Uncovering communication strategies used in language-discordant consultations with people who are migrants: Qualitative interviews with healthcare providers

Background: Global migration has led to a sharp increase in the number of language-discordant consultations (LDCs) in healthcare. Evidence on how healthcare providers (HCPs) meet migrant patients' needs while mitigating language barriers is lacking.Design: Using purposive and snowball sampling, we recruited twenty-seven Dutch HCPs (Mage = 45.07, SD = 11.46) and conducted semi-structured interviews to collect qualitative, open-ended data for identifying the communication strategies used with migrant patients in LDCs. We analysed the transcripts using deductive and inductive approaches (e.g., constant comparative method from Grounded Theory). Final pattern codes (i.e., key themes) were discussed among the research team until mutual agreement had been achieved.Results: Five key themes emerged from the analyses: HCPs often ‘got-by’ with (1) instrumental and (2) affective communication strategies used in language-concordant consultations to start medical consultations. When some instrumental communication strategies were deemed ineffective (e.g., lingua franca, gesturing, etc.) to bridge language barriers, HCPs turned to (3) incorporating digital tools (e.g., Google Translate). When HCPs were unable to communicate with migrant patients at all, (4) informal, ad-hoc and professional interpreters were involved. Finally, HCPs often (5) involved additional support to engage migrant patients to engage in treatment-related behaviours.Discussion and Conclusions: Our results highlight the importance of raising awareness among HCPs about using various combinations of different strategies. The development of a guideline indicating the optimal combination of communication strategies for different medical consultation goals may be useful in reshaping the current communication behaviour of HCPs in LDCs.Patient or Public Contribution: HCPs were the study population involved in this qualitative study. Refugee health advisors, general practitioners and linguistic specialists (i.e., members of the Right2Health consortium) with experience with the Dutch healthcare system were involved throughout the development of this research. This includes a review of the research question, participant information sheet and interview topic guide as well as providing interpretations of the data and feedback to this manuscript

New Charged Dilaton Solutions in 2+1 Dimensions and Solutions with Cylindrical Symmetry in 3+1 Dimensions

We report a new family of solutions to Einstein-Maxwell-dilaton gravity in 2+1 dimensions and Einstein-Maxwell gravity with cylindrical symmetry in 3+1 dimensions. A set of static charged solutions in 2+1 dimensions are obtained by a compactification of charged solutions in 3+1 dimensions with cylindrical symmetry. These solutions contain naked singularities for certain values of the parameters considered. New rotating charged solutions in 2+1 dimensions and 3+1 dimensions are generated treating the static charged solutions as seed metrics and performing $SL(2;R)$ transformations.Comment: Latex. No figure

Conformally dressed black hole in 2+1 dimensions

A three dimensional black hole solution of Einstein equations with negative cosmological constant coupled to a conformal scalar field is given. The solution is static, circularly symmetric, asymptotically anti-de Sitter and nonperturbative in the conformal field. The curvature tensor is singular at the origin while the scalar field is regular everywhere. The condition that the Euclidean geometry be regular at the horizon fixes the temperature to be $T=\frac{9\, r_+}{16\pi l^2}$. Using the Hamiltonian formulation including boundary terms of the Euclidean action, the entropy is found to be $\frac{2}{3}$ of the standard value ($\frac{1}{4} A$), and in agreement with the first law of thermodynamics.Comment: LaTeX ,RevTeX, 13pages, no figure

Critical Exponents for Three-Dimensional Superfluid--Bose-Glass Phase Transition

The critical phenomenon of the zero temperature superfluid--Bose-glass phase transition for hard-core bosons on a three-dimensional disordered lattice is studied using a quantum real-space renormalization-group method. The correlation-length exponent $\nu$ and the dynamic exponent z are computed. The critical exponent z is found to be 2.5 for compressible states and 1.3 for incompressible states. The exponent $\nu$ is shown to be insensitive to z as that in the two-dimensional case, and has value roughly equal to 1.Comment: 11 pages, REVTE

Dynamics of Non-adiabatic Charged Cylindrical Gravitational Collapse

This paper is devoted to study the dynamics of gravitational collapse in the Misner and Sharp formalism. We take non-viscous heat conducting charged anisotropic fluid as a collapsing matter with cylindrical symmetry. The dynamical equations are derived and coupled with the transport equation for heat flux obtained from the M$\ddot{u}$ller-Israel-Stewart causal thermodynamic theory. We discuss the role of anisotropy, electric charge and radial heat flux over the dynamics of the collapse with the help of coupled equation.Comment: 15 pages, accepted for publication in Astrophys. Space Sc

Disordered Boson Systems: A Perturbative Study

A hard-core disordered boson system is mapped onto a quantum spin 1/2 XY-model with transverse random fields. It is then generalized to a system of spins with an arbitrary magnitude S and studied through a 1/S expansion. The first order 1/S expansion corresponds to a spin-wave theory. The effect of weak disorder is studied perturbatively within such a first order 1/S scheme. We compute the reduction of the speed of sound and the life time of the Bloch phonons in the regime of weak disorder. Generalizations of the present study to the strong disordered regime are discussed.Comment: 27 pages, revte

On WZ-pairs which prove Ramanujan series

The known WZ-proofs for Ramanujan-type series related to $1/\pi$ gave us the insight to develop a new proof strategy based on the WZ-method. Using this approach we are able to find more generalizations and discover first WZ-proofs for certain series of this type.Comment: 12 pages (preprint) + 1 page (addendum). The addendum (A Maple program) is not in the Journal referenc

Defining and characterizing team resilience in elite sport

Objectives: The objectives of this study were to develop a definition of team resilience and to identify the resilient characteristics of elite sport teams. Design and Method: Focus groups consisting of a total of 31 participants were conducted with five elite teams from a range of sports. An interpretive thematic analysis using inductive and deductive reasoning was employed to analyze the data. Results and Conclusions: Team resilience was defined as a dynamic, psychosocial process which protects a group of individuals from the potential negative effect of the stressors they collectively encounter. It comprises of processes whereby team members use their individual and combined resources to positively adapt when experiencing adversity. Findings revealed four main resilient characteristics of elite sport teams: group structure, mastery approaches, social capital, and collective efficacy. This study extends resilience research in sport psychology by providing greater conceptual clarity of resilience at a team level. The implications of the findings for those conducting research in this area and for those consulting with elite sport teams are discussed

Neutrino Mass from R-parity Violation in Split Supersymmetry

We investigate how the observed neutrino data can be accommodated by R-parity violation in Split Supersymmetry. The atmospheric neutrino mass and mixing are explained by the bilinear parameters $\xi_i$ inducing the neutrino-neutralino mixing as in the usual low-energy supersymmetry. Among various one-loop corrections, only the quark-squark exchanging diagrams involving the order-one trilinear couplings $\lambda'_{i23,i32}$ can generate the solar neutrino mass and mixing if the scalar mass $m_S$ is not larger than $10^9$ GeV. This scheme requires an unpleasant hierarchical structure of the couplings, e.g., $\lambda_{i23,i32}\sim 1$, $\lambda'_{i33} \lesssim 10^{-4}$ and $\xi_i \lesssim 10^{-6}$. On the other hand, the model has a distinct collider signature of the lightest neutralino which can decay only to the final states, $l_i W^{(*)}$ and $\nu Z^{(*)}$, arising from the bilinear mixing. Thus, the measurement of the ratio; $\Gamma(e W^{(*)}) : \Gamma(\mu W^{(*)}) : \Gamma(\tau W^{(*)})$ would provide a clean probe of the small reactor and large atmospheric neutrino mixing angles as far as the neutralino mass is larger than 62 GeV.Comment: 10 pages, 3 figures, version submitted to JHE