Search

Introduction Oral language skills are associated with children’s later self-regulation and academic skills; in turn, self-regulation in early childhood predicts successful functioning later in life. The primary objective of this study is to evaluate the separate and combined effectiveness of an oral language intervention (Enhancing Rich Conversations, ENRICH) and a self-regulation intervention (Enhancing Neurocognitive Growth with the Aid of Games and Exercise, ENGAGE) with early childhood teachers and parents for children’s oral language, self-regulation and academic functioning.Methods and analysis The Kia Tīmata Pai (Best Start) study is a cluster randomised controlled trial with teachers and children in approximately 140 early childhood centres in New Zealand. Centres are randomly assigned to receive either oral language intervention only (ENRICH), self-regulation intervention only (ENGAGE), both interventions (ENRICH+ENGAGE) or an active control condition. Teachers’ and parents’ practices and children’s oral language and self-regulation development are assessed at baseline at age 1.5 years and approximately every 9 months to age 5, and academic performance at age 6. Teacher–child interactions will also be videotaped each year in a subset of the centres. Children’s brain and behaviour development and parent–child interactions will be assessed every 6 months to age 6 years in a subgroup of volunteers.Ethics and dissemination The Kia Tīmata Pai trial and the two substudies (Video Project; Brain and Behaviour Development) have been approved by the University of Otago Human Ethics Committee (Health; H20/116), and reviewed for cultural responsiveness by: the Ngāi Tahu Research Committee (University of Otago), the Māori Advisory Group (University of Auckland, Liggins Institute) and an internal cultural advisory group. Results will be disseminated in international and national peer-reviewed academic journals and communicated to local, national and international organisations serving early childhood teachers, parents and young children. Data will be available via communication with the corresponding author.Trial registration number ACTRN12621000845831.

Abstract Background The use of data in targeting malaria control efforts is essential for optimal use of resources. This work provides a practical mechanism for prioritizing geographic areas for insecticide-treated net (ITN) distribution campaigns in settings with limited resources. Methods A GIS-based weighted approach was adopted to categorize and rank administrative units based on data that can be applied in various country contexts where Plasmodium falciparum transmission is reported. Malaria intervention and risk factors were used to rank local government areas (LGAs) in Nigeria for prioritization during mass ITN distribution campaigns. Each factor was assigned a unique weight that was obtained through application of the analytic hierarchy process (AHP). The weight was then multiplied by a value based on natural groupings inherent in the data, or the presence or absence of a given intervention. Risk scores for each factor were then summated to generate a composite unique risk score for each LGA. This risk score was translated into a prioritization map which ranks each LGA from low to high priority in terms of timing of ITN distributions. Results A case study using data from Nigeria showed that a major component that influenced the prioritization scheme was ITN access. Sensitivity analysis results indicate that changes to the methodology used to quantify ITN access did not modify outputs substantially. Some 120 LGAs were categorized as ‘extremely high’ or ‘high’ priority when a spatially interpolated ITN access layer was used. When prioritization scores were calculated using DHS-reported state level ITN access, 108 (90.0%) of the 120 LGAs were also categorized as being extremely high or high priority. The geospatial heterogeneity found among input risk factors suggests that a range of variables and covariates should be considered when using data to inform ITN distributions. Conclusion The authors provide a tool for prioritizing regions in terms of timing of ITN distributions. It serves as a base upon which a wider range of vector control interventions could be targeted. Its value added can be found in its potential for application in multiple country contexts, expediated timeframe for producing outputs, and its use of systematically collected malaria indicators in informing prioritization.

Abstract Background We assessed the feasibility of implementing psychological counseling services (PCS) for mothers of children with autism spectrum disorders (ASD) integrated within special education settings in urban Bangladesh. Method In two special education schools for ASD in Dhaka City, trained female psychologists screened mothers using the Patient Health Questionnaire (PHQ-9). PCS was administered to all the mothers irrespective of a diagnosis of depression. Mothers with a PHQ-9 score >4 who met criteria for a major depressive episode (MDE) based on the DSM-IV Structured Interview Axis I Disorders (SCID-I) were also administered skill-building training through monthly home visits to support ASD care. The level of depression was assessed by the Depression Measurement Scale (DMS), and quality of life (QoL) was measured by Visual Analogue Scale (VAS) of EQ5D5L scale before and after PCS. Result Among 188 mothers enrolled in the study, 81 (43%) received PCS, and 27.1% (22) had MDE. In the first month, 73 sessions were scheduled and 60 completed (85%). In the last month, 53 sessions were scheduled and 52 completed (98%). The mean DMS score decreased from 79.5 ± 23 to 60 ± 20 (p = 0.004), and DMS scores were significantly higher among mothers with MDE (97.8 ± 12.1 v. 69.9 ± 22.1; p < 0.001) compared to those without MDE (72.7 ± 22.6 v. 56.1 ± 18.1; p = 0.003). The mean VAS score improved from 70.3 ± 14.1 to 80.2 ± 13.3 (p = 0.001) between the first and the last session. Changes in DMS were negatively correlated with changes in VAS scores (β: −0.213, 95% CI 0.370 to −0.056). Conclusion Within special education schools for ASD in urban Bangladesh, it was feasible to administer an integrated program of PCS for mothers of children with ASD by trained psychologists who were able to screen and intervene to reduce their level of depression and improve their quality of life.

BackgroundDespite increased coverage of Insecticide Treated Nets (ITNs) due to free distribution programs, ITN use in Uganda remains sub optimal among pregnant women. This study explored the relationship between constructs of a theoretical framework and Net use.ObjectiveThe study examined the role of constructs from the Extended Parallel Process Model (EPPM) in determining ITN use amongst pregnant women 15-49 years in Tororo district, Uganda.MethodsA cross-sectional study using a systematic sample was conducted among 230 pregnant women attending antenatal care. The questionnaire was administered by trained research assistants. Analysis was conducted to establish the relationship between ITN use and perceived susceptibility, severity, self-efficacy and response efficacy.ResultsOver three-quarters (78.6%) reported using ITNs the night before the study while 49.78% reported consistent Net use. High self-efficacy (AOR 9.48 95%CI 3.34-26.91) was associated with ITN use the previous night and consistent use. High perceived threat was associated with consistent ITN use (AOR 2.78, 95%CI 1.16-6.67) but not with Net use the previous night.ConclusionSelf-efficacy was an important predictor of ITN use, as well as high levels of fear, as measured through perceived threat, which was associated with consistent ITN use, but not ITN use the previous night. Social and behavior change communication interventions should focus on improving self-efficacy to use ITNs.

Heathers have been cultivated for several centuries, both the hardy heaths (Calluna, Daboecia and Erica) from the northern hemisphere and the more frost-tender species of Erica from southern Africa known as Cape heaths. In the late 19th century, a number of heather gardens were created, especially in Britain, and the popularity of heathers as long-lasting garden plants reached its zenith in western Europe and temperate North America in the late 20th century. At about the same time, deliberate breeding and selecting of Calluna vulgaris (ling) for flowers that lack normal sexual parts and remain bud-like led to a revolution in heather production with tens of millions of these bud-bloomer Calluna propagated each year for an ephemeral trade dominated by throwaway plants. Concomitantly, the diversity of hardy heathers offered by the trade has declined sharply with a small number of artificially raised clones, protected by plant breeders’ rights, now dominating the market. In contrast, the discovery of living lineages of a few Erica species that are extinct in the wild in South Africa has led to successful reintroduction programmes, particularly of Erica verticillata. The Erica Conservation Consortium, inaugurated in 2020, aims to coordinate and prioritise ex situ conservation of endangered Cape heaths.

Light propagation through the atmosphere is affected by fluctuations in the refractive index along the path of propagation, called optical turbulence. In the atmospheric surface layer, these fluctuations are due mostly to turbulent mixing of variations in temperature. To this end, a characterization of the atmospheric surface layer above the water in Maryland, USA, is presented. Meteorological data were collected from a sensor array comprising two sonic anemometers and an infrared gas analyzer (IRGASON) over the 12-month period from January to December, 2021. The instruments were positioned vertically at heights of approximately 4 m, 6 m, and 8 m above the water. The temperature structure parameter CT2 was calculated and scaled using Monin–Obukhov assumptions. We find that the distribution of atmospheric stability presents as an approximately normal distribution during the winter and early spring, but is skewed negatively during the summer and late fall. We hypothesize that this could be due to a more stable stratification of the underlying water during summer months. Under unstable (−z/L) conditions, turbulent quantities including the temperature structure parameter scale in a manner consistent with the literature, but with generally better agreement during the summer months. Additionally, the CT2 estimations appear more consistent during the summer months across all values of (z/L). Under stable (+z/L) conditions, there are wide variations in CT2, which is also consistent with the literature.

Purpose: Total hip arthroplasty (THA) is one of the fastest growing procedures. There is increasing evidence that social determinants of health influence health care utilization and outcomes after THA, including postoperative care. We sought to examine how race impacts discharge destination after elective THA, and we assessed the impact of discharge destination on 90-day readmission to an acute care hospital. Methods: We conducted a retrospective study using data from the Pennsylvania Health Care Cost Containment Council Database. We included patients of African American (AA) or white race undergoing THA, discharge disposition (inpatient rehabilitation facility [IRF], skilled nursing facility [SNF], home health care (HHC), home), and 90-day readmission rates. Results: Our study included 93,493 primary elective THAs. Compared with whites, AAs were more likely to be discharged to an IRF or SNF or HHC than home after THA. In all age groups, discharge to an IRF, SNF, or HHC for postop care/rehab was associated with higher odds of 90-day readmission as compared with home. Conclusion: AA race was associated with higher odds of discharge to an institution (IRF/SNF) or HHC for post-THA care. Disposition to these were associated with significantly higher risk of 90-day readmission to acute care hospital compared with home.

AbstractThe let-7Caenorhabditis eleganslet-7let-7let-7lin-41let-7CaenorhabditisC. elegans,let-7let-7Caenorhabditis sulstonilet-7-let-7let-7let-7let-7let-7-

Prior research has demonstrated that distributed optical fiber sensors (DOFS) based on Rayleigh scattering can be embedded in carbon fiber/epoxy composite structures to rapidly detect temperature changes approaching 1000 °C, such as would be experienced during a high energy laser strike. However, composite structures often experience mechanical strains that are also detected during DOFS interrogation. Hence, the combined temperature and strain response in the composite can interfere with rapid detection and measurement of a localized thermal impulse. In this research, initial testing has demonstrated the simultaneous response of the DOFS to both temperature and strain. An embedded DOFS network was designed and used to isolate and measure a localized thermal response of a carbon fiber/epoxy composite to a low energy laser strike under cyclic bending strain. The sensor interrogation scheme uses a simple signal processing technique to enhance the thermal response, while mitigating the strain response due to bending. While our ultimate goal is rapid detection of directed energy on the surface of the composite, the technique could be generalized to structural health monitoring of temperature sensitive components or smart structures.

As the applications of fiber Bragg gratings (FBGs) continue to grow and become more advanced, it becomes necessary to understand their behavior when exposed to high temperatures in unique situations. In these experiments, uniform 1530-nm fiber Bragg gratings and Type K Cr-Al thermocouples were embedded in three-ply carbon fiber composites. A 100 W high energy laser (HEL) heated the composites to high temperatures over timespans less than one second, and FBG spectral data and thermocouple temperature data were collected during each HEL heating test. The data from three high energy laser tests that represent different levels of damage to the FBG are analyzed to explore the spectral response and thermal decay of embedded FBG sensors when exposed to high temperatures over short timespans. Results are compared to a previously proposed power-law model describing the decay of FBGs in bare fiber when held at constant temperatures over much longer timespans.

Large-scale ecosystem restoration projects seldom undergo comprehensive evaluation to determine project effectiveness. Consequently, there are missed opportunities for learning and strategy refinement. Before our study, monitoring information from California’s middle Sacramento River had not been synthesized, despite restoration having been ongoing since 1989. Our assessment was based on the development and application of 36 quantitative ecological indicators. These indicators were used to characterize the status of terrestrial and floodplain resources (e.g., flora and fauna), channel dynamics (e.g., planform, geomorphology), and the flow regime. Indicators were also associated with specific goal statements of the CALFED Ecosystem Restoration Program. A collective weight of evidence approach was used to assess restoration success. Our synthesis demonstrates good progress in the restoration of riparian habitats, birds and other wildlife, but not in restoration of streamflows and geomorphic processes. For example, from 1999 to 2007, there was a > 600% increase in forest patch core size, and a 43% increase in the area of the river bordered by natural habitat > 500 m wide. Species richness of landbirds and beetles increased at restoration sites, as did detections of bats. However, degraded post-Shasta Dam streamflow conditions continued. Relative to pre-dam conditions, the average number of years that pass between flows that are sufficient to mobilize the bed, and those that are of sufficient magnitude to inundate the floodplain, increased by over 100%. Trends in geomorphic processes were strongly negative, with increases in the amount of bank hardened with riprap, and decreases in the area of floodplain reworked. Overall the channel simplified, becoming less sinuous with reduced overall channel length. Our progress assessment presents a compelling case for what needs to be done to further advance the ecological restoration of the river. The most important actions to be taken relate to promoting river meander and floodplain connectivity, and restoring components of the natural flow regime.

This study focused on gender stereotypes in Thomas Hardy's Tess of the D'Urbervilles (1891) and F. Scott Fitzgerald's The Great Gatsby (1925). The objectives of the study were to: examine the portrayal of masculinityfemininity stereotype; examine the language used in gender stereotype and analyse the impact of traditional gender stereotype on female characters. The study used the feminist theory to examine gender stereotype in the two maleauthored novels to show how they have positioned and portrayed women in their literature in the Victorian period both in England and America The literary analysis was to ascertain whether or not the gender stereotype was a global notion in literature or a misrepresentation of the women not as persons but as sexualized figures. Gender stereotype in these novels was examined using the descriptive research design and data was collected using literary analysis. The findings indicated that both novels portrayed the female gender with discrimination, injustice, dishonesty and exploitatively. This was done with the use of symbolism, imagery, similes and metaphor. The conclusion drawn points to the fact that the quest for a masculine identity is a common theme as male characters are seen struggling to become real men with traits such as: power, strength and robustness whereas female characters were portrayed as sexualized figure used for social status in the male dominated societies. With regard to language stereotype, the male characters employed language to paint negative image in line with the accepted image in the male dominated society. The researchers recommend that detailed and comprehensive studies be conducted in the area of gender and culture and gender and literature in the novel as a genre generally. [ABSTRACT FROM AUTHOR]

Purpose To assess risk factors for arterial and venous thromboses (AVT) in patients hospitalized in general wards for COVID-19 pneumonia and requiring oxygen therapy. Methods Our study was based on three randomized studies conducted as part of the CORIMUNO-19 platform in France between 27 March and 26 April 2020. Adult inpatients with COVID-19 pneumonia requiring at least 3 l/min of oxygen but not ventilation were randomized to receive standard care alone or standard care plus biologics. Patients were followed up for 3 months, and adverse events were documented. Risk factor for AVT and bleeding was identified by analyzing clinical, laboratory, and treatment data at baseline among the 315 patients with complete datasets. A Fine and Gray model was used to take account of competing events. Results During the 3-month follow-up period, 39 AVT occurred in 38 (10%) of the 388 patients: 26 deep vein thromboses and/or pulmonary embolisms in 25 (6%) patients, and 14 arterial thrombotic events in 13 (3%) patients. A history of diabetes at inclusion [sHR (95% CI) = 2.65 (1.19–5.91), P  = .017] and the C-reactive protein (CRP) level (sHR = 1 [1–1.01], P  = .049) were significantly associated with an elevated risk of thrombosis. Obesity was not associated with a higher risk of thrombosis (sHR = 1.01 [0.4–2.57], P  = .98). The CRP level and diabetes were not risk factors for hemorrhage. Conclusion Among patients hospitalized in general wards for COVID-19 pneumonia during the first wave of the epidemic, diabetes (but not obesity) and a high CRP level were risk factors for AVT. The use of higher doses of anticoagulant in these high-risk patients could be considered. Key messages What is already known on this topic—Arterial and venous thromboses are potentially serious complications of COVID-19 What this study adds—Arterial and venous thromboses occurred in 10% of the 388 patients hospitalized for COVID-19 pneumonia in a general ward and requiring oxygen treatment during the first wave of the pandemic. History of diabetes and intense inflammation were associated with an elevated risk of thromboses in this category of patients. How this study might affect research, practice, or policy—Higher doses of anticoagulants could be considered in these high-risk patients (diabetes and/or high CRP) and might open up opportunities for interventional studies. [ABSTRACT FROM AUTHOR]