Understanding and optimising an identification/brief advice (IBA) service about alcohol in the community pharmacy setting

This is the final report of an evaluation into the identification/brief advice (IBA) service about alcohol in community pharmacy settings in the North West of England. Since 2007, almost 100 pharmacies in the North West have - at some point - been commissioned to provide an identification and brief advice (IBA) service for alcohol. This evaluation sought to understand how the service had been adapted for and implemented in the community pharmacy setting, and how its potential might be maximised. Its aims were: 1. To characterise, consolidate and optimise both the constant and variable elements of the pharmacy alcohol identification/brief advice (IBA) service in NHS Northwest, and 2. To inform planning for current and future pharmacy based services promoting safe consumption of alcohol. The evaluation was split into three main workstreams, supported by a preliminary scoping phase, and combined quantitative and qualitative methods: • Descriptive and comparative statistical analysis of pharmacy alcohol IBA data; • In-pharmacy work, including observation of staff engagement with customers, recording consultations between staff and customers, follow-up telephone interviews with customers, and group feedback interviews with pharmacy staff; • Stakeholder engagement through self-completion surveys, semi-structured interviews and a workshop. This report gives the background to the project, and details the methods, results and implications

Biomarkers of cerebral damage in fatal hypothermia

The identification of hypothermia as the cause of death remains challenging in forensic pathology because of unspecific radiological, morphological, and biochemical results. Hyperaemia, oedema, and petechial haemorrhages within the cerebral parenchyma were described in cases of death by hypothermia. On the other hand, the effect of low temperatures in the brain has been speculated to cause local injuries on a cellular level with potential occurrences of necrosis, and inflammation. In the study herein described, endocan, alkaline phosphatase, neuronal specific enolase, S100 protein subunit B, glial fibrillary acidic protein, and C-reactive protein were measured in postmortem serum from femoral blood and cerebrospinal fluid in a series of hypothermia fatalities and control cases. The combination of data collected failed to identify a specific biochemical profile for death by hypothermia in postmortem serum and/or the cerebrospinal fluid, thus suggesting that an alternative panel of brain damage biomarkers indicative of diffuse hypoxic brain injury need to be defined in hypothermia fatalities

Evaluation of work-based screening for early signs of alcohol-related liver disease in hazardous and harmful drinkers: the PrevAIL study

Background The direct cost of excessive alcohol consumption to health services is substantial but dwarfed by the cost borne by the workplace as a result of lost productivity. The workplace is also a promising setting for health interventions. The Preventing Alcohol Harm in Liverpool and Knowsley (PrevAIL) project aimed to evaluate a mechanism for detecting the prevalence of alcohol related liver disease using fibrosis biomarkers. Secondary aims were to identify the additive effect of obesity as a risk factor for early liver disease; to assess other impacts of alcohol on work, using a cross-sectional survey. Methods Participants (aged 36-55y) from 13 workplaces participated (March 2011–April 2012). BMI, waist circumference, blood pressure and self-reported alcohol consumption in the previous week was recorded. Those consuming more than the accepted UK threshold (men: >21 units; female: >14 units alcohol) provided a 20 ml venous blood sample for a biomarker test (Southampton Traffic Light Test) and completed an alcohol questionnaire (incorporating the Severity of Alcohol Dependence Questionnaire). Results The screening mechanism enrolled 363 individuals (52 % women), 39 % of whom drank above the threshold and participated in the liver screen (n = 141, complete data = 124 persons). Workplaces with successful participation were those where employers actively promoted, encouraged and facilitated attendance. Biomarkers detected that 30 % had liver disease (25 %, intermediate; 5 % probable). Liver disease was associated with the frequency of visits to the family physician (P = 0.036) and obesity (P = 0.052). Conclusions The workplace is an important setting for addressing alcohol harm, but there are barriers to voluntary screening that need to be addressed. Early detection and support of cases in the community could avert deaths and save health and social costs. Alcohol and obesity should be addressed simultaneously, because of their known multiplicative effect on liver disease risk, and because employers preferred a general health intervention to one that focused solely on alcohol consumption

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The nature and strength of the relationship between expenditure on alcohol and food: an analysis of adult-only households in the UK

Introduction and Aims. Unhealthy lifestyle behaviours can cluster to produce more detrimental overall health consequences than expected with a simple additive effect. This study aims to expand current knowledge of the nature and strength of the relationship between two such health behaviours, alcohol and diet, through analysis of household expenditure on food and drink from a nationally representative UK sample. Design and Methods. Data from the Expenditure and Food Survey for 2005–2006 was used to analyse expenditure on alcohol and diet for 3146 UK households. The classification of a food as healthy or unhealthy was determined using dietary advice provided by the Food Standards Agency. Alcohol expenditure was disaggregated into spending in pubs, bars, clubs and restaurants (on-trade expenditure) and spending in off-licenses and supermarkets (off-trade expenditure). Analyses were stratified according to household disposable income quintile and household beverage preference. Results. As household expenditure on alcohol increases, spending on both healthy and unhealthy food decreases. Higher income households spend proportionately more on on-trade alcohol and healthy food than lower income households, and less on unhealthy food. Off-trade alcohol expenditure does not differ significantly according to household income. Households that prefer to purchase wine have healthier expenditure patterns than those that prefer to buy beer or spirits, even after controlling for income. Discussion and Conclusions. Low-income households and those that purchase more beer or spirits than wine could be targeted for health promotion interventions to reduce their risk of negative health outcomes from the clustering of alcohol consumption and unhealthy diet

O ensino do PB e a prática da legendagem. Ideias para a sala de aula

Talking about the didactics of Brazilian Portuguese as foreign language is not a matter exhaustible just considering the didactics of a foreign language as a series of methodologies devoted to the teaching of specific linguistic and cultural elements, since when we think of the language used in Brazil, we are immediately led to consider the sociolinguistic aspects of this variety of the Portuguese language. In the first stage of learning, the students meet the Portuguese language only as a foreign language which has its geographical placement on the world map; then the students discover that there are differences between the Portuguese of Portugal, the Portuguese of Brazil and the Portuguese spoken in Africa, relating to concepts such as linguistic norms, linguistic registers, variation, and variability. The discourse becomes even more intricate when the difference that exists in Brazilian Portuguese between written and spoken language is presented, and it is necessary to consider that even the most dedicated students show a difficulty in getting around the variational intricacies of Brazilian Portuguese - there not being many occasions in class to reflect on this subject. This issue represents a linguistic, but also a social and cultural fact that learner may meet in his/her experience with this variety of Portuguese. Targeting the development of language skills and knowledge by an independent learner, it is desirable the development of a teaching practice based on communication and interaction that enjoys the potentialities of translation (although it does not directly develop any of the language skills, i.e., reading, writing, speaking and listening) together with credible data that can propose to the learner more verisimilar fictional situations in relation to the linguistic reality of Brazil

A VARIAÇÃO DIAMÉSICA E A COMU NICAÇÃO POLÍTICA INSTITUCIONAL A interação “político-jornalista” no Brasil de Bolsonaro entre velhas e novas formas de diálogo

This contribution proposes an analysis of the political language of Jair Bolsonaro, the current Brazialian president. Starting from the diamesic dichotomy between written written and spoken-spoken (Nencioni, 1976) and considering the scheduled interviews (interactions via videocall) and the questions of journalists in the public interventions of the Brazilian president (face-to-face interactions), it is possible to observe how, in cases like those here mentioned, the medium does not influence communication, only allowing a distinction between planned and unplanned communication. Furthermore, in line with the scientific research on conversation analysis, an analysis of the dialogue between Brazilian politicians and journalists is proposed as a form of unequal communication: in all cases, the asymmetry of social positions between the speaker and his interviewers is evidentEsta contribuição propõe uma análise da linguagem política dentro da comunicação institucional de Jair Bolsonaro, atual presidente do Brasil. Partindo da dicotomia diamésica entre escrito-escrito e falado-falado (Nencioni, 1976) e considerando as entrevistas agendadas (interações via videochamada) e as perguntas dos jornalistas nas intervenções públicas do presidente brasileiro (interações presenciais), é possível observar como, neste caso, o meio não influencia a comunicação; permitindo apenas uma distinção entre comunicação planejada e não planejada (Marcuschi 1999, 2008; Marcuschi & Dionisio 2005). Além disso, em consonância com a pesquisa científica sobre a análise da conversa, propõe-se uma análise do diálogo entre o político brasileiro e os jornalistas como forma de comunicação desigual: em todos os casos é evidente a assimetria de posições sociais entre o orador e seus interlocutores

"POIS": PROPRIETÀ DISCORSIVE E INTERAZIONALI DI UN MARCATORE DISCORSIVO PORTOGHESE TRADOTTO IN ITALIANO

Pois: discursive and interactional properties of a Portuguese discourse marker translated into Italian. In this paper we intend to present the study of the Portuguese discursive marker pois to emphasise the various discursive and interactional possibilities. This discursive connector is included by Lopes e Carrilho (2020) among the explanatory discursive markers: the lexical element takes the form of an operator with anaphoric value that proposes the part of discourse that follows it as an explanation of the part of discourse that precedes it. Part of this semantic value is also found in the pois with an interactional function of response. This phenomenon could be explained by considering the process of semantic drift that sees the expansion of the discursive space of use of a lexical element. To present the various areas of use of the discursive marker pois, written and oral language data will be examined. In addition, a contrastive analysis with Italian will be proposed based on the possible translations that this discourse marker can have in this language in order to broaden the contrastive studies between the two Romance languages. REZUMAT. Pois: proprietăți discursive și interacționale ale unui marcator discursiv portughez tradus în italiană. În această lucrare ne propunem să studiem marcatorul discursiv pois (portugheză europeană), pentru a sublinia diferitele sale posibilități discursive și interacționale. Acest conector discursiv este inclus de Lopes e Carrilho (2020) în categoria marcatorilor discursivi explicativi: elementul lexical ia forma unui operator cu valoare anaforică ce propune partea de discurs care îl urmează ca explicație a părții de discurs care îl precedă. O parte a acestei valori semantice se regăsește și în pois cu funcție interacțională de răspuns. Acest fenomen ar putea fi explicat prin prisma procesului de derivă semantică care cuprinde extinderea spațiului discursiv de utilizare a unui element lexical. Pentru a prezenta diferitele domenii de utilizare ale marcatorului discursiv pois, vor fi examinate date de limbă scrisă și orală. În plus, se va propune o analiză contrastivă cu limba italiană, bazată pe posibilele traduceri ale acestui marcator discursiv, pentru a îmbogăți studiile contrastive între cele două limbi romanice. Cuvinte-cheie: marcatori discursivi; portugheză, italiană; pois; interacțiune lingvistică. Article history: Received 1 August 2023; Revised 1 November 2023; Accepted 10 November 2023; Available online 20 December 2023; Available print 31 December 2023

A variação diamésica e a comunicação política institucional. A inte-ração “político-jornalista” no Brasil de Bolsonaro entre velhas e novas formas de diálogo

This contribution proposes an analysis of the political language of Jair Bolsonaro, the current Brazialian president. Starting from the diamesic dichotomy between written-written and spoken-spoken (Nencioni, 1976) and considering the scheduled interviews (interactions via videocall) and the questions of journalists in the public interventions of the Brazilian president (face-to-face interactions), it is possible to observe how, in cases like those here mentioned, the medium does not influence communication, only allowing a distinction between planned and unplanned communication. Furthermore, in line with the scientific research on conversation analysis, an analysis of the dialogue between Brazilian politicians and journalists is proposed as a form of unequal communication: in all cases, the asymmetry of social positions between the speaker and his interviewers is evident