A harm reduction approach to the practice of language access in language-discordant care.

Antibiotic resistance (ABR) poses a significant global health and development threat from increasing globalization of travel, trade, and animal and human migration. ABR impacts refugees and migrants in unique ways due to increased exposure to infections and inequitable access to healthcare. The objective of this review is to synthesize the evidence on access to and appropriate use of antibiotics by migrants and refugees, identify the barriers they may experience in accessing and using antibiotics, and reflect on global policy entry points to modify such barriers considering the persistent globalization-related impacts on ABR. A global rapid scoping review was conducted to collect evidence on barriers to access and appropriate use of antibiotics among migrants and refugees. MEDLINE (Ovid), Scopus, Web of Science, CABI Global Health and the IGO Custom Search Engine were searched for academic and grey literature published in English, French, or Spanish from inception until September 22nd, 2025. A conceptual framework structured data extraction and thematic analysis of barriers to antibiotic use along the access pathway, including approachability, acceptability, availability, accommodation, affordability, and appropriateness. This review included 125 studies from an array of geographic locations. Migrants and refugees experience barriers along the continuum of care from both the patient and health-system side, impacting access to, and appropriate use of antibiotics. Limited access to resources, prevalence of certain social norms and values, health literacy and beliefs, and autonomy, can impact healthcare seeking and utilization. Health system barriers, such as location and affordability of services or language barriers, can also limit access and appropriate use of quality-assured antibiotics. Migrants and refugees face structural, financial, and systemic barriers in accessing and using antibiotics. While globalization processes have shaped the barriers migrants and refugees experience when accessing health services, access pathways are heterogeneous and influenced by the health systems of the host countries, and other contextual, non-health policies and factors. Potential policy solutions to mitigate these barriers include initiatives to address country-of-origin norms and values and improving language accessibility. Improved global policy coordination can also address access challenges for migrants and refugees, as tackling ABR requires collective global action. Not applicable.

We propose five guiding values for early sign language access as guidelines for change in the design and practice of early intervention and education of Deaf children. Applying these guiding values will facilitate language-rich environments and reduce the harms associated with language deprivation experienced by many Deaf children. These guiding values are distinct yet interconnected and are applicable for professionals and families alike.

Purpose The Gerascophobia or Excessive Fear of Aging Scale (GEFAS) is a recently developed instrument designed to assess aging-related fears; however, no validated Urdu version has been available for use among Urdu-speaking populations. Given the centrality of language accessibility in mental health equity, the absence of an Urdu translation limits assessment and intervention efforts in large and often marginalized communities. This study aims to translate and validate the GEFAS into Urdu, ensuring its linguistic and cultural relevance. Design/methodology/approach This study followed a rigorous translation process involving forward translation, back-translation, expert evaluation and pilot testing. A sample of 370 participants (37% men, 63% women; aged 18–58 years) was recruited in two phases to assess the scale’s psychometric properties. Findings The GEFAS-Urdu demonstrated high internal consistency (Cronbach’s alpha = 0.898). Confirmatory factor analysis confirmed a single-factor structure, with significant factor loadings ranging from 0.800 to 0.857, an average variance extracted of 0.689 and excellent model fit indices (e.g. comparative fit index = 0.999, root mean square error of approximation = 0.040). Convergent validity was established through significant positive correlations with depression (r = 0.501), anxiety (r = 0.395) and stress (r = 0.435). Divergent validity was demonstrated by a significant inverse correlation with psychosocial health (r = −0.175). Measurement invariance analysis shows that the scale demonstrated configural, metric and scalar invariance across gender groups. Item response theory analysis revealed appropriate item difficulty estimates and fit statistics, confirming the reliability and validity of the scale for Urdu speakers. Originality/value The GEFAS-Urdu is a reliable and valid instrument for assessing gerascophobia in Urdu-speaking populations.

Abstract BACKGROUND The Lincoln Ostomy Output Consistency Scale for jejunostomy, ileostomy and colostomy (LOOCS) is a medical instrument providing standardized stool descriptors for the ostomate community (Acad J Gastroenterol Hepatol 2021; 3:554). A limitation of many medical instruments is language accessibility. Language barriers in a clinical setting can hinder quality of care, lead to miscommunications, and decrease patient and physician satisfaction. Understanding these barriers, the Bristol Stool Form Scale has been translated in over 40 languages. Traditional translation involving human experts is often time-consuming and resource-intensive. Neural machine translation and generative artificial intelligence tools pose an opportunity to enhance translation efficiency. This project aimed to increase accessibility of the LOOCS. METHODS Using Ethnologue data, the top 100 most spoken languages were selected for translation, as well as several languages requested by bilingual speakers. The translation tools used included Google Translate, DeepL, ChatGPT, and MistralAI. Two separate translation tools were selected, labeled Tool A and Tool B, and four routes of forward and backward translation were used to determine the most effective and accurate route. The translation process included 7 steps. Step 1 involved preparing key phrases. Step 2 was forward translation using Tools A and B. Step 3 compared the two tool’s output. Step 4 was backward translation to English using Tools A and B on their respective forward translations. Step 5 was comparison to the original LOOCS. If the backward translation did not adequately represent the original LOOCS, steps 2-5 could be performed using different translation tools. Step 6 was selection of the most accurate translation based on likeness to the original content, fluency, and medical appropriateness. Step 7 (optional) entailed human validation. If verification of the AI translation by a human speaker is deemed invalid, steps 2-7 can be repeated using different translation tools. RESULTS The LOOCS was translated into 116 languages. Currently, 14 translations have been evaluated by bilingual speakers with 13 deemed accurate. According to the Urdu speaker, none of the AI tools produced an accurate Urdu translation. ChatGPT was deemed most accurate in 82 target language translations, Google Translate in 22, MistralAI in 7, and DeepL in 5. ChatGPT was able to translate 8 languages not able to be translated by any other tool, including Farsi and Karen. CONCLUSION This project demonstrated the utility and effectiveness of AI translation tools in a clinical healthcare setting. Though it appears AI translation tools can successfully translate the LOOCS, which uses simple and concise phrases, further research would be needed to determine their effectiveness in the translation of longer, more scientifically complex texts.

ABSTRACT Museums have the opportunity to provide a great learning experience for children but do not always seem to use their full potential. In this study, we quantify child-friendly initiatives in the 100 most visited art museums in the world. Specifically, we looked at whether museums offered workshops or audio guides for children, guided tours for children or families, interactive maps or children's guides to the exhibition, additional online materials for children, labels designed for children, and their pricing models. The results show that the focus tends to be on children's workshops. While 52% of the museums offer tours specifically designed for families and children, 58% offer additional resources inside the museum, such as interactive maps or children's guides. In addition, only 7% of museums offered labels specifically written for children or families, e.g. by using accessible language and focusing on aspects that might be of more interest to children. This landscape review highlights the need for specialized child-friendly services.

Introduction The growing population of bilingual children and lack of bilingual clinicians have created an increased need for reliable and accessible bilingual language assessment to accurately detect language delays and disorders globally. To address this growing need, this study evaluated the Mandarin-English Receptive Language Screener (MERLS), a web-based receptive language assessment designed for bilingual Mandarin-English (ME) speaking children. Methods Using a citizen science approach, bilingual ME speaking parents based in the United States served as the test administrators. This two-phase study compared bilingual ME speaking children’s performance and parent-child interactions across in-person ( n = 16) and telehealth ( n = 43) settings. Participants in both phases were typically developing children aged 3–10 years who used Mandarin and English for at least 20% of their daily communication. Results In Phase I (in-person), despite variability in parent behaviors during administration, parent-administered assessments demonstrated comparable test-retest reliability (Pearson correlation: r = 0.95, p < 0.01) and item-by-item agreement (82%) to researcher-administered assessments. These reliability metrics are comparable to those of established standardized child language assessments (e.g., PPVT-5 and the QUILS). In Phase II (telehealth), platform improvements (e.g., educational quizzes and videos on proper test administration) significantly reduced interfering parent behaviors (Mandarin items: W = 485 , p = 0.004; English items: W = 482 , p = 0.003) without affecting children’s test performance. Discussion These results support the feasibility of using a citizen science approach and a digital assessment platform MERLS for parent-administered language assessments. Such innovative assessment approach has great potentials to increase access to accurate and reliable language assessment services for bilingual ME speaking children in the United States. The findings offer clinical and technical insights for developing bilingual child language assessments across both in-person and telehealth settings.

Language concordance between patients and physicians may improve health outcomes; the extent to which academic ophthalmology centers meet the needs of limited English proficiency populations remains unclear. To evaluate alignment between ophthalmologists language skills at US academic ophthalmology centers and linguistic needs of surrounding limited English proficiency populations. This cross-sectional study included ophthalmologists affiliated with 32 ophthalmology programs across 28 metropolitan areas, identified from overlap of 2024-2025 US News & World Report "Best Hospitals for Ophthalmology" rankings and 2024 Blue Ridge Institute for Medical Research data on National Institutes of Health funding. Language and training data were collected from institutional websites and public sources. Ophthalmologist language offerings and local limited English proficiency (LEP) language composition derived from institutional websites and US Census Bureau American Community Survey data. Language coverage (proportion of limited English proficiency languages represented by ophthalmologists), adjusted ratios (proportion of ophthalmologists speaking a language relative to the limited English proficiency population speaking it), and ophthalmologist availability (number of ophthalmologists per 10 000 limited English proficiency patients). Regional differences were tested using χ2 and ANOVA tests. A mean of 330 (range, 314-367) ophthalmologists were evaluated per region. Across regions, total coverage was 45 of 82 ophthalmologists (54.9%) in the Northeast, 31 of 59 (52.5%) in the South, 29 of 72 (40.3%) in the West, and 24 of 74 (32.4%) in the Midwest. Coverage in the Midwest was lower than in the Northeast (difference, -0.22; 95% CI, -0.42 to -0.02; P = .03). Across 49 identified languages, only Spanish (mean adjusted ratio, 0.64 [95% CI, 0.28-1.00]) and Vietnamese (mean adjusted ratio, 0.86 [95% CI, 0.05-1.67]) were present in every region with consistent underrepresentation. Ophthalmologist availability was lowest for Spanish (mean adjusted ratio, 4.97 [95% CI, -4.49 to 14.43] per 10 000 limited English proficiency patients overall; <3.0 in 3 regions) and Chinese (mean adjusted ratio, 33.25 [95% CI, -33.26 to 99.76] per 10 000). In this cross-sectional study, academic ophthalmology centers demonstrated substantial gaps in language concordance, with Spanish-speaking patients disproportionately affected despite representing the largest limited English proficiency population nationally. These findings extend prior evidence of patient-level disparities by identifying potential workforce-level contributors to inequities in ophthalmic care and support targeted recruitment, training, and reporting strategies to expand Spanish-language capacity and address region-specific shortages.

This study examines how faith and religious communities shape hearing parents’ decisions to learn American Sign Language (ASL) for communication with their deaf children. Drawing on Parent Acceptance Theory (PAT), the paper argues that emotional acceptance of a child’s Deaf identity is a pivotal step that enables sustained language learning and reduces the risk of language deprivation. Through qualitative analysis of ten parental interviews, the study explores how faith functions both as a support and a potential barrier—depending on whether Deafness is framed as purposeful or pathological. While some parents drew strength and clarity from their beliefs, others struggled with religious messages emphasizing healing or deficiency. These divergent experiences suggest that faith can either open or obstruct pathways to ASL acquisition. The paper concludes with recommendations for religious and secular institutions, emphasizing the importance of inclusive theologies, culturally aware practices, and cross-sector collaboration to support language access and family resilience.

In the modern world, individuals with intellectual or communication disabilities face significant challenges in communicating with others. To reduce their communication difficulties, a communication system is designed and developed to convert sign language into text and speech. Dynamic hand gesture recognition (HGR) is a preferred option that focuses on human-computer interactions (HCI). HGR investigation is obtaining increasing attention from investigators globally. Also, regular application in day-to-day life, gesture recognition (GR) is beginning to enter education, virtual reality, automotive, mobile devices, and so on. Owing to the massive growth in artificial intelligence (AI), computer vision (CV)-based GR systems are the most extensively researched field recently. This paper presents a Feature Fusion-based Hand Gesture Recognition for Sign Language Accessibility using the Tornado Optimisation Algorithm (FFHGR-SLATOA) model to aid hearing- and speech-impaired people. The aim is to develop an innovative deep learning-based HGR model to enhance communication accessibility for hearing- and speech-impaired individuals. The image pre-processing stage begins with median filtering (MF) to improve image quality by removing noise. Furthermore, the fusion of ConvNeXt Base, VGG16, and EfficientNet-V2 techniques is employed for the feature extraction process. Moreover, the FFHGR-SLATOA approach employs the deep belief network (DBN) model for classification. Finally, the tornado optimization algorithm (TOA) model is implemented for the parameter tuning process. The experimental analysis of the FFHGR-SLATOA approach is performed under the GR dataset. The comparison study of the FFHGR-SLATOA approach portrayed a superior accuracy value of 99.14% over existing models.

P0217 Enhancing Patient Understanding of Perianal Fistula MRI Findings Using ChatGPT: A Real-World Evaluation

BackgroundThere is a gap in mental health care among Latino/x and Spanish-speaking communities, and the care that is available is often difficult to access, lacks cultural nuance, and results in low engagement and satisfaction.ObjectiveThe study aimed to evaluate the reach, adoption, and acceptability of digital Spanish-language psychosocial and emotional wellness services among Latino/x adults offered by the digital health company Sanarai.MethodsData included in this study were collected between August 2020 and September 2024 by Sanarai as part of its ongoing services. Quantitative data sources included individual customers’ appointment data, individual session payment data, and customer satisfaction data. Qualitative data were obtained from transcribed notes of telephone or video-based user interviews conducted by Sanarai staff between August 2020 and May 2024.ResultsBetween August 2020 and September 2024, Sanarai served 6163 users (n=3662, 59.42% women participants) across all 50 US states, with the highest concentration of participants in Texas and California. Results showed 94% (n=5793) of users scheduled a first appointment within 1 week, with 43% (n=2650) doing so within 1 day. Over 62.60% (n=3858) of participants engaged in two or more sessions, attending an average of 8.94 (SD 13) sessions over 110 days (SD 169). The platform delivered a total of 36,858 appointments, including individual and couples sessions. Only 22.47% (n=1385) of users responded to a customer satisfaction survey for a total of 2287 distinct responses; among this subgroup, session satisfaction was high with an average satisfaction rating of 4.88 out of 5.0 (SD 0.49) and a Net Promoter Score of +85. Nearly all responses (n=2174, 95.06%) expressed intent to schedule another session, but these results should be interpreted with caution, given the low response rate. Qualitative interviews with 30 users (n=21, 70% women) revealed a diverse user base. Many users reported prior mental health service experiences, while one-third were new to care. Participants cited cost, cultural fit, language access, and convenience as key reasons for choosing Sanarai over local services. Users highlighted the platform’s affordability, scheduling flexibility, and provider professionalism as central to their positive experiences.ConclusionsThese findings underscore the value of culturally responsive, accessible online mental health care for Spanish-speaking communities.

The present study, a community-engaged research initiative, was specifically designed to enhance MRI accessibility and optimize the overall experience for autistic Latino young adults. Crucially, we employed a Community-Based Participatory Research (CBPR) approach, ensuring that the voices and perspectives of the target community were central to every stage of inquiry. Insights were gathered from Community Scientist meetings and 18 autistic Latino young adults (ages 18–25) through focus groups with nine MRI-naïve individuals and individual interviews with a separate cohort of nine individuals who had prior MRI experience. Transcripts from these sessions underwent thematic analysis to identify key patterns related to MRI barriers and facilitators. Participants voiced initial apprehension and the challenging sensory experience of MRI noise as a primary barrier. To counter this, participants overwhelmingly desired enhanced preparation and information, specifically emphasizing the value of mock scanner simulations and readily available, in-depth explanations delivered in culturally and linguistically accessible language. A robust theme was the profound importance of human connection and unwavering support from both research staff and family members. A key motivational factor identified was the strong desire for personalized results and feedback from their MRI scans. While monetary compensation was acknowledged as a clear and effective incentive, altruism and genuine scientific curiosity also significantly drove participation. Practical suggestions for improvement included enhancing physical comfort within the scanner, providing better visual aids, and proactively addressing common logistical barriers such as transportation to the facility. This CBPR-driven research provides actionable insights to design more comfortable, transparent, and culturally responsive MRI protocols, thereby fostering greater participation of autistic adults.

This study investigates the effectiveness of e-learning in supporting language acquisition and academic performance among multilingual learners (MLs) in the digital age. As educational technology continues to evolve, e-learning platforms offer unique opportunities for personalised and accessible language instruction tailored to diverse linguistic backgrounds. It highlights the advantages of e-learning, including the accessibility of resources, personalised learning experiences, and the incorporation of multimedia elements that enhance engagement and comprehension. The study adopts descriptive design of the survey type. The sample size comprises 300 students and 50 teachers of English language randomly selected from five (5) grade A and five (5) grade B public and private junior secondary schools in Ekiti State, Southwest, Nigeria. The instrument used for the collection of data was a structured questionnaire titled “Questionnaire on Language Acquisition and Academic Performance among Multilingual Learners” (QLAAPMLL). The instrument was validated by experts. A reliability coefficient of 0.67 was obtained. The data collected were analysed using descriptive statistics. The result revealed a mean of 3.49 and a standard deviation of 1.37, the responses show that many students experience a sense of disconnection during online learning, valuing the social component of in-person interactions. The findings underscore the importance of inclusive and adaptive e-learning strategies that consider the unique needs of this diverse population in order to enhance their educational experiences in a rapidly changing digital landscape. It is therefore recommended that to support multilingual learners in the digital age, e-learning platforms should be inclusive, offering multilingual support and culturally relevant content.

ABSTRACTBackgroundAccurate assessment of language comprehension is crucial to positive outcomes for children with cerebral palsy (CP) but is difficult for those with significant speech and physical impairments (SSPI). Standardized tools that typically require these children to speak, vocalize or select directly pose particular challenges.AimTo describe Canadian caregivers’ and clinicians’ language comprehension assessment experiences and needs for children with CP and SSPI prior to soliciting feedback to advance the Computer‐Based instrument for Low motor Language Testing (C‐BiLLT‐CAN), a standardized and accessible tool designed specifically for these children.Methods and ProceduresRecruiting from Canadian children's treatment centres, augmentative and alternative communication clinics, and via social media, we conducted an environmental scan of caregivers of and clinicians providing services to children with CP and SSPI. Surveys designed using the Knowledge to Action Framework solicited both quantitative and qualitative data, summarized using descriptive statistics and inductive content analysis, respectively.Outcomes and ResultsTwenty‐two caregivers (21 females, 1 male; mean age = 42 years) and 39 clinicians (36 females, 3 males; mean age = 41 years) from 7 Canadian provinces completed the survey. Most caregivers had experienced language comprehension assessment but were typically only ‘somewhat confident’ in the results, despite considering accuracy ‘very important.’ Most clinicians were involved in language comprehension assessment and overwhelmingly relied on non‐standardized tools despite feeling at best ‘fairly confident’ in their results. Qualitative comments indicated the utility of a population‐specific test/testing procedures and/or associated normative data to complement non‐standardized tools. Participants indicated that the C‐BiLLT‐CAN could be improved by expanding available response methods and supporting visual and auditory access modifications to promote customization. Anticipated benefits of the C‐BiLLT‐CAN included improved interaction with, participation for, and understanding of the abilities of children with CP and SSPI; and improved interventions and outcomes for these children and their families.Conclusions and ImplicationsThe C‐BiLLT‐CAN could fill a critical gap in services available to Canadian children with CP and SSPI. Caregivers and clinicians recognized the benefits of incorporating a reliable and valid standardized tool as part of a comprehensive language comprehension assessment battery for this population but valued additional response methods and features to support access and implementation. Integration of the additional response methods and customization options recommended by end users is expected to further increase the usefulness and feasibility of the C‐BiLLT‐CAN in the Canadian clinical context.WHAT THIS PAPER ADDSWhat is already known on this subjectAccurate assessment of language comprehension is crucial to positive outcomes for children with cerebral palsy (CP), but is especially difficult for those with significant speech and physical impairments (SSPI). Standardized tools that typically require these children to speak, vocalize or select directly pose particular challenges.What this paper adds to existing knowledgeThis environmental scan describes Canadian caregivers’ and clinicians’ language comprehension assessment experiences and needs for children with CP and SSPI and solicits feedback to advance the Computer‐Based instrument for Low motor Language Testing (C‐BiLLT‐CAN), a standardized and accessible language comprehension assessment tool designed specifically for these children.What are the potential or actual clinical implications of this work?With the incorporation of an expanded breadth of response methods and customization options, the C‐BiLLT‐CAN could fill a critical gap in services available to Canadian children with CP and SSPI. Caregivers and clinicians recognize the benefits of incorporating a reliable and valid standardized tool along with commonly used non‐standardized techniques as part of a comprehensive language comprehension assessment battery for this population.

Background/Objectives: Large Language Models (LLMs) may help translate complex Magnetic Resonance Imaging (MRI) fistula reports into accessible, patient-friendly summaries. This study evaluated the clinical utility, safety, and patient acceptability of Generative Pre-trained Transformer (GPT-4o) in generating such reports. Methods: A three-phase study was conducted at a single centre. Phase I involved prompt engineering and pilot testing of GPT-4o outputs for feasibility. Phase II assessed 250 consecutive MRI fistula reports from September 2024 to November 2024, each reviewed by a multi-disciplinary panel to determine hallucinations and thematic content. Phase III randomised patients to review either a simple or complex fistula case, each containing an original report and an Artificial Intelligence (AI)-generated summary (order randomised, origin blinded), and rate readability, trustworthiness, usefulness and comprehension. Results: Sixteen patients participated in Phase I pilot testing. In Phase II, hallucinations occurred in 11% of outputs, with unverified recommendations also identified. In Phase III, 61 patients (mean age 48, 41% female) evaluated paired original and AI-generated summaries. AI summaries scored significantly higher for readability, comprehension, and usefulness than original reports (all p < 0.001), with equivalent trust ratings. Mean Flesch-Kincaid scores were markedly higher for AI-generated summaries (66 vs. 26; p < 0.001). Clinicians highlighted improved anatomical structuring and accessible language, but emphasised risks of inaccuracies. A revised template incorporating Multi-Disciplinary Team (MDT)-focused action points and a lay summary section was co-developed. Conclusions: LLMs can enhance the readability and patient understanding of complex MRI reports but remain limited by hallucinations and inconsistent terminology. Safe implementation requires structured oversight, domain-specific refinement, and clinician validation. Future development should prioritise standardised reporting templates incorporating clinician-approved lay summaries.

This study sought to find: How is language used to describe social mobility in Access and Participation Plans of universities in England? Are there differences in how social mobility is discussed by universities in England in relation to the university’s HE grouping? Are there implications for particular student groups due to the language and focus of Access and Participation Plans? The study focuses on universities in England, drawing on a sample of 25. We have used publicly available Access and Participation Plans for each university to develop a corpus for each grouping. The corpora were then analysed and coded to identify inductive themes from the data. They were further analysed using a Foucauldian Discourse Analysis to identify the power relationships. The findings show the plans discussed widening participation in similar ways but lacked specific commitments and detail about how they intended to achieve that. This helps to reveal the intent and clarity of widening participation efforts in universities. Universities appeared to miss a ‘big picture’ approach to enabling social mobility. The language in Access and Participation Plans appeared to be focused on meeting the requirements set by the OfS rather than a considered intersectional approach to enabling social mobility.

Participation in clinical cancer research trials should diversely reflect the intersectionality characteristics of the general population for results to be representative and applicable. European migrant populations residing in the United Kingdom (UK) are a group whose participation in clinical research warrants further exploration from a community and clinical perspective. This study aimed to explore the barriers and facilitators of individuals who have migrated to the UK from an EU8 or EU2 (EU8/2) country to participating in clinical cancer research trials to update clinical and research agendas for optimising inclusive engagement strategies. Perspectives of migrant individuals and of clinical research staff were explored to identify barriers and opportunities for optimising engagement. Five focus groups with clinical research staff at four hospitals across the East Midlands and three online focus groups with individuals who had migrated to the UK from Poland, Latvia and Romania were conducted. Data was analysed using template analysis. Twenty-two clinical research staff and 17 individuals from EU8/2 countries participated in the study. Three key themes and related subthemes were identified: (1) Ambivalence, misunderstanding and fear shape cancer research perceptions (1.1. a lack of familiarity with cancer research practices; 1.2. Cancer fear may hinder participation); (2) Structural barriers and gaps in cultural competency; and (3) Building trust through community engaged research (3.1.Co-researching with communities; 3.2.Incentivising and legitimising research). Many migrant participants were unfamiliar with UK-based research practices, and it was suggested that fatalist attitudes towards a cancer diagnosis and mistrust of research generally created apprehension and defensiveness when hearing about clinical cancer research in migrant communities. Migrant individuals and staff endorsed research design strategies which engage community champions (including clinicians); narrate positive stories of cancer research participation; and consider language accessibility and comprehension as key elements of engagement-focused research design.

In the digital era, the diversity of audience needs and the influence of platform algorithms pose significant challenges for digital da'wah practices. These conditions require da'i (Islamic preachers) to adapt to technological developments and shifting audience preferences in order to enhance the effectiveness of religious communication. This study aims to examine the dynamics of da'wah in the digital era through the Instagram platform, with a focus on communication strategies, audience interaction, and emerging challenges. Using a qualitative descriptive approach through a literature study, this research analyzes secondary data from books, scholarly journals, articles, and digital documents to systematically describe the phenomenon of digital da'wah without direct field observation. The findings indicate that many da'i demonstrate positive attitudes in conveying religious messages and maintain constructive social interactions with their audiences. Their communication strategies vary, including the use of simple and accessible language, visually engaging content, and interactive two-way communication to foster audience engagement. These strategies have proven effective in enhancing followers’ religious understanding and influencing positive behavioral changes. However, the study also identifies contextual challenges in Instagram-based da'wah, such as ethical concerns related to misinformation and hate speech driven by viral content, polarization of religious narratives that intensify interpretive divisions, and the emergence of religious consumerism through sponsored content or merchandise that may shift da'wah orientation from spiritual authenticity toward commercial interests

The French Language Acculturation Programme in Nigerian Colleges of Education is designed to equip future French teachers with the linguistic proficiency, cultural competence, and socio-communicative skills necessary for effective engagement in Francophone environments. Despite its importance, students have increasingly faced barriers that hinder their full participation, including financial limitations, visa and travel difficulties, low initial language proficiency, cultural adjustment challenges, security concerns, and limited access to healthcare. Insights from structured interviews with staff at the Nigerian French Language Village (NFLV), Badagry, and the Pan-African University Institute (PAUI), Porto-Novo revealed that, while institutional practical and logistical challenges such as delayed visa processing, high programme costs, and inadequate pre-departure preparation continue to restrict student engagement. The main aim of this paper isto identify, analyse, and explain these barriers, drawing on student questionnaires, participation records, and staff interviews to capture both the prevalence and intensity of the challenges. Furthermore, it explores innovative interventions to strengthen the acculturation programme, including expanded TETFund scholarships, institutional agreements to facilitate visa and travel processes, systematic exposure to French media and language labs, comprehensive pre-departure cultural orientation, selection of secure Francophone destinations, and guidance on accessing healthcare abroad. The findings are expected to provide valuable insights for policymakers, educational administrators, and teacher trainers, ultimately contributing to the development of a more effective, accessible, and sustainable French Language Acculturation Programme in Nigerian Colleges of Education.