[1] We present an integrated analysis of bank erosion in a high-curvature bend of the gravel bed Cecina River (central Italy). Our analysis combines a model of fluvial bank erosion with groundwater flow and bank stability analyses to account for the influence of hydraulic erosion on mass failure processes, the key novel aspect being that the fluvial erosion model is parameterized using outputs from detailed hydrodynamic simulations. The results identify two mechanisms that explain how most bank retreat usually occurs after, rather than during, flood peaks. First, in the high curvature bend investigated here the maximum flow velocity core migrates away from the outer bank as flow discharge increases, reducing sidewall boundary shear stress and fluvial erosion at peak flow stages. Second, bank failure episodes are triggered by combinations of pore water and hydrostatic confining pressures induced in the period between the drawdown and rising phases of multipeaked flow events.

Riverbank retreat along a bend of the Cecina River, Tuscany (central Italy) was monitored across a near annual cycle (autumn 2003 to summer 2004) with the aim of better understanding the factors influencing bank changes and processes at a seasonal scale. Seven flow events occurred during the period of investigation, with the largest having an estimated return period of about 1·5 years. Bank simulations were performed by linking hydrodynamic, fluvial erosion, groundwater flow and bank stability models, for the seven flow events, which are representative of the typical range of hydrographs that normally occur during an annual cycle. The simulations allowed identification of (i) the time of onset and cessation of mass failure and fluvial erosion episodes, (ii) the contributions to total bank retreat made by specific fluvial erosion and mass-wasting processes, and (iii) the causes of retreat. The results show that the occurrence of bank erosion processes (fluvial erosion, slide failure, cantilever failure) and their relative dominance differ significantly for each event, depending on seasonal hydrological conditions and initial bank geometry. Due to the specific planimetric configuration of the study bend, which steers the core of high velocity fluid away from the bank at higher flow discharges, fluvial erosion tends to occur during particular phases of the hydrograph. As a result fluvial erosion is ineffective at higher peak discharges, and depends more on the duration of more moderate discharges. Slide failures appear to be closely related to the magnitude of peak river stages, typically occurring in close proximity to the peak phase (preferentially during the falling limb, but in some cases even before the peak), while cantilever failures more typically occur in the late phase of the flow hydrograph, when they may be induced by the cumulative effects of any fluvial erosion.

This paper focuses on communication between Italian midwives and migrant patients, in which the midwives deal with the patients’ limited proficiency in Italian language. The paper presents a study conducted in two women’s health assistance centres in an Italian province, and is based on 7 hours of audiotaped and transcribed interactions between midwives and migrant patients during prenatal check-ups. The analysis concerns those actions in which the midwives (1) formulate patients’ previous utterances in order to check their own understanding and then provide explanations or continue their inquiry, and (2) reformulate their own utterances in order to solve explicit or expected problems of understanding on the part of patients. The paper illustrates how formulations and reformulations are used by midwives to try to overcome language barriers in healthcare interactions and give meanings to medical terms and patients’ health problems. The analysis shows that formulations and reformulations can enhance both a patient-centred form of communication and a form of midwives’ authority, discussing how these forms establish conditions and meanings of intercultural communication. An analysis of this kind can be useful to raise awareness and promote training among healthcare providers, particularly regarding situations and conditions of effective communication with migrant patients