Music in mind, a randomized controlled trial of music therapy for young people with behavioural and emotional problems: study protocol

Aims. This article is a report of a trial protocol to determine if improvizational music therapy leads to clinically significant improvement in communication and interaction skills for young people experiencing social, emotional or behavioural problems. Background. Music therapy is often considered an effective intervention for young people experiencing social, emotional or behavioural difficulties. However, this assumption lacks empirical evidence. Study design. Musicinmindisamulti-centredsingle-blindrandomizedcontrolledtrial involving 200 young people (aged 8–16 years) and their parents. Eligible participants willhaveaworkingdiagnosiswithintheambitofInternational ClassificationofDisease 10 Mental and Behavioural Disorders and will be recruited over 15 months from six centres within the Child and Adolescent Mental Health Services of a large health and social care trust in Northern Ireland. Participants will be randomly allocated in a 1:1 ratio to receive standard care alone or standard care plus 12 weekly music therapy sessions delivered by the Northern Ireland Music Therapy Trust. Baseline data will be collectedfromyoungpeopleandtheirparentsusingstandardizedoutcomemeasuresfor communicative and interaction skills (primary endpoint), self-esteem, social functioning, depressionandfamilyfunctioning.Follow-updatawillbecollected1and13 weeks afterthefinalmusictherapysession.Acost-effectivenessanalysiswillalsobecarriedout. Discussion. This study will be the largest trial to date examining the effect of music therapy on young people experiencing social, emotional or behavioural difficulties and will provide empirical evidence for the use of music therapy among this population. Trial registration. This study is registered in theISRCTNRegister,ISRCTN96352204. Ethical approval was gained in October 2010.

Globalization, Plurilingualism and Young Learners in Mexico and Beyond

In the 21st century the teaching of English to young learners (TEYL) has become a truly global phenomenon. It is therefore important to deepen our understanding of the lived experience of TEYL in the very different settings where it is being taught. The 11 research-led accounts included in this volume are by TEYL teachers, teacher educators and other important stakeholders in a range of contexts around the world. The accounts span a variety of topics and issues in TEYL, each of personal importance to the authors themselves, and resonant with TEYL educators everywhere. The fresh practical and theoretical perspectives on different facets of TEYL that the chapters offer provide teachers and researchers with a set of stimulating ideas which can inform debate and pedagogical innovation in all areas of language teaching and educational research.

Holocene climate change, vegetation history and human impact in the Central Mediterranean: evidence from the Maltese Islands

Holocene climates and human impact in the Mediterranean basin have received much attention, but the Maltese Islands in the Central Mediterranean, although a pivotal area, have been little researched. Here, sedimentary and palynological data are presented for three cores from the Holocene coastal and shallowmarine
deposits of the Maltese Islands. These show deforestation from Pinus-Cupressaceae woodland in the early Neolithic, and then a long, but relatively stable history of agriculturally degraded environments to the present day. The major climate events which have affected the Italian and Balkan peninsulas to the
north, and Tunisia to the south, are not reflected in the pollen diagrams from the Maltese Islands because of the strong anthropogenic imprint on the Maltese vegetation from early in the Neolithic. Previous suggestions of environmentally-driven agricultural collapse at the end of the Neolithic appear, however,
to be substantiated and may be linked to regional aridification around 4300 cal. BP. Depopulation in early Medieval times is not supported by the current palynological evidence.

Risk of fatal injury in older adult drivers, passengers, and pedestrians

Objectives To compare risk of fatal injury in elderly road users (drivers, passengers, pedestrians) with that of younger age groups and to assess the contribution of elderly road users to the number of reported fatalities in the population. Design Fatality age was categorized as 21 to 29, 30 to 39, 40 to 49, 50 to 59, 60 to 69, or 70 and older, and road user was categorized as driver, passenger, or pedestrian. Estimated number of trips made by each age group was used to adjust for exposure and to measure individual risk. Setting Fatalities recorded in Britain between 1989 and 2009. Participants Population-wide fatal injury counts in Britain. Measurements Age of fatally injured drivers, passengers, and pedestrians. Estimated number of trips made per year by drivers, passengers, and pedestrians. Results Risk of fatal injury, but not fatality numbers in the population, were higher for older adult (=70) drivers than for younger age groups. Risk of fatal injury was also high for older adult passengers and pedestrians, who represented the majority of older adult fatalities. Conclusion Previous emphasis on driver impairment in older age has unduly focussed attention on elderly drivers, who represent a minority of all driver fatalities. Older adults represent a much larger proportion of passenger and pedestrian fatalities. Additional policy schemes and initiatives should be targeted at safeguarding older adult passengers and making the road environment safer for elderly pedestrians. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

Glacial to paraglacial history and forest recovery in the Oglio glacier system (Italian Alps) between 26 and 15 ka cal BP

The integrated stratigraphic, radiocarbon and palynological record from an end-moraine system of the Oglio valley glacier (Italian Alps), propagating a lobe upstream in a lateral reach, provided evidence for a complete cycle of glacial advance, culmination and withdrawal during the Last Glacial Maximum and early Lateglacial. The glacier culminated in the end moraine shortly after 25.8 +/- 0.8 ka cal BP, and cleared the valley floor 18.3-17.2 +/- 0.3 ka cal BP. A primary paraglacial phase is then recorded by fast progradation of the valley floor.

As early as 16.7 +/- 0.3 ka cal BP, early stabilization of alluvial fans and lake filling promoted expansion of cembran pine. This is an unprecedented evidence of direct tree response to depletion of paraglacial activity during the early Lateglacial, and also documents the cembran pine survival in the mountain belt of the Italian Alps during the last glaciation. Between 16.1 and 14.6 +/- 0.5 ka cal BP, debris cones emplacement points to a moisture increase favouring tree Betula and Pinus sylvestris-mugo. A climate perturbation renewed paraglacial activity. According to cosmogenic ages on glacial deposits and AMS radiocarbon ages from lake records in South-Eastern Alps such phase compares favourably with the Gschnitz stadial and with the oscillations recorded at lakes Ragogna. Langsee and Jeserzersee, most probably forced by the latest freshening phases of the Heinrich Event 1.

A further sharp pine rise marks the subsequent onset of Bolling interstadial. The chronology of the Oglio glacier compares closely with major piedmont glaciers on the Central and Eastern Alpine forelands. On the other hand, the results of the present study imply a chronostratigraphic re-assessment of the recent geological mapping of the Central Italian Alps. (C) 2012 Elsevier Ltd. All rights reserved.

'One cut too many?' History and film: a practice-based case study

This article explores the different ways that film-makers and historians approach the narrating of the past. It draws upon a collaborative, practice-based case study of a feature film project, The enigma of Frank Ryan, in order to explore the role of the history film as a vehicle for extending historical understanding. In the dialogue between film-maker and historian, a range of issues regarding the import of the history film for the practice or 'poetics' of history is explored.

Dietary exposure to aflatoxin from maize and groundnut in young children from Benin and Togo, West Africa

Aflatoxins are a family of fungal toxins that are carcinogenic to man and cause immunosuppression, cancer and growth reduction in animals. We conducted a cross-sectional study among 480 children (age 9 months to 5 years) across 4 agroecological zones (SS, NGS, SGS and CS) in Benin and Togo to identify the effect of aflatoxin exposure on child growth and assess the pattern of exposure. Prior reports on this study [Gong, Y.Y., Cardwell, K., Hounsa, A., Egal, S., Turner, Hall, A.J., Wild, C.P., 2002. Dietary aflatoxin exposure and impaired growth in young children from Benin and Togo: cross sectional study. British Medical Journal 325, 20-21, Gong, Y.Y., Egal, S., Hounsa, A., Turner, P.C., Hall, A.J., Cardwell, K., Wild, C.P., 2003. Determinants of aflatoxin exposure in young children from Benin and Togo, West Africa: the critical role of weaning and weaning foods. International Journal of Epidemiology, 32, 556-562] showed that aflatoxin exposure among these children is widespread (99%) and that growth faltering is associated with high blood aflatoxinalbumin adducts (AF-alb adducts), a measure of recent past exposure. The present report demonstrates that consumption of maize is an important source of aflatoxin exposure for the survey population. Higher AF-alb adducts were correlated with higher A. flavus (CFU) infestation of maize (p=0.006), higher aflatoxin contamination (ppb) of maize (p<0.0001) and higher consumption frequencies of maize (p=0.053). The likelihood of aflatoxin exposure from maize was particularly high in agro-ecological zones where the frequency of maize consumption (SGS and CS), the presence of allatoxin in maize (SGS) or the presence of A. flavus on maize (NGS and SGS) was relatively high. Socio-economic background did not affect the presence of A. flavus and aflatoxin in maize, but better maternal education was associated with lower frequencies of maize consumption among children from the northernmost agro-ecological zone (SS) (p=0.001). The impact of groundinit consumption on aflatoxin exposure was limited in this population. High AF-alb adduct levels were correlated with high prevalence of A. flavus and aflatoxin in groundinit, but significance was weak after adjustment for weaning status, agro-ecological zone and maternal socio-economic status (resp. p = 0.091 and p = 0.083). Ingestion of A. flavus and aflatoxin was high in certain agro-ecological zones (SS and SGS) and among the higher socio-economic strata due to higher frequencies of groundnut consumption. Contamination of groundnuts was similar across socio-economic and agroecological boundaries.

In conclusion, dietary exposure to aflatoxin from groundnut was less than from maize in young children from Benin and Togo. Intervention strategies that aim to reduce dietary exposure in this population need to focus on maize consumption in particular, but they should not ignore consumption of groundnuts. (c) 2005 Elsevier B.V. All rights reserved.

Determinants of aflatoxin exposure in young children from Benin and Togo, West Africa: the critical role of weaning

Background Dietary exposure to high levels of the fungal toxin, aflatoxin, occurs in West Africa, where long-term crop storage facilitates fungal growth.

Methods We conducted a cross-sectional study in Benin and Togo to investigate aflatoxin exposure in children around the time of weaning and correlated these data with food consumption, socioeconomic status, agro-ecological zone of residence, and anthropometric measures. Blood samples from 479 children (age 9 months to 5 years) from 16 villages in four agro-ecological zones were assayed for aflatoxin-albumin adducts (AF-alb) as a measure of recent past (2-3 months) exposure.

Results Aflatoxin-albumin adducts were detected in 475/479 (99%) children (geometric mean 32.8 pg/mg, 95% CI: 25.3-42.5). Adduct levels varied markedly across agro-ecological zones with mean levels being approximately four times higher in the central than in the northern region. The AF-alb level increased with age up to 3 years, and within the 1-3 year age group was significantly (P=0.0001) related to weaning status; weaned children had approximately twofold higher mean AF-alb adduct levels (38 pg AF-lysine equivalents per mg of albumin [pg/mg]) than those receiving a mixture of breast milk and solid foods after adjustment for age, sex, agro-ecological zone, and socioeconomic status. A higher frequency of maize consumption, but not groundnut consumption, by the child in the preceding week was correlated with higher AF-alb adduct level. We previously reported that the prevalence of stunted growth (height for age Z-score HAZ) and being underweight (weight for age Z-score WAZ) were 33% and 29% respectively by World Health Organziation criteria. Children in these two categories had 30-40% higher mean AF-alb levels than the remainder of the children and strong dose- response relationships were observed between AF-alb levels and the extent of stunting and being underweight.

Conclusions Exposure to this common toxic contaminant of West African food increases markedly following weaning and exposure early in life is associated with reduced growth. These observations reinforce the need for aflatoxin exposure intervention strategies within high-risk countries, possibly targeted specifically at foods used in the post-weaning period.