English Speech Act Realization of “Refusals” among Iranian EFL Learners

Speech act of refusal has been one of the important topics in the discourse pragmatic research over the past few decades. In fact, pragmatics plays a very important role in the process of communication and the action of refusal is performed in our daily lives and in a variety of situations. Therefore, in the present study, the researcher has tried to investigate how Iranian EFL learners followed different pragmatic patterns to produce the speech act of refusal and what strategies they used in different situations and under various conditions. And also to examine if their use of the strategies were dependent on gender and finally to see if there was any difference in the type of strategies used by students at different levels of education at the university. So, forty eight students, both males and females were randomly selected to be representative of the accessible population from the students studying at different levels of education at the university; that is, twenty MA students majoring in TEFL and twenty eight BA students majoring in English Literature at Shiraz University. Thus, the students were given a questionnaire on discourse completion test (DCT). In the present study, the researcher benefited from a qualitative mode of inquiry for the analysis of discourse pragmatics; that is, the obtained data from the questionnaires were first codified and then each refusal was classified, analyzed and interpreted based on a modified version of Beebe et al.’s (1990) taxonomy of refusal strategies. The results indicated that Iranian EFL learners usually followed implicit or indirect strategies to talk to their interlocutors or hearers and express their intended meaning in a way that they would not cause any offence or threaten their listener’s face. Moreover, indirect speech act usually denoted politeness in the Iranian context as well. In other words, the mostly common strategies used by Iranian learners were excuses, explanations, or reasons following or preceding a sense of regret. Regarding gender differences, due to the limited number of the participants who were mostly females, the researcher in this study could not draw any definite conclusions. Finally, no difference was found between the participants in both levels of education in using the aforementioned strategies. Key words: Discourse Pragmatic; Pragmatics; Refusal Speech Act; Refusal Strategies; Iranian Context Resumé: L'acte de discours de refus a été l'un des thèmes importants dans la recherche sur le discours pragmatique des dernières décennies. En fait, la pragmatique joue un rôle très important dans le processus de communication et l'action de refus est réalisée dans notre vie quotidienne et dans une variété de situations. Par conséquent, dans la présente étude, le chercheur a tenté de déterminer comment les apprenants ALE iraniens ont suivi de différents schémas pragmatiques pour former l'acte de discours de refus et quelles stratégies ils ont utilisées dans de différentes situations et de diverses conditions. Il esssaie aussi d'examiner si leur utilisation des stratégies étaient dépendante du sexe et enfin de voir s'il y avait une différence dans le type de stratégies utilisées par les étudiants à des niveaux de l'éducation différents à l'université. Ainsi, 48 élèves, des garçons et des filles ont été sélectionnés au hasard pour représenter la population accessible des étudiants à des niveaux de l'éducation différents à l'université; soit vingt étudiants MA avec la spécialisation en EALE et vingt-huit étudiants BA avec la spécialisation en littérature anglaise à l'université de Shiraz. Ainsi, les élèves ont reçu un questionnaire sur le test de complétion de discours (TCD). Dans la présente étude, le chercheur a bénéficié d'un mode qualitatif de l'enquête pour l'analyse de la pragmatique de discours, c'est-à-dire, les données obtenues à partir des questionnaires ont d'abord été codifiées et ensuite chaque refus est classé, analysé et interprété en fonction d'une version modifiée de la la taxonomie des stratégies de refus de Beebe et al. (1990). Les résultats indiquent que les apprenants ALE iraniens ont généralement utilisé des stratégies implicites ou indirectes à parler à leurs interlocuteurs ou auditeurs et ils expriment leur sens voulu d'une manière qui ne causerait pas de tort ou de menacent face à leurs auditeurs. Par ailleurs, l'acte de discours indirect signifie habituellement la politesse dans le contexte iranien. En d'autres termes, la plupart des stratégies communes utilisées par les apprenants iraniens ont été des excuses, des explications ou des motifs qui suivent ou précèdent un sentiment de regret. En ce qui concerne les différences des sexes, comme les participants étaient principalement des femmes, le chercheur de cette étude ne pouvait pas tirer de conclusions définitives. Enfin, aucune différence n'a été observée entre les participants à ces deux niveaux de l'éducation en utilisant les stratégies ci-dessus. Mots-clés: Discours Pragmatique; Pragmatique; Acte de Discours de Refus; Stratégies de Refus; Contexte Iranie

The IELTS Preparation Washback on Learning and Teaching Outcomes

Abstract Due to the important roles that nowadays standardized tests such as IELTS, TOEFL, etc. have on students’ lives around the world like Iran, the present study has tried to provide both a clear view toward the washback effect of IELTS preparation courses on learning and teaching outcomes and an obvious path for IELTS teachers in order to modify their methods and their way of teaching if it is necessary. Therefore, the present study has tried to investigate whether IELTS preparation classes have any influence on the learning processes and the achievement of students in such an examination, specifically in the Iranian context, and at the same time to seek whether the construct of such tests makes any difference in the methods used in teaching or not. Accordingly, the researcher benefited from a mixed method approach that is both qualitative and quantitative modes of inquiry. So, fifty five students who took part in the IELTS preparation courses and nine IELTS teachers who involved in this learning and teaching process were selected to be representative of the accessible population. The students were supposed to be given one questionnaire before and one after taking part in IELTS preparation classes to extract their expectations of such classes. But because of the limitation of the study that is the shortage of time, both questionnaires were given to them at the same time. The teachers were also supposed to be interviewed and their ideas about these classes were transcribed and codified. However, because of inaccessibility to the teachers, the researcher had to type the questions and give them to the teachers. Finally, the gathered data were submitted to SPSS Software and the results were analyzed and interpreted. The results indicated a significant difference between the students’ expectations before taking part in the IELTS preparation courses and their expectations after taking part in such courses. In other words, these classes had both positive and little effects not necessarily negative effects on different Iranian students’ learning processes and their achievement in such an examination. Although the students’ expectations before and after taking the course changed significantly due to their both optimistic and pessimistic views toward some aspects of these courses, it was too difficult to make it clear that in which aspects of the course their expectations changed. Moreover, the construction of such tests affected the teachers’ way of teaching processes and made them teach students different techniques and strategies in comparison to other types of tests. Key words: Washback; IELTS preparation courses; Learning outcomes; Teaching outcomes; Iranian context Résumé En raison de l'importance du rôle que les tests de nos jours standardisés tels que l'IELTS, TOEFL, etc avoir sur la vie des étudiants du monde entier comme l'Iran, la présente étude a tenté de fournir à la fois une vision claire vers l'effet en retour des cours de préparation IELTS apprentissage et l'enseignement des résultats et un chemin évident pour les professeurs IELTS afin de modifier leurs méthodes et leur façon d'enseigner si elle est nécessaire. Par conséquent, la présente étude a tenté de déterminer si les cours de préparation IELTS avoir une quelconque influence sur le processus d'apprentissage et le rendement des élèves dans un tel examen, en particulier dans le contexte iranien, et dans le même temps de rechercher si la construction de ces tests rend aucune différence dans les méthodes utilisées dans l'enseignement ou non. En conséquence, le chercheur a bénéficié d'une méthode mixte qui est à la fois qualitatives et quantitatives des modes d'enquête. Ainsi, 55 étudiants qui ont pris part au cours de préparation IELTS IELTS et neuf professeurs qui participent à ce processus d'apprentissage et d'enseignement ont été sélectionnés pour être représentatifs de la population accessible. Les élèves étaient censés être donnés un questionnaire avant et un après avoir participé à des cours de préparation IELTS pour extraire leurs attentes de ces classes. Mais en raison de la limitation de l'étude qui est le manque de temps, deux questionnaires ont été donnés à la fois. Les enseignants étaient également censés être interrogés et leurs idées sur ces classes ont été transcrites et codifiées. Cependant, en raison de l'inaccessibilité à l'enseignant, le chercheur avait pour taper les questions et les donner à l'enseignant. Enfin, les données recueillies ont été soumises au logiciel SPSS et les résultats ont été analysés et interprétés. Les résultats indiquent une différence significative entre les attentes des étudiants avant de prendre part aux cours de préparation à l'IELTS et de leurs attentes, après avoir participé à ces cours. En d'autres termes, ces classes ont eu des effets positifs et peu pas nécessairement des effets négatifs sur les processus différents étudiants iraniens d'apprentissage et leur réalisation dans un tel examen. Bien que les attentes des étudiants avant et après avoir suivi le cours a changé considérablement en raison de leurs opinions à la fois optimistes et pessimistes envers certains aspects de ces cours, il était trop difficile à établir clairement que dans laquelle les aspects du cours de leurs attentes modifiées. Par ailleurs, la construction de tels tests affectés manière dont les enseignants du processus d'enseignement et les firent enseigner aux élèves les différentes techniques et stratégies en comparaison à d'autres types de tests. Mots clés: Washback; des cours de préparation d’IELTS; Résultats d'apprentissage; L'enseignement des résultats; Contexte Iranie

Seroepidemiological study of Toxoplasma gondii infection of mentally retarded patients (Chahrmahal Va Bakhtiari Province, Iran)

Toxoplasmosis is a widespread zoonosis disease in the world. Although the infection by Toxoplasmo gondii is widely prevalent, the disease is not common and the most of acquired infections are asymptomatic. Whereas congenital Toxoplasmosis can occur with passing the trophozoite of the parasite from mother to child and the important aspect of this parasitic infection are the probable danger of congenital transmission and its severe effects of the fetus. In this case- control study, a total of 108 mentally-retarded cases inhabited in 3 rehabilitation centers and 50 apparently healthy donors as a control were screened to detect Toxoplasmosis antibodies. In this study serum of all participants (including mental retard & voluntary blood donors) were kept at - 20°C until laboratory examination. Samples were tested by commercial kit to detect anti Toxoplasma IgG and IgM antibodies. The survey showed that 35.2 of the mental retard group and 30 of control group had anti Toxoplasma IgG and IgM antibodies. From 31 cases in the group of mental retard who were positive for IgG antibody of Toxoplasmosis, 22 cases were male and 9 cases were female that indicated a positive relationship between presence of anti Toxoplasma IgG antibody and being male (P<0.05). Out of 50 volunteer blood donors 15 cases (30) had IgG and IgM antibodies of Toxoplasma gondii and statistic tests showed that there was no significant difference between cases and controls for IgG and IgM antibodies of Toxoplasma gondii. The rate of Toxoplasma infection in the mentally retarded group was approximately the same as in the normal control group that indicated Toxoplasmosis is not a serious problem in this individual group and played little or no role as a predisposing factor in the occurrence of congenital mental deficiency in this setting

Which came first, the risk of migraine or the risk of asthma? A systematic review

Objectives We conducted this review to systematically assess the association and risk of the migraine in the patient with asthma and vice versa. Methods We systematically searched publishes articles indexed in PubMed, Scopus, Cochrane library, PsycINFO, CINAHL, ISI Web of Science, Science Direct from inception, and Embase databases until June 2017. The quality assessment of the involved studies was done using the Newcastle-Ottawa Scale (NOS). Results Eight studies with 389,573 participants were reviewed and selected for data extraction. Among the selected studies, 5 were reported the association between migraine with asthma risk, and the rest three studies reported the risk of asthma in patient with migraine compared to non-moraine individuals. Odds ratio (OR) of migraine for patient with asthma as compared with non-asthmatic individuals was 1.62 (95% CI 1.43–1.82). Data pooling using a random-effect model showed that migraine was associated with a significant increased risk of asthma (relative risk (RR): 1.56; 95% CI: 1.51–1.60; p &lt; .00001). Besides, sub-group and sensitivity analyses supported the positive association between asthma and migraine, and risk of asthma in migraine patients. Conclusion Now it is unknown if control of the asthma will impact the severity of migraines or vice versa, but it is necessary to perform more research to further explain the mechanisms through which asthma increases the frequency of migraine or vice versa. If two conditions linked, once an individual undergo better control of asthma symptoms, might the excruciating migraine ease, too

Factors associated with breakfast consumption based on Social Cognitive Theory in primary school students in Marivan City, 2017

Background and Aims: Social cognitive theory is one of the most effective theories used to predict the behavior of breakfast consumption and the teaching of nutritional behaviors. Considering the importance of breakfast consumption in the physical, psychological and social health of students, this study was conducted to determine the factors associated with breakfast consumption based on social cognitive theory in students. Materials and Methods: In this cross-sectional descriptive analytical study, 299 male and female elementary students in Marivan city were selected by multi-stage cluster sampling. Data gathering tools included demographic and background questionnaire, as well as a valid and reliable questionnaire based on social cognitive theory about breakfast consumption. Data were analysed by SPSS software version 16 exploiting Chi-square and t-test.  All stages of the study were conducted according to moral standards.Results: Overall, 81.6% (n=244) of students showed a good pattern of breakfast consumption. The results of t-test revealed that there was a statistically significant difference between expected outcome, outcome evaluation, self-efficacy and self-regulation constructs among students with appropriate and inappropriate breakfast consumption pattern (P&lt;0.001).Conclusion: Considering the existence of a significant relationship between the constructs of social cognitive theory and breakfast consumption in studied students, the constructs of this theory can be used to predict the factors influencing breakfast consumption in students and will be effective in promoting supportive breakfast consumption programs.Keywords: Breakfast consumption, Social Cognitive Theory, Students, Mariva

The relationship between ultra processed food consumption and premature coronary artery disease: Iran premature coronary artery disease study (IPAD)

BackgroundUltra-processed foods (UPF) consumption may affect the risk of PCAD through affecting cardio metabolic risk factors. This study aimed to evaluate the association between UPFs consumption and premature coronary artery disease (PCAD).MethodsA case–control study was conducted on 2,354 Iranian adults (≥ 19 years). Dietary intake was assessed using a validated 110-item food frequency questionnaire (FFQ) and foods were classified based on the NOVA system, which groups all foods according to the nature, extent and purposes of the industrial processes they undergo. PCAD was defined as having an stenosis of at least single coronary artery equal and above 75% or left main coronary of equal or more than 50% in women less than 70 and men less than 60 years, determined by angiography. The odds of PCAD across the tertiles of UPFs consumption were assessed by binary logistic regression.ResultsAfter adjustment for potential confounders, participants in the top tertile of UPFs were twice as likely to have PCAD compared with those in the bottom tertile (OR: 2.52; 95% CI: 1.97–3.23). Moreover, those in the highest tertile of the UPFs consumption had more than two times higher risk for having severe PCAD than those in the first tertile (OR: 2.64; 95% CI: 2.16–3.22). In addition, there was a significant upward trend in PCAD risk and PCAD severity as tertiles increased (P-trend &lt; 0.001 for all models).ConclusionHigher consumption of UPFs was related to increased risk of PCAD and higher chance of having severe PCAD in Iranian adults. Although, future cohort studies are needed to confirm the results of this study, these findings indicated the necessity of reducing UPFs intake

The unfinished agenda of communicable diseases among children and adolescents before the COVID-19 pandemic, 1990-2019: a systematic analysis of the Global Burden of Disease Study 2019

BACKGROUND: Communicable disease control has long been a focus of global health policy. There have been substantial reductions in the burden and mortality of communicable diseases among children younger than 5 years, but we know less about this burden in older children and adolescents, and it is unclear whether current programmes and policies remain aligned with targets for intervention. This knowledge is especially important for policy and programmes in the context of the COVID-19 pandemic. We aimed to use the Global Burden of Disease (GBD) Study 2019 to systematically characterise the burden of communicable diseases across childhood and adolescence. METHODS: In this systematic analysis of the GBD study from 1990 to 2019, all communicable diseases and their manifestations as modelled within GBD 2019 were included, categorised as 16 subgroups of common diseases or presentations. Data were reported for absolute count, prevalence, and incidence across measures of cause-specific mortality (deaths and years of life lost), disability (years lived with disability [YLDs]), and disease burden (disability-adjusted life-years [DALYs]) for children and adolescents aged 0-24 years. Data were reported across the Socio-demographic Index (SDI) and across time (1990-2019), and for 204 countries and territories. For HIV, we reported the mortality-to-incidence ratio (MIR) as a measure of health system performance. FINDINGS: In 2019, there were 3·0 million deaths and 30·0 million years of healthy life lost to disability (as measured by YLDs), corresponding to 288·4 million DALYs from communicable diseases among children and adolescents globally (57·3% of total communicable disease burden across all ages). Over time, there has been a shift in communicable disease burden from young children to older children and adolescents (largely driven by the considerable reductions in children younger than 5 years and slower progress elsewhere), although children younger than 5 years still accounted for most of the communicable disease burden in 2019. Disease burden and mortality were predominantly in low-SDI settings, with high and high-middle SDI settings also having an appreciable burden of communicable disease morbidity (4·0 million YLDs in 2019 alone). Three cause groups (enteric infections, lower-respiratory-tract infections, and malaria) accounted for 59·8% of the global communicable disease burden in children and adolescents, with tuberculosis and HIV both emerging as important causes during adolescence. HIV was the only cause for which disease burden increased over time, particularly in children and adolescents older than 5 years, and especially in females. Excess MIRs for HIV were observed for males aged 15-19 years in low-SDI settings. INTERPRETATION: Our analysis supports continued policy focus on enteric infections and lower-respiratory-tract infections, with orientation to children younger than 5 years in settings of low socioeconomic development. However, efforts should also be targeted to other conditions, particularly HIV, given its increased burden in older children and adolescents. Older children and adolescents also experience a large burden of communicable disease, further highlighting the need for efforts to extend beyond the first 5 years of life. Our analysis also identified substantial morbidity caused by communicable diseases affecting child and adolescent health across the world. FUNDING: The Australian National Health and Medical Research Council Centre for Research Excellence for Driving Investment in Global Adolescent Health and the Bill & Melinda Gates Foundation

Global, regional, and national sex differences in the global burden of tuberculosis by HIV status, 1990–2019: results from the Global Burden of Disease Study 2019

Background Tuberculosis is a major contributor to the global burden of disease, causing more than a million deaths annually. Given an emphasis on equity in access to diagnosis and treatment of tuberculosis in global health targets, evaluations of differences in tuberculosis burden by sex are crucial. We aimed to assess the levels and trends of the global burden of tuberculosis, with an emphasis on investigating differences in sex by HIV status for 204 countries and territories from 1990 to 2019. Methods We used a Bayesian hierarchical Cause of Death Ensemble model (CODEm) platform to analyse 21 505 site-years of vital registration data, 705 site-years of verbal autopsy data, 825 site-years of sample-based vital registration data, and 680 site-years of mortality surveillance data to estimate mortality due to tuberculosis among HIV-negative individuals. We used a population attributable fraction approach to estimate mortality related to HIV and tuberculosis coinfection. A compartmental meta-regression tool (DisMod-MR 2.1) was then used to synthesise all available data sources, including prevalence surveys, annual case notifications, population-based tuberculin surveys, and tuberculosis cause-specific mortality, to produce estimates of incidence, prevalence, and mortality that were internally consistent. We further estimated the fraction of tuberculosis mortality that is attributable to independent effects of risk factors, including smoking, alcohol use, and diabetes, for HIV-negative individuals. For individuals with HIV and tuberculosis coinfection, we assessed mortality attributable to HIV risk factors including unsafe sex, intimate partner violence (only estimated among females), and injection drug use. We present 95% uncertainty intervals for all estimates. Findings Globally, in 2019, among HIV-negative individuals, there were 1.18 million (95% uncertainty interval 1.08-1.29) deaths due to tuberculosis and 8.50 million (7.45-9.73) incident cases of tuberculosis. Among HIV-positive individuals, there were 217 000 (153 000-279 000) deaths due to tuberculosis and 1.15 million (1.01-1.32) incident cases in 2019. More deaths and incident cases occurred in males than in females among HIV-negative individuals globally in 2019, with 342 000 (234 000-425 000) more deaths and 1.01 million (0.82-1.23) more incident cases in males than in females. Among HIV-positive individuals, 6250 (1820-11 400) more deaths and 81 100 (63 300-100 000) more incident cases occurred among females than among males in 2019. Age-standardised mortality rates among HIV-negative males were more than two times greater in 105 countries and age-standardised incidence rates were more than 1.5 times greater in 74 countries than among HIV-negative females in 2019. The fraction of global tuberculosis deaths among HIV-negative individuals attributable to alcohol use, smoking, and diabetes was 4.27 (3.69-5.02), 6.17 (5.48-7.02), and 1.17 (1.07-1.28) times higher, respectively, among males than among females in 2019. Among individuals with HIV and tuberculosis coinfection, the fraction of mortality attributable to injection drug use was 2.23 (2.03-2.44) times greater among males than females, whereas the fraction due to unsafe sex was 1.06 (1.05-1.08) times greater among females than males. Interpretation As countries refine national tuberculosis programmes and strategies to end the tuberculosis epidemic, the excess burden experienced by males is important. Interventions are needed to actively communicate, especially to men, the importance of early diagnosis and treatment. These interventions should occur in parallel with efforts to minimise excess HIV burden among women in the highest HIV burden countries that are contributing to excess HIV and tuberculosis coinfection burden for females. Placing a focus on tuberculosis burden among HIV-negative males and HIV and tuberculosis coinfection among females might help to diminish the overall burden of tuberculosis. This strategy will be crucial in reaching both equity and burden targets outlined by global health milestone

Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health: all-cause and cause-specific mortality findings from the Global Burden of Disease Study 2019

Background Sustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential trajectories of child mortality for the next decade, we present the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 findings for all-cause mortality and cause-specific mortality in children younger than 5 years of age, with multiple scenarios for child mortality in 2030 that include the consideration of potential effects of COVID-19, and a novel framework for quantifying optimal child survival. Methods We completed all-cause mortality and cause-specific mortality analyses from 204 countries and territories for detailed age groups separately, with aggregated mortality probabilities per 1000 livebirths computed for neonatal mortality rate (NMR) and under-5 mortality rate (USMR). Scenarios for 2030 represent different potential trajectories, notably including potential effects of the COVID-19 pandemic and the potential impact of improvements preferentially targeting neonatal survival. Optimal child survival metrics were developed by age, sex, and cause of death across all GBD location-years. The first metric is a global optimum and is based on the lowest observed mortality, and the second is a survival potential frontier that is based on stochastic frontier analysis of observed mortality and Healthcare Access and Quality Index. Findings Global U5MR decreased from 71.2 deaths per 1000 livebirths (95% uncertainty interval WI] 68.3-74-0) in 2000 to 37.1 (33.2-41.7) in 2019 while global NMR correspondingly declined more slowly from 28.0 deaths per 1000 live births (26.8-29-5) in 2000 to 17.9 (16.3-19-8) in 2019. In 2019,136 (67%) of 204 countries had a USMR at or below the SDG 3.2 threshold and 133 (65%) had an NMR at or below the SDG 3.2 threshold, and the reference scenario suggests that by 2030,154 (75%) of all countries could meet the U5MR targets, and 139 (68%) could meet the NMR targets. Deaths of children younger than 5 years totalled 9.65 million (95% UI 9.05-10.30) in 2000 and 5.05 million (4.27-6.02) in 2019, with the neonatal fraction of these deaths increasing from 39% (3.76 million 95% UI 3.53-4.021) in 2000 to 48% (2.42 million; 2.06-2.86) in 2019. NMR and U5MR were generally higher in males than in females, although there was no statistically significant difference at the global level. Neonatal disorders remained the leading cause of death in children younger than 5 years in 2019, followed by lower respiratory infections, diarrhoeal diseases, congenital birth defects, and malaria. The global optimum analysis suggests NMR could be reduced to as low as 0.80 (95% UI 0.71-0.86) deaths per 1000 livebirths and U5MR to 1.44 (95% UI 1-27-1.58) deaths per 1000 livebirths, and in 2019, there were as many as 1.87 million (95% UI 1-35-2.58; 37% 95% UI 32-43]) of 5.05 million more deaths of children younger than 5 years than the survival potential frontier. Interpretation Global child mortality declined by almost half between 2000 and 2019, but progress remains slower in neonates and 65 (32%) of 204 countries, mostly in sub-Saharan Africa and south Asia, are not on track to meet either SDG 3.2 target by 2030. Focused improvements in perinatal and newborn care, continued and expanded delivery of essential interventions such as vaccination and infection prevention, an enhanced focus on equity, continued focus on poverty reduction and education, and investment in strengthening health systems across the development spectrum have the potential to substantially improve USMR. Given the widespread effects of COVID-19, considerable effort will be required to maintain and accelerate progress. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd