An insight into adolescent transition from rural to urban centres

[Abstract]: A cooperative research project between the Health Promotion Unit of the Health Department and the university is tracking the adjustment of adolescents leaving country towns to seek educational or employment opportunities in urban centres. Over 400 Queensland families willingly participated in the project, their enthusiasm reflecting the widespread concern in Australian country towns about the out-migration of their youth, their apparent failure to return and a sense of hopelessness about how to stem the flow. The project collects data on three occasions over a twelve month period during which time a proportion of the adolescents move to the city. Additional data are contributed by the family or caregiver and the school teacher. Only Time 1 data are available for this study which investigates how parent and child expectations and preferences are implicated in one of the key adolescent transitions, that of leaving a rural home and school to enrol in an urban boarding school. Data show some unexpected discrepancies and the discussion reviews some key features that could be important components for future health promotion intervention programs designed to prepare and support adolescents in transition

Peripheral blood responses to specific antigens and CD28 in sarcoidosis

SummaryBackgroundPotential antigens inducing sarcoid inflammation include mycobacterial and auto-antigens. Paradoxically, peripheral anergy to common recall antigens also occurs, possibly due to impaired dendritic cell or regulatory T-cell responses, or impaired T-cell co-stimulation. The purpose of this study was to compare peripheral blood responses of patients with sarcoidosis to candidate antigens, and examine CD28 T-cell co-stimulation.MethodsPeripheral blood mononuclear cell (PBMC) responses were examined from patients with sarcoidosis (n=16) and healthy control subjects (n=22) following PBMC stimulation with: anti-CD3/CD28 coated beads; Mycobacterium tuberculosis ESAT-6 and KatG peptides; vimentin and lysyl tRNA peptides; and common recall antigens, including cytomegalovirus (CMV) cell lysate as well as CMV, Epstein-Barr virus, influenza virus (CEF) peptides.ResultsESAT-6/KatG peptide stimulation induced greater numbers of IFN-γ producing T-cells, and elevated IL-2, IL-6 and TNF-α production in sarcoidosis compared to purified protein derivative (PPD)-negative healthy control subjects. PBMCs from patients with sarcoidosis showed reduced IFN-γ producing T-cells following stimulation with CMV lysate, CEF peptides and CD3/CD28 beads; and reduced IL-4 and TNF-α production following CD3/CD28 activation.ConclusionsPatients with sarcoidosis exhibit greater PBMC responses to M. tuberculosis antigens compared to PPD-negative controls, but reduced T-cell responses to common recall antigens. One contributing mechanism may be impairment of T-cell CD28 co-stimulation

Dinosaur tracks from the Kilmaluag Formation (Bathonian, Middle Jurassic) of Score Bay, Isle of Skye, Scotland, UK

Tracks of a juvenile theropod dinosaur with footprint lengths of between 2 and 9 cm as well as adults of the same ichnospecies with footprints of about 15–25 cm in length were found in the Bathonian (Middle Jurassic) Kilmaluag Formation of Score Bay, northwestern Trotternish Peninsula, Isle of Skye, Scotland, UK. Two footprint sizes occur together on the same bedding plane in the central portion of Score Bay, both in situ and on loose blocks. Another horizon containing footprints above this was also identified. The footprints from the lowest horizon were produced in a desiccated silty mud that was covered with sand. A close association of both adults and juveniles with similar travel direction indicated by the footprints may suggest post-hatching care in theropod dinosaurs. Other footprints, produced on a rippled sandy substrate, have been found on the slightly higher bedding plane at this locality. Loose blocks found 130 m to the northeast in the central part of Score Bay have not been correlated with any in situ sediments, but were preserved in a similar manner to those from the higher bedding plane. These tracks represent the youngest dinosaur remains yet found in Scotland

A Methodology for Flash Drought Identification: Application of Flash Drought Frequency across the United StatesJORDAN

With the increasing use of the term ‘‘flash drought’’ within the scientific community, Otkin et al. provide a general definition that identifies flash droughts based on their unusually rapid rate of intensi- fication. This study presents an objective percentile-based methodology that builds upon that work by identifying flash droughts using standardized evaporative stress ratio (SESR) values and changes in SESR over some period of time. Four criteria are specified to identify flash droughts: two that emphasize the vegetative impacts of flash drought and two that focus on the rapid rate of intensification. The method- ology was applied to the North American Regional Reanalysis (NARR) to develop a 38-yr flash drought climatology (1979–2016) across the United States. It was found that SESR derived from NARR data compared well with the satellite-based evaporative stress index for four previously identified flash drought events. Furthermore, four additional flash drought cases were compared with the U.S. Drought Monitor (USDM), and SESR rapidly declined 1–2 weeks before a response was evident with the USDM. From the climatological analysis, a hot spot of flash drought occurrence was revealed over the Great Plains, the Corn Belt, and the western Great Lakes region. Relatively few flash drought events occurred over mountainous and arid regions. Flash droughts were categorized based on their rate of intensification, and it was found that the most intense flash droughts occurred over the central Great Plains, Corn Belt, and western Great Lakes region

A Methodology for Flash Drought Identification: Application of Flash Drought Frequency across the United States

With the increasing use of the term ‘‘flash drought’’ within the scientific community, Otkin et al. provide a general definition that identifies flash droughts based on their unusually rapid rate of intensification. This study presents an objective percentile-based methodology that builds upon that work by identifying flash droughts using standardized evaporative stress ratio (SESR) values and changes in SESR over some period of time. Four criteria are specified to identify flash droughts: two that emphasize the vegetative impacts of flash drought and two that focus on the rapid rate of intensification. The methodology was applied to the North American Regional Reanalysis (NARR) to develop a 38-yr flash drought climatology (1979–2016) across the United States. It was found that SESR derived from NARR data compared well with the satellite-based evaporative stress index for four previously identified flash drought events. Furthermore, four additional flash drought cases were compared with the U.S. Drought Monitor (USDM), and SESR rapidly declined 1–2 weeks before a response was evident with the USDM. From the climatological analysis, a hot spot of flash drought occurrence was revealed over the Great Plains, the Corn Belt, and the western Great Lakes region. Relatively few flash drought events occurred over mountainous and arid regions. Flash droughts were categorized based on their rate of intensification, and it was found that the most intense flash droughts occurred over the central Great Plains, Corn Belt, and western Great Lakes region

Discordance between the predictors of clinical and imaging remission in patients with early rheumatoid arthritis in clinical practice: implications for the use of ultrasound within a treatment to target strategy

Objective: To assess the prevalence, relationship between and predictors of clinical and imaging remission in early rheumatoid arthritis (RA), achieved with treat-to-target management in clinical practice. Methods: A prospective observational study was conducted in patients with new-onset RA. The treatment target was remission by disease activity score (DAS28-CRP<2.6). Twelve month outcomes included DAS28-CRP remission, DAS44-CRP remission, ACR/EULAR Boolean remission (BR) and absent or absent/minimal power Doppler activity (PDA) on ultrasound (US) of 26 joints (total PDA score=0 or ≤1, respectively). Logistic regression was conducted to identify baseline predictors of these outcomes. Results: Of 105 patients with complete 12-month data, the rate of DAS28-CRP remission was 43%, DAS44-CRP remission was 39%, BR was 14%, absent PDA was 40% and absent/minimal PDA was 57%. Amongst patients achieving clinical remission defined by DAS28-CRP, DAS44-CRP or BR, absence of PDA was observed in 42%, 44% and 40%, respectively; absent/minimal PDA was detected in 62%, 66% and 67%, respectively. On multivariable analysis, shorter symptom duration, male gender, fewer tender joints and lower disability were associated with the clinical remission definitions. Lack of osteoarthritis predicted absence of PDA and lower total baseline PDA predicted absent/minimal PDA. Conclusion: DAS28-CRP remission and absence of PDA were observed in almost half of patients, but less than a quarter achieved both. Achievement of BR was rare. The low agreement between any of the clinical and imaging outcomes and differences in their predictors highlight the complex interaction between symptoms and synovitis, with implications for treat-to-target management. Long-term follow-up should determine the most appropriate target

Social work and social care: mapping workforce engagement, relevance, experience and interest in research.

Evidence-based practice (EBP) has been promoted within social work/social care, with emerging evidence of benefit to practitioners and service users. Advocates argue that EBP enables practitioners to have the skills to interpret and evaluate evidence and be actively involved in research. This project aimed to evaluate awareness, experience/skills and value of research, and explore barriers to engagement with research. A cross-sectional survey was undertaken across a diverse range of social work/care staff at a large National Health Service (NHS) Foundation Trust and partner Local Authority. The survey included both closed and an open-ended response to facilitate a mixed method analysis. In total, 208 staff responded (55 percent response) and findings show a high rating on the relevance of research to professional development (73 percent); however, a low level of actual involvement (10 percent) and low levels of confidence/knowledge across a range of research skills. Identified barriers include a lack of knowledge on where/how to begin, lack of evidence that it improves practice, the potential to threaten practice and low capacity and time. These findings highlight a potential gap between a current drive for social work/care to be more evidenced based and the ability of social work/care to enact this approach

Muscle stiffness in rheumatoid arthritis is not altered or associated with muscle weakness: a shear wave elastography study

Objective: To investigate muscle stiffness and strength in rheumatoid arthritis patients compared to healthy controls. Methods: A sample of 80 RA patients from three discrete groups: 1-newly diagnosed treatment-naïve RA (n = 29), 2-active RA for at least 1 year (n = 18) and 3-in remission RA for at least 1 year (n = 33), was compared to 40 healthy controls. Shear wave velocity (SWV) was measured using shear wave elastography as a surrogate for tissue stiffness in multiple muscles. All participants performed isometric grip strength, timed get-up-and-go test, 30-sec chair stand test and isokinetic knee extension/flexion(60°/sec). The difference in SWV amongst the groups was tested using one-way ANOVA, and the correlation between SWV and muscle strength results were calculated using Pearson's coefficients. Results: The mean age ± SD was 61.2 ± 12.8 for RA patients and 61.5 ± 10.5 years for controls. SWV was not significantly different amongst the groups on all muscles (p > 0.05). In comparison to controls, the new and active RA groups showed a significantly lower isokinetic strength by -29%(p = 0.013) and -28%(p = 0.040), fewer chair stands by -28%(p = 0.001) and -44%(p  0.05). Conclusions: Significant muscle weakness was demonstrated in patients with RA disease. However, muscle stiffness was normal and not associated with muscle strength