Patients' experiences of communication support in Japanese-English medical encounters

This thesis explores patients’ experiences of cross-linguistic medical encounters, with a particular focus on encounters by Japanese speakers in the Australian health care system. It aims to identify the views and practices of Japanese speakers when negotiating communication, and their views on preferred communication supports. The thesis identifies gaps between the perceptions of health care interpreters held by patients through their real experiences and the idealised model of interpreter-mediated health communication which underpins the Australian language service industry and quality improvement in interpreter practice. Language barriers are a major obstacle to accessing health care. In Australia, language service agencies send credentialed, professional interpreters to health care facilities. However, the uptake of their services is low, even in Australia which provides fee-free, rapid-access telephone interpreters to doctors in private practice, and where interpreter provision is an accreditation requirement for hospitals. The barriers are generally assumed to be lack of knowledge by clinicians, lack of supportive systems, or insufficient interpreters. There is little research on the perspectives of patients towards interpreters. Australia and Japan are highly monolingual countries; thus visitors from each country to the other frequently need language support. Australia differs from Japan in that it has a highly developed, government-funded interpreter system which has been promoted to clinicians. I interviewed thirty-one adults who have experienced Japanese-English medical consultations, four doctors with extensive experience in cross-linguistic communication; attended as a participant observer seminars and workshops on health care interpreting in Japan and Australia, and a seminar for Japanese residents in Australia on how to access Australian health services; and analysed technical documents in English and Japanese used in the interpreting and health communication fields. Most Japanese-speaking interviewees were reluctant to use interpreters. The socially constructed meanings which Japanese patients attach to the English language suggests that Japanese patients may feel humiliated if they find a professional interpreter has been arranged for them, leading them to further avoid interpreting services. The interpreter’s flexibility to adopt different roles and their emotional proximity to the patient helped dismantle boundaries which patients draw to exclude outsiders. Preference for relationship-centred communication interventions over professional interpreting services was particularly prominent among Japanese women who have English-speaking partners, irrespective of how fluent the partner’s Japanese was. The ideal model promoted in the Australian code of ethics for interpreters emphasises accurate rendition of verbal statements and detachment of the interpreter from the speakers. There is a discrepancy between this ideal model held by the interpreting profession and the expectations of interpreters’ engagement in communication held by patients and medical practitioners. Japanese patients often expect an interpreter to render their tacit messages which often carry culturally nuanced connotations. Doctors often assume that interpreters are able to recognise these tacit messages, too. Many multicultural health policies in Australia warn health professionals of the risks of using interpreters who do not have professional credentials. Findings from this study suggest the necessity for revisiting this position and focusing on relationship-based care in cross-linguistic medical encounters, incorporating interpreters and other language support

The Effect of Prior Knowledge of Color on Behavioral Responses and Event-Related Potentials During Go/No-go Task

In daily life, the meaning of color plays an important role in execution and inhibition of a motor response. For example, the symbolism of traffic light can help pedestrians and drivers to control their behavior, with the color green/blue meaning go and red meaning stop. However, we don’t always stop with a red light and sometimes start a movement with it in such a situation as drivers start pressing the brake pedal when a traffic light turns red. In this regard, we investigated how the prior knowledge of traffic light signals impacts reaction times (RTs) and event-related potentials (ERPs) in a Go/No-go task. We set up Blue Go/Red No-go and Red Go/Blue No-go tasks with three different go signal (Go) probabilities (30, 50, and 70%), resulting in six different conditions. The participants were told which color to respond (Blue or Red) just before each condition session but didn’t know the Go probability. Neural responses to Go and No-go signals were recorded at Fz, Cz, and Oz (international 10–20 system). We computed RTs for Go signal and N2 and P3 amplitudes from the ERP data. We found that RT was faster when responding to blue than red light signal and also was slower with lower Go probability. Overall, N2 amplitude was larger in Red Go than Blue Go trial and in Red No-go than Blue No-go trial. Furthermore, P3 amplitude was larger in Red No-go than Blue No-go trial. Our findings of RT and N2 amplitude for Go ERPs could indicate the presence of Stroop-like interference, that is a conflict between prior knowledge about traffic light signals and the meaning of presented signal. Meanwhile, the larger N2 and P3 amplitudes in Red No-go trial as compared to Blue No-go trial may be due to years of experience in stopping an action in response to a red signal and/or attention. This study provides the better understanding of the effect of prior knowledge of color on behavioral responses and its underlying neural mechanisms

Honeycomb layered oxides: Structure, energy storage, transport, topology and relevant insights

The advent of nanotechnology has hurtled the discovery and development of nanostructured materials with stellar chemical and physical functionalities in a bid to address issues in energy, environment, telecommunications and healthcare. In this quest, a class of two-dimensional layered materials consisting of alkali or coinage metal atoms sandwiched between slabs exclusively made of transition metal and chalcogen (or pnictogen) atoms arranged in a honeycomb fashion have emerged as materials exhibiting fascinatingly rich crystal chemistry, high-voltage electrochemistry, fast cation diffusion besides playing host to varied exotic electromagnetic and topological phenomena. Currently, with a niche application in energy storage as high-voltage materials, this class of honeycomb layered oxides serves as ideal pedagogical exemplars of the innumerable capabilities of nanomaterials drawing immense interest in multiple fields ranging from materials science, solid-state chemistry, electrochemistry and condensed matter physics. In this review, we delineate the relevant chemistry and physics of honeycomb layered oxides, and discuss their functionalities for tunable electrochemistry, superfast ionic conduction, electromagnetism and topology. Moreover, we elucidate the unexplored albeit vastly promising crystal chemistry space whilst outlining effective ways to identify regions within this compositional space, particularly where interesting electromagnetic and topological properties could be lurking within the aforementioned alkali and coinage-metal honeycomb layered oxide structures. We conclude by pointing towards possible future research directions, particularly the prospective realisation of Kitaev-Heisenberg-Dzyaloshinskii-Moriya interactions with single crystals and Floquet theory in closely-related honeycomb layered oxide materials. This journal i

The Practical Research of the Support for the Preschooler from Abroad: To Construct Early Childhood Education for Promote Communication

本研究では，近年増加傾向にある外国籍幼児の支援に関する実践的研究を行った。外国籍の幼児は，母語しか話せない場合がほとんどであり，制度としても就学児のような手厚いサポートが受けられない。そのため，保育における意思疎通の難しさが問題となるため，コミュニケーションの広がりを目指した保育の構築を検討した。エピソード収集及びカンファレンスを行うことで対象児の変容と支援の内容を把握することを通して，外国籍幼児のコミュニケーションを広げるためには，以下の四点が有効であることが示唆された。①遊びを通して幼児同士が通じ合える経験の重要性，②双方の言葉を用いたアプローチの有効性，③保育者の意識変容の重要性，④保護者と保育者の隙間を埋めることの必要性。This study aimed to support the preschoolers from abroad. Most of them speak an only mother tongue. There is no institutional support for them. Accordingly the communication between the children from abroad and the children who speak Japanese faces many difficulties. This study examined what is important to improve their communication. Two caregivers have made documents describing the characteristics of subject's communication for two years and some caregivers in the kindergarten have held conferences in which they revealed the relationship between the supports which caregivers have done and the changes of subject's communication. The result shows that it is important that (1) caregivers speak a word in Japanese with a corresponding word in subject's language, (2) caregivers attempt not to adapt subject's behavior to the classroom culture but to attract his/her interest in the classroom activities, and (3) caregivers and subject's parents get to know each other

Delayed Follow-up Visits and Thyrotropin Among Patients With Levothyroxine During the COVID-19 Pandemic

Context: The indirect effects of the COVID-19 pandemic on clinical practice have received great attention, but evidence regarding thyroid disease management is lacking. Objective: We aimed to investigate the association between delayed follow-up visits during the pandemic and their serum thyrotropin (TSH) levels among patients being treated with levothyroxine. Methods: This study included 25 361 patients who made a follow-up visit as scheduled (n = 9063) or a delayed follow-up visit ( 4.5 mIU/L, aRR [95% CI] = 1.72 [1.60-1.85]; and TSH > 10 mIU/L, aRR [95% CI] = 2.38 [2.16-2.62]). Conclusion: A delayed follow-up visit during the COVID-19 pandemic was associated with less well-controlled TSH among patients with levothyroxine

Living with Diversity Vol. I: 8-9 November 2008, University of Ljubljana

oai:ojs.hass.tsukuba.ac.jp:article/1Living with Diversity, volume I, documents the proceedings of the Slovenia-Japan University Cooperation Network Graduate Student Forum Series held at Ljubljana University in 2008. The proceedings comprise the individual research papers as well as detailed reports of the three discussion sessions. While the individual papers discuss issues from each researcher’s specific field of expertise within the federating theme, the three discussion sessions address a wide range of issues and problems concerning identity, society and language from an essentially trans-disciplinary perspective. 『多様性を生きる』第1巻は、2008年にリュブリャナ大学において開催された「スロベニア・日本学生知的交流会議」の報告書です。本報告書は、個々の論文および3つのディスカッション・セッションの詳報を収めています。各論文においては、統一テーマの枠内で、研究者が各自の専門領域から問題を論じているのに対して、3つのディスカッション・セッションにおいては、本質的に領域横断的な視点から、アイデンティティ、社会、言語に関する広範な論点と課題を取り上げています

Sugar Scrub Effects on Skin Barrier Function and Heat Retention in Low Birth Weight Infants

Objective: This investigation sought to compare changes in body heat after using a sugar scrub to bathe lowbirth weight infants (< 2,500 g), compared with those bathed using conventional baby soap, and to evaluatethe relationship between skin barrier function and changes in body heat.Design: Non-Randomized clinical trialsSetting: A neonatal intensive care unit in a university hospital in JapanParticipants: 22 Low birth weight infants for whom bathing was permittedMethods: Sebum quantity and skin temperature were each measured before and after bathing for a control groupbathed with conventional baby soap and a group bathed with a sugar scrub skin care product. Ethical approvalfor this study was obtained from Aino university of Ethics committee review board (Approval number/27)Results: The results demonstrated that both sebum quantity and skin temperature increased significantly afterbathing in the sugar scrub group compared with the baby soap group.Conclusion: Increases in sebum quantity are thought to influence the normal barrier function of skin and to helpretain skin temperature. This study suggests that the use of this skin care product can be expected to effectivelyhelp maintain body temperature in low birth weight infants, who are prone to low body temperature