Cigarette smoking in adolescents with asthma in Jordan: Impact of peer-led education in high schools

Background: Peer-led smoking prevention programs focus on teaching adolescentsespecially those with asthma- who are affected most by cigarettes, refusal skills to lower their intention to smoke. The purpose of this study was to determine the impact of a peer-led asthma education program on students who were smokers in terms of self-efficacy to resist smoking, asthma knowledge and asthma-related quality of life

Morphology and distribution of the spinner dolphin, <i>Stenella longirostris</i>, rough-toothed dolphin, <i>Stenella bredanensis</i> and melon-headed whale, <i>Peponocephala electra</i>, from waters off the Sultanate of Oman

The morphology of three tropical delphinids from the Sultanate of Oman and their occurrence in the Arabian Sea are presented. Body lengths of four physically mature spinner dolphins (three males) ranged from 154-178.3cm (median 164.5cm), i.e. smaller than any known stock of spinner dolphins, except the dwarf forms from Thailand and Australia. Skulls of Oman spinner dolphins (n=10) were practically indistinguishable from those of eastern spinner dolphins (Stenella longirostris orientalis) from the eastern tropical Pacific, but were considerably smaller than skulls of populations of pantropical (Stenella longirostris longirostris) and Central American spinner dolphins (Stenella longirostris centroamericana). Two colour morphs (CM) were observed. The most common (CM1) has the typical tripartite pattern of the pantropical spinner dolphin. A small morph (CM2), so far seen mostly off Muscat, is characterised by a dark dorsal overlay obscuring most of the tripartite pattern and by a pinkish or white ventral field and supragenital patch. Two skulls were linked to a CM1 colour morph, the others were undetermined. It is concluded that Oman spinner dolphins should be treated as a discrete population, morphologically distinct from all known spinner dolphin subspecies. Confirmed coastal range states off the Arabian Peninsula include the United Arab Emirates, the Sultanate of Oman, Yemen, Somalia, Djibouti, Saudi Arabia, Sudan and Egypt. The taxonomic position of the two damaged dolphin calvariae from Oman has been the issue of much debate. This paper discusses the cranial characteristics that allow positive identification as rough-toothed dolphin (Steno bredanensis) and melon-headed whale (Peponocephala electra) respectively. The calvariae represent the first confirmed specimen records of these dolphin species for the Arabian Sea sensu lato

Effectiveness of semantic therapy for word-finding difficulties in pupils with persistent language impairments: a randomized control trial

BACKGROUND: Word-finding difficulties (WFDs) in children have been hypothesized to be caused at least partly by poor semantic knowledge. Therefore, improving semantic knowledge should decrease word-finding errors. Previous studies of semantic therapy for WFDs are inconclusive. AIMS: To investigate the effectiveness of semantic therapy for secondary school-aged pupils with WFDs using a randomized control trial with blind assessment. METHODS & PROCEDURES: Fifteen participants with language impairments and WFDs (aged 9;11–15;11) were randomly assigned to a therapy versus waiting control group. In Phase 1 the therapy group received two 15-min semantic therapy sessions per week for 8 weeks with their usual speech and language therapist. Therapy for each participant targeted words from one of three semantic categories (animals, food, clothes). All participants were tested pre- and post-phase 1 therapy on the brief version of the Test of Adolescent Word Finding (TAWF), semantic fluency and the Test of Word Finding in Discourse (TWFD). In Phase 2 the waiting control group received the same therapy as the original therapy group, which received therapy targeted at other language areas. Testing after Phase 2 aimed to establish whether the waiting control group made similar progress to the original therapy group and whether the original therapy group maintained any gains. OUTCOMES & RESULTS: The original therapy group made significant progress in standard scores on the TAWF (d= 0.94), which was maintained 5 months later. However, they made no progress on the semantic fluency or discourse tests. Participants in the waiting control group did not make significant progress on the TAWF in Phase 1 when they received no word-finding therapy. However, after Phase 2, when they received the therapy, they also made significant progress (d= 0.81). The combined effect of therapy over the two groups was d= 1.2. The mean standard scores on the TAWF were 67 pre-therapy and 77 post-therapy. CONCLUSIONS & IMPLICATIONS: Four hours of semantic therapy on discrete semantic categories led to significant gains on a general standardized test of word finding, enabling the participants to begin to close the gap between their performance and that of their typically developing peers. These gains were maintained after 5 months. A small amount of therapy can lead to significant gains even with secondary aged pupils with severe language difficulties. However, further studies are needed to find ways of improving word-finding abilities in discourse

Effectiveness and cost effectiveness of pharmacist input at the ward level: a systematic review and meta-analysis

Background Pharmacists play important role in ensuring timely care delivery at the ward level. The optimal level of pharmacist input, however, is not clearly defined. Objective To systematically review the evidence that assessed the outcomes of ward pharmacist input for people admitted with acute or emergent illness. Methods The protocol and search strategies were developed with input from clinicians. Medline, EMBASE, Centre for Reviews and Dissemination, The Cochrane Library, NHS Economic Evaluations, Health Technology Assessment and Health Economic Evaluations databases were searched. Inclusion criteria specified the population as adults and young people (age >16 years) who are admitted to hospital with suspected or confirmed acute or emergent illness. Only randomised controlled trials (RCTs) published in English were eligible for inclusion in the effectiveness review. Economic studies were limited to full economic evaluations and comparative cost analysis. Included studies were quality-assessed. Data were extracted, summarised. and meta-analysed, where appropriate. Results Eighteen RCTs and 7 economic studies were included. The RCTs were from USA (n=3), Sweden (n=2), Belgium (n=2), China (n=2), Australia (n=2), Denmark (n=2), Northern Ireland, Norway, Canada, UK and Netherlands. The economic studies were from UK (n=2), Sweden (n=2), Belgium and Netherlands. The results showed that regular pharmacist input was most cost effective. It reduced length-of-stay (mean= -1.74 days [95% CI: -2.76, -0.72], and increased patient and/or carer satisfaction (Relative Risk (RR) =1.49 [1.09, 2.03] at discharge). At £20,000 per quality-adjusted life-year (QALY)-gained cost-effectiveness threshold, it was either cost-saving or cost-effective (Incremental Cost Effectiveness Ratio (ICER) =£632/ QALY-gained). No evidence was found for 7-day pharmacist presence. Conclusions Pharmacist inclusion in the ward multidisciplinary team improves patient safety and satisfaction and is cost-effective when regularly provided throughout the ward stay. Research is needed to determine whether the provision of 7-day service is cost-effective.Peer reviewe

Early Cenozoic denudation of central west Britain in response to transient and permanent uplift above a mantle plume

Upwelling mantle plumes beneath continental crust are predicted to produce difficult to quantify, modest uplift and denudation. The contribution of permanent and transient components to the uplift is also difficult to distinguish. A pulse of denudation in Britain in the Early Paleogene has been linked, although with some controversy, with the arrival of the proto-Iceland mantle plume. In this contribution we show that combining apatite and zircon (U-Th-Sm)/He and apatite fission track analyses from central west Britain with numerical modeling clearly identifies a pulse of early Cenozoic denudation. The data indicate that rock uplift and denudation were centered on the northern East Irish Sea Basin and 1.0–2.4 km of rocks were removed during the latest Cretaceous-early Paleogene. Uplift and erosion appears to have started a few million years before the earliest magmatism in the region. The regional denudation pattern mirrors the distribution of low-density magmatic rocks that has been imaged in the deep crust. However, the injection of the underplating melt is not enough to account for the total denudation. An additional regional uplift of at least 300 m is required, which is consistent with a transient thermal effect from the hot mantle plume. The rapid exhumation event ceased by ~40 Ma and the data do not require significant Neogene exhumation

Marginalization of end-use technologies in energy innovation for climate protection

Mitigating climate change requires directed innovation efforts to develop and deploy energy technologies. Innovation activities are directed towards the outcome of climate protection by public institutions, policies and resources that in turn shape market behaviour. We analyse diverse indicators of activity throughout the innovation system to assess these efforts. We find efficient end-use technologies contribute large potential emission reductions and provide higher social returns on investment than energy-supply technologies. Yet public institutions, policies and financial resources pervasively privilege energy-supply technologies. Directed innovation efforts are strikingly misaligned with the needs of an emissions-constrained world. Significantly greater effort is needed to develop the full potential of efficient end-use technologies

Attitudes towards translanguaging: how future teachers perceive the meshing of Arabic and English in children’s storybooks

© 2018 Informa UK Limited, trading as Taylor & Francis Group This paper seeks to identify the attitudes of bilingual future teachers towards translanguaging when writing stories for bilingual young learners, and to understand the various forces that shape their attitudes. Translanguaging, in the context of this study, refers to the dynamic and intended shuttling between languages or dialects. An assignment in a Children’s Literature course in a bilingual university in the United Arab Emirates required participants to move across Modern Standard Arabic, their native Emirati Arabic, and English both between and within sentences, and to allocate equal weight to these languages/varieties in the meaning-making process. As an ethnographic study, participants’ attitudes were elicited at various stages of the research project. The findings indicate that they held paradoxical and ambivalent attitudes towards translanguaging, and that language ideology played a crucial role in determining their attitudes, as well as the degree to which translanguaging in writing was accepted or rejected

Determination of free 25(OH)D concentrations and their relationships to total 25(OH)D in multiple clinical populations

Context : The optimal measure of vitamin D(D) status is unknown. Objective : Directly measure circulating free 25(OH)D concentrations and relationships to total 25(OH)D in a clinically diverse sample of humans. Design : Cross-sectional analysis Setting : Seven academic sites Patients : 1661 adults: (healthy(n=211), pre-diabetic(n=479), outpatients(n=783), cirrhotic(n=90), pregnant(n=20), nursing home(n=79)) Interventions : Merge research data on circulating free 25(OH)D (directly measured immunoassay), total 25(OH)D (LC/MS/MS), D binding protein (DBP by radial (polyclonal) immunodiffusion assay)), albumin, creatinine, iPTH and DBP haplotype Main outcome measures : Distribution of free 25(OH)D (ANOVA with Bonferroni correction for post hoc comparisons) and relationships between free and total 25(OH)D (mixed effects modeling incorporating clinical condition, DBP haplotype with sex, race, eGFR, BMI and other covariates). Results : Free 25(OH)D was 4.7±1.8 pg/mL (mean ±SD) in healthy and 4.3 ±1.9 pg/mL in outpatients with 0.5-8.1 pg/mL and 0.9-8.1 pg/mL encompassing 95% of healthy and outpatients, respectively. Free 25(OH)D was higher in cirrhotics (7.1 ±3.0 pg/mL, pnursing home>prediabetic > outpatient > pregnant), and BMI (lesser effect) as covariates affecting relationships but not eGFR, sex, race or DBP haplotype. Conclusions : Total 25(OH)D, health condition, race and DBP haplotype affected free 25(OH)D, but only health conditions and BMI affected relationships between total and free 25(OH) D. Clinical importance of free 25(OH)D needs to be established in studies assessing outcomes

Adjusting to bodily change following stoma formation: a phenomenological study

Purpose: Scant research has been undertaken to explore in-depth the meaning of bodily change for individuals following stoma formation. The aim of this study was to understand the experience of living with a new stoma, with a focus on bodily change. Method: The study adopted a longitudinal phenomenological approach. Purposeful sampling was used to recruit twelve participants who had undergone faecal stoma-forming surgery. Indepth, unstructured interviews were conducted at three, nine and fifteen months following surgery. A five-stage framework facilitated iterative data analysis. Results: Stoma formation altered the taken-for-granted relationship individuals had with their bodies in terms of appearance, function and sensation, undermining the unity between body and self. Increasing familiarity with and perceived control over their stoma over time diminished awareness of their changed body, facilitating adaptation and self-acceptance. Conclusions: Stoma formation can undermine an individual’s sense of embodied self. A concept of embodiment is proposed to enable the experience of living with a new stoma to be understood as part of a wider process of re-establishing a unity between body, self and world. In defining a framework of care, individuals with a new stoma can be assisted to adapt to and accept a changed sense of embodied self

Microcrystalline testing used in combination with Raman micro-spectroscopy for absolute identification of novel psychoactive substances

Two new psychoactive substances, namely 4-methylmethcathinone (mephedrone) and 5,6-methylenedioxy-2-aminoindane (MDAI) were analysed with a novel combination of microcrystalline tests followed by Raman micro-spectroscopy to facilitate their absolute identification. The discrimination power of the proposed combination was successfully demonstrated through the analysis of the positional isomers 2- and 3-methylmethcathinone. The addition of mercury dichloride as a microcrystalline test reagent produced specific microcrystals of each tested analyte. The robustness of the method was evaluated in the presence of common cutting agents (caffeine and benzocaine) as well as on street samples. The crystal lattice structures of mephedrone, 2-methylmethcathinone and MDAI mercury dichloride microcrystals were determined by single crystal X-ray diffraction. This confirmed the presence of both drug and reagent together in the lattice and accounts for the distinct habit of the observed microcrystals. Raman spectra of the formed microcrystals differed from those obtained from their standard salt form by loss and/or gain of some vibrational modes. Particularly important was the appearance of the mercury chloride link to each tested drug molecule which showed as strong bands at low wavenumbers. Its presence was corroborated by its detection in the crystal lattice. It was therefore concluded that microcrystalline testing followed by Raman micro-spectroscopy satisfies the technique combination requirement for psychoactive substances recommended by the Scientific Working Group for the Analysis of Seized Drugs (SWGDRUG) and provides a rapid and cheap analysis route. The proposed technique combination also aids the development of new microcrystalline tests as it allows for confirmation of the uniqueness of the developed microcrystals almost in-situ rather than growing single crystals for often long periods of time needed for single crystal X-ray diffraction analysis