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With over 17 million children learning English, Bangladesh has one of the world’s largest English-learning populations. However, despite this, the country faces challenges in achieving the optimal level of English proficiency. English language teaching (ELT) initiatives in Bangladesh, which have evolved over time, can be broadly classified based on the Grammar-Translation Method, Communicative Language Teaching, and the English in Action project. These approaches predominantly reinforced traditional monolingual and bilingual frameworks while overlooking the rich metalinguistic, cultural, and intellectual resources that students bring to English classrooms. This article critically examines past ELT efforts, policies and their outcomes through a translanguaging lens, which challenges the rigid language separation ideology in traditional models and encourages the use of all linguistic repertoires in learning English as a target language. This article provides fresh perspectives on the strengths and weaknesses of past initiatives, as well as suggestions for developing linguistically and culturally sustainable ELT models based on translanguaging scholarship.
Discussing various versions of two medieval arguments for the impossibility of infinity, this Element sheds light on early stages of the evolution of the notion of INFINITIES OF DIFFERENT SIZES. The first argument is called 'the Equality Argument' and relies on the premise that all infinities are equal. The second argument is called 'the Mapping Argument' and relies on the assumption that if one thing is mapped/ superposed upon another thing and neither exceeds the other, the two things are equal to each other. Although these arguments were initially proposed in the context of discussions against the possibility of infinities, they have played pivotal roles in the historical evolution of the notion of INFINITIES OF DIFFERENT SIZES.
High levels of caregiver burden (CB) are experienced by informal caregivers of pediatric patients with cancer. There is increasing evidence highlighting the extent of CB across sub-Saharan African countries, although there remains lack of interventions that target improvements in their experience. This study aimed to determine the impact of a structured psychoeducation program on caregivers’ outcomes relating to preparedness to provide care, burden of caregiving, and quality of life (QoL).
Methods
This quasi-experimental (pre-and-posttest) design, involved family caregivers of children on admission for cancer treatment in 4 Nigerian tertiary hospitals. Eligible participants received 2 structured, psychoeducational training sessions delivered by a multidisciplinary oncology team, focusing on the management of patients’ condition, spiritual care, self-care, and support.
Results
Subjects were mainly female (79.5%) and mostly mothers to children undergoing cancer treatment (74.7%). Commonest cancer type was acute lymphoblastic leukemia (23.9%) with evidence of metastatic disease found in 9.6% of children. Significant improvements were observed between pre- and posttest for unmet needs (z = −9.3; p < 0.001), preparedness for caregiving in palliative care (PCPC) (z = −7.0; p < 0.001), and overall QoL (z = −7.3; p < 0.001). A significant reduction in CB was also reported (z = −8.7; p < 0.001).
Significance of results
This psychoeducational intervention (PEI) resulted in significant improvements in unmet needs, CB and significant improvements in PCPC. However, a reduction in QoL of the family caregivers was also observed. Findings from this study should encourage the use of well-crafted PEIs, delivered within hospital settings to promote improvements in outcomes for informal caregivers of hospitalized children suffering from cancer, in an African context. Further intervention development is required to better understand intervention components influencing changes in outcomes, while exploring feasibility testing and adaptation to similar settings in Nigeria and within Africa.
Disaster medicine aims to prevent and respond to devastating events. Health professionals need to understand their role in disaster management to effectively respond when disasters occur. The aim of the study is to assess the knowledge level, preparedness, and the training gaps regarding disaster medicine among health professionals and medical students/interns in Makkah (Mecca) city.
Method:
This is an online-based cross-sectional study design conducted in Makkah City. Physicians, nurses, and medical students/interns were included. Continuous variables were reported as means and confidence intervals. While categorical variables were reported as frequencies and percentages. Data were analyzed by Chi-square and Anova test as appropriate.
Results:
Of the 651 participants, the mean age was 27.69 (95% CI 28.13 to 27.24) with 360 (55.30%) participants being males. The mean average score of disaster medicine knowledge was 7.90 (95% CI 8.29-7.51) for medical students/interns, 8.12 (95% CI 8.77-7.47) for nurses, and 4.85 (95% CI 5.21-4.49) for physicians (P <0.0001). The majority of participants selected first-aid skills and triage and evacuation as crucial aspects to be covered in learning disaster medicine, 406 (62.4%) and 373 (57.3%) respectively.
Conclusion:
In this study, the level of knowledge regarding disaster management is average among the healthcare population. Certain aspects of disaster medicine are needed to be focused on such as first-aid skills and triage and evacuation. Incorporating disaster medicine as part of training programs is a demand.
It is currently debated whether vitamin D requirements during pregnancy differ from those during non-gravid states. In current analyses, we aimed to determine the best model for the association between PTH and serum 25-hydroxyvitamin D (25(OH)D) and the threshold for circulating 25(OH)D at which serum parathyroid hormone (PTH) is suppressed. This multicenter prospective cross-sectional study was conducted on 227 Iranian pregnant women aged 15–45 years in their third trimester of pregnancy. The locally weighted smoothing scatter plot (LOWESS) was used to determine the curvilinear shape of the 25(OH)D/PTH relationship. Linear and non-linear methods were employed to determine the best fit and cut-point for serum 25(OH)D concentration. The median serum 25(OH)D and corresponding serum PTH concentration were 17⋅26 (13⋅44–23⋅08) ng/ml and 19⋅46 (15⋅08–25⋅04) pg/ml in our study population, respectively. The LOWESS curve suggested a non-linear and monotonic with a negative slope relation between PTH (pg/ml) and serum 25(OH)D (ng/ml). The optimal model for the association between PTH and serum 25(OH)D was a one-term fractional polynomial (FP1) (AIC = 1640⋅463). The FP1 analysis identified the 25(OH)D threshold of 12⋅48 ng/ml at which serum PTH rapidly rose. The expected degree of PTH stimulation seems to have a linear trend as 25(OH)D falls below 40 ng/ml. 25(OH)D (ng/ml) and PTH (pg/ml) had a non-linear and monotonic relationship with a negative slope. Our data suggest that a 25(OH)D threshold of 12⋅48 ng/ml is sufficient for parathyroid hormone suppression, which could be used to screen for deficient individuals.
The transition of foods during toddlerhood and the suboptimal diets consumed in the Middle East make children susceptible to malnutrition and micronutrient deficiencies. Based on international recommendations, coupled with the merits of clinical studies on the application of young child formula (YCF), a group of fourteen experts from the Middle East reached a consensus on improving the nutritional status of toddlers. The recommendations put forth by the expert panel comprised twelve statements related to the relevance of YCF in young children; the impact of YCF on their nutritional parameters and functional outcomes; characteristics of the currently available YCF and its ideal composition; strategies to supply adequate nutrition in young children and educational needs of parents and healthcare professionals (HCPs). This consensus aims to serve as a guide to HCPs and parents, focusing on improving the nutritional balance in toddlers in the Middle Eastern region. The panellists considere YCF to be one of the potential solutions to improve the nutritional status of young children in the region. Other strategies to improve the nutritional status of young children include fortified cow's milk and cereals, vitamin and mineral supplements, early introduction of meat and fish, and the inclusion of diverse foods in children's diets.
Avicenna believes that God must be understood in the first place as the Necessary Existent (wâǧib al-wuǧûd). In his various works, he provides different versions of an ingenious argument for the existence of the Necessary Existent—the so-called Proof of the Sincere (burhân al-ṣiddîqîn)—and argues that all the properties that are usually attributed to God can be extracted merely from God's having necessary existence. Considering the centrality of tawḥîd to Islam, the first thing Avicenna tries to extract from God's necessary existence is God's oneness. The aim of the present Element is to provide a detailed discussion of Avicenna's arguments for the existence and unity of God. Through this project, the author hopes to clarify how, for Avicenna, the Islamic concept of monotheism is intertwined with the concept of essential existence.
Hereditary spastic paraplegia (HSP) is a heterogeneous neurodegenerative disorder with lower-limb spasticity and weakness. Different patterns of inheritance have been identified in HSP. Most autosomal-dominant HSPs (AD-HSPs) are associated with mutations of the SPAST gene (SPG4), leading to a pure form of HSP with variable age-at-onset (AAO). Anticipation, an earlier onset of disease, as well as aggravation of symptoms in successive generations, may be correlated to SPG4. Herein, we suggested that anticipation might be a relatively common finding in SPG4 families.
Methods:
Whole-exome sequencing was done on DNA of 14 unrelated Iranian AD-HSP probands. Data were analyzed, and candidate variants were PCR-amplified and sequenced by the Sanger method, subsequently checked in family members to co-segregation analysis. Multiplex ligation-dependent probe amplification (MLPA) was done for seven probands. Clinical features of the probands were recorded, and the probable anticipation was checked in these families. Other previous reported SPG4 families were investigated to anticipation.
Results:
Our findings showed that SPG4 was the common subtype of HSP; three families carried variants in the KIF5A, ATL1, and MFN2 genes, while five families harbored mutations in the SPAST gene. Clinical features of only SPG4 families indicated decreasing AAO in affected individuals of the successive generations, and this difference was significant (p-value <0.05).
Conclusion:
It seems SPAST will be the first candidate gene in families that manifests a pure form of AD-HSP and anticipation. Therefore, it may be a powerful situation of genotype–phenotype correlation. However, the underlying mechanism of anticipation in these families is not clear yet.
According to Avicenna, some of the objects of mathematics exist and some do not. Every existing mathematical object is a non-sensible connotational attribute of a physical object and can be perceived by the faculty of estimation. Non-existing mathematical objects can be represented and perceived by the faculty of imagination through separating and combining parts of the images of existing mathematical objects that are previously perceived by estimation. In any case, even non-existing mathematical objects should be considered as properties of material entities. They can never be grasped as fully immaterial entities. Avicenna believes that we cannot grasp any mathematical concepts unless we first have some specific perceptual experiences. It is only through the ineliminable and irreplaceable operation of the faculties of estimation and imagination upon some sensible data that we can grasp mathematical concepts. This shows that Avicenna endorses some sort of concept empiricism about mathematics.
Over the past decade, a growing interest has developed on the archaeology, palaeontology, and palaeoenvironments of the Arabian Peninsula. It is now clear that hominins repeatedly dispersed into Arabia, notably during pluvial interglacial periods when much of the peninsula was characterised by a semiarid grassland environment. During the intervening glacial phases, however, grasslands were replaced with arid and hyperarid deserts. These millennial-scale climatic fluctuations have subjected bones and fossils to a dramatic suite of environmental conditions, affecting their fossilisation and preservation. Yet, as relatively few palaeontological assemblages have been reported from the Pleistocene of Arabia, our understanding of the preservational pathways that skeletal elements can take in these types of environments is lacking. Here, we report the first widespread taxonomic and taphonomic assessment of Arabian fossil deposits. Novel fossil fauna are described and overall the fauna are consistent with a well-watered semiarid grassland environment. Likewise, the taphonomic results suggest that bones were deposited under more humid conditions than present in the region today. However, fossils often exhibit significant attrition, obscuring and fragmenting most finds. These are likely tied to wind abrasion, insolation, and salt weathering following fossilisation and exhumation, processes particularly prevalent in desert environments.
Western values influence cognitive behavioural therapy (CBT) as it was primarily developed and practised in the West. As understanding the cultural context has been linked to better therapy outcomes, it has been suggested that CBT might need modification to non-Western clients’ cultural backgrounds. Previously we developed a cost-effective approach to adapt CBT for clients in China and Pakistan. In this study, we applied the same methodology for local clients suffering from depression and anxiety in the Kingdom of Saudi Arabia and Bahrain. This study aimed to understand the views of patients with depression and anxiety, caregivers and mental health professionals about CBT to develop guidelines for culturally adapting CBT for depression and anxiety. We conducted semi-structured interviews with the patients (n = 42), caregivers (n = 11), and psychiatrists and psychologists (n = 16). The data were analysed using a thematic framework analysis by identifying emerging themes and categories. The themes emerging from the analyses of interviews by each interviewer were compared and contrasted with those of other interviewers. The results highlighted barriers of access to and strengths of CBT while working with these patient groups. Patients and their caregivers in both countries use a bio-psycho-spiritual-social model of illness and seek help from multiple sources. Therapists emphasized the need for using local idioms, culturally appropriate translation and minor adjustments in therapy. There were no thematic differences between the two sites. These findings will be used to culturally adapt a CBT manual, which will be tested in a randomized controlled trial.
Key learning aims
After reading this article, readers will be able to:
(1) Understand the need for cultural adaptation of CBT.
(2) Identify the necessary steps to adapt CBT for the Muslim Arab population.
(3) Understand the modifications required to deliver culturally adapted CBT for the Muslim Arab population.
This study examines the leaching of aluminium from calcined kaolin (metakaolin) with citric, oxalic and lactic acid and binary combinations of these organic acids. The investigated parameters were the pulp density, acid concentration, pH, agitation speed, temperature and contact time. The kinetics of aluminium dissolution from metakaolin in binary organic acid mixtures were determined and scanning electron microscopy examination and energy-dispersive spectrometry mapping of Si and Al of untreated kaolin and residual solids were also carried out. Aluminium dissolution increased with temperature, time, acid concentration, pulp density and acidity. At maximum dissolution, citric–oxalic (1:4 w/w) and lactic–oxalic (1:4 w/w) mixtures dissolved 77% and 78% aluminium, respectively, from metakaolin in 11 h. The activation energy ranged from 57.8 to 74.6 kJ/mol. The most effective parameter in the dissolution of aluminium was the temperature, indicating that the reaction was not diffusion-controlled. It was concluded on the basis of the activation energy values and the sensitivity of the reaction to temperature that the dissolution was under chemical-reaction control.
By discussing three different understandings of the notion of God's propositional omniscience from a theistic point of view, I show that the strictly restricted account (SPO) – according to which God knows all true propositions that He can know – is preferable to the two other candidates as the standard interpretation of God's propositional omniscience. To establish this conclusion, I argue that Pruss's argument that strictly restricted omniscience (SPO) entails full omniscience (FPO) fails because it relies on a flawed construal of the former thesis. I propose an alternative construal for strictly restricted omniscience and defend it against some potential objections.
Some authors have proposed that Avicenna considers mathematical objects, i.e., geometric shapes and numbers, to be mental existents completely separated from matter. In this paper, I will show that this description, though not completely wrong, is misleading. Avicenna endorses, I will argue, some sort of literalism, potentialism, and finitism.
Carbon films deposited by filtered cathodic vacuum arc have been used to form high quality Schottky diodes on p-Si. Energetic deposition with an applied substrate bias of -1 kV and with a substrate temperature of 100 °C has produced carbon diodes with rectification ratios of ∼ 3 × 106, saturation currents of ∼0.02 nA and ideality factors close to unity (n = 1.05). Simulations were used to estimate the effective work function and the thickness of an interfacial mixed (C/SiO2) layer from the current/voltage characteristics of the diodes.
This paper presents a novel configuration optimization method for multi degree-of-freedom modular reconfigurable robots (MRR) using a memetic algorithm (MA) that combines genetic algorithms (GAs) and a local search method. The proposed method generates multiple solutions to the inverse kinematics (IK) problem for any given spatial task and the MA chooses the most suitable configuration based on the search objectives. Since the dimension of each robotic link in this optimization is considered telescopic, the proposed method is able to find better solutions to the IK problem than GAs. The case study for a 3-DOF MRR shows that the MA finds solutions to the IK problem much faster than a GA with noticeably less reachability error. Additional case studies show that the proposed MA method can find multiple IK solutions in various scenarios and identify the fittest solution as a suboptimal configuration for the MRR.
This article analyses contemporary Eritrea's acute crisis within the framework of the theory of anomie. It is based on the hypothesis that militarisation, forced labour, mass exodus and family disintegration can be interpreted as the consequences of two incompatible norm and value systems: the collectivist, nationalistic and militaristic worldview of the former liberation front and ruling party People's Front for Democracy and Justice (PFDJ), and the traditional cultural system of Eritrea's society. In 2002 the regime introduced an unlimited ‘development campaign’, thereby forcing large parts of the society to live as conscripts and perform unpaid labour. This has caused a mass exodus of young people and a rapid process of family disintegration. The article is based on empirical fieldwork and evaluates the ongoing developments which have led to rapid economic decline and the destabilisation of the entire fabric of society.