Is the Front Line Prepared for the Changing Faces of Patients? Predictors of Cross-Cultural Preparedness Among Clinical Nurses and Resident Physicians in Lausanne, Switzerland.

UNLABELLED: Phenomenon: Assuring quality medical care for all persons requires that healthcare providers understand how sociocultural factors affect a patient's health beliefs/behaviors. Switzerland's changing demographics highlight the importance of provider cross-cultural preparedness for all patients-especially those at risk for social/health precarity. We evaluated healthcare provider cross-cultural preparedness for commonly encountered vulnerable patient profiles. APPROACH: A survey on cross-cultural care was mailed to Lausanne University hospital's "front-line healthcare providers": clinical nurses and resident physicians at our institution. Preparedness items asked "How prepared do you feel to care for ... ?" (referring to example patient profiles) on an ascending 5-point Likert scale. We examined proportions of "4 - well/5 - very well prepared" and the mean composite score for preparedness. We used linear regression to examine the adjusted effect of demographics, work context, cultural-competence training, and cross-cultural care problem awareness, on preparedness. FINDINGS: Of 885 questionnaires, 368 (41.2%) were returned: 124 (33.6%) physicians and 244 (66.4%) nurses. Mean preparedness composite was 3.30 (SD = 0.70), with the lowest proportion of healthcare providers feeling prepared for patients "whose religious beliefs affect treatment" (22%). After adjustment, working in a sensitized department (β = 0.21, p = .01), training on the history/culture of a specific group (β = 0.25, p = .03), and awareness regarding (a) a lack of practical experience caring for diverse populations (β = 0.25, p = .004) and (b) inadequate cross-cultural training (β = 0.18, p = .04) were associated with higher preparedness. Speaking French as a dominant language and physician role (vs. nurse) were negatively associated with preparedness (β = -0.26, p = .01; β = -0.22, p = .01). Insights: The state of cross-cultural care preparedness among Lausanne's front-line healthcare providers leaves room for improvement. Our study points toward institutional strategies to improve preparedness: notably, making sure departments are sensitized to cross-cultural care resources and increasing provider diversity to reflect the changing Swiss demographic.

Translation and psychometric evaluation of a French version of the Readiness for Hospital Discharge Scale.

AIMS AND OBJECTIVES: To evaluate the reliability and the factor structure of the Readiness for Hospital Discharge Scale - French version. BACKGROUND: The patient's perspective is essential when assessing risk for adverse events at hospital discharge. Developed in the USA, the Readiness for Hospital Discharge Scale is the only instrument that measures an individual's self-perception of readiness before leaving the hospital. A French version of the Readiness for Hospital Discharge Scale was developed and validated. DESIGN: Cross-sectional study. METHODS: A convenience sample of 265 older inpatients from four medical units was selected. The translation and cultural adaptation of the scale involved experts in gerontology and the French language and included back translation. The items were semantically evaluated and pretested in 10 older inpatients. The scale's psychometric properties were internally validated by using confirmatory and exploratory factor analyses. Reliability was assessed by examining the internal consistency of its items. RESULTS: Goodness-of-fit indices of the confirmatory factor analyses were not adequate, but reliability was acceptable (Cronbach's α = 0·80). Exploratory factor analysis of the French version provided results close to those described for the English version, with three similar subscales (physical and emotional readiness, coping with medical treatment and personal care), whereas the initially described Expected Support subscale was not identified in the French version. CONCLUSION: The Readiness for Hospital Discharge Scale - French version appears to be partially consistent with its original English version, but requires additional adaptation to fully take into account the Swiss context and culture to achieve its original aim. RELEVANCE TO CLINICAL PRACTICE: Assessing patient readiness for hospital discharge before leaving hospital could help nurses to improve the discharge planning process and achieve better patient preparedness and care coordination.

Effects of Three Types of Exercise Interventions on Healthy Old Adults' Gait Speed : A Systematic Review and Meta-Analysis.

BACKGROUND: Habitual walking speed predicts many clinical conditions later in life, but it declines with age. However, which particular exercise intervention can minimize the age-related gait speed loss is unclear. PURPOSE: Our objective was to determine the effects of strength, power, coordination, and multimodal exercise training on healthy old adults' habitual and fast gait speed. METHODS: We performed a computerized systematic literature search in PubMed and Web of Knowledge from January 1984 up to December 2014. Search terms included 'Resistance training', 'power training', 'coordination training', 'multimodal training', and 'gait speed (outcome term). Inclusion criteria were articles available in full text, publication period over past 30 years, human species, journal articles, clinical trials, randomized controlled trials, English as publication language, and subject age ≥65 years. The methodological quality of all eligible intervention studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. We computed weighted average standardized mean differences of the intervention-induced adaptations in gait speed using a random-effects model and tested for overall and individual intervention effects relative to no-exercise controls. RESULTS: A total of 42 studies (mean PEDro score of 5.0 ± 1.2) were included in the analyses (2495 healthy old adults; age 74.2 years [64.4-82.7]; body mass 69.9 ± 4.9 kg, height 1.64 ± 0.05 m, body mass index 26.4 ± 1.9 kg/m(2), and gait speed 1.22 ± 0.18 m/s). The search identified only one power training study, therefore the subsequent analyses focused only on the effects of resistance, coordination, and multimodal training on gait speed. The three types of intervention improved gait speed in the three experimental groups combined (n = 1297) by 0.10 m/s (±0.12) or 8.4 % (±9.7), with a large effect size (ES) of 0.84. Resistance (24 studies; n = 613; 0.11 m/s; 9.3 %; ES: 0.84), coordination (eight studies, n = 198; 0.09 m/s; 7.6 %; ES: 0.76), and multimodal training (19 studies; n = 486; 0.09 m/s; 8.4 %, ES: 0.86) increased gait speed statistically and similarly. CONCLUSIONS: Commonly used exercise interventions can functionally and clinically increase habitual and fast gait speed and help slow the loss of gait speed or delay its onset.

Les oracions comparatives prototípiques en català : Estudi general i relació amb altres llengües romàniques

Descripció de les oracions comparatives prototípiques en llengua catalana i anàlisi de les normes de funcionament d'aquest tipus d'oracions a nivell sintàctic, semàntic i pragmàtic. El treball es complementa amb un estudi comparatiu d'una seixantena de casos en les quatre llengües romàniques més properes al català: castellà, francès, portuguès i italià.

Construction of an index of information from clinical practice in Radiology and Imaging Diagnosis based on text mining and thesaurus

Objective To construct a Portuguese language index of information on the practice of diagnostic radiology in order to improve the standardization of the medical language and terminology. Materials and Methods A total of 61,461 definitive reports were collected from the database of the Radiology Information System at Hospital das Clínicas – Faculdade de Medicina de Ribeirão Preto (RIS/HCFMRP) as follows: 30,000 chest x-ray reports; 27,000 mammography reports; and 4,461 thyroid ultrasonography reports. The text mining technique was applied for the selection of terms, and the ANSI/NISO Z39.19-2005 standard was utilized to construct the index based on a thesaurus structure. The system was created in *html. Results The text mining resulted in a set of 358,236 (n = 100%) words. Out of this total, 76,347 (n = 21%) terms were selected to form the index. Such terms refer to anatomical pathology description, imaging techniques, equipment, type of study and some other composite terms. The index system was developed with 78,538 *html web pages. Conclusion The utilization of text mining on a radiological reports database has allowed the construction of a lexical system in Portuguese language consistent with the clinical practice in Radiology.

Els altres parlants i la història social de la llengua

The social history of language is usually focused on collective actors. This article aims to reflect both on the speakers as individual subjects of the social history of language and on the sources which allow an approach to speakers, more precisely immigrants of the contemporary Catalonia. In very different narratives, immigrants talk about their territory of origin or economic conditions, and also about languages expressing the most varied language attitudes. Prejudices or language uses, common topics of these narratives, are fully within the field of social history of the language. Speakers cannot be always out of disciplines whose narrative axis is the time

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Machiavelli translated into Catalan: textuals and editorials choices

This article provides an appraisal of all published and unpublished, complete and excerpted translations into Catalan of Machiavelli's works, and reconstructs the cultural circumstances around their completion as a means to determine from which editions the various translators worked. It also explains how the translators confronted and resolved issues of language and syntax in The Prince .

The usefulness of phonological information for the acquisition of grammatical structure in child language development

During the process of language development, one of the most important tasks that children must face is that of identifying the grammatical category to which words in their language belong. This is essential in order to be able to form grammatically correct utterances. How do children proceed in order to classify words in their language and assign them to their corresponding grammatical category? The present study investigates the usefulness of phonological information for the categorization of nouns in English, given the fact that it is phonology the first source of information that might be available to prelinguistic infants who lack access to semantic information or complex morphosyntactic information. We analyse four different corpora containing linguistic samples of English speaking mothers addressing their children in order to explore the reliability with which words are represented in mothers’ speech based on several phonological criteria. The results of the analysis confirm the prediction that most of the words to which English learning infants are exposed during the first two years of life can be accounted for in terms of their phonological resemblance

Del papel a la pantalla y del aula a la nube: ideas para dinamizar la expresión escrita en secundaria = From paper to the screen and from the classroom to the cloud: ideas to energise written expression at secondary level

The spread of sociocultural focuses and critical literacy studies, which offer an holistic perspective on communicative skills, has reached our country at a time when the commonest environment for writing is the internet, and information technologies have transformed writing with new channels, genres, forms of preparation and languages. Thanks to these changes, educational programmes now include new concepts of literacy related to knowledge and the use of digital environments. This paper explores the impact of introducing these new communicative environments to teaching written expression at secondary level and puts forward some ideas to link learning how to write to present communicative contexts and established practices. Without forgetting the achievements of recent decades, we need to bring about a series of changes to bring new learned writing practices to class and leave behind others we had championed as necessary when the goal was to move beyond exclusively linguistic or grammatical approaches

Causation and dominance : a study of Finnish causative verbs expressing social dominance

En väsentlig fråga inom såväl lingvistiska som kognitiva teorier är, hur språket beskriver kausala relationer. I finskan finns det en speciell typ av kausativa verb avledda med suffixet (U)ttA som används för att uttrycka att handlingen i fråga utförs av någon annan än subjektreferenten, t.ex. Maija haetuttaa Matilla kirjastosta kirjan ’Maija låter Matti hämta boken från biblioteket’ och Matti juoksuttaa Maijan kaupunkiin ’Matti låter Maija springa till staden’. Syftet med denna avhandling var att med exempel av sociala dominansens kausativer undersöka ordbildningens natur samt begreppet ’socialt förorsakande’. För att beskriva avledningars regelbundna argumentstruktur i form av kopplingen mellan syntaxen och semantiken upprättades deras prototypiska strukturer. Dessa verb har emellertid också specifika användningsområden som framhäver variationer i sociala relationer. Säregna egenskaper hos den sociala dominansens kausativer inkluderades i undersökningen och definierades som konstruktioner. Konstruktionerna omfattar speciella syntaktiska och/eller semantiska element och utöver det också pragmatiska värderande implikationer. Uppbyggnaden av den sociala dimensionen hos de undersökta verben består av egenskaper förbundna med typen av förorsakande, argumentens agentiva egenskaper (aktivitet eller passivitet, dominans, kontroll, viljestyrdhet och ansvarighet) samt konventionaliserade attityder och tolkningar. Ett exempel på en s.k. 'tolkningskonstruktion’ är den negativa dominansens uttryck som i avhandlingen kallas Maktmissbrukskonstruktionen. Denna konstruktion inkluderar talarens starkt kritiska hållning till den uttryckta situationen, t.ex. Asiakas juoksuttaa lentoemäntää ’Kunden låter flygvärdinnan springa’. Dessa konstruktioner fyller en viktig funktion i språklig kommunikation: att beskriva avvikande av sociala normer och att foga expressivitet till budskapet. Metodologiskt kombinerar denna avhandling teorier som baseras på det aktuella språkbruket och teoretisk lingvistisk analys. Verbens samt konstruktionernas konceptuella lexikala struktur och prototypstrukturerna analyserades med hjälp av den konceptuella semantikens verktyg, som har utvecklats av Jackendoff, Nikanne och Pörn.

Neural correlates of language learning in adults

The human language-learning ability persists throughout life, indicating considerable flexibility at the cognitive and neural level. This ability spans from expanding the vocabulary in the mother tongue to acquisition of a new language with its lexicon and grammar. The present thesis consists of five studies that tap both of these aspects of adult language learning by using magnetoencephalography (MEG) and functional magnetic resonance imaging (fMRI) during language processing and language learning tasks. The thesis shows that learning novel phonological word forms, either in the native tongue or when exposed to a foreign phonology, activates the brain in similar ways. The results also show that novel native words readily become integrated in the mental lexicon. Several studies in the thesis highlight the left temporal cortex as an important brain region in learning and accessing phonological forms. Incidental learning of foreign phonological word forms was reflected in functionally distinct temporal lobe areas that, respectively, reflected short-term memory processes and more stable learning that persisted to the next day. In a study where explicitly trained items were tracked for ten months, it was found that enhanced naming-related temporal and frontal activation one week after learning was predictive of good long-term memory. The results suggest that memory maintenance is an active process that depends on mechanisms of reconsolidation, and that these process vary considerably between individuals. The thesis put special emphasis on studying language learning in the context of language production. The neural foundation of language production has been studied considerably less than that of perceptive language, especially on the sentence level. A well-known paradigm in language production studies is picture naming, also used as a clinical tool in neuropsychology. This thesis shows that accessing the meaning and phonological form of a depicted object are subserved by different neural implementations. Moreover, a comparison between action and object naming from identical images indicated that the grammatical class of the retrieved word (verb, noun) is less important than the visual content of the image. In the present thesis, the picture naming was further modified into a novel paradigm in order to probe sentence-level speech production in a newly learned miniature language. Neural activity related to grammatical processing did not differ between the novel language and the mother tongue, but stronger neural activation for the novel language was observed during the planning of the upcoming output, likely related to more demanding lexical retrieval and short-term memory. In sum, the thesis aimed at examining language learning by combining different linguistic domains, such as phonology, semantics, and grammar, in a dynamic description of language processing in the human brain.

Saksan opiskelijasta saksan opettajaksi. Aineenopettajaopiskelijan ammatillinen kasvu ohjatussa harjoitttelussa

Tutkimuksessani tarkastelin, miten ammatillinen kasvu ilmenee saksan opetusharjoittelijoiden näkemyksissä ja toiminnassa opettajan pedagogisiin opintoihin kuuluvan ohjatun harjoittelun aikana. Keräsin tutkimusaineiston lukuvuosina 2007–2010 kaikilta saksan opetusharjoittelijoilta, jotka suorittivat ohjatussa harjoittelussa vähintään 15 op Turun normaalikoulussa. Tutkimusaineistona käytin henkilökohtaisia harjoittelusuunnitelmia (HOPS) ja reflektiovihkoja, jotka ovat ohjatun harjoittelun normaaleja työvälineitä. Täydensin aineistoa ohjatun harjoittelun alussa toteutetulla kyselyllä ja harjoittelun päätteeksi tehdyllä puolistrukturoidulla teemahaastattelulla. Toimin tutkimuksen aikana Turun normaalikoulussa saksan opettajana ja aineryhmän harjoittelusta vastaavana opettajana. Tutkimuskysymykset tarkentuivat aineistolähtöisesti. Ensimmäinen tutkimuskysymys liittyi siihen, miten harjoittelijoiden ideaalit hyvästä vieraan kielen opetuksesta ja henkilökohtaiset tavoitteet toteutuivat ohjatun harjoittelun aikana. Alkukyselyn pohjalta ideaaleiksi nousivat vuorovaikutus ja monipuoliset työtavat, kulttuurin opettaminen, tavoitekielen käyttö luokkakielenä sekä selkeä kieliopin opetus. Tutkimuksessa kävi ilmi, että alkukyselyssä esiin tullut hyvän opettajan tai vieraan kielen opetuksen ideaali ei välttämättä näy opettajaksi opiskelevan HOPSeihin kirjatuissa henkilökohtaisissa tavoitteissa tai toteudu hänen harjoitustunneillaan. Parhaiten opetusharjoittelijat kokivat onnistuneensa vuorovaikutuksen luomisessa oppilaisiin ja opiskelijoihin sekä monipuolisten työtapojen käytössä. Eriyttäminen ja oppimaan oppimisen ohjaaminen koettiin hankalina. Suurin osa harjoittelijoista oli tyytyväisiä siihen, miten he onnistuivat tuomaan kulttuuria opetukseensa, kun taas tavoitekielen käyttö luokkakielenä ja kieliopin opetus koettiin haasteellisiksi. Toisessa tutkimuskysymyksessä tarkasteltiin, millainen ammatillinen näkemys vieraan kielen opiskelijalla on ohjatun harjoittelun jälkeen. Opetusharjoittelijat korostivat opettajan kasvatustyötä ja opettajien välistä yhteistyötä. Ajatus toimia saksan tai vieraan kielen opettajana oli vahvistunut pedagogisten opintojen aikana. Kolmas tutkimuskysymys kohdistui sen selvittämiseen, miten HOPS ja reflektiovihko toimivat harjoittelijoiden kasvun tukena. Harjoittelijoiden kirjallinen itsereflektio vaihteli syvällisistä pohdinnoista niukkiin merkintöihin. Suurimmassa osassa reflektiovihoista harjoittelijat olivat miettineet palautteissa esille tulleita asioita. HOPS ja reflektiovihko ovat tämän tutkimuksen perusteella toimivia harjoittelun ohjauksen välineitä, kunhan harjoittelijoita ohjataan niiden käytössä. Itsereflektion merkityksen puolesta puhuu se, että harjoittelijat, jotka olivat myös kirjallisesti pohtineet saksan käyttöä luokkakielenä, olivat muita tyytyväisempiä siihen, miten he kokivat onnistuneensa luokkakielen käytössä.

Tekijännimet Mikael Agricolan teosten kielessä. Henkilötarkoitteisten johdosten merkitykset, funktiot ja rakenteet

My research deals with agent nouns in the language of the works of Mikael Agricola (ca. 1510–1557). The main tasks addressed in my thesis have been to describe individual agent noun types, to provide a comprehensive picture of the category of agent nouns and to clarify the relations between different types of agent nouns. My research material consists of all the agent nouns referring to persons in the language of Agricola’s works, together with their context. The language studied is for the most part translated language. Agent nouns play an important role both in the vocabulary of natural language and in broader sentence structures, since in a text it is constantly necessary to refer to actors re-ferring to persons in the text. As a concept and a phenomenon, the agent noun is widely known in languages. It is a word formed with a certain derivational affixes, which typical-ly refers to a person. In my research the agent noun category includes both deverbal and denominal derivatives referring to persons, e.g. kirjoittaa > kirjoittaja (to write > writer), asua > asuva (to inhabit > inhabitant), imeä > imeväinen (to suck > suckling), juopua > juopunut (to drink > drunkard), pelätä > pelkuri (to fear > one who fears ‘a coward’), apu > apulainen (help/to help > helper); lammas > lampuri (sheep > shepherd). Besides original Finnish expressions, agent noun derivatives taken as such from foreign languages form a word group of central importance for the research (e.g. nikkari, porvari, ryöväri, based on the German/Swedish for carpenter, burgher, robber). Especially important for the formation of agent nouns in Finnish are the models offered by foreign languages. The starting point for my work is predominantly semantic, as both the criteria for collecting the material and the categorisation underlying the analysis of the material are based on semantic criteria. When examining derivatives, aspects relating to structure are also inevitably of central importance, as form and meaning are closely associated with each other in this type of vocabulary. The alliance of structure and meaning can be described in an illustrative manner with the help of structural schemata. The examination of agent nouns comprises on the one hand analysis of syntactic elements and on the other, study of cultural words in their most typical form. The latter aspect offers a research object in which language and the extralinguistic world, referents, their designations and cultural-historical reality are in concrete terms one and the same. Thus both the agent noun types that follow the word formation principles of the Finn-ish language and those of foreign origin borrowed as a whole into Finnish illustrate very well how an expression of a certain origin and formed according to a certain structural model is inseparably bound up with the background of its referent and in general with semantic factors. This becomes evident both on the level of the connection between cer-tain linguistic features and text genre and in relation to cultural words referring to per-sons. For example, the model for the designations of God based on agent nouns goes back thousands of years and is still closely linked in 16th century literature with certain text genres. This brings out the link between the linguistic feature and the genre in a very con-crete manner. A good example of the connection between language and the extralinguistic world is provided by the cultural vocabulary referring to persons. Originally Finnish agent noun derivatives are associated with an agrarian society, while the vocabulary relat-ing to mediaeval urbanisation, the Hansa trade and specialisation by trade or profession is borrowed and originates in its entirety from vocabulary that was originally German.