The Effect of Van Dijk Discourse Strategies on Iranian EFL Learners’ Writing Proficiency

This study tried to improve the writing proficiency of Iranian EFL students utilizing an innovative model through implementing and operationalizing the principles of critical discourse analysis which was introduced by Van Dijk’s (2000) well-known socio-cognitive model. To this end, 57 intermediate language learners studying English in language institutes for several years were selected as the participants of the study using a version of TOEFL test as the selected proficiency test. The included participants were randomly divided into two groups of experimental and control—with 28 students in experimental group (16 females and 12 males) and 29 students in control group (17 females and 12 males). Both groups went through a three-stage model (pre-writing, during-writing and post-writing). The teaching procedure on writing had some differences between the instruction provided for the experimental group and the instruction presented to the control group in which the experimental group received some instruction of some suitable discursive strategies, namely, comparison, example (illustration), explanation, repetition, reasonableness and context description. After instruction, two groups were asked to write on a topic and their compositions were scored using holistic scoring procedure in order to guarantee the high reliability. The results of the study showed the significant differences between the performances of the experimental and control groups which indicated to the efficiency of the CDA-oriented approach to teach writing skill. However, the result of the study showed non-significant differences between the performances of the two genders as well as the performances of females and males in each group

Evaluation of surface expression of platelet markers and left ventricle ejection fraction in patients with coronary artery disease

Background and Aims: Surface expression of  platelet markers enhanced during ischemic events and appear to play an important role in myocardial repair. Stromal cell-derived factor-1 (SDF-1) is one of these factors which its effects Mediated through CXCR4 and CXCR7 receptors. In our study we are going to determine the the surface expressions of platelet markers  and the changes of left ventricle ejection fraction in patients with coronary artery disease. Materials and Methods: This descriptive cross-sectional study measured the superficial expression of platelet indices (SDF-1R, CXCR4, and CXCR7) and its association with the changes of the left ventricle ejection fraction in patients with coronary artery disease who have referred to Taleghani Hospital, Tehran in 2016-2018. Results: Among all patients referred to Taleghani Hospital with symptoms of coronary artery disease, 57 patient had inclusion criteria. this study demonstrated that mean SDF1 and CXCR4 level were respectively 1.1 and 2.3 which there  were significant difference between those with severe EF reduction comparing to the rest of the groups (respectively P<0.002 & P<0.004 ). The mean CXCR7 value of all patients was 3.5 (SD= 0.27) and showed a significant difference in patients with severe (6) and low (4.7) ejection fraction reductions compared to those with moderate (2.5) and normal (2.8) ejection fraction reductions (P<0.009). &nbsp

Global burden of chronic respiratory diseases and risk factors, 1990–2019: an update from the Global Burden of Disease Study 2019

Background: Updated data on chronic respiratory diseases (CRDs) are vital in their prevention, control, and treatment in the path to achieving the third UN Sustainable Development Goals (SDGs), a one-third reduction in premature mortality from non-communicable diseases by 2030. We provided global, regional, and national estimates of the burden of CRDs and their attributable risks from 1990 to 2019. Methods: Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated mortality, years lived with disability, years of life lost, disability-adjusted life years (DALYs), prevalence, and incidence of CRDs, i.e. chronic obstructive pulmonary disease (COPD), asthma, pneumoconiosis, interstitial lung disease and pulmonary sarcoidosis, and other CRDs, from 1990 to 2019 by sex, age, region, and Socio-demographic Index (SDI) in 204 countries and territories. Deaths and DALYs from CRDs attributable to each risk factor were estimated according to relative risks, risk exposure, and the theoretical minimum risk exposure level input. Findings: In 2019, CRDs were the third leading cause of death responsible for 4.0 million deaths (95% uncertainty interval 3.6–4.3) with a prevalence of 454.6 million cases (417.4–499.1) globally. While the total deaths and prevalence of CRDs have increased by 28.5% and 39.8%, the age-standardised rates have dropped by 41.7% and 16.9% from 1990 to 2019, respectively. COPD, with 212.3 million (200.4–225.1) prevalent cases, was the primary cause of deaths from CRDs, accounting for 3.3 million (2.9–3.6) deaths. With 262.4 million (224.1–309.5) prevalent cases, asthma had the highest prevalence among CRDs. The age-standardised rates of all burden measures of COPD, asthma, and pneumoconiosis have reduced globally from 1990 to 2019. Nevertheless, the age-standardised rates of incidence and prevalence of interstitial lung disease and pulmonary sarcoidosis have increased throughout this period. Low- and low-middle SDI countries had the highest age-standardised death and DALYs rates while the high SDI quintile had the highest prevalence rate of CRDs. The highest deaths and DALYs from CRDs were attributed to smoking globally, followed by air pollution and occupational risks. Non-optimal temperature and high body-mass index were additional risk factors for COPD and asthma, respectively. Interpretation: Albeit the age-standardised prevalence, death, and DALYs rates of CRDs have decreased, they still cause a substantial burden and deaths worldwide. The high death and DALYs rates in low and low-middle SDI countries highlights the urgent need for improved preventive, diagnostic, and therapeutic measures. Global strategies for tobacco control, enhancing air quality, reducing occupational hazards, and fostering clean cooking fuels are crucial steps in reducing the burden of CRDs, especially in low- and lower-middle income countries

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Examining Five Behaviors Conducted by Two Groups of Novice and Experienced Raters in Two Rating Processes

This study aims at comparing five rating behaviors of 8 raters; four novice raters and four experienced raters. The five specific behaviors including number and frequency of referring to the rating scale (Jacobs’ et al. EFL Composition Profile), number of interpretation (justification), total rating time, total score, and number of pauses longer than 5 seconds are compared between the two groups. The 8 raters were asked to rate two essays written by two B.A. students of English Literature attending their 4 semester at Persian Gulf university of Bushehr, Iran. Using TAPs the behaviors conducted by the eight raters were transcribed, then analyzed. It was found that although a similar pattern was observed in both groups’ total scores assigned to the two essays, there was found no consistent trend in both the experienced and novice raters’ number of referring to the rating scale. In addition, we found that the novice raters’ number of referring to the rating scale, and number of pauses were higher than those of the experienced ones, while the experienced raters’ number of interpretation (justification) and total rating time were higher than the novices’. The findings while supporting the findings by the previous research, paves the way for future researchers in this regard.

Assessing emergency nurses' clinical competency: An exploratory factor analysis study

Background: Nursing as a clinical discipline is developing in the emergency wards. Health care systems should continuously assess and prioritize indicators of clinical competency in these wards. The lack of clear standards of clinical competency indicators challenges evaluation. The purpose of this study was to determine clinical competency indicators and its priority based on nurses' views in educational and therapeutic centers in Guilan. Materials and Methods: The Q methodology was conducted in three phases, that is, phase I (determining the clinical competency indicators), phase II (classifying clinical competency indicators by an expert panel), and phase III (prioritizing clinical competency indicators). The subjects were selected by convenience sampling among nurses working in the emergency wards of teaching hospitals affiliated to Guilan in 2013. Finally, clinical competency indicators were prioritized using exploratory factor analysis. Results: In the prioritizing phase, data were collected from 710 nurses over two months. Five factors with 30 general competencies were found in three domains: communication, professional maturity, and personality characteristics. Six factors with 37 specific competencies were also found in two domains: scientific and technical capabilities and basic clinical skills that can provide a structured instrument for assessing clinical competence in emergency nurses. Conclusions: Achieved competencies can be used as a reference for nursing education and practice in emergency. Further research on health care system is needed in order to achieve a reliable and valid instrument