The case of The Bahamas highlights the institutionally disruptive impacts of climate change. Despite pioneering efforts in national adaptation legislation in the mid 2000s, the chapter finds that The Bahamas has largely focused on relatively conservative programs concerned with climate change mitigation rather than adaptation or loss and damage. Yet drawing on semi-structured interviews and an analysis of relevant policy documents, the chapter also suggests that climate change has impacted the configuration of relevant institutional bodies in The Bahamas. As the analysis demonstrates, the loss and damage associated with several extreme weather events in the late 2010s led to the establishment of the Ministry of Disaster Preparedness, Management and Reconstruction; the strengthening of the legal framework for environmental protection; and the growing resonance among civil society organizations of the implications of climate change for their humanitarian and nature preservation work. The chapter argues that while much of The Bahamas’ loss and damage policy agenda is focused on developing the knowledge, resources, skills, and governance frameworks to grapple with the impacts of climate change, it is also worth paying attention to how climate change impacts are reshaping political institutions and defining the possible contours of knowledge generation.

The use of technology in language learning classrooms depends largely on its availability and accessibility. Language practitioners in the twenty-first century continue to face the issue of digital divide, as some developing countries struggle to provide basic hardware such as computers, projectors, and speakers in every language classroom and rely heavily on the technology they and their students bring to class. This is complicated further when language learning must be done online and remotely, as reliable internet connectivity is required but not always available. Numerous language teachers in these low-tech environments have adopted the low-tech approach by maximizing the affordability of “simple” hardware such as feature phones and “common” tools such as email and mobile applications such as chat apps. They engage in technology literacy, which reaches the level of inventive use of “common” technology that has long been used to bring sound pedagogy to various modes of language learning. The chapter attempts to describe how language is taught in low-tech environments and how an inclusive approach must use technology that assures that no one is excluded. It also describes how the incorporation of simple technology into various modes of language teaching and learning has supported sound language pedagogy through creativity and flexibility.

The trajectory of care for patients with neurologic respiratory impairment can roughly be subdivided into the three stages of acute, post-acute and long-term care. Patients with acute neurological illness and respiratory impairment are treated in stroke units, intermediate care units or intensive care units, depending on the severity of their condition. Patients with respiratory impairment due to chronic or chronic progressive neurological conditions are treated in variable settings, comprising outpatient clinics, sleep medicine departments and hospital wards as well as medical and neurosciences intermediate and intensive care units. The disciplines of neurology and pulmonology both strongly contribute to the post-acute setting of neurorespiratory care. Post-acute treatment facilities, where neurological patients with tracheostomy or mechanical ventilation are treated, can be part of acute care hospitals or function as stand-alone institutions. Health care structures and centers for neurological patients with respiratory impairment have been comprehensively organized for only a few countries. To explore differences (and detect needs) this chapter provides some insights in healthcare structures and their variability between regions and countries – the disparity is obvious.

This chapter discusses sleep-disordered breathing (SDB), a highly prevalent condition that affects over 1 billion people worldwide, and the incidence of SDB is likely to increase in over the next decades. At first thought to be a moderate disruption in sleep, leading to snoring, intermittent awakenings and daytime sleepiness, SDB has now been shown to be strongly associated with severe health outcomes such as cardiovascular disease, stroke, pulmonary hypertension, and even death. Most of those with SDB suffer from obstructive sleep apnea resulting from upper airway obstruction during sleep, distinct from central sleep apnea in which the control of breathing in the brain is impaired. Diagnosis is primary made by polysomnography, with increasing application of lower cost and widely scalable home sleep apnea testing. In neuromuscular disease, SDB is more prevalent than in the general population. Treatment typically involves lifestyle management changes, CPAP therapy and noninvasive positive airway pressure ventilation. These and other treatment options, including dental appliances and surgical therapies, are presented.