Is language a barrier for quality care in hospitals? A case series from an Emergency Department of a teaching hospital in Brisbane

Aim: The aim of this pilot study is to describe the use of an Emergency Department (ED) at a large metropolitan teaching hospital by patients who speak English or other languages at home. Methods: All data were retrieved from the Emergency Department Information System (EDIS) of this tertiary teaching hospital in Brisbane. Patients were divided into two groups based on the language spoken at home: patients who speak English only at home (SEO) and patients who do not speak English only or speak other language at home (NSEO). Modes of arrival, length of ED stay and the proportion of hospital admission were compared among the two groups of patients by using SPSS V18 software. Results: A total of 69,494 patients visited this hospital ED in 2009 with 67,727 (97.5%) being in the SEO group and 1,281 (1.80%) in the NSEO group. The proportion of ambulance utilisation in arrival mode was significantly higher among SEO 23,172 (34.2%) than NSEO 397 (31.0%), p <0.05. The NSEO patients had longer length of stay in the ED (M = 337.21, SD = 285.9) compared to SEO patients (M= 290.9, SD = 266.8), with 46.3 minutes (95%CI 62.1, 30.5, p <0.001) difference. The admission to the hospital among NSEO was 402 (31.9%) higher than SEO 17,652 (26.6%), p <0.001. Conclusion: The lower utilisation rates of ambulance services, longer length of ED stay and higher hospital admission rates in NSEO patients compared to SEO patients are consistent with other international studies and may be due to the language barriers.

Metacognitive strategy instruction in English as Foreign Language (EFL) listening skill

Listening skill is a critical part of language learning in general, and second, and foreign language learning, in particular. However, the process of this basic skill has been overlooked compared to other skills such as speaking, reading and writing, in terms of an explicit instruction, and the product of listening is instead mainly tested indirectly through comprehension questions in classrooms. Instruction of metacognitive strategies demonstrates the pivotal impact on second language listening skill development. In this vein, this study used a mixed method with an experimental male group (N = 30) listened to texts using process-approach pedagogy directed students through metacognitive strategies over a semester (10 weeks) in Iran. To investigate the impact of metacognitive strategy instruction, the following approaches were implemented. First, IELTS listening test was used to track any development of listening comprehension. Second, using Vandergrift et al. (2006) Metacognitive Awareness Listening Questionnaire (MALQ) helped examine students’ use of metacognitive strategies in listening comprehension. Finally, interviews were used to examine students’ use of strategies in listening. The results showed that students had a development in comprehension of IELTS listening test, but no statistical significant development of metacognitive awareness in listening was demonstrated. Students and teacher reported in the interviews students used multiple strategies to approach listening comprehension besides metacognitive strategies.

Instructing foreign language learners how to listen through metacognitive strategies : an empirical study

This study uses a mixed method approach to investigate the impact of metacognitive strategies instruction on listening comprehension. An experimental group (N = 30) of university students are guided through a process-approach pedagogy over one semester (10 weeks) in Iran. IELTS listening tests are used to track development of listening comprehension in participants who are then asked to complete a Metacognitive Awareness Listening Questionnaire (MALQ). The questionnaire examines students’ employment of metacognitive strategies in listening comprehension. Finally, interviews are used to explore students’ use of strategies in listening. Results indicate that participants develop listening comprehension, but no metacognitive awareness in listening. Students reported in the interviews that they use multiple strategies (cognitive and metacognitive) to approach listening comprehension.

The impact of English as a Foreign Language (EFL) listening comprehension through first language (L1) listening strategy training

Listening is the basic and complementary skill in second language learning. The term listening is used in language teaching to refer to a complex process that allows us to understand spoken language. Listening, the most widely used language skill, is often used in conjunction with the other skills of speaking, reading and writing. Listening is not only a skill area in primary language performance (L1), but is also a critical means of acquiring a second language (L2). Listening is the channel in which we process language in real time – employing pacing, units of encoding and decoding (the 2 processes are central to interpretation and meaning making) and pausing (allows for reflection) that are unique to spoken language. Despite the wide range of areas investigated in listening strategies during training, there is a lack of research looking specifically at how effectively L1 listening strategy training may transfer to L2. To investigate the development of any such transfer patterns the instructional design and implementation of listening strategy of L1 will be critical.

Sections of the city : architecturalising the tools of urban morphology

The study of urban morphology has become an expanding field of research within the architectural discipline, providing theories to be used as tools in the understanding and design of urban landscapes from the past, the present and into the future. Drawing upon contemporary architectural design theory, this investigation reveals what a sectional analysis of an urban landscape can add to the existing research methods within this field. This paper conducts an enquiry into the use of the section as a tool for urban morphological analysis. Following the methodology of the British school of urban morphology, sections through the urban fabric of the case study city of Brisbane are compared. The results are categorised to depict changes in scale, components and utilisation throughout various timeframes. The key findings illustrate how the section, when read in conjunction with the plan can be used to interpret changes to urban form and the relationship that this has to the quality of the urban environment in the contemporary city.

A world map of knowledge in the making : Wikipedia's Inter-Language Linkage as a dependency explorer of global knowledge accumulation

Analysis of Wikipedia's inter-language links provides insight into a new mechanism of knowledge sharing and linking worldwide.

From slum to suburbia : examining a spectrum of planned and unplanned urban morphology in humid sub-tropical regions of the world

The current rapid urban growth throughout the world manifests in various ways and historically cities have grown, similarly, alternately or simultaneously between planned extensions and organic informal settlements (Mumford, 1989). Within cities different urban morphological regions can reveal different contexts of economic growth and/or periods of dramatic social/technological change (Whitehand, 2001, 105). Morpho-typological study of alternate contexts can present alternative models and contribute to the present discourse which questions traditional paradigms of urban planning and design (Todes et al, 2010). In this study a series of cities are examined as a preliminary exploration into the urban morphology of cities in ‘humid subtropical’ climates. From an initial set of twenty, six cities were selected: Sao Paulo, Brazil; Jacksonville, USA; Maputo, Mozambique; Kanpur, India; Hong Kong, China; and Brisbane, Australia. The urban form was analysed from satellite imagery at a constant scale. Urban morphological regions (types) were identified as those demonstrating particular consistant characteristics of form (density, typology and pattern) different to their surroundings when examined at a constant scale. This analysis was correlated against existing data and literature discussing the proliferation of two types of urban development, ‘informal settlement’ (defined here as self-organised communities identifiable but not always synonymous with ‘slums’) and ‘suburbia’ (defined here as master planned communities of generally detached houses prevalent in western society) - the extreme ends of a hypothetical spectrum from ‘planned’ to ‘spontaneous’ urban development. Preliminary results show some cities contain a wide variety of urban form ranging from the highly organic ‘self-organised’ type to the highly planned ‘master planned community’ (in the case of Sao Paulo) while others tend to fall at one end of the planning spectrum or the other (more planned in the cases of Brisbane and Jacksonville; and both highly planned and highly organic in the case of Maputo). Further research will examine the social, economical and political drivers and controls which lead to this diversity or homogeneity of urban form and speculates on the role of self-organisation as a process for the adaptation of urban form.

Languages of Communication : Indigenous language and/or English?

My interest in producing this paper on Indigenous languages was borne out of conversations with and learnings from community members in the Torres Straits and those connected to the ‘Dream Circle’. Nakata (2003, p. 12) laments the situation whereby ‘teachers are transitionary and take their hard-earned knowledge with them when they leave’. I am thus responding to the call to add to the conversation in a productive albeit culturally loaded way. To re-iterate, I am neither Indigenous nor am I experienced in teaching and learning in these contexts. As problematic as these two points are, I am in many ways typical of the raft of inexperienced white Australian teachers assigned to positions in school contexts where Indigenous students are enrolled or in mainstream contexts with substantial populations of Indigenous students. By penning this article, it is neither my intention to contribute to the silencing of Indigenous educators or Indigenous communities. My intention is to articulate my teacherly reflections as they apply to the topic under discussion. The remainder of this paper is presented in three sections. The next section provides a brief overview of the number of Indigenous people and Indigenous languages in Australia and the role of English as a language of communication. The section which follows draws on theorisations from second/additional language acquisition to overview three different schools of thought about the consequences of English in the lives of Indigenous Australians. The paper concludes by considering the tensions for inexperienced white Australian teachers caught up in the fray.

Listening skill requires a further look into second/foreign language learning

Current English-as-a-second and foreign-language (ESL/EFL) research has encouraged to treat each communicative macroskill separately due to space constraint, but the interrelationship among these skills (listening, speaking, reading, and writing) is not paid due attention. This study attempts to examine first the existing relationship among the four dominant skills, second the potential impact of reading background on the overall language proficiency, and finally the relationship between listening and overall language proficiency as listening is considered an overlooked/passive skill in the pedagogy of the second/foreign language classroom. However, the literature in language learning has revealed that listening skill has salient importance in both first and second language learning. The purpose of this study is to investigate the role of each of four skills in EFL learning and their existing interrelationships in an EFL setting. The outcome of 701 Iranian applicants undertaking International English Language Testing System (IELTS) in Tehran demonstrates that all communicative macroskills have varied correlations from moderate (reading and writing) to high (listening and reading). The findings also show that the applicants’ reading history assisted them in better performing at high stakes tests, and what is more, listening skill was strongly correlated with the overall language proficiency.

An analytical tool that quantifies cellular morphology changes from three-dimensional fluorescence images

The most common software analysis tools available for measuring fluorescence images are for two-dimensional (2D) data that rely on manual settings for inclusion and exclusion of data points, and computer-aided pattern recognition to support the interpretation and findings of the analysis. It has become increasingly important to be able to measure fluorescence images constructed from three-dimensional (3D) datasets in order to be able to capture the complexity of cellular dynamics and understand the basis of cellular plasticity within biological systems. Sophisticated microscopy instruments have permitted the visualization of 3D fluorescence images through the acquisition of multispectral fluorescence images and powerful analytical software that reconstructs the images from confocal stacks that then provide a 3D representation of the collected 2D images. Advanced design-based stereology methods have progressed from the approximation and assumptions of the original model-based stereology(1) even in complex tissue sections(2). Despite these scientific advances in microscopy, a need remains for an automated analytic method that fully exploits the intrinsic 3D data to allow for the analysis and quantification of the complex changes in cell morphology, protein localization and receptor trafficking. Current techniques available to quantify fluorescence images include Meta-Morph (Molecular Devices, Sunnyvale, CA) and Image J (NIH) which provide manual analysis. Imaris (Andor Technology, Belfast, Northern Ireland) software provides the feature MeasurementPro, which allows the manual creation of measurement points that can be placed in a volume image or drawn on a series of 2D slices to create a 3D object. This method is useful for single-click point measurements to measure a line distance between two objects or to create a polygon that encloses a region of interest, but it is difficult to apply to complex cellular network structures. Filament Tracer (Andor) allows automatic detection of the 3D neuronal filament-like however, this module has been developed to measure defined structures such as neurons, which are comprised of dendrites, axons and spines (tree-like structure). This module has been ingeniously utilized to make morphological measurements to non-neuronal cells(3), however, the output data provide information of an extended cellular network by using a software that depends on a defined cell shape rather than being an amorphous-shaped cellular model. To overcome the issue of analyzing amorphous-shaped cells and making the software more suitable to a biological application, Imaris developed Imaris Cell. This was a scientific project with the Eidgenössische Technische Hochschule, which has been developed to calculate the relationship between cells and organelles. While the software enables the detection of biological constraints, by forcing one nucleus per cell and using cell membranes to segment cells, it cannot be utilized to analyze fluorescence data that are not continuous because ideally it builds cell surface without void spaces. To our knowledge, at present no user-modifiable automated approach that provides morphometric information from 3D fluorescence images has been developed that achieves cellular spatial information of an undefined shape (Figure 1). We have developed an analytical platform using the Imaris core software module and Imaris XT interfaced to MATLAB (Mat Works, Inc.). These tools allow the 3D measurement of cells without a pre-defined shape and with inconsistent fluorescence network components. Furthermore, this method will allow researchers who have extended expertise in biological systems, but not familiarity to computer applications, to perform quantification of morphological changes in cell dynamics.

The language of optimism : how entrepreneurs sell the sizzle in business plan offer documents

Existing macro level research on the new venture creation process recognises the entrepreneur as a central agent in the process yet generally avoids, at each stage of the process, an examination of the micro level psychological behaviour of the individual entrepreneur. By integrating two theoretical approaches to entrepreneurship research, the psychology of the entrepreneur and the entrepreneurship process, this paper examines, using content analysis, the language used by new venture founders in documents directly linked to their capital raising activity. The study examined the language of 108 offer documents (information memorandum’s) which were divided between 54 new ventures that were successful in raising capital and 54 new ventures that either did not proceed further or were not successful in raising capital through the Australian Small Scale Offerings Board. Specifically, we were interested in examining the level of optimism evident in these narratives given that entrepreneurs have been previously described in the literature as being excessively optimistic.

The pedagogical, linguistic and content features of popular English language learning websites in China : a framework for analysis and design

As increasing numbers of Chinese language learners choose to learn English online (CNNIC, 2012), there is a need to investigate popular websites and their language learning designs. This paper reports on the first stage of a study that analysed the pedagogical, linguistic and content features of 25 Chinese English Language Learning (ELL) websites ranked according to their value and importance to users. The website ranking was undertaken using a system known as PageRank. The aim of the study was to identify the features characterising popular sites as opposed to those of less popular sites for the purpose of producing a framework for ELL website design in the Chinese context. The study found that a pedagogical focus with developmental instructional materials accommodating diverse proficiency levels was a major contributor to website popularity. Chinese language use for translations and teaching directives and intermediate level English for learning materials were also significant features. Content topics included Anglophone/Western and non-Anglophone/Eastern contexts. Overall, popular websites were distinguished by their mediation of access to and scaffolded support for ELL.