Protocol for the Smoking, Nicotine and Pregnancy (SNAP) trial: double-blind, placebo-randomised, controlled trial of nicotine replacement therapy in pregnancy

Background: Smoking in pregnancy remains a public health challenge. Nicotine replacement therapy (NRT) is effective for smoking cessation in non-pregnant people, but because women metabolise nicotine and cotinine much faster in pregnancy, it is unclear whether this will be effective for smoking cessation in pregnancy. The NHS Health Technology Assessment Programme (HTA)-funded smoking, nicotine and pregnancy ( SNAP) trial will investigate whether or not nicotine replacement therapy ( NRT) is effective, cost-effective and safe when used for smoking cessation by pregnant women. Methods/Design: Over two years, in 5 trial centres, 1050 pregnant women who are between 12 and 24 weeks pregnant will be randomised as they attend hospital for ante-natal ultrasound scans. Women will receive either nicotine or placebo transdermal patches with behavioural support. The primary outcome measure is biochemically-validated, self-reported, prolonged and total abstinence from smoking between a quit date ( defined before randomisation and set within two weeks of this) and delivery. At six months after childbirth self-reported maternal smoking status will be ascertained and two years after childbirth, self-reported maternal smoking status and the behaviour, cognitive development and respiratory symptoms of children born in the trial will be compared in both groups. Discussion: This trial is designed to ascertain whether or not standard doses of NRT ( as transdermal patches) are effective and safe when used for smoking cessation during pregnancy

PhOTO Zebrafish: A Transgenic Resource for In Vivo Lineage Tracing during Development and Regeneration

Background: Elucidating the complex cell dynamics (divisions, movement, morphological changes, etc.) underlying embryonic development and adult tissue regeneration requires an efficient means to track cells with high fidelity in space and time. To satisfy this criterion, we developed a transgenic zebrafish line, called PhOTO, that allows photoconvertible optical tracking of nuclear and membrane dynamics in vivo. Methodology: PhOTO zebrafish ubiquitously express targeted blue fluorescent protein (FP) Cerulean and photoconvertible FP Dendra2 fusions, allowing for instantaneous, precise targeting and tracking of any number of cells using Dendra2 photoconversion while simultaneously monitoring global cell behavior and morphology. Expression persists through adulthood, making the PhOTO zebrafish an excellent tool for studying tissue regeneration: after tail fin amputation and photoconversion of a ~100µm stripe along the cut area, marked differences seen in how cells contribute to the new tissue give detailed insight into the dynamic process of regeneration. Photoconverted cells that contributed to the regenerate were separated into three distinct populations corresponding to the extent of cell division 7 days after amputation, and a subset of cells that divided the least were organized into an evenly spaced, linear orientation along the length of the newly regenerating fin. Conclusions/Significance: PhOTO zebrafish have wide applicability for lineage tracing at the systems-level in the early embryo as well as in the adult, making them ideal candidate tools for future research in development, traumatic injury and regeneration, cancer progression, and stem cell behavior

The young active star SAO 51891 (V383 Lac)

Our aim is investigating surface inhomogeneities of the young late-type star SAO51891, from photosphere to upper chromosphere, analyzing contemporaneous high-resolution spectra and broad-band photometry. The FOCES@CAHA spectral range is used to determine spectral classification and derive vsini and Vrad. The Li abundance is measured to estimate the age. The BVRIJHKs bands are used to construct the SED. The variations of our BV fluxes and Teff are used to infer the presence of photospheric spots and observe their behavior over time. The chromospheric activity is studied applying the spectral subtraction technique to Halpha, CaII H&K, Heps, and CaII IRT lines. We find SAO51891 to be a young K0-1V star with Li abundance close to the Pleiades upper envelope, confirming its youth (~100 Myr), also inferred from its kinematical membership to the Local Association. We detect no IR excess from SED analysis, and rotational modulation of luminosity, Teff, CaII, and Heps total fluxes. A spot model with two active regions, ~240 K cooler than the surrounding photosphere, fits our light/Teff curves, and reproduces the small-amplitude Vrad variations. The anti-correlation of light curves and chromospheric diagnostics indicates plages spatially associated with spots. The large amplitude observed in the Heps-flux curve suggests that this line is very sensitive to the plage presence. Finally, SAO51891 is a young active star, lacking significant amounts of circumstellar dust or any evidence for low mass companions. The spots turn out to be larger and warmer than those in less active MS stars. The Vrad variation produced by spots has an amplitude comparable with those induced by Jupiter-mass planets orbiting close to the star. SAO51891 is a good example of star where the detection of planets may be hampered by the high activity level.Comment: 16 pages, 12 figures, 7 tables, accepted by Astronomy and Astrophysics; abstract here was shortene

Early intervention in Portugal: study of professionals’ perceptions

Early intervention (EI) has been characterized by considerable advances in its domain, which has had great repercussions in the implementation of the family-centered approach. These changes have had implications in the practices and in the adoption and learning of new values that should be implemented in EI. This study evaluates the professional perspectives regarding familycentered practices in EI programs in Portugal. The results highlight the importance of effective collaboration and coordination between health, education, and social services and the importance of providing child and family support in a natural context. These results reinforce the need to invest in professional training to improve the quality of services offered to families in EI.Fundação para a Ciência e a Tecnologia (FCT) no âmbito do projecto PEst-OE/CED/UI1661/2014 do CIEd

Views on and experiences of electronic cigarettes: a qualitative study of women who are pregnant or have recently given birth.

Background Electronic cigarettes (ECs) are increasingly used for reducing or stopping smoking, with some studies showing positive outcomes. However, little is known about views on ECs during pregnancy or postpartum and previous studies have nearly all been conducted in the US and have methodological limitations, such as not distinguishing between smokers and ex/non-smokers. A greater understanding of this topic will help to inform both clinicians and EC interventions. We elicited views and experiences of ECs among UK pregnant or recently pregnant women. Methods We conducted semi-structured telephone interviews, using topic guides, with pregnant or recently pregnant women, who were current or recent ex-smokers. To ensure broad views of ECs were obtained, recruitment was from several geographical locations and via various avenues of recruitment. This included stop smoking services, antenatal and health visitor clinics, a pregnancy website and an informal network. Participants were 15 pregnant and 15 postpartum women, including nine current EC users, 11 ex-users, and 10 never-users. Five women who were interviewed in pregnancy were later interviewed in postpartum to explore if their views had changed. Audio data was transcribed verbatim and framework analysis was applied. Results Five main themes emerged: motivations for use (e.g., for stopping or reducing smoking), social stigma (e.g., avoiding use in public, preferring ‘discrete’ NRT), using the EC (e.g., mostly used at home); consumer aspects (e.g., limited advice available), and harm perceptions (e.g., viewed as less harmful than smoking; concerns about safety and addiction). Conclusions ECs were viewed positively by some pregnant and postpartum women and seen as less harmful than smoking and useful as aids for reducing and stopping smoking. However, due to perceived social stigma, some women feel uncomfortable using ECs in public, especially during pregnancy, and had concerns about safety and nicotine dependence. Health professionals and designers of EC interventions need to provide women with up-to-date and consistent information and advice about safety and dependence, as well as considering the influence of social stigma

Globalização multicultural, direitos universais humanos e socioambientais

O processo de globalização relaciona-se com o multiculturalismo sob uma ótica colonial europeia, em que a cultura hegemônica ocidental subjugou culturas periféricas em uma clara demonstração de racismo. A atual fase de globalização que o mundo vive refere-se mais diretamente ao modelo capitalista de economia, com sua lógica de mercado individualista, patrimonialista, privatista. Essa mesma lógica contribuiu para o surgimento do Estado Nacional, um modelo de organização política com tendência e vocação homogeneizante da sociedade, baseado em uma concepção universal de direitos, em que diferentes comunidades humanas, portadoras de diferentes valores e visões próprias de mundo, foram reunidas sob uma mesma ordem, unitária, em um território único e bem definido. A economia globalizada de mercado favorece o contato entre diferentes culturas, tanto dentro como fora de um mesmo Estado. O multiculturalismo é considerado uma estratégia de povos e comunidades periféricas para se defenderem do efeito homogeneizante da economia de mercado e do seu órgão político, o Estado Nacional. Há duas globalizações: a hegemônica ocidental, levada a cabo pelo sistema econômico capitalista; e a contra-hegemônica, das culturas dominadas, uma reação contra o extermínio de práticas e tradições culturais locais. O discurso dos direitos humanos é usado de forma hegemônica, direcionado para os valores do mercado capitalista, e de forma contra-hegemônica, como reação das minorias. Diante desse quadro plural, o texto mostra alguns métodos de harmonização intercultural, o papel das constituições, das estruturas estatais e dos direitos humanos, quer como instrumentos de dominação, quer como mecanismos de contra-hegemonia

Incursões Militares Unilaterais em Solo Estrangeiro e a Sua Legitimidade: O Caso Líbio de 2013

 In 1945, the Truman Proclamation, a government unilateral act of the United Sta- tes, led to the rapid emergence of an international custom that in 1958 turned into a con- vention and in 1969 was recognized by the International Court of Justice as the right of states to economically exploit their continental shelves. This paper examines the effects of the Bush Doctrine, another US unilateral act, under public international law, due to the attacks of 11th September 2001. This research centers on a specific case: the capture of Abu Anas al -Liby, a Libyan citizen who was stopped at the door of his home in October 5th, 2013, in the city of Tripoli, the Libyan territory. It happened in a joint operation, which saw the participation of the CIA - Central Intelligence Agency, the FBI - Federal Bureau of Investigation and the Delta Force soldiers, a group of elite US military - United States , on the grounds that the targeted one had links with the terrorist group Al Qaeda. After his capture, al-Liby was taken in for questioning on a warship in the Mediterrane- an sea and then was presented before a Federal Court of New York to stand trial for the attacks that in 1998 killed hundreds of people in US Embassies, in Kenya and Tanzania. The Libyan state denied having granted any authorization and complained of violation of sovereignty. This work has importance in the context of the Iberian Peninsula, due to the fact that Portugal and Spain are now potentially inserted into the terrorist agenda of the Islamic State of Iraq and al-Sham (ISIS), a group that, in 2014, declared his intent to recover all the territories that belonged to Islam, announcement that has been considered the most significant development of international jihadism since 11th September. From these elements, the paper investigates whether there is any right capable of legitimizing unilateral military raids on foreign soil. As a result, it can be said that there is an ongoing accelerated formation of international custom.Em 1945, a Proclamação Truman, um ato unilateral do governo dos Estados Unidos da América, levou ao rápido surgimento de um costume internacional que, em 1958, transformou-se em uma convenção e, em 1969, foi reconhecido pela Corte Internacional de Justiça como o direito dos Estados de explorarem economicamente as suas plataformas continentais. O presente trabalho examina os efeitos da Doutrina Bush, outro ato unilateral dos EUA, no âmbito do Direito Internacional Público, em decorrência dos atentados do 11 de setembro de 2001. A pesquisa gira em torno de um caso concreto: a captura de Abu Anas al-Liby, um cidadão líbio que foi interceptado na porta de sua casa, em 05 de outubro de 2013, na cidade de Trípoli, território da Líbia. O fato aconteceu através de uma operação conjunta, que contou com a participação da CIA – Agência Central de Inteligência, do FBI – Agência Federal de Investigação e de militares do Comando Delta, um grupo de elite das Forças Armadas dos EUA – Estados Unidos da América, sob alegação de que o alvo tinha ligações com o grupo terrorista Al Qaeda. Após a captura, al-Liby foi levado para interrogatório em um navio de guerra no Mediterrâneo e, depois, foi apresentado a uma Corte Federal de Nova York para ser julgado pelos atentados que, em 1998, mataram centenas de pessoas nas Embaixadas dos EUA, no Quênia e na Tanzânia. O Estado líbio negou ter concedido qualquer autorização e queixou-se de violação de soberania. O presente trabalho possui importância, no contexto da Península Ibérica, devido ao fato de que Portugal e Espanha estão hoje potencialmente inseridos na agenda terrorista do Estado Islâmico do Iraque e Al-Sham (ISIS), grupo que, em 2014, declarou seu intento de recuperar todos os territórios que pertenceram ao Islão, anúncio que vem sendo considerado o mais significativo desenvolvimento do jihadismo internacional desde o 11 de setembro. A partir desses elementos, o artigo investiga se existe algum direito capaz de legitimar incursões militares unilaterais em solo estrangeiro. Como resultado, pode-se dizer que está em curso uma formação acelerada de costume internacional

Insect pathogens as biological control agents: back to the future

The development and use of entomopathogens as classical, conservation and augmentative biological control agents have included a number of successes and some setbacks in the past 15 years. In this forum paper we present current information on development, use and future directions of insect-specific viruses, bacteria, fungi and nematodes as components of integrated pest management strategies for control of arthropod pests of crops, forests, urban habitats, and insects of medical and veterinary importance. Insect pathogenic viruses are a fruitful source of MCAs, particularly for the control of lepidopteran pests. Most research is focused on the baculoviruses, important pathogens of some globally important pests for which control has become difficult due to either pesticide resistance or pressure to reduce pesticide residues. Baculoviruses are accepted as safe, readily mass produced, highly pathogenic and easily formulated and applied control agents. New baculovirus products are appearing in many countries and gaining an increased market share. However, the absence of a practical in vitro mass production system, generally higher production costs, limited post application persistence, slow rate of kill and high host specificity currently contribute to restricted use in pest control. Overcoming these limitations are key research areas for which progress could open up use of insect viruses to much larger markets. A small number of entomopathogenic bacteria have been commercially developed for control of insect pests. These include several Bacillus thuringiensis sub-species, Lysinibacillus (Bacillus) sphaericus, Paenibacillus spp. and Serratia entomophila. B. thuringiensis sub-species kurstaki is the most widely used for control of pest insects of crops and forests, and B. thuringiensis sub-species israelensis and L. sphaericus are the primary pathogens used for medically important pests including dipteran vectors,. These pathogens combine the advantages of chemical pesticides and microbial control agents (MCAs): they are fast acting, easy to produce at a relatively low cost, easy to formulate, have a long shelf life and allow delivery using conventional application equipment and systemics (i.e. in transgenic plants). Unlike broad spectrum chemical pesticides, B. thuringiensis toxins are selective and negative environmental impact is very limited. Of the several commercially produced MCAs, B. thuringiensis (Bt) has more than 50% of market share. Extensive research, particularly on the molecular mode of action of Bt toxins, has been conducted over the past two decades. The Bt genes used in insect-resistant transgenic crops belong to the Cry and vegetative insecticidal protein families of toxins. Bt has been highly efficacious in pest management of corn and cotton, drastically reducing the amount of broad spectrum chemical insecticides used while being safe for consumers and non-target organisms. Despite successes, the adoption of Bt crops has not been without controversy. Although there is a lack of scientific evidence regarding their detrimental effects, this controversy has created the widespread perception in some quarters that Bt crops are dangerous for the environment. In addition to discovery of more efficacious isolates and toxins, an increase in the use of Bt products and transgenes will rely on innovations in formulation, better delivery systems and ultimately, wider public acceptance of transgenic plants expressing insect-specific Bt toxins. Fungi are ubiquitous natural entomopathogens that often cause epizootics in host insects and possess many desirable traits that favor their development as MCAs. Presently, commercialized microbial pesticides based on entomopathogenic fungi largely occupy niche markets. A variety of molecular tools and technologies have recently allowed reclassification of numerous species based on phylogeny, as well as matching anamorphs (asexual forms) and teleomorphs (sexual forms) of several entomopathogenic taxa in the Phylum Ascomycota. Although these fungi have been traditionally regarded exclusively as pathogens of arthropods, recent studies have demonstrated that they occupy a great diversity of ecological niches. Entomopathogenic fungi are now known to be plant endophytes, plant disease antagonists, rhizosphere colonizers, and plant growth promoters. These newly understood attributes provide possibilities to use fungi in multiple roles. In addition to arthropod pest control, some fungal species could simultaneously suppress plant pathogens and plant parasitic nematodes as well as promote plant growth. A greater understanding of fungal ecology is needed to define their roles in nature and evaluate their limitations in biological control. More efficient mass production, formulation and delivery systems must be devised to supply an ever increasing market. More testing under field conditions is required to identify effects of biotic and abiotic factors on efficacy and persistence. Lastly, greater attention must be paid to their use within integrated pest management programs; in particular, strategies that incorporate fungi in combination with arthropod predators and parasitoids need to be defined to ensure compatibility and maximize efficacy. Entomopathogenic nematodes (EPNs) in the genera Steinernema and Heterorhabditis are potent MCAs. Substantial progress in research and application of EPNs has been made in the past decade. The number of target pests shown to be susceptible to EPNs has continued to increase. Advancements in this regard primarily have been made in soil habitats where EPNs are shielded from environmental extremes, but progress has also been made in use of nematodes in above-ground habitats owing to the development of improved protective formulations. Progress has also resulted from advancements in nematode production technology using both in vivo and in vitro systems; novel application methods such as distribution of infected host cadavers; and nematode strain improvement via enhancement and stabilization of beneficial traits. Innovative research has also yielded insights into the fundamentals of EPN biology including major advances in genomics, nematode-bacterial symbiont interactions, ecological relationships, and foraging behavior. Additional research is needed to leverage these basic findings toward direct improvements in microbial control

School Effects on the Wellbeing of Children and Adolescents

Well-being is a multidimensional construct, with psychological, physical and social components. As theoretical basis to help understand this concept and how it relates to school, we propose the Self-Determination Theory, which contends that self-determined motivation and personality integration, growth and well-being are dependent on a healthy balance of three innate psychological needs of autonomy, relatedness and competence. Thus, current indicators involve school effects on children’s well-being, in many diverse modalities which have been explored. Some are described in this chapter, mainly: the importance of peer relationships; the benefits of friendship; the effects of schools in conjunction with some forms of family influence; the school climate in terms of safety and physical ecology; the relevance of the teacher input; the school goal structure and the implementation of cooperative learning. All these parameters have an influence in promoting optimal functioning among children and increasing their well-being by meeting the above mentioned needs. The empirical support for the importance of schools indicates significant small effects, which often translate into important real-life effects as it is admitted at present. The conclusion is that schools do make a difference in children’s peer relationships and well-being

Increased incidence of glucose disorders during pregnancy is not explained by pre-pregnancy obesity in London, Canada

<p>Abstract</p> <p>Background</p> <p>The increasing incidence of impaired glucose tolerance (IGT), gestational diabetes (GDM) and type 2 diabetes (T2D) during pregnancy was hypothesized to be associated with increases in pre-pregnancy body mass index (BMI). The aims were to 1) determine the prevalence of IGT/GDM/T2 D over a 10 year period; 2) examine the relationship between maternal overweight/obesity and IGT/GDM/T2D; and 3) examine the extent to which maternal metabolic complications impact maternal and fetal pregnancy outcomes.</p> <p>Methods</p> <p>Data arose from a perinatal database which contains maternal characteristics and perinatal outcome for all singleton infants born in London, Canada between January 1, 2000 and December 31, 2009. Univariable and multivariable odds ratios (OR) were estimated using logistic regression with IGT/GDM/T2 D being the outcome of interest.</p> <p>Results</p> <p>A total of 36,597 women were included in the analyses. Population incidence of IGT, GDM and T2 D rose from 0.7%, 2.9% and 0.5% in 2000 to 1.2%, 4.2% and 0.9% in 2009. The univariable OR for IGT, GDM and T2 D were 1.65, 1.52 and 2.06, respectively, over the ten year period. After controlling for maternal age, parity and pre-pregnancy BMI the OR did not decrease. Although there was a positive relationship between pre-pregnancy BMI and prevalence of IGT/GDM/T2 D, this did not explain the time trends in the latter. Diagnosis of IGT/GDM/T2 D increased the risk of having an Apgar score <7 at 5 minutes, which was partially explained by gestational hypertension, high placental ratio, gestational age and large for gestational age babies.</p> <p>Conclusions</p> <p>We found a significant increase in the incidence of IGT/GDM/T2 D for the decade between 2000-2009 which was not explained by rising prevalence of maternal overweight/obesity.</p