Lack Of Fluency In English Research Articles

Exploring Teachers' Responses to a Workshop for Developing Critical & Creative Thinking Through Storytelling

Current Malaysian educational policy requires school teachers to include critical and creative thinking in their classrooms; however, few teachers have been trained to do so. The research investigated an approach for developing teachers’ critical and creative thinking through story writing. Qualitative research methodology was employed to explore teachers' understanding and views of the program. The results yielded four main themes, namely: Benefits, Challenges, Satisfaction and Improvement of the Writing Thinking Stories (WTS) program. Participants acknowledged that the program presented new ways for teaching critical and creative thinking (CCT) in a meaningful environment. Some challenges included overcoming caution when being creative; integrating philosophical concepts into their stories and a lack of fluency in English resulting in some participants requesting the chance to write stories in their mother tongue in groups. There was general satisfaction with the program, although some participants expressed a need for training in Community of Philosophical Inquiry (COPI) prior to the program. All in all, the WTS program resulted in teachers successfully producing short thinking stories that integrated values and CCT in a fun and meaningful way.
 Keywords: Story writing, Critical and Creative thinking, community of philosophical inquiry

Resettlement Stressors for Women of Refugee Background Resettled in Regional Australia.

Women of Refugee Background (WoRB) have been repeatedly identified as an extremely vulnerable population. Within an Australian context, WoRB are increasingly resettled to non-metropolitan locations, otherwise known as regional locations. Despite this, to date, no research has focused on the lived experience and challenges associated with the resettlement of WoRB to regional contexts. This study aimed to address this gap in the literature by investigating the resettlement experience of WoRB resettled in Tasmania—a state in Australia classified as a rural and regional location. Qualitative interviews were conducted with a group of 21 individuals (nine WoRB and 12 service providers). Thematic analysis identified four overarching themes—Communication Barriers and Lack of Fluency in English, Challenges Accessing Everyday Basic Needs, Loss of Connection to Culture of Origin and Inability to Access Mainstream Mental Health Services for Help. Participants also highlighted a number of unique gender-related vulnerabilities experienced during resettlement, which were exacerbated in regional locations due to health services being overstretched and under-resourced. Results of the current study are discussed in regard to policy and practical implications, taking into consideration the unique vulnerabilities experienced by WoRB, which, to date, are often overlooked.

Intention to Behavior: Using the Integrative Model of Behavioral Prediction to Understand Actual Control of PrEP Uptake Among Gay Men.

PrEP is an effective daily prevention medicine used to reduce risks of HIV infections. Previous research has pointed out the intention-behavior gap on PrEP uptake among gay men. The current study built on research examining how the integrative model of behavioral prediction (IMBP) factors influences PrEP uptake among gay men to explore how actual control variables, namely skills and environmental constraints, moderated the intention-behavior relationship. We used results from formative interviews to construct a survey and collected data from 420 gay men. Results showed several factors that were associated with PrEP uptake among gay men. Specifically, the lack of access to an LGBTQ-friendly healthcare provider(s) and lack of English fluency had significant main effects on PrEP uptake behavior, while lack of access to a healthcare provider and lack of healthcare system knowledge were significant moderators of the intention-behavior relationship. This study advances our understanding of the IMBP and offers practical implications for PrEP promotion. Limitations and suggestions for future studies are discussed.

P121 Real-world use of the IBD disk tool in unselected cohorts of outpatients

Abstract Background The IBD Disability Index (IBD-DI) is a validated health care professional (HCP) administered tool that can assess the functional status of patients in trials. The IBD-Disk was adapted from the IBD-DI as a tool that patients can use to capture their functional status for HCPs to review. We report patient acceptability and use of the IBD-disk in the real-world setting. Methods The IBD-Disk was constructed by an expert steering committee of international gastroenterologists/nurses who ranked the IBD-DI items. A modified Delphi process was used to agree on 10 IBD-Disk items. It was administered in outpatient clinics to patients across NHS hospitals. Inclusion criteria comprised patients aged 18 and over, of all ethnicities, with a confirmed diagnosis of IBD. Exclusion criteria were lack of fluency in English, not agreeable to take part or participation was deemed inappropriate. Patients were asked to rate their level of agreement for each item on the IBD Disk on a visual analogue scale of 0–10 (0 = absolutely NO, 10 = definitely YES). We included a difficulty rating of 1–10 to assess ease of completion of the questionnaire (1 = very easy; 10 = very difficult) as well as qualitative feedback. Results A total of 377 patients agreed to take part. The mean age of the cohort was 42 years. Two hundred and twenty-one were female (59 %). 287 were White. One hundred and ninety-nine patients had CD, 159 UC, the remaining unknown. Of the domains of the IBD Disk (see Figure), energy levels, sleep and joint pain scored highest (most impairing) with mean values of 5.68, 4.85 and 4.68, respectively, whereas interpersonal interactions and sexual functions were least affected, mean scores 2.51 and 2.81. The mean difficulty rating was 2.3 (SD = 2.29). Correlations were performed between abdominal pain and energy levels/sleep {r = 0.6 and r = 0.56)} and between joint pain and energy levels/sleep {r = 0.57 and r = 0.58). Clinicians highlighted that the IBD-disk opened up conversations beyond GI issues and gave a good overview of well-being. It facilitated discussion on sexual function and body image. Patients’ feedback highlighted that they were glad they were able to express their functional status and its severity. Conclusion Energy levels, sleep and joint pain were the most disabling for this unselected IBD cohort. This may help to focus the discussion in the clinic setting. Our experience with the IBD-Disk proved very positive with high patient acceptability.

Educational attainment of Eastern European pupils in primary schools in England: Implications for policy and practice

The aim of this article is to explore the attainment of Eastern European children in primary schools in England. The research draws on detailed National Pupil Database and school census data for 586,181 pupils who completed Key Stage 2 in England in 2016. Two methodological approaches were used to analyse the data. First, the performance of all pupils was analysed by ethnic and language background to illustrate patterns of attainment for each group. Second, attainment data were further analysed by social background factors to explore the main factors influencing performance in schools and the reasons for underachievement. The main findings from the study confirm that a number of Eastern European pupils have low attainment, and their performance in English schools has been masked by government statistics that fail to distinguish between 'White Other' ethnic groups. The empirical data suggest that speakers of Czech, Slovak, Hungarian, Polish, Romanian, Latvian, Lithuanian and Bulgarian are particularly underachieving, and that the difference between their educational performance and others is larger than for any other main groups. There is also a wide variation in performance between regions in England, with large attainment gaps between Eastern European and White British children. Some of the main reasons for underachievement identified from the study are the lack of fluency in English, economic deprivation, a disrupted or non-existent prior education and parental lack of understanding of the British education system. Overall, this research confirms that the underachievement of Eastern European children remains a cause for concern and is obviously an issue that policymakers and schools need to address. Implications for policy and practice are discussed in the final section.

LEGAL EDUCATION: PRODUCING "PRACTICE-READY" CANDIDATES IN MALAYSIA

Despite the existing exam requirements in a bachelor of law degree, it is claimed that local law graduates are ill-prepared for legal practice, lack of fluency in English, particularly in writing and speaking skills. This paper explores efforts made by the law schools in Malaysia within their existing curriculum to prepare students for future legal practice careers and to cater to the needs of the legal industry. The requirement of a recognized law degree has been fulfilled by most law schools, and students studying in law schools without recognition by the Legal Profession Qualifying Board (LPQB) would have to sit for Certificate of Legal Practice (CLP) to qualify as a practitioner. Nevertheless, the Bar Council has been proposing for additional curriculum of Common Bar Course and Common Bar Exam. It is claimed that these additional stage of common bar course and exam would be beneficial for candidates alongside their somewhat “inefficient” bachelor of law degree. Sitting for this bar exam would allow candidates to qualify as “qualified person” under the law. Nevertheless, this paper holds on to the view that training in chambers or the pupillage period, would be the best place platform for law graduates to equip themselves with hands-on experience in legal practice, and that the “higher-standard” of paper-based exams proposed by the Bar would be futile in keeping up with the expectations of the legal industry for “practice-ready” candidates. (Key words: legal education; academia; common bar exam)

Barriers to Health Care among Laotian Americans in Middle Tennessee.

We examined barriers to health care among Laotian Americans in a Middle Tennessee community that included a Laotian-speaking practitioner. A Laotian American primary care clinic nurse practitioner surveyed 312 adult Laotian Americans. The dependent variable was whether respondents visited (n = 214, 77.8%) or did not visit (n = 61,22.2%) primary care providers (PCP) in the last year. Chi-square analysis found visiting less likely if respondents were age 18-34 (p < .001), born in U.S. (p < .001), spent less time in U.S. (p = .010), never married (p = .001), lacked health insurance (p < .001), or lacked a PCP (p < .001). Chi-square analysis segmented by age found neither lack of English fluency nor preference for Laotian-speaking providers significantly reduced access, possibly because of the Laotian practitioner. Logistic regression found individuals with insurance five times more likely to visit and individuals with PCP 8.5 times more likely. Results support the value of training minority providers.

Validation of a bowel dysfunction instrument for adolescents with spina bifida

Existing survey instruments for bowel dysfunction in the pediatric population are either parent-reported or focus on non-neurogenic bowel dysfunction. The purpose of this study was to develop and validate an adolescent-reported survey to assess the severity of bowel dysfunction in spina bifida patients and examine its impact on quality of life (QOL). We performed a cross-sectional study of patients in our Myelodysplasia Program, aged 11-17 years, with a history of constipation and/or fecal incontinence (FI) from November 2010 to June 2013. Control patients, aged 11-17 years, were recruited from the stone clinic. Exclusion criteria were lack of English fluency, insufficient reading skills, or an incontinent fecal diversion. A 29-item version of the Adolescent Fecal Incontinence and Constipation Symptom Index (A-FICSI) was developed with five domains (Figure). Test re-test reliability and correlation with the total global health-related QOL score from the Parkin survey were measured using the Pearson correlation coefficient. A factor analysis model with four-fold correlations was tested. Of the 65 study-eligible individuals approached, 25 (11 boys) completed the A-FICSI (median age 12.6 years, IQR 11.8-14.7 years) and 17 completed another survey on urinary incontinence (64.6% response rate). Twenty-one control patients with nephrolithiasis completed the A-FICSI. Nine of the 25 completed a second administration of the survey. The mean correlation between repeated administrations of the survey was r = 0.43. There was a significant negative correlation between severity of constipation (r = -0.299, p < 0.05) and severity of FI (r = -0.316, p < 0.05) with the total Parkin QOL score. The Comparative Fit Index (CFI) was 0.864. Most items loaded significantly on their respective factors. Between-factor correlations were all significant (>0.30) in the predicted direction. Unstandardized residuals were 8.7% (95% CI 6.4-10.9%). Item reduction was performed on the 29-item instrument based on results of the factor analysis. The finalized instrument contained 21 items. This is the first adolescent-reported bowel dysfunction instrument to undergo formal psychometric assessment in the spina bifida population. The instrument demonstrated adequate reliability and the five-factor structure fit the data well. This study highlights the negative impact of bowel dysfunction on the QOL of spina bifida patients. It is limited by the moderate sample size that is a common issue in relatively rare diseases. The A-FICSI possesses desirable psychometric properties for the measurement of bowel dysfunction in the spina bifida population.

Describing creative products in an intercultural context: Toward a pragmatic and empirical account

This study examines a neglected type of intercultural business communication: English descriptions of creative products designed and made in Asia where English is a foreign language. This type of discourse may be called creative product description (CPD) due to its creative use of language and its being used in the creative industries. Based on data collected from Taiwan's creative industries, it investigates what kind of product description would receive positive feedback and whether there exist general pragmatic principles for such descriptions. The data comprised 10 sets of CPDs, each set containing three versions featuring one and the same product: the original version collected online and two alternative versions written by the author based on each of the collected examples. Ten native English speakers (NESs) living in the UK were invited to comment on the 10 sets and choose their favorite in each set and explain why. This research design is aimed at investigating what discourse elements in CPDs contribute to generating positive effects and what factors other than a lack of English fluency could cause negative feedback in global business communication. The analysis shows that appropriate uses of length, information content, manner of presentation, and cultural empathy are key elements. Together with these crucial elements, three types of pragmatic principles are utilized to elucidate why some descriptions were favored and some were rejected: Cooperative Principle, Interest Principle, and Moderate Principle.

Navigating the cultural transition alone: Psychosocial adjustment of Korean early study abroad students.

Precollege study abroad in English-speaking countries is an increasingly popular educational strategy among Asian families. We used grounded theory method to construct a model of cultural adjustment process for unaccompanied minors based the retrospective narratives of 10 (8 male) South Korean adolescents who came to the United States, unaccompanied by parents, to attend middle schools or high schools. We found that unaccompanied minors' cultural adjustment progressed from their predeparture ambivalence to initial sense of vulnerability to an eventual sense of reengagement. Unaccompanied minor students' pervasive sense of vulnerability upon arrival was heightened not only by their lack of English fluency but also their reluctance to seek the support of parents in Korea and of local Korean peers. This study has implications for educators and counselors in secondary schools who work with international students who are unaccompanied minors.

Using CALL to bridge the culture gap between discourse communities and ESP learners

Learners of English for computer science have to master one essential skill: reading technical documentation. This documentation, available online and consulted whenever programmers need information to code programs, is barely understood by French first-year university students in computing. Faced with these professional texts, they experience linguistic as well as cultural problems due to lack of fluency in English and lack of knowledge in computer science. Our pedagogic aim is to lighten the cognitive overload induced when they read texts written by members of the discourse community. To this end, we have developed a software application to help students understand these authentic texts. Based on computer-assisted reading research and socio-constructivist learning theories, different types of aids were designed to alleviate the learner's difficulties and make the input comprehensible. Our software provides scaffolding on the macrostructural level (textual and rhetorical organisation) and the microstructural level (lexis and syntax). It was tested with 112 students who had to answer comprehension questions and carry out professional tasks similar to the activities programmers undertake in real life. We present the results of our experiment and reflect on a genre-centred, action-oriented, task-based learning approach that requires the learner to participate actively in these computer-mediated learning systems.

Addressing Health Disparities Through Patient Education: The Development of Culturally-Tailored Health Education Materials at Puentes de Salud

The availability of culturally appropriate written health information is essential for promoting health in diverse populations. Lack of English fluency has been shown to negatively impact health outcomes for Latinos in the United States. The authors conducted a needs assessment at a clinic serving Latino immigrants, focusing on patients' health and previous experiences with written health information. Based on these results and a literature review, we developed 10 Spanish language brochures to better serve the target population. This article outlines the process of developing and implementing this intervention, which can serve as a model for similar projects targeting diverse populations.

P.1.i.012 Treatment of insomnia in patients with schizophrenia

Existing survey instruments for bowel dysfunction in the pediatric population are either parent-reported or focus on non-neurogenic bowel dysfunction.The purpose of this study was to develop and validate an adolescent-reported survey to assess the severity of bowel dysfunction in spina bifida patients and examine its impact on quality of life (QOL).We performed a cross-sectional study of patients in our Myelodysplasia Program, aged 11–17 years, with a history of constipation and/or fecal incontinence (FI) from November 2010 to June 2013. Control patients, aged 11–17 years, were recruited from the stone clinic. Exclusion criteria were lack of English fluency, insufficient reading skills, or an incontinent fecal diversion. A 29-item version of the Adolescent Fecal Incontinence and Constipation Symptom Index (A-FICSI) was developed with five domains (Figure). Test re-test reliability and correlation with the total global health-related QOL score from the Parkin survey were measured using the Pearson correlation coefficient. A factor analysis model with four-fold correlations was tested.Of the 65 study-eligible individuals approached, 25 (11 boys) completed the A-FICSI (median age 12.6 years, IQR 11.8–14.7 years) and 17 completed another survey on urinary incontinence (64.6% response rate). Twenty-one control patients with nephrolithiasis completed the A-FICSI. Nine of the 25 completed a second administration of the survey. The mean correlation between repeated administrations of the survey was r = 0.43. There was a significant negative correlation between severity of constipation (r = −0.299, p < 0.05) and severity of FI (r = −0.316, p < 0.05) with the total Parkin QOL score. The Comparative Fit Index (CFI) was 0.864. Most items loaded significantly on their respective factors. Between-factor correlations were all significant (>0.30) in the predicted direction. Unstandardized residuals were 8.7% (95% CI 6.4–10.9%). Item reduction was performed on the 29-item instrument based on results of the factor analysis. The finalized instrument contained 21 items.This is the first adolescent-reported bowel dysfunction instrument to undergo formal psychometric assessment in the spina bifida population. The instrument demonstrated adequate reliability and the five-factor structure fit the data well. This study highlights the negative impact of bowel dysfunction on the QOL of spina bifida patients. It is limited by the moderate sample size that is a common issue in relatively rare diseases.The A-FICSI possesses desirable psychometric properties for the measurement of bowel dysfunction in the spina bifida population.

Identifying reasons for failure in biomedical research and publishing

The regular assessment of Brazilian scientific output means that individual university departments need to constantly improve the quantity and quality of their scientific output. A significant proportion of this output involves the work of Master's and Doctoral students, but getting this work published in a suitable journal can often prove to be a challenge. Although students' lack of fluency in English is a contributing factor, many of the problems observed have an early origin in the formulation of the research problem and its relevance to current research trends in the international literature. In short, more time needs to be spent in the library and less in the laboratory, and more effort needs to be made in teaching students basic research skills such as the effective use of bibliographic databases like PubMed, Web of Science and Scopus.

Immigration, Health Care Access, and Recent Cancer Tests Among Mexican-Americans in California

Immigrants' lower rates of cancer testing may be due to lack of fluency in English and other skills and knowledge about navigating US health care markets, lack of access to health services, or both. We analyzed 9,079 Mexican-American respondents to the 2001 California Health Interview Survey (CHIS) grouped as born in the US, living in the US 10 or more years, or living in the US less than 10 years. The CHIS provides the largest Mexican-American sample in a US survey. Access to care meant having health insurance coverage and a usual source of care. English proficiency meant the respondent took the interview in English. Multivariate logistic regression was used to predict outcomes. Respondents reporting more time in the US were more likely to report access to medical care and to report getting a cancer screening exam. Regardless of time in the US, respondents reporting access had similar test rates. Regression results indicate that time in the US and primary language were not significant relative to use of cancer screening tests, but access to care was. Cancer screening tests that are covered by Every Woman Counts, California's breast and cervical cancer early detection program, had smaller gaps among groups than colorectal cancer screening which is not covered by a program. California is the only state with a survey able to monitor changes in small population groups. Understanding barriers specific to subgroups is key to developing appropriate policy and interventions to increase use of cancer screening exams.

Minority Talent Loss and the Texas Top 10 Percent Law*

OBJECTIVE: To examine how knowledge about the Texas top 10% law influences college enrollment decisions of high achieving students minority and nonminority students. DATA AND METHODS: Using a representative survey of graduates from Texas public high schools in 2002, we compare self-reported and transcript-verified class rank and estimate probit models to assess the likelihood that top-ranked minority students know about the law. RESULTS: Family socioeconomic status largely explains why highly ranked black and Hispanic students know less about the top 10% law than comparable whites, but parents' lack of fluency in English is a significant information barrier for college-bound, top 10% Hispanic students from predominantly minority high schools. Nearly one-fifth of college-oriented black and Hispanic top 10% seniors who did not know about the law failed to enroll anywhere. CONCLUSION: Inadequate information about the top 10% law undermines enrollment of talented minorities in higher education.

Adaptation Problems among Adolescent Immigrants from Korea, Mexico and Poland

ABSTRACT The objective of this study was to explore the adaptation problems of Korean, Mexican, and Polish first and one-and-a-half generation adolescent immigrants residing in Midwestern U.S. The study was based on 16 in-depth, semi-structured interviews with teenagers and young adults from the metro Chicago and Champaign-Urbana, IL areas. Three main themes were identified with respect to adaptation problems among adolescent immigrants. First, the interviewees spoke of problems they experienced in their schools, including lack of English fluency, negative interactions with teachers and other school personnel, and drawbacks of bi-lingual education. Second, they discussed issues surrounding their family relations after immigration. Family separation, inadequate interactions with parents following arrival, and intergenerational conflict were the main problems identified by the interviewees. Lastly, adolescents commented on their peer relationships that hindered their adaptation, including discrimination by the mainstream youth and divisions within ethnic groups based on the teens' acculturation level.

Longitudinal assessment of physical and psychological function in older patients with acute myeloid leukemia (AML): A pilot study

8273 Background: Physical and psychological function in older patients with AML has not been studied previously. It is important to understand whether intensive treatment of leukemia adversely affects functional status in older patients. We evaluated the functional, mood, and cognitive changes over time in older patients with AML. Methods: All patients age 60 or greater with a new diagnosis of de novo or secondary AML were approached. Exclusion criteria were another actively treated malignancy, lack of English fluency and life expectancy less than 1 month. Baseline patient data collected included personal and medical information. Activities of daily living (ADL) were assessed by the Barthel Questionnaire and instrumental activities of daily living (IADL) by the Lawton-Brody tool. The Geriatric Depression Scale (GDS) was given to assess mood. Cognition was assessed via the Folstein Mini Mental Status Examination (MMSE). Follow up assessments were obtained 1, 4, and 6 months after entry into the study. Resu...

The Dynamics of Self‐employment and Ethnic Business Ownership among Taiwanese in Australia

AbstractTaiwan‐born business and skilled migrants who settle in Australia have high unemployment rates despite being well educated and fairly affluent. This phenomenon, commonly found in Australia among new Asian immigrants, has seldom been researched. Using qualitative methodologies, including ethnographic interviews and participant observation, this paper examines economic integration of recent Taiwanese business and skilled migrants in three Australian cities: Sydney, Brisbane, and Melbourne. The results indicate that Taiwanese immigrants find it difficult to secure employment, start profitable businesses, and adapt to the host society. The integration challenges include: lack of fluency in English, different social and cultural milieu, lack of familiarity with Australian business culture and labour relations, complex rules and regulations governing the establishment of business enterprises, small size of the market, high taxes, and lack of willingness to take up work not commensurate with their education and economic background. Policy recommendations to foster early integration of skilled migrants from Taiwan are included.

Chicanas and the Issue of Involuntary Sterilization: Reforms Needed to Protect Informed Consent

The purpose of this article is to inform the public and its government representatives about practices which have caused the involuntary sterilization of Chicanas. These unauthorized medical practices have occurred within the area presently governed by laws which sanction voluntary sterilization. The right to procure a voluntary sterilization is not challenged, but the duty to provide an opportunity to render informed consent is in need of more stringent guarantees. In too many instances women have been coerced into undergoing sterilization surgery without their informed consent. Most of the areas to be reviewed involve women who are poor, usually on welfare, and of a racial minority. With respect to Chicanas an additional element, lack of English fluency, deserves considerable attention. Furthermore, any concrete form of analysis cannot ignore the fact that women eligible for welfare not only must contend with the doctor-patient relationship, but also with government participation- At present, the federal and state governments provide substantial assistance to hospitals and women unable to afford medical care on their own. Consequently, doctors and hospitals which receive government subsidies to perform sterilization surgery, but violate a patient's right to informed consent, not only violate existing government regulations but raise the issue of inadequate government enforcement. A thorough examination of this topic would not be complete without some understanding of the attitudes which cause unwanted sterilizations. Special focus will be directed toward the ethical beliefs held by many medical practitioners, and the transference of these beliefs into nationwide practice. The interrelationship between government and the medical profession also requires some mention of the Supreme Court decision in Buck v. Bell.' A state