Taken by strum: ukuleles and participatory music-making in Hamilton, Aotearoa/New Zealand

Ethnographic study of ukulele playing in Hamilton, N

Azithromycin in the extremely low birth weight infant for the prevention of Bronchopulmonary Dysplasia: a pilot study

<p>Abstract</p> <p>Background</p> <p>Azithromycin reduces the severity of illness in patients with inflammatory lung disease such as cystic fibrosis and diffuse panbronchiolitis. Bronchopulmonary dysplasia (BPD) is a pulmonary disorder which causes significant morbidity and mortality in premature infants. BPD is pathologically characterized by inflammation, fibrosis and impaired alveolar development. The purpose of this study was to obtain pilot data on the effectiveness and safety of prophylactic azithromycin in reducing the incidence and severity of BPD in an extremely low birth weight (≤ 1000 grams) population.</p> <p>Methods</p> <p>Infants ≤ 1000 g birth weight admitted to the University of Kentucky Neonatal Intensive Care Unit (level III, regional referral center) from 9/1/02-6/30/03 were eligible for this pilot study. The pilot study was double-blinded, randomized, and placebo-controlled. Infants were randomized to treatment or placebo within 12 hours of beginning mechanical ventilation (IMV) and within 72 hours of birth. The treatment group received azithromycin 10 mg/kg/day for 7 days followed by 5 mg/kg/day for the duration of the study. Azithromycin or placebo was continued until the infant no longer required IMV or supplemental oxygen, to a maximum of 6 weeks. Primary endpoints were incidence of BPD as defined by oxygen requirement at 36 weeks gestation, post-natal steroid use, days of IMV, and mortality. Data was analyzed by intention to treat using Chi-square and ANOVA.</p> <p>Results</p> <p>A total of 43 extremely premature infants were enrolled in this pilot study. Mean gestational age and birth weight were similar between groups. Mortality, incidence of BPD, days of IMV, and other morbidities were not significantly different between groups. Post-natal steroid use was significantly less in the treatment group [31% (6/19)] vs. placebo group [62% (10/16)] (p = 0.05). Duration of mechanical ventilation was significantly less in treatment survivors, with a median of 13 days (1–47 days) vs. 35 days (1–112 days)(p = 0.02).</p> <p>Conclusion</p> <p>Our study suggests that azithromycin prophylaxis in extremely low birth weight infants may effectively reduce post-natal steroid use for infants. Further studies are needed to assess the effects of azithromycin on the incidence of BPD and possible less common side effects, before any recommendations regarding routine clinical use can be made.</p

Knowledge and perceptions of ACES (Adverse Childhood Experiences) among parents and providers in Northeast Tennessee

Background: Adverse Childhood Experiences (ACEs) are a risk factor for the development of future physical and mental health problems. Programs are needed that prevent and address the impact of ACEs on a population-based level. As a pediatric primary care clinic serving Northeast Tennessee, our goal was to better understand the knowledge and perceptions of the effects of ACEs among parents/caregivers and health professionals in Northeast Tennessee. Methods: During the summer of 2017, 51 parents/caregivers visiting a health education table at a family event in a local public library completed an anonymous survey to help us understand what people think about how ACEs affect children and adults. 20 health care professionals at a local pediatric primary care clinic completed the same anonymous survey. Survey results were entered into Excel and analyzed using Excel and SPSS. Results: Fewer than one-third of parents/caregivers in this sample had heard of the term ACEs prior to receiving this survey. However, after being provided with a definition of ACEs, most respondents agreed that ACEs could affect children\u27s behavior and adult mental health. Agreement was less for perceptions of effects on physical health in adults. Most respondents recognized that a parent’s own ACE exposure could make parenting more difficult and that having a strong support system is helpful in counteracting these negative effects. Healthcare providers were more likely than parents/caregivers to have heard of the term ACEs before, however only half were familiar with the term. After being provided with a definition of ACEs, most healthcare providers agreed on their effects on children and adults. Perceptions that having a strong support system could counteract the effects of ACEs were slightly lower among health care providers as compared to parents/caregivers. Conclusion: The low awareness of ACEs found by our survey confirms the need for a new initiative to screen for ACEs and provide trauma-informed care in our clinic. The project, Baby Steps for Success, will involve screening children and parents/caregivers for ACEs, providing brief education on ACEs, and building resilience. Engaging and supporting families around healthy behaviors and interactions will be accomplished using Reach Out and Read and ReadNPlay for a Bright Future beginning in early infancy. Intervention with the Incredible Years program and Ecomap assessments will be provided to high-risk families with 2 or more ACEs. Families with four or more ACEs will be offered the Nurturing Parenting curriculum through a series of home and group visits. Partners for this project will include ETSU Pediatrics, Families Free, and the Northeast TN Regional Health Office

Brain leukocyte infiltration initiated by peripheral inflammation or experimental autoimmune encephalomyelitis occurs through pathways connected to the CSF-filled compartments of the forebrain and midbrain.

International audienceUNLABELLED: ABSTRACT: BACKGROUND: Cerebrospinal fluid (CSF) has been considered as a preferential pathway of circulation for immune cells during neuroimmune surveillance. In order to evaluate the involvement of CSF-filled spaces in the pathogenesis of experimental autoimmune encephalomyelitis (EAE), a model of multiple sclerosis, we performed a time-course analysis of immune cell association with the CSF-containing ventricles, velae, and cisterns in two active models of this disease. METHODS: Guinea-pig spinal cord homogenate-induced EAE in rat and myelin oligodendrocyte glycoprotein-induced EAE in mouse were used. Leukocyte distribution and phenotypes were investigated by immunohistochemistry in serial sections of brain areas of interest, as well as in CSF withdrawn from rat. Immune cells associated with the choroid plexuses were quantified. RESULTS: Freund's adjuvant-induced peripheral inflammation in the absence of brain antigen led to a subtle but definite increase in the number of myeloid cells in the extraventricular CSF spaces. In both rats and mice, EAE was characterized by a sustained and initial infiltration of lymphocytes and monocytes within forebrain/midbrain fluid-filled compartments such as the velum interpositum and ambient cisterns, and certain basal cisterns. Leukocytes further infiltrated periventricular and pericisternal parenchymal areas, along perivascular spaces or following a downward CSF-to-tissue gradient. Cells quantified in CSF sampled from rats included lymphocytes and neutrophils. The distinctive pattern of cell distribution suggests that both the choroid plexus and the vessels lying in the velae and cisterns are gates for early leukocyte entry in the central nervous system. B-cell infiltration observed in the mouse model was restricted to CSF-filled extraventricular compartments. CONCLUSION: These results identified distinctive velae and cisterns of the forebrain and midbrain as preferential sites of immune cell homing following peripheral and early central inflammation and point to a role of CSF in directing brain invasion by immune cells during EAE