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.

Validation and reliability of a Spanish version of Simple Shoulder Test (SST-Sp)

Background: The Simple Shoulder Test (SST-Sp) is a widely used outcome measure. Objective: The purpose of this study was to develop and validate a Spanish-version SST (SST-Sp). Methods: A two-stage observational study was conducted. The SST was initially cross-culturally adapted to Spanish through double forward and backward translation and then validated for its psychometric characteristics. Participants (n = 66) with several shoulder disorders completed the SST-Sp, DASH, VAS and SF-12. The full sample was employed to determine factor structure, internal consistency and concurrent criterion validity. Reliability was determined in the first 24–48 h in a subsample of 21 patients. Results: The SST-Sp showed three factors that explained the 56.1 % of variance, and the internal consistency for each factor was α = 0.738, 0.723 and 0.667, and reliability was ICC = 0.687–0.944. The factor structure was three-dimensional and supported construct validity. Criterion validity determined from the relationship between the SST-Sp and DASH was strong (r = −0.73; p < 0.001) and fair for VAS (r = −0.537; p < 0.001). Relationships between SST-Sp and SF-12 were weak for both physical (r = −0.47; p < 0.001) and mental (r = −0.43; p < 0.001) dimensions. Conclusions: The SST-Sp supports the findings of the original English version as being a valid shoulder outcome measure with similar psychometric properties to the original English version.

Spanish version of the screening Orebro Musculoskeletal Pain Questionnaire: A cross-cultural adaptation and validation

Background Spanish is one of the five most spoken languages in the world. There is currently no published Spanish version of the Örebro Musculoskeletal Pain Questionnaire (OMPQ). The aim of the present study is to describe the process of translating the OMPQ into Spanish and to perform an analysis of reliability, internal structure, internal consistency and concurrent criterion-related validity. Methods Design: Translation and psychometric testing. Procedure: Two independent translators translated the OMPQ into Spanish. From both translations a consensus version was achieved. A backward translation was made to verify and resolve any semantic or conceptual problems. A total of 104 patients (67 men/37 women) with a mean age of 53.48 (±11.63), suffering from chronic musculoskeletal disorders, twice completed a Spanish version of the OMPQ. Statistical analysis was performed to evaluate the reliability, the internal structure, internal consistency and concurrent criterion-related validity with reference to the gold standard questionnaire SF-12v2. Results All variables except “Coping” showed a rate above 0.85 on reliability. The internal structure calculation through exploratory factor analysis indicated that 75.2% of the variance can be explained with six components with an eigenvalue higher than 1 and 52.1% with only three components higher than 10% of variance explained. In the concurrent criterion-related validity, several significant correlations were seen close to 0.6, exceeding that value in the correlation between general health and total value of the OMPQ. Conclusions The Spanish version of the screening questionnaire OMPQ can be used to identify Spanish patients with musculoskeletal pain at risk of developing a chronic disability.

Validation of a Spanish version of the Spine Functional Index

Background The Spine Functional Index (SFI) is a recently published, robust and clinimetrically valid patient reported outcome measure. Objectives The purpose of this study was the adaptation and validation of a Spanish-version (SFI-Sp) with cultural and linguistic equivalence. Methods A two stage observational study was conducted. The SFI was cross-culturally adapted to Spanish through double forward and backward translation then validated for its psychometric characteristics. Participants (n = 226) with various spine conditions of >12 weeks duration completed the SFI-Sp and a region specific measure: for the back, the Roland Morris Questionnaire (RMQ) and Backache Index (BADIX); for the neck, the Neck Disability Index (NDI); for general health the EQ-5D and SF-12. The full sample was employed to determine internal consistency, concurrent criterion validity by region and health, construct validity and factor structure. A subgroup (n = 51) was used to determine reliability at seven days. Results The SFI-Sp demonstrated high internal consistency (α = 0.85) and reliability (r = 0.96). The factor structure was one-dimensional and supported construct validity. Criterion specific validity for function was high with the RMQ (r = 0.79), moderate with the BADIX (r = 0.59) and low with the NDI (r = 0.46). For general health it was low with the EQ-5D and inversely correlated (r = −0.42) and fair with the Physical and Mental Components of the SF-12 and inversely correlated (r = −0.56 and r = −0.48), respectively. The study limitations included the lack of longitudinal data regarding other psychometric properties, specifically responsiveness. Conclusions The SFI-Sp was demonstrated as a valid and reliable spine-regional outcome measure. The psychometric properties were comparable to and supported those of the English-version, however further longitudinal investigations are required.

Generalized Query-By-Rule: a heterogeneous database query language

This paper describes the design and implementation of a high-level query language called Generalized Query-By-Rule (GQBR) which supports retrieval, insertion, deletion and update operations. This language, based on the formalism of database logic, enables the users to access each database in a distributed heterogeneous environment, without having to learn all the different data manipulation languages. The compiler has been implemented on a DEC 1090 system in Pascal.

Language and Letters of the Bluestocking Network : Sociolinguistic Issues in Eighteenth Century Epistolary English

This study deals with language change and variation in the correspondence of the eighteenth-century Bluestocking circle, a social network which provided learned men and women with an informal environment for the pursuit of scholarly entertainment. Elizabeth Montagu (1718 1800), a notable social hostess and a Shakespearean scholar, was one of their key figures. The study presents the reconstruction of Elizabeth Montagu s social networks from her youth to her later years with a special focus on the Bluestocking circle, and linguistic research on private correspondence between Montagu and her Bluestocking friends and family members between the years 1738 1778. The epistolary language use is investigated using the methods and frameworks of corpus linguistics, historical sociolinguistics, and social network analysis. The approach is diachronic and concerns real-time language change. The research is based on a selection of manuscript letters which I have edited and compiled into an electronic corpus (Bluestocking Corpus). I have also devised a network strength scale in order to quantify the strength of network ties and to compare the results of the linguistic research with the network analysis. The studies range from the reconstruction and analysis of Elizabeth Montagu s most prominent social networks to the analysis of changing morphosyntactic features and spelling variation in Montagu s and her network members correspondence. The linguistic studies look at the use of the progressive construction, preposition stranding and pied piping, and spelling variation in terms of preterite and past participle endings in the regular paradigm (-ed, - d, -d, - t, -t) and full / contracted spellings of auxiliary verbs. The results are analysed in terms of social network membership, sociolinguistic variables of the correspondents, and, when relevant, aspects of eighteenth-century linguistic prescriptivism. The studies showed a slight diachronic increase in the use of the progressive, a significant decrease of the stigmatised preposition stranding and increase of pied piping, and relatively informal but socially controlled epistolary spelling. Certain significant changes in Elizabeth Montagu s language use over the years could be attributed to her increasingly prominent social standing and the changes in her social networks, and the strength of ties correlated strongly with the use of the progressive in the Bluestocking Corpus. Gender, social rank, and register in terms of kinship/friendship had a significant influence in language use, and an effect of prescriptivism could also be detected. Elizabeth Montagu s network ties resulted in language variation in terms of network membership, her own position in a given network, and the social factors that controlled eighteenth-century interaction. When all the network ties are strong, linguistic variation seems to be essentially linked to the social variables of the informants.

Análisis de la preposición hacia y establecimiento de sus equivalentes en finés

Title of the Master's thesis: Análisis de la preposición hacia y establecimiento de sus equivalentes en finés (trans. Analysis of the Spanish preposition hacia and the finding of its equivalents in Finnish) Abstracts: The aim of this Master thesis is to provide a detailed analysis of the Spanish preposition hacia from a cognitive perspective and to establish its equivalents in Finnish language. In this sense, my purpose is to demonstrate the suitability of both cognitive perspectives and Contrastive Linguistics for semantic analysis. This thesis is divided into five chapters. The first chapter includes a presentation and a critical review of the monolingual lexical processing and semantic analysis of the Spanish preposition hacia in major reference works. Through this chapter it is possible to see both the inadequacies and omissions that are present in all the given definitions. In this sense, this chapter shows that these problems are not but the upper stage of an ontological (and therefore methodological) problem in the treatment of prepositions. The second chapter covers the presentation of the methodological and theoretical perspective adopted for this thesis for the monolingual analysis and definition of the Spanish preposition hacia, following mainly the guidelines established by G. Lakoff (1987) and R. Langacker (2008) in his Cognitive grammar. Taken together, and within the same paradigm, recent analytical and methodological contributions are discussed critically for the treatment of polysemy in language (cf. Tyler ja Evans 2003). In the third chapter, and in accordance with the requirements regarding the use of empirical data from corpora, is my aim to set out a monolingual original analysis of the Spanish preposition hacia in observance of the principles and the methodology spelled out in the second chapter. The main objective of this chapter is to build a full fledged semantic representation of the polysemy of this preposition in order to understand and articulate its meanings with Finnish language (and other possible languages). The fourth chapter, in accordance with the results of chapter 3, examines and describes and establishes the corresponding equivalents in Finnish for this preposition. The results obtained in this chapter are also contrasted with the current bilingual lexicographical definitions found in the most important dictionaries and grammars. Finally, in the fifth chapter of this thesis, the results of this work are discussed critically. In this way, some observations are given regarding both the ontological and theoretical assumptions as well regarding the methodological perspective adopted. I also present some notes for the construction of a general methodology for the semantic analysis of Spanish prepositions to be carried out in further investigations. El objetivo de este trabajo, que caracterizamos como una tarea de carácter comparativo-analítico, es brindar un análisis detallado de la preposición castellana hacia desde una perspectiva cognitiva en tanto y a través del establecimiento de sus equivalentes en finés. Se procura, de esta forma, demostrar la adecuación de una perspectiva cognitiva tanto para el examen como para el establecimiento y articulación de la serie de equivalentes que una partícula, en nuestro caso una preposición, encuentra en otra lengua. De esta forma, y frente a definiciones canónicas que advierten sobre la imposibilidad de una caracterización acabada del conjunto de usos de una preposición, se observa como posible, a través de la aplicación de una metodología teórica-analítica adecuada, la construcción de una definición viable tanto en un nivel jerárquico como descriptivo. La presente tesis se encuentra dividida en cinco capítulos. El primer capítulo comprende una exposición y revisión critica del tratamiento monolingüe lexicográfico y analítico que la preposición hacia ha recibido en las principales obras de referencia, donde se observa que las inadecuaciones y omisiones presentes en la totalidad de las definiciones analizadas representan tan sólo el estadio superior de una problemática de carácter ontológico y, por tanto, metodológico, en el tratamiento de las preposiciones. El capítulo segundo comprende la presentación de la perspectiva teórica metodológica adoptada en esta tesis para el análisis y definición monolingüe de la preposición hacia, teniendo por líneas directrices las propuestas realizadas por G. Lakoff , así como a los fundamentos establecidos por R. Langacker en su propuesta cognitiva para una nueva gramática. En forma conjunta y complementaria, y dentro del mismo paradigma, empleamos, discutimos críticamente y desarrollamos diferentes aportes analítico-metodológicos para el tratamiento de la polisemia en unidades lingüísticas locativas. En el capítulo tercero, y en acuerdo con las exigencias respecto a la utilización de datos empíricos obtenidos a partir de corpus textuales, se expone un análisis original monolingüe de la preposición hacia en observancia de los principios y la metodología explicitada en el capítulo segundo, teniendo por principal objetivo la construcción de una representación semántica de la polisemia de la preposición que comprenda y articule los sentidos prototípicos para ésta especificados. El capítulo cuarto, y en acuerdo con los resultados de nuestro análisis monolingual de la preposición, se examinan, describen y establecen los equivalentes correspondientes en finés para hacia; asimismo, se contrastan en este capítulo los resultados obtenidos con las definiciones lexicográficas bilingües vigentes. Se recogen en el último y quinto capítulo de esta tesis algunas observaciones tanto respecto a los postulados ontológicos y teórico-metodológicos de la perspectiva adoptada, así como algunas notas para la construcción de una metodología general para el análisis semántico preposicional.