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Background Methods Results Conclusion Coexistence of chest wall hypomobility and lung hyperinflation compromises respiratory muscle function and respiratory efficiency in people with severe chronic obstructive pulmonary disease (COPD). This study aimed to investigate the effect of chest wall mobilization on functional exercise capacity, respiratory muscle activity and respiratory muscle tissue oxygen saturation for people with severe COPD.Thirty male adults (age: 75 ± 6) diagnosed with severe COPD completed a 6‐week programme (twice/week) according to intervention randomization (chest wall mobilization group, CWMG, n = 15; control group, CG, n = 15). Both groups received standardized education and walking exercise, while CWMG also received chest wall and thoracic spine mobilization. Electromyography of the essential and accessory respiratory muscles and tissue oxygen saturation of the intercostal muscle (StO2, measured by near‐infrared spectroscopy) during incremental cycle exercise test were measured and compared between the two groups at pre‐programme, post‐programme and 3‐month follow‐up.Patients in CWMG demonstrated a significant increase in exercise tolerance from <3 METS to 4–6 METS (p = 0.000) after intervention. A significant decrease in activity of scalene, sternocleidomastoids and intercostal muscle during exercise test (p < 0.01) was found in CWMG, as compared to CG. A significant decrease in StO2 (p < 0.05) and greater decline in the slope of oxygenation dissociation (p = 0.000) were seen in CWMG during exercise test. These positive results were maintained at 3‐month follow‐up in CWMG.Improvements in exercise tolerance, respiratory muscle efficiency and oxygenation extraction ability in CWMG suggest a potential clinical benefit of integrating chest wall and thoracic spine mobilization for rehabilitation of people with severe COPD. [ABSTRACT FROM AUTHOR]

BACKGROUND: Many health and demographic surveys routinely collect information on women's exposure to family planning (FP) messages, counseling on contraceptive side effects, discussions about FP with providers, contraceptive decision-making autonomy, and the desire for additional children. Several studies have shown significant associations with current contraceptive use status from these cross-sectional data. However, the predictive utility of these indicators on contraceptive use and its dynamics over time is not wellknown, primarily due to the lack of longitudinal data. OBJECTIVE: To empirically assess the predictive utility of key family planning indicators on contraceptive use outcomes using longitudinal data from women participating in national annual surveys in four sub-Saharan African countries. METHODS: This study utilizes nationally representative longitudinal Performance and Monitoring for Action data collected in Kenya, Burkina Faso, Uganda, and Côte d'Ivoire from reproductive-age women to model the predictive influence of indicators measured at baseline on their subsequent contraceptive use (including intentions to use and method type) and contraceptive dynamics (including adoption, discontinuation, and switching) over an approximately three-year period. RESULTS: Some indicators measured at baseline (e.g., FP media exposure and fertility preferences) consistently influenced women's contraceptive adoption and intentions over two to three years of observation, but the predictive utility of most indictors was largely weak for dynamic outcomes such as switching and discontinuation. CONTRIBUTION: Our study highlights a programmatic need to reconsider long-standing FP indicators given the mixed evidence of their influence on contraceptive behavior over time. We recommend the identification of key measures that can predict dynamic contraceptive behaviors established through longitudinal data to inform actionable interventions. [ABSTRACT FROM AUTHOR]

The question of how class size impacts on student learning has been debated for some time, not least because it has substantial financial implications for educational policy. The strength of this debate notwithstanding, results from numerous international studies have been inconclusive. The study from which this paper stems sought to conceptualise the effects of class size on teaching and learning processes, an under-researched area in this field. To do that, the study explored qualitative differences in learning processes in large and small classes, drawing on social learning theory and the conceptual framework of community of practice to elucidate any differences. The data set includes classroom observations and interviews with students and teachers in four pairs of large and reduced-size English language classes in four Hong Kong secondary schools. Findings show that students were more motivated and engaged in their learning in the small classes studied. They also showed that the characteristics of a community of practice were more evident in the smaller classes. This paper concludes that it is the conditions that foster the development of a community of practice that have a critical role in bringing about high quality learning and that these conditions tend to be more easily met in smaller classes although there is no necessary relationship between the two.

This article examines the role of language policies in mediating access and equity in education. By examining a range of research and case studies on language policies, the authors explore how educational language policies serve as a central gatekeeper to education itself, as well as to quality education that may fundamentally depend on language ability, not only for literacy and classroom interaction but also for textbooks, materials, assessment, and other language-related aspects of education. The analysis offers an argument for placing language policies at the center of debates about educational access and equity, as well as a broad range of sociopolitical processes that shape learners' educational achievement.