Supporting siblings of children with a special educational need or disability : an evaluation of Sibs Talk, a one‐to‐one intervention delivered by staff in mainstream schools

A group often overlooked for specific supports in schools are siblings of children with a disability, special educational needs or a serious long‐term condition (SEND). In this article we review the current sibling research and identify a lack of literature on interventions, particularly within a school context. We then present a description of Sibs Talk, an example of a new school‐based intervention to support siblings. Sibs Talk is a ten‐session, one‐to‐one intervention approach for schools to complete with Key Stage 2 children who have a brother or sister with SEND. Finally, we present an initial evaluation of the effectiveness of Sibs Talk, using a pre and post evaluation format with a sample of 55 children from 11 schools. The data presented in this evaluation indicate that Sibs Talk may have contributed to positive outcomes for participating children

The onset of the North Atlantic Igneous Province in a rifting perspective

The processes that led to the onset and evolution of the North Atlantic Igneous Province IN A I P) have been a theme of debate ill the past decades. A popular theory has been that the impingement on the lower lithosphere of a hot mantle plume (the 'Ancestral Iceland' plume) initiated the first voluminous outbursts of lava and initiated rifling in the North Atlantic area in Early Palaeogene times. Here we review previous studies in order to set the NAIP magmatism in a time-space context. We suggest that global plate reorganizations and lithospheric extension across old orogenic fronts and/or suture zones, aided by other processes in the mantle (e.g. local or regional scale upwellings prior to and during the final Early Eocene rifting), played a role in the generation of the igneous products recorded ill the NAIP for this period. These events gave rise to the extensive Paleocene and Eocene igneous rocks in W Greenland, NW Britain and at the conjugate E Greenland-NW European margins. Many of the relatively large magmatic centres of the NAIP were associated with transient and geographically confined doming in Early Paleocene times prior to the final break-up of the North Atlantic area

Clinician-reported changes in octreotide prescribing for malignant bowel obstruction as a result of an adequately powered phase III study: A transnational, online survey

© The Author(s) 2018. Background: Translating research evidence into clinical practice often has a long lag time. Aim: To determine the impact of a phase III randomised controlled trial on palliative care clinicians’ self-reported practice change. Design: Online survey about use of octreotide in managing inoperable malignant bowel obstruction due to cancer or its treatments distributed in November 2016, 2 years after the first publication of the study in a peer-reviewed journal. Demographic, self-reported practice and the reasons underpinning this were collected. Responses were aggregated to ‘practice modified’ or ‘practice not modified’. A multinomial regression model explored predictors of practice change. Setting: Members of the Australian New Zealand Society of Palliative Medicine. Results: Response rate was 20.8% (106/509): 55.6% were aged >50 years, 56.5% were female and 77% had previously prescribed octreotide for this clinical indication. Out of 106 respondents, 52 (49.1%) indicated modified practice (60.9% of those who had previously prescribed octreotide in this setting). In those who reported practice change, most frequently octreotide was now used when other therapies failed; for not changing practice, ‘more confirmatory evidence was needed’ was most often cited. In the regression model, older age (clinician age = 50–59 years; relative risk = 0.147; 95% confidence interval = 0.024–0.918; p = 0.04) and having practices with lower proportions of people treated with octreotide (0%–20%; relative risk = 0.039; 95% confidence interval = 0.002–0.768; p = 0.033) predicted greater self-reported practice change. Conclusion: Clinician-reported change in practice in the survey is seen in the majority of respondents. This suggests that there is a cohort of ‘early adopters’ within palliative care practice as new evidence becomes available

Powers of 10: seeking ‘sweet spots’ for rapid climate and sustainability actions between individual and global scales

Achieving the goals of the Paris Agreement and related sustainability initiatives will require halving of global greenhouse gas emissions each decade from now on through to 2050, when net zero emissions should be achieved. To reach such significant reductions requires a rapid and strategic scaling of existing and emerging technologies and practices, coupled with economic and social transformations and novel governance solutions. Here we present a new ‘Powers of 10’ (P10) logarithmic framework and demonstrate its potential as a practical tool for decision makers and change agents at multiple scales to inform and catalyze engagement and actions, complementing and adding nuance to existing frameworks. P10 assists in identifying the suitable cohorts and cohort ranges for rapidly deploying climate and sustainability actions between a single individual and the globally projected ∼ 10 billion persons by 2050. Applying a robust dataset of climate solutions from Project Drawdown’s Plausible scenario that could cumulatively reduce greenhouse gas emissions by 1051 gigatons (Gt) against a reference scenario (2190 Gt) between 2020 and 2050, we seek to identify a ‘sweet spot’ where these climate and sustainability actions are suitably scaled. We suggest that prioritizing the analyzed climate actions between community and urban scales, where global and local converge, can help catalyze and enhance individual, household and local practices, and support national and international policies and finances for rapid sustainability transformations

Practice variation in late-preterm deliveries: a physician survey

Objective: Late preterm (LPT) neonates account for over 70% of all preterm births in the US. Approximately 60% of LPT births are the result of non-spontaneous deliveries.The optimal timing of delivery for many obstetric conditions at LPT gestations is unclear, likely resulting in obstetric practice variation. The purpose of this study is to identify variation in the obstetrical management of LPT pregnancies. Study design: We surveyed obstetrical providers in NC identified from NC Medical Board and NC Obstetrical and Gynecological Society membership lists. Participants answered demographic questions and 6 multiple-choice vignettes on management of LPT pregnancies. Result: We obtained 215/859 (29%) completed surveys; 167 (78%) from Obstetrics/Gynecology, 27 (13%) from Maternal-Fetal Medicine, and 21 (10%) from Family Medicine physicians. Overall, we found more agreement on respondents’ management of chorioamnionitis (97% would proceed with delivery), mild preeclampsia (84% would delay delivery/expectantly manage), and fetal growth restriction (80% would delay delivery/expectantly manage). We found less agreement on the management of severe preeclampsia (71% would proceed with delivery), premature preterm rupture of membranes (69% would proceed with delivery), and placenta previa (67% would delay delivery/expectantly manage). Management of LPT pregnancies complicated by PPROM, FGR, and placenta previa vary by specialty. Conclusion: Obstetrical providers report practice variation in the management of LPT pregnancies. Variation might be influenced by provider specialty. The absence of widespread agreement on best practice might be a source of modifiable LPT birth

An evaluation of Mesozoic rift-related magmatism on the margins of the Labrador Sea: Implications for rifting and passive margin asymmetry

The Labrador Sea is a small (∼900 km wide) ocean basin separating southwest Greenland from Labrador, Canada. It opened following a series of rifting events that began as early as the Late Triassic or Jurassic, culminating in a brief period of seafloor spreading commencing by polarity chron 27 (C27; Danian) and ending by C13 (Eocene-Oligocene boundary). Rift-related magmatism has been documented on both conjugate margins of the Labrador Sea. In southwest Greenland this magmatism formed a major coast-parallel dike swarm as well as other smaller dikes and intrusions. Evidence for rift-related magmatism on the conjugate Labrador margin is limited to igneous lithologies found in deep offshore exploration wells, mostly belonging to the Alexis Formation, along with a postulated Early Cretaceous nephelinite dike swarm (ca. 142 Ma) that crops out onshore, near Makkovik, Labrador. Our field observations of this Early Cretaceous nephelinite suite lead us to conclude that the early rift-related magmatism exposed around Makkovik is volumetrically and spatially limited compared to the contemporaneous magmatism on the conjugate southwest Greenland margin. This asymmetry in the spatial extent of the exposed onshore magmatism is consistent with other observations of asymmetry between the conjugate margins of the Labrador Sea, including the total sediment thickness in offshore basins, the crustal structure, and the bathymetric profile of the shelf width. We propose that the magmatic and structural asymmetry observed between these two conjugate margins is consistent with an early rifting phase dominated by simple shear rather than pure shear deformation. In such a setting Labrador would be the lower plate margin to the southwest Greenland upper plate

Concordant integrative gene set enrichment analysis of multiple large-scale two-sample expression data sets

Background Gene set enrichment analysis (GSEA) is an important approach to the analysis of coordinate expression changes at a pathway level. Although many statistical and computational methods have been proposed for GSEA, the issue of a concordant integrative GSEA of multiple expression data sets has not been well addressed. Among different related data sets collected for the same or similar study purposes, it is important to identify pathways or gene sets with concordant enrichment. Methods We categorize the underlying true states of differential expression into three representative categories: no change, positive change and negative change. Due to data noise, what we observe from experiments may not indicate the underlying truth. Although these categories are not observed in practice, they can be considered in a mixture model framework. Then, we define the mathematical concept of concordant gene set enrichment and calculate its related probability based on a three-component multivariate normal mixture model. The related false discovery rate can be calculated and used to rank different gene sets. Results We used three published lung cancer microarray gene expression data sets to illustrate our proposed method. One analysis based on the first two data sets was conducted to compare our result with a previous published result based on a GSEA conducted separately for each individual data set. This comparison illustrates the advantage of our proposed concordant integrative gene set enrichment analysis. Then, with a relatively new and larger pathway collection, we used our method to conduct an integrative analysis of the first two data sets and also all three data sets. Both results showed that many gene sets could be identified with low false discovery rates. A consistency between both results was also observed. A further exploration based on the KEGG cancer pathway collection showed that a majority of these pathways could be identified by our proposed method. Conclusions This study illustrates that we can improve detection power and discovery consistency through a concordant integrative analysis of multiple large-scale two-sample gene expression data sets