Knowledge, attitudes and beliefs of parents regarding fever in children: a Danish interview study

Aim: Fever and febrile illness are some of the most common conditions managed by parents. The aim of this study was to examine the knowledge, attitudes and beliefs of parents around fever in children under five years of age. Methods: Between July and August 2014, a convenience sample of parents was invited to participate in this study in Copenhagen, Denmark. Results were analysed thematically using a constant comparison method. Results: Twenty-one parents participated in the study. Five themes emerged from the data: parental concern, help-seeking behaviour, parental knowledge, parent fever management practices and initiatives. Parents used a range of information sources to obtain their knowledge on management of fever; however, due to issues of trust with these sources, reassurance was often sought from healthcare practitioners. There was a desire amongst most parents for initiatives to be introduced which provide general information on how to manage fever in children. Conclusion: Parents were very concerned when their child was febrile and instigated practices obtained from accessible information sources. This study has identified a need for specific and reliable information initiatives to be introduced as a means of reducing parental concern and ensuring evidence-based strategies for managing a child with fever.

Perceptions of European medical staff on the facilitators and barriers to physical closeness between parents and infants in neonatal units

AIM: Studies have provided insights into factors that may facilitate or inhibit parent-infant closeness in neonatal units, but none have specifically focused on the perspectives of senior neonatal staff. The aim of this study was to explore perceptions and experiences of consultant neonatologists and senior nurses in five European countries with regard to these issues. METHODS: Six small group discussions and three one-to-one interviews were conducted with 16 consultant neonatologists and senior nurses representing nine neonatal units from Estonia, Finland, Norway, Spain and Sweden. The interviews explored facilitators and barriers to parent-infant closeness and implications for policy and practice and thematic analysis was undertaken. RESULTS: Participants highlighted how a humanising care agenda that enabled parent-infant closeness was an aspiration, but pointed out that neonatal units were at different stages in achieving this. The facilitators and barriers to physical closeness included socio-economic factors, cultural norms, the designs of neonatal units, resource issues, leadership, staff attitudes and practices and relationships between staff and parents. CONCLUSION: Various factors affected parent-infant closeness in neonatal units in European countries. There needs to be the political motivation, appropriate policy planning, legislation and resource allocation to increase measures that support closeness agendas in neonatal units. This article is protected by copyright. All rights reserved.

Avaliação da eficiência do sistema de abastecimento de água da APA

A água é um recurso essencial e escasso, como tal, é necessário encontrar medidas que permitam o seu uso de modo sustentável e garantam a proteção do meio ambiente. Devido a esta crescente preocupação assiste-se a um movimento legislativo, nacional e internacional, no sentido de garantir o desenvolvimento sustentável. Surge assim, a Diretiva Quadro da Água e a Lei da Água, que é complementada com legislação diversa. Como elemento constituinte do ciclo urbano da água, os Sistemas de Abastecimento têm sofrido evoluções nem sempre adequadas. É neste contexto que, em Portugal, nascem as diversas ferramentas para a melhoria da gestão dos recursos hídricos. As Entidades Gestoras têm como finalidade a gestão eficiente do bem água, e dispõe de dois importantes instrumentos, o Programa Nacional para o Uso Eficiente da Água e o Guia para o “controlo de perdas de água em sistemas públicos de adução e distribuição”(ERSAR). Esta Gestão passa, não só pela abordagem da problemática das perdas de água, reais e aparentes, como também pela análise do comportamento que origina o desperdício. A APA, enquanto entidade gestora, procura maximizar a eficiência do seu sistema de abastecimento, para tal, foram aplicadas as ferramentas propostas pelo ERSAR. Concluindo-se que este sistema tem um total de perdas de água de 34%, devendo-se estas perdas essencialmente ao envelhecido parque de contadores e perdas nos ramais de distribuição (teórico). As perdas comerciais representam cerca de 69%, o que revela que os volumes de água não faturados (medidos ou não) são muito elevados. Por outro lado, a realização do cálculo do Balanço Hídrico e dos índices de desempenho permitem classificar a performance do sistema de abastecimento e compará-la com os seus objetivos de gestão. Atendendo ao volume de água perdido nos ramais, foram efetuadas medições noturnas, verificando-se que no Porto de Pesca Costeira existe um volume de água escoado não justificado. Neste sentido, elaborou-se um plano de ação para aumentar a eficiência do sistema, ou seja, reduzir as perdas totais de 34% para 15%.

Changes in the appearance of stimuli of very high luminance

"Evidence concerning the absorption of light quanta by visual pigment molecules is used to derive a theoretical relationship between the parameters of light incident on the retina and the output of the receptor cells. This relationship leads to the following prediction: when two retinal areas are illuminated, one very intensely and the other still more intensely, there will be a period of time during which the less intensely illuminated region will appear brighter than the more intensely illuminated one. Data verifying this prediction are presented. When the theoretical treatment is expanded to include certain assumptions about retinal color mechanisms, it provides an explanation of some of the changes in hue that occur when a very intense colored stimulus is viewed steadily." (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1962 American Psychological Association.

High alkaline phosphatase activity in phosphate replete waters: The case of two macrotidal estuaries

The occurrence of alkaline phosphatase activity (APA) that hydrolyses organic phosphorus into phosphate (PO4) is commonly related to PO4 deficiency of oceanic, coastal and fresh waters. APA is almost never investigated in PO4-rich estuaries, since very low activities are expected to occur. As a consequence, microbial mineralization of organic phosphorus into PO4 has often been ignored in estuaries. In this study, we examined the importance of potential APA and the associated microbial dynamics in two estuaries, the Aulne and the Elorn (Northwestern France), presenting two different levels of PO4 concentrations. Unexpected high potential APA was observed in both estuaries. Values ranged from 50 to 506 nmol L−1 h−1, which range is usually found in very phosphorus-limited environments. High potential APA values were observed in the oligohaline zone (salinity 5–15) in spring and summer, corresponding to a PO4 peak and a maximum bacterial production of particle-attached bacteria. In all cases, high potential APA was associated with high suspended particulate matter and total particulate phosphorus. The low contribution of the 0.2–1 μm fraction to total APA, the strong correlation between particulate APA and bacterial biomass, and the close relationship between the production of particle-attached bacteria and APA, suggested that high potential APA is mainly due to particle-attached bacteria. These results suggest that the microbial mineralization of organic phosphorus may contribute to an estuarine PO4 production in spring and summer besides physicochemical processes.

Shifting development in mid-childhood: the influence of between-task interference

Performance on the task-switching paradigm is greatly affected by the amount of conflict between tasks. Compared to adults, children appear to be particularly influenced by this conflict, suggesting that the ability to resolve interference between tasks improves with age. We used the task-switching paradigm to investigate how this ability develops in mid-childhood. Experiment 1 compared 5- to 8-year-olds’ and 9- to 11-year-olds’ ability to switch between decisions about the colour of an object and its shape. The 5- to 8-year-olds were slower to switch task and experienced more interference from the irrelevant task than the 9-to 11-year-olds, suggesting a developmental improvement in resolving conflict between tasks during mid-childhood. Experiment 2 explored this further, examining the influence of stimulus and response interference at different ages. This was done by separating the colour and shape dimensions of the stimulus and reducing overlap between responses. The results supported the development of conflict resolution in task-switching during mid-childhood. They also revealed that a complex interplay of factors, including the tasks used and previous experience with the task, affected children’s shifting performance.

MicroRNA modulation of aldosterone production in the adrenal gland

Hypertension is the major risk factor for coronary disease worldwide. Primary hypertension is idiopathic in origin but is thought to arise from multiple risk factors including genetic, lifestyle and environmental influences. Secondary hypertension has a more definite aetiology; its major single cause is primary aldosteronism (PA), the greatest proportion of which is caused by aldosteroneproducing adenoma (APA), where aldosterone is synthesized at high levels by an adenoma of the adrenal gland. There is strong evidence to show that high aldosterone levels cause adverse effects on cardiovascular, cerebrovascular, renal and other systems. Extensive studies have been conducted to analyse the role that regulation of CYP11B2, the gene encoding the aldosterone synthase enzyme plays in determining aldosterone production and the development of hypertension. One significant regulatory factor that has only recently emerged is microRNA (miRNA). miRNAs are small non-coding RNAs, synthesized by a series of enzymatic processes, that negatively regulate gene expression at the posttranscriptional level. Detection and manipulation of miRNA is now known to be a viable method in the treatment, prevention and prognosis of certain diseases. The aim of the present study was to identify miRNAs likely to have a role in the regulation of corticosteroid biosynthesis. To achieve this, the miRNA profile of APA and normal human adrenal tissue was compared, as was the H295R adrenocortical cell line model of adrenocortical function, under both basal conditions and following stimulation of aldosterone production. Key differentially-expressed miRNAs were then identified and bioinformatic tools used to identify likely mRNA targets and pathways for these miRNAs, several of which were investigated and validated using in vitro methods. The background to this study is set out in Chapter 1 of this thesis, followed by a description of the major technical methods employed in Chapter 2. Chapter 3 presents the first of the study results, analysing differences in miRNA profile between APA and normal human adrenal tissue. Microarray was implemented to detect the expression of miRNAs in these two tissue types and several miRNAs were found to vary significantly and consistently between them. Furthermore, members of several miRNA clusters exhibited similar changes in expression pattern between the two tissues e.g. members of cluster miR-29b-1 (miR-29a-3p and miR-29b-3p) and of cluster miR-29b-2 (miR-29b-3p and miR-29c- 3p) are downregulated in APA, while members of cluster let-7a-1 (let-7a-5p and let-7d-5p), cluster let-7a-3 (let-7a-5p and let-7b-5p) and cluster miR-134 (miR- 134 and miR-382) are upregulated. Further bioinformatic analysis explored the possible biological function of these miRNAs using Ingenuity® Systems Pathway Analysis software. This led to the identification of validated mRNAs already known to be targeted by these miRNAs, as well as the prediction of other mRNAs that are likely targets and which are involved in processes relevant to APA pathology including cholesterol synthesis (HMGCR) and corticosteroidogenesis (CYP11B2). It was therefore hypothesised that increases in miR-125a-5p or miR- 335-5p would reduce HMGCR and CYP11B2 expression. Chapter 4 describes the characterisation of H295R cells of different strains and sources (H295R Strain 1, 2, 3 and HAC 15). Expression of CYP11B2 was assessed following application of 3 different stimulants: Angio II, dbcAMP and KCl. The most responsive strain to stimulation was Strain 1 at lower passage numbers. Furthermore, H295R proliferation increased following Angio II stimulation. In Chapter 5, the hypothesis that increases in miR-125a-5p or miR-335-5p reduces HMGCR and CYP11B2 expression was tested using realtime quantitative RT-PCR and transfection of miRNA mimics and inhibitors into the H295R cell line model of adrenocortical function. In this way, miR-125a-5p and miR-335-5p were shown to downregulate CYP11B2 and HMGCR expression, thereby validating certain of the bioinformatic predictions generated in Chapter 3. The study of miRNA profile in the H295R cell lines was conducted in Chapter 6, analysing how it changes under conditions that increase aldosterone secretion, including stimulation Angiotensin II, potassium chloride or dibutyryl cAMP (as a substitute for adrenocorticotropic hormone). miRNA profiling identified 7 miRNAs that are consistently downregulated by all three stimuli relative to basal cells: miR-106a-5p, miR-154-3p, miR-17-5p, miR-196b-5p, miR-19a-3p, miR-20b- 5p and miR-766-3p. These miRNAs include those derived from cluster miR-106a- 5p/miR-20b-5p and cluster miR-17-5p/miR-19a-3p, each producing a single polycistronic transcript. IPA bioinformatic analysis was again applied to identify experimentally validated and predicted mRNA targets of these miRNAs and the key biological pathways likely to be affected. This predicted several interactions between miRNAs derived from cluster miR-17-5p/miR-19a-3p and important mRNAs involved in cholesterol biosynthesis: LDLR and ABCA1. These predictions were investigated by in vitro experiment. miR-17-5p/miR-106a-p and miR-20b-5p were found to be consistently downregulated by stimulation of aldosterone biosynthesis. Moreover, miR-766-3p was upregulation throughout. Furthermore, I was able to validate the downregulation of LDLR by miR-17 transfection, as predicted by IPA. In summary, this study identified key miRNAs that are differentially-expressed in vivo in cases of APA or in vitro following stimulation of aldosterone biosynthesis. The many possible biological actions these miRNAs could have were filtered by bioinformatic analysis and selected interactions validated in vitro. While direct actions of these miRNAs on steroidogenic enzymes were identified, cholesterol handling also emerged as an important target and may represent a useful point of intervention in future therapies designed to modulate aldosterone biosynthesis and reduce its harmful effects.

The women role in the agroenvironmental activities of Amazon agroforeststry systems.

This paper presents the results of a research on the way which shows the role of the farmer women to contribute to overcome the life hindrances in the Amazonian agroforest environment, for food safety and familiar income. The sample was the women of the Associação de Produtores Alternativos - APA, Ouro Preto do Oeste, Rondônia, Brazil. Questionnaires were applied to 50 women of this community, in 2004/2005, with additional interviews in 2006, taking into account their role in the farms, and their several invisible activities. The role of APA?s women was compared to that of other Amazonian women, like rubber tappers and riverine people. The APA?s women perform tasks as field manpower - 78.0% of them, making decisions about what to plant - 18.0%, harvest destination - 32.0%, which animals to raise -14.0% and animal products destination -34.0%. Traditionally, in rural zone, the women with their children play a role as non-paid manpower, getting some monetary income with occasional commercialization of on-farm processed products as cheese, pickles, jellies and fruit liqueurs. They are responsible for the cultures practiced around the house. All these Amazonian women edaphoclimatic conditions, greatly contributing to the biodiversity, conservation, and to ecological, social and economic stability.are guardians, perpetuators and disseminators of a rich germplasm adapted to local.

ROTEIROS (ECO) TURÍSTICOS EM ÁREAS PROTEGIDAS DA AMAZÔNIA: PLICAÇÃO DO SISTEMA DE INFORMAÇÃO GEOGRÁFICA (SIG) NA APA ALGODOAL/MAIANDEUA, PARÁ, BRASIL.

O uso de recursos naturais para a composição de roteiros (eco) turísticos é uma premissa fundamental para o planejamento de áreas com apelo turístico. Na Amazônia brasileira, o uso do Sistema de Informação Geográfica como instrumento de planejamento turístico ainda é pouco utilizada. O objetivo deste trabalho foi de apresentar o uso de recursos tecnológicos na composição de roteiros (eco) turísticos na APA de Algodoal/Maiandeua, Estado do Pará, Brasil, fazendo-se uso das trilhas existentes na região, demonstrando mapas e perfis de cada trilha. Foram utilizados suportes teóricos de Bahl (2004) e Nóbrega (2007, 2008) para uma discussão conceitual sobre planejamento, roteiros e turismo. Acerca dos aspectos do SIG, teóricos como Nodari et. al.(2006) e Rocha (2002) deram suporte para o diálogo sobre o tema em questão. Acerca da metodologia, foram utilizadas pesquisas bibliográficas do tipo exploratórias, coleta de dados com o suporte GPS – Garmin eTrex Vista HCx, além do uso do Software ArcGIS 9.2 para construção dos mapas digitais com base nos dados obtidos. Percebeu-se que a elaboração de roteiros (eco) turísticos sob o uso do SIG pode ser um grande aliado para o planejamento turístico na Amazônia brasileira.

PLANEJAMENTO AMBIENTAL COMO SUBSÍDIO PARA O ORDENAMENTO TERRITORIAL DA APA DE BALBINO-CASCAVEL-CEARÁ

As políticas ambientais ao longo do percurso histórico sofreram alterações de acordo com a necessidade do meio ambiente, assim as unidades de conservação referenciadas na Lei do Sistema Nacional de Unidades de Conservação (SNUC) propõe a necessidade da realização do Plano de Manejo como forma de planejamento do território. Porém existem áreas que não se desenvolvem com o que se é proposto, a exemplo da APA de Balbino-Cacavel, CE. A Área de Proteção Ambiental de Balbino em Cascavel-CE foi estabelecida pela Lei Nº 479 de 21 de setembro de 1988, tendo como finalidade proteger, conservar e melhorar o meio ambiente, mantendo seu ecossistema natural além do valor histórico e paisagístico. Partindo dessas iniciativas pretende-se  propor ações ordenadas para o território, para que assim os órgãos competente estabeleçam o Plano de Manejo em âmbito socioambiental. Nesse sentido a Geoecologia da Paisagem permite estudar a integração entre a natureza e a sociedade, em seus aspectos estruturais e funcionais,  tendo na teoria e metodologia subsídios para elaboração do planejamento ambiental, sendo uma forma de gestão e ordenamento territorial, direcionado principalmente para áreas propícias ao uso inadequado.

Pipkiiα Is Widely Expressed In Hematopoietic-derived Cells And May Play A Role In The Expression Of Alpha- And Gamma-globins In K562 Cells.

Characterized for the first time in erythrocytes, phosphatidylinositol phosphate kinases (PIP kinases) belong to a family of enzymes that generate various lipid messengers and participate in several cellular processes, including gene expression regulation. Recently, the PIPKIIα gene was found to be differentially expressed in reticulocytes from two siblings with hemoglobin H disease, suggesting a possible relationship between PIPKIIα and the production of globins. Here, we investigated PIPKIIα gene and protein expression and protein localization in hematopoietic-derived cells during their differentiation, and the effects of PIPKIIα silencing on K562 cells. PIPKIIα silencing resulted in an increase in α and γ globins and a decrease in the proliferation of K562 cells without affecting cell cycle progression and apoptosis. In conclusion, using a cell line model, we showed that PIPKIIα is widely expressed in hematopoietic-derived cells, is localized in their cytoplasm and nucleus, and is upregulated during erythroid differentiation. We also showed that PIPKIIα silencing can induce α and γ globin expression and decrease cell proliferation in K562 cells.

The Clinical Impact Of Cerebellar Grey Matter Pathology In Multiple Sclerosis.

The cerebellum is an important site for cortical demyelination in multiple sclerosis, but the functional significance of this finding is not fully understood. To evaluate the clinical and cognitive impact of cerebellar grey-matter pathology in multiple sclerosis patients. Forty-two relapsing-remitting multiple sclerosis patients and 30 controls underwent clinical assessment including the Multiple Sclerosis Functional Composite, Expanded Disability Status Scale (EDSS) and cerebellar functional system (FS) score, and cognitive evaluation, including the Paced Auditory Serial Addition Test (PASAT) and the Symbol-Digit Modalities Test (SDMT). Magnetic resonance imaging was performed with a 3T scanner and variables of interest were: brain white-matter and cortical lesion load, cerebellar intracortical and leukocortical lesion volumes, and brain cortical and cerebellar white-matter and grey-matter volumes. After multivariate analysis high burden of cerebellar intracortical lesions was the only predictor for the EDSS (p<0.001), cerebellar FS (p = 0.002), arm function (p = 0.049), and for leg function (p<0.001). Patients with high burden of cerebellar leukocortical lesions had lower PASAT scores (p = 0.013), while patients with greater volumes of cerebellar intracortical lesions had worse SDMT scores (p = 0.015). Cerebellar grey-matter pathology is widely present and contributes to clinical dysfunction in relapsing-remitting multiple sclerosis patients, independently of brain grey-matter damage.

Dna Extraction From Filter-paper Spots Of Vaginal Samples Collected After Sexual Violence.

To detect the presence of male DNA in vaginal samples collected from survivors of sexual violence and stored on filter paper. A pilot study was conducted to evaluate 10 vaginal samples spotted on sterile filter paper: 6 collected at random in April 2009 and 4 in October 2010. Time between sexual assault and sample collection was 4-48hours. After drying at room temperature, the samples were placed in a sterile envelope and stored for 2-3years until processing. DNA extraction was confirmed by polymerase chain reaction for human β-globin, and the presence of prostate-specific antigen (PSA) was quantified. The presence of the Y chromosome was detected using primers for sequences in the TSPY (Y7/Y8 and DYS14) and SRY genes. β-Globin was detected in all 10 samples, while 2 samples were positive for PSA. Half of the samples amplified the Y7/Y8 and DYS14 sequences of the TSPY gene and 30% amplified the SRY gene sequence of the Y chromosome. Four male samples and 1 female sample served as controls. Filter-paper spots stored for periods of up to 3years proved adequate for preserving genetic material from vaginal samples collected following sexual violence.

Analysis Of The Dna Fourier Transform-infrared Microspectroscopic Signature Using An All-reflecting Objective.

The Fourier transform-infrared (FT-IR) signature of dry samples of DNA and DNA-polypeptide complexes, as studied by IR microspectroscopy using a diamond attenuated total reflection (ATR) objective, has revealed important discriminatory characteristics relative to the PO2(-) vibrational stretchings. However, DNA IR marks that provide information on the sample's richness in hydrogen bonds have not been resolved in the spectral profiles obtained with this objective. Here we investigated the performance of an all reflecting objective (ARO) for analysis of the FT-IR signal of hydrogen bonds in DNA samples differing in base richness types (salmon testis vs calf thymus). The results obtained using the ARO indicate prominent band peaks at the spectral region representative of the vibration of nitrogenous base hydrogen bonds and of NH and NH2 groups. The band areas at this spectral region differ in agreement with the DNA base richness type when using the ARO. A peak assigned to adenine was more evident in the AT-rich salmon DNA using either the ARO or the ATR objective. It is concluded that, for the discrimination of DNA IR hydrogen bond vibrations associated with varying base type proportions, the use of an ARO is recommended.

Antiangiogenic And Finasteride Therapies: Responses Of The Prostate Microenvironment In Elderly Mice.

The aim of this study was to evaluate the structural and molecular effects of antiangiogenic therapies and finasteride on the ventral prostate of senile mice. 90 male FVB mice were divided into: Young (18 weeks old) and senile (52 weeks old) groups; finasteride group: finasteride (20mg/kg); SU5416 group: SU5416 (6 mg/kg); TNP-470 group: TNP-470 (15 mg/kg,) and SU5416+TNP-470 group: similar to the SU5416 and TNP-470 groups. After 21 days, prostate ventral lobes were collected for morphological, immunohistochemical and Western blotting analyses. The results demonstrated atrophy, occasional proliferative lesions and inflammatory cells in the prostate during senescence, which were interrupted and/or blocked by treatment with antiangiogenic drugs and finasteride. Decreased AR and endostatin reactivities, and an increase for ER-α, ER-β and VEGF, were seen in the senile group. Decreased VEGF and ER-α reactivities and increased ER-β reactivity were verified in the finasteride, SU5416 groups and especially in SU5416+TNP-470 group. The TNP-470 group showed reduced AR and ER-β protein levels. The senescence favored the occurrence of structural and/or molecular alterations suggesting the onset of malignant lesions, due to the imbalance in the signaling between the epithelium and stroma. The SU5416+TNP-470 treatment was more effective in maintaining the structural, hormonal and angiogenic factor balance in the prostate during senescence, highlighting the signaling of antiproliferation via ER-β.