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The language continuum is defined by the dimensions of language ability (from language talent to language disorder) and bilingual language proficiency (from monolingual to multilingual) in this chapter. Although the terms “language ability” and “proficiency” are often used interchangeably in the literature, we systematically differentiate these two dimensions in order to explain variations in speakers from different linguistic backgrounds. Cross-linguistic data are presented to strengthen this argument. The differentiation of these two language dimensions is important for professionals to prevent the over- and underdiagnosis of children who come from language minority groups or exhibit bilingual language disorder. A discussion of similarities in language acquisition between typically developing monolingual and bilingual first language speakers and between monolingual and bilingual children with developmental language disorder is included to highlight common features along the language dimensions. Within-subject approaches and different measures of assessment are described to support the classification of children from diverse linguistic environments.
The complex interactions between cognitive control and language ability and those between cognitive control and language proficiency are reviewed first separately and then in relationship to each other, and in association with the development of academic skills and social interactions. Both behavioral and neurophysiological studies suggest that language ability and proficiency modulate the engagement of cognitive control processes, particularly working memory, attention, and interference control. Thus, better language abilities and higher bilingual language proficiencies are associated with superior cognitive control performance, whereas language disorder and low bilingual language proficiency are linked to weaker cognitive control performance. Response inhibition, however, does not show a close link with language skills; children with different language abilities and proficiencies may perform similarly on tasks of response inhibition. Age, prior experience, and variation in task types may all influence these relationships.
Kripke finds in Wittgenstein an argument for the view that there is no such thing as meaning. A key premise in that argument is that there are semantic norms – norms governing the uses of expressions that hold in virtue of what those expressions mean. Standardly, those norms are understood to be norms of truth – roughly, they permit truly applying expressions and prohibit falsely applying them. An increasing number of philosophers reject the standard interpretation. In this chapter, I explore alternative construals due to Alan Millar and Indrek Reiland and argue that they are either unmotivated or not competitors with the standard account. In doing so, I defend a kind of pluralism about semantic normativity. If there are norms of truth that hold in virtue of what expressions mean, there will be further norms that make reference to the doxastic, epistemic, and motivational states of language-users, norms that are explanatory posterior to the norms of truth.
Kripke’s writings can be understood as suggesting that Wittgenstein, though a non-reductionist, was not a quietist about meaning, that is, did not maintain that nothing philosophically constructive could be said about it. It is Kripke and the quietist who can in fact be seen to have much in common. For, though they both conceive of the skeptical challenge as a meta-semantical challenge, calling for a foundational account of meaning, they both end up with purely semantic, descriptive remarks about meaning. Failing to share his diagnosis of the paradox with Wittgenstein, Kripke does not recognize that, once the skeptical problem is dissolved, as Wittgenstein recommends, a new meta-semantical challenge arises, which is connected to the essential link Wittgenstein emphasizes between meaning and use. Consequently, Kripke does not see that the positive remarks Wittgenstein makes after dismissing the skeptical paradox, especially those concerning agreement, are meant to do some constructive, not just descriptive, work, in response to the problem newly arisen.
Chapter 5 considers the ways in which Piers Plowman attempts to translate a Franciscan form-of-life into vernacular, worldly terms. While the Franciscan forma vitae details the way of living for each brother, from his clothing to his daily activities to the correction of his faults, Piers Plowman details the means of making a living in an inappropriable world. I argue that the poem asks these questions by way of its sustained meditation on the meaning and nature of labour as the continual payment of an unpayable debt. Langland explores the value and meaning of labour most explicitly in and through the three figures in the poem who are most closely linked with Franciscanism, and who court most dangerously the charges of idleness and default: Rechelesnesse, Nede, and the Dreamer himself. As this chapter shows, the irreducibly ambiguous nature of these three figures, who mix truth with half-truth and misunderstanding, who aspire to the ideals taught by Holy Church, Patience, Kynde, and Conscience, but who embody an all-too-human failure to attain them, encapsulates the poem’s interpretive inappropriability.
This chapter finds that Augustine self-consciously departed from Stoicism and Platonism (while remaining within eudaimonism) in finding that there were other natural objects of human beings’ eros-love besides the highest good. This finding leads to a new explanation of Augustine’s distinction between use and enjoyment and to a new explanation of his view that grief would be found not only in the lives of the vicious but in the lives of the virtuous as well.
Informal borrowings are used for several reasons. They are used to name things, providing alternative synonyms for things already named in English but also names for things yet to be named. More often, however, they are used instead of standard English to communicate additional information that is social, psychological, rhetorical, or cultural in nature. The social function involves group solidarity and social distancing. The psychological function includes expression of emotions via a repertoire of expressions for a variety of emotional states and emotive labels. The rhetorical function includes informality, conciseness, forcefulness, wordplay, and small talk. The cultural function involves expressing cultural identity and stylization; while expressing cultural identity is often the reason for using such expressions, stylization is another phenomenon accounting for their common use among larger segments of American society.
There is evidence for intergenerational transmission of substance use and disorder. However, it is unclear whether separation from a parent with substance use disorder (SUD) moderates intergenerational transmission, and no studies have tested this question across three generations. In a three-generation study of families oversampled for familial SUD, we tested whether separation between father (G1; first generation) and child (G2; second generation) moderated the effect of G1 father SUDs on G2 child SUDs. We also tested whether separation between father (G2) and child (G3; third generation) moderated the effect of G2 SUDs on G3 drinking. Finally, we tested whether G1-G2 or G2-G3 separation moderated the mediated effect of G1 SUDs on G3 drinking through G2 SUDs. G1 father-G2 child separation moderated intergenerational transmission. In families with G1-G2 separation, there were no significant effects of father SUD on G2 SUD or G3 drinking. However, in nonseparated families, greater G1 father SUDs predicted heightened G2 SUDs and G3 grandchild drinking. In nonseparated families, G1 father SUDs significantly predicted G2 SUDs, which predicted G3 drinking. However, G2-G3 separation predicted heightened G3 drinking regardless of G2 and G1 SUDs. Parental separation may introduce risk for SUDs and drinking among youth with lower familial risk.
This chapter reviews the types, use, production, accessibility and efficacy of data visuals contained in IPCC assessments and special reports, drawing upon available published literature. Visuals of different types are key to the communication of IPCC assessments. They have been subject to academic interest among social and cognitive scientists. Furthermore, wider societal interest in the IPCC has increased, especially since the publication of its Fifth Assessment Report. In response, the IPCC has revisited its approach to communication including visuals, which has resulted in a greater professionalisation of its visualisations — involving information designers and cognitive scientists — and in new forms of co-production between authors and users.
To evaluate Lebanese licensed dietitians’ knowledge, prevalence of use and recommendation of dietary supplements (DS), and their associated factors.
Design:
Cross-sectional survey.
Setting:
Dietitians across Lebanon were contacted through the telephone and were asked to participate in the study. An online self-administered questionnaire was designed and sent to dietitians either by email or by WhatsApp, between 4 March and 4 May 2020.
Participants:
This study included 319 dietitians randomly selected from the dietitians’ list that was provided by the Lebanese Ministry of Public Health.
Results:
Around 75 % of dietitians had a knowledge score above 50 %. Overall, 73·7 % of them have used DS and 46·1 % have recommended them. Higher knowledge score was associated with less years of experience, using scientific articles as source of information on DS, and participating in research. Resorting to pharmacists was significantly associated with both nutrient supplements (NS) and herbal supplements (HS) use, whereas referring to health food stores was associated with HS use only. NS recommendation to patients was associated with personal NS use (OR = 3·38, P < 0·001), considering pharmacists as a source of information on DS (OR = 2·29, P = 0·01) and discussing DS with patients (OR = 3·82, P = 0·01). Having personally used HS (OR = 12·23, P < 0·001) and having discussed DS with patients (OR = 8·51, P = 0·01) increased the likelihood of recommending HS.
Conclusions:
A proper DS education, the elaboration of national scientific guidelines and the implementation of concise laws regarding the regulations of DS would play a crucial role in supporting dietitians’ practices and improving the quality of patient care with respect to DS.
The aim of this study was to determine how the early stages of the coronavirus disease 2019 (COVID-19) pandemic affected the use of the pediatric emergency department (PED).
Methods:
Cross-sectional study of PED visits during January through April, 2016-2020. Data included: total PED visits, emergency severity index (ESI), disposition, chief complaint, age (months), time from first provider to disposition (PTD), and PED length of stay (PED-LOS). P-value <0.01 was statistically significant.
Results:
In total, 67,499 visits were reported. There was a significant decrease in PED visits of 24-71% from March to April 2020. Chief complaints for fever and cough were highest in March 2020; while April 2020 had a shorter mean PED-LOS (from 158 to 123 min), an increase of admissions (from 8% to 14%), a decrease in ESI 4 (10%), and an increase in ESI 3 (8%) (P < 0.001). There was no difference in mean monthly PTD time.
Conclusions:
Patient flow in the PED was negatively affected by a decrease in PED visits and increase in admission rate that may be related to higher acuity. By understanding the interaction between hospital processes on PEDs and patient factors during a pandemic, we are able to anticipate and better allocate future resources.
This chapter turns to Aquinas’s view that the human act is a hylomorphic composite. To discuss the human act’s hylomorphic structure, it first considers three power-exercises crucial to the execution of the human act once the choice has been made, namely, “command,” “use,” and the “commanded act.” It contends that the act of command is an act of reason that specifies the power by which a choice is to be executed. Use is a volitional act that activates, and sustains the exercise, of the power determined by command, and the commanded act is the exercise of this power. It then argues that use (rather than command) functions as the form of the commanded act by virtue of directing the latter to an end. The chapter draws on an insight from Chapter 4, arguing that formal and final causation coincide here, because what it is for a human act to be of a certain kind (and so to have a certain form) is for it to be directed to a certain end. The last section of this chapter discusses Aquinas’s account of how choice explains the hylomorphically organized human act, which relies on the notion of “virtual existence.”
This chapter applies the general hylomorphic theory of the human act to one of the two kinds of human acts that Aquinas countenances, namely, bodily human acts. In keeping with the general hylomorphic framework, it argues that a bodily human act is a composite of a volitional act of use and a bodily commanded act. This chapter investigates each of these two components and considers how they form one unified human act. It argues that while use is an immanent act, any bodily commanded is traunseunt. That is to say, use remains in the agent, while the bodily commanded act, which is an exercise of the “motive power” (vis motiva), comes to inhere in a patient external to the human body. What is more, it argues that use is an intrinsically instantaneous act, whereas any bodily commanded act takes time to be completed. On this basis, it concludes that use and the bodily commanded act are inherentially as well as durationally heterogeneous. The last section of the chapter examines whether this dual heterogeneity prevents use and the bodily commanded act from constituting a unified hylomorphic whole. It argue that this is not the case.
To explore in a community-based sample of persons aged 0–25 years:
– trends in antipsychotic prescribing;
– characteristics of the zone of residence associated with antipsychotic prescribing rates;
– the pattern of antipsychotic prescribing.
Methods
The study was performed using reimbursement data from the French Insurance Healthcare system. Prescribing trends were investigated over the period 2006–2013. An ecological design was used to assess the impact of the socio-economical and health resource characteristics of the zone of residence (n = 96 administrative subdivisions of French territory) on antipsychotic prescribing rates. The pattern of antipsychotic prescribing was explored in a cohort of youths newly treated with antipsychotics.
Results
Over the period 2006–2013, antipsychotic dispensing rates were globally stable in persons aged 0–25 years (4.8 per 1000 in 2006 and 4.9 per 1000 in 2013). First-generation antipsychotic dispensing rates decreased from 3.1 to 2.6 per 1000 (OR = 0.96, 95% CI = 0.94–0.98), while second-generation antipsychotic dispensing rates increased from 2.7 to 3.4 per 1000 (OR = 1.03, 95% CI = 1.01–1.05). Antipsychotic prescribing rates were impacted by health resource characteristics of the zone of residence in children aged 10 years and under and by socio-economical characteristics in those aged 16–20 years. In all the age groups, antipsychotics were principally started by hospital practitioners (47%) and general practitioners (34%). The rates of psychostimulants concomitantly prescribed with antipsychotics were lower than 5%.
Conclusion
Rates of youths exposed to second-generation antipsychotics are still rising. The impact of environmental characteristics on antipsychotics prescribing and appropriateness of these prescriptions in youths should be further investigated.
In Canada, recreational use of cannabis was legalized in October 2018. This policy change along with recent publications evaluating the efficacy of cannabis for the medical treatment of epilepsy and media awareness about its use have increased the public interest about this agent. The Canadian League Against Epilepsy Medical Therapeutics Committee, along with a multidisciplinary group of experts and Canadian Epilepsy Alliance representatives, has developed a position statement about the use of medical cannabis for epilepsy. This article addresses the current Canadian legal framework, recent publications about its efficacy and safety profile, and our understanding of the clinical issues that should be considered when contemplating cannabis use for medical purposes.
Ludwig Wittgenstein has a recognizable approach that he regularly pursues in his philosophical investigations. There is a problem that he often presses, a form of criticism that he often develops, against traditional pursuits of philosophy. It is surprisingly difficult to say clearly what this problem is. But it is worthwhile to try, for this criticism is not only a hallmark of his thought but is also closely connected to other central features of it, for instance, to his conceptions of language and of the nature of philosophical investigation. These features can be properly understood only in concert with a correct view of his terms of criticism of traditional philosophy. In this essay, Alexander George articulates a problem Wittgenstein sees with philosophy, shows how it illuminates otherwise peculiar features of Wittgenstein’s investigations, and finally considers an interesting situation in which Wittgenstein’s goals might be thwarted.
Numerous treatment guidelines recommend that long-term use of benzodiazepines (BZD) should be avoided primarily due to development of tolerance and a risk for BZD dependence. Despite this, long-term BZD use remains a controversial subject in clinical patient care with “for and against” debates. However, there is no explicit understanding of what is meant by long-term BZD use in real world. The aim of this study was to assess different definitions, usage patterns, prevalence and other characteristics of long-term BZD use based on published register-based studies. Synthesis of these characteristics is essential to derive a meaningful definition of long-term BZD.
Methods
Systematic review of register-based studies on long-term BZD use published in 1994–2014.
Results
Fourty-one studies met our predetermined inclusion criteria. The length of BZD use defined as “long-term” varied in these studies ranging from one month to several years. The most common definition was six months or longer during a year. The prevalence of long-term BZD use in the general population was estimated to be about 3%. The relative proportion of long-term BZD users (all definitions) in adult BZD users ranged from 6% to 76% (mean 24%; 95% CL 13–36%). The estimates were higher in studies only on the elderly (47%; 95% CL 31–64%). Long-term use involved typically steady treatment with low BZD doses. However, in elderly patients long-term BZD use and exceeding recommended doses was relatively common. Several characteristics associated with long-term use were found.
Conclusions
Long-term BZD use is common and a clinical reality. Uniform definitions for “long-term”, which is in line with population-based evidence, is needed to have more comparable results between studies. Our systematic review suggests that duration of BZD treatment over six months, the most common definition for long-term BZD use in the included studies. As also recommended previously, it is a useful starting point for further analyses on disadvantages but also potential advantages associated with long-term BZD use.