ترجمه و میانجی‌گری دانش در محیط‌های پزشکی و بهداشتی (لینگویستیکا آنتورپیسیانسیا Ns - موضوعات در)

## Background "A word, discourse, language or culture undergoes 'dialogization' when it becomes relativized, deprivileged, aware of competing definitions for the same thing. Undialogized language is authoritative and absolute." (Bakhtin, 1935(Bakhtin, /1981, p. 427) , p. 427) Health-defined by the World Health Organization as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity" (Preamble to the Constitution of the World Health Organization)-is one of the most fundamental values in today's societies. The physical, mental and social aspects of health indicated by the WHO suggest contexts in which communication is bound to be a major contributing factor. ### 1.1. Medical and healthcare settings Medical and healthcare settings are embedded in a complex and varied continuum of communication, interaction and dialogue-ranging from the laboratory to the clinic and to patient education-in which participants of all kinds-patients, physicians, nurses, the general public, researchers, healthcare managers, policy makers, technicians, journalists, writers, translators, interpreters, etc.-each with different linguistic and cultural backgrounds, take part in different ways and for different purposes. In such a continuum of communication, interaction and dialogue, many genres and forms of discourse co-exist. Because of the complexity and variety of these different forms of interaction, medical and healthcare settings offer a rich environment for research in translation and interpreting from a "dialogic" (Linell, 2009) perspective. Medical and healthcare settings are defined in this paper by the social interaction and discursive processes that take place in them as much as by the research processes, therapeutic actions, specific concepts and knowledge repositories that constitute them. Knowledge, in the previous sentence, is taken to mean the factual information accumulated collectively ### 2.3. Concept-centred approaches to knowledge mediation Conceptual mediation focuses on what happens to factual information in communication processes and the way in which concepts are shaped and reshaped through dialogues of various kinds across space and time. The paper by Major and Napier, Interpreting and Knowledge Mediation in the Healthcare Setting: What Do We Really Mean by 'Accuracy'?, could also have been included in Section 2.1 on participantcentred approaches to knowledge mediation because it explores the doctorpatient consultation and analyses some of the ways in which interpreters render factual information. However, we have preferred to include it in this section because it investigates interaction from the conceptual perspective of what is today perhaps a less fashionable topic within translation studies: the concept of accuracy. Major and Napier offer a nuanced discussion of this notion in the context of interpreter-mediated healthcare interaction. Their data are derived from an investigation into doctor-patient consultation role-plays conducted with professional interpreters working between Australian Sign Language (Auslan) and English. The question of how interpreters operate in this respect has not received a significant amount of attention in the existing literature. The article is the first to apply Wadensjö's (1998) taxonomy of renditions to analyse the ways in which signed language interpreters convey health information. Within this context, Major and Napier's data indicate that interpreters often produce renditions that are reduced or expanded (rather than close), but that these do not detract from the message or the interaction as a whole since interpreters respond dynamically to the situation by making implicit information more explicit, by adding cohesion, or by including visual information in the signing to make the message clearer. Although the use of role-plays can be said to represent a limitation in view of their non-authentic nature, on the positive side it can be argued that they allow researchers to carry out a systematic comparison of the performance of different interpreters. In so doing, they provide more robust data that can be used for the purposes of healthcare interpreter training. Since scientific concepts in general and medical concepts in particular are constructed or mediated semiotically, socially and culturally-as we have pointed out in Section 1-they are not fixed entities. They not only change synchronically-across different knowledge communities, national-ethnic cultures and languages-but also diachronically. For example, we tend to think that a scientific and medical concept such as "gene" is and has always been totally objective and immutable. In fact, it has not and is not, as Vandaele and Béland show in Les Modes de Conceptualisation des Unités d'Hérédité au XIXe Siècle: Spencer, Haeckel et Elsberg. Vandaele and Béland start from the premise that the study of metaphorical conceptualizations can shed light on the understanding of both popularization and translation. Vandaele and Béland Research in translation and knowledge mediation 25 focus on the evolution of one crucial concept for biology and medicine, that of the unit of inheritance. According to the authors, it is important to look back at history and to study how scientific thought has evolved to achieve a better understanding of how discourse is constructed by borrowing elements from existing theories and how the metaphors that have nourished those theories have been used and translated. In very much the same way that rocks show successive geological periods, theories and their metaphorizations have left their traces in discourse up to the present. The authors formulate the hypothesis that although some well-established metaphors in biomedical discourse have become or will soon become obsolete, they are still being used either naïvely or at the service of particular rhetorical ends. In their historical analysis of this concept, the authors investigate, on the one hand, how the unit of inheritance is designated, described and conceptualized by three authors-Spencer, Haekel and Elsberg-writing at the pre-experimental period towards the end of the nineteenth century; and, on the other hand, how various metaphorical conceptualizations are expressed in English and French. In their article entitled Access to Health in an Intercultural Setting: The Role of Corpora and Images in Grasping Term Variation, Tercedor and López-Rodríguez provide an analysis of terminological variation. Of interest to them are, for example, the communicative reasons for choosing one term rather than another. Like Pittarello, Tercedor and López-Rodríguez are concerned with how medical concepts are lexicalized differently depending on the aspect of the concept that is being highlighted or the particular context in which the term is being used. The authors take their data firstly from an international project in the Yucatan peninsula, Mexico, that aims to provide Mayan and Spanish audiovisual materials for the promotion of healthcare, and secondly from a research project designed to investigate lexical variation. The possibilities provided by terminological variation for improving interlinguistic and intercultural communication are investigated in the paper. The study also explores ways in which corporaand, in particular, corpora of semi-specialized medical texts-can be exploited to shed light on this kind of variation by means of the use of particular lexical, grammatical and paralinguistic patterns such as search terms. Finally, the paper offers a discussion of the vital role played by images in the localization process required to bridge the gap between medical practitioners and lay audiences. Medical knowledge mediation through translation encompasses both interlingual translation and intralingual translation or reformulation. The communicative continuum across which medical knowledge is transferred and distributed is wide and complex, ranging from the lab to the mass media. At every stage of that transfer process, there are multiple phenomena of recontextualization and reformulation at work between different knowledge communities with different knowledge backgrounds and needs, both within a given language and between different languages and cultures. The role played by these different forms of translation and interpreting in such medical communication settings is the main focus of this special issue of 'Linguistica Antverpiensia New Series - Themes in Translation Studies'. - Back cover Medical knowledge mediation through translation encompasses both interlingual translation and intralingual translation or reformulation and this collection of essays explores the communicative continuum across which medical knowledge is transferred and distributed. At every stage of that transfer process, there are multiple phenomena of recontextualization and reformulation at work between different knowledge communities with different knowledge backgrounds and needs, both within a given language and between different languages and cultures. The role played by these different forms of translation and interpretation in such medical communication settings is the main focus of this special issue of Linguistica Antverpiensia New Series Themes in Translation Studies.