Writing in Crisis: Rhetorical Considerations in Child Advocate Reports

One aspect of human rights often overlooked in and beyond professional communication involves the rights of minor children whose parents or guardians are accused of abusing, abandoning, or neglecting them. Children in the United States who enter the dependency court system, where such matters are adjudicated, have few legal protections because of their status as minors, and parents or legal guardians under investigation are seldom appropriate advocates for such children due to real, potential, or perceived conflicts of interest (Litzelfelner & Petr, 1997; Minow, 1995; Reynaert, Bouverne-de-Bie, & Vandevelde, 2009). Many state and county governments have established programs designed to secure advocates for children in jeopardy. Known by names such as Court Appointed Special Advocates (CASA) and Guardian ad Litem (GAL), these programs recruit, train, and appoint volunteers to represent children in court.1 These efforts are significant. According to program websites, in 2007 the national CASA/GAL movement reached a milestone of serving more than two million children in its first 30 years (CASA for Children, 2007; Piraino, 2007). In 2012 alone, the CASA/GAL network consisted of 946 local and state programs. These organizations engage more than 77,000 volunteers and serve more than 234,000 neglected and abused children annually (National CASA, 2012). Research shows that a child who is represented by a CASA/GAL advocate is more likely to find a permanent home, be adopted, and spend less time in the foster care system than one without such representation (CASA Boston, n.d.; CASA for Children, 2012; Litzerfelner & Petr, 1997; Ottmar, 2007; Piraino, 2007). Clearly child advocacy is a critical matter of human rights. In this article we examine relationships among the theory and practice of human rights, children’s rights, and rhetorical action in relation to child advocate report writing

What services are useful for patients with an intellectual disability?

It is well-known that people with an intellectual disability often face a host of health inequalities and co-morbidities. These include childhood obesity, mental health problems, and challenging behaviour. People with an intellectual disability also have reduced life expectancy. GPs are uniquely placed to advocate for and signpost these patients, ensuring they have access to appropriate support. However, it is often unclear what resources are, in reality, both available and beneficial. Here we aim to summarise some of the common inequalities and complexities when working with patients with an intellectual disability and provide an overview of some potentially helpful services.NIHR School for Primary Care Research [RG94577] and Wellcome Trust [Grant WT103343MA]

The Influence of Physical Activity on Monocyte Phenotype on Circulating Platelet-Monocyte Complexes in Overweight/Obese Persons

Elevated platelet-monocyte complexes (PMC) promote atherosclerosis and are associated with cardiovascular disease. It is unknown whether consistent physical activity (PA) decreases circulating PMCs. Additionally, no one has determined the monocyte phenotype most associated with PMCs. Purposes: 1) to examine the influence of PA on PMCs and their association with inflammatory /prothrombotic markers such as C-reactive protein (CRP), L-selectin (LS), platelet factor 4 (PF4), von Willebrand Factor (vWF), and hemoglobin A1C (HbA1c) and 2) to determine the monocyte phenotype most likely to form PMCs. Methods: Thirty-one overweight/obese subjects (44±5yr, BMI 34.2±5 kg×m2) were divided into two groups: sedentary (SED, n=17) and physically active (PA, n=14) based on physical activity logs. SED participated in \u3c 1 h of formal exercise while PA participated in moderate-high intensity exercise at least 3 h per week. Flow cytometry was used to identify PMCs on the monocyte phenotypes: classical (CD14+CD16-), intermediate (CD14+CD16+), and non-classical (CD14+CD16++). Platelets were identified using the marker CD42a. Results: Percentage of circulating PMCs and median fluorescence intensity of CD42a (MedFI; marker of platelet density per monocyte) were not different between groups; however, monocyte phenotype significantly impacted PMC percentage and MedFI where the lower the CD16 expression, the greater the adhesion of platelets. Classical monocytes (CD16-) had the highest % of PMC, etc. (Fig 1). HbA1c was greater (p=0.031) and LS (p=0.019) was lower in SED compared to PA (Fig. 2). There were no significant associations between any blood marker and PMC percentage, but PF4 was correlated with percent of CD16 -(r= -0.482, p=0.031) and CD16+(r= 0.473, p=0.035) monocytes. Conclusions: The absence of a separation between groups in VO2max may partially explain the lack of a difference in PMCs between groups. Regarding our second aim, classical monocytes appear to be more involved in PMC formation than do CD16+ monocytes with CD16++ having the lowest percentage of cells with platelets adhered (PMC). This observation may be due to the shedding of adhesion molecules from platelets and monocytes during activation from classical (CD16-) to a more inflammatory state (ie. CD16+)

Concert recording 2016-04-16

[Track 01]. Meditation no. 1 / Casey Cangelosi -- [Track 02]. Into the air / Ivan Trevino -- [Track 03]. Ku-ka ilimoku / Christopher Rouse -- [Track 04]. Good vibes / Oscar Hernandez -- [Track 05]. Arabesque no. 2 / Claude Debussy ; arranged by Evans -- [Track 06]. The odyssey, according to Penelope. Afternoon at the park ; [Track 07]. Toddling waltz ; [Track 08]. Babble songs ; [Track 09]. Naptime prelude ; [Track 10]. Run amok rondo / Kevin Bobo -- [Track 11]. Tiger dance / Jeffery Dennis Smith

A Comparison of Temperatures Inside Protective Headgear With Indicators of Physiological Strain and Core Temperatures During Exercise in a Hot Environment

Introduction: Non-invasive temperature monitoring with a sensor mounted inside protective headgear such as a football or military helmet or a construction hardhat may be an effective method of detecting temperatures that are indicative of increased risk of heat illness. Hothead Technologies has developed a system for providing temperature information to medical personnel responsible for the health of the individual. Purpose: The purposes of this study were to establish the relationship between in-hardhat temperature (Tih) readings, markers of physiological strain and perceptual responses, and to determine the differences between the in-helmet temperature readings and core temperature (Tc) as measured by rectal (Tre) and esophageal (Tes) probes. Methods: Thirty males (age, 24.57 ± 4.32 years; height 180.51 ±7.06 cm; body mass, 81.06 ±9.35 kg; percent body fat, 13.76 ±5.11; VO2max, 46.84 ± 7.10 mL/Kg/min) completed two experimental trials separated by a minimum of one week: a continuous submaximal exercise (CSE) condition and a series of high intensity 30-second sprints (HIE) with a one-minute rest period between each sprint. Exercise in both conditions was carried out in a 36o C environment with a relative humidity of 40% while wearing a standard construction hardhat with a sensor mounted in the forehead area of the head strap, and continued until one of the following two criteria was met: the subject voluntarily terminated the session, or the subject’s Tc reached 39.5oC. Temperatures, heart rate, cardiorespiratory, and perceptual responses were monitored throughout, and balance error scoring system (BESS) and mental function tests were conducted before and after exercise. A physiological strain index (PSI) was calculated from Tc and HR. Results: CV- Calculated from final temp. Conclusion: The general agreement between the Tih and other temperature measures along with the consistency as indicated by the low coefficient of variation in the recordings of the Tih sensors at the point of termination suggest that this device may have application as a warning system for impending heat-related problems

Concert recording 2015-04-26

[Track 01]. Catching shadows / Ivan Trevino -- [Track 02]. Variation in F-sharp minor, op. 24. Theme : Andante cantabile ; Variation I : Allegretto scherzando ; Variations III : Andante molto sostenuto ; Variation V : Vivo scherzando / Léon Stekke -- [Track 03]. Concerto in E minor. Allegro apassionoto / Felix Mendelssohn -- [Track 04]. Cantabile et presto / George Enesco -- [Track 05]. Poem / Charles Griffes -- [Track 06]. Legende / George Enesco -- [Track 07]. Violin concerto in A minor, op. 53. Allegro ma non troppo / Antonin Dvorâk -- [Track 08]. Fantasie concertante / Jacques Casérède

Moderate reductions in dissolved oxygen may compromise performance in an ecologically-important estuarine invertebrate

Coastal ecosystems, including estuaries, are increasingly pressured by expanding hypoxic regions as a result of human activities such as increased release of nutrients and global warming. Hypoxia is often defined as oxygen concentrations below 2 mL O2 L−1. However, taxa vary markedly in their sensitivity to hypoxia and can be affected by a broad spectrum of low oxygen levels. To better understand how reduced oxygen availability impacts physiological and molecular processes in invertebrates, we investigated responses of an estuarine amphipod to an ecologically-relevant level of moderate hypoxia (~2.6 mL O2 L−1) or severe hypoxia (~1.3 mL O2 L−1). Moderate hypoxia elicited a reduction in aerobic scope, and widespread changes to gene expression, including upregulation of metabolic genes and stress proteins. Under severe hypoxia, a marked hyperventilatory response associated with maintenance of aerobic performance was accompanied by a muted transcriptional response. This included a return of metabolic genes to baseline levels of expression and downregulation of transcripts involved in protein synthesis, most of which indicate recourse to hypometabolism and/or physiological impairment. We conclude that adverse ecological effects may occur under moderate hypoxia through compromised individual performance and, therefore, even modest declines in future oxygen levels may pose a significant challenge to coastal ecosystems