Development in Crisis: Adolescent Sibling Bereavement

The death of a sibling represents a major crisis in the life of an adolescent. Instead of exploring the new intellectual, emotional, and psychological components of their identities, teens who lose a sibling often become isolated. Peer groups who were once helpful in providing crucial support and refuge from parental norms may become difficult for teens to relate to, while parents may become so engaged in their own grief they may be unable to provide the surviving adolescent sibling with guidance. Modern research suggests that bereavement is a lifelong process, yet at the very time an adolescent ideally is determining who he is, the death of a sibling threatens the developmental progression for many such youth. Despite the profundity of this dilemma, there is insufficient research that addresses the impact of adolescent sibling bereavement on identity development. In fact, Balmer (1992) has argued that “a conceptual model of adolescent sibling bereavement does not exist” (p. 4). This dissertation explores the symptomatology of adolescent bereavement and its impact on adolescent identity development. This author will utilize the literature to provide a conceptual description of adolescent coping styles during sibling bereavement with an acknowledgement of both pathological and resilient responses and their impact on identity formation. Implications for social work practice, research and knowledge-building will be provided

Well structured program equivalence is highly undecidable

We show that strict deterministic propositional dynamic logic with intersection is highly undecidable, solving a problem in the Stanford Encyclopedia of Philosophy. In fact we show something quite a bit stronger. We introduce the construction of program equivalence, which returns the value $\mathsf{T}$ precisely when two given programs are equivalent on halting computations. We show that virtually any variant of propositional dynamic logic has $\Pi_1^1$-hard validity problem if it can express even just the equivalence of well-structured programs with the empty program \texttt{skip}. We also show, in these cases, that the set of propositional statements valid over finite models is not recursively enumerable, so there is not even an axiomatisation for finitely valid propositions.Comment: 8 page

Pneumococcal conjugate vaccine given shortly after birth stimulates effective antibody concentrations and primes immunological memory for sustained infant protection.

BACKGROUND: In developing countries, newborn immunization with pneumococcal conjugate vaccines (PCVs) could protect young infants who are at high risk of invasive pneumococcal disease (IPD) but might lead to immune tolerance. METHODS: In a randomized trial, young infants received 7-valent PCV at 6, 10, and 14 weeks (Expanded Programme on Immunization [EPI] group) or 0, 10, and 14 weeks (newborn group). Safety was monitored actively at 2-7 days and then passively. Serum samples obtained at birth and 6, 10, 14, 18, 36, and 37 weeks were assayed by enzyme-linked immunosorbent assay for anticapsular immunoglobulin G concentration and avidity. Infants were boosted with either 7-valent PCV or one-fifth dose of pneumococcal polysaccharide vaccine at 36 weeks. Nasopharyngeal swab samples were obtained at 18 and 36 weeks. RESULTS: Three-hundred neonates and young infants were enrolled. Newborn vaccination was well tolerated. Adverse events occurred equally in each group; none was related to immunization. One infant, immunized at birth, died of unrelated neonatal sepsis. At 18 weeks, protective concentrations (≥0.35 μg/mL) were achieved against each serotype by ≥87% of infants with no significant differences between groups. Geometric mean concentrations were higher in the EPI group for serotypes 4, 9V, 18C, and 19F at 18 weeks and for serotype 4 at 36 weeks. Avidity was greater in the newborn group for serotypes 4, 6B, and 19F at 18 weeks and for serotype 19F at 36 weeks. Booster responses and vaccine-type/nonvaccine-type carriage prevalence did not differ between groups. CONCLUSIONS: PCV was safe, immunogenic, and primed for memory when given at birth. There was no evidence of immune tolerance. Vaccination beginning at birth offers an alternative to control IPD in vulnerable young infants

Cooperative Acquisitions among Law Libraries: A Review

A brief review of established cooperative arrangements among large academic libraries may suggest reasons for the recent emergence of cooperatives among law libraries. The authors examine in detail three law library consortia that are developing cooperative acquisitions plans. Although the prospects for a single, physical national law library are slight, the full potential of a national database of law library holdings has yet to be explored

Effect of Maternally Derived Anti-protein and Anticapsular IgG Antibodies on the Rate of Acquisition of Nasopharyngeal Carriage of Pneumococcus in Newborns

BACKGROUND: In developing countries, introduction of pneumococcal conjugate vaccine has not eliminated circulation of vaccine serotypes. Vaccinating pregnant mothers to increase antibody concentrations in their newborn infants may reduce the acquisition of pneumococcal carriage and subsequent risk of disease. We explored the efficacy of passive immunity, attributable to anti-protein and anticapsular pneumococcal antibodies, against acquisition of carriage. METHODS: We examined the rate of nasopharyngeal acquisition of pneumococci in the first 90 days of life associated with varying anticapsular and anti-protein antibody concentrations in infant cord/maternal venous blood in Kilifi, Kenya. We used multivariable Cox proportional hazard models to estimate continuous functions relating acquisition of nasopharyngeal carriage to the concentration of maternally derived antibody. RESULTS: Cord blood or maternal venous samples were collected from 976 mother-infant pairs. Pneumococci were acquired 561 times during 33,905 person-days of follow-up. Increasing concentrations of anti-protein antibodies were associated with either a reduction (PhtD1, PspAFam2, Spr0096, StkP) or, paradoxically, an increase (CbpA, LytC, PcpA, PiaA, PspAFam1, RrgBT4) in acquisition rate. We observed a nonsignificant reduction in the incidence of homologous carriage acquisition with high concentrations of maternally derived anticapsular antibodies to 5 serotypes (6A, 6B, 14, 19F, and 23F). CONCLUSION: The protective efficacy of several anti-protein antibodies supports the strategy of maternal vaccination to protect young infants from carriage and invasive disease. We were not able to demonstrate that passive anticapsular antibodies were protective against carriage acquisition at naturally occurring concentrations though it remains possible they may do so at the higher concentrations elicited by vaccination

Opsonophagocytic Killing Assay to Measure Anti–Group A Streptococcus Antibody Functionality in Human Serum

The opsonophagocytic killing assay (OPKA) is designed to measure the functionality of strain-specific antibodies and, therefore, assess protective immunity or the immunogenicity of Group A Streptococcus (GAS) (type A Streptococcus pyogenes) vaccines. Opsonization of GAS for phagocytosis is an important mechanism by which antibodies protect against disease in vivo. The Opsonophagocytic Index or Opsonic Index (OI) is the estimated dilution of antisera that kills 50% of the target bacteria. Here, we describe the protocol of the standardized GAS OPKA developed by Jones et al., 2018

A Topological Study of Contextuality and Modality in Quantum Mechanics

Kochen-Specker theorem rules out the non-contextual assignment of values to physical magnitudes. Here we enrich the usual orthomodular structure of quantum mechanical propositions with modal operators. This enlargement allows to refer consistently to actual and possible properties of the system. By means of a topological argument, more precisely in terms of the existence of sections of sheaves, we give an extended version of Kochen-Specker theorem over this new structure. This allows us to prove that contextuality remains a central feature even in the enriched propositional system.Comment: 10 pages, no figures, submitted to I. J. Th. Phy

Pneumococcal conjugate vaccine induced IgG and nasopharyngeal carriage of pneumococci: Hyporesponsiveness and immune correlates of protection for carriage

BACKGROUND: Prior studies have demonstrated hyporesponsiveness to pneumococcal conjugate vaccines (PCVs) when administered in the presence of homologous carriage. This may be substantially more important in Africa where carriage prevalence is high. Deriving a correlate of protection (CoP) for carriage is important in guiding the future use of extended PCVs as population control of pneumococcal disease by vaccination is now focused principally on its indirect effect. We therefore explored the complex relationship between existing carriage and vaccine responsiveness, and between serum IgG levels and risk of acquisition. METHODS: We undertook secondary analyses of data from two previously published clinical trials of the safety and immunogenicity of PCV in Kenya. We compared responses to vaccination between serotype-specific carriers and non-carriers at vaccination. We assessed the risk of carriage acquisition in relation to PCV-induced serum IgG levels using either a step- or continuous-risk function. RESULTS: For newborns, the immune response among carriers was 51–82% lower than that among non-carriers, depending on serotype. Among toddlers, for serotypes 6B, 14 and 19F the post-vaccination response among carriers was lower by between 29 and 70%. The estimated CoP against acquisition ranged from 0.26 to 1.93 μg/mL across serotypes, however, these thresholds could not be distinguished statistically from a model with constant probability of carriage independent of assay value. CONCLUSION: We have confirmed hyporesponsiveness in an equatorial African setting in both infants and toddlers. Population responses to vaccination are likely to improve with time as carriage prevalence of vaccine serotypes is reduced. We have not found clear correlates of protection against carriage acquisition among toddlers in this population. Assessing the potential of new vaccines through the use of CoP against carriage is still difficult as there are no clear-cut serotype specific correlates