Upholding heightened expectations of Indigenous children? Parents do, teachers do not

This paper argues that a component of increasing the rate of Aboriginal and Torres Strait Islander children and youths completing their secondary education is having parents and teachers maintain heightened expectations of these children in achieving this goal. To understand this phenomenon, we investigate the importance of, and discrepancies between, primary caregiver and teacher outlooks regarding Indigenous youths completing year 12. For the purpose of this paper, we adopt the term ‘primary caregiver’ in place of parent. This is because the majority (87.7%) of P1s analysed are the biological mothers with the remainder being close female relatives. P2s analysed are all male, 93.3% are biological fathers; remainder are step-fathers or adoptive fathers. This paper uses quantitative data from the Longitudinal Study of Indigenous Children to measure expectations from parents and teachers of Indigenous children. Results suggest that parents maintain exceptionally high expectations of their children, while teacher's expectations significantly decline over the course of Indigenous children's primary and secondary schooling years. We suggest that relationships and communication between parents and teachers, regarding expectations of students, are important to establishing an equilibrium in expectations of children, and that teachers may benefit from further training to address any underlying biases towards Indigenous children

Galcanezumab for the treatment of chronic migraine and medication overuse headache: Real-world clinical evidence in a severely impaired patient population

Background: Galcanezumab is a monoclonal antibody acting against the calcitonin gene-related peptide approved for the preventive treatment of migraine. The aim of this article is to explore its effectiveness and safety of galcanezumab in chronic migraine (CM) with medication overuse-headache (MOH). Methods: Seventy-eight patients were consecutively enrolled at the Modena headache center and followed up for 15 months. Visits were scheduled every 3 months, and the following variables were collected: the number of migraine days per month (MDM); the painkillers taken per month (PM); the number of days per month in which the patient took, at least, one painkiller; the six-item headache impact test; and the migraine disability assessment questionnaire (MIDAS) score. Demographic features of the analyzed sample were collected at the baseline and adverse events (AEs) were collected at every visit. Results: After 12 months, galcanezumab significantly reduced the MDM, the PM, the number of days on medication, the HIT-6 as well as the MIDAS scores (all p <.0001). The greatest amelioration was obtained in the first trimester of treatment. A higher MDM, a higher NRS score at the baseline, and a higher number of failed preventive treatments negatively predict the CM relief at the year of treatment. No serious AEs were registered and only one drop-out was due to AE. Conclusions: Galcanezumab is effective and safe for the treatment of patients affected by CM and MOH. Patients with a higher impairment at the baseline may found less benefits with galcanezumab

Predictors of response to erenumab after 12 months of treatment

Objective: Erenumab is a monoclonal antibody acting against calcitonin gene-related peptide receptor and approved for the preventive treatment of chronic migraine. The aim of the present study is to identify clinical predictors of good response in patients with chronic migraine and medication overuse-headache. Material and methods: This was a retrospective single-center not funded study. Enrolled patients were affected by chronic migraine and medication overuse-headache treated with erenumab monthly, up to 1 year. At 1 year, patients were classified as good responders if they displayed a ≥50% reduction in the number of headache days per months compared to the baseline. Results: After 1 year, a significant improvement in the number of headache days per months, analgesic consumption, 6-items headache impact test, and migraine disability assessment questionnaire scores were obtained compared to the baseline. Patients who obtained a ≥50% reduction in the number of headache days per month compared to the baseline displayed a longer history of medication overuse-headache, a higher number of painkillers taken per month at the baseline and a higher number of failed preventive treatments in the past. Conclusions: Patients with longer medication overuse-headache duration, higher analgesic intake, and a higher number of previous preventive treatment failures may receive less benefit with erenumab

OnabotulinumtoxinA: Still the Present for Chronic Migraine

OnabotulinumtoxinA (BT-A) is one of the few drugs approved for the preventive treatment of chronic migraine (CM). Despite this, some aspects of its mechanism of action are still a matter of debate, and the precise magnitude of BT-A effects needs to be completely elucidated. BT-A acts primarily upon trigeminal and cervical nerve endings, by inhibiting the release of inflammatory mediators such as calcitonin gene-related peptide, as well as reducing the insertion of ionotropic and metabotropic receptors into the neuronal membrane. These actions increase the depolarization threshold of trigeminal and cervical nerve fibers, thus reducing their activation. The central actions of BT-A are still a matter of debate: a retrograde axonal transport has been postulated, but not clearly assessed in humans. Clinically, the efficacy of BT-A in CM has been assessed by large, randomized placebo-controlled trials, such as the Phase 3 REsearch Evaluating Migraine Prophylaxis Therapy (PREEMPT) trials. Those results were also confirmed in a wide range of open-label studies, even for long-term periods. Recently, novel findings have led to a better understanding of its pharmacological actions and clinical usefulness in migraine prevention. This narrative review summarizes, updates and critically revises the available data on BT-A and its possible implementation in chronic migraine. Moreover, the current role of BT-A in CM treatment has been discussed

Secondary spontaneous pneumothorax and bullous lung disease in cannabis and tobacco smokers. A case-control study.

Background The notion that smoking cannabis may damage the respiratory tract has been introduced in recent years but there is still a paucity of studies on this subject. The aim of this study was to investigate the relationship between cannabis smoking, pneumothorax and bullous lung disease in a population of operated patients. Methods and findings We performed a retrospective study on patients operated on for spontaneous pneumothorax. Patients were divided into three groups according to their smoking habit: cannabis smokers, only-tobacco smokers and nonsmokers. Cannabis lifetime exposure was expressed in dose-years (1d/y = 1 gram of cannabis/week for one year). Clinical, radiological and perioperative variables were collected. The variables were analyzed to find associations with smoking habit. The impact of the amount of cannabis consumption was also investigated by ROC curves analysis. Of 112 patients, 39 smoked cannabis, 23 smoked only tobacco and 50 were nonsmokers. Median cannabis consumption was 28 dose/years, median tobacco consumption was 6 pack/years. Cannabis smokers presented with more severe chronic respiratory symptoms and bullous lung disease and with a higher incidence of tension pneumothorax than both tobacco smokers and nonsmokers. Cannabis smokers also developed a larger pneumothorax, experienced prolonged postoperative stay and demonstrated a higher incidence of pneumothorax recurrence after the operation than nonsmokers did. The risk of occurrence of chronic respiratory symptoms and bullous lung disease in cannabis smokers was dose-related. Conclusions Cannabis smoking seems to increase the risk of suffering from respiratory complaints and can have detrimental effects on lung parenchyma, in a dose-dependent manner. Cannabis smoking also negatively affected the outcome of patients operated for spontaneous pneumothorax. A history of cannabis abuse should always be taken in patients with pneumothorax. There may be need for a specific treatment for pneumothorax in cannabis smokers

Longitudinal study of Salmonella infection in four Italian farrow-to finish swine herds

A longitudinal study of Salmonella enterica infection was carried out in 4 Italian farrow-to-finish swine herds. In each herd 5 litters were randomly selected and in each litter 6 piglets ear tagged. Thus, on each farm 30 pigs were included in the study. Individual blood samples were collected for serologic examination at weaning from all piglets and in the same day from all sows 1n the farrowing unit. Piglets were bled again at approximately 60, 90, 150, 210 and 270 days of life with the last blood sample collected at slaughtering. In one herd, in which the duration of productive cycle was about 12 months, the last blood samples was collected at 350 days of life. 5 pen pooled faecal samples were collected from each herd for bacteriological examination with the same time schedule of blood samples. At slaughtering mesenteric lymph nodes were collected from each ear tagged pig. Sera-prevalence (cutoff S/P ratio 0,25) in sows varied from 93,8% to 100%. In all herds sera-prevalence in piglets showed a similar profile with complete decline of maternal antibodies at day 60 and clear sera-conversion between day 90 and day 150. The peak of sera-prevalence was observed between day 210 and day 270. Sera-prevalence at slaughtering varied from 66% to 100%. Salmonella was isolated from faecal samples in 3 out of 4 herds. No Salmonella was isolated from mesenteric lymph nodes at slaughter in 2 herds. Culture prevalence from mesenteric lymph nodes in the other herds was respectively 3,3% and 30%. This longitudinal study provides original information about epidemiological dynamics of Salmonella enterica infection in Italian swine herds in consideration of the typical longer fattening cycles

Lower All-Cause Mortality Risk in Females and Males with Peripheral Artery Disease following Pain-Free Home-Based Exercise: A 7-Year Observational Study

We evaluated the sex-specific difference in response upon participation in an exercise program with respect to the risk of adverse clinical outcomes among patients with peripheral artery disease (PAD) and claudication. The records of 400 PAD patients were assessed between 2012 and 2015. Two hundred of them were addressed to a walking program prescribed at the hospital and executed at home at symptom-free walking speed (Ex), while the remaining 200 acted as a control group (Co). The number and date of deaths, all-cause hospitalizations, and amputations for a 7-year period were collected from the regional registry. At baseline, no differences were observed (MEX n = 138; FEX n = 62; MCO n = 149; FCO n = 51). The 7-year survival rate was significantly higher in FEX (90%) than in MEX (82% hazard ratio, HR: 0.542 95% CI 0.331–0.885), FCO (45%, HR: 0.164 95% CI 0.088–0.305), and MCO (44%; HR: 0.157 95% CI 0.096–0.256). A significantly lower rate of hospitalization (p < 0.001) and amputations (p = 0.016) was observed for the Ex group compared to the Co group, without differences by sex. In conclusion, in PAD patients, active participation in a home-based pain-free exercise program was associated with a lower rate of death and better long-term clinical outcomes, particularly among women

Fungal microbiota from rain water and pathogenicity of Fusarium species isolated from atmospheric dust and rainfall dust

In order to determine the presence of Fusarium spp. in atmospheric dust and rainfall dust, samples were collected during September 2007, and July, August, and October 2008. The results reveal the prevalence of airborne Fusarium species coming from the atmosphere of the South East coast of Spain. Five different Fusarium species were isolated from the settling dust: Fusarium oxysporum, F. solani, F. equiseti, F. dimerum, and F. proliferatum. Moreover, rainwater samples were obtained during significant rainfall events in January and February 2009. Using the dilution-plate method, 12 fungal genera were identified from these rainwater samples. Specific analyses of the rainwater revealed the presence of three species of Fusarium: F. oxysporum, F. proliferatum and F. equiseti. A total of 57 isolates of Fusarium spp. obtained from both rainwater and atmospheric rainfall dust sampling were inoculated onto melon (Cucumis melo L.) cv. Piñonet and tomato (Lycopersicon esculentum Mill.) cv. San Pedro. These species were chosen because they are the main herbaceous crops in Almeria province. The results presented in this work indicate strongly that spores or propagules of Fusarium are able to cross the continental barrier carried by winds from the Sahara (Africa) to crop or coastal lands in Europe. Results show differences in the pathogenicity of the isolates tested. Both hosts showed root rot when inoculated with different species of Fusarium, although fresh weight measurements did not bring any information about the pathogenicity. The findings presented above are strong indications that long-distance transmission of Fusarium propagules may occur. Diseases caused by species of Fusarium are common in these areas. They were in the past, and are still today, a problem for greenhouses crops in Almería, and many species have been listed as pathogens on agricultural crops in this region. Saharan air masses dominate the Mediterranean regions. The evidence of long distance dispersal of Fusarium spp. by atmospheric dust and rainwater together with their proved pathogenicity must be taken into account in epidemiological studies

Evaluation of trace metal fluxes to soils in hinterland of Porto Marghera, industrial zone: comparisons with direct measurements in the Lagoon of Venice

Trace metal (As, Cd, Cr, Ni, Hg, Pb) concentrations in soil samples collected around the Porto Marghera (Italy) industrial district (2-40 km) near the city of Venice were compared with direct measurements of atmospheric deposition measured at comparable distances from the same source. Concentrations of Cd and Pb in soils decreased exponentially with increasing distance from the source; less clear signals were detected for As, Cr and Ni. Significant differences were found among the soils, which were partially resolved when applying normalisation to their clay contents. Preliminary comparisons of fluxes of Cd and Pb derived from soil with direct deposition measurements show increasing values with longer integration times. Annual Cd and Pb flux values of one year of direct deposition were 5 to 10 times lower than mean annual fluxes derived from soils, integrating 50 to 100 years. Values range from ~ 0.1-0.4 to 1-2 mg m -2 yr -1 for Cd, and from 3-18 to 50-100 mg m -2 yr -1 for Pb. These results fit information on “historical” emission trends as recorded in sediments of the lagoon

Relative contribution of atmospheric and riverine inputs of metals, nutrients and POPs into the Lagoon of Venice.

Atmospheric deposition in the lagoon of Venice and river inputs from the watershed were collected and analysed over more than one year (1999-2000) using the same analytical methods. The input from riverine sources largely prevails (>70%) over that from the atmosphere for As, Cr, Fe, Mn, Ni, nitrogen and phosphorus. Equivalent amounts of Hg, Pb, PCB, HCB are discharged into the lagoon from the two sources, whilst atmospheric inputs prevail for Cd, ammonia and dioxins. A comparison with figures of maximum allowable discharges (MAD) for various compounds, recently set by the Italian Ministry for the Environment, showed that total inputs (riverine + atmospheric) of trace metals were lower than the MAD only for Cr, Cu, Ni and Zn. The total inputs of Cu and Ni, and Cr and Zn were approximately 20% and 40% of the MAD limit, respectively. The total phosphorus input of 284 t was close to the imposed limit, whilst the total inorganic nitrogen load (>4000 t) was much higher than the MAD. For those metals and POPs (As, Cd, Hg, Pb, PCDD/Fs) where the MAD states that the load should tend to “0” (no discharge), the measured inputs of 4.8 (As) and 5.1 t (Pb), 151 (Cd) and 39 kg (Hg), 18 g (PCDD/F) and 440 mg (TEQPCDD/F) are by definition “above” the MAD. Using principal component analysis (PCA) data have been compared with available input profiles (markers) related to production typologies, both in the watershed and in the industrial zone located on the lagoon border (Porto Marghera). PCA showed that river and atmosphere contributions can be easily separated and recognised due to their different fingerprints. In particular, riverine inputs were more similar to chemical and glass work production markers, whereas atmospheric ones appeared to be mainly influenced by industry (PVC and VCM production), metallurgy and paper-mill. These results highlight the need to implement improved technologies in order to arrive at a “good ecological status” for all surface and ground water bodies by 2015, as stated by the EU Water Framework Directive