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This research yields a review on demotivation among students due to poor language skills resulting in less participation in classrooms. It provides code-switching, the alternating use of languages in the discourse, as a solution to this problem. It is mixed-method research in which the data was collected from university teachers and students on a survey. The study followed Fairclough's model of Critical Discourse Analysis and helped reach conclusions regarding the use of code-switching in classes. It finds out that our university teachers are already using code-switching in their classes to help reduce foreign language anxiety and motivate learners towards learning. The study also highlighted the possible harm code-switching may bring to the students: students suffer in the long run due to their reliance on the usage of code-switching, and this complete dependency ultimately results in poor language skills development. Thus, the study recommends that teachers be careful and judicious in the use of code-switching in classes and that too only in the initial phase of university education.

This sociolinguistic paper intends to investigate the perceptions of adult bilingual learners to explore whether they view Punjabi use as a blessing or a barrier as a mode of interaction and communication in light of the impact of social attitudes. A mixed-method approach was used to obtain the data. An online circulation of questionnaires among 100 female students from two universities in Sialkot was made, and follow-up interviews were conducted with two students from each university. The paper has highlighted the positive and negative outcomes of Punjabi use in the Punjabi society/community. [ABSTRACT FROM AUTHOR]

Objective: To assess children with cerebral palsy using the Common Brief Core Set of International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY). Study Design: Cross-sectional study Place and Duration of Study: Children Hospital & Institute of Child Health, Lahore Pakistan, from Nov 2020 to Jan 2021. Methodology: Fifty-nine children with cerebral palsy (CP) aged 0-18 years were included. Common Brief Core Set of International Classification of Functioning, Disability, and Health in Children and Youth (ICF-CY) was administered to children with cerebral palsy to assess their functional status. Strengths and weaknesses in body structure, body function, activity and participation and environmental factors were evaluated using the Common Brief Core Set of ICF-CY. Results: The majority of study participants were 38(64.4%), were spastic quadriplegic. Periventricular leukomalacia was noted in 36(67.9%) cases on MRI brain. Moderate to severe impairment was noted in body functions like intellectual function 46(78%). In addition, 26(44.1%) children with cerebral palsy had mild to moderate impairment in walking, while 4(6.8 %) could walk without any impairment. Social attitudes, construct, and design of buildings were the major barriers affecting the functionality of children with cerebral palsy. Conclusion: It was found that the Common Brief Core Set of ICF-CY in children with different types of cerebral palsy is a useful tool for assessing their functional level. [ABSTRACT FROM AUTHOR]

Objective: To determine the association between parenting practices and aggression in children with behaviour disorders. Study Design: Cross-sectional study. Place and Duration of Study: Children Hospital and Institute of Child Health, Lahore Pakistan, from Nov 2020 to Jan 2021. Methodology: Parents of children and eighty-five children between the ages of 3 to 12 years with the diagnosis of behaviour disorders (autism spectrum disorder, attention deficit hyperactive disorder, social communication disorder) and showing aggressive behaviour were enrolled. The multidimensional assessment of parenting scale was used to assess positive (proactive parenting, positive reinforcement, warmth and supportiveness) and negative (hostility, lax control, physical control) parenting practices. The modified overt aggression scale was used to assess aggression, including verbal aggression, aggression against property, auto-aggression (towards self), and physical aggression (towards others). Correlation and multiple regression analysis were done. Results: Among negative practices, it was found that leniency and inconsistent parenting (lax control) was significant positive predictor of aggression (p<0.01) in children with behaviour disorders. Supportiveness was a significant negative predictor of verbal aggression (p<0.01), while physical control positively predicted total aggression (p<0.05). Among positive parenting practices, positive reinforcement decreased auto aggression (p<0.05) in children with behaviour disorders. Lower maternal education correlated with more aggressive behaviours (p<0.05) in these children. Conclusion: Negative parenting practices may lead to aggression in children with behaviour disorders. While positive reinforcement by parents may encourage less self-harm in these children and help improve their behaviour problems. [ABSTRACT FROM AUTHOR]

Objective: To see the impact of screen media usage on early childhood development. Study Design: Cross-sectional study. Place and Duration of Study: Developmental Behavioural Paediatrics Department, Children's Hospital and Institute of Child Health, Lahore Pakistan, from Oct to Dec 2020. Methodology: This study included 100 children with an age range between 15-36 months and divided into two groups. Group-1 was children with communication behaviour disorders (CBD) (n=50), and Group-2 was typically developing (TD) children (n=50). ShaMaq Developmental Screening Tool (SDST) was administered to children to screen their development. Childhood behaviours were rated on a scale of 0-10 on a Behaviour rating scale. Results: Children with CBD had poor eye contact, response to names, poor imitation, poor pointing and poor one-step command following (p<0.001) compared to typically developing children. Children with CBD had poor eating habits (p<0.01), were more restless (p<0.001), and had a developmental delay (p<0.001) on SDST as compared to the other group. In children with CBD, the extent of screen media exposure was significantly correlated with restlessness (p<0.05) and poor pointing (p<0.01). Conclusion: Exposure to screen media at an early age and prolonged use of screens can lead to adverse developmental outcomes and behaviour issues in children. This is more evident in children with CBD than in typically developing children. [ABSTRACT FROM AUTHOR]

The study explores the relationship between spirituality and religion from a critical discourse analysis (CDA) perspective. As every religion has particular spiritual dimensions according to its beliefs, the paper seeks to analyze the specific dimensions of spirituality in significant religions. The study’s research design is purely qualitative as it uses the textual narrative method to investigate the visions of scholars on the conception of spirituality. The study’s major findings reveal that spirituality is not a dormant illustration of religion. Christian scholars tried to link spirituality with society and the Church. Most Buddhist and Hindu scholars believe that religion does not need to gain the true light of spirituality. The Islamic concept of spirituality is likely to stick with religion. Therefore, it is suggested in continuation of the present study that future researchers consider the factors that push persons to become spiritual souls. Moreover, future researchers can also pay attention to the subconscious mind by giving a solid distinction between the sub-consciousness and spirituality of a person. [ABSTRACT FROM AUTHOR]

Objective: To determine the risk factors in children presenting with developmental delay coming to the tertiary care hospital. Study Design: Case control study. Place and Duration of Study: The Children’s Hospital and Institute of Child Health, Lahore, from Nov 2018 to Jan 2019. Methodology: This was a case control study that included 280 children aged 6 months to 5 years. All children were assessed on ShaMaq Developmental Inventory in four equal groups of age ranges 6-10 months, 18-24 months, 3-3.5 years and 4-4.5 years. Demographic information was gathered through specially designed questionnaire that included risk factors such as gestational age, nutritional status of child, family income and others. Different risk factors were then compared between children with developmental delay and normal development. Results: Results found that there were more delays in male children (p<0.05). Moderate to severe malnutrition was mostly present in children with developmental delay (p<0.01). Premature birth (gestational age <37 weeks), family income of less than PKR 12000 and rural background were found to be important risk factors for developmental delay (p<0.01). No significant association was found between developmental delay and cousin marriage. Conclusion: Risk factors like prematurity, malnutrition, low socioeconomic status and habitat in rural areas had significant effect on child development. [ABSTRACT FROM AUTHOR]

Objective: To determine the role of cerebral oximetry in addition to conventional monitors during cardiopulmonary bypass in coronary artery bypass grafting (CABG) patients for prevention of acute kidney injury. Study Design: Randomized controlled trial. Place and Duration of Study: Six months study at department of cardiac anesthesia, Armed Forces institute of Cardiology and National institute of heart diseases, Rawalpindi. Methodology: We prospectively analyzed the collected data of 100 adult patients with normal. Preoperative renal function who underwent isolated coronary artery bypass grafting (CABG) from June 2018 to Dec 2018. Patients were randomly allocated into two groups i.e., control group A (n=50) and test group B (n=50). Patients in group A were monitored for organ perfusion using standard tool i.e., MAP, SvO2, pump flow and lactate levels while patients in group B were monitored with near infrared spectroscopy (NIRS) in addition to standard monitoring. Kidney injury was assessed according to the Acute Kidney Injury Network criteria. Cerebral oximetery, hemoglobin and other important variables were measured every hour intra-operatively and for the first 24 hours postoperatively. Results: AKI developed less in cerebral oximetery group as compare to control group i.e., 5 (10%) vs. 15 (30%). In this study, the rate of postoperative AKI development was high in patients with a low values of cerebral oximetry (SrcO2). Conclusion: This randomized controlled trial showed that a lower cerebral oximetery is correlated well with AKI after CABG patients. Our study concludes that cerebral oximetry in addition to conventional perfusion monitoring may help to prevent AKI after cardiac surgery. [ABSTRACT FROM AUTHOR]

This study highlights the major emotional and psychological factors related to the medium of instruction (use of First Language (L1) in the classroom) in the domain of bilingual education for adult Saudi English as foreign language (EFL) learners. The primary area of emphasis is to consider whether the use of L1 in the class reduces the Foreign Language Classroom Anxiety (FLCA) or it deprives the learners of the real and constant language inputs, viz., the words of the teacher in the target language. Thus, the main research question of the study is how the medium of instruction (use/mixing of Arabic or use of English-only approach) impacts the FLCA (Foreign Language Classroom Anxiety) of Saudi adult learners. The quantitative research tool of survey has been administered on the teachers and students on five-point Likert-scale with the responses ranging from strongly agree to strongly disagree. There are twelve items in the survey and each item tends to explore different psychological dimension of the issue. 100 adult Saudi university students and 100 EFL teachers have responded to these items. The main finding of the study is that learner's L1 speeds up the language learning process in a natural way if used occasionally and judiciously with the objective of keeping self-esteem and self image of the learners intact and bringing their FLCA down. The research study not only brings to surface the current state of bilingual EFL education in Saudi context, but also puts forth recommendations for learners, teachers, administrators, and policy makers to strengthen English language teaching/learning in EFL perspective in the bilingual context. [ABSTRACT FROM AUTHOR]

The purpose of this research study is to explore the moderating role of test anxiety in the relationship between the English language proficiency and job achievement in Pakistan. There was a dire need to carry out this research to highlight the components of the test anxiety faced by the job-candidates to find out how they can deal with them to perform better in their English language test/interview. The quantitative tool of FLCAS helped find out that English language test has a positive impact on job achievement, and test anxiety plays a moderating role between EFL test and Job achievement, whereas, the qualitative tool of interview served the purpose of finding the factors causing anxiety among the test-takers/interviewees. The major factors among these are lack of EFL training, failure apprehension, negative evaluation and level of comfort. Descriptive statistics measured using SPSS 20 (mean, standard deviation), correlation matrix and regression analysis were used to test the propositions or hypotheses, whereas the qualitative data was then given a graphical representation form followed by the interpretative analyses of the responses. Anxiety was found to be the consequence of inadequate skills required to use the target language. The major recommendations, which surfaced as a result of the research in the present study included i) the understanding of the importance of the English language in job achievements so as to introduce English language learning from the early age, ii) having more exposure of English language in the field through some means like simulations, etc., giving/getting more exposure to the culture of the place where English is spoken, iii) and controlling anxiety by having focused training or practice of the English language skills required in the job. All this may help reduce the test anxiety and facilitate in job achievement. [ABSTRACT FROM AUTHOR]

Introduction: The diagnosis of developmental delay and early intervention ameliorates long-term sequelae. There is a need for an appropriate, regionally adapted and reliable developmental screening tool to be used in low and middle-income countries with scarce resources., Aim: The aim of this research is to construct and validate a screening tool for identifying developmental delay in Pakistani children., Method: ShaMaq developmental screening tool (SDST) was developed consisting of five proformas to be administered at different age groups: 6-8 weeks (Group 1), 6-10 months (Group 2), 18-24 months (Group 3), 3-3.5 years (Group 4), and 4.5-5.5 years (Group 5). On an average, Groups 1-3 took 10-15 min, whereas Groups 4 and 5 took 20-25 min. We sampled children between the ages of 6 weeks to 5.5 years and tested them all within their designated age groups. Internal consistency was assessed by Cronbach's alpha. Interobserver testing was done for reliability and concurrent validity was undertaken by using the senior consultant developmental paediatrician's final diagnosis as the gold standard., Results: Out of 550 healthy children, 8-19% in the five groups were found to have some form of developmental delay using SDST. Approximately 50% of the families were in the low-to-moderate income bracket, and nearly 93% lived in a joint family system. Internal consistency of items in the five groups ranged from 0.784 to 0.940, whereas both interobserver reliability and concurrent validity ranged from 0.737 to 1.0. SDST showed 94.4% sensitivity and 92.9% specificity., Conclusion: SDST is an effective tool for identifying delay in healthy children with good internal consistency, reliability, and validity., (© 2023 John Wiley & Sons Ltd.)