Parenting functioning in stunting management: A concept analysis

Stunting, a global issue, is the retarded growth and development of children resulting from inadequate nutrition, frequent infection, and insufficient psychosocial stimulation. It is usually an indicator of poor parenting. The role of parents is important for children’s growth, development and learning. Parenting functioning is a concept health care professionals use to describe parenting activities for the purpose of intervention. But, the health professionals and patients have different understanding on parental functioning. There is a need to have a consistent definition of parenting functioning, and therefore this study aims to analyze the concept. Walker and Avant’s method of concept analysis was used to study parenting functioning for the purpose of improving management of stunting. The attributes of parenting functioning are knowledge, competency, effort, responsibility, partnership, caring, teaching and communicating. Antecedents for parenting functioning are relationship, children’s characteristics, careful observation and vicarious experiences. The consequences are positive child-rearing practice, less psychological stress and children’s wellness. The empirical referents for parenting functioning are Keys to Interactive Parenting Scale (KIPS) and Parenting Interaction with Children: Checklist of Observations Linked to Outcomes (PICCOLO). In conclusion, this analytical concept can provide insights into nursing and public health colleagues to improve understanding of parenting functioning and to facilitate development of instrument to improve to an advance stage and to improve the stunting management

Development Of Community Psychiatric Crisis Management Indicators And Assessment Framework In Taiwan: A Focus Group Study

This study was to develop the Community Psychiatric Crisis Management (CPCM) Model for community-dwelling psychiatric patients of Taiwan. Purposes of this study were: 1. To develop psychiatric patients’ community crisis management indictors; 2. To develop the psychiatric patients’ community crisis management framework. Methods: Three focus group interviews involving a total of 42 experts, included psychiatrists, psychiatric nurses, social worker, and community mental health service providers were implemented. Interview data were analyzed with qualitative content analysis. Results: The model of CPCM concretized the objectives, crisis assessment indicators, and crisis intervention services for community psychiatric patients, and proved to be an important part of CPCM. The level of crisis severity and impact of patient can be assessed by the four indicators: medical care seeking behaviors, psychiatric symptom severity and impact, history of violence and substance abuse, and protective factors of family and social support system. In addition, the severity and impact of CPCM score could be implement to provide home visiting care and crisis management interventions. The recommended CPCM model enabled community mental health care professionals’ assessment and management the patient’s crisis problems in three stages, from crisis, acute and maintenance stage. Conclusions: The CPCM model was improved practically, and the contents of the intervention were constructed. It is important to integrate crisis management with the preventive intervention to the community psychiatric patient care

Differentiated rare-element mineralization in an ongonite − topazite composite dike at the Xianghualing tin district, Southern China: an electron-microprobe study on the evolution from niobium-tantalum-oxides to cassiterite

International audienceOur study characterizes in detail the mineralogical, textural and compositional features of a highly evolved, composite ongonite-topazite dike and its magmatic differentiation history. We present compositional data collected by established techniques, i.e. by electron microprobe and wet-chemical analysis, which provide a detailed framework for future studies that employ state-of-the-art analytical techniques. The studied dike (referred to as the No. 431 dike) crops out within the Xianghualing area in the Nanling Range of southern China, in close spatial association with Jurassic Sn-Nb-Ta granite plutons. The rock samples in the No. 431 dike were collected from a structurally lower drill hole and a trench at higher level. The ongonite is encountered throughout the dike, but the topazite is only revealed along the margin of the upper, near-surface dike. The results of whole-rock major and trace element analyses show that the rocks of the No. 431 dike are strongly peraluminous with an average ACNK value of ~ 1.5 for ongonite and > 3.9 for topazite. They are enriched in F, 1.7 wt.% and 5.4 wt.% on average for ongonite and topazite, respectively. The rocks have low Zr/Hf and Nb/Ta ratios, and high levels of ore-forming elements including Nb, Ta, Sn, and W. Silicate and oxide mineral assemblages, textures, and compositions are also distinct for the two rock types studied. In the lower ongonite of the dike, there are abundant phenocrysts of K-feldspar, quartz, and albite, and microphenocrysts of topaz and zinnwaldite in a matrix dominated by quartz, K-feldspar, and albite. Characteristic oxides are columbite-tantalite, tapiolite, and microlite, but cassiterite is absent. The upper ongonite of the dike has a silicate assemblage similar to the lower ongonite; columbite-(Mn), uranomicrolite, and limited amounts of cassiterite are the dominant accessory minerals. The topazite is characterized by large amounts of topaz and zinnwaldite intergrown with quartz, while K-feldspar, albite, and quartz phenocrysts have rounded shapes and are relatively rare. Cassiterite is the most abundant ore mineral, while Nb-Ta oxide minerals are less abundant. We interpret the whole-rock compositional trends, mineral textures, assemblages, and compositions to reflect the differentiation of an evolved, initially homogeneous magma that separated into aluminosilicate and hydrosaline melts, corresponding to crystallization of ongonite and topazite, respectively. The crystallization of Nb-Ta- and Sn-bearing ore minerals was strongly controlled by the separation of the two melt phases. We hypothesize that dike propagation/widening subsequent to the initial dike emplacement may have driven the separation of the aluminosilicate and hydrosaline melt phases that crystallized to ongonite in the core and topazite along the margins of the structurally higher part of the dike

Effects of Safflower Yellow on the Treatment of Severe Sepsis and Septic Shock: A Randomized Controlled Clinical Trial

Objective. To evaluate the clinical effect of safflower yellow on the treatment of severe sepsis and septic shock. Methods. 85 patients with severe sepsis and septic shock were randomly selected to receive either therapy according to the international guidelines for management of severe sepsis and septic shock (Surviving Sepsis Campaign 2012) (control group, n = 45) or conventional therapy plus safflower yellow (study group, n = 40). The 28-day mortality and 28-day Kaplan-Meier survival curves were compared as primary outcomes. Results. The 28-day mortality from all causes and in-hospital mortality were significantly lower in the study group (50%, 17.5%) as compared to the control group (78.58%, 54.76%) (P = 0.007, all causes, P < 0.001, in-hospital), and the 28-day Kaplan-Meier survival curve was higher in the study group than in the control group (P = 0.008, all causes, P < 0.001, in-hospital, Log Rank). 72 hours after treatment, secondary outcomes including heart rate, leukocyte counts, lactate levels, and platelet counts of patients in the study group were ameliorated significantly as compared with the control group. Conclusion. This study offers a potential new strategy employing safflower yellow to more effectively treat patients with severe sepsis and septic shock. This trial is registered with identifier ChiCTR-TRC-14005196

TMRT observations of 26 pulsars at 8.6 GHz

Integrated pulse profiles at 8.6~GHz obtained with the Shanghai Tian Ma Radio Telescope (TMRT) are presented for a sample of 26 pulsars. Mean flux densities and pulse width parameters of these pulsars are estimated. For eleven pulsars these are the first high-frequency observations and for a further four, our observations have a better signal-to-noise ratio than previous observations. For one (PSR J0742-2822) the 8.6~GHz profiles differs from previously observed profiles. A comparison of 19 profiles with those at other frequencies shows that in nine cases the separation between the outmost leading and trailing components decreases with frequency, roughly in agreement with radius-to-frequency mapping, whereas in the other ten the separation is nearly constant. Different spectral indices of profile components lead to the variation of integrated pulse profile shapes with frequency. In seven pulsars with multi-component profiles, the spectral indices of the central components are steeper than those of the outer components. For the 12 pulsars with multi-component profiles in the high-frequency sample, we estimate the core width using gaussian fitting and discuss the width-period relationship.Comment: 33 pages, 49 figures, 5 Tables; accepted by Ap

Large A-fiber activity is required for microglial proliferation and p38 MAPK activation in the spinal cord: different effects of resiniferatoxin and bupivacaine on spinal microglial changes after spared nerve injury

BACKGROUND: After peripheral nerve injury, spontaneous ectopic activity arising from the peripheral axons plays an important role in inducing central sensitization and neuropathic pain. Recent evidence indicates that activation of spinal cord microglia also contributes to the development of neuropathic pain. In particular, activation of p38 mitogen-activated protein kinase (MAPK) in spinal microglia is required for the development of mechanical allodynia. However, activity-dependent activation of microglia after nerve injury has not been fully addressed. To determine whether spontaneous activity from C- or A-fibers is required for microglial activation, we used resiniferatoxin (RTX) to block the conduction of transient receptor potential vanilloid subtype 1 (TRPV1) positive fibers (mostly C- and Adelta-fibers) and bupivacaine microspheres to block all fibers of the sciatic nerve in rats before spared nerve injury (SNI), and observed spinal microglial changes 2 days later. RESULTS: SNI induced robust mechanical allodynia and p38 activation in spinal microglia. SNI also induced marked cell proliferation in the spinal cord, and all the proliferating cells (BrdU+) were microglia (Iba1+). Bupivacaine induced a complete sensory and motor blockade and also significantly inhibited p38 activation and microglial proliferation in the spinal cord. In contrast, and although it produced an efficient nociceptive block, RTX failed to inhibit p38 activation and microglial proliferation in the spinal cord. CONCLUSION: (1) Blocking peripheral input in TRPV1-positive fibers (presumably C-fibers) is not enough to prevent nerve injury-induced spinal microglial activation. (2) Peripheral input from large myelinated fibers is important for microglial activation. (3) Microglial activation is associated with mechanical allodynia

High remission and low relapse with prolonged intensive DMARD therapy in rheumatoid arthritis (PRINT): A multicenter randomized clinical trial

Objectives: To determine whether prolonged intensive disease-modifying antirheumatic drug (DMARD) treatment (PRINT) leads to high remission and low relapse rates in patients with severe rheumatoid arthritis (RA). Methods: In this multicenter, randomized and parallel treatment trial, 346 patients with active RA (disease activity score (28 joints) [DAS28] (erythrocyte sedimentation rate [ESR]) &gt; 5.1) were enrolled from 9 centers. In phase 1, patients received intensive treatment with methotrexate, leflunomide, and hydroxychloroquine, up to 36 weeks, until remission (DAS28 ≤ 2.6) or a low disease activity (2.6 &#60; DAS28 ≤ 3.2) was achieved. In phase 2, patients achieving remission or low disease activity were followed up with randomization to 1 of 2 step-down protocols: leflunomide plus hydroxychloroquine combination or leflunomide monotherapy. The primary endpoints were good European League Against Rheumatism (EULAR) response (DAS28 (ESR) &#60; 3.2 and a decrease of DAS28 by at least 1.2) during the intensive treatment and the disease state retention rate during step-down maintenance treatment. Predictors of a good EULAR response in the intensive treatment period and disease flare in the maintenance period were sought. Results: A good EULAR response was achieved in 18.7%, 36.9%, and 54.1% of patients at 12, 24, and 36 weeks, respectively. By 36 weeks, 75.4% of patients achieved good and moderate EULAR responses. Compared with those achieving low disease activity and a high health assessment questionnaire (HAQ &gt; 0.5), patients achieving remission (DAS28 ≤ 2.6) and low HAQ (≤ 0.5) had a significantly higher retention rate when tapering the DMARDs treatment (P = 0.046 and P = 0.01, respectively). There was no advantage on tapering to combination rather than monotherapy. Conclusions: Remission was achieved in a proportion of patients with RA receiving prolonged intensive DMARD therapy. Low disease activity at the start of disease taper leads to less subsequent flares. Leflunomide is a good maintenance treatment as single treatment

Sodium-Related Adaptations to Drought: New Insights From the Xerophyte Plant Zygophyllum xanthoxylum

Understanding the unusual physiological mechanisms that enable drought tolerance in xerophytes will be of considerable benefit because of the potential to identify novel and key genetic elements for future crop improvements. These plants are interesting because they are well-adapted for life in arid zones; Zygophyllum xanthoxylum, for example, is a typical xerophytic shrub that inhabits central Asian deserts, accumulating substantial levels of sodium (Na+) in its succulent leaves while growing in soils that contain very low levels of this ion. The physiological importance of this unusual trait to drought adaptations remains poorly understood, however. Thus, 2-week-old Z. xanthoxylum plants were treated with 50 mM NaCl (Na) for 7 days in this study in order to investigate their drought tolerance, leaf osmotic potential (Ψs) related parameters, anatomical characteristics, and transpiration traits. The results demonstrated that NaCl treatment significantly enhanced both the survivability and durability of Z. xanthoxylum plants under extreme drought conditions. The bulk of the Na+ ions encapsulated in plants was overwhelmingly allocated to leaves rather than roots or stems under drought conditions; thus, compared to the control, significantly more Na+ compared to other solutes such as K+, Ca2+, Cl-, sugars, and proline accumulated in the leaves of NaCl-treated plants and led to a marked decrease (31%) in leaf Ψs. In addition, the accumulation of Na+ ions also resulted in mesophyll cell enlargement and leaf succulence, enabling the additional storage of water; Na+ ions also reduced the rate of water loss by decreasing stomatal density and down-regulating stomatal aperture size. The results of this study demonstrate that Z. xanthoxylum has evolved a notable ability to utilize Na+ ions to lower Ψs, swell its leaves, and decrease stomatal aperture sizes, in order to enable the additional uptake and storage of water and mitigate losses. These distinctive drought adaption characteristics mean that the xerophytic plant Z. xanthoxylum presents a fascinating case study for the potential identification of important and novel genetic elements that could improve crops. This report provides insights on the eco-physiological role of sodium accumulation in xerophytes adapted to extremely arid habitats