Code-switching is a very important aspect of bilingualism, and is a natural occurrence when two bilingual speakers engage in discourse. For the most part, such individuals are not consciously aware that they are code-switching. Nonetheless, it serves an important social function.Whenever there is more than one language spoken in a community, its population will code-switch. The purpose of this paper is to first examine the types of code-switches that bilingual speakers use and listener attitudes toward this behavior. Some linguists view code-switching as inevitable, and feel that it helps to express meanings more precisely, while others believe that code-switching can serve to pollute a language, rather than enhance the communication between bilingual individuals. Professionals in speech-language pathology have viewed the use of the amount and types of codeswitching as indicators for relative language proficiency or, on occasion, as the lack thereof. Some practitioners view code-switching as a symptom of language deficiency. However, the authors contend that when code-switching is used to maximize communication and to strengthen not only the content but the essence of the message, it can be considered an asset, not a deficiency. However when used in great abundance, and to the degree that it interferes with communication, it can be considered a deficit. Second, this paper discusses the importance of collecting data based on the ethnographic approach in order to gain more insight into this phenomenon. Such data need to be analyzed qualitatively as well as quantitatively. The authors propose a framework for in-depth studies, i.e. cumulative studies of code-switching under various contexts. The following analyses of each instance of code-switching may then assist researchers to obtain a holistic and qualitative understanding of such behaviors.
International telecytology can improve patient care by increasing access to regional and international expertise in cytopathology. The majority of international telecytology studies published to date have been based on static telepathology platforms. Overall concordance rates for these studies ranged from 71% to 93%. This is comparable to the concordance rates published for other studies comparing diagnoses made by digital still images to reference glass slides, which vary from 80% to 95%. Static telepathology systems are relatively cheap and easy to use, and have the potential to increase access to international experts in developing countries with limited resources. In contrast, resource-rich academic and private medical centers can use whole slide digital imaging (WSI) for telecytology consultation, though few studies have been published addressing this topic. International telepathology consultation services with digital whole slide image capabilities have been established at several academic medical centers including the University of Pittsburgh Medical Center (UPMC) and the University of California at Los Angeles (UCLA), through the UCLA Center for Telepathology and Digital Pathology. In a small series of 20 telecytology cases submitted to UCLA from 2014 to 2017 (10 gynecologic and 10 fine needle aspiration cases), a meaningful diagnosis was rendered for 100% of cases, with 100% concordance between the submitting institution, versus consultation diagnosis provided by UCLA. These limited results are promising, and in the future both WSI and static telecytology consultation may have a place serving clinical needs in different practice settings.
This paper presents critical elements and current needs in educating speech-language pathologists for a multicultural world. A proposed paradigm shift in clinical teaching using the UK model is also introduced. In addition, a case study on the American Speech Language Hearing Association’s efforts in implementing the Multicultural Action Agenda by networking with the Asian Pacific Islander caucus is described. A survey of multicultural elements in programs in Australia and New Zealand is included. Finally, suggestions for collaboration with those in established professional bodies to meet the increasing needs of a multicultural world are provided.
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