non-English Speaking Research Articles

A Scientific Approach to Improving IELTS Speaking Scores: Best Practices and Techniques

Improving performance in the IELTS Speaking test is critical for non-native English speakers aiming for higher band scores. This article explores various strategies to enhance speaking skills, including understanding the test format, engaging in regular practice, expanding vocabulary, refining pronunciation, developing fluency and coherence, receiving constructive feedback, building confidence, and providing detailed responses. Through a combination of evidence-based methodologies and practical tips, this study aims to equip learners with the necessary tools to excel in the IELTS Speaking test. The findings suggest that a structured and consistent approach can significantly improve test outcomes.

Comprehension in native and non-native English speakers

Comprehension in native and non-native English speakers

Exploring Phatic Communication Functions among Native and Nonnative English Speakers at Saudi Multilingual Context

English language is the first spoken language around the world, and it is the formal language for communication in my multilingual Saudi context. This paper is to conduct a further investigation to findings of a similar study conducted by Jumanto (2014) exploring the functions of phatic communication among English native speakers. Furthermore, this study aims at exploring phatic communication among native and nonnative English speakers in my workplace to have a healthy distinguished working atmosphere through guiding them to build a solid social relationship at workplace through involving in various communicative situations for the sake of rapport, not to convey information. For instance, to greet or reply to a greeting properly, start or end conversations with native or nonnative colleagues to avoid any inconvenience or misunderstanding due to the likely distinctions related to their different social or cultural backgrounds which may affect negatively on their relationship. To achieve this, an exploratory mixed study will be conducted in two phases using a questionnaire for quantitatively collected data, and then conducting semi-structured interviews for the same population to qualitatively collect data to have reliable findings. Additionally, the findings of this study reflect a great harmony among the phatic expressions used by native and nonnative speakers, especially native English speakers who try speaking the mother language, Arabic, of the nonnative English speakers for the purpose of greeting or starting interaction with each other. Accordingly, further research investigation could be conducted to explore the impact of phatic communication functions among native and nonnative speakers of any other languages on learning a second or a foreign language.

Linguistic Accommodation in English-Medium Instruction: Investigating Adjustments by Non-Native English Speakers

This study explores how non-native English-speaking students and teachers accommodate each other linguistically in EMI classrooms. The research explores the features of these strategies, including language simplification, visual aids, code-switching, and non-verbal cues, in terms of their frequency and types to identify how they impact communication/learning.Structured questionnaires were used to collect data from 200 students and 50 teachers. The study found that both students and teachers used simplification in language and visual aids to show what was being discussed.These are also well-documented, underscoring their importance in multilingual classrooms.The Pearson correlation analysis in Table 2 suggests significant positive correlations between the use of simplification and non-verbal cues language proficiency scores, which reveals that more proficient learners can employ these strategies better.This article highlights the importance of linguistic accommodation in EMI. It offers suggestions for targeted intervention programs as well as professional development to improve successful educational outcomes through English medium instruction.

Research Article Abstracts in Management Sciences Written by Thai EFL Scholars: An Analysis of Rhetorical Moves, Verb Tenses and Voices

Research article (RA) abstracts play a critical role in disseminating research findings, particularly challenging for non-native English speakers. While prior studies have explored the move analysis of RA abstracts across various subjects, the management sciences—a globally prominent field—have received less attention. This study addresses this gap by examining the rhetorical move patterns, verb tense usage, and voice constructions in 200 RA abstracts from Thai tier 1 management journals written by Thai scholars. The results showed that: 1) the Purpose-Method-Product structure was the most commonly employed move pattern; 2) present simple tense was mostly found in the Introduction, Purpose, and Conclusion sections, while past simple tense was preferred in the Method and Result sections; and 3) active voice was frequently used in the Introduction, Purpose, Product, and Conclusion sections, with a mix of active and passive voice mainly appearing in the Method section. The findings of the present study offer valuable insights for academic writing course developers, material designers, lecturers, and novice researchers, enhancing their understanding of RA abstract writing and supporting their integration into scientific communities.

Abstract 4137479: Integrating Ambulatory Care Pharmacists into Value-Based Primary Care: A Scalable Model for Addressing Cardiometabolic Disease

Background: Chronic disease is common, costly, and complicated. In the shift to value-based payment models, interventions to engage patients and improve disease control are necessary to reduce morbidity, mortality, and cost. The use of ambulatory pharmacists has demonstrated improved management of chronic diseases. Traditionally, ambulatory pharmacists are employed by healthcare systems. In this study, we test if integrating ambulatory pharmacists hired, trained, and managed by a retail pharmacy into value-based primary care (VBPC) clinics improves care. Hypothesis: Integrating a Walgreens pharmacist empowered by collaborative drug therapy management agreements (CDTM) into Village Medical (VMD) clinics will improve indicators of chronic disease control. Aims: Improve hemoglobin A1c (HbA1c) in patients with type 2 diabetes (T2D) and systolic blood pressure (SBP) and diastolic blood pressure (DBP) measurements in patients with hypertension (HTN). Methods: An ambulatory pharmacist was embedded into VMD clinics in Phoenix, Arizona under the supervision of VMD primary care providers via a CDTM. The pharmacist provided education, coaching, and medication management by prescribing and titrating therapies for treating T2D and HTN - enabled by access to pharmacy dispensing data. β was generated from difference-in-differences (DID) analyses with propensity score matched controls. Results: 125 patients had T2D, and 43 patients had HTN in the intervention group with 250 and 86 in the matched control group, respectively. The mean age was 65 years, 54% were female, 2% non-English speaking, and 29% racial/ethnic minorities. The average baseline HbA1c was 9% in the intervention group and 10% in the matched cohort. The average baseline SBP was 146 mmHg in the intervention group and 142 mmHg in the matched cohort. The β in the T2D group was -1.61% (p<0.001) while the β in the HTN group was -10.2 mmHg (p<0.01) for SBP and -2.0 mmHg (p=0.42) for DBP. Conclusion: We saw significant reductions in SBP and HbA1c in the pharmacist-managed group compared with matched controls. These results demonstrate that pharmacist integration into VBPC clinics may improve measures of chronic disease known to be associated with morbidity and mortality.

Abstract 4147618: Modality of Research Engagement Among Postpartum Women with Hypertension and High Health-Related Social Needs

Introduction: People of color and non-English speakers are underrepresented in research and disproportionately affected by health-related social needs (HRSNs). Research engagement can be particularly challenging after pregnancy as postpartum care attendance is low. We describe our experience with remote recruitment modalities in a such a population. Methods: The study population included all patients affected by hypertension during a pregnancy who delivered at a large safety-net hospital 1/2022-6/2023. These patients also engaged in 6 weeks of remote blood pressure monitoring postpartum. Patients were contacted between 6 weeks and 12 months post-delivery to complete an online survey regarding HRSNs and provide consent to link survey data to clinical data. The recruitment protocol included initial outreach via the electronic medical record (EMR) patient portal, if available, or else a hard copy letter via mail, followed by a series of text messages then phone calls. All communication was conducted in the patient’s primary language (English, Spanish, or Haitian Creole). Results: We recruited 148 (9.4%) of 1571 patients contacted. Respondents were 51% Black, 39% Latina, 26% White. Table illustrates the comparable rate of recruitment across languages, dominance of EMR as mode of engagement and an illustration of the high rate of complex HRSN among our participants. The most effective recruitment method was EMR communication (57% of total recruitment) followed by text messages (28%). Our Haitian Creole-speaking respondents had the highest rates of HRSN - possibly representing the Haitian migrant crisis affecting Boston in this time period - as well as the highest rate of engaging via EMR messaging. Other domains of HRSN were high among all language groups including trouble affording medication (11-23%) and heating/electric access (21-34%). Conclusions: A diverse postpartum population with a high prevalence of HRSNs is hard to engage in research. Despite presumed digital barriers, EMR and secure text were effective and secure methods of online survey recruitment. Future studies seeking to understand the intersection of health outcomes and HRSNs should consider adding recruitment with EMR to common texting strategies.

IndoGovBERT: A Domain-Specific Language Model for Processing Indonesian Government SDG Documents

Achieving the Sustainable Development Goals (SDGs) requires collaboration among various stakeholders, particularly governments and non-state actors (NSAs). This collaboration results in but is also based on a continually growing volume of documents that needs to be analyzed and processed in a systematic way by government officials. Artificial Intelligence and Natural Language Processing (NLP) could, thus, offer valuable support for progressing towards SDG targets, including automating the government budget tagging and classifying NSA requests and initiatives, as well as helping uncover the possibilities for matching these two categories of activities. Many non-English speaking countries, including Indonesia, however, face limited NLP resources, such as, for instance, domain-specific pre-trained language models (PTLMs). This circumstance makes it difficult to automate document processing and improve the efficacy of SDG-related government efforts. The presented study introduces IndoGovBERT, a Bidirectional Encoder Representations from Transformers (BERT)-based PTLM built with domain-specific corpora, leveraging the Indonesian government’s public and internal documents. The model is intended to automate various laborious tasks of SDG document processing by the Indonesian government. Different approaches to PTLM development known from the literature are examined in the context of typical government settings. The most effective, in terms of the resultant model performance, but also most efficient, in terms of the computational resources required, methodology is determined and deployed for the development of the IndoGovBERT model. The developed model is then scrutinized in several text classification and similarity assessment experiments, where it is compared with four Indonesian general-purpose language models, a non-transformer approach of the Multilabel Topic Model (MLTM), as well as with a Multilingual BERT model. Results obtained in all experiments highlight the superior capability of the IndoGovBERT model for Indonesian government SDG document processing. The latter suggests that the proposed PTLM development methodology could be adopted to build high-performance specialized PTLMs for governments around the globe which face SDG document processing and other NLP challenges similar to the ones dealt with in the presented study.

Cancer Clinical Trial Participation Amongst Culturally and Linguistically Diverse Patients in Australia.

Clinical trials play a large role in oncological. Many barriers to participation in cancer clinical trials exist, including a patient's status as "culturally and linguistically diverse (CALD)". Globally, it is thought that CALD patients experience lower rates of trial participation, although very few studies quantify rates of cancer clinical trial participation in this group. Our study therefore aims to characterize CALD participation in cancer clinical trials in an Australian setting. We conducted a retrospective analysis of data from the Cancer Clinical Trials Centre at Austin Health, a large tertiary metropolitan cancer center in Melbourne, Australia. Participation in cancer clinical trials between groups was compared using simple descriptive analysis, Chi-squared analysis, and logistic regression. Of 2568 patients (mean age 57.9 years, 37% female) offered entry into a cancer clinical trial between 2018 and 2023, 26% were from a CALD background (n = 678), and 9% had a preferred language other than English (n = 219). A greater proportion of non-CALD patients participated in a cancer clinical trial compared with CALD patients (37% versus 33% respectively, p =0.04). In logistic regression models, Arabic (OR,0.46; 95% CI,0.21-0.93 [univariate]) and Greek (OR,0.54; 95% CI,0.31-0.91 [multivariate]) language groups, along with overall CALD status (OR,0.81; 95% CI,0.67-0.99 [univariate]) were associated with lower cancer clinical trial participation. We found that CALD patients, those born in non-English speaking countries, and specific language groups, were associated with lower cancer clinical trial participation.

Analysis of high-frequency errors and linguistic patterns in EFL medical students’ English writing: Insights from a learner corpus

BackgroundThe perceived language barrier in English is said to hinder, and in certain instances, impede the global dissemination of knowledge, including medical information, to non-native English speakers within medical institutions. As English for medical purposes instructors, we contend that the issue persists in medical universities across various EFL contexts. Medical students face the challenge of presenting their research findings in English for international journals and conferences. Given this, the present research study aimed to compile a comprehensive catalog of high-frequency errors and examine them in recurring linguistic patterns commonly found in the writing of Iranian medical students.MethodsIn conducting the present study, we developed a learner corpus of 1,040 essays (339,040 words and 18,235 sentences in total). Through using the results obtained from Wordsmith Tools 8 and sifting the leaner corpus, we identified 11 high-frequency errors and five commonly used linguistic patterns.ResultsOnly five out of 11 high-frequency errors account for 61% of the total number of errors. Results also showed that a majority of errors were of grammatical nature. In this regard, cohesion and cohesive devices (16%) were the most prevalent errors followed by omission/misusing of articles/determiners (14%). Additionally, results showed that discourse markers were extensively used in the corpus (22.07%), followed by hedges (11.42%).ConclusionsThe outcomes of this study are expected to assist English for medical purposes instructors in designing focused lesson plans and classroom activities. Ultimately, these efforts might contribute to enhancing medical education in non-English speaking universities.

Language and parental satisfaction during inpatient stay: A pilot survey study in a quaternary pediatric hospital.

Considering the significant volume of non-English speakers seeking medical care in the United States and the challenges they may encounter within the hospital environment, it is necessary to assess the satisfaction of non-English-speaking families during their hospital stays and to determine potential areas of improvement in order to optimize care. We aimed to evaluate and describe the satisfaction of Arabic-, Spanish-, and English-speaking families at a quaternary pediatric hospital. From the measures assessed, we sought to identify perceived strengths and weaknesses of the inpatient experience for families who spoke different languages. In doing so, we aimed to identify ways to improve the hospital experience for patients and their families. We created a 23-item satisfaction questionnaire that was vetted by the hospital's Global Services Department, professionally translated into Arabic and Spanish, and tested by native speakers. The survey contained questions pertaining to parent/guardian demographics, their experience with the hospital environment, and their care team or services. Using the questionnaire, we surveyed Arabic-, Spanish-, and English-speaking parents/guardians of post-procedural patients under 18 years of age in intensive care units (ICUs) and on inpatient floors. A total of 162 surveys were collected with roughly equal distribution across the three language groups (52 Arabic, 53 Spanish, 57 English). We found no statistically significant difference in satisfaction scores across the three language groups, nor across self-reported English-proficient and non-English-proficient Arabic and Spanish respondents. In addition, there was no statistically significant difference in satisfaction between parents/guardians in ICUs and those on inpatient floors. This pilot survey suggests that inclusivity and availability of interpretation resources play a role in successfully creating an environment where both English and non-English speakers are satisfied. Further development and validation of the survey instrument should be performed, along with testing at other institutions.

Disparities in Patient Portal Activation and Usage at a Large Pediatric Academic Institution.

Access to personal medical information promotes patient understanding of health issues and enables patient self-advocacy of healthcare needs. The advent of electronic medical record systems and the 2016 21st Century CURES Act promoted and encouraged patient access to personal medical information, yet technology-dependent modalities have often disadvantaged certain communities. We sought to evaluate whether disparities existed in access to patient portals at our institution, the main pediatric care provider in an area serving one million children. We evaluated the activation of patient portal accounts at our institution over the past decade (2010-2021). Portal activation data were analyzed by ethnic background and language preference and income information available based on primary home access location. Further, we evaluated portal activation rates over time and across institutional interventions. A logistic regression model was used to identify important demographic associations with portal account status. Over 1 million patients were served at our pediatric institution over the study period with 47.7% having ever activated their patient portals. Univariate analyses and ultimately logistic regression modeling demonstrated significant differences in portal activation by ethnicity (odds ratio (confidence interval):1.36 (1.34, 1.37)), language preference (1.39 (1.37, 1.40)), and median household income (1.00001 (1.00001, 1.00001)). Interim interventions were successful in improving portal activation rates. Overall, electronic medical record portal activation was less prevalent among Hispanic, non-English speakers, and patients living in communities with lower median household income. Opportunities for interventions exist to reduce healthcare disparities in these underserved communities.

Intersectionality of gender with social determinants of health and asymptomatic Alzheimer's disease neuropathology.

Women comprise approximately two-thirds of Alzheimer's disease cases. This is the first known study to investigate the role of intersectionality between gender and other social determinants of health (SDOH) in the presentation of cognitive symptoms (i.e., being asymptomatic or symptomatic) among those with pathologically confirmed Alzheimer's disease. We studied 3107 individuals with Alzheimer's disease neuropathology (ADNP) confirmed at autopsy. Asymptomatic ADNP was defined as the absence of a clinical diagnosis of mild cognitive impairment (MCI) or dementia before death (versus symptomatic: diagnosis of MCI/dementia). SDOH included gender, education, ethnoracial group, living alone, and primary language. Multivariable logistic regression tested associations between SDOH and asymptomatic ADNP (versus symptomatic); models were also stratified by gender. Women, Hispanics, those living alone, and more educated individuals were found to have higher odds of asymptomatic ADNP. Non-English speakers had lower odds of asymptomatic ADNP. Both women and men had higher odds of asymptomatic ADNP if Hispanic or living alone. In only women, non-English speakers had lower odds while in only men, more education was associated with higher odds of asymptomatic ADNP. Gender, education, ethnicity, primary language, and living alone, and intersectionality of gender with primary language, may differentially influence MCI and dementia diagnosis prior to death among those with underlying ADNP. These findings emphasize the need for future Alzheimer's disease research to prioritize social determinants of brain health including their intersectionality with gender and how to inform targeted interventions.

Caregiver-reported satisfaction with pediatric movement disorder surgery.

Patient- and surrogate-reported outcomes are increasingly recognized as important and historically limited dimensions of satisfaction with medical care. Evaluating caregiver satisfaction for cerebral palsy (CP) patients with pediatric movement disorders (PMDs) remains undefined, limited by a lack of appropriate tools and the heterogeneity of the patient population. The authors identified caregiver satisfaction with the neurosurgical management of PMDs as a key quality metric and report their results across an institutional experience. A retrospective single-institution survey study was performed on caregivers of consecutive children who underwent PMD surgery from March 2022 to December 2023. The authors designed a brief 4-question satisfaction survey with dichotomous yes/no answers. The telephone survey solicited answers from primary caregivers, and contact attempts were made 3 times before labeling a nonresponder. Non-English speakers were included. The survey answers were correlated with demographic characteristics, clinical data, and complications. Descriptive statistics were performed using Excel. Seventy patients were identified in the study period with 50 associated caregivers voluntarily responding to the questionnaire (50/70 [71.4%]). Forty-six male and 24 female patients with a mean (range) age of 13.1 (2-34) years and a follow-up range of 3-20 months were included. All 50 caregivers reported satisfaction with the surgical care their child received: 100% confirmed they would refer others to the program and 94% confirmed that they would have the surgery again in retrospect. Ten caregivers (10/50 [20%]) recalled complications, but only 5 (5/50 [10%]) surgical complications resulted in hospital readmission. Caregivers were overwhelmingly satisfied with the neurosurgical care for PMDs and would recommend the functional pediatric neurosurgery program to others. A large percentage would again submit to the surgery. There is a perception disparity between caregiver- and hospital-identified complications; it may be beneficial to emphasize expected adverse effects with caregivers prior to surgery. Caregiver satisfaction remains an important quality dimension and future research may benefit from more objective metrics.

An Autoethnographic Account of a Native English-Speaking Teacher’s Change in Attitude to Non-Native English-Speaking Teachers

This study investigates and reflects upon how over a decade of teaching English as a foreign language my attitude towards non-native English-speaking teachers (NNESTs) changed from a negative perception to one of admiration. Focusing on language ideology and NNEST discrimination as conceptual lenses, I detail the evolution of my attitudes across time and space as a language educator using autoethnographic inquiry. I detail how my attitudinal changes towards NNESTs evolved, from beginnings where I questioned their authenticity, due to my sociocultural background, to a status where I espoused their competence and began researching how equity can be achieved in English language teaching (ELT) for NNESTs globally. I also summarize how my lived experiences can be replicated in official policy within ELT with a focus on critical reflexivity and exposure. As a ‘native English-speaking teacher,’ my experiences and perceptions seek to add countenance to those documented by NNESTs, therefore offering fluidity and depth to the discussion within the NNEST movement on how equity can be achieved.

Ensuring Accuracy and Equity in Vaccination Information From ChatGPT and CDC: Mixed-Methods Cross-Language Evaluation.

In the digital age, large language models (LLMs) like ChatGPT have emerged as important sources of health care information. Their interactive capabilities offer promise for enhancing health access, particularly for groups facing traditional barriers such as insurance and language constraints. Despite their growing public health use, with millions of medical queries processed weekly, the quality of LLM-provided information remains inconsistent. Previous studies have predominantly assessed ChatGPT's English responses, overlooking the needs of non-English speakers in the United States. This study addresses this gap by evaluating the quality and linguistic parity of vaccination information from ChatGPT and the Centers for Disease Control and Prevention (CDC), emphasizing health equity. This study aims to assess the quality and language equity of vaccination information provided by ChatGPT and the CDC in English and Spanish. It highlights the critical need for cross-language evaluation to ensure equitable health information access for all linguistic groups. We conducted a comparative analysis of ChatGPT's and CDC's responses to frequently asked vaccination-related questions in both languages. The evaluation encompassed quantitative and qualitative assessments of accuracy, readability, and understandability. Accuracy was gauged by the perceived level of misinformation; readability, by the Flesch-Kincaid grade level and readability score; and understandability, by items from the National Institutes of Health's PatientEducationMaterials Assessment Tool (PEMAT) instrument. The study found that both ChatGPT and CDC provided mostly accurate and understandable (eg, scores over 95 out of 100) responses. However, Flesch-Kincaid grade levels often exceeded the American Medical Association's recommended levels, particularly in English (eg, average grade level in English for ChatGPT=12.84, Spanish=7.93, recommended=6). CDC responses outperformed ChatGPT in readability across both languages. Notably, some Spanish responses appeared to be direct translations from English, leading to unnatural phrasing. The findings underscore the potential and challenges of using ChatGPT for health care access. ChatGPT holds potential as a health information resource but requires improvements in readability and linguistic equity to be truly effective for diverse populations. Crucially, the default user experience with ChatGPT, typically encountered by those without advanced language and prompting skills, can significantly shape health perceptions. This is vital from a public health standpoint, as the majority of users will interact with LLMs in their most accessible form. Ensuring that default responses are accurate, understandable, and equitable is imperative for fostering informed health decisions across diverse communities.

Delays in Treatment for Temporal Encephaloceles and Cerebrospinal Fluid Leaks.

Lateral skull base defects (LSBD) pose a diagnostic challenge; however, early recognition and treatment are important to avoid sequelae. This study examines the impact of health care disparities associated with time to diagnosis and treatment for patients with LSBD. Multi-institutional retrospective cohort study at four U.S. tertiary centers from 2000 to 2022. Adult patients with a primary diagnosis of CSF leak or encephalocele were included. Multivariate regressions used to analyze how age, sex, race/ethnicity, insurance, language, zip code, distance to medical center, referral patterns, diagnostic workup, and clinical course affected time to diagnosis and treatment. In 127 patients with LSBD, mean time to treatment of CSF leak or encephalocele was 13.9 months. On average, patients waited 10.6 months from initial assessment to diagnosis and saw 2 providers prior to diagnosis. Approximately 91% (115) of patients had a CT scan, and 75% (95) had an MRI. Imaging did not influence time to treatment. Older age, public insurance, and number of providers seen were associated with delays. Non-English speakers (5% of 127) encountered treatment delays, although this was not statistically significant. Fifty-eight (46%) people had private insurance. The average traveled distance for care was 62.6 miles. Clinical presentation, race, zip code, imaging, myringotomy, beta-2 transferrin, and ED workup were not found to be associated with delays to care. There are significant delays in diagnosis and management of LSBD. Referral patterns did influence care. Health care disparities did not impact care; however, disparities and language barriers need to be studied further to determine contributions to delays in care.

Health inequities in cardiac care and cardiovascular guideline concordance in Australian migrant populations: data correlation for culturally and linguistically diverse populations (DatCALD) project

Abstract Background Evidence of inequities in acute cardiac care and concordance with cardiovascular guidelines in migrant populations have not been well documented in Australia. Additionally, knowledge of correlations between clinical data and population health data of these marginalised groups is seriously lacking. Purpose To establish an interactive population health atlas and perform data correlations to determine health inequities in cardiac care provision in emergency departments (EDs) and examine guideline concordance in migrant populations. Methods This study correlated population health data derived from public health surveillance systems with the clinical data of migrant populations in Australia. The interactive atlas has been established and data correlations between relevant variables have been produced. Degree of correlations were presented as a correlation coefficient (r). Results The evidence revealed a strong relationship between migrant status and poor cardiac care provision. Migrant populations who were born overseas in non-English-speaking (NES) countries were less likely to access universal health coverage in Australia (Medicare) and were more likely to live with socioeconomic disadvantage (r= 0.24). Birthplaces of migrants were associated with longer processing time for cardiac care in ED, including time to meet an ED doctor and total ED stay time (Figure 1). Migrant populations were less likely to receive cardiac care at triage within the recommended timeframe of 10 minutes (r= -0.35), whereas the Australian-born group were more likely to reach ED treatment within 10 minutes (r= -0.52). Interestingly, migrants who were born in English speaking countries had the strongest relationship with an ED stay longer than the recommended time of four hours (r= -0.42). An association between migrant populations and non-concordance with guidelines for management of chest pain was evident (Figure 2). The population born overseas in NES countries, resident in Australia ≥ 5 years had the strongest correlation with non-concordance (r= 0.50); whereas the Australian-born population were the most likely to meet the concordance guideline. The evidence suggested that permanent migrants entering Australia between 2000-2006 under family and skill stream visas have a higher likelihood of non-concordance with guidelines for chest pain management (r= 0.50) compared to those of this group who arrived in Australia after 2006. Conclusions Health inequities in cardiac care in ED and concordance with cardiovascular guidelines have been found to be associated with migrant status at varying degrees, related to their birthplace and duration of residency. Universal health coverage and sociocultural factors are related to those health inequities. Addressing these determinants of health, normalizing cultural competence and increase health service accessibility are recommended to promote and sustain health equities and wellbeing in these disadvantaged populations.Birthplace and ED provisionBirthplace and non-concordance

Response accuracy of GPT-4 across languages: insights from an expert-level diagnostic radiology examination in Japan.

This study aims to investigate the effects of language selection and translation quality on Generative Pre-trained Transformer-4 (GPT-4)'s response accuracy to expert-level diagnostic radiology questions. We analyzed 146 diagnostic radiology questions from the Japan Radiology Board Examination (2020-2022), with consensus answers provided by two board-certified radiologists. The questions, originally in Japanese, were translated into English by GPT-4 and DeepL and into German and Chinese by GPT-4. Responses were generated by GPT-4 five times per question set per language. Response accuracy was compared between languages using one-way ANOVA with Bonferroni correction or the Mann-Whitney U test. Scores on selected English questions translated by a professional service and GPT-4 were also compared. The impact of translation quality on GPT-4's performance was assessed by linear regression analysis. The median scores (interquartile range) for the 146 questions were 70 (68-72) (Japanese), 89 (84.5-95.5) (GPT-4 English), 64 (55.5-67) (Chinese), and 56 (46.5-67.5) (German). Significant differences were found between Japanese and English (p = 0.002) and between Japanese and German (p = 0.022). The counts of correct responses across five attempts for each question were significantly associated with the quality of translation into English (GPT-4, DeepL) and German (GPT-4). In a subset of 31 questions where English translations yielded fewer correct responses than Japanese originals, professionally translated questions yielded better scores than those translated by GPT-4 (13 versus 8 points, p = 0.0079). GPT-4 exhibits higher accuracy when responding to English-translated questions compared to original Japanese questions, a trend not observed with German or Chinese translations. Accuracy improves with higher-quality English translations, underscoring the importance of high-quality translations in improving GPT-4's response accuracy to diagnostic radiology questions in non-English languages and aiding non-native English speakers in obtaining accurate answers from large language models.

Lexical coverage in L1 and L2 viewing comprehension

Abstract This study aimed to investigate the relationship between lexical coverage and TV viewing comprehension. Previous studies have indicated that 95% to 98% of lexical coverage may be needed for reading comprehension (Hu & Nation, 2000). To understand informal listening passages, lower coverage figures (95%-90%) may suffice. However, no study has researched the lexical coverage needed to understand audiovisual texts. We adopted a counter-balanced within-participants design, in which 5%, 10%, or 20% of the words in four 2-min documentaries were replaced with nonwords. Native and non-native speakers of English participated in this study. Results showed that comprehension scores decreased as lexical coverage decreased; comprehension at 100% coverage was significantly higher than 90% and 80% in the two groups; and optimal adequate comprehension is achieved with an optimal lexical coverage of 95%, whereas minimal adequate comprehension is reached with a minimal lexical coverage of 80%.