Whole-body protein turnover and resting energy expenditure in obese, prepubertal children.

BACKGROUND: Obesity is becoming more frequent in children; understanding the extent to which this condition affects not only carbohydrate and lipid metabolism but also protein metabolism is of paramount importance. OBJECTIVE: We evaluated the kinetics of protein metabolism in obese, prepubertal children in the static phase of obesity. DESIGN: In this cross-sectional study, 9 obese children (x +/- SE: 44+/-4 kg, 30.9+/-1.5% body fat) were compared with 8 lean (28+/-2 kg ,16.8+/-1.2% body fat), age-matched (8.5+/-0.2 y) control children. Whole-body nitrogen flux, protein synthesis, and protein breakdown were calculated postprandially over 9 h from 15N abundance in urinary ammonia by using a single oral dose of [15N]glycine; resting energy expenditure (REE) was assessed by indirect calorimetry (canopy) and body composition by multiple skinfold-thickness measurements. RESULTS: Absolute rates of protein synthesis and breakdown were significantly greater in obese children than in control children (x +/- SE: 208+/-24 compared with 137+/-14 g/d, P < 0.05, and 149+/-20 compared with 89+/-13 g/d, P < 0.05, respectively). When these variables were adjusted for fat-free mass by analysis of covariance, however, the differences between groups disappeared. There was a significant relation between protein synthesis and fat-free mass (r = 0.83, P < 0.001) as well as between protein synthesis and REE (r = 0.79, P < 0.005). CONCLUSIONS: Obesity in prepubertal children is associated with an absolute increase in whole-body protein turnover that is consistent with an absolute increase in fat-free mass, both of which contribute to explaining the greater absolute REE in obese children than in control children.

Regionalização e Integração Sistêmica: cenários para a reforma do Sistema de Saúde de Cabo Verde

Este trabalho discute o conceito da regionalização a partir de três eixos principais: a regionalização como um modelo organizacional dos serviços de saúde; a regionalização como um modelo de gestão dos sistemas de saúde que remete para o conceito de racionalização e a regionalização como um modelo de integração sistêmica dos serviços de saúde voltados para a produção de cuidados e ações de prevenção e promoção da saúde por meio de redes assistenciais hierarquizadas, integradas e solidárias. A regionalização dos serviços de saúde surgiu como um dos principais veículos de reforma que os sistemas de saúde de vários países adotaram na sua política de descentralização. Trinta anos depois da independência, a Republica de Cabo Verde busca através da regionalização reformar o seu Serviço Nacional de Saúde. É apresentado um diagnóstico do sistema de saúde do país. Um dos principais condicionantes das reformas são os atores que participam delas. O objetivo deste trabalho foi de analisar o comprometimento dos atores-chave com o processo de regionalização na Região Sanitária Santiago Norte – Cabo Verde e a partir daí construir cenários múltiplos de sua operacionalização. Foram construídos três cenários prospectivos. A construção dos cenários prospectivos foi baseada no método de elaboração de cenários de Godet e com adaptações propostas por Rivera com um enfoque mais qualitativo. Outros métodos foram utilizados para apoiar a construção dos cenários: O método Delphy, o método de sistema de impactos cruzados, o método de análise de Discurso do Sujeito Coletivo. A construção dos cenários permitiu a reflexão prospectiva dos atores sobre o processo de regionalização e a antecipação da ação estratégica dos mesmos. O estudo mostrou que a regionalização ocorrerá num ambiente do tipo sistema instável, dependendo a realização do cenário desejável das negociações e coalizões entre os atores-chave. A construção de cenários prospectivos numa perspectiva qualitativa mostrou-se como uma possibilidade consistente e promissora ainda passível de aprofundamento teórico.

A Comparison of the Management Models of Protected Areas between China and the Southern African Region

A Comparison of the Management Models of Protected Areas between China and the African South Region allows reading and evaluating the similarities and differences in the use of management model as a management tool for protected areas in China and South African Region. Specifically, some positive and negative features of the management approaches for the two regions. Secondary data was collected from various related literature such as policy documents, students‟ dissertations/thesis, scientific articles and magazines. Based on the method above, the study found out that China's first nature reserve was the Dingus Mountain Nature Reserve in Zhaoqing, Guangdong province established in 1956. By the end of 2005, about 2,349 nature reserves of various kinds were set up throughout the country, covering a total area of 149.95 million ha and accounting for 15 percent of the total land territory. The study further found that Southern Africa has approximately 4,390 protected areas out of 11487920 total land areas and Eastern Africa has approximately 1838144 protected areas, which is equivalent to 15.0% of the total land areas. South Africa in this region had its first declared natural park in 1926 after Paul Kruger (a war hero) had alerted the authorities of the extinguishing threat of some animal species of region.

Causes for the underreporting of adverse drug events by health professionals: a systematic review

Objective: Identifying the main causes for underreporting of Adverse Drug Reaction (ADR) by health professionals. Method: A systematic review carried out in the following databases: LILACS, PAHO, SciELO, EMBASE and PubMed in the period between 1992 and 2012. Descriptors were used in the search for articles, and the identified causes of underreporting were analyzed according to the classification of Inman. Results: In total, were identified 149 articles, among which 29 were selected. Most studies were carried out in hospitals (24/29) for physicians (22/29), and pharmacists (10/29). The main causes related to underreporting were ignorance (24/29), insecurity (24/29) and indifference (23/29). Conclusion: The data show the eighth sin in underreporting, which is the lack of training in pharmacovigilance. Therefore, continuing education can increase adherence of professionals to the service and improve knowledge and communication of risks due to drug use.


Uppröjningen av de steniga åkrarna (tal i Rautalampi vid öppnandet av Lantbruksutställningen den 23.8.1952)

Puhe

Eversti evp. Alpo K. Marttinen 8/5 1973

Kirje 8.5.1973

Intervention précoce en Guidance Interactive et modification de la réactivité neuroendocrinienne chez l'ancien grand prématuré âgé de 12 mois et sa mère

L'étude a pour objectif de mettre en évidence les effets d'une intervention précoce inspirée des thérapies en Guidance Interactive sur la qualité de l'attachement ainsi que sur la réactivité neuroendocrinienne de stress chez des grands prématurés âgés de 12 mois ainsi que chez leurs mères. La population étudiée comprend 48 grands prématurés (<33 semaines de gestation) et leurs mères. Un programme d'intervention précoce a été proposé aléatoirement à la moitié des dyades incluses dans l'étude. Des mesures de cortisol salivaire ont été effectuées à 12 mois lors d'un épisode de stress modéré (la Situation Étrange) tant chez la mère que chez l'enfant. Les mères ayant bénéficié de l'intervention précoce montrent des taux de cortisol plus élevés que celles n'ayant pas bénéficié de l'intervention. Les auteurs font l'hypothèse que ces mères ont pu développer leur sensibilité envers leur enfant et se montrent, par conséquent, plus concernées lors de l'épisode de stress modéré. The present project aims to assess the effects of an early intervention inspired from Interactive Guidance therapy, on later attachment quality and stress reactivity of prematurely born infants and their mothers. The studied population contends 48 preterm born infants (< 33 weeks og gestational age). Half of the dyads receive an intervention program aiming at promoting the parents' responsivity-sensitivity to infant's cues. Infant's and mother's stress reactivity (salivary cortisol) to mild stressors (Strange Situation) will be assessed at 12 months. Mothers with intervention program show higher cortisol levels than the others. The authors postulate that these mothers enhance their caregiving quality and, subsequently, are more prone to be sensitive to infant's cues and to be concerned during the mild stress episode.

Maatalousministeri J. Virolainen 26/11 1962

Kirje 26.11.1962

Exome Sequencing Identifies INPPL1 Mutations as a Cause of Opsismodysplasia.

Opsismodysplasia (OPS) is a severe autosomal-recessive chondrodysplasia characterized by pre- and postnatal micromelia with extremely short hands and feet. The main radiological features are severe platyspondyly, squared metacarpals, delayed skeletal ossification, and metaphyseal cupping. In order to identify mutations causing OPS, a total of 16 cases (7 terminated pregnancies and 9 postnatal cases) from 10 unrelated families were included in this study. We performed exome sequencing in three cases from three unrelated families and only one gene was found to harbor mutations in all three cases: inositol polyphosphate phosphatase-like 1 (INPPL1). Screening INPPL1 in the remaining cases identified a total of 12 distinct INPPL1 mutations in the 10 families, present at the homozygote state in 7 consanguinous families and at the compound heterozygote state in the 3 remaining families. Most mutations (6/12) resulted in premature stop codons, 2/12 were splice site, and 4/12 were missense mutations located in the catalytic domain, 5-phosphatase. INPPL1 belongs to the inositol-1,4,5-trisphosphate 5-phosphatase family, a family of signal-modulating enzymes that govern a plethora of cellular functions by regulating the levels of specific phosphoinositides. Our finding of INPPL1 mutations in OPS, a severe spondylodysplastic dysplasia with major growth plate disorganization, supports a key and specific role of this enzyme in endochondral ossification.