Adolescents' Views on Seeking Help for Emotional and Behavioral Problems: A Focus Group Study

This study aimed to get insight into adolescents' views on help-seeking for emotional and behavioral problems. Fourteen focus groups were conducted. Two vignettes, depicting one healthy adolescent with few issues and one adolescent with severe psychosocial problems, were used to structure the focus groups. The focus groups were framed within a youth help-seeking model. Adolescents (mean age of 15.0 years) generally reported seeking help from friends or the internet for mild issues and from a person they trust like a parent or school mentor, for more severe problems. Adolescents correctly recognized the issues in vignette one as surmountable and the problems in vignette two as severe. A bond of trust with a help source was regarded as the main facilitator for the decision to seek help. Adolescents reported a preference for help sources who clearly displayed their expertise for the issue at hand and for informal help-sources, particularly friends

Rabbit ATG/ATLG in preventing graft-versus-host disease after allogeneic stem cell transplantation: consensus-based recommendations by an international expert panel

This collaborative initiative aimed to provide recommendations on the use of polyclonal antithymocyte globulin (ATG) or anti-T lymphocyte globulin (ATLG) for the prevention of graft-versus-host disease (GvHD) after allogeneic hematopoietic stem cell transplantation (HSCT). A comprehensive review of articles released up to October, 2018 was performed as a source of scientific evidence. Fourteen clinically relevant key questions to the domains indication, administration, and post-transplant management were developed and recommendations were produced using the Delphi technique involving a Panel of 14 experts. ATG/ATLG was strongly recommended as part of myeloablative conditioning regimen prior to matched or mismatched unrelated bone marrow or peripheral blood allogeneic HSCT in malignant diseases to prevent severe acute and chronic GvHD. ATG/ATLG was also recommended prior to HLA-identical sibling peripheral HSCT with good but lesser bulk of evidence. In reduced intensity or nonmyeloablative conditioning regimens, ATG/ATLG was deemed appropriate to reduce the incidence of acute and chronic GvHD, but a higher risk of relapse should be taken into account. Recommendations regarding dose, application, and premedication were also provided as well as post-transplant infectious prophylaxis and vaccination. Overall, these recommendations can be used for a proper and safe application of polyclonal ATG/ATLG to prevent GvHD after allogeneic HSCT

Enzyme replacement therapy and/or hematopoietic stem cell transplantation at diagnosis in patients with mucopolysaccharidosis type I: results of a European consensus procedure

<p>Abstract</p> <p>Background</p> <p>Mucopolysaccharidosis type I (MPS I) is a lysosomal storage disorder that results in the accumulation of glycosaminoglycans causing progressive multi-organ dysfunction. Its clinical spectrum is very broad and varies from the severe Hurler phenotype (MPS I-H) which is characterized by early and progressive central nervous system (CNS) involvement to the attenuated Scheie phenotype (MPS I-S) with no CNS involvement. Indication, optimal timing, safety and efficacy of the two available treatment options for MPS I, enzyme replacement therapy (ERT) and hematopoietic stem cell transplantation (HSCT), are subject to continuing debate. A European consensus procedure was organized to reach consensus about the use of these two treatment strategies.</p> <p>Methods</p> <p>A panel of specialists, including 8 specialists for metabolic disorders and 7 bone marrow transplant physicians, all with acknowledged expertise in MPS I, participated in a modified Delphi process to develop consensus-based statements on MPS I treatment. Fifteen MPS I case histories were used to initiate the discussion and to anchor decisions around either treatment mode. Before and at the meeting all experts gave their opinion on the cases (YES/NO transplantation) and reasons for their decisions were collected. A set of draft statements on MPS I treatment options composed by a planning committee were discussed and revised during the meeting until full consensus.</p> <p>Results</p> <p>Full consensus was reached on several important issues, including the following: 1) The preferred treatment for patients with MPS I-H diagnosed before age 2.5 yrs is HSCT; 2) In individual patients with an intermediate phenotype HSCT may be considered if there is a suitable donor. However, there are no data on efficacy of HSCT in patients with this phenotype; 3) All MPS I patients including those who have not been transplanted or whose graft has failed may benefit significantly from ERT; 4) ERT should be started at diagnosis and may be of value in patients awaiting HSCT.</p> <p>Conclusions</p> <p>This multidisciplinary consensus procedure yielded consensus on the main issues related to therapeutic choices and research for MPS I. This is an important step towards an international, collaborative approach, the only way to obtain useful evidence in rare diseases.</p

Encounters with the moral economy of water: convergent evolution in Valencia

[EN] This article presents the results of comparative fieldwork on the huerta of Valencia in Spain, a successful community-managed irrigation system of medium scale, one governed collectively by thousands of small farmers organized into 10 autonomous but highly interdependent irrigator groups. The study tested a model identified previously in research on successful systems of much smaller scale in Peru, a set of principles of operation that, when affirmed by farmers and obeyed as collective-choice rules, interact to create equity among water rights and transparency in water use in an unusual way. The authors show that a nearly identical set are at work in all 10 communities of Valencia, revealing the unique manner in which these work together to promote successful and sustainable cooperation, both within and between the user groups, and arguing that their presence in Spain and the Andes is indicative, not of diffusion from one continent to another, but of independent invention. These principles together laid the foundations for separate Andean and Islamic hydraulic traditions, which were often manifested locally in robust and equitable systems of the same general type, here called the moral economy of water. This kind of communal system appears to have emerged repeatedly, and often independently, in a great many other locales and settings throughout the world; its adaptive dynamics are shown to be of great relevance to small farmers today as they face the growing scarcity of water being induced by population growth and by climate change.Trawick, P.; Ortega Reig, MV.; Palau-Salvador, G. (2014). Encounters with the moral economy of water: convergent evolution in Valencia. Wiley Interdisciplinary Reviews: Water. 1(1):87-110. doi:10.1002/wat2.1008S871101

Binding hotspots of BAZ2B bromodomain: Histone interaction revealed by solution NMR driven docking.

Bromodomains are epigenetic reader domains, which have come under increasing scrutiny both from academic and pharmaceutical research groups. Effective targeting of the BAZ2B bromodomain by small molecule inhibitors has been recently reported, but no structural information is yet available on the interaction with its natural binding partner, acetylated histone H3K14ac. We have assigned the BAZ2B bromodomain and studied its interaction with H3K14ac acetylated peptides by NMR spectroscopy using both chemical shift perturbation (CSP) data and clean chemical exchange (CLEANEX-PM) NMR experiments. The latter was used to characterize water molecules known to play an important role in mediating interactions. Besides the anticipated Kac binding site, we consistently found the bromodomain BC loop as hotspots for the interaction. This information was used to create a data-driven model for the complex using HADDOCK. Our findings provide both structure and dynamics characterization that will be useful in the quest for potent and selective inhibitors to probe the function of the BAZ2B bromodomain.This is the final published version of the article. It has been published by the American Chemical Society in Biochemistry. The article can be accessed on their website here: http://pubs.acs.org/doi/abs/10.1021/bi500909d. It is freely available under a CC BY licence

The Subak in Diaspora: Balinese Farmers and the Subak in South Sulawesi

The subak has a long history as an irrigators’ institution on Bali. It has also spread across Indonesia along with Balinese farmers who were resettled by colonial and post-colonial governments or who have migrated spontaneously since colonial times. While subaks have been much researched in Bali itself, little is known about subaks outside Bali. Luwu District in South Sulawesi is one of the areas where thousands of Balinese families settled in the last four decades. Based on research in this transmigration area, this paper analyzes the emergence and development of the subak in relation to the development of irrigation infrastructure of a state-built irrigation system. A comparison between two Balinese settlements in the same system shows that differences in infrastructural and managerial conditions and arrangements between parts of the irrigation system were major determinants of the institutional space allowed for the subak and ways in which the subaks developed

Heterogeneity of the humoral immune response following Staphylococcus aureus bacteremia

Expanding knowledge on the humoral immune response in Staphylococcus aureus-infected patients is a mandatory step in the development of vaccines and immunotherapies. Here, we present novel insights into the antibody responses following S. aureus bacteremia. Fifteen bacteremic patients were followed extensively from diagnosis onwards (median 29 days, range 9-74). S. aureus strains (median 3, range 1-6) and serial serum samples (median 16, range 6-27) were collected. Strains were genotyped by pulsed-field gel electrophoresis (PFGE) and genes encoding 19 staphylococcal proteins were detected by polymerase chain reaction (PCR). The levels of IgG, IgA, and IgM directed to these proteins were determined using bead-based flow cytometry. All strains isolated from individual patients were PFGE-identical. The genes encoding clumping factor (Clf) A, ClfB, and iron-responsive surface-determinant (Isd) A were detected in all isolates. Antigen-specific IgG levels increased more frequently than IgA or IgM levels. In individual patients, different proteins induced an immune response and the dynamics clearly differed. Anti-ClfB, anti-IsdH, and anti-fibronectin-binding protein A IgG levels increased in 7 of 13 adult patients (p < 0.05). The anti-IsdA IgG level increased in 12 patients (initial to peak level: 1.13-10.72 fold; p < 0.01). Peak level was reached 7-37 days after diagnosis. In a bacteremic 5-day-old newborn, antistaphylococcal IgG levels declined from diagnosis onwards. In conclusion, each bacteremic patient develops a unique immune response directed to different staphylococcal proteins. Therefore, vaccines should be based on multiple components. IsdA is immunogenic and, therefore, produced in nearly all bacteremic patients.