Syk and Src family kinases regulate C-type lectin receptor 2 (CLEC-2)-mediated clustering of podoplanin and platelet adhesion to lymphatic endothelial cells

The interaction of C-type lectin receptor 2 (CLEC-2) on platelets with Podoplanin on lymphatic endothelial cells initiates platelet signaling events that are necessary for prevention of blood-lymph mixing during development. In the present study, we show that CLEC-2 signaling via Src family and Syk tyrosine kinases promotes platelet adhesion to primary mouse lymphatic endothelial cells at low shear. Using supported lipid bilayers containing mobile Podoplanin, we further show that activation of Src and Syk in platelets promotes clustering of CLEC-2 and Podoplanin. Clusters of CLEC-2-bound Podoplanin migrate rapidly to the center of the platelet to form a single structure. Fluorescence lifetime imaging demonstrates that molecules within these clusters are within 10 nm of one another and that the clusters are disrupted by inhibition of Src and Syk family kinases. CLEC-2 clusters are also seen in platelets adhered to immobilized Podoplanin using direct stochastic optical reconstruction microscopy. These findings provide mechanistic insight by which CLEC-2 signaling promotes adhesion to Podoplanin and regulation of Podoplanin signaling, thereby contributing to lymphatic vasculature development.

Prevention of Risky drinking among students at a Brazilian University

Aim: The aim of this paper was to compare the quantity and frequency of alcohol use and its associated negative consequences between two groups of college students who were identified as being risky drinkers. Subjects were randomly allocated in a clinical trial to intervention or control groups. Methods: Risky drinking use was defined as Alcohol Use Disorders Identification Test (AUDIT) >= 8 and/or Rutgers Alcohol Problem Index (RAPI) >= 5 problems in the previous year. Students who had undergone the Brief Alcohol Screening and Intervention for College Students (BASICS) (N = 145 at baseline; 142 at 12 months, and 103 at 24 months, loss of 29.7%) were compared with a control group (N = 121 at baseline; 121 at 12 months and 113 at 24 months, loss of 9.3%), the nonintervention group. Variables included drinking frequency, quantity and peak consumption, dependence assessment, and family and friends' abuse assessment. Results: Treated students at a 24-month follow-up decreased quantity of alcohol use per occasion and lowered AUDIT and RAPI scores. Conclusions: This is the first brief intervention work on risky drinking with college students in Brazil and the results are encouraging. However, it is difficult to conduct individual prevention strategies in a country where culture fosters heavy drinking through poor public policy on alcohol and lack of law enforcement.

Oral cleft prevention program (OCPP)

Background: Oral clefts are one of the most common birth defects with significant medical, psychosocial, and economic ramifications. Oral clefts have a complex etiology with genetic and environmental risk factors. There are suggestive results for decreased risks of cleft occurrence and recurrence with folic acid supplements taken at preconception and during pregnancy with a stronger evidence for higher than lower doses in preventing recurrence. Yet previous studies have suffered from considerable design limitations particularly non-randomization into treatment. There is also well-documented effectiveness for folic acid in preventing neural tube defect occurrence at 0.4 mg and recurrence with 4 mg. Given the substantial burden of clefting on the individual and the family and the supportive data for the effectiveness of folic acid supplementation as well as its low cost, a randomized clinical trial of the effectiveness of high versus low dose folic acid for prevention of cleft recurrence is warranted.Methods/design: This study will assess the effect of 4 mg and 0.4 mg doses of folic acid, taken on a daily basis during preconception and up to 3 months of pregnancy by women who are at risk of having a child with nonsyndromic cleft lip with/without palate (NSCL/P), on the recurrence of NSCL/P. The total sample will include about 6,000 women (that either have NSCL/P or that have at least one child with NSCL/P) randomly assigned to the 4 mg and the 0.4 mg folic acid study groups. The study will also compare the recurrence rates of NSCL/P in the total sample of subjects, as well as the two study groups (4mg, 0.4 mg) to that of a historical control group. The study has been approved by IRBs (ethics committees) of all involved sites. Results will be disseminated through publications and presentations at scientific meetings.Discussion: The costs related to oral clefts are high, including long term psychological and socio-economic effects. This study provides an opportunity for huge savings in not only money but the overall quality of life. This may help establish more specific clinical guidelines for oral cleft prevention so that the intervention can be better tailored for at-risk women.

Experiences of family members regarding the oral health care of children

Este estudo objetivou verificar a compreensão das experiências dos familiares em relação ao cuidado com a saúde bucal das crianças. É estudo qualitativo, realizado em 2007, em distrito de saúde do município de Ribeirão Preto, SP, com 12 cuidadores. Utilizou-se referencial teórico da vulnerabilidade e a perspectiva hermenêutica. Três categorias empíricas foram elaboradas: os significados do cuidado com a saúde bucal, em busca das causas e da prevenção de agravos bucais e a realidade dos serviços de saúde bucal. Entre outros elementos potencializadores da vulnerabilidade infantil aos agravos bucais, emergiu a supervalorização da causalidade biológica, do atendimento de alta complexidade e da odontologia estética e, entre os protetores, a valorização do saber popular e a integração de ações e conhecimentos profissionais. Aponta-se para a revisão das estratégias de prevenção e promoção de saúde bucal, fornecendo elementos para auxiliar os serviços de saúde a reorganizarem o cuidado com a saúde bucal de crianças.

Bites caused by Giant Water Bugs belonging to belostomatidae family (Hemiptera, Heteroptera) in humans: A Report of Seven cases

We report 7 cases of patients bitten by giant water bugs, large predatory insects belonging to the Belostomatidae family (Hemiptera, Heteroptera). These insects have toxic saliva capable of provoking intense pain and paralysis in vertebrates. Victims experienced intense, excruciating pain and 1 manifested hypoesthesia in the forearm. Bites by Belostomatidae are often reported by clinicians working in areas where these insects live, but there are no detailed case reports in the medical literature. There are no specific treatment modalities known to be effective, making prevention an important strategy. © 2010 Wilderness Medical Society.

Aspergillus niger beta-Glucosidase Has a Cellulase-like Tadpole Molecular Shape INSIGHTS INTO GLYCOSIDE HYDROLASE FAMILY 3 (GH3) beta-GLUCOSIDASE STRUCTURE AND FUNCTION

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Depression in children and adolescents: family narratives in Brazilian primary attention

Background: The incidence of depression in children and adolescents still increasing and this disorder is now a major public health challenge worldwide. The Psychiatric Reform suggested an end to the fragmented and inefficient service by proposing integrated and quality care. In this context, family narratives are a way to recognize vulnerabilities and provide psychopathology prevention in primary care. Methods: Two medical databases (LILACS and SciELO) were surveyed and 14 texts published between 2004 and 2011 were selected and reviewed. Results and discussion: Children and adolescents are nowadays exposed to several stressing factors, in addition to natural vulnerabilities of this age group. Prevention is associated with a qualified hearing of family narratives in primary care and healthcare professionals should be able to perceive said and unsaid elements across the speech. Conclusion: In spite of the advances about children and adolescents mental health, some procedures must be adapted to achieve an efficient mental health policy though analyzing family discourse.

The process of constructing new competencies in the family agricultural production unit

This article discusses the difficulties dairy farmers face when they decide to install a new type of production on their units. We intend to discuss the nature of the new competencies the farmers will construct in order to install new production ateliers, and to show the complexity of the means they used, the difficulties they face in this process, and the strategies farmers develop in consonance with the practical knowledge of their profession. The method used was Ergonomic Work Analysis, together with semi-structured interviews, done after sessions of observation and work analysis. The results show that it is possible to apprehend a part of the complexity of the process of constructing competencies among dairy farmers, the diversity of kinds of resources they mobilize, integrate and transfer in this construction process that materializes through their activities in the work context.

Oral cleft prevention program (OCPP)

Background Oral clefts are one of the most common birth defects with significant medical, psychosocial, and economic ramifications. Oral clefts have a complex etiology with genetic and environmental risk factors. There are suggestive results for decreased risks of cleft occurrence and recurrence with folic acid supplements taken at preconception and during pregnancy with a stronger evidence for higher than lower doses in preventing recurrence. Yet previous studies have suffered from considerable design limitations particularly non-randomization into treatment. There is also well-documented effectiveness for folic acid in preventing neural tube defect occurrence at 0.4 mg and recurrence with 4 mg. Given the substantial burden of clefting on the individual and the family and the supportive data for the effectiveness of folic acid supplementation as well as its low cost, a randomized clinical trial of the effectiveness of high versus low dose folic acid for prevention of cleft recurrence is warranted. Methods/design This study will assess the effect of 4 mg and 0.4 mg doses of folic acid, taken on a daily basis during preconception and up to 3 months of pregnancy by women who are at risk of having a child with nonsyndromic cleft lip with/without palate (NSCL/P), on the recurrence of NSCL/P. The total sample will include about 6,000 women (that either have NSCL/P or that have at least one child with NSCL/P) randomly assigned to the 4 mg and the 0.4 mg folic acid study groups. The study will also compare the recurrence rates of NSCL/P in the total sample of subjects, as well as the two study groups (4mg, 0.4 mg) to that of a historical control group. The study has been approved by IRBs (ethics committees) of all involved sites. Results will be disseminated through publications and presentations at scientific meetings. Discussion The costs related to oral clefts are high, including long term psychological and socio-economic effects. This study provides an opportunity for huge savings in not only money but the overall quality of life. This may help establish more specific clinical guidelines for oral cleft prevention so that the intervention can be better tailored for at-risk women. ClinicalTrials.gov Identifier NCT00397917

Predicting childhood sexual or physical abuse: a logistic regression geo-mapping approach to prevention.

This study investigates the degree to which gender, ethnicity, relationship to perpetrator, and geomapped socio-economic factors significantly predict the incidence of childhood sexual abuse, physical abuse and non- abuse. These variables are then linked to geographic identifiers using geographic information system (GIS) technology to develop a geo-mapping framework for child sexual and physical abuse prevention.

Family Preservation Research: Where We've Been, Where We Should Be Going

Although the literature has provided many critiques of research done on family preservation programs, these critiques have usually been limited to the studies ' assumptions, approach, or methodology. Because of the nature of these critiques, suggestions for future research in this field of practice have been scattered throughout the literature and have not benefitted from a wider historical perspective. This paper examines the historical evolution of family preservation studies in child welfare and suggests future directions for research in the field. Among the suggestions the authors posit are (1) research questions should be framed by what we know about improvements in the lives of families and children served by family preservation programs; (2) future explorations should include areas that have received relatively little attention in current research, including the impact of organizational conditions on service fidelity and worker performance; (3) newer treatment models, particularly those that provide both intensive services during a crisis period and less intensive services for maintenance, should be tested; (4) data collection points in longitudinal studies should be guided by theory, and measures should change over time to reflect the theoretically expected changes in families; (5) complex measures of placement prevention and other measures that capture changes in family functioning, child well-being, and child safety, should be utilized to obtain a full picture of program effects; and (6) multiple informants should be used to provide data about program effectiveness. In addition, the authors will argue that the field should carefully consider the amount of change that should be expected from the service models delivered.

Family Preservation Services to At-Risk Families: A Macro Case Study

Although the literature has provided many critiques of research done on family preservation programs, these critiques have usually been limited to the studies ' assumptions, approach, or methodology. Because of the nature of these critiques, suggestions for future research in this field of practice have been scattered throughout the literature and have not benefited from a wider historical perspective. This paper examines the historical evolution of family preservation studies in child welfare and suggests future directions for research in the field. Among the suggestions the authors posit are (1) research questions should be framed by what we know about improvements in the lives of families and children served by family preservation programs; (2) future explorations should include areas that have received relatively little attention in current research, including the impact of organizational conditions on service fidelity and worker performance; (3) newer treatment models, particularly those that provide both intensive services during a crisis period and less intensive services for maintenance, should be tested; (4) data collection points in longitudinal studies should be guided by theory, and measures should change over time to reflect the theoretically expected changes in families; (5) complex measures of placement prevention and other measures that capture changes in family functioning, child well-being, and child safety, should be utilized to obtain a full picture of program effects; and (6) multiple informants should be used to provide data about program effectiveness. In addition, the authors will argue that the field should carefully consider the amount of change that should be expected from the service models delivered.

Design and evaluation of the parent education component of a comprehensive violence prevention project in middle schools

Low parental monitoring is related to youth risk behaviors such as delinquency and aggression. The purpose of this dissertation was to describe the development and evaluation of a parent education intervention to increase parental monitoring in Hispanic parents of middle school children.^ The first study described the process of intervention mapping as used to develop Padres Trabajando por la Paz, a newsletter intervention for parents. Using theory, empirical literature, and information from the target population, performance objectives and determinants for monitoring were defined. Learning objectives were specified and a staged social-cognitive approach was used to develop methods and strategies delivered through newsletters.^ The second study examined the outcomes of a randomized trial of the newsletter intervention. Outcome measures consisted of a general measure of monitoring, parent and child reports of monitoring behaviors targeted by the intervention, and psychosocial determinants of monitoring (self-efficacy, norms, outcome expectancies, knowledge, and beliefs). Seventy-seven parents completed the randomized trial, half of which received four newsletters over an eight-week period. Results revealed a significant interaction effect for baseline and treatment for parent's reports of norms for monitoring (p =.009). Parents in the experimental condition who scored low at baseline reported increased norms for monitoring at follow-up. A significant interaction effect for child reports of parental monitoring behaviors (p =.04) reflected an small increase across baseline levels in the experimental condition and decreases for the control condition at higher baseline scores. Both groups of parents reported increased levels of monitoring at follow-up. No other outcome measures varied significantly by condition.^ The third study examined the relationship between the psychosocial determinants of parental monitoring and parental monitoring behaviors in the study population. Weak evidence for a relationship between outcome expectancies and parental monitoring behaviors suggests further research in the area utilizing stronger empirical models such as longitudinal design and structural equation modeling.^ The low-cost, minimal newsletter intervention showed promise for changing norms among Hispanic parents for parental monitoring. In light of the importance of parental monitoring as a protective factor for youth health risk behaviors, more research needs to be done to develop and evaluate interventions to increase parental monitoring. ^

Teaching practice recommendations: prevention and screening

The aim of this article is to provide guidance to family doctors on how to tutor students about effective screening and primary prevention. Family doctors know their patients and adapt national and international guidelines to their specific context, risk profile, sex and age as well as to the prevalence of the disorders under consideration. Three cases are presented to illustrate guideline use according to the level of evidence (for a 19-year-old man, a 60-year-old woman, and an 80-year-old man). A particular strength of family medicine is that doctors see their patients over the years. Thus they can progressively go through the various prevention strategies, screening, counselling and immunisation, accompanying their patients with precious advice for their health throughout their lifetime.

Development and preliminary validation of the cancer family impact scale for colorectal cancer

This study aimed to develop and validate The Cancer Family Impact Scale (CFIS), an instrument for use in studies investigating relationships among family factors and colorectal cancer (CRC) screening when family history is a risk factor. We used existing data to develop the measure from 1,285 participants (637 families) across the United States who were in the Johns Hopkins Colon Cancer Genetic Testing study. Participants were 94% white with an average age of 50.1 years, and 60% were women. None had a personal CRC history, and eighty percent had 1 FDR with CRC and 20% had more than one FDR with CRC. The study had three aims: (1) to identify the latent factors underlying the CFIS via exploratory factor analysis (EFA); (2) to confirm the findings of the EFA via confirmatory factor analysis (CFA); and (3) to assess the reliability of the scale via Cronbach's alpha. Exploratory analyses were performed on a split half of the sample, and the final model was confirmed on the other half. The EFA suggested the CFIS was an 18-item measure with 5 latent constructs: (1) NEGATIVE: negative effects of cancer on the family; (2) POSITIVE: positive effects of cancer on the family; (3) COMMUNICATE: how families communicate about cancer; (4) FLOW: how information about cancer is conveyed in families; and (5) NORM: how individuals react to family norms about cancer. CFA on the holdout sample showed the CFIS to have a reasonably good fit (Chi-square = 389.977, df = 122, RMSEA= 0.058 (.052-.065), CFI=.902, TLI=.877, GF1=.939). The overall reliability of the scale was α=0.65. The reliability of the subscales was: (1) NEGATIVE α = 0.682; (2) POSITIVE α = 0.686; (3) COMMUNICATE α = 0.723; (4) FLOW α = 0.467; and (5) NORM α = 0.732. ^ We concluded the CFIS to be a good measure with most fit levels over 0.90. The CFIS could be used to compare theoretically driven hypotheses about the pathways through which family factors could influence health behavior among unaffected individuals at risk due to family history, and also aid in the development and evaluation of cancer prevention interventions including a family component. ^