“If You Are Old Enough to Die for Your Country, You Should Be Able to Get a Pinch of Snuff”: Views of Tobacco 21 Among Appalachian Youth

Background: Multiple strategies have been utilized in attempts to decrease the prevalence of youth tobacco use. One strategy, raising the minimum legal sale age (MLSA) of tobacco products to 21, known as Tobacco 21, has recently gained popularity. Tobacco 21 legislation targets youth tobacco use by obstructing two main sources of youth tobacco products: stores and older friends. Although these sources are the most common for youth across the nation, regional differences have not been explored. Further, youth perspectives about raising the tobacco MLSA have not been considered. Youth may help identify potential challenges to implementing tobacco control measures, as well as suggest alternatives for intervention, thus helping to shape successful tobacco control policies. Study Aim: This study aimed to 1) examine youth perspectives on raising the tobacco minimum legal sale age to 21 and 2) identify common sources of tobacco products among middle and high school students living in rural, low-income Appalachian communities. Methods: A cross-sectional survey about perceptions and use of tobacco products was conducted with students in the Appalachian regions of Kentucky and North Carolina (N=426). Questions were asked concerning perspectives on the effect of Tobacco 21 implementation. Descriptive statistics characterized participants by Tobacco 21 perspectives. Participants were given the opportunity to further expand upon their opinions in an open-ended format. Results: The majority (58.7%) of participants responded that the same number of youth would use tobacco if the legal purchase age were raised, followed by responses that fewer would use (28.9%) and more would use (12.4%). Significant differences emerged based on tobacco use status (p\u3c.05), friends’ tobacco use (p\u3c.001), and whether participants identified family members as sources of youth tobacco products (p=.047). When given the opportunity to expand upon their views concerning the implementation of Tobacco 21 laws in their communities, many respondents cited poor enforcement of tobacco MLSAs at stores, continued access to tobacco products from family members and friends, and the overall abundance of tobacco in their communities as potential barriers to the successful implementation. Conclusion: Fewer than one-third of participants believed that Tobacco 21 legislation would succeed in reducing the prevalence of youth tobacco use. Perspectives on the effect of Tobacco 21 legislation were related to personal tobacco use, exposure to tobacco users, and beliefs that family members provide tobacco products to youth. Open-ended responses identify potential obstacles in implementing Tobacco 21 legislation in Appalachia. Future research should attempt to include youth perspectives when designing and implementing tobacco control policies and examine family members as sources of tobacco products for youth

Substitusi Agregat Halus Beton Menggunakan Kapur Alam Dan Menggunakan Pasir Laut Pada Campuran Beton

The limited of material that occur in Sumba Barat Daya district cause the used of natural limestone and sea sand as a substitute for fine aggregate that is scientifically unknown quality, so it needs to do a study of the material. The purpose of this research is to determine the percentage of natural limestone and sea sand that can be used and to determine the quality of the resulting concrete. Specimens used in this research is concrete cylinder (diameter 15 cm and high 30 cm). The methods used for data analysis was descriptive statistics. Based on the results obtained that the percentage that can be used for sea sand is 100% and for natural limestone is 25%. The result of Quality test obtained that the concrete with natural limestone have compressive strength and split tensile strength is smaller than the normal concrete and do not reach the compressive strength of the plan. While the concrete using sea sand is concrete which produces compressive strength and split tensile strength greater than normal concrete

A world wide web informational reference source for viral ocular disease

This World Wide Web page is a quick reference source for anyone wishing to research ocular viral disease. Doctors and medical students will find the web site helpful to aid in the diagnosis and treatment of ocular viral disease. Topics within the site are cross-linked and presented in subjective, objective, assessment, plan format (SOAP). Photographs are included as are references for further study

Environmental and Technical Approach In the Selection of Fishing Gear Featured in WPP 571 Aceh

Fishery management area 571 (WPP 571) Aceh is fertile waters and become a major fishing ground for fishermen who settled along the north coast of Aceh. The research aimed to analyze the condition of the waters around fishing ground and fish production in WPP 571 Aceh, and to determine the fishing gear featured for environmental and technical aspects in WPP 571 Aceh

Fat, syn and disordered eating: The dangers and powers of excess

This is an accepted manuscript of an article published by Taylor & Francis in Fat Studies on 8 April 2015 available online: http://wwww.tandfonline.com/10.1080/21604851.2015.1016777This article draws on qualitative research inside one UK secular commercial weight loss group to show how ancient Christian suspicions of appetite and pleasure resurface in this group’s language of “Syn.” Following ancient Christian representations of sin, members assume that Syn depicts disorder and that fat is a visible sign of a body which has fallen out of place. Syn, though, is ambiguous, utilizing ancient theological meanings to discipline fat while containing within it the power to resist the very borders which hold women’s bodies and fat in place. Syn thus signals both the dangers and powers of disordered eating.This article draws on qualitative research inside one UK secular commercial weight loss group to show how ancient Christian suspicions of appetite and pleasure resurface in this group’s language of “Syn.” Following ancient Christian representations of sin, members assume that Syn depicts disorder and that fat is a visible sign of a body which has fallen out of place. Syn, though, is ambiguous, utilizing ancient theological meanings to discipline fat while containing within it the power to resist the very borders which hold women’s bodies and fat in place. Syn thus signals both the dangers and powers of disordered eating

Randomized Trial of Artesunate+Amodiaquine, Sulfadoxine-Pyrimethamine+Amodiaquine, Chlorproguanal-Dapsone and SP for Malaria in Pregnancy in Tanzania

Malaria in pregnancy is serious, and drug resistance in Africa is spreading. Drugs have greater risks in pregnancy and determining the safety and efficacy of drugs in pregnancy is therefore a priority. This study set out to determine the efficacy and safety of several antimalarial drugs and combinations in pregnant women with uncomplicated malaria.Pregnant women with non-severe, slide proven, falciparum malaria were randomised to one of 4 regimes: sulfadoxine-pyrimethamine [SP]; chlorproguanil-dapsone [CD]; SP+amodiaquine [SP+AQ] or amodiaquine+artesunate [AQ+AS]. Randomisation was on a 1ratio2ratio2ratio2 ratio. Women were admitted for treatment, and followed at days 7, 14, 21, 28 after the start of treatment, at delivery and 6 weeks after delivery to determine adverse events, clinical and parasitological outcomes. Primary outcome was parasitological failure by day 28.1433 pregnant women were screened, of whom 272 met entry criteria and were randomised; 28 to SP, 81 to CD, 80 to SP+AQ and 83 to AQ+AS. Follow-up to day 28 post treatment was 251/272 (92%), and to 6 weeks following delivery 91%. By day 28 parasitological failure rates were 4/26 (15%, 95%CI 4-35) in the SP, 18/77 (23%, 95%CI 14-34) in the CD, 1/73 (1% 95%CI 7-0.001) in the SP+AQ and 7/75 (9% 95%CI 4-18) in the AQ+AS arms respectively. After correction by molecular markers for reinfection the parasitological failure rates at day 28 were 18% for CD, 1% for SP+AQ and 4.5% for AQ+AS. There were two maternal deaths during the trial. There was no apparent excess of stillbirths or adverse birth outcomes in any arm. Parasitological responses were strikingly better in pregnant women than in children treated with the same drugs at this site.Failure rates with monotherapy were unacceptably high. The two combinations tested were efficacious and appeared safe. It should not be assumed that efficacy in pregnancy is the same as in children.ClinicalTrials.gov NCT00146731

Assessing the impact of a construction virtual reality game on design review skills of construction student

Being able to perform an effective design review is a fundamental skill that every design or construction student should possess. Performing a design review requires critical thinking, analysis, and communication skills. To support the acquisition of these skills, this study investigated the impact of a virtual reality game, the design review simulator (DRS), in a classroom environment. To assess the impact of the game, the authors performed a crossover experiment with 120 students. The students were split into groups and were asked to perform design reviews in two treatment conditions, 2D drawings or the DRS. A knowledge test was administered at the end of different treatments to collect quantitative data on the students’ performance. Results from this research indicate that the DRS supported students in identifying a higher number of design mistakes. Furthermore, students that played with the DRS after performing 2D drawings reviews scored significantly higher in the knowledge test. The research results contribute to the growing knowledge base on the implementation of VR in the classroom and in supporting students in meeting learning objectives related to design review skills. In particular, the research illustrated that the benefits of VR found in the construction industry in terms of improved communication, user involvement, and feedback collection could be translated into the classroom environment