SEA are formalised through legislation in each Member State, to guide institutions at regional and local level. Defining SEA effectiveness is quite difficult. Its’ capacity-building process appears quite far from its conclusion, even if any definitive version can be conceptualized. In this paper, we consider some European nations with different planning systems and SA traditions. After the identification of some analytical criteria, a multi-dimensional cluster analysis is developed on some case studies, to outline current weaknesses.

Book Review: "Language learning beyond the classroom"

Language learning beyond the classroom is part of a growing body of literature focused on teaching and learning in contexts that are informal and unstructured. Areas include so-called shadow education and informal pedagogies. Shadow education refers to the privatised tutoring supplementing school curricular that is a pervasive feature of education in parts of Asia (Bray & Lykins, 2012) and increasingly evident in Australia. Informal pedagogies refers to teaching in informal contexts and was the focus of a Special Interest Group (SIG) at the recent American Educational Research Association (AERA) annual conference in Chicago. Presentations in the SIG included designing tools for supporting learning in science classes after school and in sites such as zoos...

Prevalence and developmental course of 'secret language'.

The prevalence and developmental course of supposed ‘secret language’ was examined in a cohort of twins and closely spaced singletons pairs, with systematic assessments at 20 months and again at 36 months. Two forms of apparent ‘secret language’ were examined: (1) shared understanding—speech directed generally but unintelligible to the parent, although apparently clearly understood within the child pair, and (2) private language directed exclusively to the other twin/sibling—not intelligible to the parent, but apparently clearly understood and used only within the child pair. Both occurred in singleton pairs, but the rate was much higher in twins. In most cases it seemed to be a developmental phenomenon occurring in the second year of life with the emergence of immature speech, and decreasing considerably over the next 16 months. A small group of children, primarily male twins, was reported to use a private language at 36 months. This group had poorer cognitive and language functioning, and was characterized by highly dependent relationships. Some aspects of the twins’ home environment were less stimulating and less responsive, most probably reflecting the abilities and relationships of the children. A follow-up of these children when they were ~6 years of age showed that language outcome was poor for the subgroup (n = 4) who did not develop normal language alongside the use of a private language.

Reasoning about natural language phrases for semantic goal driven exploration

This paper presents a symbolic navigation system that uses spatial language descriptions to inform goal-directed exploration in unfamiliar office environments. An abstract map is created from a collection of natural language phrases describing the spatial layout of the environment. The spatial representation in the abstract map is controlled by a constraint based interpretation of each natural language phrase. In goal-directed exploration of an unseen office environment, the robot links the information in the abstract map to observed symbolic information and its grounded world representation. This paper demonstrates the ability of the system, in both simulated and real-world trials, to efficiently find target rooms in environments that it has never been to previously. In three unexplored environments, it is shown that on average the system travels only 8.42% further than the optimal path when using only natural language phrases to complete navigation tasks.

Lung cancer risk of airborne particles for Italian population

Airborne particles, including both ultrafine and supermicrometric particles, contain various carcinogens. Exposure and risk-assessment studies regularly use particle mass concentration as dosimetry parameter, therefore neglecting the potential impact of ultrafine particles due to their negligible mass compared to supermicrometric particles. The main purpose of this study was the characterization of lung cancer risk due to exposure to polycyclic aromatic hydrocarbons and some heavy metals associated with particle inhalation by Italian non-smoking people. A risk-assessment scheme, modified from an existing risk model, was applied to estimate the cancer risk contribution from both ultrafine and supermicrometric particles. Exposure assessment was carried out on the basis of particle number distributions measured in 25 smoke-free microenvironments in Italy. The predicted lung cancer risk was then compared to the cancer incidence rate in Italy to assess the number of lung cancer cases attributed to airborne particle inhalation, which represents one of the main causes of lung cancer, apart from smoking. Ultrafine particles are associated with a much higher risk than supermicrometric particles, and the modified risk-assessment scheme provided a more accurate estimate than the conventional scheme. Great attention has to be paid to indoor microenvironments and, in particular, to cooking and eating times, which represent the major contributors to lung cancer incidence in the Italian population. The modified risk assessment scheme can serve as a tool for assessing environmental quality, as well as setting up exposure standards for particulate matter.

Indoor Air Quality in Naturally Ventilated Italian Classrooms

Characterization of indoor air quality in school classrooms is crucial to children’s health and performance. The present study was undertaken to characterize the indoor air quality in six naturally ventilated classrooms of three schools in Cassino (Italy). Indoor particle number, mass, black carbon, CO2 and radon concentrations, as well as outdoor particle number were measured within school hours during the winter and spring season. The study found the concentrations of indoor particle number were influenced by the concentrations in the outdoors; highest BC values were detected in classrooms during peak traffic time. The effect of different seasons’ airing mode on the indoor air quality was also detected. The ratio between indoor and outdoor particles was of 0.85 ± 0.10 in winter, under airing conditions of short opening window periods, and 1.00 ± 0.15 in spring when the windows were opened for longer periods. This was associated to a higher degree of penetration of outdoor particles due to longer period of window opening. Lower CO2 levels were found in classrooms in spring (908 ppm) than in winter (2206 ppm). Additionally, a greater reduction in radon concentrations was found in spring. In addition, high PM10 levels were found in classrooms during break time due to re-suspension of coarse particles. Keywords: classroom; Ni/Nout ratio; airing by opening windows; particle number