Identification of factors predictive of outcome following Roux-en-Y gastric bypass for obesity

INTRODUCTION: Worldwide obesity levels have doubled since 1980. Bariatric surgery is the only effective long-term treatment however its results remain highly patient, procedure and surgeon dependent. This study aimed to assess the impact of a range of factors on the outcome of Roux-en-Y gastric bypass (RYGBP) surgery. METHOD: All patients eligible for RYGBP at 2 regional centres were approached for inclusion. Data pertaining to 13 factors identified as potentially associated with reduction in excess BMI (eBMI) following RYGBP were collected: genetic predisposition to obesity, ethnicity, reasons for seeking surgery, eating behaviour, physical activity level, quality of life, personality score, motivation to change, alcohol intake, smoking history, social class, working pattern and past medical history. The data were analysed using multivariate linear and logistic regression analysis. The primary outcome was the percentage eBMI loss at 12 months postoperatively. The secondary outcomes were the resolution of diabetes and/ or hypertension. RESULTS: 129 patients were recruited after written informed consent of whom just 60 were eligible for analysis. At 12 months postoperatively their percent eBMI losses ranged between 33.4% and 136.2% (mean 67.3%, SD 18.8%). Of the 13 factors investigated using linear regression none showed a significant correlation with percent eBMI loss. Logistic regression analysis showed that personality score, motivation to change score and smoking status were all significantly associated with eBMI loss of 70% or greater when combined with the other investigated factors (p = 0.013, p = 0.016 and p = 0.027 respectively) but not when analysed individually. 9 out of 12 (75%) and 5 out of 14 (35.7%) patients on medication preoperatively for type 2 diabetes mellitus and hypertension respectively were able to discontinue their medication by 12 months post-RYGBP. CONCLUSIONS: This pilot study shows that a multi-factorial approach to clinical prediction and patient selection is viable and feasible

Japanese EFL Learners’ Pragmatic Development in the Production of Speech Acts Drawing on ACT-R Model and Skill Acquisition Theory

This mixed-methods quasi-experimental study explored the development of pragmatic competence of lower-proficiency EFL learners in their university English classes in Japan. Although pragmatic competence has emerged as a key topic within the field of interlanguage pragmatics (ILP), almost all studies have examined L2 learners’ language use rather than pragmatic development focusing on learning outcomes than process. This study investigates both learners’ language use and development, in order to draw a more comprehensive picture of pragmatic development. It also attempts to identify the mechanisms that drive this development by employing a framework of Adaptive Control Thought-Rational (ACT-R) theory in tandem with skill acquisition theory, which is a promising but underexplored framework in the L2 pragmatic development context. As such, this study aims to fill a gap in the research literature and make a theoretical contribution by showing the potential of the framework to account for learners’ pragmatic development. For this study, I recruited 120 Japanese EFL learners making up four intact classes to examine the development over one term (14 weeks) of their skills for producing speech acts after receiving pragmatic instruction. The development was examined both in terms of knowledge and processing ability with more focus on the latter to produce speech acts. Four types of speech acts were chosen for this experiment: request and refusal speech acts, for which specific instruction was provided; and complaint and disagreement speech acts, for which no instruction was provided. Request and refusal were selected as they were most widely studied, and complaints and disagreements were selected as they are relatively similar in nature to request and refusal speech acts and a good candidate to examine learners’ ability of knowledge extension. Quantitative and qualitative analyses were employed to see how much learners improved their production of request and refusal speech acts - in light of the effectiveness of instruction they had received. A similar analysis was carried out on the uninstructed speech acts of complaint and disagreement to assess their capability to extend their learned knowledge from request and refusal making to the production of new speech acts, namely to assess their processing capability. The results showed that the participants in the treatment groups (TGs) improved in the production of both instructed and uninstructed speech acts by developing their knowledge and processing ability. The development of such knowledge was assessed by measuring the TGs’ improvement in the use of politeness strategies, which are associated with declarative knowledge. As for the development of their processing ability, this was assessed in two ways: in terms of their ability to select contextually appropriate strategies and to apply their learned knowledge sufficiently to produce uninstructed speech acts, these being associated with procedural knowledge. Since the application of the learned speech act schema enables learners to produce ostensibly ‘new’ speech acts with relative ease, not from scratches. This frees up most of the working memory to be available for other purposes, such as planning what to say next, and looking for more sophisticated expressions. This was reflected in the results of this experiment that showed, following instruction, the use of a wider range of strategies and more sophisticated lexical and syntactic expressions. However, the results did show that the participants were still in an early stage of proceduralisation and needed further practice to improve their processing ability to move toward automatisation. This study has pedagogical, theoretical, and methodological implications. Pedagogically, there are several implications afforded by a clearer understanding of learning processes that can be used to revise the EFL curriculum. Theoretically, by showing how pragmatic competence develops in an EFL classroom, this study shows the potential of the ACT-R model, partially revised to apply to this study, to elucidate the operational mechanism of pragmatic ability. Methodologically, this study shows how the application of the revised model I formulated through adaptation and clarification of a range of interpretations of the ACT-R model can better account for proceduralisation in pragmatic development, raising implications for allowing related research to move forward in an otherwise muddled ongoing discussion in the field

A Study on the Acquisition of English Function-chains: A Focus on Japanese EFL Learners

広島大学(Hiroshima University)博⼠ (教育学)Pedagogydoctora

Changes in body imagery of physically handicapped children due to summer camp experience

Thesis (Ed.D.)--Boston University

Annual Report of the University, 1988-1989, Volumes 1-5

Significant Developments During Academic Year, 1988-89 A. Approximately one man-year of effort was devoted to analysis to detect possible gender or racial/ethnic bias in faculty personnel operations at the university. This effort was required to support responses by the Counsel\\u27s office to queries put by OFCCP. B. Approval by the NMCHE of its statewide postsecondary education plan, Planning for the Class of 2005, required review of the plan by President May. P&PS provided that review plus all of the written institutional testimony. C. NMCHE developed a 16-page directive, Institutional Planning Guidelines, which required extensive input to the Commission\\u27s Planning Committee. Commissioner Taylor and the NMCHE staff resisted most of the institutional recommendations. Of some significance was the addition by NMCHE of a set of statewide issues in New Mexico higher education drafted in P&PS

Requests in Brazilian Portuguese : new theoretical and methodological approaches in interlanguage pragmatics

Abstract unavailable please refer to PD

SCELIDOSAURUS HARRISONII OWEN, 1861 (DINOSAURIA: ORNITHISCHIA) FROM THE EARLY JURASSIC OF DORSET, ENGLAND: BIOLOGY AND PHYLOGENETIC RELATIONSHIPS

A layer of keratinous scutes encased the skull of Scelidosaurus. The neurocranium as well as the associated principal sensory systems of this dinosaur are described. The cranial musculature is reconstructed and a subsequent functional analysis suggests that jaw motion was orthal, allowing pulping of vegetation and some high-angle shearing between opposing teeth. Wishboning of the lower jaw was enabled by transverse displacement of the quadrates; and the long-axis mandibular torsion that occurred during the chewing cycle was permitted by flexibility at the dentary symphysis. Limb proportions and pectoral and pelvic musculature reconstructions suggest that Scelidosaurus was a facultative quadruped of ‘average’ locomotor ability; it retains some anatomical features indicative of a bipedal-cursorial ancestry. Hindlimb motion was oblique-to-parasagittal to accommodate the girth of the abdomen. Scelidosaurus used a combination of costal and abdominally driven aspiration. The hypothesis that respiration was an ‘evolutionary driver’ of opisthopuby in all dinosaurs is overly simplistic. A critical assessment of datasets used to analyse the systematics of ornithischians (and thyreophoran subclades) has led to a revised dataset that positions Scelidosaurus as a stem ankylosaur, rather than a stem thyreophoran. The value of phylogenetic definitions is reconsidered in the light of the new thyreophoran cladogram.PRISM FUND, TRINITY COLLEGE CAMBRIDGE, SMITHSONIAN INSTITUTION WASHINGTON DC, ST JOHN'S COLLEGE OXFORD

Producing the Dead Sea Scrolls: (Trans)national Heritage and the Politics of Popular Representation

This thesis explores the politics of representing the assemblage of ancient manuscripts known as the Dead Sea Scrolls to popular audiences in Israel, the occupied West Bank, and the United States. I demonstrate that these objects of national heritage are circulated along transnational routes to maintain the legitimacy of nationalist discourse abroad. Three sites—the Shrine of the Book at the Israel Museum in Jerusalem, Qumran National Park in the West Bank, and a travelling exhibit presented at the Boston Museum of Science—are examined for textual narrative, spatial arrangement, and visitor behavior. Analysis of these observations illuminates two recurring motifs common to all three sites: the restoration of an ancient ethno-national landscape (“land of Israel”) in the contemporary landscape of Palestine/Israel and the important legacy of ancient Jewish society in contemporary Israel and “the West.” These motifs and the way they are presented through a framing of cultural heritage can be associated with a larger nationalist discourse maintained by Israeli state authorities and mainstream media that perpetuates a linking of western liberal and Zionist ideologies. I contend that the transnational circulation of this nationalist heritage narrative works to legitimize—at a global scale—an ongoing Israeli program of occupation and settlement in Palestinian territory subsumed under the biblical/Zionist frame of the “land of Israel.” While making preliminary suggestions toward critical interventions, I also suggest that the analysis of transnational encounters with nationalist heritage merits deeper ethnographic investigation towards understanding its impact on individuals’ political (in)action towards the Israel/Palestine conflict