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Providing linguistically appropriate services to persons with limited English proficiency: a needs and resources investigation.

Increasing numbers of persons in the United States cannot speak, read, write, or understand the English language at a level that permits them to interact effectively. These limitations can hamper encounters between patients and healthcare providers, often leading to misunderstandings as to diagnosis and treatment, which in turn may result in poor patient compliance, unsatisfactory outcomes, and increased costs. A questionnaire was developed and distributed to clinical practice managers at the University of Maryland School of Medicine to assess the needs for language interpretation services and resources among clinical faculty providing healthcare to persons with limited English proficiency (LEP). Literature review, search of key Web sites, and consultation with national experts on issues pertaining to language access, health services, and reimbursement strategies also were done. Then, recommendations regarding the costs and benefits of language interpretation in healthcare settings were developed. Because recipients of federal financial assistance from the Department of Health and Human Services must provide meaningful access to persons with LEP at no cost to the client, there are clear benefits to providing language interpretation. Providers and managers should be made aware of interpretation service options and cost-saving strategies.

Communication↗

Cultural competency as it intersects with racial/ethnic, linguistic, and class disparities in managed healthcare organizations.

Culture in and of itself is not the most central variable in the patient-provider encounter. The effect of culture is most pronounced when it intersects with low education, low literacy skills, limited proficiency in English, culture-specific values regarding the authority of the physician, and poor assertiveness skills. These dimensions require attention in Medicaid managed care settings. However, the promise of better-coordinated and higher quality care for low-income and working-poor racial/ethnic populations--at a lower cost to government--has yet to be fully realized. This paper identifies strategies to reduce disparities in access to healthcare that call for partnerships across government agencies and between federal and state governments, provider institutions, and community organizations. Lessons learned from successful precedents must drive the development of new programs in Medicaid managed care organizations (MCOs) to reduce disparities. Collection of population-based data and analyses by race, ethnicity, education level, and patient's primary language are critical steps for MCOs to better understand their patients' healthcare status and improve their care. Research and experience have shown that by acknowledging the unique healthcare conditions of low-income racial and ethnic minority populations and by recruiting and hiring primary care providers who have a commitment to treat underserved populations, costs are reduced and patients are more satisfied with the quality of care.

Cost Control↗

[Transformation of the names of certain herbs by linguistic transfer - colchicum, wormseed, soybean, nandina and wijnruit].

Five examples of transformation of the names of certain herbal medicines by transfer from one language to another are presented: (1) to meadow saffron (colchicum) from Medea's saffron, (2) from semenzina to semen cinae or semen China, (3) from the Japanese condiment sho-yu to soy and soybeans, (4) from the Japanese plant nanten to the genus Nandina, and (5) from the Dutch term wijnruit (wine-ruta) to hen-ruda in Japanese. In most cases, the transformation underwent phonetically and resulted in a departure from the original meaning.

China↗

Spatial differentiation of RH and GM haplotype frequencies in Sub-Saharan Africa and its relation to linguistic affinities.

This study analyzes patterns of variation in eight GM and seven Rhesus (RH) haplotypes across sub-Saharan Africa. We examine the concordance with genetic patterns of both geographic and language-family relationships by spatial analysis and ordination techniques. The genetic variation has significant spatial structure, but positive autocorrelation declines neither asymptotically nor proportionally with increasing distance. Evidently, neither isolation by distance with increasing distance. Evidently, neither isolation by distance nor clinical migration-selection models account for the observed genetic structure. Language-family relationship is the best predictor of genetic relationship and may reflect historic migrations and expansions of ethnically different peoples within sub-Saharan Africa. Yet the greatest part of the genetic variance remains unexplained by the models we have tested.

Africa, Central↗

Genetic polymorphisms in the Croatian ethno-linguistic minority of Italy.

Phenotype and gene frequencies of twelve genetic markers (ABO, RH, MNS, ACP1, ESD, PGD, PGM1, PGM2, HB, ALB, CP and HP) of the three Croatian communities (Acquaviva Collecroce, Montemitro and S. Felice del Molise) living in Southern Italy are reported. From the comparison with the surrounding Italian population and with Balkan populations, some instances of still incomplete genetic admixture can be inferred (ABO*A and O, ESD, PGD and PGM1).

Adolescent↗

Linguistic and cognitive failures in schizophrenia. A multivariate analysis.

Schizophrenic (N = 38), manic (N = 30), and normal (N = 25) subjects were examined with laboratory tasks measuring serial recall and encoding, distractibility, and reality monitoring. In addition, the psychiatric patients were examined with three measures of verbal communication disorder, including positive thought disorder, negative thought disorder, and frequency of reference failures. It was found that positive thought disorder and reference failures in schizophrenics were best predicted by measures of distractibility and reality monitoring, with communication disorder in mania, although common and severe, not predicted by these cognitive performance measures. Furthermore, negative thought disorder in schizophrenics was not predicted by the cognitive measures. These results are discussed in terms of their implications regarding the differences in potential determinants of positive and negative thought disorders.

Adult↗

[Speech therapy for children with cleft lips and palates. I. Basic linguistic considerations].

According to several basic principals of hermeneutic theory (theory of understanding natural languages) we describe the major fields of language acquisition in which anomalies of CPL children often can be found. Besides phonation and articulation there are morphological, psychomotoric, onomatopoetic, and isotopic disorders. Also a delay of understanding by listening is often observed. Additionally some cofactors in psychodynamics of the family have to be respected. Defense mechanisms, somatization, and social symptomatization are described. Some examples from statistics and experimental psycholinguistics show, that a diagnosis of early language acquisition can't be found by comparing means (naive model of diagnosis). We show how to find out the multiple covariance of early language acquisition tests with the control groups. A final case study shows a typical process of CLP children's language acquisition.

Child↗