The sustainability of public health interventions in schools: a systematic review

Background: The sustainability of school-based health interventions after external funds and/or other resources end has been relatively unexplored in comparison to health care. If effective interventions discontinue, new practices cannot reach wider student populations and investment in implementation is wasted. This review asked: What evidence exists about the sustainability of school-based public health interventions? Do schools sustain public health interventions once start-up funds end? What are the barriers and facilitators affecting the sustainability of public health interventions in schools in high-income countries? Methods: Seven bibliographic databases and 15 websites were searched. References and citations of included studies were searched, and experts and authors were contacted to identify relevant studies. We included reports published from 1996 onwards. References were screened on title/abstract, and those included were screened on full report. We conducted data extraction and appraisal using an existing tool. Extracted data were qualitatively synthesised for common themes, using May's General Theory of Implementation (2013) as a conceptual framework. Results: Of the 9677 unique references identified through database searching and other search strategies, 24 studies of 18 interventions were included in the review. No interventions were sustained in their entirety; all had some components that were sustained by some schools or staff, bar one that was completely discontinued. No discernible relationship was found between evidence of effectiveness and sustainability. Key facilitators included commitment/support from senior leaders, staff observing a positive impact on students' engagement and wellbeing, and staff confidence in delivering health promotion and belief in its value. Important contextual barriers emerged: the norm of prioritising educational outcomes under time and resource constraints, insufficient funding/resources, staff turnover and a lack of ongoing training. Adaptation of the intervention to existing routines and changing contexts appeared to be part of the sustainability process. Conclusions: Existing evidence suggests that sustainability depends upon schools developing and retaining senior leaders and staff that are knowledgeable, skilled and motivated to continue delivering health promotion through ever-changing circumstances. Evidence of effectiveness did not appear to be an influential factor. However, methodologically stronger primary research, informed by theory, is needed. Trial registration: The review was registered on PROSPERO: CRD42017076320, Sep. 2017

Sharing a different voice: Attending to stories in collaborative writing

Through three stories, we hope to reveal how sometimes contradictory or unrecognizable aspects of our lives, selves, and stories can create tensions in the collaborative writing endeavor. We begin with a story that illuminates some of the narrative tensions that surface during a decade of writing collaboratively. In an effort to navigate these tensions, we explore two further stories in dialogue as a way to reveal how dominant narratives shape our lives and the stories we might tell. One aim of sharing these stories is to reveal how problematic ways of being are often inseparable from one’s cultural legacy. Making previously obscured narratives visible paves the way for imaginary leaps that are necessary for change. We hope these insights are useful for other writers and collaborators and those who seek caring, responsive, and nurturing writing relationships yet realize this journey can be problematic

Lake-size dependency of wind shear and convection as controls on gas exchange

High-frequency physical observations from 40 temperate lakes were used to examine the relative contributions of wind shear (u*) and convection (w*) to turbulence in the surface mixed layer. Seasonal patterns of u* and w* were dissimilar; u* was often highest in the spring, while w * increased throughout the summer to a maximum in early fall. Convection was a larger mixed-layer turbulence source than wind shear (u */w*-1 for lakes* and w* differ in temporal pattern and magnitude across lakes, both convection and wind shear should be considered in future formulations of lake-air gas exchange, especially for small lakes. © 2012 by the American Geophysical Union.Jordan S. Read, David P. Hamilton, Ankur R. Desai, Kevin C. Rose, Sally MacIntyre, John D. Lenters, Robyn L. Smyth, Paul C. Hanson, Jonathan J. Cole, Peter A. Staehr, James A. Rusak, Donald C. Pierson, Justin D. Brookes, Alo Laas, and Chin H. W

Integrable boundary conditions for classical sine-Gordon theory

The possible boundary conditions consistent with the integrability of the classical sine-Gordon equation are studied. A boundary value problem on the half-line $x\leq 0$ with local boundary condition at the origin is considered. The most general form of this boundary condition is found such that the problem be integrable. For the resulting system an infinite number of involutive integrals of motion exist. These integrals are calculated and one is identified as the Hamiltonian. The results found agree with some recent work of Ghoshal and Zamolodchikov.Comment: 10 pages, DTP/94-3

Organic compounds in surface sediments and oyster tissues from the Chesapeake Bay

This report contains three parts. In Part I, the methodology to extract and analyze sediment and oyster tissue samples from the Chesapeake Bay is described in detail. Remaining problems are clearly identified. Part II contains the results and their discussion. Part III contains a number of appendices with detailed data. For those readers interested in still more detail, the complete bank of processed data is on computer tapes at this institute and at the Environmental Protection Agency-Chesapeake Bay Program office at Annapolis, Maryland. Also included in Part III we give the results of volatile halogenated organic compounds determined in water collected near the outfalls of several chlorine using facilities as well as from river mouths. The distribution of the total and a few specific organic compounds within the Bay is presented by histograms. Mass spectrometric analyses clearly reveal the fact that one specific class of organic compounds, hydrocarbons, are the most prominent pollutants in the Bay. The application of two different search routines, one concentrating on compounds at levels \u3e50 ppb and the other on temporal changes, allows a quick determination of areas where problems may exist and where additional research may be indicated. Two unusual sediment samples collected during the fall 1979 cruise are discussed separately: Sample 2-19-S which clearly indicates a recent dumping of DDT and polychlorinated biphenyls, and Sample 2-27-S which contained very high concentrations of unsubstituted polynuclear aromatics

Specific Lipopolysaccharide Serotypes Induce Differential Maternal and Neonatal Inflammatory Responses in a Murine Model of Preterm Labor.

Intrauterine inflammation is recognized as a key mediator of both normal and preterm birth but is also associated with neonatal neurological injury. Lipopolysaccharide (LPS) is often used to stimulate inflammatory pathways in animal models of infection/inflammation-induced preterm labor; however, inconsistencies in maternal and neonatal responses to LPS are frequently reported. We hypothesized that LPS serotype-specific responses may account for a portion of these inconsistencies. Four different Escherichia coli LPS serotypes (O111:B4, O55:B5, O127:B8, and O128:B12) were administered to CD1 mice via intrauterine injection at gestational day 16. Although control animals delivered at term 60 ± 15 hours postinjection (p.i.), those administered with O111:B4 delivered 7 ± 2 hours p.i., O55:B5 delivered 10 ± 3 hours p.i., O127:B8 delivered 16 ± 10 hours p.i., and O128:B12 delivered 17 ± 2 hours p.i. (means ± SD). A correlation between the onset of preterm labor and myometrial activation of the inflammatory transcription factor, activator protein 1, but not NF-κB was observed. Specific LPS serotypes induced differential activation of downstream contractile and inflammatory pathways in myometrium and neonatal pup brain. Our findings demonstrate functional disparity in inflammatory pathway activation in response to differing LPS serotypes. Selective use of LPS serotypes may represent a useful tool for targeting specific inflammatory response mechanisms in these models

Multiple air pollutants and their health impacts for both present-day and future scenarios

The adverse health impacts of air pollution, both short-term and long-term, have been widely studied in recent years; however there are a number of uncertainties to consider when carrying out health impact assessments. Health effects attributable to exposure to air pollutants are typically estimated using measured or modelled pollutant concentrations which vary both temporally and spatially. The goal of this thesis is to perform health impact assessments using modelled pollutant concentrations for present-day and future. The specific aims are: (i) to study the influence of model horizontal resolution on simulated concentrations of ozone (O3) and particulate matter less than 2.5 μm in diameter (PM2.5) for Europe and the implications for health impact assessments associated with long-term exposure (ii) to model air pollutant concentrations during two air pollution episodes in July 2006 together with the corresponding short-term health impact in the UK (iii) to estimate potential future health burdens associated with long-term pollutant exposure under future UK emission changes for 2050 in the UK. First, the impact of model horizontal resolution on simulated concentrations of O3 and PM2.5, and on the associated long-term health impacts over Europe is examined, using the HadGEM3–UKCA (UK Chemistry and Aerosol) chemistry– climate model to simulate pollutant concentrations at a coarse (~140 km) and a finer (~50 km) horizontal resolution. The attributable fraction (AF) of total mortality due to long-term exposure to warm season daily maximum 8-hr running mean (MDA8) O3 and annual-mean PM2.5 concentrations is then estimated for each European country using pollutant concentrations simulated at each resolution. Results highlight seasonal variations in simulated O3 and PM2.5 differences between the two model resolutions in Europe. Simulated O3 concentrations averaged for Europe at the coarse resolution are higher in winter and spring (~10 and ~6 %, respectively) but lower in summer and autumn (~-1 and ~-4 %, respectively) compared to the finer resolution results. These differences may be partly explained by differences in nitrogen dioxide (NO2) concentrations simulated at the two resolutions. Compared to O3, the opposite seasonality in simulated PM2.5 differences between the two resolutions is found. In winter and spring, simulated PM2.5 concentrations are lower at the coarse compared to the finer resolution (~-8 and ~-6 % averaged for Europe, respectively) but higher in summer and autumn (~29 and ~8 %, respectively). Differences in simulated PM2.5 levels are largely related to differences in convective rainfall and boundary layer height between the two resolutions for all seasons. These differences between the two resolutions exhibit clear spatial patterns for both pollutants that vary by season, and exert a strong influence on country to country variations in the estimated AF of mortality for the two resolutions. Results demonstrate that health impact assessments calculated using modelled pollutant concentrations, are sensitive to a change in model resolution with differences in AF of mortality between the countries ranging between ~-5% and ~+3%. Under climate change, the risk of extreme weather events, such as heatwaves, is likely to increase. Thus the UK health burden associated with short-term exposure to MDA8 O3 and daily mean PM2.5 is examined during two five-day air pollution episodes during a well-known heatwave period in July 2006 (1st - 5th July and 18th – 22nd July) using the UK Met Office air quality model (AQUM) at 12 km horizontal resolution. Both episodes are found to be driven by anticyclonic conditions (mean sea-level pressures ~1020hPa over the UK) with light easterly and south easterly winds and high temperatures that aided pollution build up in the UK. The estimated total mortality burden associated with short-term exposure to O3 is similar during the each episode with about 70 daily deaths brought forward summed across the UK. The estimated health burden associated with short-term exposure to daily mean PM2.5 concentrations differs between the first and second episode resulting in about 43 and 36 daily deaths brought forward, respectively. The attributable fraction of all-cause (excluding external) mortality for both pollutants differs between UK regions and ranges between 1.6% to 5.2% depending on the pollution levels in each episode; the overall total estimated health burdens are highest in regions with higher population totals. Results show that during these episodes, short-term exposure to MDA8 O3 and daily mean PM2.5 is between 36- 38% and 39-56% higher, respectively, than if the pollution levels represented typical seasonal-mean concentrations. Finally, emission scenarios for the UK following three Intergovernmental Panel on Climate Change (IPCC) Representative Concentration Pathways (RCPs); RCP2.6, RCP6.0 and RCP8.5 are used to simulate future concentrations of O3, NO2 and PM2.5 for 2050 relative to 2000 using the AQUM air quality model at 12km resolution. The present-day and future AF of mortality associated with long-term exposure to annual mean MDA8 O3, NO2 and PM2.5 and the corresponding mortality burdens are estimated for each region in the UK. For all three RCPs, simulated annual mean MDA8 O3 concentrations in 2050 are estimated to increase compared to 2000, due to decreases in nitrogen oxides (NOx) emissions reducing titration of O3 by NO, and to increases in methane (CH4) levels across all of the UK. In contrast, annual mean NO2 concentrations decrease everywhere. This highlights that the whole of the UK is simulated to be in a NOx-saturated chemical environment. PM2.5 concentrations decrease under all RCPs for the 2050s mostly driven by decreases in NOx and sulphur dioxide (SO2) emissions affecting secondary inorganic aerosols concentrations. For all pollutants the largest changes are estimated under RCP8.5 while the smallest changes are estimated for RCP6.0 in 2050 as compared to present-day. Consequently, these two RCPs represent the high and low end of the AF and mortality burden difference range relative to present-day for all three pollutants. For all UK regions and all three RCPs, the AF of mortality associated with long-term exposure to O3 is estimated to increase in 2050 while the AF associated with long-term exposure to NO2 and PM2.5 is estimated to decrease as a result of higher and lower projected pollutant concentrations, respectively. Differences in the UK-wide mortality burden attributable to long-term exposure to annual mean MDA8 O3 across the RCPs range from +2,529 to +5,396 additional attributable deaths in 2050 compared to 2000. Long-term exposure to annual mean NO2 and PM2.5 differences in health burdens are between - 9,418 and -15,782 and from - 4,524 to -9,481 avoided attributable deaths in 2050 relative to present-day, respectively. These mortality burdens are also sensitive to future population projections. These results demonstrate that long-term health impact assessments estimated using modelled pollutant concentrations, are sensitive to a change in model resolution across Europe, especially in southern and eastern Europe. In addition, air pollution episodes are shown to have the potential to cause substantial short-term impacts on public health in the UK. Finally the sensitivity of future MDA8 O3-, NO2- and PM2.5-attributable health burdens in the UK to future emission scenarios as well as population projections is highlighted with implications for informing future emissions control strategies for the UK

The Present State of Organic Xenobiotics in the Chesapeake Bay - A Synthesis Paper

This manuscript discusses the results of the first two and one half years of a three-year study designed to determine the present state of xenobiotic compounds in the Chesapeake Bay. It shows that polynuclear aromatic hydrocarbons are the most frequently encountered compounds and are the most abundant. Concentrations are highest in the Northern Bay with several sources implicated. During this study an apparent dumping of the pesticide, DDT, occurred. Either the quantity disposed of was small enough or the assimulation capacity was large enough that no adverse effects were noted. The detection by us of 6-phenyldodecane in bottom sediments of the Patapsco River and its detection in a nearby industrial outfall by the Monsanto Research Corporation shows that chemicals entering the River can be dispersed throughout the system and can enter the Chesapeake Bay

Predicting language learners' grades in the L1, L2, L3 and L4: the effect of some psychological and sociocognitive variables

This study of 89 Flemish high-school students' grades for L1 (Dutch), L2 (French), L3 (English) and L4 (German) investigates the effects of three higher-level personality dimensions (psychoticism, extraversion, neuroticism), one lower-level personality dimension (foreign language anxiety) and sociobiographical variables (gender, social class) on the participants' language grades. Analyses of variance revealed no significant effects of the higher-level personality dimensions on grades. Participants with high levels of foreign language anxiety obtained significantly lower grades in the L2 and L3. Gender and social class had no effect. Strong positive correlations between grades in the different languages could point to an underlying sociocognitive dimension. The implications of these findings are discussed

Boundary breathers in the sinh-Gordon model

We present an investigation of the boundary breather states of the sinh-Gordon model restricted to a half-line. The classical boundary breathers are presented for a two parameter family of integrable boundary conditions. Restricting to the case of boundary conditions which preserve the \phi --> -\phi symmetry of the bulk theory, the energy spectrum of the boundary states is computed in two ways: firstly, by using the bootstrap technique and subsequently, by using a WKB approximation. Requiring that the two descriptions of the spectrum agree with each other allows a determination of the relationship between the boundary parameter, the bulk coupling constant, and the parameter appearing in the reflection factor derived by Ghoshal to describe the scattering of the sinh-Gordon particle from the boundary.Comment: 16 pages amslate