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Study abroad is typically viewed as a catalyst for pronunciation learning because it affords learners both massive amounts of L2 input and abundant opportunities for meaningful L2 use. Yet, even in such an environment, there is substantial variability in learning trajectories and outcomes. The nature of the target structure is also a powerful determinant of learning; some structures seem to develop effortlessly, whereas others do not improve much at all. Additionally, study abroad research brings to light the important issue of speaker identity, as learners often make decisions about how they want to sound and what pronunciation features they will adopt. This chapter examines developmental time frames, trajectories, and turning points in the phonetics and phonology of L2 learners in a study abroad context. We also describe how learners acquire the regional pronunciation variants of their host communities considering the phonetics of the target feature and learners’ attitudes and beliefs. We argue that study abroad should be situated within a dynamic, longitudinal, and context-dependent view of phonetic and phonological learning.
Pronunciation teaching is often based on assumptions that learners are monolingual speakers, with the sound system of their native language determining the segmental and suprasegmental difficulties that mark learners’ foreign accents. However, many, if not a majority of speakers of other languages come to pronunciation with more than one language under their command. These bilingual/multilingual speakers are the norm in a globalized world, but how we teach pronunciation rarely accounts for the knowledge and skills these speakers bring to the learning of pronunciation. This chapter describes how the characteristics of bilingual speakers suggest how pronunciation teaching can be reimagined to take into account the range and flexibility of bilingual speakers in using multiple languages. Specifically, we argue that taking a nativeness viewpoint is inconsistent with taking a bilingual viewpoint and calls for pedagogical techniques that build on the kinds of needs bilingual speakers have in pronouncing additional languages.
This chapter examines the conceptualization and measurement of contact phenomena in the context of bilingualism across various languages. The goal of the chapter is to account for various phonetic contact phenomena in sociolinguistic analysis, as well as providing context for elaborating on quantitative methodologies in sociophonetic contact linguistics. More specifically, the chapter provides a detailed account of global phenomena in modern natural speech contexts, as well as an up-to-date examination of quantitative methods in the field of sociolinguistics. The first section provides a background of theoretical concepts important to the understanding of sociophonetic contact in the formation of sound systems. The following sections focus on several key social factors that play a major part in the sociolinguistic approach to bilingual phonetics and phonology, including language dominance and age of acquisition at the segmental and the suprasegmental levels, as well as topics of language attitudes and perception, and typical quantitative methods used in sociolinguistics.
The associations of prior homelessness with current health are unknown. Using nationally representative data collected in private households in England, this study aimed to examine Common Mental Disorders (CMDs), physical health, alcohol/substance dependence, and multimorbidities in people who formerly experienced homelessness compared to people who never experienced homelessness.
Methods
This cross-sectional study utilised data from the 2007 and 2014 Adult Psychiatric Morbidity Surveys. Former homelessness and current physical health problems were self-reported. Current CMDs, alcohol dependence and substance dependence were ascertained using structured validated scales. Survey-weighted logistic regression was used to compare multimorbidities (conditions in combination) for participants who formerly experienced homelessness with those who had never experienced homelessness, adjusting for sociodemographic characteristics, smoking status and adverse experiences. Population attributable fractions (PAFs) were calculated.
Results
Of 13,859 people in the sample, 535 formerly experienced homelessness (3.6%, 95% CI 3.2–4.0). 44.8% of people who formerly experienced homelessness had CMDs (95% CI 40.2–49.5), compared to 15.0% (95% CI 14.3–15.7) for those who had never experienced homelessness. There were substantial associations between prior homelessness and physical multimorbidity (adjusted odds ratio [aOR] 1.98, 95% CI 1.53–2.57), CMD–physical multimorbidity (aOR 3.43, 95% CI 2.77–4.25), CMD–alcohol/substance multimorbidity (aOR 3.53, 95% CI 2.49–5.01) and trimorbidity (CMD–alcohol/substance–physical multimorbidity) (aOR 3.26, 95% CI 2.20–4.83), in models adjusting for sociodemographic characteristics and smoking. After further adjustment for adverse experiences, associations attenuated but persisted for physical multimorbidity (aOR 1.40, 95% CI 1.10–1.79) and CMD–physical multimorbidity (aOR 1.55, 95% CI 1.20–2.00). The largest PAFs were observed for CMD–alcohol/substance multimorbidity (17%) and trimorbidity (16%).
Conclusions
Even in people currently rehoused, marked inequities across multimorbidities remained evident, highlighting the need for longer-term integrated support for people who have previously experienced homelessness.
Humanitarian migrants are at increased risk of post-traumatic stress disorder (PTSD) and elevated psychological distress. However, men and women often report varying degrees of stress and experience different challenges during migration. While studies have explored PTSD, psychological distress, gender, and resettlement stressors, they have not explored the interplay between these factors. This study aims to address that gap by investigating gender disparities in PTSD and psychological distress among humanitarian migrants in Australia, with a focus on the moderating role of socioeconomic factors.
Methods
This study used data from five waves of the Building a New Life in Australia (BNLA) survey, a longitudinal study of 2,399 humanitarian migrants who arrived in Australia in 2013. PTSD and psychological distress were measured using the PTSD-8 and Kessler-6 (K6) scales, respectively. We conducted generalised linear mixed-effect logistic regression analyses stratified by gender.
Results
Female humanitarian migrants exhibited a significantly higher prevalence of PTSD and psychological distress than males over five years of resettlement in Australia. Women facing financial hardship, unemployment, or residing in short-term housing reported greater levels of PTSD and distress compared to men.
Conclusions
Women facing financial hardship, inadequate housing, and unemployment exhibit higher rates of PTSD and psychological distress, underscoring the significant impact of socioeconomic factors. Addressing these challenges at both individual and systemic levels is essential for promoting well-being and managing mental health among female humanitarian migrants.
While factors such as age and education have been associated with persistent differences in functional cognitive decline, they do not fully explain observed variations particularly those between different racial/ethnic and sex groups. The aim of this study was to explore the association between allostatic load (AL) and cognition in a racially diverse cohort of young adults.
Methods:
Utilizing Wave V of the National Longitudinal Study of Adolescent to Adult Health – a nationally representative, longitudinal survey of adults aged 34–44, this study utilized primary data from 10 immune, cardiovascular, and metabolic biomarkers to derive an AL Index. Cognition was previously recorded through word and number recall scores. Regression analysis evaluated the association between cognitive recall, AL, age, sex, and race/ethnicity.
Results:
Regression results indicated statistically higher AL scores among Blacks (IRR = 1.09, CI = 1.01, 1.19) compared to Whites and lower AL score among females compared to males (IRR = 0.76, CI = 0.72, 0.81). At zero AL, Blacks (IRR = 1.2399, CI = 1.2398, 1.24) and Other races (IRR = 1.4523, CI = 1.452, 1.4525) had higher recall while Hispanics (IRR = 0.808, CI = 0.8079, 0.8081) had lower recall compared to Whites. Relative to males, females had higher number recall (IRR = 1.1976, CI = 1.1976, 1.1977). However, at higher, positive levels of AL, Blacks (IRR = 0.9554, CI = 0.9553, 0.9554), Other races (IRR = 0.9479, CI = 0.9479, 0.9479) and females (IRR = 0.9655, CI = 0.9655, 0.9655) had significantly lower number recall than Whites and males respectively.
Conclusions:
Race and sex differences were observed in recall at different levels of AL. Findings demonstrate the need for further exploration of cognition in young adults across diverse populations that includes examination of AL.
Refugees are at an elevated risk of some mental disorders with studies highlighting the contributing role of post-migration factors. Studies of migrant groups show neighborhood social composition, such as ethnic density, to be important. This is the first longitudinal study to examine this question for refugees and uses a novel quasi-experimental design.
Methods
We followed a cohort of 44 033 refugees from being first assigned housing under the Danish dispersal policy, operating from 1986 to 1998, until 2019. This comprised, in effect, a natural experiment whereby the influence of assigned neighborhood could be determined independently of endogenous factors. We examined three aspects of neighborhood social composition: proportion of co-nationals, refugees, and first-generation migrants; and subsequent incidence of different mental disorders.
Results
Refugees assigned to neighborhoods with fewer co-nationals (lowest v. highest quartile) were more likely to receive a subsequent diagnosis of non-affective psychosis, incident rate ratio (IRR) 1.25 (95% confidence interval (CI) 1.06–1.48), and post-traumatic stress disorder (PTSD), IRR 1.21 (95% CI I.05–1.39). A comparable but smaller effect was observed for mood disorders but none observed for stress disorders overall. Neighborhood proportion of refugees was less clearly associated with subsequent mental disorders other than non-affective psychosis, IRR 1.24 (95% CI 1.03–1.50). We found no statistically significant associations with proportion of migrants.
Conclusions
For refugees, living in a neighborhood with a lower proportion of co-nationals is related to subsequent increased risk of diagnosed mental disorders particularly non-affective psychosis and PTSD.
Edited by
David Kingdon, University of Southampton,Paul Rowlands, Derbyshire Healthcare NHS foundation Trust,George Stein, Emeritus of the Princess Royal University Hospital
CL psychiatry is one of the newer sub-specialties of adult psychiatry and is concerned with the practice of psychiatry in non-psychiatric settings. Typically, this means in general hospital wards and outpatient clinics, although in some countries, it also includes liaison with primary care. In recent years, there have been important changes in general medicine relevant to CL psychiatry. There is now a much wider recognition of the high prevalence of psychiatric and physical comorbidity and how this influences consultation frequency, service utilisation, treatment adherence, the physical prognosis and probably the overall cost as well. The relationship between physical disease and mental disorder is influenced by biological factors contributing to psychological change in physical disease, psychological factors in physical disease, social factors and comorbidity. There has also been recognition of the high prevalence of non-organic complaints among general medical patients as well as an awareness of the high costs of investigating these patients, which has led to a search for better ways to manage this group of patients.
Collaboration between general medical and psychiatric staff is essential. Psychological treatment and psychotropic medication can be effective. Mental capacity is an important and sometimes complex issue.
Edited by
David Kingdon, University of Southampton,Paul Rowlands, Derbyshire Healthcare NHS foundation Trust,George Stein, Emeritus of the Princess Royal University Hospital
Patients with bodily distress, hypochondriasis and chronic pain experience symptoms that impair their functioning and cause them significant degrees of discomfort. They also represent a significant public health challenge. Problems in classification/nosology continue to bedevil this area, and these difficulties – along with the use of the language of psychiatric classification, which most patients find unacceptable – continue to led to the DSM/ICD terms being little used in day-to-day clinical practice, including liaison psychiatry. Biological, psychological and social factors are relevant to both the aetiology and the maintenance of these syndromes, as well as to their treatment. In recent years, a variety of effective biological and psychosocial approaches to treatment have been developed, and these patients can now be considered as a group for whom medical and psychological approaches should be offered.
Edited by
David Kingdon, University of Southampton,Paul Rowlands, Derbyshire Healthcare NHS foundation Trust,George Stein, Emeritus of the Princess Royal University Hospital
Psychosis is characterized by distortions in thinking (e.g. fixed, false beliefs), in perception (e.g. hearing voices or less commonly seeing things that are not there), emotions, language, sense of self and behaviour. Although it used to be thought that schizophrenia was a discrete entity, much recent evidence has shown that this is not so. Schizophrenia does not have clear boundaries; rather, it merges into schizoaffective disorder and bipolar disorder on the one hand and into schizotypal and paranoid personality on the other. It is best considered as the severe form of psychosis. The different psychotic disorders share some of the same risk factors and are sometimes associated with cognitive impairments, co-existing mental health conditions, substance misuse and physical health problems; the latter often develop over the course of the illness.
In this chapter, we review genetic and then environmental risk factors for psychosis. Much knowledge has accumulated regarding both in the last two decades. We now know that the aetiology of psychosis is multifactorial. Genetic and environmental factors occasionally act alone but usually in combination as well as operate at a number of levels and over time to influence an individual’s likelihood of developing psychotic symptoms.
This Element provides readers with a detailed overview of the social factors that affect second language (L2) phonology acquisition and use. Through a state-of-the art synthesis of the relevant literature, this Element addresses the following questions: What do we mean by social factors? Which social factors have been investigated in research on L2 phonological acquisition and use? How and why do social factors affect L2 phonological acquisition (production and perception) and use? What are the implications of the social factor findings for teaching L2 pronunciation? The Element answers these questions through a synthesis of key findings in research on social factors and L2 phonology. Conclusions and implications for teaching, as well as key readings and references, follow the research synthesis.
Chapter 5 describes the patterns found in the data set with a focus on /str/-clusters. Theanalysis starts with a general description of data dispersion and the nature of sibilants in the data set. It addresses the distribution of the data, showing that /str/-clusters are more likely to be retracted than pre-vocalic realizations of /s/. This section further establishes how the distance between /s/ and /ʃ/ can be described by center-of-gravity measurements. Following this operationalization, the focus is on internal factors of language change, namely the question of phonetic and lexical gradualness. Both types of gradualness are confirmed in the analysis of the sibilant space.
The following section focuses on a descriptive statistical account of further social factors in the description of /str/-lowering, of which ethnicity and age are the most relevant. Together with the linguistic factors, the final mixed-effects regression model is then developed and fully evaluated, indicating sibilant duration, age, and ethnicity as most important factors in the change. These results are further confirmed by a random forest regression.
In a qualitative extension of the insights gained through the regression analysis, a brief thematic analysis summarizes the patterns found in the commentary part of the interviews.
This chapter analyses the corpus of epigraphic evidence from the period 400-200 BC (c. 480 inscriptions). The inscriptions present a multifaceted and sometimes mixed situation in relation to graphemic and phonological features, with notable fluctuation between the preservation of fossilised, old-fashioned and innovative traits, sometimes occurring together in the same type of text. Fluctuations between archaic and innovative traits characterise a differentiated level of literacy in the documents from Rome and from the neighbouring towns and districts of old Latium, such as Praeneste, Tusculum, and Ardea. The chapter examines text classes, tendencies, quantitative data and distribution of the inscriptions on the territory (altars, objects,pocola deorum, tabulae triumphales, graffiti on pottery, jars); graphemic innovations/reforms (e.g. rhotacism, gemination of consonants and vowels, diphthongs; omission of final -s); social aspects such as features of urban vs rustic features. The emerging picture is that of a complex situation, the analysis of which is further complicated by the lack of a central Roman control and the persistence of epichoric linguistic and graphic practices.
In 1978, the theory behind helminth parasites having the potential to regulate the abundance of their host populations was formalized based on the understanding that those helminth macroparasites that reduce survival or fecundity of the infected host population would be among the forces limiting unregulated host population growth. Now, 45 years later, a phenomenal breadth of factors that directly or indirectly affect the host–helminth interaction has emerged. Based largely on publications from the past 5 years, this review explores the host–helminth interaction from three lenses: the perspective of the helminth, the host, and the environment. What biotic and abiotic as well as social and intrinsic host factors affect helminths? What are the negative, and positive, implications for host populations and communities? What are the larger-scale implications of the host–helminth dynamic on the environment, and what evidence do we have that human-induced environmental change will modify this dynamic? The overwhelming message is that context is everything. Our understanding of second-, third-, and fourth-level interactions is extremely limited, and we are far from drawing generalizations about the myriad of microbe-helminth-host interactions.Yet the intricate, co-evolved balance and complexity of these interactions may provide a level of resilience in the face of global environmental change. Hopefully, this albeit limited compilation of recent research will spark new interdisciplinary studies, and application of the One Health approach to all helminth systems will generate new and testable conceptual frameworks that encompass our understanding of the host–helminth–environment triad.
Previous epidemiological evidence identified a concerning increase in behavioural problems among young children from 1997 to 2008 in Brazil. However, it is unclear whether behavioural problems have continued to increase, if secular changes vary between sociodemographic groups and what might explain changes over time. We aimed to monitor changes in child behavioural problems over a 22-year period from 1997 to 2019, examine changing social inequalities and explore potential explanations for recent changes in behavioural problems between 2008 and 2019.
Methods
The Child Behaviour Checklist was used to compare parent-reported behavioural problems in 4-year-old children across three Brazilian birth cohorts assessed in 1997 (1993 cohort, n = 633), 2008 (2004 cohort, n = 3750) and 2019 (2015 cohort, n = 577). Response rates across all three population-based cohorts were over 90%. Moderation analyses tested if cross-cohort changes differed by social inequalities (demographic and socioeconomic position), while explanatory models explored whether changes in hypothesized risk and protective factors in prenatal development (e.g., smoking during pregnancy) and family life (e.g., maternal depression and harsh parenting) accounted for changes in child behavioural problems from 2008 to 2019.
Results
Initial increases in child behavioural problems from 1997 to 2008 were followed by declines in conduct problems (mean change = −2.75; 95% confidence interval [CI]: −3.56, −1.94; P < 0.001), aggression (mean change = −1.84; 95% CI: −2.51, −1.17; P < 0.001) and rule-breaking behaviour (mean change = −0.91; 95% CI: −1.13, −0.69 P < 0.001) from 2008 to 2019. Sex differences in rule-breaking behaviour diminished during this 22-year period, whereas socioeconomic inequalities in behavioural problems emerged in 2008 and then remained relatively stable. Consequently, children from poorer and less educated families had higher behavioural problems, compared to more socially advantaged children, in the two more recent cohorts. Changes in measured risk and protective factors partly explained the reduction in behavioural problems from 2008 to 2019.
Conclusions
Following a rise in child behavioural problems, there was a subsequent reduction in behavioural problems from 2008 to 2019. However, social inequalities increased and remained high. Continued monitoring of behavioural problems by subgroups is critical for closing the gap between socially advantaged and disadvantaged children and achieving health equity for the next generation.
Social factors affecting pregnancy include poverty, deprivation, ethnicity and refugee status. Drug and alcohol misuse, poor nutrition and obesity also have harmful effects. Reports in the 1930s included information on social circumstances of the women who died but early CEMD Reports contained virtually none. In 1977 the Labour government commissioned an enquiry by Sir Douglas Black into social determinants of health but in 1980 the Black Report was all but suppressed by the new Conservative government. In the 1990s further reports appeared at a time when the future of the CEMD was in doubt because of its focus on clinical care. In 1994-6 the scope of the Enquiries broadened. The Reports stopped blaming women and focussed on barriers to accessing care. Shockingly the Enquiries revealed that mortality rates were much higher in deprived areas and among ethnic minorities, particularly Black women.The data stimulated a raft of well-meaning NHS initiatives but the lofty policy declarations remained disconnected from reality. In 2016-18 three quarters of women who died had pre-existing medical or mental health conditions and 90% were in some measure socially vulnerable.
Stunted children have an increased risk of diminished cognitive development, diabetes, degenerative and CVD later in life. Numerous modifiable factors decrease the risk of stunting in children. This study aimed to assess the role of the individual, household and social factors on stunting in Zimbabwean children.
Design:
A 1:2 unmatched case–control study.
Setting:
This study was conducted in two predominantly rural provinces (one with the highest national prevalence of stunting and one with the lowest prevalence) in Zimbabwe.
Participants:
Data were obtained from the caregivers of 150 children aged between 6 and 59 months with stunting and from the caregivers of 300 children without stunting.
Results:
Multiple (39) correlates of stunting were identified. Child’s age, birth length, birth weight, and weight-for-age outcome (child-related factors), caregiver’s age, maternal HIV status, occupation, and education (parental factors), breast-feeding status, number of meals, and dietary quality (dietary factors), child’s appetite, diarrhoeal and worm infection (childhood illnesses), income status, access to safe water, access to a toilet, health clubs and maternal support in infant feeding (household, socio-cultural factors) were all found to be significant predictors of childhood stunting.
Conclusion:
Nearly all aspects under review from the individual-, household- to social-level factors were significantly associated with childhood stunting. These findings add to the growing body of evidence supporting the WHO stunting framework and strengthen the need to focus interventions on a multi-sectoral approach to effectively address stunting in high prevalence countries.
To explore communities’ perspectives on the factors in the social food environment that influence dietary behaviours in African cities.
Design:
A qualitative study using participatory photography (Photovoice). Participants took and discussed photographs representing factors in the social food environment that influence their dietary behaviours. Follow-up in-depth interviews allowed participants to tell the ‘stories’ of their photographs. Thematic analysis was conducted, using data-driven and theory-driven (based on the socio-ecological model) approaches.
Setting:
Three low-income areas of Nairobi (n 48) in Kenya and Accra (n 62) and Ho (n 32) in Ghana.
Participants:
Adolescents and adults, male and female aged ≥13 years.
Results:
The ‘people’ who were most commonly reported as influencers of dietary behaviours within the social food environment included family members, friends, health workers and food vendors. They mainly influenced food purchase, preparation and consumption, through (1) considerations for family members’ food preferences, (2) considerations for family members’ health and nutrition needs, (3) social support by family and friends, (4) provision of nutritional advice and modelling food behaviour by parents and health professionals, (5) food vendors’ services and social qualities.
Conclusions:
The family presents an opportunity for promoting healthy dietary behaviours among family members. Peer groups could be harnessed to promote healthy dietary behaviours among adolescents and youth. Empowering food vendors to provide healthier and safer food options could enhance healthier food sourcing, purchasing and consumption in African low-income urban communities.
Mental disorders are one of the largest contributors to the burden of disease globally, this holds also for children and adolescents, especially in low- and middle-income countries. The prevalence and severity of these disorders are influenced by social determinants, including exposure to adversity. When occurring early in life, these latter events are referred to as adverse childhood experiences (ACEs).
In this editorial, we provide an overview of the literature on the role of ACEs as social determinants of mental health through the lenses of global mental health. While the relation between ACEs and mental health has been extensively explored, most research was centred in higher income contexts. We argue that findings from the realm of global mental health should be integrated into that of ACEs, e.g. through preventative and responsive psychosocial interventions for children, adolescents and their caregivers. The field of global mental health should also undertake active efforts to better address ACEs in its initiatives, all with the goal of reducing the burden of mental disorders among children and adolescents globally.
The COVID-19 pandemic has harmed many people's mental health globally. Whilst the evidence generated thus far from high-income countries regarding the pandemic's impact on suicide rates is generally reassuring, we know little about its influence on this outcome in lower- and middle-income countries or among marginalised and disadvantaged people. There are some signals for concern regarding the pandemic's potentially unequal impact on suicide rates, with some of the affected demographic subgroups and regions being at elevated risk before the pandemic began. However, the evidence-base for this topic is currently sparse, and studies conducted to date have generally not taken account of pre-pandemic temporal trends. The collection of accurate, complete and comparable data on suicide rate trends in ethnic minority and low-income groups should be prioritised. The vulnerability of low-income groups will likely be exacerbated further by the current energy supply and cost-of-living crises in many countries. It is therefore crucial that reassuring messaging highlighting the stability of suicide rates during the pandemic does not lead to complacency among policymakers.