Search Results (1,003)

Bilingual children learn their languages through rich interactions with caregivers within dynamic family contexts. However, little is known about how families align their two languages to support bilingual acquisition and how this varies across bilingual communities. This study examines language choice alignment across two communities: French–English families in Quebec (Canada) and Spanish–English families in New Jersey (United States). Thirty-nine children aged 18–35 months and their families were video-recorded during two 20 min home play sessions—one with a primary caregiver only and one including additional household members. Utterances were coded for speaker identity and language. We found strong turn-by-turn alignment between primary caregivers and children across both communities and sessions, with observed alignment exceeding chance in ⅔ of analyzed sessions at rates 20–22% above baseline. Other family members showed weaker correspondence with children’s language choices. Children’s alignment was modulated by language exposure and age, whereas caregivers’ alignment only decreased when additional members were present. These findings demonstrate that primary caregivers and their bilingual children align language choices consistently across diverse family configurations and communities. This linguistic coupling may support bilingual development across diverse interaction contexts, highlighting primary caregivers’ central role in early bilingual experiences across societies where bilingualism is and is not the norm. Full article

Children of prisoners (CoP) and their families experience stigmatisation simply because a family member is imprisoned. The stigma of familial imprisonment compels CoP to keep their family circumstances hidden, which intensifies isolation and restricts access to essential support. Furthermore, the impact of language used to represent CoP, along with media reporting of familial crimes, perpetuates stigmatising narratives and subsequent marginalisation. Despite long-standing recommendations, efforts to enhance provision for CoP in schools across England and Wales have been only partially implemented, resulting in inconsistent and inadequate support. As CoP remain unrecognised as a priority group, policy inaction and stigmatisation risk perpetuating cycles of exclusion. Drawing upon empirical data, this article provides a unique contribution to the academic field using a symbolic interactionist, labelling theory and critical realist framework to examine how targeted strength-based support for CoP can help them to reconstruct stigmatising narratives and mitigate negative outcomes by moving from a position of silence to a position of strength. Full article

Background: Endometrial cancer outcomes differ among Black women when examined by nativity, and timely evaluation of postmenopausal bleeding (PMB), the most common presenting symptom, may contribute to these disparities. Methods: This qualitative study explored cultural, societal, and behavioral factors shaping PMB appraisal and anticipated care-seeking among US-born Black, Caribbean-born Black, and Haitian Creole-speaking women in South Florida, guided by the Safer–Andersen Model of Total Patient Delay. Ten focus groups were conducted with 55 Black women aged ≥50 years recruited through purposive and snowball sampling. Discussions were held in English or Haitian Creole, audio-recorded, professionally transcribed, translated when needed, and analyzed thematically using a hybrid deductive–inductive approach. Reporting followed the Consolidated Criteria for Reporting Qualitative Research. Results: Three themes emerged: limited awareness and information-seeking regarding menopause and PMB; cultural and societal influences, including faith-based coping, traditional remedies, and limited family discussion of health history; and healthcare system barriers, including cost, lack of insurance, distrust, and communication challenges with providers. Subgroup differences were noted in preferred information sources, perceived susceptibility, and the role of religion in care-seeking. Conclusions: Findings suggest that PMB appraisal and anticipated care-seeking vary by nativity and language among Black women. Nativity- and language-tailored community education and navigation strategies may improve symptom recognition and support timely evaluation, but future quantitative studies are needed to test whether these approaches reduce pre-diagnostic intervals for endometrial cancer. Full article

The Mabia languages belong to the Niger–Congo family and are spoken primarily across the savannah and Sahelian regions of West Africa, including northern Ghana, Ivory Coast, Togo, Benin, Nigeria, Burkina Faso, Niger, and Mali. Tone plays a crucial role in these languages, shaping both lexical meaning and grammatical structure. This study is a synthesis or an overview of previously described facts about the tonal phenomena in six Mabia languages, Dagaare, Dagbani, Gurenɛ, Kusaal, Likpakpaln, and Buli—highlighting their tonal inventories, structures, and distinctive tonal processes. Dagaare and Dagbani exhibit a two-tone system (high and low), with an additional down-stepped high tone. Kusaal, Likpakpaln, and Buli employ a three-tone system (high, mid, and low), while the tonal status of Gurenɛ remains contested: some scholars describe it as a two-tone language, whereas others provide evidence for a three-tone system. The mid tone, though relatively less productive, appears to represent a later innovation within the group. The mid tone performs both lexical and grammatical functions. Notable tonal phenomena across these languages include tonal polarity, low tone spreading, and restrictions on contour tones, with Buli exhibiting particularly productive low tone spread. In all six languages, tone plays both lexical and grammatical functions. This paper explores these features and offers basic theoretical explanations for their occurrence. Overall, tone is a defining characteristic of the Mabia languages, intricately shaping their phonological and morphological structures. Full article

Context: Automatic Speech Recognition (ASR) in healthcare is undergoing a significant shift driven by the integration of Large Language Models (LLMs). While traditional ASR focused on transcription fidelity, LLM-based systems extend this capability to intelligently reason, summarize, and structure clinical data. This scoping review maps the emerging landscape of LLM-based ASR in healthcare, examining its applications, technical foundations, evaluation practices, and reported challenges. Methods: Following PRISMA-ScR guidelines, we searched different databases for peer-reviewed, open-access studies published between January 2022 and December 2025 to ensure reproducibility and accessibility. Results: Nineteen studies met the inclusion criteria from 384 screened records. Administrative documentation was the most common application (42.1%), followed by diagnosis, therapy, and doctor–patient communication. Whisper dominated ASR (52.6%), typically paired with GPT-family or LLaMA-family LLMs in frozen configurations steered through prompting. LLMs served as the primary component in 68.4% of studies. ASR evaluation within the reviewed studies predominantly relied on word error rate, while LLM evaluation remains fragmented with no standard metric. Studies reported documentation time reductions of 30–90%, though privacy reporting was inconsistent, equity concerns were rarely tested systematically, and only five studies provided replication packages. Conclusions: LLM-based ASR shows potential for reducing documentation burden and supporting clinical workflows, but gaps in evaluation standardization, equity testing, and reproducibility must be addressed before safe clinical deployment. Full article

This article discusses the role of Kaupapa Māori in transforming Māori educational experiences within Aotearoa (New Zealand) over the past forty years. Since the initial articulation of Kaupapa Māori from the mid-1980s, there has been an exponential growth in its development and application across Aotearoa (New Zealand). There has been extensive documentation that it was within the education sector that Kaupapa Māori initiatives were developed and initiated by Māori in response to the failure of mainstream conventional education to provide for Māori children. That response was formalized through the establishment of Te Kōhanga Reo (Māori Language Nests) and Kura Kaupapa Māori (Māori Immersion Schools), which were led by Māori. Since then, there has been an increased utilization of Kaupapa Māori theory as a foundation for understanding, explaining and critiquing key issues facing Māori and Aotearoa more broadly. In the research project “Kaupapa Māori: Creating an Indigenous Model for Systems Change”, we undertook a series of interviews (n = 80) with Māori people involved in a range of sites who utilize Kaupapa Māori as the foundation in their lives, both personally, as whānau (extended family), and in their work. A key question posed was: What are the success factors within Kaupapa Māori that can inform innovative models for systems change that will transform inequities experienced by Māori? This was asked to gain insights into how Kaupapa Māori have created transformative and meaningful change across a range of sectors and sites. Where the wider project included participation from across a broad range of social contexts, this article looks at key themes that arose from how kaikōrero (participants) saw transformative change occurring through being a part of Kaupapa Māori educational developments. Kaikōrero shared multiple ways in which transformation occurred for individuals, within their whānau (extended families), through intergenerational changes and impacts at community and systems levels. Full article

We study a class of wrapping operators acting on the space of formal languages over a fixed finite alphabet. The underlying space is equipped with a length-based ultrametric, in which two languages are close whenever they coincide on all sufficiently short words. We prove that every wrapping operator generated by a finite family of guards with positive total guard length is a contraction. As a consequence, Banach’s contraction principle yields existence and uniqueness of a fixed point for the corresponding recursive language equation, together with convergence of the Picard iteration from an arbitrary initial language. We also obtain an explicit quantitative estimate for the rate of convergence. This makes it possible to determine how many iterations are sufficient to recover the fixed point correctly on all words up to a prescribed length. Several examples illustrate the theory, including operators with different guard lengths and a case showing that convergence in the length-based ultrametric does not coincide with set-theoretic convergence. An application to recursive structures and document validation is also presented, including recursive data formats, abstract syntax trees, and a restricted fragment of JSON schemas. The results provide a formal foundation for validation together with explicit bounds for correctness on inputs of bounded length. Full article

Introduction: Chinese seniors in North America represent a growing population, and Traditional Chinese medicine (TCM) continues to play an important role in their health practices; however, TCM use has not been comprehensively synthesized from an immigrant perspective in North America. The purpose of this scoping review is to explore the use of TCM by Chinese seniors in Canada and the United States of America (USA). Methods: This scoping review is written in accordance with PRISMA guidelines. PubMed, PsycINFO, CINAHL, AgeLine, ERIC, ProQuest, Nursing and Allied Health Database, PsycARTICLES, Sociology Database, and Education Research Complete were selected for the literature search, which was conducted in August 2025. Articles were included if they investigated the use of any form of TCM among Chinese seniors aged 65 years or older living in the USA and Canada, and were published in an English-language peer-reviewed journal. Results: Twenty-four studies were included in this review, with a total sample size of 7288. The findings indicated that, in the majority of the included studies, over half of the Chinese seniors used some form of TCM. TCM therapies included over-the-counter herbal products, TCM-based physical activities, TCM practitioner consulting, and TCM food practices and therapies. Use of TCM among Chinese seniors was related to musculoskeletal symptoms, cardiovascular symptoms, mental health, severe acute respiratory syndrome prevention, cancer screening, and oral health. Chinese seniors tend to integrate TCM with Western medicine in their healthcare practices. Several factors from individual, familial, and community levels influenced Chinese seniors’ use of TCM. Conclusions: Future research should investigate the integration of TCM with Western healthcare, the training of healthcare providers to improve their understanding of TCM, and the underlying mechanisms of TCM products. Full article

Background/Objectives: Digital systems are being increasingly used to mediate pediatric care, yet many competency models remain predominantly technical and may unintentionally dilute patient- and family-centered care. This study aimed to identify empirically grounded digital competencies that enable pediatric nurse leaders to sustain patient- and family-centered care and to propose a practice-ready competency map. Methods: An interpretative phenomenological study was conducted across three hospitals in Saudi Arabia, purposively selected for varying levels of digital maturity. Ten pediatric nurse leaders completed two in-depth, semi-structured interviews (60–90 min) and a four-week reflective journal. Data were analyzed ideographically and then across cases using interpretative phenomenological analysis. Interviews were conducted in Arabic or English; translation included professional translation, partial back-translation (30%), and bilingual review. Results: Four interlinked competency domains emerged: (1) Relational digital presence, co-viewing the electronic health record, narrating documentation, and coordinating gaze and screen use to preserve relational connection; (2) Vulnerable expertise, micro-coaching at the point of care and transparent discussion of near-misses to build psychological safety; (3) Culturally legible communication, multimodal, language-congruent communication and explicit boundaries for sensitive information; and (4) Judgment-with-data, documenting override rationales and balancing algorithmic indicators with contextual family need. Together, these domains formed a screen-side competency map translating lived experience into trainable micro-practices. Conclusions: Digital competence in pediatric nursing leadership is relational, culturally situated, and clinically interpretive rather than a linear technical checklist. Embedding these competencies into leadership development and digital workflow design may help protect and strengthen patient- and family-centered care in technology-mediated pediatric care. Full article

Drone-based smart sensing increasingly relies on Vision–Language Models (VLMs) for real-time scene interpretation, obstacle detection, and autonomous navigation reasoning. Deploying such systems at scale demands not only high perceptual accuracy but also energy efficiency, a critical constraint on battery-powered Unmanned Aerial Vehicle (UAV) platforms, and linguistic flexibility for multinational operational contexts. We present a systematic benchmarking framework that jointly evaluates perception performance and inference energy for five open-source VLMs across thirteen languages spanning six language families, including three low-resource varieties (Arabic, Basque, and Luxembourgish). Using imagery sampled from the Berkeley DeepDrive 10K (BDD10K), each model is evaluated on four sensing tasks of increasing difficulty scored via a sentence-transformer backbone, with energy measured following the AI Energy Score methodology (Wh per 1000 queries) through continuous NVML-based GPU power sampling. Across 65 language–model observations, LLaVA-1.6 achieves the highest perception score ($\overline{S}=0.160$) while Phi-3-Vision attains the best energy efficiency ($66.3$ Wh/1000 queries); energy consumption and task accuracy are statistically uncorrelated (Spearman $\rho =0.001$; $p=0.995$). A formal UAV inference energy model instantiated for four commercial platforms confirms LLaVA-1.6 as Pareto-optimal on heavy-lift platforms (DJI Matrice 300/350 RTK) and LLaVA-1.5 on the energy-constrained Matrice 30; compact UAVs such as the Mavic 3 Enterprise exceed the budget of all evaluated models at standard query rates. Friedman tests reveal significant cross-language variability in energy demands (${\chi }^2=40.43$; $p=3.5\times {10}^{-8}$) and navigation reasoning performance (${\chi }^2=13.35$; $p=0.010$). Critically, we document a double penalty for low-resource languages, which simultaneously incur higher inference energy costs and lower task accuracy, with direct implications for equitable multilingual UAV deployments. Full article

Precise coagulant dosage control is essential for stable drinking-water treatment, yet conventional machine learning (ML) methods can be sensitive to data conditions. This study evaluates a large language model (LLM)-based in-context workflow for this tabular prediction task using the DeepSeek family, benchmarked against XGBoost, ANN, SVM, and k-NN under a shared chronological protocol. We examined performance across feature configurations, training-pool conditions, and outlier subsets. On the HQ-WTP case dataset, full-feature input outperformed temperature-only input, indicating the value of multivariate information. Performance responses to training-pool condition were model-dependent, with no universal optimum. Under the fixed protocol, in the full-feature test setting, the strongest tabular baseline showed the strongest test performance, while DeepSeek-Reasoner and DeepSeek-Chat showed intermediate performance, and DeepSeek-R1-Distill-Qwen-32B showed relatively lower stability. DeepSeek-Reasoner reached its best test performance at the 1/2 condition. We also coded narrative rationale patterns in generated responses and performed a protocol-based hallucination audit. DeepSeek-Reasoner showed comparatively lower hallucination incidence and more stable error behavior in this benchmark. These analyses are interpreted as response-level reliability evidence rather than verification of internal computational mechanisms. Overall, the study provides transparent, case-specific benchmark evidence for LLM-assisted decision support, while broader deployment claims require strict hallucination control, human-in-the-loop safeguards, and independent multi-site validation. Full article

This study investigates language transmission in immigrant families. The study is based on a bidimensional acculturation model, which assumes that immigrants acquire the new culture and preserve their culture of origin to different degrees. The model was tested using a stratified sample of first-generation immigrants from the former Soviet Union in Israel whose children were born in the host country (n = 725). The assimilation pattern was observed across all components of language transmission, with Hebrew being more prevalent than Russian among parents and children, as well as in their interactions. In addition, the two languages were competitive (negatively correlated) with respect to parents’ language proficiency and parent–child interactions. However, they were complementary (non-correlated) with respect to children’s language proficiency. The hypothesized bidimensional model linking parents’ language proficiency, the frequency of parent–child interactions in a specific language, and children’s language proficiency was corroborated for both languages. In addition, positive effects of parents’ proficiency in Russian on children’s proficiency in both Russian and Hebrew were found. Finally, the duration of residence in Israel, religiosity, education, and gender affected various aspects of language transmission in immigrant families. The study’s results advance our understanding of immigrants’ language acculturation and chart new directions for language policy and practice. Full article

Background: Goals of care discussions are essential communication skills in medical training that bridge patient values with clinical decision-making. Integrating palliative care principles into these conversations enables holistic, patient-centered care, yet medical trainees often lack structured preparation for these critical interactions. Objective: This narrative review examines how medical training can effectively integrate palliative care approaches into goals of care discussions through structured communication frameworks, interdisciplinary collaboration, and emerging innovations to promote patient-centered outcomes. Methods: This narrative review is conducted using a structured literature search that includes relevant studies pertaining to goals of care (GOC) discussions, evidence-based communication frameworks, and communication training curricula. Databases used were PubMed and Google Scholar, using articles published between 2000 and 2025. The following keywords were used in our search: “SPIKES”, “REMAP”, “SUPER”, “serious illness conversation”, “goals of care,” “end of life,” “holistic care,” “palliative care,” and “medical education.” Exclusion criteria were used to select those relevant to inpatient care and training in inpatient settings. Studies in an outpatient setting were excluded. Findings were reviewed and synthesized to identify types of training approaches. An emphasis on clinical outcomes including patient satisfaction, hospice utilization, ICU transfers, and intervention intensity were examined. Educational barriers and facilitators—including communication training curricula, cultural competency, language considerations, and multidisciplinary team involvement—were evaluated. Emerging technologies supporting clinician education and practice were also assessed. Results: Training in structured communication frameworks improves patient–physician relationships, reduces patient anxiety, and increases family satisfaction. Early palliative care integration through effective discussions leads to increased hospice awareness and utilization while reducing burdensome interventions. Key educational facilitators include dedicated communication skills training, multidisciplinary team participation (including chaplains and palliative care specialists), and AI-assisted documentation tools that support learning while preserving humanistic clinician–patient interactions. Conclusions: Integrating palliative care principles into medical training for goals of care discussions is essential for developing patient-centered clinicians. Combining structured communication frameworks, interprofessional education, targeted skills training, and technological support creates a comprehensive educational approach that prepares trainees to elicit patient goals, create individualized care plans, and deliver holistic care that honors patient values. Full article

Edge generative artificial intelligence (AI) increasingly combines language, perception, reasoning, audio, and action on resource-constrained devices. This paper profiles public GPT-Generated Unified Format (GGUF) checkpoints from the Hugging Face Hub (HFH) across conversational, instruct, thinking, audio, vision-language (VL), and vision-language-action (VLA) categories using a shared parser-based deployment-envelope workflow. The main category-specific run retained 21,039 profiled entries and estimated the minimum memory bandwidth, compute throughput, and unified-memory architecture (UMA) footprint needed to satisfy category-specific target throughput values. The resulting measurement protocol was symmetric, but the deployment envelopes were asymmetric: VL and thinking workloads were the heaviest on the compute–bandwidth axis, VLA formed a smaller elevated multimodal branch, and audio, instruct, and conversational workloads were lighter on average. A unified 10-tokens-per-second (TPS) sensitivity run compressed the compute–bandwidth gaps, showing that service-rate assumptions contributed strongly to cross-category separation. Welch/Games–Howell and Kruskal/Dunn analyses confirmed large category effects for bandwidth and compute in the category-specific regime, but only small memory effects. The results show that edge-model feasibility cannot be inferred from parameter count alone; throughput target, backbone family, modality, and memory budgeting must be considered jointly. Full article

Background: Chronic pain in children with cancer is a major challenge in pediatric palliative care. It results from the interaction of disease-related and treatment-related factors, psychological distress, and the child’s family and social environment. When poorly controlled, it can impair quality of life, emotional development, social functioning, and family well-being. This narrative review examines the challenges and management strategies for chronic pain in children with cancer from a pediatric palliative care perspective, with attention to pain mechanisms, assessment difficulties, and psycho-emotional influences. Methods: This narrative review was based on a structured literature search conducted in PubMed/MEDLINE, Scopus, and Web of Science for English-language articles published between January 2000 and October 2025. Of 135 records identified, 15 studies judged most relevant to the thematic scope of the review were included in the final synthesis. A PRISMA-based flowchart was used to illustrate study identification and selection without implying a formal systematic review. Results: Chronic pain in children with cancer emerged as a multidimensional problem requiring an integrated approach to assessment and management, and some studies suggest that 20–26% of childhood cancer survivors experience persistent pain. Pharmacological strategies, including opioids and adjuvant medications, remain central, while psychological, supportive, and non-pharmacological interventions may complement multimodal care. Conclusions: Chronic pain in children with cancer should be managed through an integrated, individualized, and child-centered approach that addresses the physical, emotional, social, and relational dimensions of suffering and may improve quality of life for both children and their families. Full article