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Gail Crowther examines Plath’s ambivalent response to religion by highlighting how the context of her religious upbringing lay at the root of her theological questionings. Crowther examines the impact of the Plath family’s Unitarian faith on Plath’s writing, her study of religion throughout her school and college education, and her adult position of reluctant atheism. Crowther shows how Plath’s writing disrupts Judeo–Christian ideas of patrilineage, instead putting Marian notions of love, care and redemption at the centre of her poems.
To determine the impact of pre-operative intratympanic gentamicin injection on the recovery of patients undergoing translabyrinthine resection of vestibular schwannomas.
This prospective, case–control pilot study included eight patients undergoing surgical labyrinthectomy, divided into two groups: four patients who received pre-operative intratympanic gentamicin and four patients who did not. The post-operative six-canal video head impulse test responses and length of in-patient stay were assessed.
The average length of stay was shorter for patients who received intratympanic gentamicin (6.75 days; range, 6–7 days) than for those who did not (9.5 days; range, 8–11 days) (p = 0.0073). Additionally, the gentamicin group had normal post-operative video head impulse test responses in the contralateral ear, while the non-gentamicin group did not.
Pre-operative intratympanic gentamicin improves the recovery following vestibular schwannoma resection, eliminating, as per the video head impulse test, the impact of labyrinthectomy on the contralateral labyrinth.
To examine when cochlear fibrosis occurs following a translabyrinthine approach for vestibular schwannoma resection, and to determine the safest time window for potential cochlear implantation in cases with a preserved cochlear nerve.
This study retrospectively reviewed the post-operative magnetic resonance imaging scans of patients undergoing a translabyrinthine approach for vestibular schwannoma resection, assessing the fluid signal within the cochlea. Cochleae were graded based on the Isaacson et al. system (from grade 0 – no obstruction, to grade 4 – complete obliteration).
Thirty-nine patients fulfilled the inclusion criteria. The cochleae showed no evidence of obliteration in: 75 per cent of patients at six months, 38.5 per cent at one year and 27 per cent beyond one year. Most changes happened between 6 and 12 months after vestibular schwannoma resection, with cases of an unobstructed cochlear decreasing dramatically, from 75 per cent to 38.5 per cent, within this time.
The progress of cochlear obliteration that occurred between 6 and 12 months following vestibular schwannoma resection indicates that the first 6 months provides a safer time window for cochlear patency.
In describing the difficulties of establishing a definition for the construct second language (L2) “speaking”, Fulcher (2014) notes that “speaking is the verbal use of language to communicate with others” (p. 23). Such a broad definition is of course limited, as what enables successful spoken communication is variable. For example, Fulcher lists the following considerations: pronunciation and intonation; accuracy and fluency; strategies for speaking; structuring speech; speaking in context; and interactional competence. Such variability is evident when considering how high-stakes language assessments (e.g., the American Council on the Teaching of Foreign Languages (ACTFL), instruments based on the Common European Framework of Reference, International English Language Testing System (IELTS), Test of English as a Foreign Language (TOEFL)) define speaking within their frameworks. For example, whereas the IELTS speaking rubric includes categories for Fluency and Coherence, Lexical Resource, Grammatical Range and Accuracy, and Pronunciation, the TOEFL speaking rubrics emphasize General Description, Delivery, Language Use, and Topic Development.
The growing availability of mobile technologies has contributed to an increase in mobile-assisted language learning in which learners can autonomously study a second language (L2) anytime or anywhere (e.g. Kukulska-Hulme, Lee & Norris, 2017; Reinders & Benson, 2017). Research investigating the effectiveness of such study for L2 learning, however, has been limited, especially regarding large-scale commercial L2 learning apps, such as Duolingo. Although one commissioned research study found favorable language learning outcomes (Vesselinov & Grego, 2012), limited independent research has reported issues related to learner persistence, motivation, and program efficacy (Lord, 2015; Nielson, 2011). The current study investigates the semester-long learning experiences and results of nine participants learning Turkish on Duolingo. The participants showed improvement on L2 measures at the end of the study, and results indicate a positive, moderate correlation between the amount of time spent on Duolingo and learning gains. In terms of perceptions of their experiences, the participants generally viewed Duolingo’s flexibility and gamification aspects positively; however, variability in motivation to study and frustration with instructional materials were also expressed.
Lying on the north-west coast of Sri Lanka, the ancient port of Mantai was ideally situated as a ‘hub’ for trade between East and West from the first millennium BC onwards. Excavations at the site were interrupted by civil war in 1984, delaying publication of these results and leading to the underestimation of Mantai's importance in the development of Early Historic Indian Ocean trade. Renewed excavations in 2009–2010 yielded extensive archaeobotanical remains, which, alongside an improved understanding of the site's chronology, provide important new insights into the development of local and regional trade routes and direct evidence for early trade in the valuable spices upon which later empires were founded.
This essay analyzes vernacular texts on reproduction from sixteenth-century Germany. It examines religious texts, including sermons and devotional treatises for pregnant women, as well as medical texts, such as midwifery manuals, books on the “secrets of nature,” and anatomical treatises. Vernacular authors, both medical and clerical, ascribed enormous spiritual and symbolic significance to human generation. Conception, pregnancy, and birth were linked to the biblical account of the creation and fall of mankind. In the creation of the child in the womb, sixteenthcentury Germans saw an echo of the original divine act of creation. And in the sufferings of a woman in labor they saw a reenactment of Christ's Passion. Discussions of reproduction thus served as a starting point for meditations on original sin, human mortality, and the relationship between body and soul.
Recovery Colleges are opening internationally. The evaluation focus has been on outcomes for Recovery College students who use mental health services. However, benefits may also arise for: staff who attend or co-deliver courses; the mental health and social care service hosting the Recovery College; and wider society. A theory-based change model characterising how Recovery Colleges impact at these higher levels is needed for formal evaluation of their impact, and to inform future Recovery College development. The aim of this study was to develop a stratified theory identifying candidate mechanisms of action and outcomes (impact) for Recovery Colleges at staff, services and societal levels.
Inductive thematic analysis of 44 publications identified in a systematised review was supplemented by collaborative analysis involving a lived experience advisory panel to develop a preliminary theoretical framework. This was refined through semi-structured interviews with 33 Recovery College stakeholders (service user students, peer/non-peer trainers, managers, community partners, clinicians) in three sites in England.
Candidate mechanisms of action and outcomes were identified at staff, services and societal levels. At the staff level, experiencing new relationships may change attitudes and associated professional practice. Identified outcomes for staff included: experiencing and valuing co-production; changed perceptions of service users; and increased passion and job motivation. At the services level, Recovery Colleges often develop somewhat separately from their host system, reducing the reach of the college into the host organisation but allowing development of an alternative culture giving experiential learning opportunities to staff around co-production and the role of a peer workforce. At the societal level, partnering with community-based agencies gave other members of the public opportunities for learning alongside people with mental health problems and enabled community agencies to work with people they might not have otherwise. Recovery Colleges also gave opportunities to beneficially impact on community attitudes.
This study is the first to characterise the mechanisms of action and impact of Recovery Colleges on mental health staff, mental health and social care services, and wider society. The findings suggest that a certain distance is needed in the relationship between the Recovery College and its host organisation if a genuine cultural alternative is to be created. Different strategies are needed depending on what level of impact is intended, and this study can inform decision-making about mechanisms to prioritise. Future research into Recovery Colleges should include contextual evaluation of these higher level impacts, and investigate effectiveness and harms.
Anti-retroviral therapy (ART) regimes for HIV are associated with raised levels of circulating triglycerides (TGs) in western populations. However, there are limited data on the impact of ART on cardiometabolic risk in sub-Saharan African (SSA) populations.
Pooled analyses of 14 studies comprising 21 023 individuals, on whom relevant cardiometabolic risk factors (including TG), HIV and ART status were assessed between 2003 and 2014, in SSA. The association between ART and raised TG (>2.3 mmol/L) was analysed using regression models.
Among 10 615 individuals, ART was associated with a two-fold higher probability of raised TG (RR 2.05, 95% CI 1.51–2.77, I2 = 45.2%). The associations between ART and raised blood pressure, glucose, HbA1c, and other lipids were inconsistent across studies.
Evidence from this study confirms the association of ART with raised TG in SSA populations. Given the possible causal effect of raised TG on cardiovascular disease (CVD), the evidence highlights the need for prospective studies to clarify the impact of long term ART on CVD outcomes in SSA.
This study critically examined the previously reported partial independence between second language (L2) accentedness (degree to which L2 speech differs from the target variety) and comprehensibility (ease of understanding). In prior work, comprehensibility was linked to multiple linguistic dimensions of L2 speech (phonology, fluency, lexis, grammar) whereas accentedness was narrowly associated with L2 phonology. However, these findings stemmed from a single task (picture narrative), suggesting that task type could affect the particular linguistic measures distinguishing comprehensibility from accentedness. To address this limitation, speech ratings of 10 native listeners assessing 60 speakers of L2 English in three tasks (picture narrative, IELTS, TOEFL) were analyzed, targeting two global ratings (accentedness, comprehensibility) and 10 linguistic measures (segmental and word stress accuracy, intonation, rhythm, speech rate, grammatical accuracy and complexity, lexical richness and complexity, discourse richness). Linguistic distinctions between accentedness and comprehensibility were less pronounced in the cognitively complex task (TOEFL), with overlapping sets of phonology, lexis, and grammar variables contributing to listener ratings of accentedness and comprehensibility. This finding points to multifaceted, task-specific relationships between these two constructs.
We present an analysis of high resolution UV (IUE) and optical (INT, AAT and ESO) spectroscopy of eight galactic WN and WC stars. We examine the correlation between ionization potential (IP) and the velocity structure of the stellar winds and find important correlations between line-width, IP and excitation potential (EP). These results provide potential constraints on the velocity law used in models of WR atmospheres.
A detailed study of the Ofpe/WN9 candidate MCA1b in M33 (Willis et al. 1992) is presented, based on new high-resolution observations. We re-classify MCA1b as WN9-10 and determine its physical parameters (T* = 29 kK, logL/L⊙ = 5.9, log· = −4.0, v∞ = 420 km s−1) and composition (H/He = 2.6, N/He = 0.003, C/N = 0.2) using the Wolf-Rayet standard model. Overall, MCA1b is very similar to the LMC stars R84 (WN9, Crowther et al. 1994) and R71 (LBV, Lennon et al. 1994) indicating a similar evolutionary status and metallicity.
We discuss the evolutionary and mass loss implications of recent non-LTE analyses of late WN (WNL) stars in the Galaxy, LMC and M33 using the Wolf-Rayet standard model and address the observed dichotomy of WNL stars discussed by Moffat (1989). Individual subtypes belong to two distinct groups. We find that the single WNL+abs and WN7 stars evolve directly from very massive O stars (60–100 M⊙) with the former intimately related to extreme Of stars and found exclusively in the youngest clusters in our Galaxy. Conversely, the observational properties and chemistries of WN8-10 stars suggest that they are descended from lower initial mass progenitors (∼25–60 M⊙). These stars are either dormant LBVs (= WN9–10) or at a phase immediately after this stage (= WN8) although a previous RSG phase cannot be excluded. Included in this subgroup are the LMC and M33 Ofpe/WN9 stars, re-classified as WN9–10 since they appear to be genuine WN stars.
An analysis of the UV, optical and IR spectra of the composite WN/WC star WR8 is presented using the WR standard model. All spectral features are consistent with formation in the same stellar wind. The stellar parameters are T*=49kK, log L/L⊙=5.1, log Ṁ = −4.2, v∞=1590 km s−1. The derived chemistry (C/He=0.025, C/N=3, C/O=4) is intermediate between normal WN and WC stars.
The observed He II Pickering decrement is modelled using the escape probability method developed by Castor & Van Blerkom (1970) to solve simultaneously the equations of radiative and statistical equilibrium for detailed model hydrogen and helium atoms. All important radiative and collisional processes are incorporated in this nLTE model. We confirm values of 0.0 ≤ H/He ≤ 0.5 for WNE stars and 0.0 ≤ H/He ≤ 3.0 for WNL stars with considerable spread in each subtype.