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ImportanceSocial needs interventions aim to improve health outcomes and mitigate inequities by addressing health-related social needs, such as lack of transportation or food insecurity. However, it is not clear whether these studies are reducing racial or ethnic inequities.ObjectiveTo understand how studies of interventions addressing social needs among multiracial or multiethnic populations conceptualize and analyze differential intervention outcomes by race or ethnicity.Evidence reviewSources included a scoping review of systematic searches of PubMed and the Cochrane Library from January 1, 1995, through November 29, 2021, expert suggestions, and hand searches of key citations. Eligible studies evaluated interventions addressing social needs; reported behavioral, health, or utilization outcomes or harms; and were conducted in multiracial or multiethnic populations. Two reviewers independently assessed titles, abstracts, and full text for inclusion. The team developed a framework to assess whether the study was "conceptually thoughtful" for understanding root causes of racial health inequities (ie, noted that race or ethnicity are markers of exposure to racism) and whether analyses were "analytically informative" for advancing racial health equity research (ie, examined differential intervention impacts by race or ethnicity).FindingsOf 152 studies conducted in multiracial or multiethnic populations, 44 studies included race or ethnicity in their analyses; of these, only 4 (9%) were conceptually thoughtful. Twenty-one studies (14%) were analytically informative. Seven of 21 analytically informative studies reported differences in outcomes by race or ethnicity, whereas 14 found no differences. Among the 7 that found differential outcomes, 4 found the interventions were associated with improved outcomes for minoritized racial or ethnic populations or reduced inequities between minoritized and White populations. No studies were powered to detect differences.Conclusions and relevanceIn this review of a scoping review, studies of social needs interventions in multiracial or multiethnic populations were rarely conceptually thoughtful for understanding root causes of racial health inequities and infrequently conducted informative analyses on intervention effectiveness by race or ethnicity. Future work should use a theoretically sound conceptualization of how race (as a proxy for racism) affects social drivers of health and use this understanding to ensure social needs interventions benefit minoritized racial and ethnic groups facing social and structural barriers to health.

Teacher cognition has attracted increased attention among second language (L2) researchers and practitioners, likely because of its potential consequences for classroom practices, such as teaching and assessment. Prior research has revealed links between teacher beliefs about pronunciation teaching and teachers' own experience (e.g. amount of teacher training and teaching experience). However, no research has to date focused on how teachers' experience and their beliefs are intertwined, possibly affecting teacher assessments of L2 speakers' pronunciation. For this study, 77 Japanese pre-service teachers of English completed an online questionnaire examining their beliefs about the teaching of English pronunciation and eliciting details about their L2 teaching and learning experience. Additionally, pre-service teachers assessed 40 Japanese secondary school students performing an extemporaneous speech task, rating these speakers for comprehensibility, accentedness, and fluency. Results showed that pre-service teachers could be categorized into two distinct profiles, defined by joint contributions of pre-service teachers' experience (a mixture of language learning/teaching experience and pronunciation-related instruction) and their beliefs (teachability of L2 pronunciation and approaches to its teaching). Pre-service teachers with more experience appeared to be more skeptical about how (easily) L2 pronunciation can be learned and taught and also provided harsher accentedness ratings, compared to pre-service teachers with less experience, revealing links between experience, beliefs, and speech assessments. Taken together, the findings reveal how pre-service teachers' experience might shape their beliefs and assessments, implying that teacher educators must encourage future teachers to hold positive views about the teachability of L2 pronunciation by shifting their attention toward communicatively oriented dimensions of L2 speech and by providing teachers with pedagogical skills to target these dimensions.

Comprehensibility, or ease of understanding, has emerged as an important construct in second language (L2) speech research. Many studies have examined the linguistic features that underlie this construct, but there has been limited work on behavioral and affective predictors. The goal of this study was therefore to examine the extent to which anxiety and collaborativeness predict interlocutors' perception of one another's comprehensibility. Twenty dyads of L2 English speakers completed three interactive tasks. Throughout their 17-minute interaction, they were periodically asked to evaluate their own and each other's anxiety and collaborativeness and to rate their partner's comprehensibility using 100-point scales. Mixed-effects models showed that partner anxiety and collaborativeness predicted comprehensibility, but the relative importance of each predictor depended on the nature of the task. Self-collaborativeness was also related to comprehensibility. These findings suggest that comprehensibility is sensitive to a range of linguistic, behavioral, and affective influences.

Comprehensibility has emerged as a useful and intuitive means of globally evaluating second language (L2) speakers in many research and instructional contexts. In most cases, L2 speakers' comprehensibility is assessed by external listeners who do not engage in extensive communication with the speakers, even though the degree to which a speaker is comprehensible is presumably of greatest concern to their interlocutor. If comprehensibility is defined as the ease with which speakers come to understand one another, then interaction-based assessments, which would include self and peer ratings, might provide different insight into interactive comprehensibility compared to assessments by external listeners. To examine this issue, in this study, 20 pairs of L2 English interactants rated themselves and their partner on 7 occasions distributed throughout a 17-minute interaction encompassing 3 communicative tasks, and recordings of the interaction were subsequently presented to external raters for evaluation. Mixed-effects models were used to compare the shape of the comprehensibility curves over time and the self, partner, and rater scores at each rating episode. Results demonstrated that self and partner assessments were always aligned, but raters consistently assigned significantly lower comprehensibility scores to the interactants. These findings have implications for how comprehensibility, and indeed other listener-based constructs, are assessed.

This study examined the effect of benchmarking and peer-assessment activities on second language (L2) French learners' self-assessments of accentedness, comprehensibility, and fluency. The learners, who included 25 L2 French students enrolled in a 15-week university-level French course, recorded two oral presentations at the beginning and the end of the course and self-assessed their accentedness, comprehensibility, and fluency four times. In addition to regular course instruction, the treatment group also engaged in benchmarking (discussing and applying pre-established evaluation criteria) and peer-assessment (evaluating peers' speaking performances). The students' self-assessments were compared with ratings of accentedness, comprehensibility, and fluency by 10 native-speaking French raters. At the end of the course (i.e., for the second oral presentation), the treatment group showed greater alignment in self-assessment of comprehensibility than the comparison group, relative to the external raters' assessments. Results highlight the value of assessment-focused activities targeting L2 learners' awareness of pronunciation.

Clinical teaching is the primary educational tool use to train learners from day one of medical school all the way to the completion of fellowship. However, concerns over time constraints and patient census have led to a decline in bedside teaching. This paper provides a critical review of the literature on clinical teaching with a focus on instructor teaching strategies, clinical teaching models, and suggestions for incorporating technology. Recommendations for instructor-related teaching factors include adequate preparation, awareness of effective teacher attributes, using evidence-based-knowledge dissemination strategies, ensuring good communication, and consideration of environmental factors. Proposed recommendations for potential teaching strategies include the Socratic method, the One-Minute Preceptor model, SNAPPS, ED STAT, teaching scripts, and bedside presentation rounds. Additionally, this article will suggest approaches to incorporating technology into clinical teaching, including just-in-time training, simulation, and telemedical teaching. This paper provides readers with strategies and techniques for improving clinical teaching effectiveness.

This study examined the relationship between targeted pronunciation instruction in French as a second language (L2) and listener-based ratings of accent, comprehensibility, and fluency. The ratings by 20 French listeners evaluating the speech of 30 adult L2 French learners enrolled in a 15-week listening and speaking course targeting segments, prosody, fluency, and connected speech processes (e.g., liaison, enchainment) were compared before and after instruction in read-aloud and extemporaneous (picture description) speaking tasks. Results showed that the learners improved in all speech ratings, especially in extemporaneous speaking. Results also revealed that accent ratings were linked to prosody (intonation accuracy, pitch range), while fluency and comprehensibility ratings were additionally linked to fluency phenomena (length of fluent run, hesitation rate). These findings are discussed in terms of their implications for L2 pronunciation learning and links between instruction, listener-rated dimensions of speech, and performance in different tasks.

Determined parents are powerful advocates at all levels of our society. Parents can move mountains for their child, and they often do. State teams that actively collaborate with parents gain new perspectives, ideas, and energy. Statewide transition planning teams welcomed the authors--three parents who are also professionals active in the deaf educational community--into their discussion and planning. These teams--part of pepnet 2, the federally funded project with the mission to increase the education, career, and lifetime choices available to individuals who are deaf or hard of hearing--are located in the states of Oregon, Colorado, and North Carolina. An ideal team is one in which parents collaborate freely with professionals with no question off limits; it has clear objectives, norms, standards of practice, and history available to all. These ideal teams include stakeholders mirroring the community's wide continuum of language, cultural diversity, and experience. Representatives come from state education agencies; vocational rehabilitation; local districts; and public, charter, and schools for the deaf. Parents of current or recent students from a variety of backgrounds and geographical areas and the students themselves also participate, adding immeasurably to the 360° view of transition planning. This article discusses barriers to parental engagement in meaningful collaboration, and provides examples of how various teams are working to gain momentum in accomplishing their team goals.

Objective: Borderline personality disorder (BPD) is the most common personality disorder, affecting 1.8% of the general population, 10% of psychiatric outpatients, and 15%–25% of psychiatric inpatients. Practice guidelines recommend psychotherapies as first-line treatments. However, psychotherapies commonly used for the treatment of BPD are numerous, and little is known about the comparative effectiveness of each individual psychotherapy versus treatment as usual (TAU) or other psychotherapies. To systematically assess the comparative effectiveness of commonly used psychotherapies versus TAU or versus other psychotherapies for BPD treatment. Method: We conducted systematic literature searches in MEDLINE, EMBASE, the Cochrane Library, and APA PsycINFO up to July 14, 2022, and searched reference lists of pertinent articles and reviews. Inclusion criteria were (a) patients 13 years or older with a diagnosis of BPD, (b) treatment with commonly used psychotherapies, (c) comparison with TAU or another psychotherapy, (d) assessment of relevant BPD-related health outcomes, and (e) randomized or nonrandomized trials or controlled observational studies. Two investigators independently screened abstracts and full-text articles and graded the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results: We found 25 psychotherapy studies meeting inclusion criteria with data on 2,545 participants. Seventeen studies compared nine psychotherapies with TAU and nine studies compared eight psychotherapies with another psychotherapy for the treatment of BPD. Overall, both TAU and included psychotherapies were effective in treating the severity and symptoms of BPD. Moderate certainty of evidence suggests that systems training for emotional predictability and problem solving is more effective than TAU for the treatment of BPD; low certainty of evidence suggests that dialectical behavior therapy, schema therapy, transference-focused psychotherapy, acceptance and commitment therapy, manual-assisted cognitive therapy, and cognitive behavioral therapy are more effective than TAU for treating BPD. We were unable to draw conclusions from head-to-head comparisons of psychotherapies, which were limited to single studies with very low to low certainty of evidence. Conclusions: All commonly used psychotherapies improve BPD severity, symptoms, and functioning. Our assessment found no strong evidence suggesting that any one psychotherapy is more beneficial than another. What is the public health significance of this article?: For clinicians, this work can be used to inform practice guidelines on psychotherapies to treat BPD. For funders, policymakers, and researchers, this work identifies research gaps and opportunities for future research in the area. [ABSTRACT FROM AUTHOR]

Previous research has shown that speakers' visual appearance influences listeners' perception of second language (L2) speech. In Québec, Canada, the context of this study, pandemic mask mandates and a provincial secularism law elicited strong societal reactions. We therefore examined how images of speakers wearing religious and nonreligious coverings such as medical masks and headscarves influenced the comprehensibility (listeners' ease of understanding) and intelligibility of L2 French speech. Four L2 French women from first language (L1) Arabic backgrounds wore surgical masks while recording 40 sentences from a standardized French-language speech perception test. A total of 104 L1 French listeners transcribed and rated the comprehensibility of the sentences, paired with images of women in four visual conditions: uncovered face, medical mask, hijab (headscarf), and niqab (religious face covering). Listeners also completed a questionnaire on attitudes toward immigrants, cultural values, and secularism. Although intelligibility was high, sentences in the medical mask condition were significantly more intelligible and more comprehensible than those in the niqab condition. Several attitudinal measures showed weak correlations with intelligibility or comprehensibility in several visual conditions. The results suggest that listeners' understanding of L2 sentences was negatively affected by images showing speakers' religious affiliation, but more extensive follow-up studies are recommended. [ABSTRACT FROM AUTHOR]

This study investigates how one English-as-a-second-language (ESL) teacher provided corrective feedback to 15 child ESL learners that the teacher had divided into two groups based on proficiency level. Classroom data in transcripts from the CHILDES database were analyzed for type of learner errors, type of teacher feedback, and rate of learner uptake (attempts at correction) and repair (correction). Results showed differences in the types of errors produced by each proficiency group and in the type of feedback the teacher provided to each proficiency group, demonstrating provision of finely tuned corrective feedback based on learners' individual differences. (Contains 3 figures, 5 tables, and 3 notes.)

Speakers of a second language (L2), regardless of profciency level, communicate for specifc purposes. For example, an L2 speaker of English may wish to build rapport with a co-worker by chatting about the weather. The speaker will draw on various resources to accomplish her communicative purposes. For instance, the speaker may say "falling ice" if she has forgotten the word "hail" or may repeat the last few words of her interlocutor's utterance to show that she is listening and engaged. The term communication strategies (CSs) refers to the strategic use of various resources (both linguistic and non-linguistic) for communicative purposes. While speakers also use CSs in their native languages (L1s), research on L2 CS use is particularly interesting because speakers' L2 linguistic resources and the associated cognitive processes are typically less developed, compared to those in their L1. Therefore, for L2 users to accomplish their communicative purposes in the L2, it is important that they effectively use the resources available to them. This research timeline presents key developments in theoretical understanding and empirical research targeting L2 CSs, mainly in oral communication. The timeline places particular emphasis on the evolution of theoretical approaches to the study of CSs and the consequent expansion of research in terms of the nature of participants, speech samples, and analytical tools used.

By the end of their studies, non-native speakers of English studying at English-medium universities have had several years of exposure to English in that setting. Do non-native students, particularly those enrolled in non-language related programs, show different levels of second language (L2) speaking ability in their final semester of studies than non-native students in their first semester, as judged by other students in the university community? In this exploratory cross-sectional study, two matched groups of L2 English university students in their first or final semester of study in non-language-related programs (N = 20) were recorded in mock job interviews. The students were rated by two groups of raters for accentedness, comprehensibility, fluency, and communicative effectiveness. Both rater groups were university students; one group was from diverse academic programs, while the other group was studying human resource management (HRM). Although the first- and final-semester L2 English students differed in how long they had studied in English, no significant difference in ratings between first- and final-semester students was found. However, the two rater groups differed in how they rated accentedness and comprehensibility, suggesting that the nature of listeners' previous academic experience (e.g., with HRM) influences their judgments. The use of holistic rating scales to evaluate L2 speech is discussed, as well as the relationship between the nature of language exposure and the performance of the student and rater groups.

To be effective second or additional language (L2) listeners, learners should be aware of typical processes in connected L2 speech (e.g. linking). This longitudinal study explored how learners' developing ability to perceive connected L2 speech was related to the quality of their language awareness. Thirty-two learners of L2 French at a university in Quebec, Canada, took a course focusing on improving learners' abilities to understand and decode standard and familiar connected speech processes in French. Learners engaged in numerous activities to raise their awareness of and to practise perception of connected speech processes. They also completed weekly journal entries about their learning experiences and language use. Results showed that learners with the most improved perception did not focus on rehearsing knowledge about connected speech processes, but focused on how to use that knowledge to extract meaning from speech. Results are discussed in relation to the relationship between L2 listening and different types of awareness.