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Few studies examine care as a relational process in long-term care, and still fewer describe the participation of residents with dementia. In this article, our objective was to understand the development of knowledge in this area by means of a meta-ethnography. Our search and selection process resulted in six eligible articles. Each documents a qualitative study of resident–staff interactions during care activities in a residential care setting, and includes participants with dementia. Tronto’s 4 Phases of Care were used to guide the identification of relational care practices within the articles selected. We identified five translatable concepts across the six studies: (1) doing with versus doing for, (2) staff responsiveness, (3) resident agency, (4) inclusive communication, and (5) time. In our new configuration of relational care, we combine these concepts to delineate an “interactive space” in which the agency of residents and initiative of staff are equally visible.
Responsive and respectful relationships are principal elements of early childhood curricula in many countries. Children seek to interact with peers, be included as part of a group, and make friends. Successful relationships in the early years lead to better communication skills, increased general knowledge, and feelings of wellbeing, all necessary for successful life and work outcomes. Making friends is often viewed as a ‘natural’ state of childhood, and consequently, assumes an individual’s social skills are the sole reason for a child’s ability to make friends or not. This chapter takes an interactional view to show that friendships are linked to ongoing and inter-dependent actions of the peer group. Seven examples of peer interactions highlight the ways in which children actively seek to participate and build friendships. It is these ‘implications for practice’ that demonstrate how early childhood educators might support children’s play and participation so as to develop responsive and respectful relationships. The chapter argues that when an interactional process approach, based on conversation analysis is adopted, educators can identify the criticality of the social context, and best support children’s opportunities to be included and make friends.
Learning vocabulary through listening is one type of learning through meaning-focused input. Learners need at least 95 per cent coverage of the running words (around 3,000 word families) in the informal spoken input in order to gain reasonable comprehension and to have reasonable success at guessing unknown vocabulary from context clues. A well-balanced listening and speaking course includes opportunities to learn through listening to monologues and interactive communication, opportunities to learn from speaking and interacting with others, the deliberate study of pronunciation, vocabulary and multiword units, and grammar, and opportunities to become fluent in listening and speaking. This chapter includes a large range of activities to provide these opportunities, and describes how teachers can design speaking activities so that vocabulary is more likely to be learned. The research shows that those who observe speaking activities are just as likely to learn the vocabulary in the activities as those who actively participate
This introductory chapter aims at giving an overview of the pervasiveness of the second-person pronoun across genres, from advertising and political slogans to Twitter via ‘you narratives’ as literature too has taken its ‘you’-turn. Starting from a linguistic template based on face-to-face interactions and adapting it to make it fit written narratives, the chapter offers a theoretical modelling of the possible references of ‘you’, given the degree of congruence between form and function, that could apply to both fictional and non-fictional texts. The pragma-rhetorical approach adopted here foregrounding the author–reader channel allows to transcend the divide between ‘you narratives’ and other genres using the pronoun that the literature has tended to keep separate. It highlights the ethicality of the second-person pronoun as readers are brought to negotiate their relation to the pragmatic effects of ‘you’ in the wide variety of texts investigated in the following chapters. The model that is designed in this chapter gives pride of place to the flesh and blood reader and her potential self-ascription as addressee even in cases where there is only an ‘effect of address’.
The present chapter focuses on the benefits of task-supported interaction among child foreign language learners. It reviews research carried out in English as a foreign language (EFL) and content and language integrated learning (CLIL) contexts, and highlights the affordances of child–child interaction in settings where access to input is restricted. The chapter provides a rationale for the increasing interest in research with the underexplored population of young learners in foreign language contexts. It also features a summary of the main findings from research carried out to date within two frameworks, namely, interactionist (Long, 1996) and sociocultural (Vygotsky, 1978). The children in the studies are in the so-called middle childhood stage, a developmental stage characterized by their becoming more logical in their thinking. The studies chosen for this chapter have considered the importance of negotiation of meaning and the impact of repeating a task on interactional patterns, attention to language form, complexity, accuracy and fluency of production and the use of the first language. The contribution ends with several suggestions for further research with young learners.
Task-based language teaching (TBLT) aims to help learners meet “present and future real-world communicative needs” (Long, 2015: 68). In Indigenous language revitalisation contexts, however, there may not be a real-world need to speak the target language, due to a lack of speakers or the widespread bilingualism associated with particular stages of language loss. Drawing on two distinct but complementary contexts, Macuiltianguis Zapotec after-school lessons (Oaxaca, Mexico) and a workshop for teachers at a Salish Qlispe immersion school (Montana, United States), we show how TBLT might be adapted for language revitalisation through the conscious creation of new spaces for meaningful communication in the target language. The Zapotec and Salish contexts represent different approaches to adapting TBLT for Indigenous language instruction. The Zapotec teachers looked for everyday communicative tasks that learners plausibly could do in Zapotec, focusing on encouraging students to speak Zapotec in situations in which they were already interacting with Zapotec speakers in the community but doing so in Spanish. The Salish teachers, on the other hand, focused on the school itself as a new space for meaningful language use. We describe how task-based methodological principles (Long, 2009, 2015) were useful for planning and teaching in these settings.
This chapter covers two related prosodic phenomena: stress, i.e. the relative perceived prominence of individual syllables, and speech rhythm, the distributed prominence of syllables across stretches of speech and their perceived regularity in time. Both stress and rhythm can be viewed from the angles of perception and production, and speakers of different languages differ in how stress and rhythm are produced, perceived and interpreted for linguistic meaning. The chapter explains which articulatory and phonatory factors have been found to play a role in the production of stressed syllables, and distinguishes between stress and accent. The historically important concepts of rhythm classes and isochrony are presented in the context of current developments and debates. Three recent issues for research are presented in some detail: the analysis of stress in different languages, rhythm metrics, and rhythm and perception. The chapter further explores the role of rhythm for turn-taking in everyday talk, showing that conversationalists aim to rhythmically integrate their turns at talk with those of other speakers.
The conclusion ties together the main themes that have been introduced and explored in the book. Through the adolescent language learning stories of the three authors, the reader is encouraged to make links between theory and/or principles of instructed language learning and practice/experience. The source of the main research evidence and literature which underpinned and informed the writing of the book is presented. The chapter describes a number of teaching scenarios and explains the teaching practice that might have accompanied each scenario, first in the conventional and then in the more progressive language classroom. In each case, the more progressive classroom showcases an example of actual practice. Task-based language teaching is described as one approach that allows for the implementation of principles of effective instructed language learning in the classroom. The chapter concludes by stressing the importance of the classroom learning environment.
Highlighting the lack of opportunities to use and practise language that is often typical of the foreign language classroom, a lesson is described where learners had opportunity to consolidate learning and develop fluency in using language they had previously covered in class. Drawing on Ortega (2007), the principles of optimal practice are described and examples from the classroom show how ‘optimal practice’ may have consolidated language learning, but also led to new learning. Perspectives from both the teacher and students are included. The importance of incorporating opportunities for practice in the language classroom is discussed and, here, as elsewhere in the book, Nation’s four strands (Nation, 2007) are presented as a way of integrating balance into a classroom language programme.
This chapter investigates why output, alongside input, is considered essential for the language learning process and what sort of output is most likely to lead to successful language acquisition. It draws on research in second language acquisition to define output, and uses an example from a classroom to demonstrate how engaging in output may have afforded learning opportunities for the student. It discusses the notion of ‘pushed output’ and suggest ways that learners may be encouraged to ‘push’ their output, including classroom examples. The different advantages, for the language learner, of opportunities for written (as opposed to spoken) output are discussed and examples from the classroom are included along with teacher comments. Referring to the idea of the importance of ‘challenge’ accompanied by ‘support’, teachers describe how they support students to deal with the challenge of producing language output. An example of an extended dialogue between a teacher and student is used to show how output may be viewed through the lens of sociocultural theory. This dialogue is used to discuss how learning may have been promoted as the teacher ‘pushed’ but also ‘scaffolded’ the learner to communicate effectively.
Drawing from research in educational psychology and in applied linguistics, this chapter profiles adolescents’ social maturation and their developmental needs. It explores how this time of transition towards greater independence has implications for teaching and learning. It focuses on the key characteristics of a supportive learning environment, and illustrates these through examples from classrooms and the voices of teachers and students. It discusses the impact of teacher expectations and it describes the complementary roles that teachers and peers play. It highlights the importance of positive classroom relationships. It discusses how teachers need to provide adolescent language learners with activities that match their interests and encourage them to engage in the learning process. The chapter concludes by describing the successful classroom as one that provides a balance of challenge and support.
In the mid-1990s Harrison White was in the midst of his “linguistic turn,” which began with the publication of Identity and Control in 1992. During that period, he engaged like-minded scholars in discussions of time, identity, language and networks. Social ties, he argued, are not static entities, but rather are generated by reporting attempts amidst contending efforts at control. Since ties are multiple, fluid, and narratively constructed, he saw the new challenge for network analysis as understanding the link between temporality, language and social relations. I discuss the tension between formalization and hermeneutics in White’s work; he sought to put networks in motion, providing a theoretical framework for understanding the linguistic and discursive processes by which networks are constituted and transformed. Finally, I present four takeaways from Identity and Control that continue to resonate with social science research: (1) the ephemeral, contingent nature of “persons,” (2) the origins of social structure in intersecting struggles for stability and control: (3) the co-constitution of narratives and networks; and (4) the generativity of ambiguity in “getting action” amidst contests for control.
This chapter argues for an alternative view of 'African youth languages' based on ethnographic and ecological approaches that link structural and discursive analyses of spontaneous communicative interactions with immediate situational and local social dynamics and then the broader sociocultural context of the speech community in which these practices occur. Using video recordings of naturally occurring conversations from twenty-two years of observation among male youth in a township in Johannesburg, South Africa, I demonstrate that so-called Tsotsitaal or tsotsitaals are interactive performative practices that constitute a performative register made up of a set of discursive strategies that draw on different linguistic resources in the quest for originality as part of male sociality during a particular life stage. I show that variation in choice of words and other semiotic features of this practice are best explained from a persona-constructionist perspective as part of male sociality where linguistic choices index attitudes, stances and identities in the service of social distinction. Innovations spread based on linguistic skill and status within male social networks. Multivalency accounts for the presence of some of the male youth lexicon in urban vernaculars. Implications for current approaches to the study of youth language in Africa are discussed.
This Element in the Cambridge Elements in Second Language Acquisition series examines the role of interaction in Second Language Acquisition research, with a focus on the cognitive interactionist approach. The Element describes the major branches of the field, considering the importance of conversational interaction in both the cognitive interactionist framework as well as in sociocultural approaches to second language learning. The authors discuss the key concepts of the framework, including input, negotiation for meaning, corrective feedback, and output. The key readings in the field and the emphases of current and future research are explained. Finally, the authors describe the pedagogical implications that the cognitive interactionist approach has had on the teaching of second languages.
Vitamin D, Ca and dairy products are negatively associated with colorectal cancer (CRC) incidence, but little is known of their influence on CRC survival. To investigate prediagnostic intakes of vitamin D, Ca and dairy products for their relevance to CRC prognosis, we analysed 504 CRC patients enrolled in the Newfoundland Colorectal Cancer Registry Cohort Study who were diagnosed for the first time with CRC between 1999 and 2003. Follow-up for mortality and cancer recurrence was through April 2010. Data on diet and lifestyle factors were gathered via a validated, semi-quantitative FFQ and a Personal History Questionnaire. Multivariate Cox models estimated hazard ratios (HR) and 95 % CI for the relationship of prediagnostic intakes of vitamin D, Ca and dairy products with all-cause mortality (overall survival, OS) and disease-free survival (DFS) among CRC patients. We found that prediagnostic Ca intake from foods, but not total Ca intake, was negatively associated with all-cause mortality (HR for Q2 v. Q1, 0·44; 95 % CI, 0·26, 0·75). An inverse relationship was also seen in a dose–response fashion for prediagnostic cheese intake (HR for Q4 v. Q1, 0·57, 95 % CI, 0·34, 0·95, Ptrend = 0·029). No evidence for modification by sex, physical activity, alcohol drinking and cigarette smoking was observed. In summary, high prediagnostic intakes of cheese and Ca from foods may be associated with increased survival among CRC patients. By manipulating diet, this study may contribute to the development of novel therapies that add to the armamentarium against CRC. Replication studies are required before any nutritional interventions are made available.
Bipolar disorder is a frequent and serious psychiatric disease. Antipsychotics are habitually required for its management especially during an acute manic episode. The association of cancer with bipolar disorder may impact psychiatric management. The choice of the adequate antipsychotic drug remains a challenge in this case. The clinical benefit of tamoxifen is obtained after the hepatic metabolism with cytochrome P450 2D6 which generates endoxifen, the potent metabolite of tamoxifen. Evidence has emerged that antipsychotics may potentially inhibit the CYP2D6. Study data supporting this interaction are rare.
In this work, we aimed to illustrate the modalities of care of bipolar disorder in a patient receiving tamoxifen.
Presentation of a clinical case of a patient treated by Tamoxifen for her breast cancer and who was admitted in our department for acute mania with psychotics features, followed by a literature review.
A 53-year-old woman with past history of breast cancer diagnosed in 2018, treated with lumpectomy and radiation, followed by tamoxifen. She has been admitted in 2019 in our department for an acute mania with psychotics features. Olanzapine was prescribed with good clinical evolution. The psychiatric and oncologic status of the patient was stable after one year under tamoxifen and olanzapine.
Psychiatrists must be aware that some of the prescribed medications co-administered with tamoxifen interfere with the CYP2D6 function, which may potentially increase the risk of breast cancer recurrence. A close collaboration between psychiatrists and oncologists is required to adapt therapeutic protocols.
This work aims to examine the interaction between apo A2 (Apo A-II) –265T > C SNP and dietary total antioxidant capacity (DTAC) on inflammation and oxidative stress in patients with type 2 diabetes mellitus. The present cross-sectional study included 180 patients (35–65 years) with identified Apo A-II genotype. Dietary intakes were assessed by a FFQ. DTAC was computed using the international databases. IL-18 (IL18), high-sensitivity C-reactive protein (hs-CRP), pentraxin (PTX3), serum total antioxidant capacity (TAC), superoxide dismutase (SOD) activity and 8-isoprostaneF2α (PGF2α) markers were obtained according to standard protocols. General linear model was used to evaluate the interaction. The interaction of gene and DTAC (PFRAP = 0·039 and PORAC = 0·042) on PGF2α level was significant after adjusting for confounders. A significant interaction was observed on IL18 level (PORAC = 0·018 and PFRAP = 0·048) and SOD (PTEAC = 0·037) in obese patients. Among patients whose DTAC was higher than the median intake, the levels of hs-CRP and PGF2α were significantly higher only in individuals with CC genotype. Serum TAC (PFRAP = 0·030, PORAC = 0·049) and SOD were significantly lower in the CC genotype. There was a favourable relationship between the high-DTAC and SOD (obese: PTEAC = 0·034, non-obese: PFRAP = 0·001, PTRAP < 0·0001, PTEAC = 0·003 and PORAC = 0·001) and PGF2α (non-obese: PORAC = 0·024) in T-allele carriers. The rs5082 SNP interacts with DTAC to influence several cardiometabolic risk factors. Also, we found dietary recommendations for antioxidant-rich foods intake might be useful in the prevention of diabetes complications in the T carrier more effectively than the CC genotype. Future large studies are required to confirm these results.
The role of childhood abuse and serum brain-derived neurotrophic factor (BDNF) levels in suicidal behaviour is controversial.
We aimed to investigate the individual and interactive effects of the childhood abuse and serum BDNF on suicidal behaviour before and after pharmacologic treatment in patients with depressive disorders.
At baseline, reported childhood emotional, physical and sexual abuse were ascertained and serum BDNF levels were measured in 1094 patients with depressive disorder, 884 of whom were followed during a 1-year period of stepwise pharmacotherapy. Suicidal behaviours evaluated at baseline were previous suicide attempt and baseline suicide severity, and suicidal behaviours evaluated at follow-up were increased suicide severity and fatal/non-fatal suicide attempt. Individual and interactive associations of any childhood abuse and serum BDNF levels with four types of suicidal behaviours were analysed using logistic regression models, after adjusting relevant covariates.
Individual associations of childhood abuse were significant only with previous suicide attempt, and no significant individual associations were found for serum BDNF with any suicide outcome. However, the presence of both childhood abuse and lower serum BDNF levels was associated with the highest prevalence/incidence of all four suicidal behaviours, with significant interactions for baseline suicide severity and fatal/non-fatal suicide attempt during follow-up.
Synergistic interactive effects of child abuse and serum BDNF levels on suicidal behaviours were found before and after pharmacologic treatment in patients with depressive disorders. Information combining childhood abuse and serum BDNF levels could improve predictions of suicidal behaviour in patients with depressive disorders.