Insulin analog preparations and their use in children and adolescents with type 1 diabetes mellitus.

Standard or 'traditional' human insulin preparations such as regular soluble insulin and neutral protamine Hagedorn (NPH) insulin have shortcomings in terms of their pharmacokinetic and pharmacodynamic properties that limit their clinical efficacy. Structurally modified insulin molecules or insulin 'analogs' have been developed with the aim of delivering insulin replacement therapy in a more physiological manner. In the last 10 years, five insulin analog preparations have become commercially available for clinical use in patients with type 1 diabetes mellitus: three 'rapid' or fast-acting analogs (insulin lispro, aspart, and glulisine) and two long-acting analogs (insulin glargine and detemir). This review highlights the specific pharmacokinetic properties of these new insulin analog preparations and focuses on their potential clinical advantages and disadvantages when used in children and adolescents with type 1 diabetes mellitus. The fast-acting analogs specifically facilitate more flexible insulin injection timing with regard to meals and activities, whereas the long-acting analogs have a more predictable profile of action and lack a peak effect. To date, clinical trials in children and adolescents have been few in number, but the evidence available from these and from other studies carried out in adults with type 1 diabetes suggest that they offer significant benefits in terms of reduced frequency of nocturnal hypoglycemia, better postprandial blood glucose control, and improved quality of life when compared with traditional insulins. In addition, insulin detemir therapy is unique in that patients may benefit from reduced risk of excessive weight, particularly during adolescence. Evidence for sustained long-term improvements in glycosylated hemoglobin, on the other hand, is modest. Furthermore, alterations to insulin/insulin-like growth factor I receptor binding characteristics have also raised theoretical concerns that insulin analogs may have an increased mitogenic potential and risk of tumor development, although evidence from both in vitro and in vivo animal studies do not support this assertion. Long-term surveillance has been recommended and further carefully designed prospective studies are needed to evaluate the overall benefits and clinical efficacy of insulin analog therapy in children and adolescents with type 1 diabetes.

Marriage, transgression and death: Wuthering heights and The awakening

Esta dissertação tem como objetivo analisar a situação da vida da mulher durante o século XIX, na Inglaterra e nos Estados Unidos da América, através de duas obras do século XIX: Wuthering Heights (1847) de Emile Brontë e The Awakening (1889) de Kate Chopin. Objetivamos, na presente dissertação, apontar a crítica dos discursos patriarcal e das práticas de poder social que tornaram o contexto social das mulheres representadas nos romances citados, propício para a anulação da expressão erótica e repressão. O objeto da análise restringiu-se às duas personagens principais dos romances, Catherine Earnshaw e Edna Pontellier; personagens cujas subjetividades foram reprimidas através da imposição e desempenho de papéis sociais que não as satisfaziam como mulheres

A matter of life and death: sociomateriality, information systems and critical care

Sociomateriality has been attracting growing attention in the Organization Studies and Information Systems literatures since 2007, with more than 140 journal articles now referring to the concept. Over 80 percent of these articles have been published since January 2011 and almost all cite the work of Orlikowski (2007, 2010; Orlikowski and Scott 2008) as the source of the concept. Only a few, however, address all of the notions that Orlikowski suggests are entailed in sociomateriality, namely materiality, inseparability, relationality, performativity, and practices, with many employing the concept quite selectively. The contribution of sociomateriality to these literatures is, therefore, still unclear. Drawing on evidence from an ongoing study of the adoption of a computer-based clinical information system in a hospital critical care unit, this paper explores whether the notions, individually and collectively, offer a distinctive and coherent account of the relationship between the social and the material that may be useful in Information Systems research. It is argued that if sociomateriality is to be more than simply a label for research employing a number of loosely related existing theoretical approaches, then studies employing the concept need to pay greater attention to the notions entailed in it and to differences in their interpretation.

The Missionary pioneer, or, A brief memoir of the life, labours, and death of John Stewart, (man of colour) founder, under God of the mission among the Wyandotts at Upper Sandusky, Ohio / Published by Joseph Mitchell.

http://www.archive.org/details/missionarypionee00stewrich

National food consumption surveys: micronutrient intakes and the role of fortified foods in the diets of Irish pre-school children and adults

This research investigated the micronutrient intakes of Irish pre-school children (1-4 years) and adults (18-64 years) and the role that fortified foods (FFs) play in the diets of these population groups. Dietary intake data were collected as part of the National Pre-school Nutrition Survey (NPNS) (2010-2011) and the National Adult Nutrition Survey (NANS) (2008-2010) using 4-day food and beverage records. Nutrient intakes were estimated using WISP©, which encompasses McCance and Widdowson’s The Composition of Foods and the Irish Food Composition Database. A FF is one in which one or more micronutrients are added. Key dietary sources of micronutrients in NPNS and NANS were “milk”, “meat & meat products”, “breakfast cereals”, “fruit & fruit juices” and “breads”. In general, intakes of most micronutrients were adequate with the exception of iron (1 year old children and adult women) and vitamin D (in all population groups). Small proportions of the pre-school population had intakes which exceeded the upper level (UL) (zinc: 11%, folic acid: 5%, retinol: 4%, copper: 2%). Less than 2% of adults had intakes of iron, copper, zinc and vitamin B6 which exceeded the UL. FFs were consumed by 97% of pre-school children and 82% of adults, representing 17% and 9% of mean daily energy intake respectively. Relative to energy intake, FFs contributed substantially greater proportions to intakes of key micronutrients, such as iron and vitamin D. FFs were effective in reducing the prevalence of inadequate micronutrient intakes in these population groups, particularly for iron in women and 1 year old children. FFs made a significant contribution to folate intake in women of childbearing age (72µg). FFs contributed greater proportions of carbohydrate and lower proportions of fat to the diets of consumers. Voluntary addition of nutrients to foods did not contribute appreciably to intakes exceeding the UL in these population groups.

An assessment of health in post-medieval Ireland: ‘One vast Lazar house filled with famine, disease and death���

Three indicators of health and diet were selected to examine the health status in three socioeconomic groups in post-medieval Ireland. The aim was to examine the reliability of traditional skeletal markers of health in highly contextualised populations. The link between socio-economic status and health was examined to determine if traditional linking of poor health with poverty was evident in skeletal samples. The analysis indicated that this was indeed the case and that health was significantly compromised in populations of low socio-economic status. Thus it indicated that status intimately influences the physical body form. Sex was also found to be a major defining factor in the response of an individual to physiological stress. It was also evident that contemporary populations may suffer from different physiological stresses, and their responses to those stresses may differ. Adaptation was a key factor here. This has implications for studies of earlier populations that may lack detailed contextual data in terms of blanket applications of interpretations. The results also show a decline in health from the medieval through to the post-medieval period, which is intimately linked with the immense social changes and all the related effects of these. The socio-economic structure of post-medieval Ireland was a direct result of the British policies in Ireland. The physical form of the Irish may be seen to have occurred as a result of those policies, with the Irish poor in particular suffering substantial health problems, even in contrast to the poor of Britain. This study has enriched the recorded historical narrative of this period of the recent past, and highlights more nuanced narratives may emerge from the osteoarchaeological analysis when sound contextual information is available. It also examines a period in Irish history that, until very recently, had been virtually untouched in terms of archaeological study.

Sociocultural and socioeconomic influences on type 2 diabetes risk in overweight/obese African-American and Latino-American children and adolescents.

PURPOSE: It is unclear whether sociocultural and socioeconomic factors are directly linked to type 2 diabetes risk in overweight/obese ethnic minority children and adolescents. This study examines the relationships between sociocultural orientation, household social position, and type 2 diabetes risk in overweight/obese African-American (n = 43) and Latino-American (n = 113) children and adolescents. METHODS: Sociocultural orientation was assessed using the Acculturation, Habits, and Interests Multicultural Scale for Adolescents (AHIMSA) questionnaire. Household social position was calculated using the Hollingshead Two-Factor Index of Social Position. Insulin sensitivity (SI), acute insulin response (AIRG) and disposition index (DI) were derived from a frequently sampled intravenous glucose tolerance test (FSIGT). The relationships between AHIMSA subscales (i.e., integration, assimilation, separation, and marginalization), household social position and FSIGT parameters were assessed using multiple linear regression. RESULTS: For African-Americans, integration (integrating their family's culture with those of mainstream white-American culture) was positively associated with AIRG (β = 0.27 ± 0.09, r = 0.48, P < 0.01) and DI (β = 0.28 ± 0.09, r = 0.55, P < 0.01). For Latino-Americans, household social position was inversely associated with AIRG (β = -0.010 ± 0.004, r = -0.19, P = 0.02) and DI (β = -20.44 ± 7.50, r = -0.27, P < 0.01). CONCLUSIONS: Sociocultural orientation and household social position play distinct and opposing roles in shaping type 2 diabetes risk in African-American and Latino-American children and adolescents.

NF-KB Activation and Severity of Gastritis in Helicobacter pylori-Infected Children and Adults.

In contrast to adults, Helicobacter pylori gastritis in children is reported as milder and ulcer disease as uncommon, but unequivocal data are lacking.

Both CD4+ and CD8+ lymphocytes participate in the IFN-y response to filamentous hemagglutinin from Bordetella pertussis in infants, children and adults

Infant CD4+ T-cell responses to bacterial infections or vaccines have been extensively studied, whereas studies on CD8 + T-cell responses focused mainly on viral and intracellular parasite infections. Here we investigated CD8 + T-cell responses upon Bordetella pertussis infection in infants, children, and adults and pertussis vaccination in infants. Filamentous hemagglutinin-specific IFN-γ secretion by circulating lymphocytes was blocked by anti-MHC-I or -MHC-II antibodies, suggesting that CD4 + and CD8 + T lymphocytes are involved in IFN-γ production. Flow cytometry analyses confirmed that both cell types synthesized antigen-specific IFN-γ, although CD4 + lymphocytes were the major source of this cytokine. IFN-γ synthesis by CD8 + cells was CD4 + T cell dependent, as evidenced by selective depletion experiments. Furthermore, IFN-γ synthesis by CD4 + cells was sometimes inhibited by CD8 + lymphocytes, suggesting the presence of CD8 + regulatory T cells. The role of this dual IFN-γ secretion by CD4 + and CD8 + T lymphocytes in pertussis remains to be investigated. © 2012 Violette Dirix et al.

Emergency care of children and young people

Children and young people account for a quarter of all patients treated in emergency departments in the UK, with three million children attending emergency departments every year. Emergency Care of Children and Young People prepares practitioners for the challenges of caring for children in emergency departments. Children requiring emergency care have unique and differing needs and may not respond or cooperate during an initial assessment as an adult would.

Identification of senescence and death in Emiliania huxleyi and Thalassiosira pseudonana: Cell staining chlorophyll alterations and dimethylsulfoniopropionate (DMSP) metabolism

We measured membrane permeability, hydrolytic enzyme, and caspase-like activities using fluorescent cell stains to document changes caused by nutrient exhaustion in the coccolithophore Emiliania huxleyi and the diatom Thalassiosira pseudonana, during batch-culture nutrient limitation. We related these changes to cell death, pigment alteration, and concentrations of dimethylsulfide (DMS) and dimethylsulfoniopropionate (DMSP) to assess the transformation of these compounds as cell physiological condition changes. E. huxleyi persisted for 1 month in stationary phase; in contrast, T. pseudonana cells rapidly declined within 10 d of nutrient depletion. T. pseudonana progressively lost membrane integrity and the ability to metabolize 5-chloromethylfluorescein diacetate (CMFDA; hydrolytic activity), whereas E. huxleyi developed two distinct CMFDA populations and retained membrane integrity (SYTOX Green). Caspase-like activity appeared higher in E. huxleyi than in T. pseudonana during the post-growth phase, despite a lack of apparent mortality and cell lysis. Photosynthetic pigment degradation and transformation occurred in both species after growth; chlorophyll a (Chl a) degradation was characterized by an increase in the ratio of methoxy Chl a : Chl a in T. pseudonana but not in E. huxleyi, and the increase in this ratio preceded loss of membrane integrity. Total DMSP declined in T. pseudonana during cell death and DMS increased. In contrast, and in the absence of cell death, total DMSP and DMS increased in E. huxleyi. Our data show a novel chlorophyll alteration product associated with T. pseudonana death, suggesting a promising approach to discriminate nonviable cells in nature.

Shore Shapers: Introducing children and the general public to biogeomorphological processes and geodiversity

Coastal processes and wildlife shape the coast into a variety of eye-catching and enticing landforms that attract people to marvel at, relax and enjoy coastal geomorphology. These landforms also influence biological communities by providing habitat and refuge. There are very few field guides to explain these processes to the general public and children. In contrast, there is a relative wealth of resources and organised activities introducing people to coastal wildlife, especially on rocky shores. These biological resources typically focus on the biology and climatic controls on their distribution, rather than how the biology interacts with its physical habitat. As an outcome of two recent rock coast biogeomorphology projects (detailed at: www.biogeomorph.org/coastal) a multi disciplinary team produced the first known guide to understanding how biogeomorphological processes help create coastal landforms. The ‘Shore Shapers’ guide (shoreshapers.org) is designed to: a. bring biotic geomorphic interactions (how animals, algae and microorganisms protect and shape rock) to life and b. introduce some of the geomorphological and geological controls on biogeomorphic processes and landform development. The guide provides scientific information in an accessible and interactive way – to help sustain children’s interest and extend their learning. We tested a draft version of the guide with children,the general public and volunteers on rocky shore rambles using social science techniques and present the findings, alongside initial results of an evaluation of a newer version of the guide and interactive workshops taking place throughout 2014.

Birth, life and death of a cyclonic eddy in the Southern Ocean

The ACC is a climatically relevant frontal structure of global importance that regularly develops instabilities which grow into meanders that eventually evolve into long-lived cyclonic eddies. These eddies exhibit sustain primary productivity that can last several months fuelled by local resupply of nutrients. During April-May 2015 we conducted an intensive field experiment in the Southern Ocean (SMILES) where we sampled and tracked an ACC meander as it developed into an eddy and later vanished some 90 days later. The meander and later eddy physical characteristics were observed with a combination of high resolution hydrography, ADCP and turbulence observations in addition to surface and depth resolved biogeochemical observations of nutrients and phytoplankton. The life and death of the eddy was subsequently tracked through ARGO, BIO-ARGO and remote sensing.