Understanding Medication Adherence in Patients with Limited English Proficiency

Introduction. Approximately 41.6% of the US population who speak a language other than English (20% over all) and have limited English proficiency (LEP) status.1 Health outcomes for patients with LEP status or who are language discordant (speak a different language than their clinicians) have been studied in several settings, including the hospital and outpatient, with results widely demonstrating that these patients have worse outcomes when a professional interpreter is not used consistently. 2,3 The aim of this study was to investigate the impact of preferred language and language discordance on medication adherence. Methods. Data were collected via review of pharmacy-acquired medication profiles for three primary language cohorts: Nepali, Spanish, and English. Total Days of Adherence, Adherence Ratio, and Maximum Days Non-adherent were calculated and compared between language groups. We examined these statistics for regular and long-acting insulin, metformin and ACE inhibitors, testing for differences between language groups and those who experienced greater vs less than the median value for language concordant clinical encounters. Results. The most adherent group over all (highest adherence-ratio) were the Nepali-speaking, but the results showed high variability across outcomes and medications. Conclusions. After adjustment and stratification for greater vs lesser language concordant patient visit experience, we found that language-spoken plays an important role in the clinical encounter, and that LEP patients could have improved outcomes in their adherence to medications by having providers who speak their language or use an interpreter.

HOMEOSTASIS AND COMPENSATION AS LINGUISTIC PHENOMENA (COMPETITION OF ASPECT AND TENSE ON THE EXAMPLE OF SLAVIC LANGUAGES WITH SPECIAL REGARD TO POLISH)

The present paper deals with two universal linguistic phenomena, homeostasis and compensation. The author examines their function in relation to two categories, aspect and tense in the history of the Slavic languages. It is beyond doubt that one of the most important categories of the Slavic verb is aspect the origin of which may lie in the Proto-Indo-European language. The effects of its emergence as a verbal category were far-reaching and can be well traced in the history of the most Slavic languages. Taking a close look to the linguistic data, it seems quite obvious that the category of tense and aspect were closely related and did interact, creating different patterns in modern Slavic languages. A certain competition between the category of aspect and that of tense can already be observed in Old Slavic and also in Old Russian and Old Polish where tenses like the aorist and the imperfect were becoming increasingly obsolete. The perfect, on the contrary, has gained ground, while the pluperfect has almost completely fallen into disuse. In the further development, the aspectual opposition also extended to the future tenses thereby affecting the entire tense system. This scenario took place everywhere in the East and West Slavic languages with some nuanced differences. Consequently, in the aspect-tense system of the modern East and West Slavic languages the tendency of the category of aspect to prevail over the category of tense together with the gradual decline in the number of tenses seems to be quite clear. The South Slavic languages, however, have taken a slightly different path showing perhaps the most complex picture. Although the Serbian and Croatian languages have preserved the old tenses, their use is rather limited. In terms of their aspectual development, these languages are getting closer and closer to the Eastern and Western Slavic language groups. In contrast, in Bulgarian and Macedonian one can see an intricate interplay of the aspectual system and the developed tense system. In the case of the change of the different Slavic languages, the phenomenon of linguistic compensation can be observed in all cases on the example of aspect and tense categories as the main means of striving to maintain linguistic homeostasis. Keywords: linguistic homeostasis, compensation, aspect, tense, Old Slavic, Slavic languages, Polish

Who Owns the Central Mosque? Ethnic Identity and the Struggle for Spiritual Space in Epe, Southwest Nigeria

Religion and ethnicity are core attributes of identity in West Africa, and the majority of the population defines itself in relation to these values. But most studies of religious conflict in Nigeria focus on the conflicts between the two great world religions, Islam and Christianity. Equally, studies of ethnic conflict tend to focus on conflict between different language groups. This article shows that it is also important to focus on sub-ethnic difference, and the meso-level conflicts and tensions that often occur within each faith. In Epe, a coastal town in Lagos, southwest Nigeria over eighty percent of the population profess Islam, but remain distinguished as different social and ethnic sub-groups, as “Ijebu Epe” and “Eko Epe.” Over time, both groups invested in ethno-religious contestation, which led to open conflict when they were brought together in the same local Council and differed over the ownership of the only Central Mosque in the town. The study shows that the struggle for the soul of the first Epe Central Mosque at Oke Balogun between Ijebu Epe and Eko Epe was used in pursuit of both spiritual and political power, and in order to gain control over important resources. This study therefore provides empirical evidence that ethnic and group differences do affect some aspects of religious practices and can even lead to rivalry within the same religion.

Acquiring Word Order in Slovak as a Foreign Language: Comparison of Slavic and Non-Slavic Learners Utilizing Corpus Data

The paper deals with the acquisition of Slovak word order in written texts of students of Slovak as a foreign language. Its attention is focused on identifying the correct and incorrect placement of enclitic components, and their erroneous usage is analysed with respect to different investigated variables (types of enclitic components, types of syntactic construction, distance from lexical/syntactic anchor, and realization in pre- or post-verbal position). The paper also pays attention to the error rate regarding individual proficiency levels of students, and error distribution in two language groups, Slavic and Non-Slavic learners, is compared.

Linguistic Movements and Political Heterogeneity: Rethinking Unification Movement across British and ‘Princely’ Karnataka

Subsequent to the Partition of Bengal in 1905, the consolidation of linguistic identities and movements emerged as an important assertion of core democratic values, positing that governance must be in a language intelligible to the majority. Like other linguistic movements in late-colonial India, the Karnataka Ekikarana (Karnataka unification) movement did not proceed with a spatially uniform logic nor followed a uniform temporality in realising its objectives of uniting Kannada speakers from disparate sub-regions. Attempting to reconcile elite literary ambitions, popular aspirations and political differences, the movement shifted gears through several phases as it worked across multiple territorial jurisdictions and political systems, including the demarcations of British India and princely India. Focussing on the period between 1860 and 1938, the present article examines the heterogeneous nature of the unification movement across British-Karnataka and two Kannada-speaking princely states, namely, Mysore in the south and Jamakhandi in the north. It explores the ways in which the ruling family of ‘model’ Mysore sought legitimacy in embracing their Kannada heritage; in contrast, the Jamakhandi rulers resisted any concession to Kannada linguistic sentiments. The article shows how, in arriving at monolingually indexed territorial entities, the bridging of ‘internal’ frontiers across these divergent political and linguistic contours proved just as crucial as the claiming of dominance over other language groups within an intensely polyglot world.

An analysis of note-taking strategies: The effect of translanguaging on content comprehension and knowledge retention

Purpose This study investigates the effectiveness of using translanguaging for note-taking on students’ lecture comprehension and retention by measuring their scores on two tests administered two weeks apart. Methods The participants were English L2 Chinese graduate students (n = 101) studying in English-language programs in various English-speaking countries at the time of the study. The study used a quasi-experimental three-arm parallel groups design to compare the relative effects of three alternative approaches to note-taking (Chinese, English, and translanguaging). All participants watched a five-minute English-language video without subtitles and took notes using their assigned strategies. Then participants immediately took a comprehension test. After two weeks, participants took a retention test. Results The results showed that those taking notes in English only outperformed those taking notes using Chinese only on low-level, fact-based questions in the comprehension test. There was no significant difference found among the three language groups (Chinese, English, and translanguaging) in other types of questions (main topic questions and numerical questions) and the overall score. In the retention test, those taking notes in English outperformed those taking notes in Chinese in the overall score and all question types except for number-based questions, with the translanguaging groups also outperforming the Chinese group in fact-based questions. In addition, students’ previous study abroad experience was not found to impact students’ comprehension and retention of the video lecture content. Conclusion It seems that translanguaging does not aid advanced L2 learners in immersion contexts; instead, translanguaging may be more helpful for lower proficiency L2 learners.

STRATEGIES IN CONVEYING INFORMATION ABOUT UNSHARED EVENTS USING AIDED COMMUNICATION

Describing events may be challenging for any child, but children who use communication aids may face unique linguistic, pragmatic, and strategic challenges in conveying information with the communication means they have available. This study explores strategies used by young, aided communicators when describing the content of a video unknown to their communication partners. The participants of the study were 48 aided communicators (aged 5;3–15;2) from nine countries and seven language groups and their communication partners (parents, professionals, and peers) who used natural speech. Descriptive and statistical analyses were utilized to investigate the relationships between individual characteristics, linguistic and non-linguistic factors, linguistic strategies, and performance in conveying the content of the video event. Analyses of the 48 videotaped interactions revealed the use of a variety of linguistic elements and multimodal strategies, demonstrating both creativity and challenges. Success in relaying messages was significantly related to age, mode of communication, and individual profiles, such as everyday communication functioning and comprehension of grammar. Measures of receptive vocabulary and non-verbal reasoning were not significantly related to communicative success. The use of shared context and negotiation of meaning of potentially ambiguous utterances demonstrate the shared responsibility of disambiguation and meaning construction in interactions involving aided and naturally speaking communicators.

The Contribution of Bilingualism to Cognitive Functioning and Regional Brain Volume in Normal and Abnormal Aging

We examined the association between bilingualism, executive function (EF), and brain volume in older monolinguals and bilinguals who spoke English, Spanish, or both, and were cognitively normal (CN) or diagnosed with Mild Cognitive Impairment (MCI) or dementia. Gray matter volume (GMV) was higher in language and EF brain regions among bilinguals, but no differences were found in memory regions. Neuropsychological performance did not vary across language groups over time; however, bilinguals exhibited reduced Stroop interference and lower scores on Digit Span Backwards and category fluency. Higher scores on Digit Span Backwards were associated with a younger age of English acquisition, and a greater degree of balanced bilingualism was associated with lower scores in category fluency. The initial age of cognitive decline did not differ between language groups. The influence of bilingualism appears to be reflected in increased GMV in language and EF regions, and to a lesser degree, in EF.

Psychosocial Contributors to Depressive Symptoms in Hispanic Patients With Type 2 Diabetes

Purpose The purpose of this study is to identify psychosocial factors associated with depressive symptoms in Hispanic patients with diabetes and explore the extent to which their effects may vary by gender and acculturation. Methods The authors completed a secondary analysis of data from 247 Hispanic adults with type 2 diabetes. Gender and language groups were compared using chi-square and t tests. Hierarchical multiple regression was used to examine associations of depressive symptoms with perceived support, diabetes-related distress, and social and personal factors. Results Women reported less support than men. English speakers reported more depressive symptoms than Spanish speakers. When adjusting for age, gender, and acculturation, psychosocial factors significantly associated with depressive symptoms included less support received, greater emotional burden, and less ability to socialize or pursue normal activities because of diabetes. Conclusions Social support provided by family among less acculturated Hispanics may play an important role in reducing emotional burden and lowering the risk of comorbid depression. The quality of interpersonal relationships and the ability to continue normal activities may also be important. More acculturated Hispanic women with diabetes may be at greater risk for comorbid depression and worse health outcomes. Screening for depression and assessment of support needs is warranted for Hispanic women.