Seismic wide-angle study of accreted Proterozoic crust in southeastern Wyoming

A seismic wide-angle xperiment was conducted in southeastern Wyoming, USA to investigate the seismic character of a postulated Proterozoic magmatic arc south of the suture (Cheyenne Belt) to the Archean Wyoming Province. Recordings from vibrator and dynamite sources with offsets between 34 and 126 km reveal no evidence for Moho reflections. The large-offset recordings contain multicyclic bands of reflective phases from the middle to lower crust. The data were transformed into the intercept ime-ray parameter (~--p) domain to estimate local depth bounds. A subsequent 1D inversion using high-amplitude ~'-p arrivals shows that the reflective part of the crust ranges from the depths of 25 to 40 km. This part of the crust exhibits velocities increasing from about 6.5 to 7.5 km/s. Reflectivity modeling shows that the lower crust might consist of a zone of alternating low- and high-velocity layers with average velocity increasing. The average lower crustal velocity of about 6.9 km/s suggests a predomi-nantly mafic composition with interlayered intermediate to felsic components generating impedance contrasts that cause observable amplitudes from reflections at large offsets but not at clearly pre-critical and near-vertical distances. Our model is consistent with observations of interlayered sequences of gabbroic to ultramafic rocks with more felsic anorthositic and charnockitic rocks in the exposed lower crust of magmatic arc complexes. The lack of wide-angle Moho reflections might be explained by a gradational compositional boundary, or a transitional phase change from granulite to eclogite facies. 1

Application LANDSAT imagery to geologic mapping in the ice-free valleys of Antarctica

The author has identified the following significant results. Studies in the Ice-Free Valleys are resulted in the compilation of a sizeable library of maps and publications. Rock reflectance measurements were taken during the Antarctic summer of 1973. Spectral reflectance of rocks (mostly mafic lava flows) in the McMurdo and Ice-Free Valleys areas were measured using a filter wheel photometer equipped to measure reflectances in the four Landsat bands. A series of samples were collected at regular intervals across a large differentiated, mafic sill near Lake Vida. Chemical analyses of the sample suggest that the tonal variations in this sill are controlled by changes in the iron content of the rock. False color images were prepared for a number of areas by the diazo method and with an optical multispectral biviewer. These images were useful in defining boundaries of sea ice, snow cover, and in the study of ablating glaciers, but were not very useful for rock discrimination

Some examples of deep structure of the Archean from geophysics

The development of Archean crust remains as one of the significant problems in earth science, and a major unknown concerning Archean terrains is the nature of the deep crust. The character of crust beneath granulite terrains is especially fascinating because granulites are generally interpreted to represent a deep crustal section. Magnetic data from this area can be best modeled with a magnetized wedge of older Archean rocks (granulitic gneisses) underlying the younger Archean greenstone terrain. The dip of the boundary based on magnetic modeling is the same as the dip of the postulated thrust-fault reflection. Thus several lines of evidence indicate that the younger Archean greenstone belt terrain is thrust above the ancient Minnesota Valley gneiss terrain, presumably as the greenstone belt was accreted to the gneiss terrain, so that the dipping reflection represents a suture zone. Seismic data from underneath the granulite-facies Minnesota gneiss terrain shows abundant reflections between 3 and 6 s, or about 9 to 20 km. These are arcuate or dipping multicyclic events indicative of layering

Assessment and diagnosis of Developmental Language Disorder: The experiences of speech and language therapists

© The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).Background: For many years research and practice have noted the impact of the heterogeneous nature of Developmental Language Disorder (also known as language impairment or specific language impairment) on diagnosis and assessment. Recent research suggests the disorder is not restricted to the language domain and against this background, the challenge for the practitioner is to provide accurate assessment and effective therapy. The language practitioner aims to support the child and their carers to achieve the best outcomes. However, little is known about the experiences of the language practitioner in the assessment process, in contrast to other childhood disorders, yet their expertise is central in the assessment and diagnosis of children with language disorder. Aims: This study aimed to provide a detailed qualitative description of the experiences of speech and language therapists involved in the assessment and diagnosis of children with Developmental Language Disorder. Methods & Procedures: The qualitative study included three focus groups to provide a credible and rich description of the experiences of speech and language therapists involved in the assessment of Developmental Language Disorder. The speech and language therapists who participated in the study were recruited from three NHS Trusts across the UK and all were directly involved in the assessment and diagnosis procedures. The lengths of practitioner experience ranged from 2 years to 38 years. The data was analysed using a thematic analysis in accordance with the principles set out by Braun & Clarke (2006). Outcomes & Results: The data showed a number of key themes concerning the experiences of speech and language therapists in assessing children with Developmental Language Disorder (DLD). These themes ranged from the participants’ experiences of the barriers to early referral, challenges for assessment and the concerns over continued future support. Conclusions & Implications: This study provides first-hand evidence from speech and language therapists in the assessment of children with Developmental Language Disorder, drawing together experiences from language practitioners from different regions. The findings provide insight to the barriers to referral, the potential variations in the assessment process, the role of practitioner expertise and the challenges faced them. The importance of early intervention, useful assessment tools and future support were expressed. Taken together, the results relate to some issues to be addressed on a practical level and a continuing need for initiatives to raise awareness of DLD in the public domain.Peer reviewe

Medicines adherence: Involving patients in decisions about prescribed medicines and supporting adherence

It is thought that between a third and a half of all medicines1 There are many causes of non-adherence but they fall into two overlapping categories: intentional and unintentional. Unintentional non-adherence occurs when the patient wants to follow the agreed treatment but is prevented from doing so by barriers that are beyond their control. Examples include poor recall or difficulties in understanding the instructions, problems with using the treatment, inability to pay for the treatment, or simply forgetting to take it. prescribed for long-term conditions are not taken as recommended. If the prescription is appropriate, then this may represent a loss to patients, the healthcare system and society. The costs are both personal and economic. Adherence presumes an agreement between prescriber and patient about the prescriber’s recommendations. Adherence to medicines is defined as the extent to which the patient’s action matches the agreed recommendations. Non-adherence may limit the benefits of medicines, resulting in lack of improvement, or deterioration, in health. The economic costs are not limited to wasted medicines but also include the knock-on costs arising from increased demands for healthcare if health deteriorates. Non-adherence should not be seen as the patient’s problem. It represents a fundamental limitation in the delivery of healthcare, often because of a failure to fully agree the prescription in the first place or to identify and provide the support that patients need later on. Addressing non-adherence is not about getting patients to take more medicines per se. Rather, it starts with an exploration of patients’ perspectives of medicines and the reasons why they may not want or are unable to use them. Healthcare professionals have a duty to help patients make informed decisions about treatment and use appropriately prescribed medicines to best effec

Building an online community to promote communication and collaborative learning between health professionals and young people who self-harm: an exploratory study

This is the accepted version of the article, which has been published in final form at doi: 10.1111/hex.12011.Background: Online communities are known to break down barriers between supposed experts and non-experts and to promote collaborative learning and 'radical trust' among members. Young people who self-harm report difficulties in communicating with health professionals, and vice versa. Aim: We sought to bring these two groups together online to see how well they could communicate with each other about self-harm and its management, and whether they could agree on what constituted safe and relevant advice. Methods: We allocated 77 young people aged 16-25 with experience of self-harm and 18 recently/nearly qualified professionals in relevant health-care disciplines to three separate Internet discussion forums. The forums contained different proportions of professionals to young people (none; 25%; 50% respectively) to allow us to observe the effect of the professionals on online interaction. Results: The young people were keen to share their lived experience of self-harm and its management with health professionals. They engaged in lively discussion and supported one another during emotional crises. Despite registering to take part, health professionals did not actively participate in the forums. Reported barriers included lack of confidence and concerns relating to workload, private-professional boundaries, role clarity, duty of care and accountability. In their absence, the young people built a vibrant lay community, supported by site moderators. Conclusions: Health professionals may not yet be ready to engage with young people who self-harm and to exchange knowledge and experience in an anonymous online setting. Further work is needed to understand and overcome their insecurities.NIH

Open-label, cluster randomised controlled trial and economic evaluation of a brief letter from a GP on unscheduled medical contacts associated with the start of the school year: the PLEASANT trial

BACKGROUND: Asthma is seasonal with peaks in exacerbation rates in school-age children associated with the return to school following the summer vacation. A drop in prescription collection in August is associated with an increase in the number of unscheduled contacts after the school return. OBJECTIVE: To assess whether a public health intervention delivered in general practice reduced unscheduled medical contacts in children with asthma. DESIGN: Cluster randomised trial with trial-based economic evaluation. Randomisation was at general practice level, stratified by size of practice. The intervention group received a letter from their general practitioner (GP) in late July outlining the importance of (re)taking asthma medication before the return to school. The control group was usual care. SETTING: General practices in England and Wales. PARTICIPANTS: 12 179 school-age children in 142 general practices (70 randomised to intervention). MAIN OUTCOME: Proportion of children aged 5-16 years who had an unscheduled contact in September. Secondary endpoints included collection of prescriptions in August and medical contacts over 12 months (September-August). Economic endpoints were quality-adjusted life-years gained and health service costs. RESULTS: There was no evidence of effect (OR 1.09; 95% CI 0.96 to 1.25 against treatment) on unscheduled contacts in September. The intervention increased the proportion of children collecting a prescription in August by 4% (OR 1.43; 95% CI 1.24 to 1.64). The intervention also reduced the total number of medical contacts between September-August by 5% (incidence ratio 0.95; 95% CI 0.91 to 0.99).The mean reduction in medical contacts informed the health economics analyses. The intervention was estimated to save £36.07 per patient, with a high probability (96.3%) of being cost-saving. CONCLUSIONS: The intervention succeeded in increasing children collecting prescriptions. It did not reduce unscheduled care in September (the primary outcome), but in the year following the intervention, it reduced the total number of medical contacts. TRIAL REGISTRATION NUMBER: ISRCTN03000938; Results