Fetal alcohol spectrum disorders: current issues in awareness, prevention and intervention

This paper reviews the research and current policy surrounding prenatal alcohol exposure and fetal alcohol spectrum disorders (FASD). Alcohol use during pregnancy is linked to a spectrum of adverse fetal outcomes. This spectrum of abnormalities is collectively termed fetal alcohol spectrum disorders and may include physical, cognitive and/or developmental symptoms. The aim of this paper is to inform practitioners and other professionals working in a range of fields about the implications of FASD for children and their families. Current research on interventions or programs to work with families affected by FASD is also explored. Key messages Prenatal alcohol exposure can cause a range of cognitive and physical abnormalities in embryos that can lead to impairments in a range of functions: sensory systems, language and communication, processing pace, learning and memory, abstract thinking, and executive functioning. Misunderstanding and labelling of those with FASD can lead to a poor self-concept, disrupted peer relationships, fractured educational and placement experiences and contact with youth justice services. The prevalence of FASD is likely to be underestimated by current measures. Certain populations, including children in out-of-home care and children in contact with youth justice services are thought to include an over-representation of individuals living with an undetected FASD. Tackling FASD requires focused and coordinated multidisciplinary and cross sector approaches. More information about the prevalence and nature of FASD will allow for improved service planning and implementation. Policy directions are needed that prioritise the screening and prevention of FASD in the community. Current and future professionals, including those in traditionally adult-focused services, need awareness and knowledge about the significance of FASD and prenatal alcohol exposure on children\u27s lives

Cinnamon Shows Antidiabetic Properties that Are Species-Specific : Effects on Enzyme Activity Inhibition and Starch Digestion

The study was funded by the Rural and Environment Science and Analytical Services Division of the Scottish government (RESAS). The authors are grateful to Phyllis Nicol for assisting with AGE measurements.Peer reviewedPublisher PD

Digital arts – refugee engagement

Digital Arts – Refugee Engagement (DA-RE) is an exploratory research partnership between refugee youth, academics, practitioners and community activists. Arts-based activities were combined with digital literacy to develop the capabilities of refugee youth in Turkey and Bangladesh. DA-RE’s participants co-created digital arts and connected with one another across the two settings in a digital third space to share narratives from their situated perspectives and lived experiences. In these ways, they developed skills of engagement and agency through the project, but at the heart of DA-RE was the intention to explore the links between refugee youths’ own creative agency, harnessed in new contexts enabled by the project, and their existing digital literacies. DA-RE sought to identify, with a theory of change, potential opportunities for refugee youth to both use this capability in the host community and provide a platform for their digital arts to offer a counter-narrative to ‘othering’ discourses at work in both their host communities and in the UK, where the project was coordinated, in so doing converting (digital) literacy into capability with positive consequences for social good

Clinical, Pathologic, and Functional Outcomes After Nephron-Sparing Surgery in Patients with a Solitary Kidney: A Multicenter Experience

Abstract Background and Purpose: Surgical management of a renal neoplasm in a solitary kidney is a balance between oncologic control and preservation of renal function. We analyzed patients with a renal mass in a solitary kidney undergoing nephron-sparing procedures to determine perioperative, oncologic, and renal functional outcomes. Patients and Methods: A multicenter study was performed from 12 institutions. All patients with a functional or anatomic solitary kidney who underwent nephron-sparing surgery for one or more renal masses were included. Tumor size, complications, and recurrence rates were recorded. Renal function was assessed with serum creatinine level and estimated glomerular filtration rate. Results: Ninety-eight patients underwent 105 ablations, and 100 patients underwent partial nephrectomy (PN). Preoperative estimated glomerular filtration rate (eGFR) was similar between the groups. Tumors managed with PN were significantly larger than those managed with ablation (P<0.001). Ablations were associated with a lower overall complication rate (9.5% vs 24%, P=0.01) and higher local recurrence rate (6.7% vs 3%, P=0.04). Eighty-four patients had a preoperative eGFR ≥60?mL/min/1.73?m2. Among these patients, 19 (23%) fell below this threshold after 3 months and 15 (18%) at 12 months. Postoperatively, there was no significant difference in eGFR between the groups. Conclusions: Extirpation and ablation are both reasonable options for treatment. Ablation is more minimally invasive, albeit with higher recurrence rates compared with PN. Postoperative renal function is similar in both groups and is not affected by surgical approach.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/98449/1/end%2E2012%2E0114.pd

Recommendations for defining preventable HIV-related mortality for public health monitoring in the era of Getting to Zero: an expert consensus

Getting to Zero is a commonly cited strategic aim to reduce mortality due to both HIV and avoidable deaths among people with HIV. However, no clear definitions are attached to these aims with regard to what constitutes HIV-related or preventable mortality, and their ambition is limited. This Position Paper presents consensus recommendations to define preventable HIV-related mortality for a pragmatic approach to public health monitoring by use of national HIV surveillance data. These recommendations were informed by a comprehensive literature review and agreed by 42 international experts, including clinicians, public health professionals, researchers, commissioners, and community representatives. By applying the recommendations to 2019 national HIV surveillance data from the UK, we show that 30% of deaths among people with HIV were HIV-related or possibly HIV-related, and at least 63% of these deaths were preventable or potentially preventable. The application of these recommendations by health authorities will ensure consistent monitoring of HIV elimination targets and allow for the identification of inequalities and areas for intervention

Colliding Worlds: Asteroid research and the legitimization of war in space

Accepted versio

Safety and efficacy of fluoxetine on functional outcome after acute stroke (AFFINITY): a randomised, double-blind, placebo-controlled trial

Background Trials of fluoxetine for recovery after stroke report conflicting results. The Assessment oF FluoxetINe In sTroke recoverY (AFFINITY) trial aimed to show if daily oral fluoxetine for 6 months after stroke improves functional outcome in an ethnically diverse population. Methods AFFINITY was a randomised, parallel-group, double-blind, placebo-controlled trial done in 43 hospital stroke units in Australia (n=29), New Zealand (four), and Vietnam (ten). Eligible patients were adults (aged ≥18 years) with a clinical diagnosis of acute stroke in the previous 2–15 days, brain imaging consistent with ischaemic or haemorrhagic stroke, and a persisting neurological deficit that produced a modified Rankin Scale (mRS) score of 1 or more. Patients were randomly assigned 1:1 via a web-based system using a minimisation algorithm to once daily, oral fluoxetine 20 mg capsules or matching placebo for 6 months. Patients, carers, investigators, and outcome assessors were masked to the treatment allocation. The primary outcome was functional status, measured by the mRS, at 6 months. The primary analysis was an ordinal logistic regression of the mRS at 6 months, adjusted for minimisation variables. Primary and safety analyses were done according to the patient's treatment allocation. The trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12611000774921. Findings Between Jan 11, 2013, and June 30, 2019, 1280 patients were recruited in Australia (n=532), New Zealand (n=42), and Vietnam (n=706), of whom 642 were randomly assigned to fluoxetine and 638 were randomly assigned to placebo. Mean duration of trial treatment was 167 days (SD 48·1). At 6 months, mRS data were available in 624 (97%) patients in the fluoxetine group and 632 (99%) in the placebo group. The distribution of mRS categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio 0·94, 95% CI 0·76–1·15; p=0·53). Compared with patients in the placebo group, patients in the fluoxetine group had more falls (20 [3%] vs seven [1%]; p=0·018), bone fractures (19 [3%] vs six [1%]; p=0·014), and epileptic seizures (ten [2%] vs two [<1%]; p=0·038) at 6 months. Interpretation Oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and epileptic seizures. These results do not support the use of fluoxetine to improve functional outcome after stroke

Adultery and the Law in Fifteenth Century France

https://scholarship.law.bu.edu/clark_speakers/1006/thumbnail.jp

À la recherche des enfants illégitimes dans les archives de l’officialité de Troyes au xve siècle

Ce chapitre étudie les enfants illégitimes des roturiers dans la France du Nord. Nous pourrions supposer que les femmes enceintes d’enfants illégitimes avaient souvent recours à l’avortement ou l’infanticide. Cependant, nous avons peu de preuves concernant ces pratiques. L’abandon des enfants illégitimes est certainement une autre possibilité qui peut se présenter, mais les sources du Nord de la France nous renseignent beaucoup moins sur le sujet que celles d’Italie. Ce chapitre interrogera ce que nous pouvons apprendre au sujet des enfants illégitimes de roturiers en étudiant la documentation laissée par l’officialité de Troyes au XVe siècle. Certaines mères gardaient leurs enfants illégitimes, ou les donnaient à leurs propres familles ou à la famille paternelle. Comment ces enfants étaient-ils traités par leurs parents et leurs communautés ?This chapter takes as its subject the illegitimate children of commoners in Northern France. It is assumed that women pregnant with illegitimate children often practiced abortion or infanticide. However, we have very little evidence of these practices. The abandonment of illegitimate children is certainly another possibility these women may have availed themselves of, but the sources for Northern France offer far less information for us than those from Italy. Some mothers kept their illegitimate children, or gave them to members of their family or to the father’s family. My chapter examines these parents and their children. How were these children treated by their parents and by their communities? This chapter investigates what we can learn on the subject of the illegitimate children of commoners by studying the documentation left by the officiality of Troyes in the 15 th century