non-English Speaking Research Articles

Age Impacts Speech-in-Noise Recognition Differently for Nonnative and Native Listeners.

The purpose of this study was to explore potential differences in suprathreshold auditory function among native and nonnative speakers of English as a function of age. Retrospective analyses were performed on three large data sets containing suprathreshold auditory tests completed by 5,572 participants who were self-identified native and nonnative speakers of English between the ages of 18-65 years, including a binaural tone detection test, a digit identification test, and a sentence recognition test. The analyses show a significant interaction between increasing age and participant group on tests involving speech-based stimuli (digit strings, sentences) but not on the binaural tone detection test. For both speech tests, differences in speech recognition emerged between groups during early adulthood, and increasing age had a more negative impact on word recognition for nonnative compared to native participants. Age-related declines in performance were 2.9 times faster for digit strings and 3.3 times faster for sentences for nonnative participants compared to native participants. This set of analyses extends the existing literature by examining interactions between aging and self-identified native English speaker status in several auditory domains in a cohort of adults spanning young adulthood through middle age. The finding that older nonnative English speakers in this age cohort may have greater-than-expected deficits on speech-in-noise perception may have clinical implications on how these individuals should be diagnosed and treated for hearing difficulties.

Universal and Language-Specific Connected Speech Characteristics of Bilingual Speakers With Alzheimer's Disease: Insights From Case Studies of Structurally Distinct Languages.

Connected speech analysis has been effectively utilized for the diagnosis and disease monitoring of individuals with Alzheimer's disease (AD). Existing research has been conducted mostly in monolingual English speakers with a noticeable lack of evidence from bilinguals and non-English speakers, particularly in non-European languages. Using a case study approach, we characterized connected speech profiles of two Bengali-English bilingual speakers with AD to determine the universal features of language impairments in both languages, identify language-specific differences between the languages, and explore language impairment characteristics of the participants with AD in relation to their bilingual language experience. Participants included two Bengali-English bilingual speakers with AD and a group of age-, gender-, education-, and language-matched neurologically healthy controls. Connected speech samples were collected in first language (L1; Bengali) and second language (L2; English) using a novel storytelling task (i.e., Frog, Where Are You?). These samples were analyzed using an augmented quantitative production analysis and correct information unit analyses for productivity, fluency, syntactic and morphosyntactic features, and lexical and semantic characteristics. Irrespective of the language, AD impacted speech productivity (speech rate and fluency) and semantic characteristics in both languages. Unique language-specific differences were noted on syntactic measures (reduced sentence length in Bengali), lexical distribution (fewer pronouns and absence of reduplication in Bengali), and inflectional properties (no difficulties with noun or verb inflections in Bengali). Among the two participants with AD, the individual who showed lower proficiency and usage in L2 (English) demonstrated reduced syntactic complexity and morphosyntactic richness in English. Evidence from these case studies suggests that language impairment features in AD are not universal across languages, particularly in comparison to impairments typically associated with language breakdowns in English. This study underscores the importance of establishing connected speech profiles in AD for non-English-speaking populations, especially for structurally different languages. This would in turn lead to the development of language-specific markers that can facilitate early detection of language deterioration and aid in improving diagnosis of AD in individuals belonging to underserved linguistically diverse populations. https://doi.org/10.23641/asha.25412458.

Adaptation of the Communities That Care Youth Survey for Use in Estonia: A Pilot Study.

The Communities That Care Youth Survey (CTCYS) assesses risk and protective factors, predicting a range of behavioural health problems, including substance use, violence, and delinquency. Although the survey has been adapted to other contexts and languages, further studies on cross-cultural adaptations, particularly in non-English speaking countries, are needed. In 2022, CTCYS was adapted for Estonia, incorporating 38 risk and protective factors, along with measures of substance use, antisocial behaviour, mental health problems, and self-harm. This study investigated the psychometric properties and applicability of the CTCYS in Estonia. The adaptation process involved translating and refining the US CTCYS, followed by focus group discussions with students and specialists and a pilot study in two municipalities, with data obtained from 265 students. A focus group with municipality members explored the measure's feasibility. Results indicate that the original CTC framework largely captures key issues within the Estonian context. Overall, the survey showed good validity, as evidenced by its ability to predict problem outcomes through both risk and protective factors. Regarding reliability, with the removal of one item, internal consistency reached acceptable levels for all but eight risk and protective factor subscales. The most problematic scales in the Estonian context were Prosocial Involvement, Social Skills, and Belief in the Moral Order. Municipality members perceived the measure as useful but highlighted some challenges regarding its practicality and comprehensibility. It became clear that other elements are needed to effectively support communities in using the CTCYS results for preventive efforts.

Influence of Talker and Accent Variability on Rapid Adaptation and Generalization to Non-Native Accented Speech in Younger and Older Adults

ABSTRACT Listeners can rapidly adapt to English speech produced by non-native speakers of English with unfamiliar accents. Prior work has shown that the type and number of talkers contained within a stimulus set may impact rate and magnitude of learning, as well as any generalization of learning. However, findings across the literature have been inconsistent, with relatively little study of these effects in populations of older listeners. In this study, adaptation and generalization to unfamiliar talkers with familiar and unfamiliar accents are studied in younger normal-hearing adults and older adults with and without hearing loss. Rate and magnitude of adaptation are modeled using both generalized linear mixed-effects regression and generalized additive mixed-effects modeling. Rate and magnitude of adaptation were not impacted by increasing the number of talkers and/or varying the consistency of non-native English accents across talkers. Increasing the number of talkers did strengthen generalization of learning for a talker with a familiar non-native accent, but not for an unfamiliar accent. Aging alone did not diminish adaptation or generalization. These findings support prior evidence of a limited benefit for talker variability in facilitating generalization of learning for non-native accented speech, and extend the findings to older adults.

Miscommunication and Mismatched Expectations: Challenges in an EFL Writing Center

Recently writing centers are expanding to Asian higher education contexts. However, there is a scarcity of research from writing centers in Asian settings and from non-native English speaker (NNES) tutor perspectives. Therefore, the purpose of this study is to enrich understandings of the challenges and expectations perceived by NNES tutors during tutoring writing sessions with intermediate level Japanese EFL (English as Foreign Language) students. A qualitative approach was employed utilizing two data collection methods: 16 interviews with writing tutors, and two quasi-focus groups. Thematic analysis of the data revealed five major categories for challenges perceived by NNES tutors: miscommunication, student silence, mismatched expectations, interpretation of teacher feedback and error correction. It is argued that these are the main challenges that EFL writing tutors face and hence indicate the necessity to train tutors how to deal with them. The implications for creating Asian writing centers and tutor training are discussed.

Should Medicine be Taught in Leading Medical Languages or the Mother Tongue?

Abstract In non-English speaking developing countries, several debates have arisen over choosing the language of instruction in medical education, whether it should be one of the leading medical languages, such as English, or the mother tongue. In this article, we discuss this debate and provide a brief review of the pedagogical evidence supporting the superiority of the mother tongue as a language of instruction. We also highlight the academic challenges associated with second-language-based medical education and emphasize the impact of language of instruction on the doctor–patient relationship and health care. Finally, we examine the reasons or arguments for not including the mother tongue in medical education. In conclusion, the importance of English as a leading scientific and medical language should not overshadow the crucial role of the native language as the language of instruction in non-English speaking countries. Each country should develop strategies to include the mother tongue in medical education, following the example of developed countries.

The Influence of Meta-Cognitive Listening Strategies on Listening Performance in the MALL: The Mediation Effect of Learning Style and Self-Efficacy

The ability to understand listening is an essential skill for non-native speakers of English as a foreign language (EFL). Research has shown that several factors can influence EFL students’ English listening comprehension, including the listening strategy they use during listening activities. This study, therefore, used the meta-cognitive listening strategy to explore the mediation role of learning style and self-efficacy in the relationship with listening performance. In this study, 632 Chinese university students participated in a survey and completed electronic questionnaires on MALQ (Meta-cognitive Awareness of Listening Questionnaire), PLSPQ (Perceptual Learning Style Preference Questionnaire), and GSE (General Self-Efficacy Scale). The data were analyzed using AMOS software and a structural equation modeling (SEM) technique. The results showed that students’ listening strategy directly and positively predicted their English listening performance. Moreover, students’ listening performance was fully mediated by learning style and self-efficacy. After discussing these findings, suggestions as well as limitations for future studies will be given. The findings of this study are expected to contribute to a better understanding of the factors that may affect EFL students’ English listening comprehension and inform instructional practices in the EFL classroom. Specifically, the results of this study may suggest the use of teaching strategies tailored to individual learning styles and the adoption of measures to improve self-efficacy of EFL students. Ultimately, the goal of this research is to improve EFL students’ English listening comprehension skills and enhance their overall language proficiency.

Feasibility Study on the Application of Interactive Teaching Model in TESOL under the Background of Universal Grammar and L2 Acquisition Model

The interactive teaching model is a new teaching methodology that is quite different from the traditional teaching model based on teacher's lectures and rote learning. It plays an important role in teaching English to non-native speakers of English, and more and more Teaching English to Speakers of Other Languages (TESOL) practitioners are trying to adopt this model in their teaching. This paper will analyse the specific role played by the interactive teaching mode in TESOL from a linguistic point of view, and study the feasibility of the application of this mode in English teaching under the framework of Chomsky's Universal Grammar and Krashen's theory of second language acquisition. The teaching model will be analysed through the research methodology of literature study within the theoretical framework of universal grammar, input hypothesis, affective filter hypothesis and monitoring model. Through the study, this paper concludes that the interactive teaching model is in line with linguistic findings such as Universal Grammar and L2 Acquisition Theory, and its application in TESOL is highly feasible.

Exploring the relationship between language, postoperative pain, and opioid use

Racial and ethnic disparities in pain management are well documented. Differences in pain assessment and management by language have not been studied in the postoperative setting in gynecologic surgery. This study aimed to investigate the association between language and immediate postoperative pain management by comparing pain assessments and perioperative opioid use in non-English speakers and English speakers. This was a retrospective cohort study comparing perioperative outcomes between non-English-speaking patients and English-speaking patients who had undergone a gynecologic oncology open surgery between July 2012 and December 2020. The primary language was extracted from the electronic medical record. Opioid use is expressed in oral morphine equivalents. Proportions are compared using chi-square tests, and mean values are compared using 2-sample t tests. Although interpreter services are widely available in our institution, the use of interpreters for any given inpatient-provider interaction is not documented. Between 2012 and 2020, 1203 gynecologic oncology patients underwent open surgery, of whom 181 (15.1%) were non-English speakers and 1018 (84.9%) were English speakers. There was no difference between the 2 cohorts concerning body mass index, surgical risk score, or preoperative opioid use. Compared with the English-speaking group, the non-English-speaking group was younger (57 vs 54 years old, respectively; P<.01) and had lower rates of depression (26% vs 14%, respectively; P<.01) and chronic pain (13% vs 6%, respectively; P<.01). Although non-English-speaking patients had higher rates of hysterectomy than English-speaking patients (80% vs 72%, respectively; P=.03), there was no difference in the rates of bowel resections, adnexal surgeries, lengths of surgery, intraoperative oral morphine equivalents administered, blood loss, use of opioid-sparing modalities, lengths of hospital stay, or intensive care unit admissions. In the postoperative period, compared with English-speaking patients, non-English-speaking patients received fewer oral morphine equivalents per day (31.7 vs 43.9 oral morphine equivalents, respectively; P<.01) and had their pain assessed less frequently (7.7 vs 8.8 checks per day, respectively; P<.01) postoperatively. English-speaking patients received a median of 19.5 more units of oral morphine equivalents daily in the hospital and 205.1 more units of oral morphine equivalents at the time of discharge (P=.02 and P=.04, respectively) than non-English-speaking patients. When controlling for differences between groups and several factors that may influence oral morphine equivalent use, English-speaking patients received a median of 15.9 more units of oral morphine equivalents daily in the hospital cohort and similar oral morphine equivalents at the time of discharge compared with non-English-speaking patients. Patients who do not speak English may be at risk of undertreated pain in the immediate postoperative setting. Language barrier, frequency of pain assessments, and provider bias may perpetuate disparity in pain management. Based on this study's findings, we advocate for the use of regular verbal pain assessments with language-concordant staff or medical interpreters for all postoperative patients.

Persistent depression in pregnant refugee and migrant women living along the Thai-Myanmar Border: a secondary qualitative analysis.

Antepartum depression affects around 15% of pregnant women worldwide, and may negatively impact their infants' physical, cognitive and social development, and confer a greater risk of emotional dysregulation in their children. Risk factors for antepartum depression disproportionately affect women from resource-sparse settings. In particular, pregnant refugee and migrant women face many barriers to diagnosis and care of mental health conditions, yet this group is under-represented in the literature. This study explores what refugee and migrant women living along the Thai-Myanmar border perceive as being contributory and protective factors to their antepartum depression, through secondary qualitative analysis of responses to clinical interviews for depression. Previous research investigating perinatal depression in pregnant refugee and migrant women on the Thai-Myanmar border involved assessing 568 women for depression, using the Structured Clinical Interview for the diagnosis of DSM-IV Disorders (SCID). This study analyses a subsample of 32 women, diagnosed with persistent depression during the antepartum period. Thematic analysis of responses to the SCID and social and demographic surveys was undertaken to investigate factors which contribute towards, or protect against, persistent antepartum depression. Major themes which women described as contributing towards persistent antepartum depression were financial problems, interpersonal violence, substance misuse among partners, social problems and poor health. Factors women considered as protecting mental wellbeing included social support, accessible healthcare and distractions, highlighting the need for focus on these elements within refugee and migrant settings. Commonly expressed phrases in local Karen and Burmese languages were summarised. Knowledge of factors affecting mental wellbeing in the study population and how these are phrased, may equip stakeholders to better support women in the study area. This study highlighted the limitations of contextually generic diagnostic tools, and recommends the development of tools better suited to marginalised and non-English speaking groups.

“Allot?” is “A Lot!” Towards Developing More Generalized Speech Recognition System for Accessible Communication

The proliferation of Automatic Speech Recognition (ASR) systems has revolutionized translation and transcription. However, challenges persist in ensuring inclusive communication for non-native English speakers. This study quantifies the gap between accented and native English speech using Wav2Vec 2.0, a state-of-the-art transformer model. Notably, we found that accented speech exhibits significantly higher word error rates of 30-50%, in contrast to native speakers’ 2-8% (Baevski et al. 2020). Our exploration extends to leveraging accessible online datasets to highlight the potential of enhancing speech recognition by fine-tuning the Wav2Vec 2.0 model. Through experimentation and analysis, we highlight the challenges with training models on accented speech. By refining models and addressing data quality issues, our work presents a pipeline for future investigations aimed at developing an integrated system capable of effectively engaging with a broader range of individuals with diverse backgrounds. Accurate recognition of accented speech is a pivotal step toward democratizing AI-driven communication products.

Construction and improvement of English vocabulary learning model integrating spiking neural network and convolutional long short-term memory algorithm.

To help non-native English speakers quickly master English vocabulary, and improve reading, writing, listening and speaking skills, and communication skills, this study designs, constructs, and improves an English vocabulary learning model that integrates Spiking Neural Network (SNN) and Convolutional Long Short-Term Memory (Conv LSTM) algorithms. The fusion of SNN and Conv LSTM algorithm can fully utilize the advantages of SNN in processing temporal information and Conv LSTM in sequence data modeling, and implement a fusion model that performs well in English vocabulary learning. By adding information transfer and interaction modules, the feature learning and the timing information processing are optimized to improve the vocabulary learning ability of the model in different text contents. The training set used in this study is an open data set from the WordNet and Oxford English Corpus data corpora. The model is presented as a computer program and applied to an English learning application program, an online vocabulary learning platform, or a language education software. The experiment will use the open data set to generate a test set with text volume ranging from 100 to 4000. The performance indicators of the proposed fusion model are compared with those of five traditional models and applied to the latest vocabulary exercises. From the perspective of learners, 10 kinds of model accuracy, loss, polysemy processing accuracy, training time, syntactic structure capturing accuracy, vocabulary coverage, F1-score, context understanding accuracy, word sense disambiguation accuracy, and word order relation processing accuracy are considered. The experimental results reveal that the performance of the fusion model is better under different text sizes. In the range of 100-400 text volume, the accuracy is 0.75-0.77, the loss is less than 0.45, the F1-score is greater than 0.75, the training time is within 300s, and the other performance indicators are more than 65%; In the range of 500-1000 text volume, the accuracy is 0.81-0.83, the loss is not more than 0.40, the F1-score is not less than 0.78, the training time is within 400s, and the other performance indicators are above 70%; In the range of 1500-3000 text volume, the accuracy is 0.82-0.84, the loss is less than 0.28, the F1-score is not less than 0.78, the training time is within 600s, and the remaining performance indicators are higher than 70%. The fusion model can adapt to various types of questions in practical application. After the evaluation of professional teachers, the average scores of the choice, filling-in-the-blank, spelling, matching, exercises, and synonyms are 85.72, 89.45, 80.31, 92.15, 87.62, and 78.94, which are much higher than other traditional models. This shows that as text volume increases, the performance of the fusion model is gradually improved, indicating higher accuracy and lower loss. At the same time, in practical application, the fusion model proposed in this study has a good effect on English learning tasks and offers greater benefits for people unfamiliar with English vocabulary structure, grammar, and question types. This study aims to provide efficient and accurate natural language processing tools to help non-native English speakers understand and apply language more easily, and improve English vocabulary learning and comprehension.

Acute rotenone poisoning: A scoping review

ContextRotenone is a toxic chemical found in various plants, including some used as food. Rotenone poisoning can be fatal and there is no antidote. Mechanistically, rotenone inhibits mitochondrial complex I, leading to reduced ATP production, compensatory glycolytic upregulation and secondary lactate production, and oxidative stress. Our literature review examined acute rotenone poisoning in humans, including exposure scenarios, clinical presentations, and treatments. MethodsWe searched five databases for relevant literature from database inception through the search date: July 12, 2022, pairing controlled vocabulary and keywords for “rotenone” with terms relating to human exposures and outcomes, such as “ingestion,” “exposure,” and “poisoning.” We included all peer-reviewed reports found using the search terms where the full English text was available. Data abstracted included the number, age, weight, and sex of the exposed person(s), country where exposure happened, exposure scenario, ingestion context, estimated dose, clinical features, whether hospitalization occurred, treatments, and outcomes. ResultsAfter removing non-qualifying sources from 2,631 publications, we identified 11 case reports describing 18 victims, 15 of whom were hospitalized and five died. Most cases occurred in private quarters where victims unknowingly consumed rotenone-containing plants. Vomiting and metabolic acidosis occurred most commonly. Some patients exhibited impaired cardiopulmonary function. Supportive treatment addressed symptoms and included gastric lavage and/or activated charcoal to remove rotenone from the stomach, vasopressors for hypotension, mechanical ventilation for respiratory insufficiency, and sodium bicarbonate for acidosis. Some patients received N-acetylcysteine to counter oxidative stress. ConclusionsRotenone poisoning, though rare, can be fatal. Exposure prevention is impractical since rotenone is found in some plants used as food or pesticides. Cases may be under-diagnosed because symptoms are non-specific and under-reported in English-language journals since most cases occurred in non-English speaking countries. Treatments are supportive. Exploring antioxidant therapy in animal models of rotenone poisoning may be indicated considering rotenone's mechanism of toxicity.

Patient Engagement With and Perspectives on a Mobile Health Home Spirometry Intervention: Mixed Methods Study.

Patient engagement attrition in mobile health (mHealth) remote patient monitoring (RPM) programs decreases program benefits. Systemic disparities lead to inequities in RPM adoption and use. There is an urgent need to understand patients' experiences with RPM in the real world, especially for patients who have stopped using the programs, as addressing issues faced by patients can increase the value of mHealth for patients and subsequently decrease attrition. This study sought to understand patient engagement and experiences in an RPM mHealth intervention in lung transplant recipients. Between May 4, 2020, and November 1, 2022, a total of 601 lung transplant recipients were enrolled in an mHealth RPM intervention to monitor lung function. The predictors of patient engagement were evaluated using multivariable logistic and linear regression. Semistructured interviews were conducted with 6 of 39 patients who had engaged in the first month but stopped using the program, and common themes were identified. Patients who underwent transplant more than 1 year before enrollment in the program had 84% lower odds of engaging (odds ratio [OR] 0.16, 95% CI 0.07-0.35), 82% lower odds of submitting pulmonary function measurements (OR 0.18, 95% CI 0.09-0.33), and 78% lower odds of completing symptom checklists (OR 0.22, 95% CI 0.10-0.43). Patients whose primary language was not English had 78% lower odds of engaging compared to English speakers (OR 0.22, 95% CI 0.07-0.67). Interviews revealed 4 prominent themes: challenges with devices, communication breakdowns, a desire for more personal interactions and specific feedback with the care team about their results, understanding the purpose of the chat, and understanding how their data are used. Care delivery and patient experiences with RPM in lung transplant mHealth can be improved and made more equitable by tailoring outreach and enhancements toward non-English speakers and patients with a longer time between transplant and enrollment. Attention to designing programs to provide personalization through supplementary provider contact, education, and information transparency may decrease attrition rates.

Characterization of Telerehabilitation Visits and Patient Satisfaction in Outpatient Physical Medicine and Rehabilitation Clinics From March 2020 to November 2021.

The aim of the study is to explore the usability of and satisfaction with telerehabilitation services provided to rehabilitation patients with various diagnoses at two large urban medical facilities during the COVID-19 pandemic. This was a usability study and all patients that received telerehabilitation services from March 2020 to November 2021 were included. Of the 4070 surveys sent via mail or email links to REDCap, 405 were completed (10% response rate). Participants completed demographic surveys, surveys on the telerehabilitation visit characteristics, telerehabilitation usability, and overall satisfaction with the visit. Patients were mostly women (64.4%), White, non-Hispanic (74.3%), and English-speaking (99%). Most patients were seen via telerehabilitation due to COVID-19 restrictions (37.1%). Patients were generally satisfied with their telerehabilitation visit (3.64 out of 4). Additionally, patients generally found telerehab to be useful (6.4 out of 7), easy to use (6.3 out of 7), effective (6.2 out of 7), satisfactory (6.3 out of 7), and comparable to in-person visits (6.5 out of 7). Patients generally reported feeling satisfied and comfortable with telerehabilitation visits and felt that they were comparable to in-person visits. Future research should examine the impact of socioeconomic factors on telerehabilitation use, with a focus on education level and non-English speakers.

Quality of Outpatient Pediatric Palliative Care Telehealth: A Retrospective Chart Review

ContextStudies suggest the feasibility and acceptability of telehealth in outpatient pediatric palliative care. However, there is a need for data that describes the implementation and quality of telehealth, relying on objective and validated measures. ObjectiveWe sought to compare the provision of pediatric palliative care by delivery method. MethodsWe conducted a retrospective electronic health record review of patients seen by our outpatient palliative care team over a two-year period. Demographic, diagnostic, and health utilization data as well as encounter characteristics were compared between patients seen in person (IP), through telehealth (TH), and both (IP/TH). ResultsThree hundred ninety-four patients were evaluated with 889 outpatient pediatric palliative care encounters. Non-English speaking patients were less likely to receive palliative care through TH, as were patients without active patient portals. Median follow-up time was longer for patients seen through TH or IP/TH. Patients with malignancies were seen more frequently IP while children with neurologic diagnoses, technology dependence, and a higher number of complex chronic conditions were seen more frequently via TH. Health outcomes, end of life quality metrics, and encounter-level quality indicators were similar across care delivery methods. Review of systems, pain, and mood management, and advance care planning happened more frequently IP while goals of care discussions and medical decision-making happened more through TH. ConclusionDespite differences in patients seen and palliative interventions provided in person compared to telehealth, health outcomes, and quality indicators were similar across care delivery methods. These data support the continued practice of telehealth in palliative care and highlight the need for equity in its evolution.

Experiences of Financial Stress and Supports in Caregivers During Pediatric Hospital Admission.

In Canada and the United States, ∼1 in 5 children live in poverty, contributing to poor health outcomes. Families with children with chronic illness may experience additional financial stress related to hospitalization. This study aimed to capture experiences of financial needs and supports among caregivers with a child admitted to a tertiary care pediatric hospital to inform hospital-based financial services to reduce financial stress in families. We recruited caregivers of children admitted to the general inpatient ward of an academic pediatric center using purposive sampling with no exclusion criteria. Individual, semistructured, in-depth interviews with participants were conducted. Data collected included socio-demographics, financial needs, and experiences with financial supports. Interviews were audio-recorded, transcribed verbatim, coded, and analyzed on NVivo software using a modified-grounded theory approach and summative content analysis. Fifteen caregivers of diverse backgrounds were interviewed, including non-English speakers (n = 4). Three themes and associated subthemes (in parentheses) were identified: (1) financial stress expressed by participants (acute admission-related and chronic financial stress), (2) challenges associated with accessing and utilizing financial supports (caregiver factors, systemic hospital factors, and systemic government factors), and (3) ideas for financial services at the pediatric hospital (services that will provide acute- and chronic financial assistance including education about financial supports and benefits). Our study highlighted acute and chronic financial needs as well as challenges in accessing financial support. Participants were interested in the healthcare system gaining a comprehensive understanding of their financial circumstances and accessing financial services in a hospital setting.

Barriers and strategies to implementing safe routes to school programs within disadvantaged communities: Interviews with state-level representatives

ObjectiveSafe Routes to School (SRTS) programs promote walking, bicycling, and other alternative transportation modes to school for children. These programs have shown increases in active transportation in children and implement programs through non-infrastructure (e.g., education) and infrastructure (e.g., sidewalks) projects. Although SRTS have been shown to be successful in increasing active transportation and promoting healthy lifestyles, many state SRTS representatives have noted many barriers to reaching disadvantaged populations (e.g., low-income, communities of color, individuals with disabilities, non-English speakers, etc.), which may be contributing to the various participation/injury/fatality disparities seen within these populations. Purpose/methodsThis study attempted to qualitatively understand the current barriers, successful strategies, and future resources/tools needed to provide equitable SRTS programming by interviewing state SRTS representatives/coordinators (or similar) (n = 13). Thematic analysis was conducted on interview transcripts, and eight common themes arose. ResultsThemes noted barriers to funding, community involvement, lack of personnel, and lack of proper education/experience/expertise within stakeholders., Common desired resources/tools were increased funding, the hiring of consultants, and a federal SRTS mandate. Strategies to address disparities focused on strategic partnerships, both within the government and with community organizations, providing consulting to communities, and access to funding. ConclusionVarious barriers were seen among state SRTS coordinators when attempting to reach disadvantaged populations. State SRTS coordinators should attempt to implement strategies to increase their capacity to reaching disadvantaged populations, including early contact with disadvantaged communities, hiring consultants for communities, and partnering with other government organizations who attempt to address the needs of disadvantaged students.

Long-term Quality of Life After Thyroidectomy: Transoral Endoscopic Thyroidectomy Vestibular Approach Versus Transcervical Approach.

To compare long-term health-related quality of life (HRQOL) after Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) and transcervical approach (TCA) thyroidectomy. Prospective cohort study. Tertiary referral center. A web-based survey was distributed to patients at our institution who met the criteria for TOETVA and underwent thyroidectomy by TOETVA or TCA between August 2017 and October 2021. All survey participants were at least 6 months postsurgery. Minors, non-English speakers, and patients who received concomitant neck dissection or reoperative thyroidectomy were excluded from the study. The survey assessed quality of life through 4 standardized instruments: the Dermatology Life Quality Index (DLQI), the Eating Assessment Tool (EAT-10), the Voice Handicap Index (VHI-10), and the Short Form Health Survey (SF-36). A total of 108 TOETVA and 129 TCA patients were included in the study. The median age of respondents was 44 (36, 54; 25th, 75th percentile) years and median time from surgery to survey was 35 (22, 45; 25th, 75th percentile) months. TOETVA group DLQI (0.63 vs 0.99; P = .17), VHI-10 (1.94 vs 1.67; P = .35), EAT-10 (2.14 vs 2.32; P = .29), SF-36 physical component (52.25 vs 51.00; P = .25), and SF-36 mental component (47.74 vs 47.29; P = .87) scores were all similar to those of the TCA group. Scrutinizing specific DLQI questions, individuals in the TOETVA group were less self-conscious of their skin as compared to the TCA group (Q2; 0.08 vs 0.26, P = .03). Long-term HRQOL after TOETVA is similar to TCA, with significantly lower skin-related self-consciousness.

Language Discordance in Music Therapy: A Phenomenological Study of Delivering Music Therapy Services with Interpreters

Abstract The United States Census Bureau suggests that the number of non-English speakers is on the rise, and thus, music therapists may be faced with working with patients who speak different languages, necessitating the need for language interpretation (Dietrich &amp; Hernandez, 2022). In efforts to explore and better understand music therapists’ experiences of delivering music therapy services with language interpreters, five music therapists were interviewed in a semi-structured format. Interviews were conducted and analyzed using interpretative phenomenological analysis. Five domains emerged from the data: (a) benefits of working with interpreters, (b) drawbacks of working with interpreters, (c) feelings associated when working with interpreters, (d) potential reasons why music therapists may not work with interpreters, and (e) considerations for music therapists working with interpreters. The findings provide a greater understanding of how music therapists currently work with interpreters, as well as indicate the need for increased education and awareness.