Includes bibliographical references (leaves 185-194) / Underpinned by the premise that any text can be studied as a translation provided it is identified as such, this study theoretically uses Descriptive Translation Studies (DTS) to investigate English-Swahili healthcare texts. The aim of the study was to: identify, describe and analyse linguistic and cultural aspects in the texts; identify, describe, and analyse translation strategies used in the texts; and describe and analyse the use of illustrations in the texts. The study made use of Kruger and Wallmach’s (1997) analytical framework. The Tertium Comparationis of the study was descriptive terms, cohesive devices, translation strategies, division of texts, illustrations, text titles, and taboo words. On the linguistic aspects, the study’s main findings were: that the English texts use more descriptive terms than the Swahili texts; Swahili texts have a higher frequency use of references because it contains a number of derivational and inflectional morphemes; substitution is sparingly used whereas ellipsis is almost non-existent in Swahili texts in spite of its presence in the source texts; additive and causal conjunctions were the most prevalent in the texts; and inasmuch as there were no significant differences in the use of lexical cohesion in the ST and TT, Swahili texts were found to be more cohesive due to the slightly higher number of lexical items. Regarding the cultural aspects, it was found that translators use euphemism in the translation of words considered taboo and this informed the conclusion that there reigns the euphemism norm in Swahili texts. It equally emerged that strategies used to overcome non-lexicalisation include: use of pure loan words, use of pure loan words preceded by explanation, use of indigenised loan words, use of omission and translation by a more general word. On the other hand, translators used strategies of substitution, use of general words, paraphrasing and cultural substitution to translate words considered taboo. In addition, the study found that illustrations are used in more less the same way both in the ST and TT save for some slight modifications that are done in order to align them with the target culture expectations. Furthermore, the study theoretically effectuated four norms: explicitation norm, explicitness norm, euphemism norm, and illustration norm / Linguistics and Modern Languages / D. Litt.et Phil. (Linguistics)

Indiana University-Purdue University Indianapolis (IUPUI) / Reducing medical error remains in the forefront of healthcare reform. The use of health information technology, specifically the electronic health record (EHR) is one attempt to improve patient safety. The implementation of the EHR in the Emergency Department changes physician workflow, which can have negative, unintended consequences for patient safety. Inaccuracies in clinical documentation can contribute, for example, to medical error during transitions of care. In this quasi-experimental comparison study, we sought to determine whether there is a difference in document quality, error rate, error type, cognitive load and time when Emergency Medicine (EM) residents use paper charts versus the EHR to complete physician documentation of clinical encounters. Simulated patient encounters provided a unique and innovative environment to evaluate EM physician documentation. Analysis focused on examining documentation quality and real-time observation of the simulated encounter. Results demonstrate no change in document quality, no change in cognitive load, and no change in error rate between electronic and paper charts. There was a 46% increase in the time required to complete the charting task when using the EHR. Physician workflow changes from partial documentation during the patient encounter with paper charts to complete documentation after the encounter with electronic charts. Documentation quality overall was poor with an average of 36% of required elements missing which did not improve during residency training. The extra time required for the charting task using the EHR potentially increases patient waiting times as well as clinician dissatisfaction and burnout, yet it has little impact on the quality of physician documentation. Better strategies and support for documentation are needed as providers adopt and use EHR systems to change the practice of medicine.