Qualitative exploration of a targeted school-based mindfulness course in England.

BACKGROUND: Mindfulness-based training has been shown to provide benefits for adults with numerous conditions such as cancer, chronic pain, and depression. However, less is known about its impact for young people. Early adolescence (typically 10-14 years) is a time fraught with challenges such as cognitive changes, social, and academic pressures in the form of exams, all of which can provoke anxiety. While there is a lack of effectiveness studies, there is growing interest in the potential for school-based mindfulness programmes to help young people cope with the pressures of modern life. METHODS: This study outlines a qualitative exploration of a school-based targeted mindfulness course. We interviewed 16 young people who had taken part in a 10-week mindfulness course, and held a focus group with three members of teaching staff who delivered the programme. Interviews and focus groups were analysed using applied thematic analysis. RESULTS: While young people felt that they had to take part, once they started the programme they enjoyed it. Young people felt that they learned a range of coping skills, and it had a positive impact on their behaviour. However, the targeted approach of the intervention could lead to young people being stigmatised by their peers. Teaching staff could see the potential benefit of mindfulness courses in schools but felt there were some barriers to be overcome if it were to be implemented in the long term. CONCLUSIONS: Young people were willing to engage in mindful practice and felt it better equipped them to deal with stressful situations.

Maternal vitamin D and E intakes during pregnancy are associated with asthma in children.

Are maternal vitamin D and E intakes during pregnancy associated with asthma in 10-year-old children? In a longitudinal study of 1924 children born to women recruited during pregnancy, maternal vitamin D intake during pregnancy was assessed by the Food Frequency Questionnaire (FFQ) and vitamin E by FFQ and plasma α-tocopherol; respiratory questionnaires were completed for the 10-year-old children. Their treatment for asthma was also ascertained using administrative data. Longitudinal analyses included data collected at 1, 2, 5 and 10 years. Symptom data were available for 934 (49%) children and use of asthma medication for 1748 (91%). In the children maternal vitamin D intake during pregnancy was negatively associated with doctor-diagnosed asthma at 10 years of age (OR per intake quintile 0.86, 95% CI 0.74-0.99) and over the first 10 years (hazard ratio 0.90, 95% CI 0.81-1.00). Maternal plasma α-tocopherol at 11 weeks gestation was negatively associated with children receiving asthma treatment (OR per standard deviation increase 0.52, 95% CI 0.31-0.87). Maternal vitamin E intake was negatively associated with doctor-diagnosed asthma (OR 0.89, 95% CI 0.81-0.99) in the first 10 years. Low maternal vitamin D and E intakes during pregnancy are associated with increased risk of children developing asthma in the first 10 years of life. These associations may have significant public health implications.

An exploratory study of the associations between maternal iron status in pregnancy and childhood wheeze and atopy.

Maternal nutritional status during pregnancy has been reported to be associated with childhood asthma and atopic disease. The Avon Longitudinal Study of Parents and Children has reported associations between reduced umbilical cord Fe status and childhood wheeze and eczema; however, follow-up was short and lung function was not measured. In the present study, the associations between maternal Fe status during pregnancy and childhood outcomes in the first 10 years of life were investigated in a subgroup of 157 mother-child pairs from a birth cohort with complete maternal, fetal ultrasound, blood and child follow-up data. Maternal Fe intake was assessed using FFQ at 32 weeks of gestation and Hb concentrations and serum Fe status (ferritin, soluble transferrin receptor and TfR-F (transferrin receptor:ferritin) index) were measured at 11 weeks of gestation and at delivery. Maternal Fe intake, Hb concentrations and serum Fe status were found to be not associated with fetal or birth measurements. Unit increases in first-trimester maternal serum TfR concentrations (OR 1.44, 95% CI 1.05, 1.99) and TfR-F index (OR 1.42, 95% CI 1.10, 1.82) (i.e. decreasing Fe status) were found to be associated with an increased risk of wheeze, while unit increases in serum ferritin concentrations (i.e., increasing Fe status) were found to be associated with increases in standardised mean peak expiratory flow (PEF) (ß 0.25, 95% CI 0.09, 0.42) and forced expiratory volume in the first second (FEV1) (ß 0.20, 95% CI 0.08, 0.32) up to 10 years of age. Increasing maternal serum TfR-F index at delivery was found to be associated with an increased risk of atopic sensitisation (OR 1.35, 95% CI 1.02, 1.79). The results of the present study suggest that reduced maternal Fe status during pregnancy is adversely associated with childhood wheeze, lung function and atopic sensitisation, justifying further studies on maternal Fe status and childhood asthma and atopic disease.

First- and second-trimester fetal size and asthma outcomes at age 10 years.

RATIONALE: Greater early fetal size is associated with reduced asthma risk and improved lung function in early childhood. OBJECTIVES: To test the hypothesis that associations between early fetal size, asthma symptoms, and lung function persist into later childhood. METHODS: In a longitudinal study, first- and second-trimester fetal measurements were recorded. At 10 years of age a respiratory questionnaire was completed. Spirometry, bronchial challenge, and skin-prick testing were undertaken in a subset. MEASUREMENTS AND MAIN RESULTS: Fetal measurements were available in the first trimester for 853 individuals and the second trimester for 1,453. Questionnaires were returned for 927 children and 449 underwent detailed phenotyping. For each millimeter increase in first trimester size, asthma risk reduced by 6% (95% confidence interval[CI], 1­11) and FEV1 was higher by an average of 6 ml (95% CI, 1­11).First-trimester size was reduced in those with asthma at both 5 and 10 years compared with early or late onset wheeze (P , 0.02). Compared with persistent high growth in first and second trimesters,persistent low growth was associated with increased asthma risk(odds ratio, 2.8; 95% CI, 1.2­6.9) and a mean reduction in FEV1 of 103 ml (95% CI, 13­194), whereas increasing fetal size was associated with increased eczema risk (odds ratio, 2.5; 95% CI, 1.2­5.3). CONCLUSIONS: Reduced fetal size from the first trimester is associated with increased risk for asthma and obstructed lung function in childhood. Relative change in size after the first trimester is associated with eczema.

The interactions between wheat starch and Mesona chinensis polysaccharide: A study using solid-state NMR.

The interaction between wheat starch and Mesona chinensis polysaccharide (MCP) was found to change the molecular mobility of the water and carbohydrate populations in starch-MCP gels, when measured using proton and carbon nuclear magnetic resonance relaxation methods. The starch and MCP mobilities appeared similar at a micron scale. However, at a distance of less than 5 nm could they be detected as having separate mobility states, indicating close interaction between the starch and MCP. The carbon-6 of the starch glucan monomer was observed to have the largest mobility change in the presence of MCP. Two mobility populations of carbon-6 were observed, possibly corresponding to the carbon-6 in the linear chains of both amylose and amylopectin, and another to the carbon-6 involved in the branching of amylopectin. The change in the mobility of one of the carbon-6 populations indicates an increase in molecular freedom of movement in the presence of MCP.

The effect of gel structure on the in vitro digestibility of wheat starch-Mesona chinensis polysaccharide gels.

The digestibility of wheat starch gels in the presence of Mesona chinensis polysaccharide (MCP) was studied. MCP was found to be the most effective polysaccharide in reducing wheat starch digestion in comparison to starch gels of similar hardness containing xanthan, guar, locust bean gum (LBG) and agar. A 33% reduction in the digestibility of intact starch gels containing 5% w/w MCP (after 120 minutes of digestion) was observed and this was attributed to the strengthening of the gels in the presence of high concentration of the polysaccharide. In contrast, despite a reduction in the firmness of the gel when 2% w/w MCP was present, there was a 7% reduction in starch digestibility and hence, firmness was deduced to be not solely responsible for the digestibility of the gels. When these gels were macerated, starch digestibility was reduced regardless of the MCP concentration. Starch digestion in the macerated samples seemed to cease after 10 minutes with about 30% more starch remaining when 5% w/w MCP was present, suggesting that the amount of starch available for digestion was reduced in the presence of MCP. The reduced availability of starch for digestion was hypothesised to be due to starch-MCP interactions, which formed amylose-MCP complexes that are likely to be resistant to enzymatic digestion. Overall, this work shows the potential for MCP to be utilized as an ingredient to reduce the glycaemic index.

Exploring young women's perspectives of a targeted support programme for teenage parents.

CONTEXT: Teenage parents and their children are at risk of poorer outcomes than older mothers, and their peers. OBJECTIVE: Evaluate participants' experiences of a targeted teenage parent support programme. DESIGN: A qualitative study was conducted to gain feedback from participants of a locally commissioned teenage parent support programme. Four focus groups were held with participants attending the programme in different areas of the county, and analysed using applied thematic analysis. PARTICIPANTS: Teenage mothers aged 16-19 years from vulnerable backgrounds (n=18) attending a teenage parent support programme in County Durham. RESULTS: Two major themes emerged from the analysis focusing on factors influencing enrolment and continued engagement and how the programme leads to personal development for mother and child.The majority of participants felt that the group fostered a supportive environment and led to a reduction in social isolation. The provision of free transport and childcare onsite was seen as a key component of the service without which many would not have been able to attend. DISCUSSION: The programme appeared effective at increasing the emotional and social capabilities of teenage mothers. It had a positive impact on parents' engagement in education and employment, as well as impacting on children's social development. CONCLUSIONS: Targeted support programmes have the ability to increase social and emotional capabilities of teenage mothers and their children. They can increase engagement in education and employment for teenage mothers. The provision of transport and free child care places can enhance engagement in such programmes.

Contextual determinants on the meaning of the N word.

Use of the word nigger is very often castigated as slurring the referent, but this ignores the context of use. For many people the word itself is a slur no matter what the context, and such people argue for its eradication from the English language. Eradicationists confuse the form of the word with its frequent use as a slur that discredits, slights, smears, stains, besmirches people of black African descent. In this paper I discuss several occurrences of the N word in Quentin Tarantino's film 'Pulp Fiction'. At least one is a slur. As with many slurs, in-group usage by people who might themselves have been slurred with the term by out-groupers, nigger is used among African Americans to express camaraderie. Three instances of this are examined. Another instance is where black gangster millionaire Marcellus Wallace, after handing white boxer Butch Coolidge money to go down in the fifth round, tells him 'You're my nigger' to which Butch replies 'Certainly appears so'. Lastly I consider the tricky situation where a white uses the term nigger to a black friend, not as a term of address and not as a slur either, I argue. I discuss the composition of context and the semantics and connotations of nigger. I examine the place and function of the uses of nigger within the context of the film, 'Pulp Fiction', to demonstrate that the affective quality of a linguistic expression should never be judged without taking account of its intended perlocutionary effect within the context in which it is uttered. We see that the basic semantic content invariably contributes to the functional (compositional) meaning, but that pragmatic input from connotations is essential in determining the truth value of the utterance in which nigger appears.

Pragmatics in language change and lexical creativity.

This essay examines language change and linguistic creativity as revealed by remodelling, especially as a source for euphemisms and euphemistic dysphemisms and as a function of verbal play. Within the scope of this essay, there are predominantly two ways in which novel terms and expressions are created leading to language change: formally through remodelling and semantically through figurative language. Consider some of the words for nakedness. There is the orthophemistic term nude, from Latin nudus, often used of photographic or painted representations of naked women and, much more rarely, of a naked man-hence the marked term male nude. Whether a nude is artistic or pornographic depends on the viewer belief. A colloquial Australian euphemism for being in the nude is in the nuddie. Other euphemisms include as nature intended, in one's birthday suit, in the altogether, and in the buff (⇐buff[alo] leather, buff skin transferred to humans). Being naked is captured by the dysphemism bare-arsed and the more euphemistic butt / buck naked in which buck â‡ butt. The orthophemistic term stark naked and the connected colloquial euphemism starkers also arose by replacing a final /t/ with a /k/: stark â‡ start "tail, arse". Nudists like to go about in the open air without clothes on and, being as nature intended when in natural surroundings, are euphemistically called naturists. Such expressions display folk-culture in a remarkable inventiveness of metaphor and figurative language sourced in the perceived characteristics of whatever is being talked about. For instance, terms for tabooed objects and events provide ready-made material for the dysphemistic language of curses, insults, epithets, and expletives. The essay shows that X-phemisms (orthophemisms and/or euphemisms and/or dysphemisms) are motivated by a speaker/writer's want to be seen to take a certain stance by upgrading, downgrading, obfuscating, and deceiving; and they extensively manifest indulgence in verbal play. Although the discussion focuses on English, the categories illustrated occur across the world's languages, and many of them are significant for the study of language change.

What makes a compliant Phase III and pre-launch patient advocacy strategy?

BACKGROUND: A key task for the pharmaceutical industry is to understand the compliance implications of engaging with a patient advocacy group (PAG). This presents challenges for the industry to negotiate the ethical and reputational issues that can arise when working with a PAG. OBJECTIVE: To gain the views of pharmaceutical industry executives on future compliance challenges when working with PAGs. STUDY DESIGN: We conducted two surveys among two sets of industry executives: one group focussed on market access roles and the other focussed on non-market access roles. RESULTS: Transparency was identified as the biggest challenge, followed by project rationale and then by project ownership. CONCLUSION: We explore how this can be overcome and make recommendations on how best to work compliantly with PAGs.

Maternal obesity during pregnancy and premature mortality from cardiovascular event in adult offspring: follow-up of 1 323 275 person years.

OBJECTIVES: To determine whether maternal obesity during pregnancy is associated with increased mortality from cardiovascular events in adult offspring. DESIGN: Record linkage cohort analysis. SETTING: Birth records from the Aberdeen Maternity and Neonatal databank linked to the General Register of Deaths, Scotland, and the Scottish Morbidity Record systems. POPULATION: 37 709 people with birth records from 1950 to present day. MAIN OUTCOME MEASURES: Death and hospital admissions for cardiovascular events up to 1 January 2012 in offspring aged 34-61. Maternal body mass index (BMI) was calculated from height and weight measured at the first antenatal visit. The effect of maternal obesity on outcomes in offspring was tested with time to event analysis with Cox proportional hazard regression to compare outcomes in offspring of mothers in underweight, overweight, or obese categories of BMI compared with offspring of women with normal BMI. RESULTS: All cause mortality was increased in offspring of obese mothers (BMI >30) compared with mothers with normal BMI after adjustment for maternal age at delivery, socioeconomic status, sex of offspring, current age, birth weight, gestation at delivery, and gestation at measurement of BMI (hazard ratio 1.35, 95% confidence interval 1.17 to 1.55). In adjusted models, offspring of obese mothers also had an increased risk of hospital admission for a cardiovascular event (1.29, 1.06 to 1.57) compared with offspring of mothers with normal BMI. The offspring of overweight mothers also had a higher risk of adverse outcomes. CONCLUSIONS: Maternal obesity is associated with an increased risk of premature death in adult offspring. As one in five women in the United Kingdom is obese at antenatal booking, strategies to optimise weight before pregnancy are urgently required.

Diet and asthma: nutrition implications from prevention to treatment.

Asthma is characterized by lung airway inflammation initiated and perpetuated by an inappropriate immune response, increased airway responsiveness, and variable airflow obstruction. In Western countries there has been a marked increase in asthma prevalence such that it has become a public health concern. It has been hypothesized that the increase may be due to changing antioxidant intake, increasing dietary ratio of n-6:n-3 polyunsaturated fatty acids (PUFA), and vitamin D deficiency (and supplementation). Observational studies have reported associations between asthma and dietary antioxidants (vitamin E, vitamin C, carotenoids, selenium, polyphenols, and fruit), PUFA, and vitamin D. However, supplementing the diets of adults with asthma with antioxidants and n-3 PUFA has minimal, if any, clinical benefit. Currently there is insufficient evidence to support the use of nutrient supplements to complement conventional treatment; however, results of ongoing studies are awaited, and additional research is required, particularly in children. Interest in the potential of dietary intervention during pregnancy to reduce the likelihood of childhood asthma has increased. A small number of cohort studies have highlighted associations between childhood asthma and reduced maternal intake of some nutrients (vitamin E, vitamin D, selenium, zinc, and PUFA) during pregnancy. Although vitamin D intervention studies during pregnancy are ongoing and two intervention studies suggest that dietary PUFA manipulation during pregnancy may be advantageous, further trials are needed to establish if modification of maternal nutrient intake during pregnancy can be used as a healthy, low cost, public health measure to reduce the prevalence of childhood asthma.

Vitamin C deficiency in cancer patients.

PURPOSE: To assess the prevalence of vitamin C deficiency within a group of hospice patients. To assess the relationship between plasma vitamin C, dietary intake and subsequent survival. METHODS: Patients with advanced cancer were recruited from a large hospice. Data were collected on demographic details, physical functioning and smoking history. An estimate was obtained of the number of weekly dietary portions consumed equivalent to 40 mg of vitamin C, the recommended daily intake. Plasma vitamin C was measured by a single blood sample. The study had local ethical approval. RESULTS: Fifty patients were recruited (mean age 65.2 years, 28 female). Plasma vitamin C deficiency was found in 15 (30%). Dietary intake of vitamin C was correlated to plasma vitamin C (r=0.518, P<0.0001). Low dietary intake, low albumin, high platelet count, high CRP level and shorter survival were all significantly associated with low plasma vitamin C concentrations (<11 micromol/L). There was no correlation between plasma vitamin C, smoking history or physical functioning. CONCLUSION: Vitamin C deficiency is common in patients with advanced cancer and the most important factors determining plasma levels are dietary intake and markers of the inflammatory response. Patients with low plasma concentrations of vitamin C have a shorter survival.

Expression of the Isochrysis C18-delta9 polyunsaturated fatty acid specific elongase component alters Arabidopsis glycerolipid profiles.

A cDNA isolated from the prymnesiophyte micro-alga Isochrysis galbana, designated IgASE1, encodes a fatty acid elongating component that is specific for linoleic acid (C18:2n-6) and alpha-linolenic acid (C18:3n-3). Constitutive expression of IgASE1 in Arabidopsis resulted in the accumulation of eicosadienoic acid (EDA; C20:2n-6) and eicosatrienoic acid (ETrA; C20:3n-3) in all tissues examined, with no visible effects on plant morphology. Positional analysis of the various lipid classes indicated that these novel fatty acids were largely excluded from the sn-2 position of chloroplast galactolipids and seed triacylglycerol, whereas they were enriched in the same position in phosphatidylcholine. EDA and ETrA are precursors of arachidonic acid (C20:4n-6), eicosapentaenoic acid (C20:5n-3), and docosahexaenoic acid (C22:6n-3) synthesized via the so-called omega6 Delta8 desaturase and omega3 Delta8 desaturase biosynthetic pathways, respectively. The synthesis of significant quantities of EDA and ETrA in a higher plant is therefore a key step in the production of very long chain polyunsaturated fatty acid in oil-seed species. The results are further discussed in terms of prokaryotic and eukaryotic pathways of lipid synthesis in plants.