A Late Holocene community burial area: Evidence of diverse mortuary practices in the Western Cape, South Africa.

Over several decades, human skeletal remains from at least twelve individuals (males, females, children and infants) were recovered from a small area (ca. 10 x 10 m) on the eastern shore of Table Bay, Cape Town, near the mouth of the Diep River where it empties into the sea. Two groups, each comprising four individuals, appear to have been buried in single graves. Unusually for this region, several skeletons were interred with large numbers of ostrich eggshell (OES) beads. In some cases, careful excavation enabled recovery of segments of beadwork. One collective burial held items including an ostrich egg-shell flask, a tortoise carapace bowl, a fragmentary bone point or linkshaft and various lithic artefacts. This group appears to have died together and been buried expediently. A mid-adult woman from this group sustained perimortem blunt-force trauma to her skull, very likely the cause of her death. This case adds to the developing picture of interpersonal violence associated with a period of subsistence intensification among late Holocene foragers. Radiocarbon dates obtained for nine skeletons may overlap but given the uncertainties associated with marine carbon input, we cannot constrain the date range more tightly than 1900-1340 calBP (at 2 sigma). The locale appears to have been used by a community as a burial ground, perhaps regularly for several generations, or on a single catastrophic occasion, or some combination thereof. The evidence documents regional and temporal variation in burial practices among late Holocene foragers of the south-western Cape

Direct Vocabulary Instruction in Kindergarten: Teaching for Breadth versus Depth

The purpose of this study was to compare 2 methods for directly teaching word meanings to kindergarten students within storybook readalouds that varied in instructional time and depth of instruction along with a control condition that provided students with incidental exposure to target words. Embedded instruction introduces target word meanings during storybook readings in a time-efficient manner. Extended instruction is more time intensive but provides multiple opportunities to interact with target words outside the context of the story. Participants included 42 kindergarten students who were taught 9 target words, 3 with each method. Target words were counterbalanced in a within-subjects design. Findings indicated that extended instruction resulted in more full and refined word knowledge, while embedded instruction resulted in partial knowledge of target vocabulary. Implications are discussed in relation to the strengths and limitations of different approaches to direct vocabulary instruction in kindergarten and the trade-offs between instruction that focuses on teaching for breadth versus depth

Bridge study protocol : an international, observational cohort study on the transition of healthcare for adolescents with chronic conditions

Introduction More than 10% of adolescents live with a chronic disease or disability that requires regular medical follow-up as they mature into adulthood. During the first 2 years after adolescents with chronic conditions are transferred to adult hospitals, non-adherence rates approach 70% and emergency visits and hospitalisation rates significantly increase. The purpose of the Bridge study is to prospectively examine associations of transition readiness and care experiences with transition success: young patients' health, health-related quality of life (HRQoL) and adherence to medical appointments as well as costs of care. In addition, we will track patients' growing independence and educational and employment pathways during the transition process. Methods and analysis Bridge is an international, prospective, observational cohort study. Study participants are adolescents with a chronic health condition or disability and their parents/guardians who attended the New Children's Hospital in Helsinki, Finland, or the Royal Children's Hospital (RCH) in Melbourne, Australia. Baseline assessment took place approximately 6 months prior to the transfer of care and follow-up data will be collected 1 year and 2 years after the transfer of care. Data will be collected from patients' hospital records and from questionnaires completed by the patient and their parent/guardian at each time point. The primary outcomes of this study are adherence to medical appointments, clinical health status and HRQoL and costs of care. Secondary outcome measures are educational and employment outcomes. Ethics and dissemination The Ethics Committee for Women's and Children's Health and Psychiatry at the Helsinki University Hospital (HUS/1547/2017) and the RCH Human Research Ethics Committee (38035) have approved the Bridge study protocol. Results will be published in international peer-reviewed journals and summaries will be provided to the funders of the study as well as patients and their parents/guardians.Peer reviewe

Articles Aprepitant for the prevention of chemotherapy-induced nausea and vomiting in children: a randomised, double-blind, phase 3 trial

Summary Background Oral aprepitant, a neurokinin-1 receptor antagonist, is recommended in combination with other antiemetic agents for the prevention of nausea and vomiting associated with moderately or highly emetogenic chemotherapy in adults, but its effi cacy and safety in paediatric patients are unknown. We did this phase 3 trial to examine the safety and effi cacy of such treatment in children

Sequencing and analysis of an Irish human genome

BACKGROUND: Recent studies generating complete human sequences from Asian, African and European subgroups have revealed population-specific variation and disease susceptibility loci. Here, choosing a DNA sample from a population of interest due to its relative geographical isolation and genetic impact on further populations, we extend the above studies through the generation of 11-fold coverage of the first Irish human genome sequence. RESULTS: Using sequence data from a branch of the European ancestral tree as yet unsequenced, we identify variants that may be specific to this population. Through comparisons with HapMap and previous genetic association studies, we identified novel disease-associated variants, including a novel nonsense variant putatively associated with inflammatory bowel disease. We describe a novel method for improving SNP calling accuracy at low genome coverage using haplotype information. This analysis has implications for future re-sequencing studies and validates the imputation of Irish haplotypes using data from the current Human Genome Diversity Cell Line Panel (HGDP-CEPH). Finally, we identify gene duplication events as constituting significant targets of recent positive selection in the human lineage. CONCLUSIONS: Our findings show that there remains utility in generating whole genome sequences to illustrate both general principles and reveal specific instances of human biology. With increasing access to low cost sequencing we would predict that even armed with the resources of a small research group a number of similar initiatives geared towards answering specific biological questions will emerge

Clinical predictors of inflammatory bowel disease in a genetically well-defined Caucasian population

<p>Abstract</p> <p>Background</p> <p>Crohn's disease (CD) and ulcerative colitis (UC), the two main types of inflammatory bowel disease (IBD), are multifactorial conditions of unknown etiology. The objective of this study is to examine the combined gene-environment interactions influencing IBD susceptibility in a well-defined Caucasian cohort in rural mid-America.</p> <p>Methods</p> <p>Patients were diagnosed to have CD or UC using conventional radiologic, endoscopic, and/or histopathologic findings. Histological diagnosis was made by a single specialist gastrointestinal pathologist with a particular interest in IBD. Information regarding cigarette smoke exposure was obtained by administration of the Behavioral Risk Factor Surveillance System Survey (BRFSS) to all patients. Genomic DNA was extracted from peripheral blood leukocytes, and polymerase chain reaction (PCR) amplification and genotyping were performed for 11 Single Nucleotide Polymorphisms (SNP) in <it>NOD2</it>, <it>IL23r</it>, <it>OCTN1 </it>genes along with <it>IGR</it>.</p> <p>Results</p> <p>Our cohort consists of 1196 patients: 435 controls, 485 CD patients, and 276 UC patients. Only patients with genotype data for at least 7 of 11 SNPs were included in our data analysis. The control groups for all 11 SNPs were in Hardy-Weinberg Equilibrium. In genotype-association SNP analysis, all <it>NOD2 </it>SNPs (rs5743293, rs2066844, rs2066845) and the <it>IL23r </it>SNP (rs11465804) showed a significant association to IBD (<it>p </it>< 0.03). A multiple gene-interaction analysis showed an association between <it>NOD2 </it>and <it>IL23r </it>with UC (<it>p </it>= 0.04). There were no associations between any <it>OCTN1 </it>and <it>IGR </it>SNPs and IBD in this cohort. A multivariable logistic regression analysis showed that female gender, "current" or "former" smoking status, family history of IBD, and <it>NOD2 </it>SNP minor alleles were associated with CD.</p> <p>Conclusion</p> <p>IBD remains to be challenging to properly diagnose, characterize, and treat. Our study proposes a combined genetic, phenotypic, and environmental approach in an attempt to better understand IBD. Previously demonstrated associations between OCTN1 and IGR and IBD were not confirmed.</p

Bridge study protocol: an international, observational cohort study on the transition of healthcare for adolescents with chronic conditions

IntroductionMore than 10% of adolescents live with a chronic disease or disability that requires regular medical follow-up as they mature into adulthood. During the first 2 years after adolescents with chronic conditions are transferred to adult hospitals, non-adherence rates approach 70% and emergency visits and hospitalisation rates significantly increase. The purpose of the Bridge study is to prospectively examine associations of transition readiness and care experiences with transition success: young patients’ health, health-related quality of life (HRQoL) and adherence to medical appointments as well as costs of care. In addition, we will track patients’ growing independence and educational and employment pathways during the transition process.Methods and analysisBridge is an international, prospective, observational cohort study. Study participants are adolescents with a chronic health condition or disability and their parents/guardians who attended the New Children’s Hospital in Helsinki, Finland, or the Royal Children’s Hospital (RCH) in Melbourne, Australia. Baseline assessment took place approximately 6 months prior to the transfer of care and follow-up data will be collected 1 year and 2 years after the transfer of care. Data will be collected from patients’ hospital records and from questionnaires completed by the patient and their parent/guardian at each time point. The primary outcomes of this study are adherence to medical appointments, clinical health status and HRQoL and costs of care. Secondary outcome measures are educational and employment outcomes.Ethics and disseminationThe Ethics Committee for Women’s and Children’s Health and Psychiatry at the Helsinki University Hospital (HUS/1547/2017) and the RCH Human Research Ethics Committee (38035) have approved the Bridge study protocol. Results will be published in international peer-reviewed journals and summaries will be provided to the funders of the study as well as patients and their parents/guardians.</p

A Randomized Trial of Rofecoxib for the Chemoprevention of Colorectal Adenomas

BACKGROUND & AIMS: In human and animal studies, nonsteroidal anti-inflammatory drugs have been associated with a reduced risk of colorectal neoplasia. Although the underlying mechanisms are unknown, inhibition of cyclooxygenase (COX), particularly COX-2, is thought to play a role. We conducted a randomized, placebo-controlled, double-blind trial to assess whether use of the selective COX-2 inhibitor rofecoxib would reduce the risk of colorectal adenomas. METHODS: We randomized 2587 subjects with a recent history of histologically confirmed adenomas to receive daily placebo or 25 mg rofecoxib. Randomization was stratified by baseline use of cardioprotective aspirin. Colonoscopic follow-up evaluation was planned for 1 and 3 years after randomization. The primary end point was all adenomas diagnosed during 3 years' treatment. In a modified intent-to-treat analysis, we computed the relative risk of any adenoma after randomization, using Mantel-Haenszel statistics stratified by low-dose aspirin use at baseline. RESULTS: Adenoma recurrence was less frequent for rofecoxib subjects than for those randomized to placebo (41% vs 55%; P < .0001; relative risk [RR], 0.76; 95% confidence interval [CI], 0.69-0.83). Rofecoxib also conferred a reduction in risk of advanced adenomas (P < .01). The chemopreventive effect was more pronounced in the first year (RR, 0.65; 95% CI, 0.57-0.73) than in the subsequent 2 years (RR, 0.81; 95% CI, 0.71-0.93). As reported previously, rofecoxib was associated with increased risks of significant upper gastrointestinal events and serious thrombotic cardiovascular events. CONCLUSIONS: In this randomized trial, rofecoxib significantly reduced the risk of colorectal adenomas, but also had serious toxicity