High School English Language Learners of Latin American Descent Living in Rural Midwestern Communities

A phenomenological study was conducted to examine the experiences of adolescent English Language Learners (ELL) of Latin American descent living in rural Midwestern communities. Participants experienced psychological and social responses related to the major life change of immigrating to a new country and adapting to an alien culture. Challenges experienced by adolescent immigrants involved a chronological and simultaneous process of adaptation, as evidenced by the following stages: (1) apprehension about coming to a new country and fitting in with friends when they started school; (2) adjustment to the new culture and alien environment; (3) cultural bereavement and ambiguous loss. Learning English served as a means of communicating and a key factor in helping the participants adapt to a new culture. Recommendations to address the issues regarding academic and social challenges faced by immigrant students of Latino origin with limited English proficiency included providing a support person such as a home liaison or advocate for the student to increase communication between the school and family, initiating a mentor-tutor program in the school and community, and providing professional development for teachers working with ELL and immigrant students. Recommendations include further research on factors contributing to the academic success of students adjusting to major life changes may help address concerns relating to low academic achievement and high dropout rates among Latino students

Editorial: Language Acquisition in Diverse Linguistic, Social and Cognitive Circumstances

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Individualized Pain Plans for Pediatric Sickle Cell Patients

Background: Vaso-occlusive (VOC) pain crisis in sickle cell pediatric patients is a hallmark symptom, and both unpredictable and crippling. There is a lack of evidence as to what is best practice to avoid a VOC pain crisis in pediatric sickle cell patients. Individualized Pain Plans were created and trialed based off the format asthma action plans with goals to improve overall pain management and to prevent or decrease emergency department visits and hospitalizations. Aims: This is a cross-sectional and quality improvement study designed to evaluate the effectiveness of previously implemented Individualized Sickle Cell Pain Plans in a midwestern children’s hospital. The primary aim was to evaluate the physical and psychosocial risk factors related to the pain experiences in the post implementation timeline of receiving their individualized pain plan. The second aim was to evaluate the satisfaction and use by both parent and child of the pain plans. Methods: Evaluation of outcomes of these plans were done by survey using the Pediatric Pain Screening Tool (PPST), satisfaction questionnaires, and chart audits of Emergency Department (ED) visits due to pain crisis pre and post implementation administered by the Hematology/Oncology (H/O) team. Settings: This study was conducted at a midwestern children’s hospital and associated H/O clinic. Participants/Subjects: Sample population included pediatric patients, aged four to 18 years old, who are diagnosed with sickle cell disease who have an individualized pain plan created by their Hematology provider, and their parent(s) and/or caregivers. Each patient/parent/caregiver gave verbal consent to participate. Design: The data was collected at a routine follow up appointment at the H/O clinic. Surveys were administered at the appointments including the PPST, demographics, and a satisfaction/use survey for the patient and parent. A chart audit of ED visits due to pain crisis pre and post pain plan implementation was also performed. Results: A total of eleven patients and eleven parents were captured in this study that qualified based on the inclusion criteria. 73% of responses being mostly satisfied and very satisfied with the pain plans, 27% of responses were sometimes satisfied and satisfied, and one response with no satisfaction. Eleven parents were asked how often the pain plans were being used and/or referenced, 18% said they were not using it and needed help with how to use it better, 9% use it when their child cannot sleep at night due to pain, 45% use it when their child cannot play or go to school due to pain, and 27% said they use it when their child tells them they have pain. Six patients were then asked how often they were using the pain plans, one said they do not use it because he lost it, one said they do not know how to use the pain plan, one said they use it when they cannot play, and three (50%) say they use it when an adult tells them to. When compared, the number of ED and inpatient hospital admissions (IHA) for each patient pre and post pain plan implementation, it was found that ED visits increased from pre (16 of 74 patients) to post (29 of 74 patients). Conclusions: Individualized pain plans provide guidance for patients and families when a pain crisis begins. It is recommended that these pain plans be implemented at other pediatric hospitals across the nation to support patients with sickle cell disease and their families. It would be recommended that the clinic continue to collect data indefinitely due to the small sample population of this study as this could provide stronger evidence for the use of the individualized pain plans

Developing a cultural competence assessment tool for people in recovery from racial, ethnic and cultural backgrounds: the journey, challenges and lessons learned.

In 1997, Maryland implemented a new managed care mental health system. Consumer satisfaction, evaluation and cultural competency were considered high priorities for the new system. While standardized tools for measuring consumer satisfaction were readily available, no validated, reliable and standardized tool existed to measure the perception of people from minority groups receiving mental health services. The MHA*/MHP* Cultural Competency Advisory Group (CCAG) accepted the challenge of developing a consumer assessment tool for cultural competency. The CCAG, composed of people in recovery, clinicians and administrators used their collective knowledge and experiences to develop a 52-item tool that met standards for validity and reliability. Consultation from a researcher helped to further develop the tool into one possessing tremendous potential for statewide implementation within Maryland's Public Mental Health System. Recognizing the limitations of the study and the need for further research, this instrument is a work in progress. Strategies to improve the instrument are currently underway with the Mental Hygiene Administration's Systems Evaluation Center of the University of Maryland and several national researchers

Reduction in squamous cell carcinomas in mouse skin by dietary zinc supplementation.

Inadequate dietary Zn consumption increases susceptibility to esophageal and other cancers in humans and model organisms. Since Zn supplementation can prevent cancers in rodent squamous cell carcinoma (SCC) models, we were interested in determining if it could have a preventive effect in a rodent skin cancer model, as a preclinical basis for considering a role for Zn in prevention of human nonmelanoma skin cancers, the most frequent cancers in humans. We used the 7,12-dimethyl benzanthracene carcinogen/phorbol myristate acetate tumor promoter treatment method to induce skin tumors in Zn-sufficient wild-type and Fhit (human or mouse protein) knockout mice. Fhit protein expression is lost in \u3e50% of human cancers, including skin SCCs, and Fhit-deficient mice show increased sensitivity to carcinogen induction of tumors. We hypothesized that: (1) the skin cancer burdens would be reduced by Zn supplementation; (2) Fhit(-/-) (Fhit, murine fragile histidine triad gene) mice would show increased susceptibility to skin tumor induction versus wild-type mice. 30 weeks after initiating treatment, the tumor burden was increased ~2-fold in Fhit(-/-) versus wild-type mice (16.2 versus 7.6 tumors, P \u3c 0.001); Zn supplementation significantly reduced tumor burdens in Fhit(-/-) mice (males and females combined, 16.2 unsupplemented versus 10.3 supplemented, P = 0.001). Most importantly, the SCC burden was reduced after Zn supplementation in both strains and genders of mice, most significantly in the wild-type males (P = 0.035). Although the mechanism(s) of action of Zn supplementation in skin tumor prevention is not known in detail, the Zn-supplemented tumors showed evidence of reduced DNA damage and some cohorts showed reduced inflammation scores. The results suggest that mild Zn supplementation should be tested for prevention of skin cancer in high-risk human cohorts

CTQ 839: Candidate for the Smallest Projected Separation Binary Quasar

We report the discovery of the new double quasar CTQ 839. This B = 18.3, radio quiet quasar pair is separated by 2.1" in BRIH filters with magnitude differences of delta m_B = 2.5, delta m_R = delta m_I = 1.9, and delta m_H = 2.3. Spectral observations reveal both components to be z = 2.24 quasars, with relative redshifts that agree at the 100 km/s level, but exhibit pronounced differences in the equivalent widths of related emission features, as well as an enhancement of blue continuum flux in the brighter component longward of the Ly alpha emission feature. In general, similar redshift double quasars can be the result of a physical binary pair, or a single quasar multiply imaged by gravitational lensing. Empirical PSF subtraction of R and H band images of CTQ 839 reveal no indication of a lensing galaxy, and place a detection limit of R = 22.5 and H = 17.4 for a third component in the system. For an Einstein-de Sitter cosmology and SIS model, the R band detection limit constrains the characteristics of any lensing galaxy to z_lens >= 1 with a corresponding luminosity of L >~ 5 L_*, while an analysis based on the redshift probability distribution for the lensing galaxy argues against the existence of a z_lens >~ 1 lens at the 2 sigma level. A similar analysis for a Lambda dominated cosmology, however, does not significantly constrain the existence of any lensing galaxy. The broadband flux differences, spectral dissimilarities, and failure to detect a lensing galaxy make the lensing hypothesis for CTQ 839 unlikely. The similar redshifts of the two components would then argue for a physical quasar binary. At a projected separation of 8.3/h kpc (Omega_matter = 1), CTQ 839 would be the smallest projected separation binary quasar currently known.Comment: Latex, 23 pages including 5 ps figures; accepted for publication in A

Attitude Change in Competitive Framing Environments? Open‐/Closed‐Mindedness, Framing Effects, and Climate Change

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/99670/1/jcom12040.pd

An insulin signaling feedback loop regulates pancreas progenitor cell differentiation during islet development and regeneration

As one of the key nutrient sensors, insulin signaling plays an important role in integrating environmental energy cues with organism growth. In adult organisms, relative insufficiency of insulin signaling induces compensatory expansion of insulin-secreting pancreatic beta (β) cells. However, little is known about how insulin signaling feedback might influence neogenesis of β cells during embryonic development. Using genetic approaches and a unique cell transplantation system in developing zebrafish, we have uncovered a novel role for insulin signaling in the negative regulation of pancreatic progenitor cell differentiation. Blocking insulin signaling in the pancreatic progenitors hastened the expression of the essential β cell genes insulin and pdx1, and promoted β cell fate at the expense of alpha cell fate. In addition, loss of insulin signaling promoted β cell regeneration and destabilization of alpha cell character. These data indicate that insulin signaling constitutes a tunable mechanism for β cell compensatory plasticity during early development. Moreover, using a novel blastomere-to-larva transplantation strategy, we found that loss of insulin signaling in endoderm-committed blastomeres drove their differentiation into β cells. Furthermore, the extent of this differentiation was dependent on the function of the β cell mass in the host. Altogether, our results indicate that modulation of insulin signaling will be crucial for the development of β cell restoration therapies for diabetics; further clarification of the mechanisms of insulin signaling in β cell progenitors will reveal therapeutic targets for both in vivo and in vitro β cell generation

Improving the evidence base on public health assets—the way ahead: a proposed research agenda

The aim of this commentary is to set out a priority research agenda which will make more systematic the evidence base about why investing in a range of 'public health assets' is important for population health. It will rehearse in brief some of the issues that have been raised over the past few years as experience has grown about how to apply the idea to public health practice.Spanish health research council FIS-FEDER grant PI13/02410