ABSTRACT This article critically examines the visual discourse deployed in UK media coverage surrounding debates about the English language proficiency of Muslim women. Focusing on the images circulated in mainstream newspaper reporting during 2016, it foregrounds the role of visual media in meaning-making and the politicisation of racialised female subjects. Drawing on a multimodal discourse analytical approach, the paper argues that visual representations are not neutral but serve as powerful semiotic resources that construct and communicate ideological narratives. The analysis reveals how visual tropes – such as veiled, silent, or backgrounded figures – are mobilised to reinforce dominant cultural imaginaries of Muslim women as voiceless, passive, and linguistically deficient. These images function not merely to accompany textual content but to visually anchor ideological debates about integration, security, and national identity. By closely reading the interplay of image, discourse, and sociopolitical context, the paper demonstrates how visual media discourses contribute to the racialised and gendered construction of Muslim women as problematic citizens, linking their visual appearance to presumed cultural and linguistic deficits. This paper calls attention to the political work of images in shaping public understandings of minority women, particularly in securitised and racialised debates about language, belonging, and citizenship.

The association between generative artificial intelligence use and foreign language classroom anxiety.

Classroom code-switching among postgraduate EFL students in Saudi Arabia: Attitudes, reasons, and perceptions.

Association of Non- English Language Proficiency Status with Heart Transplant Recipient Outcomes

RadTranslateGPT: An Improved AI-Based System for Translation and Simplification of Structured Radiology Reports.

Impact of medical background knowledge on medical academic English proficiency

Transnational education (TNE) represents an evolutionary development in internationalisation, involving the movement of institutions or their programmes rather than student mobility. Influenced by the ambitions and strategies of sending and receiving countries, TNE offers distinct values and benefits to all stakeholders. Most previous research has focused on the successes and challenges of TNE programmes from the perspectives of programme directors, administrators, and educators, but less is known about graduates' experiences. This study explored graduates' perceptions of a UK-affiliated transnational medical programme in Egypt and its impact on their personal and professional development and careers. We conducted a qualitative study with graduates from a long-established transnational medical programme delivered under a UK university's licence in Egypt. We purposively sampled graduates to maximise variation in age, gender, nationality, professional status, current job, and country of work. We conducted semi-structured online interviews via Zoom, audio-recorded them, and transcribed the recordings. We adopted a constructivist/interpretivist approach and conducted reflexive thematic analysis, ensuring reflexivity was maintained throughout the study. Twenty-three graduates were interviewed for an average of 45min; 14 were female and 9 were male, with ages ranging from 23 to 33 years. We identified six overarching and interconnected themes: (1) Personal and professional transformation through generic skills and critical thinking; (2) An integrated and well-organised curriculum delivered through case-based discussions; (3) Clinical preparedness fostered by small class sizes and early clinical exposure; (4) International career readiness supported by English language proficiency, exchange programmes, relevant examination formats, and multinationalism; (5) Supportive teaching and leadership staff from both institutions; (6) Immersive research experience. We explored insightful perspectives and experiences of the graduates. We found that an integrated, internationally focused curriculum, delivered and overseen by effective and supportive staff, prepares graduates to serve locally and internationally with notable resilience and confidence. These firsthand insights contribute to the limited literature on graduates' perspectives in TNE, particularly in health professions education (HPE), and offer practical, achievable recommendations for curriculum, assessment, student support, and the learning environment. Further research exploring staff and institutional viewpoints is necessary to gain a more comprehensive understanding.

This study examines the psychological well-being of community-recruited Latino immigrants in Georgia's Atlanta-Dalton corridor, focusing on cultural, structural, and belief-based determinants of thriving in a nontraditional immigrant destination. Drawing on a secondary survey and focus group data collected by the Atlanta-based Latin American Association, we investigate how multicultural comfort, immigration status, religious worldview, and socioeconomic factors jointly predict psychological well-being. The sample included 479 Latino immigrants, with measures including demographic characteristics, income, education, employment, English proficiency, multicultural comfort, religious influence, and well-being (assessed via the Brief Inventory of Thriving). Hierarchical regression models evaluated the unique contributions of these variables. Findings reveal that multicultural comfort emerged as the strongest predictor of well-being in the present sample, followed by income and religious worldview. In the complete-case analysis, immigration status showed a suggestive pattern: undocumented immigrants and permanent residents reported higher well-being than U.S.-born Latinos. However, multiple imputation sensitivity analysis indicated that these immigration status effects were not robust to the inclusion of cases lost to listwise deletion, whereas multicultural comfort, income, and religious worldview remained significant predictors across both analytic approaches; employment was significant under classical but not heteroscedasticity-robust standard errors. English proficiency and education were not significant in either analysis. These results highlight the importance of emotional inclusion, stable resources, and meaning-making systems in promoting well-being, while suggesting that observed differences by immigration status may partly reflect differential survey completion patterns rather than population-level effects. Policy implications include promoting multicultural belonging, expanding economic opportunities, supporting legal integration, and leveraging faith-based networks as resilience resources.

Language barriers lead to disparities at the end of life (EOL). How providers work with medical interpreters and meet the needs of patients and families with limited English proficiency (LEP) enrolled in hospice remains poorly understood. To investigate home hospice providers' experiences when communicating with patients and families with LEP, report the frequency of use of medical interpretation, and ascertain the strategies utilized by respondents to communicate with patients and families with LEP. Cross-sectional survey of U.S. based home hospice providers delivering home hospice care. A total of 138 surveys were collected. The response rate could not be calculated due to the survey dissemination method. On average 22% of the respondents reported caring for patients/families with LEP. Over-the-phone interpreting (OPI) was the most frequent professional interpreter modality utilized to communicate with patients/families with LEP (81%). Adult family members and hospice staff, who spoke the same language as the patient, were also commonly utilized by respondents (83% and 66%, respectively). Provision of video remote interpreting written hospice and bereavement materials in various non-English languages was viewed as a beneficial interventions for this patient population. OPI was most frequently utilized by home hospice providers. Having bilingual hospice staff and non-English language bereavement materials was viewed as an important strategy to support patients and families with LEP.

Haitians have a high incidence of sickle cell disease. The Comparative Study of Children in Haiti and Miami with Sickle Cell Disease (CSHSCD) assessed clinical and social characteristics of children of Haitian immigrants and African American controls comparing them with Haitian children living in Haiti with the purpose of overcoming differences during follow-up. We hypothesized that at baseline there would be significant differences and that time since migration may correlate with improved access to medical care. Baseline clinical characteristics and parental self-reported barriers to care were compared. Acculturation measured as English proficiency was assessed among Haitian American parents. Two hundred fifty-five children (mean age 38months) were recruited: 204 Haitians, 32 Haitian Americans and 19 African Americans. African American and Haitian American children with hemoglobin SS were more likely receiving hydroxyurea (p < 0.001) and were less likely to have experienced a vaso-occlusive crisis than children in Haiti (p < 0.001). Being in the United States over 10years was associated with better English proficiency. Children in Haiti were more anemic, more likely to be malnourished and to lack pneumococcal conjugate vaccinations. Haitian families could not afford treatment. Longer length of stay in the United States was associated with appropriate pneumococcal vaccination, higher parental education, and better English competency. Haitians living in Haiti were at a significant disadvantage in every aspect of care, requiring ongoing assistance with community resources, medications and vaccines. We encourage global partnerships to decrease barriers to care in disadvantaged populations.

Impact of foreign language anxiety and expectancy for success on English outcomes: Mediating role of self-regulated learning among university freshmen.

BackgroundQuality and accreditation standards from the centres for medicare and medicaid services have prompted acute care hospitals to integrate social determinants of health (SDOH) screening into clinical workflows. However, the design of SDOH screening and response programmes is not standardised, and actual engagement of patients to use referrals, and barriers to community resources and engagement, remain understudied.MethodsWe conducted a mixed-methods study across three hospitals within the Northwestern Medicine health system in metropolitan Chicago and surrounding suburbs. Surveys and interviews were administered to discharged inpatients who screened high risk for social needs and to community-based organisations (CBOs) that received hospital referrals. Quantitative and qualitative analyses assessed barriers to patient engagement.Results30 patients and 6 CBO sites were included. The patient survey demonstrated overall low engagement with resources, with most patients not using the provided resources despite agreeing that they matched their social needs and comfort level. Key barriers included limited English proficiency, perceived lack of benefit and difficulty accessing CBO services. CBO responses highlighted operational challenges such as underfunding, understaffing and an inability to track referred patients from hospitals.ConclusionIn this Chicago-based multi-hospital study, substantial gaps were identified between discharge referrals and actual resource utilisation. Strengthening follow-up, bidirectional hospital–CBO communication and community capacity are essential to improve the effectiveness of SDOH screening programmes.

This study investigates the integration of English as a Foreign Language (EFL) into the curriculum of the Christian Bilingual University of Congo (UCBC) as a mechanism for fostering bilingualism in the Democratic Republic of Congo. Given the growing significance of English in globalization, scientific research, business, and international communication, alongside the continued predominance of French in Congolese education, the study adopts a mixed-methods approach. Data were collected from 94 students drawn from an estimated population of 800 through questionnaires, interviews, and thematic discussions. Findings indicate that UCBC has established a structured bilingual model characterized by the progressive use of English across academic levels. Language acquisition is supported through English courses, communicative teaching practices, clubs, competitions, radio programs, and promotional activities. Most participants reported substantial improvement in English proficiency and valued interactions conducted in English. Nevertheless, the limited availability of English-speaking environments beyond the university and the shortage of bilingual teaching staff remain significant constraints. Respondents also expressed strong support for extending English across all academic programs and for leveraging technology and artificial intelligence to enhance language learning. The study concludes that UCBC constitutes a noteworthy model of bilingual higher education in the DRC, while emphasizing the need for further measures to strengthen English integration and cultivate a more conducive linguistic environment.

There is increased recognition that diagnostic errors disproportionately affect marginalised and underserved patient populations in the USA. However, evidence on diagnostic inequities in mental disorders is sparse and not well integrated into the overall diagnostic safety literature. We systematically reviewed and narratively synthesised evidence on inequities in diagnosis of mental disorders, guided by the Diagnostic Process Framework developed by The National Academies of Sciences, Engineering, and Medicine. We conducted a systematic review and a narrative synthesis. Medline, Embase, PsycInfo and CINAHL were searched for studies published between 2015 and 2024. Studies were eligible if they reported on inequities in the diagnosis of mental disorders and applied a quantitative, qualitative or mixed-methods design. Studies had to be peer reviewed, US based and published in English. The Mixed-Methods Appraisal Tool was used for quality appraisal. Data were analysed with a descriptive intent, and inequities were mapped into the diagnostic process. 20 studies of varying methodological quality were included. Though not the initial focus, autism spectrum disorder (ASD) emerged as the most studied mental disorder (n=17). Of the diagnostic errors identified, most fell into the category of delayed diagnosis. 11 factors emerged as contributors to diagnostic inequities. Limited health literacy among patients and caregivers was the leading cause of diagnostic error in symptom recognition. Insurance coverage issues delayed patient engagement with the healthcare system. Provider bias during clinical history-taking and interviewing was seen as a key cause of delays and misdiagnoses. Within diagnostic testing and interpretation, culturally inequivalent assessment measures might cause misdiagnosis and delayed diagnosis for Black/African American and Hispanic/Latino patients. The use of medical jargon and lack of qualified language interpreters during communicating the diagnosis were associated with diagnostic errors impacting patients with limited health literacy and low English language proficiency. Diagnostic inequities in ASD and other mental disorders persist across US patient populations. Multiple factors such as parental health literacy, provider bias and limited access interact and impact the diagnostic process. Addressing these interconnected barriers is essential to ensure timely, accurate and equitable care. CRD42024581271.

ABSTRACT English-medium instruction (EMI) is increasingly adopted in higher education worldwide, often accompanied by English-only policies that pose unique challenges for teachers, especially in multilingual contexts. However, little is known about how EMI teachers exercise agency in navigating these policies in non-Anglophone settings. This study adopts an ecological perspective to investigate how EMI teachers in Bangladesh navigate English-only policies, focusing on their perceptions of role, pedagogical challenges, and agency-mediated language practices. The study utilises semi-structured interviews, classroom observations, and stimulated recall interviews with six EMI teachers to examine their role perceptions, pedagogical challenges, and agency-mediated language practices. Thematic analysis revealed two situated role orientations: content-focused practitioners who reproduced English-only policies, and multilingually aware facilitators who strategically integrated Bangla and multimodal scaffolding resources. Teachers reported interlocking challenges, including inadequate English proficiency, limited training in interactive pedagogy, large classes that constrained participation, and limited formative assessment. Classroom practices ranged along a continuum from policy reproduction to strategic resistance, including spontaneous translanguaging for clarification, humour, participation scaffolding, device-mediated vocabulary support, and trans-semiotizing via visuals and gesture. We argue for context-sensitive EMI policies and discipline-specific professional development that builds multilingual pedagogical content knowledge and expands multimodal scaffolding repertoires.

Culturally and linguistically diverse (CALD) populations affected by cancer experience challenges within healthcare systems leading to inequities and disparities in care. This study aimed to describe factors that affect care for gynecologic cancer patients from CALD backgrounds by gathering perspectives from patients, interpreters, and cancer care professionals. This questionnaire-based study was conducted in the Gynecologic Oncology Clinics at Princess Margaret Cancer Center, Toronto, Canada. Study-specific questionnaires were administered to CALD patients, professional interpreters, and cancer care professionals with domains including demographics, clinic experiences, and perceived barriers and facilitators to care. Descriptive statistics summarized survey results and content analysis of free-text answers was performed. Between May 2022 and December 2023, 23 patients, 10 interpreters, and 11 cancer care professionals completed surveys. Twenty (87%) patients reported English proficiency as "poor" or "very poor," but most were confident in participating in treatment decision-making (n = 20, 87%). Most agreed (n = 15, 65%) that interpretive services were beneficial however 12 (52%) preferred family members or bilingual staff to interpret. All interpreters were comfortable facilitating oncology discussions, but eight (80%) had previously been asked by family members to withhold information about cancer diagnosis or prognosis. Ten (91%) cancer care professionals reported interpreters improved care delivery for CALD patients. While language interpretation is crucial to effective cancer care delivery for CALD patients, factors including family support and patient preferences may impact consultation dynamics and patient experiences. These factors need to be considered upon implementing future interventions to optimize care.

Background:Delay in surgical fixation of distal radius fractures (DRFs) beyond 2 weeks is associated with worse patient-reported outcomes. Although socioeconomic disadvantage affects many orthopedic outcomes, its association with delayed DRF fixation is unclear. We evaluated whether neighborhood disadvantage is associated with surgical delay beyond 14 days.Methods:This retrospective study used deidentified electronic health records from multiple academic health systems to identify patients undergoing operative DRF fixation from 2012 to 2024. Multivariable logistic regression identified socioeconomic and demographic factors associated with delay beyond 14 days. Covariates included age, sex, area deprivation index (ADI), race, ethnicity, language, Medicare insurance, and Charlson Comorbidity Index (CCI).Results:The cohort included 6639 patients (median age 62 years; 64.7% female; 64.8% white; 90.4% English-speaking; 16.1% Medicare). Median time from diagnosis to surgery was 8 days (IQR 5-13), with 25.3% delayed beyond 14 days. Higher ADI (quartile 3: OR 1.59, 95% CI 1.24 to 1.81; quartile 4: OR 1.47, 95% CI 1.20 to 1.80), Spanish-speaking status (OR 1.48, 95% CI 1.08 to 2.02), higher CCI (OR 1.10, 95% CI 1.06 to 1.13), and Medicare insurance (OR 1.25, 95% CI 1.00 to 1.55) were independently associated with delay.Conclusions:Socioeconomic disadvantage, limited English proficiency, comorbidity burden, and Medicare insurance were independently associated with delayed DRF fixation. These findings highlight existing disparities in timely orthopedic care of DRFs and support targeted interventions to improve access.

This review examines the evolution, current structure and reform trajectories of dental education in Kazakhstan in relation to international standards, the Bologna Process and contemporary competency-based approaches. A literature search was conducted in PubMed, Scopus, Google Scholar and CyberLeninka, complemented by governmental and institutional documents covering the Soviet period to 2025. The review was guided by the SANRA framework. English- and Russian-language sources were included. Grey literature and policy reports were analysed due to the limited availability of peer-reviewed evidence. Kazakhstan has made important progress in structurally aligning dental education with international standards through Bologna-compatible curricula, accreditation mechanisms, competency-based educational standards and emerging simulation-based learning. However, evidence of consistent outcome-level implementation remains limited. Key challenges include uneven clinical and simulation infrastructure, faculty shortages, limited English proficiency, variable implementation of competency-based curricula, and insufficient standardization of modern assessment methods such as OSCE and workplace-based assessment. Recent initiatives focus on alignment with ADEE and WFME standards, curriculum modernization, clinical training reform and quality assurance. Kazakhstan's dental education system is transitioning from structural reform toward competency-based modernization, but its educational effectiveness remains unevenly documented. Strengthening clinical training, standardized assessment, faculty development, evidence-based teaching and policy stability is essential for improving graduate preparedness and international comparability.

To date, deaf children with deaf parents have been assumed to experience "typical" first language acquisition while deaf children from hearing families have often been excluded from research due to limited language exposure in early life. The present study eschews these assumptions and examines language development across these two populations asking whether the use of a signed language at home, the use of a signed language at school, and the family's socioeconomic status or education level can predict deaf children's fluency in American Sign Language (ASL) and English. Language and familial background data were collected from 96 preschoolers (age: 5years) and 58 middle schoolers (age range: 11-15years) in the United States. Deaf children of deaf parents reached higher proficiency in both ASL and English than those from hearing families when compared as groups, but there was considerable overlap in language proficiency between the two groups which was associated with the language environments in children's homes for preschoolers and children's schools for middle schoolers. Socioeconomic status and parent education were associated with English proficiency for deaf children of hearing parents, and with ASL proficiency for deaf children of deaf parents.

Purpose Effective communication is critical to safety and quality in healthcare. Women with limited English proficiency face barriers to quality communication in anglophone settings, perpetuating health inequities. To inform evidence-based strategies, this study aimed to evaluate and explore women’s experiences of cross-cultural communication within a women’s health service.Design/methodology/approach Women accessing maternity or gynaecology care at a women’s health service in Western Australia were eligible to participate if they had accessed interpretation support in Arabic, Burmese, Farsi, Mandarin or Vietnamese. A total of 68 women completed a cross-sectional questionnaire; 15 women participated in a semi-structured telephone interview. Quantitative and qualitative data underwent descriptive statistical and multilingual reflexive thematic analyses respectively.Findings Participants reported diverse language preferences and skills, most frequently speaking Mandarin, Arabic and Vietnamese. At their most recent visit, most recalled an in-person interpreter present speaking their preferred language. However, less than half were provided with language-concordant written health information resources. Three themes – the role of the interpreter, navigating the health service with uncertainty and a foundation of trust – explore facets of women’s experiences, linked by an overarching theme: health is too important not to understand.Originality/value Themes reflect key systemic gaps in the provision of safe quality care for women with limited English proficiency, highlighting the need for proactive service-wide approaches to cross-cultural communication encompassing but not exclusive to clinical encounters. Improved integration of interpretation services, language-concordant information resources and language-concordant support for service navigation are recommended.