Hospital-related fears and coping strategies in 4-6-year-old children

There is only little information available on the 4-6-year-old child s hospital-related fears, and on the coping with such fears, as expressed by the children themselves. However, previous data collected from parents and hospital personnel indicate that hospitalization is an anxiety-producing experience for young children. The purpose of this study was to describe the experience of hospital-related fears and the experience of coping with hospital-related fears of 4-6-year-old children. The aim of this study was to form a descriptive model of the subjective experience of hospital-related fears and coping strategies of 4-6-year old children. The data were collected by interviewing 4-6-year-old children from a hospital and kindergarten settings in Finland from 2004 to 2006. Ninety children were interviewed in order to describe the hospital-related fear and the experience of fear, and 89 to describe their coping with the fear and the experience of coping. The children were chosen through purposive sampling. The data were gathered by semi-structured interview, supported by pictures. The data about hospital-related fears and on strategies for coping with hospital-related fears were reviewed by qualitative and quantitative methods. The experience of hospital-related fears and coping with these fears were analyzed using Colaizzi s Method of Phenomenological Analysis. The results revealed that more than 90 % of the children said they were afraid of at least one thing in hospital. Most of the fears could be categorized as nursing interventions, fears of being a patient, and fears caused by the developmental stage of the child. Children interviewed in the hospital expressed substantially more fears than children interviewed in kindergarten. Children s meanings of hospital-related fears were placed into four main clusters: 1) insecurity, 2) injury, 3) helplessness, 4) and rejection. The results also showed that children have plenty of coping strategies, to deal with their fears, especially such strategies in which the children themselves play an active role. Most often mentioned coping strategies were 1) the presence of parents and other family members, 2) the help of the personnel, 3) positive images and humour, 4) play, and 5) the child s own safety toy. The children interviewed in the hospital mentioned statistically significantly more often play, positive imagination and humour as their coping strategy than children interviewed in kindergarten. The meaning of coping with hospital fears consisted of six clusters: pleasure, security, care, understanding the meaning of the situation participating, and protecting oneself. Being admitted to a hospital is an event which may increase the fears of a 4-6-year-old child. Children who have personal experience of being admitted to a hospital describe more fears than healthy children in kindergarten. For young children, hospital-related fear can be such a distressing experience that it reflects on their feelings of security and their behaviour. Children can sometimes find it difficult to admit their fear. Children need the help of adults to express their hospital-related fears, the objects of the fears, and to cope with the fears. Personnel should be aware of children s fears and support them in the use of coping strategies. In addition to the experiences of security and care, pre-school-aged children need active coping strategies that they can use themselves, regardless of the presence of the parents or nurses. Most of all, children need the possibility to play and experience pleasure. Children can also be taught coping strategies which give them an active, positive role.

Early life determinants of atopy : A 20-year prospective follow-up study on unselected, healthy newborns

Atopy-related allergic diseases, i.e. allergic rhinoconjunctivitis, atopic dermatitis and asthma, have increased in frequency in the industrialized countries. In order to reverse this trend, effective preventive strategies need to be developed. This requires a better understanding of the early-life events leading to the expression of the atopic phenotype. The present study has aimed at defining early-life factors and markers associated with the subsequent development of allergic diseases in a cohort of 200 healthy, unselected Finnish newborns prospectively followed up from birth to age 20 years. Their mothers were encouraged to start and maintain exclusive breastfeeding as long as it was nutritionally sufficient for the infant. Consequently, all the infants received some duration of exclusive breastfeeding, 58% of the infants were on exclusive breastfeeding for the first 6 months of life, and 18% received this feeding at least for the first 9 months. Of the infants, 42% had a family history of allergy. After the first year of follow-up, the children were re-assessed at ages 5, 11 and 20 years with clinical examination, skin prick testing, and parental and personal interviews. Exclusive breastfeeding for over 9 months was associated with atopic dermatitis and symptoms of food hypersensitivity at age 5 years, and with symptoms of food hypersensitivity at age 11 years in the children with a familial allergy. Subjects with allergic symptoms or a positive skin prick test in childhood or adolescence had lower retinol concentrations during their infancy and childhood than others. An elevated cord serum immunoglobulin E concentration predicted subsequent atopic manifestations though with modest sensitivity. Children and adolescents with allergic symptoms, skin prick test positivity and an elevated IgE had lower total cholesterol levels in infancy and childhood than the nonatopic subjects. In conclusion, prolonging strictly exclusive breastfeeding for over 9 months of age was not of help in prevention of allergic symptoms; instead, it was associated with increased atopic dermatitis and food hypersensitivity symptoms in childhood. Due to the modest sensitivity, cord serum IgE is not an effective screening method for atopic predisposition in the general population. Retinol and cholesterol concentrations in infancy were inversely associated with the subsequent development of allergic symptoms. Based on these findings, it is proposed that there may be differences in the inborn regulation of retinol and cholesterol levels in children with and without a genetic susceptibility to atopy, and these may play a role in the development of atopic sensitization and allergic diseases.

Evolution, Homology Conservation, and Identification of Unique Sequence Signatures in GH19 Family Chitinases

The discovery of GH (Glycoside Hydrolase) 19 chitinases in Streptomyces sp. raises the possibility of the presence of these proteins in other bacterial species, since they were initially thought to be confined to higher plants. The present study mainly concentrates on the phylogenetic distribution and homology conservation in GH19 family chitinases. Extensive database searches are performed to identify the presence of GH19 family chitinases in the three major super kingdoms of life. Multiple sequence alignment of all the identified GH19 chitinase family members resulted in the identification of globally conserved residues. We further identified conserved sequence motifs across the major sub groups within the family. Estimation of evolutionary distance between the various bacterial and plant chitinases are carried out to better understand the pattern of evolution. Our study also supports the horizontal gene transfer theory, which states that GH19 chitinase genes are transferred from higher plants to bacteria. Further, the present study sheds light on the phylogenetic distribution and identifies unique sequence signatures that define GH19 chitinase family of proteins. The identified motifs could be used as markers to delineate uncharacterized GH19 family chitinases. The estimation of evolutionary distance between chitinase identified in plants and bacteria shows that the flowering plants are more related to chitinase in actinobacteria than that of identified in purple bacteria. We propose a model to elucidate the natural history of GH19 family chitinases.

The Politics and Policies of Reproductive Agency

This study examines the politics and policies of reproductive agency through a redescription of three Finnish policy documents dealing with the declining birth rate: the Government report on the future 'Finland for people of all ages' (2004), Business and Policy Forum EVA report 'Condemned to Diminish?' (Tuomitut vähenemään?) (2003), and the Family Federation's 'Population Policy Program' (2004). The redescription is done with the help of the notion of reproductive agency, which draws on Drucilla Cornell's concepts of the imaginary domain and bodily integrity. The imaginary domain is the moral and psychic space people need in order to form their personality, which is created in constant identificatory processes. The aim of the processes is imaginary coherence. As the personality is embodied, forming one s imaginary coherence always includes attempts for bodily integrity, also entailing attempts to arrive at an understanding of one's procreative capacities. Besides Cornell, I draw on Judith Butler's thinking and comprehend gender performatively as doing, and in relation to that agency as part of the performative process of one's personality. Reproductive agency is understood in this study as the possibilities to live differently the hegemonic forms of procreative life. I deal with three redescriptive themes: the family, economics and gender. The family is a central element in that it is considered the main location of reproduction. With regard to reproductive agency, the documents include problematic conceptions of the family. It is defined as a heterosexual, monogamous, conjugal relationship, which affects reproductive agency in that these notions do not allow for different modes of family life. The second prominent aspect, economics, features on two levels: the macroeconomic level of GDP, employment and competitiveness, and the level of family policies and concern about family finances. Macroeconomic-level argumentation is problematic in the context of reproductive agency because it implies that procreation is a duty of citizens, and thus has effects on values attached to reproductive potential. On the other hand, family policies may advance reproductive agency in supporting families financially. However, such policies also define how the family is understood, thereby affecting reproductive agency. The third theme, gender, intersects with many issues in the policy documents. All three texts consider the roles of men and women differently: women are primarily responsible for the family, and both men's and women's reproductive agency is affected in that the roles in the procreative process are predefined. EVA and the Family Federation see women as the main target of population policies, and consider it legitimate to try to change women s reproductive decisions. Implicit in the notion of reproductive agency is the idea that it should be possible to overcome and live differently the sex difference, but the three documents do not open up opportunities for that. The notion of reproductive agency makes it also possible to question the legitimacy of population policies in general and offers new perspectives on the vocabularies used in the three policy texts, providing insights into the values and logics that support the concepts.

The Biopolitics of Gender

This dissertation inquires into the relationship between gender and biopolitics. Biopolitics, according to Michel Foucault, is the mode of politics that is situated and exercised at the level of life. The dissertation claims that gender is a technology of biopower specific to the optimisation of the sexual reproduction of human life, deployed through the scientific and governmental problematisation of declining fertility rates in the mid-twentieth century. Just as Michel Foucault claimed that sexuality became a scientific and political discourse in the nineteenth century, gender has also since emerged in these fields. In this dissertation, gender is treated as neither a representation of sex nor a cultural construct or category of identity. Rather, a genealogy of gender as an apparatus of biopower in conducted. It demonstrates how scientific and theoretical developments in the twentieth century marshalled gender into the sex/sexuality apparatus as a new technology of liberal biopower. Gender, I argue, has become necessary for the Western liberal order to recapture and re-optimise the life-producing functions of sex that reproduce the very object of biopolitics: life. The concept of the life function is introduced to analyse the life-producing violence of the sex/sexuality/gender apparatus. To do this, the thesis rereads the work of Michel Foucault through Gilles Deleuze for a deeper grasp of the material strategies of biopower and how it produces categories of difference and divides population according to them. The work of Judith Butler, in turn, is used as a foil against which to rearticulate the question of how to examine gender genealogically and biopolitically. The dissertation then executes a genealogy of gender, tracing the changing rationalities of sex/sexuality/gender from early feminist thought, through mid-twentieth century sexological, feminist, and demographic research, to current EU policy. According to this genealogy, in the mid-twentieth century demographers perceived that sexuality/sex, which Foucault observed as the life-producing biopolitical apparatus, was no longer sufficiently disciplining human bodies to reproduce. The life function was escaping the grasp of biopower. The analysis demonstrates how gender theory was taken up as a means of reterritorialising the life function: nature would be disciplined to reproduce by controlling culture. The crucial theoretical and genealogical argument of the thesis, that gender is a discourse with biopolitical foundations and a technology of biopower, radically challenges the premises of gender theory and feminist politics, as well as the emancipatory potential often granted to the gender concept. The project asks what gender means, what biopolitical function it performs, and what is at stake for feminist politics when it engages with it. In so doing, it identifies biopolitics and the problem of life as possibly the most urgent arena for feminist politics today.

Relações de trabalho no espaço rural friburguense: pluriatividade e complexificação das relações sociais de produção

Esse estudo tem como objetivo analisar o fenômeno da pluriatividade nos pequenos estabelecimentos familiares do espaço rural do município de Nova Friburgo, localizado na região Serrana do estado do Rio de Janeiro. Retomando a ênfase (presente em trabalho anterior) nos efeitos sociais promovidos pela inserção do espaço rural municipal em uma lógica de mercado, e, levando em consideração as cautelas que devem ser tomadas, no âmbito nacional, na utilização de tal noção, a nossa intenção foi a de questionarmos as valorações que vêm sendo atribuídas a esse fenômeno (de possibilidade de diversificação de emprego e renda; melhoria das condições de vida das populações rurais; e, até mesmo, do estabelecimento de um espaço rural dotado de múltiplas funções), a partir de uma realidade como a friburguense. Esta se, por um lado, é marcada pela significativa expressão espacial dos pequenos estabelecimentos familiares e por um quadro econômico, relativamente, diversificado, por outro lado, também, sofre os efeitos da implementação de um modelo de modernização da agricultura, extremamente excludente e desigual, e, em menor escala, do avanço de um intenso processo de urbanização. Analisado como estratégia de sobrevivência e reprodução no recorte espacial mencionado, os desdobramentos do fenômeno da pluriatividade identificados no mesmo, de certo, complexificam a realidade estudada, ficando a dialética entre relações capitalistas e não-capitalistas, balizada, grosso modo, pela permanência da agricultura com ênfase no trabalho familiar, de um lado, e pela expansão de uma lógica urbano-industrial que, além (e para além) de relações setoriais, também, envolve a inserção de membros das famílias dos pequenos produtores em outras atividades, não-agrícolas, de outro. Para que fosse atingido, portanto, o objetivo proposto, a operacionalização adotada consistiu tanto no levantamento bibliográfico acerca da temática escolhida quanto na realização de vários trabalhos de campo, direcionados a pequenos estabelecimentos familiares de algumas localidades dos vários distritos do município, assim como a órgãos públicos, ligados à produção agrícola, ao turismo e às indústrias de confecções de moda íntima.

Epitope mapping of antibodies to alpha-synuclein in LRRK2 mutation carriers, idiopathic Parkinson disease patients, and healthy controls

Alpha-synuclein (Snca) plays a major role in Parkinson disease (PD). Circulating anti-Snca antibodies has been described in PD patients and healthy controls, but they have been poorly characterized. This study was designed to assess the prevalence of anti-Snca reactivity in human subjects carrying the LRRK2 mutation, idiopathic PD (iPD) patients, and healthy controls and to map the epitopes of the anti-Snca antibodies. Antibodies to Snca were detected by ELISA and immunoblotting using purified recombinant Snca in plasma from individuals carrying LRRK2 mutations (104), iPD patients (59), and healthy controls (83). Epitopes of antibodies were mapped using recombinant protein constructs comprising different regions of Snca. Clear positive anti-Snca reactivity showed no correlation with age, sex, years of evolution, or the disability scores for PD patients and anti-Snca reactivity was not prevalent in human patients with other neurological or autoimmune diseases. Thirteen of the positive individuals were carriers of LRRK2 mutations either non-manifesting (8 out 49 screened) or manifesting (5 positive out 55), three positive (out of 59) were iPD patients, and five positive (out of 83) were healthy controls. Epitope mapping showed that antibodies against the N-terminal (a.a. 1-60) or C-terminal (a.a. 109-140) regions of Snca predominate in LRRK2 mutation carriers and iPD patients, being N122 a critical amino acid for recognition by the anti-C-terminal directed antibodies. Anti-Snca circulating antibodies seem to cluster within families carrying the LRRK2 mutation indicating possible genetic or common environmental factors in the generation of anti-Snca antibodies. These results suggest that case-controls' studies are insufficient and further studies in family cohorts of patients and healthy controls should be undertaken, to progress in the understanding of the possible relationship of anti-Snca antibodies and PD patholog

Subtypes of Patients Experiencing Exacerbations of COPD and Associations with Outcomes

Chronic obstructive pulmonary disease (COPD) is a complex and heterogeneous condition characterized by occasional exacerbations. Identifying clinical subtypes among patients experiencing COPD exacerbations (ECOPD) could help better understand the pathophysiologic mechanisms involved in exacerbations, establish different strategies of treatment, and improve the process of care and patient prognosis. The objective of this study was to identify subtypes of ECOPD patients attending emergency departments using clinical variables and to validate the results using several outcomes. We evaluated data collected as part of the IRYSS-COPD prospective cohort study conducted in 16 hospitals in Spain. Variables collected from ECOPD patients attending one of the emergency departments included arterial blood gases, presence of comorbidities, previous COPD treatment, baseline severity of COPD, and previous hospitalizations for ECOPD. Patient subtypes were identified by combining results from multiple correspondence analysis and cluster analysis. Results were validated using key outcomes of ECOPD evolution. Four ECOPD subtypes were identified based on the severity of the current exacerbation and general health status (largely a function of comorbidities): subtype A (n = 934), neither high comorbidity nor severe exacerbation; subtype B (n = 682), moderate comorbidities; subtype C (n = 562), severe comorbidities related to mortality; and subtype D (n = 309), very severe process of exacerbation, significantly related to mortality and admission to an intensive care unit. Subtype D experienced the highest rate of mortality, admission to an intensive care unit and need for noninvasive mechanical ventilation, followed by subtype C. Subtypes A and B were primarily related to other serious complications. Hospitalization rate was more than 50% for all the subtypes, although significantly higher for subtypes C and D than for subtypes A and B. These results could help identify characteristics to categorize ECOPD patients for more appropriate care, and help test interventions and treatments in subgroups with poor evolution and outcomes.

A relação família e escola na experiência do Programa Interdisciplinar de Apoio às Escolas (Proinape) no município do Rio de Janeiro

A presente pesquisa se propõe a analisar a relação entre a escola e a família na experiência de trabalho do Programa Interdisciplinar de Apoio às Escolas Proinape no município do Rio de Janeiro. A partir de uma abordagem teórica sobre as duas instituições entendidas como fundamentais no processo de socialização dos sujeitos e de como que as relações entre o Estado e a sociedade civil se materializam na esfera da reprodução social na atualidade, este estudo objetiva apresentar as estratégias da nova pedagogia da hegemonia na obtenção do consenso social. Apresenta a educação sob o contexto da hegemonia do capital financeiro e a função educativa do Estado e o papel dos intelectuais na difusão da nova pedagogia da hegemonia vinculada aos interesses da burguesia internacional, sob a gerência direta dos organismos multilaterais. Analisa as formas de intervenção do Estado sobre a família pobre da classe trabalhadora, as dimensões históricas dessa relação, os novos arranjos familiares, a relação entre o Estado e a família na constituição do Pluralismo de bem-estar e do familismo e a diminuição da capacidade protetora das famílias em tempos de reestruturação produtiva. Dá destaque as particularidades da política de educação no Brasil frente às novas exigências do capital monopolista e os reflexos dos programas de ação federais e da gestão privada da política educacional no município do Rio de Janeiro na gestão do prefeito Eduardo Paes. Através do levantamento de dados, da análise documental e dos relatórios de avaliação final das equipes do Proinape da 4 Coordenadoria Regional de Educação expõe as bases legais e os programas sociais que sustentam a ação do Estado junto às famílias pobres da classe trabalhadora na área de educação, assim como as ações da Secretaria Municipal de Educação do Rio de Janeiro junto às famílias com a ênfase no disciplinamento para a elevação dos indicadores educacionais.

Vital statistics of marine fishes of Vanuatu

Vital statistics are presented for 38 marine species of Vanuatu based on previous studies conducted in the area, with parameters describing growth (6 species, 13 sets of parameters), mortality (estimates of M for 6 species), length-weight relationship (32 species), and reproduction (length at first maturity for 26 species, months of reproduction for 18 species). The species covered belong mainly to the family Lutjanidae.

Characterisation of neurons in the pedal ganglia of the green-lipped mussel, Perna canaliculus, using antibodies raised against neuropeptides and neurotransmitters involved in gastropod egg-laying behaviour and bivalve reproduction and spawning

To characterise central neurons in the pedal ganglia of both male and female green lipped mussel, Perna canaliculus immunohistochemical techniques were used. Mollusc antibodies were used against neuropeptides and neurotansmitters known to control reproduction and spawning. Anti-ELH and anti-APGWamide showed very strong immunoreactivity in small type of neurons. Anti-5-HT and anti-DA immunoreactivity was mostly in large type of neurons. The labelled neurons are consistent with descriptions of neurosecretory cells implicated in the control of reproduction and spawning on the basis of earlier histological staining techniques used in this species. The use of selective immunological markers for peptides and amines appears to be a, promising tool for further characterisation of neurosecretory cells, and to isolate an'tl characterise neuropeptides and other biologically active materials involved in the control of reproduction in Perna canaliculus.

Neurons characterization in the cerebral ganglia of the green-lipped mussel, Perna canaliculus, using antibodies raised against neuropeptides and neurotransmitters involved in gastropod egg-laying behaviour and bivalve reproduction and spawning

Immunohistochemical techniques were used to characterise central neurons in the cerebral ganglia of both male and female Perna canaliculus. We used mollusc antibodies raised against neuropeptides and neurotransmitters known to control reproduction and spawning. Anti-ELH and anti-APGWamide showed very strong immunoreactivity in small type of neurons. Anti-5-HT and anti-DA immunoreactivity was mostly in large type of neurons. The labelled neurons are consistent with descriptions of neurosecretory cells implicated in the control of reproduction and spawning on the basis of earlier histological staining techniques used in this species. The use of selective immunological markers for peptides and amines appears to be a promising tool for further characterisation of neurosecretory cells, and to isolate and characterise neuropeptides and other biologically active materials involved in the control of reproduction in Perna canaliculus.

Determination of biological characteristics and blood groups of hilsa shad (Tenualosa ilisha) in the north of Persian Gulf (Bushehr coastal waters)

Hilsa shad, Tenuolosa ilisha, belongs to Clupeidae family and Alsinae subfamily is an euryhaline pelagic and anadromous species living in marine and freshwater waters. Regarding to study the biological characteristics of this species, this study was carried out in the Northern Persian Gulf within Bushehr province waters during years 2006-7. A total of 344 specimens were collected and transported to the laboratory for further different biological measurements consist of: reproduction (GSI, fecundity, maturity stages), feeding (stomach contents, food preference ...), aging; 58 morphometric and ٧ meristic measurements. The results indicate that minimum, maximum and mean body weight are 203, 953 and 481.35±147.64 g, respectively and this values for total length are 26.5, 45.1 and 35.99±3.98 cm. For food regimes, the most abundant phytoplankton foods belong to Bacillariophyta (83.74٪) and zooplanktons of Arthropoda (51٪). The mean RLG was measured about 1.53±0.22 and the mean feeding intensity was about 51.79±38.13. Also, the aging of studied fishes showed that they have 2 to 4 years and most of the samples had 2+ years. The reproduction studies showed that Indian shad is a batch spawner species. The average gonadosomatic index (GSI) is 1.64±1.382 and the main spawning season was determined for April-May.

Spring and autumn reproduction of Calanus sinicus in the Yellow Sea

The fecundity, hatching success and naupliar survival of Calanus sinicus were studied in the Yellow Sea during research cruises in April and October 2006, with emphasis on the regulation of reproduction. During both cruises, the egg production rate (EPR) showed large spatial variations (0 to 25.4 eggs female(-1) d(-1)), generally coinciding with the food availability. In April, the abundant phytoplankton and ciliates in the study area supported active reproduction, which would probably initiate the annual population development. In October, females remained immature in the Yellow Sea Cold Water Mass, likely due to the unfavorable environment (poor food and low temperature). However, reproduction and recruitment were high in the neritic region, which may explain the local population recovery in late autumn. Hatching success varied markedly among stations in April (4 to 85%), whereas it was high overall in the neritic region during October (> 90%). Based on the potential recruitment rates, the spring recruitment would be more important for the annual population dynamics, Female gonad maturity, body size and lipid reserve were examined in relation to fecundity. Regression analyses suggested that the reproductive index (defined as the proportion of females with mature gonads) could be an indicator for the EPR of C. sinicus. Among the regulating factors, external food (ciliates and phytoplankton) seems essential for reproduction, whereas inner lipid reserve may mainly serve metabolic needs. Moreover, fecundity is positively related to body size but independent of temperature, which might exert indirect influences on reproduction.

Debugging: the good, the bad, and the quirky -- a qualitative analysis of novices' strategies

Murphy, L., Lewandowski, G., McCauley, R., Simon, B., Thomas, L., and Zander, C. 2008. Debugging: the good, the bad, and the quirky -- a qualitative analysis of novices' strategies. SIGCSE Bull. 40, 1 (Feb. 2008), 163-167