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Sexual coercion occurs when a person applies pressure to force another person to have unwanted sex. Yet, sociocultural expectations may also impact women’s sexual consent/refusal behaviors in the absence of partner pressure. We conducted a qualitative meta-synthesis to investigate factors contributing to incongruent sexual decision-making (i.e. internal feelings which are inconsistent with their consent/refusal behaviors) among women from westernized nations. A scoping review of eight databases was conducted following PRISMA guidelines. Our search yielded 2,946 articles, with 41 meeting inclusion and quality appraisal criteria. Results revealed sources of incongruent consent/refusal behaviors through five themes: (1) women experience communication barriers, (2) women internalize relationship norms and prioritize men, (3) women experience situational pressure, (4) women experience a fear of sexual violence, and (5) women manage a double bind of sexual behavior. We propose a novel concept to understand sociocultural factors influencing people’s consent/refusal behaviors that are incongruent with their internal feelings, labeled internalized sociocultural sexual pressure (ISSP). We conceptualize ISSP as a framework for internalizing sociocultural norms to a degree that they are influential or may even feel coercive, resulting in a spectrum of sexual consent/refusal behaviors, like acquiescing to unwanted sex and declining wanted sex. The intensity of ISSP experiences can vary significantly; some people may perceive these pressures as mild, whereas others may experience them to a degree that they feel coercive. [ABSTRACT FROM AUTHOR]

Older adults from UK minority ethnic backgrounds face increased marginalisation and inequalities within prison settings compared to the general prison population. Understanding the health and social care needs of people from minority ethnic backgrounds is essential to ensure equivalency of care, however, little research exists. This paper aims to explore the needs of older prisoners from minority ethnic backgrounds from the perspectives of multidisciplinary professionals. A nominal group discussion was conducted with 13 professionals with experience of supporting older prisoners from minority ethnic backgrounds. Six key themes were identified: 1) barriers to communication; 2) relationships with prison staff; 3) health competence; 4) stigma; 5) importance of family and spirituality; and 6) data collection and research. There was a consensus that the needs of older prisoners from minority ethnic backgrounds are complex and may not be adequately met in prison. Barriers faced by people from minority ethnic backgrounds include communication difficulties, a lack of diversity and cultural competence within the prison workforce, and stigma around seeking mental health support. Recommended solutions included greater collaboration with specialist community organisations, consideration of the composition and training of prison staff, and facilitation of family and spiritual support. The needs of older prisoners from minority ethnic backgrounds are unique and must be addressed in national policy. [ABSTRACT FROM AUTHOR]

This empirical study explores migrant inclusion in the linguistically diverse city of Glasgow. The particular focus is on the minoritisation of emergent speakers of English, who can find it especially difficult to access support. The research involved in-depth interviews with professionals at third-sector organisations supporting people with a refugee or migrant background. Interviewees gave examples of flexible communicative practices that support migrant inclusion. Such communicative practices can be understood in terms of translanguaging: the way that speakers fluidly draw on their full linguistic repertoires to make meaning. The analysis indicates that language minoritisation can be reduced when services better reflect the linguistic diversity of community members who access them. The examples given show how organisations can embrace linguistic diversity in ways that appear to enable inclusion, valuing the linguistic and cultural resources of recently arrived and settled community members. The article concludes that organisations which are more community led and linguistically diverse can better support the inclusion of language-minoritised migrants. [ABSTRACT FROM AUTHOR]

Resettled refugees face physical and mental health challenges including the violence and trauma of their displacement. Once resettled in the U.S. refugees face difficulties accessing healthcare. This qualitative study explored refugees' experiences with barriers and facilitators to accessing healthcare. Thirty-four resettled refugee adults from five different countries of origin participated in focus groups. Study results identified logistical and language barriers to accessing healthcare, experiences with discrimination and fear, and the role of integration in promoting access and satisfaction with healthcare. Implications are provided for improving access to healthcare for refugees in the U.S. [ABSTRACT FROM AUTHOR]

Purpose: To identify the sub-acute rehabilitation inpatients who have communication difficulty and the range of communication supports that can facilitate communicative success. Method: A prospective cohort mixed methods study was conducted on two inpatient sub-acute rehabilitation wards. Nurses screened all new admissions for communication difficulty using the Inpatient Functional Communication Interview, Screening Questionnaire (IFCI-SQ). Patients identified as having communication difficulty were interviewed by a speech-language pathologist (SLP) using the Inpatient Functional Communication Interview (IFCI). During the interview, the SLP trialled different communication supports. The number of patients who had communication difficulty on the IFCI-SQ was calculated. The number and type of communication supports that improved communication within the patient-SLP interview were calculated. Deductive-dominant qualitative content analysis was conducted on the communication supports used during the IFCI. Result: Seventy patients were screened. Nurses reported communication difficulty in 45/70 (64%) of patients. A total of 15/45 patients were interviewed by an SLP using the IFCI. The provision of communication supports improved communication for all patients within the context of the patient-SLP interview. Conclusion: Many sub-acute rehabilitation inpatients have communication difficulty in the hospital setting. A range of communication supports facilitated communication. These insights could inform future communication partner training (CPT) programs. [ABSTRACT FROM AUTHOR]

Along with the challenges and disruptions faced in the COVID-19 outbreak, medical tourism is an emergent field of business bringing multiple sources of service providers to provide cross-border medical treatment with affordable costs and touristic activity opportunities. The sustainability of medical tourism is of paramount importance in terms of economic, social and environmental dimensions with a high level of collaboration, coordination, cooperation and integration of the stakeholders of this service network. Hence, the purpose of this study is to analyze the sustainability objectives of medical tourism service with a detailed stakeholder involvement. In this regard, medical tourism stakeholders are identified via a systematic review of literature and industrial reports, and next, the objectives associated with sustainability are described in detail, then, a novel Fermatean Fuzzy MACTOR ('Matrix of Alliances and Conflicts: Tactics, Objectives and Recommendations') is proposed to determine the triggering relationship between each stakeholder and to highlight the convergency of each stakeholder towards each objective. Hence, the findings reveal the major responsibilities of stakeholders to achieve each individual sustainability objective. The analysis results indicate that even if the main service providers fulfil their duties perfectly, in case of having language barrier, demand of medical tourists cannot be sustained. [ABSTRACT FROM AUTHOR]

This study explores the perceptions of facilitators, barriers to communication and strategies in Malaysian school-aged children with non-syndromic cleft lip and palate (CL/P), parents, and teachers. Fourteen children with non-syndromic CL/P aged 7 to 12 years, their parents (n = 16), and their teachers (n = 10) were recruited via purposive sampling. Participants were selected based on resilience scores (RS-10; (Wagnild, 2015) distinguishing low (<34) from high resilience (35–40) (Wagnild, 2015). Individual in-depth interviews were conducted online and evaluated qualitatively. The analyses were conducted utilising the guidelines by Braun and Clarke (2006). Inductive thematic analysis was performed. Facilitators for communication identified by children, parents and teachers were the child's personal attributes, common interests, and helping others. Barriers that were identified were unfamiliar conversation partners, and insensitive comments or questions. Children used passive (e.g. ignored) and active (e.g. retorted, explained the condition) strategies to address social communication issues. Children with high resilience responded more actively than children with low resilience. Strategies that were described by the parents included accepting the child, empowering themselves, following the cleft management plan, and empowering the child. Teachers adopted general approaches such as giving encouragement, increasing confidence, and teaching empathy. The presence of face masks was perceived as both a facilitator and a barrier to communication. The study provides information on challenges encountered and coping mechanisms used by children with non-syndromic CL/P, their parents and their teachers. This knowledge may help the development of targeted interventions to support the communication of children with non-syndromic CL/P in school. [ABSTRACT FROM AUTHOR]

Older migrants face special difficulties in the access and use of long-term care services and supports (LTSS). Our study was designed to examine how older persons with limited English proficiency (LEP) in two groups of migrants (Spanish or Chinese speaking) interact with the LTSS system. Focus groups were used to elicit information from members of these groups. We discovered Chinese elders were likely to believe that the LTSS services could, if managed properly, meet their needs, while the Spanish speakers were more skeptical. These differences were associated with the presence of trusted intermediaries among the Chinese elders who could represent their interests, while most Spanish speakers did not report having such intermediaries. In this way, trust, or lack of it, was uncovered as the key element defining older adults' interactions with the formal health and social service systems. Findings will be used to develop a modeling method that will allow us to analyze results in a manner that can be extended to use with other migrant groups. [ABSTRACT FROM AUTHOR]

Introduction: Visible minorities, a growing segment of Canada's population, have voiced concerns about experiencing racism while receiving care in the emergency department (ED). Understanding the ED care experiences of visible minorities is crucial to improving care and reducing health disparities. Methods: From June to August 2021, we collected data from participants in Kingston, Ontario using a sensemaking approach. Individuals who had accessed emergency care or accompanied someone else to the ED in the prior 24 months were eligible to participate. After sharing a brief narrative about their care experience, participants interpreted the experience by plotting their perspectives on a variety of pre-determined questions. Here, we conducted a thematic analysis of narratives involving patients who identified as visible minorities and complemented it with quantitative analysis of the participants' interpretative responses. This mixed-methods approach highlighted the distinct experiences of visible minority participants in relation to a comparison group. Results: Of the 1973 unique participants, 117 identified as a visible minority and 949 participants did not identify with an equity-deserving group (comparison group). Visible minority participants were more likely to report that too little attention was paid to their identity and more likely to express a desire for a balance between receiving the best medical care and being treated with kindness and respect. Visible minorities' ED experiences were also more likely to be impacted by how emergency staff behaved. Qualitative analysis revealed negative experiences of feeling uninformed and disempowered, facing judgement and discrimination, and experiencing language barriers. Positive experiences of receiving compassionate care from staff also emerged. Conclusion: Visible minority perceptions of ED care were often negative and mainly focused on staff treatment. Cultural competency and language translation services are key areas for improvement to make ED care more accessible and equitable. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodResultsConclusionThrough-knee amputation (TKA) has potential advantages over above-knee amputation (AKA) but is rarely performed in the United Kingdom (UK). This mixed methods study aimed to explore clinicians’ perceptions of TKA compared to AKA.An online survey of vascular surgeons, prosthetists, and physiotherapists between May 2019 and April 2020. Follow-up semi-structured interviews explored themes from the survey. Thematic analysis was used to draw conclusions from the data.Seventy-eight clinicians returned surveys, and follow-up interviews were completed with 21 clinicians. Reported advantages of TKA include its long lever and the femoral condyles to anchor (suspend) the prosthesis. Perceived disadvantages include poor wound healing and unsatisfactory prosthetic appearance. The interviews uncovered ineffective communication along the amputation pathway, contributing to a compartmentalised approach to amputation surgery and rehabilitation. Clinicians with strong feelings against TKA and a lack of desire/perceived ability to drive change from clinicians in favour of TKA are barriers to increasing its use.Current TKA surgery and rehabilitation practice is based on personal opinions, assumptions, or “accepted wisdom” and lacks an underpinning evidence base. Overall, opinions of TKA are divided, with conflicting views between different professional groups, highlighting the importance of multidisciplinary decision-making.Implications for rehabilitationThrough-knee amputation has advantages and disadvantages compared to above-knee amputation which have been observed in clinical practice.Decision regarding level of amputation should involve multiple members of the multidisciplinary team.Lack of amputation pathway guidance and communication barriers prevent effective multidisciplinary collaboration.Through-knee amputation has advantages and disadvantages compared to above-knee amputation which have been observed in clinical practice.Decision regarding level of amputation should involve multiple members of the multidisciplinary team.Lack of amputation pathway guidance and communication barriers prevent effective multidisciplinary collaboration. [ABSTRACT FROM AUTHOR]

Objectives. Earlier work found gaps with respect to legislative compliance and disparities in perceptions, attitudes and beliefs towards occupational health and safety in the Ontario manufacturing sector. The current follow-up study was undertaken to gain a more thorough understanding of the cause of these gaps and differences in perspectives. Methods. Focus group discussions were held with workers and managers separately. Key questions related to health and safety in general, health and safety training, and health and safety communication were asked of each focus group. The discussions were qualitatively analysed. Results. Overall, 12 worker focus groups (n = 76) and seven manager focus groups (n = 38) were conducted. Individuals who felt safe in their workplace indicated that it was a supportive environment, and that health and safety was a priority. Health and safety training was considered important but improvements in engagement and frequency were suggested. Conclusions. Health and safety communication might be hindered by technical terms and language barriers. Delivering this communication in multiple ways as well as the tone of communication should be taken into consideration. Overall, safety culture was lacking and manufacturing workplaces should be mindful of the gaps identified to improve health and safety performance. [ABSTRACT FROM AUTHOR]

Background: Black birthing people in the United States are disproportionately impacted by maternal mortality and more frequently report physical and verbal mistreatment during intrapartum care. Birth plans for prenatal and postpartum care promote autonomy and agency but have not been used as tools to address disparities in perinatal care. Methods: We reviewed the literature on the use of birth plans and communication in the pregnancy care setting. We provide an expert analysis and a recommendation for a comprehensive birth plan that incorporates patient preferences and individualizes patient risks as a communication tool. Results: In this expert opinion we outline how an equity birth plan can address social determinants of health, promote respectful communication and prioritize attention to patient narratives. This instrument can be used to address systemic problems that result in health inequities on a community, provider and institutional level. Conclusions: A birth plan with attention to equity serves as a new paradigm for care which can empower patients and reduce racial inequities in perinatal and postpartum outcomes. [ABSTRACT FROM AUTHOR]

Objective: This case report describes the physiotherapy treatment of a soldier who suffered a severe combat blast injury. Methods: A 38-year-old Ukrainian man sustained blast injuries while driving over a mine during his service in the Ukrainian army. After receiving acute treatments, he was transferred to an academic hospital in the Netherlands. There, the man presented with severe soft tissue injuries on his back, as well as injuries to multiple organs, including the sciatic nerve and sacrum. Due to these injuries, the man could only lie in a prone position. His treatment goal was to be able to walk again. Results: The patient started physiotherapy, focussing on range of motion, strengthening the leg muscles, and functional transfers. Four months after the injury, he was able to achieve a standing position using a tilt table. Subsequent exercises were conducted to enable independent walking with a scale walker and, eventually, crutches. Seven months after the injury, the patient was transferred to a military rehabilitation centre. Rehabilitation efforts continued to increase joint mobility, improve muscle strength, build stamina with hydrotherapy, and enhance independence. Thirteen months after the blast injury, the man was independent in daily activities and could walk two kilometres without walking aids. Conclusion: This case report presents the challenging yet successful physiotherapeutic treatment of a soldier who suffered a blast injury. A dedicated multidisciplinary treatment team, progressive mobilisation with walking aids, targeted exercises, and the creative use of supportive materials contributed to the patient's recovery to independent daily functioning. [ABSTRACT FROM AUTHOR]

This paper reports on the ways that coherence emerged as an ableist norm within a systematic review of literature around broken narratives. It was undertaken as part of a larger programme of research investigating the experiences of those with impaired speech. The review identified 34 sources, within which we explored the ways that coherence was discussed. Throughout the review we argue that these texts draw on, and in many cases re-enact, coherence as an ableist norm. Discussions of broken narratives were often built upon the concept of coherence, a concept which has been naturalised and rendered essential to the formation of meaning and personhood. This norm is then employed to fuel a constitutional divide between broken and unbroken narratives. However, some of the texts provide the impetus to question the usefulness of normative ideals of coherence, and to re-evaluate how we can ensure the voice of impaired speakers is heard. Points of interest: This study examined 34 articles and book chapters about broken narratives. These texts came from many different disciplines and talked about many different types of illness and disability. Many of these texts talked about the importance of coherence in peoples' lives. Coherence was discussed not merely as an element of communicative success, but rather as a prerequisite to a healthy and functioning self. However, the stories of disabled people often do not follow cultural expectations of what a narrative should be. As a result disabled narratives are thought of as broken. When we try to enforce coherence on narratives or voices which do not fit our expectations we can end up silencing disabled people. These texts demonstrate the need to rethink the ways we understand coherence, allowing space to discover new ways of listening to disabled narratives. [ABSTRACT FROM AUTHOR]

This qualitative study explored language brokers' conceptualizations of their roles and responsibilities within the family in Sydney, Australia. Semi-structured interviews were carried out to obtain retrospective accounts of language brokering experiences from 14 self-identified language brokers, 10 females and four males aged between 19 to 49 years (Mean age = 31) who started brokering between ages 7 to 16 (M = 11). Participants were from varied ethnic and socio-cultural backgrounds (Turkish, Lebanese, Filipino, Vietnamese, Chinese and Greek/German). Thematic analysis identified three primary themes: "Hidden Carers: When Parent-Child Roles are Reversed"; "Lost Childhoods: Personal Sacrifice for the Good of the Family"; and "Protecting Parents: Language Brokers as Custodians of Information." Findings revealed that language brokering constitutes a form of hidden caregiving that carries with it several ramifications for the individual and their family. These findings have important implications for future research and policymakers working towards developing culturally responsive interventions that improve the health and wellbeing of language brokers and the resettlement experiences of migrants and their families. [ABSTRACT FROM AUTHOR]

This research paper investigates the impact of language barriers on help-seeking behaviors among Black immigrants, with a focus on their experiences in various domains, including accessing and utilizing domestic violence services. The research engages ten service providers, including frontline workers from domestic violence agencies. The study adopts a qualitative approach, incorporating interviews and focus groups, to comprehensively explore the complexities of language barriers and Black immigrant help-seeking behaviors through service providers' perspectives. The qualitative findings reveal that language proficiency plays a pivotal role in shaping the help-seeking behaviors of Black immigrants. Participants with limited language skills expressed challenges in articulating their needs, understanding available resources, and navigating different service systems. Moreover, cultural stigmatization surrounding help-seeking in certain communities further discourages Black immigrants from accessing support services, contributing to underutilization. The research highlights the importance of culturally sensitive service provision and the need for social work practitioners to receive training in cultural competence. Bridging the linguistic divide and creating inclusive service delivery models are crucial steps toward providing equitable access to support resources for Black immigrants. Furthermore, the study calls for future research to explore effective interventions and strategies to overcome language barriers and encourage help-seeking behaviors in this vulnerable population. [ABSTRACT FROM AUTHOR]

Purpose: Non-invasive ventilation (NIV) provides respiratory support without invasive endotracheal intubation but can hinder patients' ability to communicate effectively. The current study presents preliminary results using a novel in-mask ventilator microphone to enhance talker intelligibility while receiving NIV. Method: A proof-of-concept study assessed sentence intelligibility of five healthy adult talkers using a prototype model of the microphone under continuous positive airway pressure (CPAP; 5/5 cm H2O) and bilevel positive airway pressure (BiPAP; 8/4 cm H2O) ventilator conditions. A pilot study then assessed intelligibility, subjective comprehensibility and naturalness, and patient- and conversation partner-reported communication outcomes for eight patients undergoing therapeutic NIV while being treated in an intensive care unit (ICU). Result: Intelligibility increased significantly with the microphone on in the BiPAP condition for healthy volunteers. For patients undergoing NIV in an ICU, intelligibility, comprehensibility, and patient and conversation partner ratings of conversation satisfaction significantly improved with the microphone on. Patients with lower baselines without the microphone in certain measures (intelligibility, comprehensibility) generally showed a greater microphone benefit than patients with higher baselines. Conclusion: Use of a novel microphone integrated into NIV improved intelligibility during ventilation for both healthy volunteers and patients undergoing therapeutic NIV. Additional clinical studies will define precise benefits and implications of such improved intelligibility. [ABSTRACT FROM AUTHOR]

When the COVID-19 pandemic mandated the swift shift to fully online learning, it triggered not only large-scale resistance but also upskilling and experimentation in order to meet the urgent demands of the crisis. This paper chronologically and thematically examines literature from 2000 to the present regarding barriers to communication in culturally diverse online delivered classes. Two empirical surveys yielded data which generically correlate with literature findings. However, some of the results fall outside this trend, specifically, the inverse anticipated level of comfort among faculty and students in fully online settings and the dominance of personality over cultural differences hindering communication. We found that pre-pandemic communication barriers have changed in the in-pandemic fully online setting and that some barriers, particular to digital settings, have emerged which were not observed in in-person learning, specifically, the degree to which a camera-on policy for online classes negatively impacted student attendance and participation. [ABSTRACT FROM AUTHOR]

Objective: The current study explored differences in mental health problems, services utilization, and support of graduate students by gender, race/ethnicity, and year in school. Participants: Participants consisted of 734 graduate students from a large, Midwestern university. Methods: Graduate students answered a series of questionnaires in fall 2021 assessing their mental health, services utilization, and perception of services. Results: Women (vs men) and participants in their second year and beyond (vs first year) reported greater mental health problems, negative impact of the pandemic, and more services utilization. White (vs non-White) participants reported greater negative impact of the pandemic, greater services utilization, and less financial strain. Finances, lack of knowledge about resources, and inadequate communication from the university about services were reported as treatment barriers. Conclusion: Graduate students struggle with mental health, and universities may need to improve communication with and tailor their services to graduate students specifically to better support them. [ABSTRACT FROM AUTHOR]

Lack of feedback about reports made to Adult Protective Services (APS) is an important barrier to elder mistreatment reporting. To better understand barriers and facilitators to APS-reporter communication, we conducted an environmental scan of state policies and practices. We gathered publicly available information from 52 states and territories on APS administrative structure, reporting, intake, investigation, and feedback processes; performed a secondary analysis of focus groups with Emergency Medical Services providers and APS staff; and interviewed 44 APS leaders in 24 states/territories. Results revealed variation in information-sharing with reporters. Qualitative analyses revealed three overarching themes related to whether, when, and how information is shared. Results were used to develop a model illustrating factors influencing APS decisions on sharing information. This model incorporates the type of reporter (professional or nonprofessional), their relationship with the APS client (brief or ongoing), and the potential risks and benefits of sharing information with the reporter. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, policymakers had to quickly offer telehealth services to address older adults' needs. This study aimed to understand the experiences of providers who implemented a telephone-based telehealth tool named Socio-Geriatric Evaluation (ESOGER), which assessed health and social isolation risks in community-dwelling older adults in Quebec (Canada). This qualitative study used 20 semi-structured online/phone interviews with health and social service providers coming from publicly-funded healthcare facilities and community organizations. We included adopters and non-adopters of the telehealth tool. Interviews were audio-recorded and transcribed verbatim. We used reflexive thematic analysis to interpret the data. Three dimensions of providers' practice influenced the tool's implementation: service organization, working conditions, and interactions with older adults. Participants reported that the tool fostered continuity of care, provided guidance for their pandemic-related new tasks, and helped identify and support socially isolated older adults. Challenges to implementation included limited appropriateness of the telehealth tool for diverse services, feasibility barriers to adopting a new tool amid the health crisis, and acceptability challenges with some older adults. Despite relevance of the telehealth tool for providers, organizational, professional, and interactional barriers could hinder implementation success. Participatory approaches to telehealth may be promising avenues for future policies in this field. [ABSTRACT FROM AUTHOR]

The article examines the relationship between language and health equity, emphasizing language as a key factor in determining access to health services and information. Topics discussed include the ethical implications of language barriers, the importance of integrating language considerations into public health frameworks, and strategies for enhancing communication to improve health outcomes for marginalized populations.

The article explores the integration of intersectionality in understanding the health disparities faced by Limited English Proficiency (LEP) populations in relation to their legal status. Topics discussed include the impact of immigration status on access to healthcare, the role of language barriers in exacerbating health inequities, and the necessity of adopting an intersectional framework to inform policy and practice.

The article focuses on the importance of terminology in clinical and public health communication, advocating for the use of "non-English language preference" (NELP) over "limited English proficiency" (LEP) to better represent linguistic minority populations. Topics discussed include the multifaceted nature of language proficiency, the implications of using preference-based terminology, and the evolving nature of language in public health advocacy.

25.6 Million people in the United States have Limited English Proficiency (LEP), defined as insufficient ability to read, write, or understand English. We will (1) Delineate the merits of approaching language as a social determinant of health, (2) highlight pertinent public health values and guidelines which are most relevant to the plight of populations with LEP and (3) Use the COVID-19 pandemic as an example of how a breakdown in public health ethics values created harm for populations and patients with LEP. We define a framework to tease out public health responsibilities given some populations' limited proficiency in a society's predominant language. The American Public Health Association (APHA) public health ethics core values serve as a framework to interrogate current practices. We use the COVID-19 case to illustrate gaps between health policy and healthcare disparities experienced by populations with LEP. [ABSTRACT FROM AUTHOR]

The accessibility, acceptance, and effectiveness of domestic violence (DV) services and resources are crucial for survivors, but previous research indicates that Black immigrant survivors face barriers in receiving and using support from formal services. The purpose of this study was to investigate how service providers perceive the available services and resources for survivors of domestic violence, particularly for Black immigrant survivors, and assess the adequacy of these services. This study aims to explore the following questions: 1. How do service providers perceive the adequacy and accessibility of support resources and services for Black immigrant survivors of DV in Calgary? 2. To what extent do existing services and supports meet the needs of Black immigrant survivors of DV, as perceived by service providers? A hermeneutic phenomenological study was conducted with 10 domestic violence service providers in Calgary who were interviewed in-depth to address these questions. The findings revealed that while numerous services and support are available for domestic violence survivors, Black immigrant survivors face barriers in accessing these services due to limited culturally relevant services, language barriers, transportation issues, financial issues, and lack of training among professionals. This research significantly contributed to the body of knowledge and recommendations to facilitate positive experiences for Black immigrant survivors receiving formal services. Overall, the study highlights the need for culturally sensitive services and training for professionals to support Black immigrant survivors of domestic violence better. The implications for research, practice, and policy are discussed in the study. [ABSTRACT FROM AUTHOR]

Military widow/ers can experience spousal death suddenly and in traumatic circumstances. Evidence shows that this experience often has a long-term effect on surviving family members, highlighting the unique experiences of loneliness and social isolation in the armed forces community. This study aimed to explore military widow/ers' lived experiences of social isolation and loneliness and unmet needs relating to social participation. This paper presents the qualitative findings of a sequential study in which Phase One utilized an online survey (N = 165) and Phase Two employed semi-structured interviews (N = 26). Almost all participants across both Phases discussed feeling lonely, socially isolated, or both. Findings highlight the complexity in transition from military spouse to military widow/er through the loss of a military community and geographical location. This was further compounded by language barriers and perceived hierarchy (through service life or circumstances of death) which created obstacles to help seeking. However, individuals who did join military widow/ers' associations valued peer support through shared connection and understanding. Peer support was particularly valued as, for many, existing relationships with friends or family members were often negatively impacted following bereavement. These changed relationships led to feelings of both vulnerability and loss. Consideration needs to be given to how access to appropriate support is gained and what provision needs to be in place. This study recommends the use of more inclusive language for the military bereaved to promote inclusive practices and broaden the availability of support, including that which would increase social participation, across the sector. [ABSTRACT FROM AUTHOR]

Objectives: Language accommodation is indispensable in making evidence-based interventions available and accessible to ethnic minorities with limited English proficiency. As part of the larger effort to culturally adapt the Savvy Caregiver Program for Korean American dementia caregivers, we first conducted linguistic adaptation, and the present study reports the preliminary findings on participants' changes in depressive Symptoms. Methods: The linguistically adapted program was delivered to two small groups of Korean American dementia caregivers (total n = 13) by two Savvy-certified Korean-speaking trainers. Participants' depressive symptoms were assessed at three time points (pre-intervention, immediate post-intervention, and 6-month follow-up). Results: Following the intervention, participants exhibited lowered depressive symptoms (t = 8.64, p <.001, Cohen's d =.89). This benefit was sustained at 6-month follow-up. Conclusions: Findings suggest that the therapeutic benefit of the Savvy Caregiver Program could potentially be shared with linguistic minorities when delivered in their native language. Clinical Implications: Although limited in its scope and nature, the pilot study with linguistic adaptation sheds light on efforts to close the gap in the evidence-based intervention delivery. [ABSTRACT FROM AUTHOR]

Background: The study explores the language barriers between two language minority populations and healthcare professionals in the Volta Region of Ghana. Methods: An interpretive description with a qualitative approach to data collection and analysis was used. This study was carried out in the Tafi-Atome and Avatime-Vane communities, the Hohoe Municipal Hospital and the Margaret Marquart Catholic Hospital in the Kpando Municipality. In all, 46 respondents comprising 19 purposively sampled community members (patients) from the two selected communities and 27 conveniently sampled healthcare professionals from the two health facilities were interviewed. The face-to-face in-depth interviews were audio-recorded, transcribed and thematically analysed. Results: The study revealed a barrier in language use between healthcare professionals and patients from the two language minority communities. While healthcare professionals preferred to use English, Akan and Ewe, the patients, on the other hand, preferred their native languages, which are Sideme and Tegbor. The services of unqualified interpreters were utilised by both healthcare professionals and patients. Study participants were aware of these challenges, which prevented the patients from receiving optimum healthcare services, and the healthcare workers from delivering client-centred healthcare services. Conclusions: The presence of communication challenges emanating from language barriers between healthcare professionals and patients should be considered as a key hindrance to the attainment of the Sustainable Development Goal Three (SDG3), which aims to promote health and well-being at all ages. Therefore, stakeholders in the healthcare delivery system in Ghana need to prioritize stronger communication and translation practices and policies. [ABSTRACT FROM AUTHOR]

Background: Historical marginalisation and ongoing trust deficits in health and government systems shape present-day vaccine perceptions among marginalised communities. This paper sought to understand the role of trust in decision-making about COVID-19 vaccine uptake in the transgender and disability communities in India. Methods: Using a participatory approach we interviewed 24 community representatives, identifying themselves as transgender individuals or as persons with disability, and 21 key informants such as vaccine programme managers, vaccine providers, and community advocates. We undertook an inductive thematic analysis of the data using a socio-ecological model. Results: Fear of side effects in relation to specific needs of the two communities and mistrust of systems involved in vaccination shaped four different pathways for vaccine decision-making. Mistrust of systems was influenced by past negative experiences with the health system, creating contexts in which information and misinformation are shared and interpreted. Participants negotiated their doubts about safety and mistrust of systems by interacting with different sources of influence showing patterns of decision-making that are dynamic, context-dependent, and intersectional. Conclusion: These findings will help in determining the content, strategies and approaches to equitable vaccine communication for these two communities. The two communities ought to be included in vaccine trials. Vaccine information must respond to the specific needs of these two communities which could be enabled by collaboration and engagement with community members and influencers. Finally, long-term investment towards the needs of marginalised communities is vital to dismantle cycles of marginalisation and distrust and in turn improve vaccine acceptance and uptake. [ABSTRACT FROM AUTHOR]

The relationship between race, disability and criminality is complex and poorly understood. Scant information, and lack of action, exists on how to best keep Indigenous people with disability out of the justice system, and support this cohort while in the system. This systematic scoping review collates grey and peer-reviewed literature in Australia, Aotearoa (New Zealand), the United States and Canada, to gain insight into the current practices in place for justice-involved Indigenous people with disability, and list promising principles which may inform future practice. We identified 1,301 sources, and 19 of these met the inclusion criteria. Across these sources, nine key principles emerged: need for Indigenous designed, led and owned approaches; appropriately identify and respond to disability/needs; appropriate court models; appropriate diversionary options; therapeutic, trauma-informed, strengths-based and agency-building responses; facilitate connection to family, community and support networks; break down communication barriers; protect human rights; and provide post-release support. Points of interest: Internationally, Indigenous people with disability are over-repre.sented in criminal justice systems. The reasons for this are complex and not well understood. Existing evidence suggests that long-lasting effects of colonisation; discrimination on the basis of race and disability; problems identifying and reporting disability; and lack of proper services contribute to this issue. Often, criminal justice systems do not recognise or support a person's disability until they reach crisis point. There is a critical need for culturally-appropriate and disability-appropriate interventions, such as diagnostic tools; training programs for police, correctional officers and other service providers; community court models; and more accessible communication. There is some evidence that Indigenous-led programs – involving country, culture, art, social connection and holistic healing – help prevent Indigenous people with disability from entering and re-entering justice systems. More research and evaluation is needed to determine how to better support Indigenous people with disability in contact with the justice system. [ABSTRACT FROM AUTHOR]

In this autoethnographic account of my experiences as a parent who discovers and attempts to respond to the abuse of her child, I highlight the ways trauma can remove access to storytelling as a sensemaking and healing tool in a crisis. I narrate how I experienced secondary trauma as a meaning-making black hole that blocked language's healing capacities, blinded me to important sensemaking turning points, and hampered my and my child's ability to ask for help. These experiences caused me to question many foundational assumptions I made as a health communication scholar and to see an interdisciplinary bias toward narrative resiliency. Narrating the inhibiting effects trauma has on emplotment, help-seeking, and meaning-making points to the uniquely communicative nature of trauma which enables narrative theory and health communication research to make strong theoretical contributions to better understand trauma and support appropriate trauma-informed practices. [ABSTRACT FROM AUTHOR]

While the topic of international students and faculty has gained much interest in research scholarship, it is important to reorganize the existing literature which continues to share narratives from a deficit model The authors aim to explore the strengthening of the multilingual abilities of international counselor educators by including creative member-checking procedures in a qualitative grounded theory study. Six participants engaged in this study, showcasing their experiences in a creative manner as they developed their professional identity as counselor educators in the U.S. Additionally, this article recommends creative member-checking processes as a strategy to address racist nativism and microaggressions toward multilingual counselor educators, whose first language is not English. [ABSTRACT FROM AUTHOR]

The importance of video remote interpreting (VRI) for providing interpreting services has drastically increased over the last decade. Empirical research has shown, however, that interpreting through video link may have a significant impact on the interaction and the interpreting performance in dialogue interpreting contexts. The present study contributes to this growing field of research by focusing on interpreters' repair initiations in the context of VRI. Although repairs are an important mechanism for addressing problems in communication, very little research has been devoted to the study of interpreter-initiated repair in dialogue settings. Based on a corpus of video-recorded interpreted interactions (Dutch-Russian), where the interpreter is either present onsite or connected through video link, we analyse interpreters' repair initiations and related risk taking behaviour. More specifically, we examine how interpreters manage a specific type of repair initiations in video remote interpreting, namely postponed repairs. The analysis reveals differences in repair patterns between video remote and onsite interpreting and we propose that these differences result from differential risk management in the two settings. [ABSTRACT FROM AUTHOR]

Transgender persons need to regularly interact with health services and practitioners for both gender-transition purposes and routine care. Communication between clinicians and patients is a key element of health care. However, barriers to communication with transgender people in the health care context are usual. They typically include a lack of willingness among health staff to care for trans patients, an adherence to cisnormativity and misgendering by clinicians, and the existence of a displeasing climate during the interaction. Miscommunication generates a series of adverse consequences, including the avoidance of health care by patients and the social marginalization of transgender people. The implementation of novel health policies and organizational restructuring are important steps to create a safe environment for the trans population within health systems. Modification of administrative procedures as well as training and advice for health practitioners are also necessary to facilitate communication with trans people and improve health outcomes among this underprivileged population. The establishment of a society with equal rights among its members and a life without discriminations is the ultimate goal. [ABSTRACT FROM AUTHOR]

This paper seeks to delimit communicational questions for the study of the phenomenon of audiophilia. The research on audiophilia raises topics such as the influence and experience of audio technologies, the circulation of different types of sound media, the feedback between production and consumption, the practices that connect human and nonhuman in the reconfiguration of artistic production, etc. We aim to present three axes of analysis of audiofilia as a problem of communication. Firstly, audiophilia as a concept, its historical, functional and ideological determinations. Secondly, the musical production practices that problematise the links between art and technique in the scope of studios and phonographic recordings. Finally, the impact audiophilia has on listening techniques and on the very forms of translation and configuration of audiophile listening as communicational processes. [ABSTRACT FROM AUTHOR]

Radio frequency identification (RFID) technology has seen rapid expansion in recent years, used in a variety of applications like tracking, monitoring, ticketing, supply-chain management, contactless payments, etc. Several researchers have recommended elliptical curve cryptography (ECC) as a great cryptosystem to pair with RFID technology to increase security and privacy. However, RFID systems have major problems with insecure communication routes, which pose security concerns. In this research, a DNA TRIKKY based security mechanism has been proposed for RFID protocol to mutually authenticate the RFID tag and reader through insecure channels. The proposed solution uses a sponge structure and DNA-XOR to enhance the hash function generation process, preventing sensitive data from being leaked from the backend server. Informal security evaluations provide proof that the proposed method can withstand many attacks. According to performance evaluation, the proposed method performs better than the current protocols, making it ideal for use with RFID systems since it necessitates less processing time, communication costs, and storage costs particularly for the tag. According to the results, the proposed authentication paradigm works well with RFID tags that have limited resources. A comparison of the proposed protocol to other protocols shows that it performs more securely. Studies have found that this method outperforms other existing strategies. [ABSTRACT FROM AUTHOR]

Effective communication plays a part in the success and the sustainability of the tourism and hospitality management, including community-based tourism (CBT). In Brunei Darussalam, communication barriers have affected the growth of the CBT industry on both local and national levels. By analyzing responses from 16 local CBT operators, this investigation focuses aspects of communication and its channels in securing sustainability and empowerment of CBT industry. This study found that the CBT ventures in Brunei include (1) horizontal/lateral communication between CBT operators and surrounding communities and (2) top-down communication and bottom-up accessibility between the authority, the community leaders, and the CBT owners. This paper further discusses how bureaucracy can impede the success of CBT operations, and how a collaborative approach between stakeholders has inspired the formulation of a new Interactional Model of Leadership and Empowerment among CBT stakeholders, which can be used to measure the efficacy of communication among stakeholders in the CBT industry. [ABSTRACT FROM AUTHOR]

This systematic review aimed to synthesize barriers and facilitators in communicative interactions between staff and people with traumatic brain injury (TBI) in the rehabilitation context. Searches captured published evidence up to November 2022 in MEDLINE, Embase, SCOPUS, Web of Science, CINAHL, AMED, and PsycINFO. Eligible studies reported on the communicative interaction between rehabilitation staff and adults with TBI. In total, 31 studies were included in the review; including quantitative, qualitative, and mixed-methods designs. Quality assessment was carried out using standard checklists. Quantitative studies and quantitative components of mixed-method studies were synthesized descriptively according to reported communication barriers and facilitators. Qualitative studies and qualitative components of mixed-method studies were analysed through an inductive thematic meta-synthesis; generating six main themes with four subthemes. Themes were categorized as barriers or facilitators to communicative interaction. Findings demonstrated that cognitive-communication disorders of people with TBI challenge the communicative interaction between rehabilitation staff and people with TBI. However, the extent to which these disorders create a communicative barrier is closely related to staff's communicative approach. While staff holding a collaborative and acknowledging approach and using supportive strategies may facilitate successful communicative interactions, staff using the opposite approach may exacerbate communication barriers. [ABSTRACT FROM AUTHOR]

ABSTRAT: Deaf and hard-of-hearing students were greatly affected by the COVID-19 pandemic due to communication barriers, social distancing, and difficulties with distance education. Numerous researchers have investigated the experiences of such students during the COVID-19 pandemic, but generally addressed single aspects of their lives; hence, there is a need to investigate the broader impact of the pandemic on deaf students. Notably, very few local or international studies on the experiences of deaf students in Georgia are available. To address this gap, I employed qualitative methods to frame the accounts and memories of deaf students during the COVID-19 pandemic. The data for this study were gathered through semi-structured interviews with 12 such students attending specialised boarding schools for the deaf in Georgia. Four main themes were identified: the impact of COVID-19 on their moods, the substantial increase in screen time due to distance learning and screen-based social interactions, the dual nature of COVID-19 as a catalyst for increased interactions with family members, and its role in prompting contemplations of the future. This article describes and explores the lived experiences of deaf students and contributes to the collective memory of affected communities by highlighting the value of individual voices, particularly in a small country that is often unknown or overlooked. [ABSTRACT FROM AUTHOR]

The Long-term Impact of Military-relevant Brain Injury Consortium-Military and Tactical Athlete Research Study (LIMBIC MATARS) program established in 2020 is comprised of 22 universities and health systems across the United States. The LIMBIC MATARS Consortium's goal is to increase understanding of the complexities of concussion in collegiate athletes by leveraging extant retrospective and novel prospective data sets through the application of innovative research designs. The manuscripts in this special issue represent findings from clinical data sets based on consensus-derived common data elements collected from the 2015–2016 to 2019–2020 sport seasons that include 1311 cases of collegiate athletes diagnosed with concussion. Using these data, LIMBIC MATARS investigators addressed hypotheses that included (1) factors, including access to athletic trainers, biological sex, and ADHD, that may influence recovery from concussion, (2) predisposing risks associated with reinjury after return-to-sport, such as sport type, and (3) therapeutic targets for intervention including language barriers, physical activity, return-to-learn, and sleep. This commentary introduces the methodology and 10 descriptive studies highlighting initial findings from the Consortium. [ABSTRACT FROM AUTHOR]

The article focuses on addressing the needs of populations with non-English language preference (NELP) in healthcare. Topics discussed include the importance of appropriate terminology, the challenges in implementing federal and state legal frameworks, and the need for culturally responsive care to address linguistic and intersectional barriers in healthcare access.

Purpose: Evidence-based practice (EBP) is considered central to ethical, effective service delivery in rehabilitation, and the implementation of the World Health Organisation's Rehabilitation Strategy 2030. This study aimed to explore and compare the experiences of health professionals regarding the application of EBP for stroke rehabilitation in each participant's region and country, which provided perspectives from low, middle, and high-income countries.Methods and materials: Interviews were conducted with 12 experienced rehabilitation professionals from 12 different countries (5 high-income, 2 upper-middle income, 3 lower-middle income, and 2 low-income countries) and interpreted using qualitative descriptive analysis.Results: Nine factors influencing evidence-based stroke rehabilitation were: 1) the complexity of rehabilitation research; 2) the (ir)relevance of research to local context; 3) lack of time for EBP; 4) minimal training in EBP; 5) changing health professional behaviours; 6) poor access to resources for developing EBP; 7) influence of culture, patients, and families; 8) language barriers; and 9) lack of access to research evidence. Economic constraints contributed to many challenges; but not all challenges related to the country's economic classification.Conclusion: A global approach is needed to share knowledge about EBP, especially scientific evidence and innovative thinking about its application to clinical practice. Rehabilitation professional groups should contribute to a global network to improve informal knowledge sharing and training around evidence-based practice. Support for training in evidence-based practice and its application needs to be developed and accessible in all countries, including low and middle-income countries. It is imperative that policymakers prioritise practical, evidence-based solutions for rehabilitation research in low and middle-income countries that can be effectively implemented within local settings. There must be solutions and increased accessibility of journal articles for those working in low and middle-income countries including those whose first language is not English. [ABSTRACT FROM AUTHOR]

This qualitative research study examines the effects of parental historical trauma on the educational aspirations and outcomes of second-generation Cambodian Americans. Twenty second-generation Cambodian Americans whose parents survived the Cambodian Genocide (1975–1979) participated. The conceptual framework of historical trauma addressed the research questions for this study which were to what extent were children of Cambodian genocide survivors affected by the trauma their parents experienced and what form did this inherited trauma take? The data were analyzed using qualitative methods and NVivo software. Three key themes were found. The first theme was denial of historical trauma, the second was unresolved grief among parents and children, the third theme was overprotection. It was common behavior among parents who survived the genocide to want to shield their children from any unforeseen circumstances. Building on the findings of this study, it is recommended that schools with large Cambodian American populations should educate later generations about Cambodian history including the genocide and provide dual immersion language classes. This would help to interrupt intergenerational trauma, reduce the language barrier, and allow students and their parents to find purpose and peace. Future research should explore the experiences of survivors, including survivors who lived through the genocide but did not suffer persecution. Such research could lead to truth and reconciliation. [ABSTRACT FROM AUTHOR]

This study aims to enable deaf and hard-of-hearing people to communicate with other individuals who know and do not know sign language. The mobile application was developed for video classification by using MediaPipe Library in the study. While doing this, considering the problems that deaf and hearing loss individuals face in Turkey and abroad modelling and training stages were carried out with the English language option. With the real-time translation feature added to the study individuals were provided with instant communication. In this way, communication problems experienced by hearing-impaired individuals will be greatly reduced. Machine learning and Deep learning concepts were investigated in the study. Model creation and training stages were carried out using VGG16, OpenCV, Pandas, Keras, and Os libraries. Due to the low success rate in the model created using VGG16, the MediaPipe library was used in the formation and training stages of the model. The reason for this is that, thanks to the solutions available in the MediaPipe library, it can normalise the coordinates in 3D by marking the regions to be detected in the human body. Being able to extract the coordinates independently of the background and body type in the videos in the dataset increases the success rate of the model in the formation and training stages. As a result of an experiment, the accuracy rate of the deep learning model is 85% and the application can be easily integrated with different languages. It is concluded that deep learning model is more accure than machine learning one and the communication problem faced by hearing-impaired individuals in many countries can be reduced easily. [ABSTRACT FROM AUTHOR]

The current study explored the experiences of Asian International Students (AISs) in terms of mental health, disclosure and help-seeking within Higher Education in Scotland, UK. A qualitative study using individual semi-structured interviews with AISs (n = 20) was used and an inductive thematic approach to analysis was conducted. Three major themes were developed: (1) Negative beliefs, stigma and fear of judgment, (2) Adaptation and acculturation difficulties and (3) Barriers in communication, social disconnection and loneliness. Supporting AISs involves challenging negative judgements surrounding mental health, increasing mental health literacy and addressing barriers that may inhibit disclosure and help-seeking behaviour. The need for culturally sensitive mental health practitioners and awareness of diverse understandings of mental health issues is essential to improving support for AISs. [ABSTRACT FROM AUTHOR]

AbstractThis study explored community-based doulas’ experiences working with immigrant clients and maternal health-care providers in Arkansas. A descriptive qualitative design was used. Three themes emerged: (1) experiences with immigrant clients; (2) experiences with maternal health-care providers; (3) suggestions to improve support for immigrant clients. Within the first theme, three subthemes emerged: (1) language barriers; (2) transportation; (3) access to food and housing. Within the second theme, two subthemes emerged: (1) dismissive; (2) takes time to build rapport. Within the third theme, two subthemes emerged: (1) listen to the client and improve communication; (2) more community-based doulas. [ABSTRACT FROM AUTHOR]

With increasing numbers of international students entering Australian social work programs, research has focused on the challenges of teaching these students due to perceived cultural differences and language comprehension. However, limited research has examined their experiences when transitioning to practice. Semi-structured interviews were conducted with 15 international MSW graduates originating from 10 countries and residing across three Australian states. Participants' transition to practice involved similar challenges to those described in research for the broader cohort of newly qualified social workers. However, for the current cohort, initial concerns are equally focused on "fitting in", due to a learned perspective that their cultural and linguistic difference would inhibit practice. Drawing on ecological systems theory, belonging was influenced by contextual factors relating to levels of cultural diversity within workplaces; co-worker support; and participants' sense of preparedness from their education. For all participants, these feelings of difference lessened over time, with some later reflecting that their cultural difference and lived experience was beneficial to their practice. Findings suggest that the strengths of these diverse students could be more readily recognised during education and the field, for improving preparedness for practice, and inclusivity in Australian social work. Problematising international social work students and focusing on their perceived deficits can erode graduates' confidence when first transitioning to the field. The need for cross-cultural learning opportunities for educators, students, and field education agencies is highlighted for recognising the benefits of diversity and for improved preparation of early career social workers for the current professional field. Advances in training and education are needed in organisations where more culturally diverse graduates are securing employment, to ensure that international graduates are supported in early practice, and that diversity is valued in workplaces. [ABSTRACT FROM AUTHOR]

Language, as an integral aspect of human interaction, plays a pivotal role in the reformation process within the correctional setting. Nigerian correctional centers consist of a diverse population of incarcerated individuals originating from various cultural backgrounds, each possessing distinct linguistic abilities and comprehension. However, a conspicuous gap in the literature remains concerning the language practices of instructors in Nigerian correctional education programs and the active participation of incarcerated individuals in shaping their own educational experiences. The present study investigates the complex dynamics of language utilization in the correctional education system, with a specific focus on the perspectives and experiences of convicted incarcerated individuals. The study gathered data from a sample of 20 convicted incarcerated individuals who were actively participating in correctional education programs, using semi-structured interviews as the primary method of data collection. Information on the various forms of language utilization within correctional institutions, the impact of language on the learning experiences of incarcerated individuals, and linguistic obstacles encountered in accessing high-quality education were thematically analyzed. The study revealed that formal language, technical language and everyday language are the various forms of language used in correctional centers. However, the form of language used by the instructor can make or mar the incarcerated person's learning experience thereby defeating the main goal of correctional education. Correctional educators should employ clear language to convey information. Insights into the influence of language on the rehabilitation of incarcerated individuals can inform the development of social work curricula. [ABSTRACT FROM AUTHOR]

People with communication differences are known to have poorer hospital outcomes than their peers. However, the combined impact of aphasia and cultural/linguistic differences on care and outcomes after stroke remains unknown. To investigate the association between cultural/linguistic differences, defined as those requiring an interpreter, and the provision of acute evidence-based stroke care and in-hospital outcomes for people with aphasia. Cross-sectional, observational data collected in the Stroke Foundation National Audit of Acute Services (2017, 2019, 2021) were used. Multivariable regression models compared evidence-based care and in-hospital outcomes (e.g., length of stay) by interpreter status. Models were adjusted for sex, hospital location, stroke type and severity, with clustering by hospital. Among 3122 people with aphasia (median age 78, 49% female) from 126 hospitals, 193 (6%) required an interpreter (median age 78, 55% female). Compared to people with aphasia not requiring an interpreter, those requiring an interpreter had similar care access but less often had their mood assessed (OR 0.50, 95% CI 0.32, 0.76), were more likely to have physiotherapy assessments (96% vs 90% p = 0.011) and carer training (OR 4.83, 95% CI 1.70, 13.70), had a 2 day longer median length of stay (8 days vs 6 days, p = 0.003), and were less likely to be independent on discharge (OR 0.54, 95% CI 0.33, 0.89). Some differences exist in the management and outcomes for people with post-stroke aphasia who require an interpreter. Further research to explore their needs and the practical issues underpinning their clinical care pathways is required. [ABSTRACT FROM AUTHOR]