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Some studies suggest that resource-rich countries tend to allocate talent and investment toward the resource sector and away from manufacturing or agriculture reducing the competitiveness of these other sectors. Because mining overwhelmingly employs men, when other sectors shrink so do employment opportunities for women (Ross, 2008). This could significantly affect core social structures. Using plausibly exogenous variation in natural resource wealth due to giant oil discoveries and an event study design, this paper finds that giant oil discoveries are associated with relatively worse female outcomes as measured by higher male/female population ratios, higher teen birth rates, and lower educational attendance of tertiary education among women relative to men. However, the impact on health outcomes tapers off within 8 years. Additionally, during periods of increasing oil prices, there is no significant evidence of such effects possibly due to an income effect. [ABSTRACT FROM AUTHOR]

The Brazilian Society of Angiology and Vascular Surgery, through the Guidelines Project, presents new Abdominal Aortic Aneurysm Guidelines, on the subject of care for abdominal aortic aneurysm patients. Its development prioritized descriptive guidelines, using the EMBASE, LILACS, and PubMed databases. References include randomized controlled trials, systematic reviews, meta-analyses, and cohort studies. Quality of evidence was evaluated by a pair of coordinators, aided by the RoB 2 Cochrane tool and the Newcastle Ottawa Scale forms. The subjects include juxtarenal aneurysms, infected aneurysms, and new therapeutic techniques, especially endovascular procedures. The current version of the guidelines include important recommendations for the primary topics involving diagnosis, treatment, and follow-up for abdominal aortic aneurysm patients, providing an objective guide for medical practice, based on scientific evidence and widely available throughout Brazil. [ABSTRACT FROM AUTHOR]

The Child Report of Posttraumatic Symptoms (CROPS) is an effective 26-item trauma assessment tool. Research has indicated a 14-item version of the CROPS for juvenile offenders with improved predictive accuracy for detecting trauma exposure among male offenders and commensurate accuracy for female offenders. However, the 14-item scale has yet to be validated for juvenile offenders with an established trauma measure. Cross-sectional retrospective data of 74 adjudicated youth (59.5% male) from the original CROPS 14-item psychometric study sample were used to examine the factor structure, internal consistency, and convergent and divergent validity of the 14-item scale. Findings indicated strong internal consistency and significant correlations with all scales of an established and more extensive trauma measure for children and adolescents. Findings also revealed a CROPS 12-item model explaining 36.9% of variance. Results supported both convergent and divergent validity, suggesting both the CROPS 14-item and 12-item may be used as valid trauma symptom screeners for juvenile offenders. [ABSTRACT FROM AUTHOR]

A child with pre-B acute lymphoblastic leukaemia (ALL) developed fatal encephalitis associated with human coronavirus OC43 (HCoV-OC43). During chemotherapy the child had a persistent HCoV-OC43 respiratory infection and later developed progressive encephalitis. Cerebrospinal fluid was negative for pathogens including HCoV-OC43, but a brain biopsy was HCoV-OC43-positive by metagenomic next-generation sequencing. [ABSTRACT FROM AUTHOR]

The Minnesota Multiphasic Personality Inventory – Adolescent (MMPI-A) is a widely researched personality assessment in psychology. However, the utility of the MMPI-A for detecting trauma among juvenile offenders is limited. A 17-item measure – Trauma Scale for Juvenile Offenders (TSJO) was examined to evaluate the trauma detection accuracy of the MMPI-A among juvenile offenders and provide preliminary validation for the TSJO. To determine the diagnostic utility of MMPI-A clinical scales, mean comparisons were conducted and significant scales were retained in a hierarchical logistic regression. To examine the diagnostic accuracy of the TSJO, the total score was included in the hierarchical model. TSJO cross tabulations were computed for the cutoff score. Mean comparisons by trauma group revealed Pa, Pt, Sc, and Si clinical scale differences. Regression output indicated statistical accuracy, but with limited clinical utility. Results showed moderate trauma detection accuracy (63.4%) of the TSJO cutoff. Findings provide limited support for using MMPI-A clinical scales in isolation when evaluating juvenile offenders for trauma. However, results provide empirical support for the TSJO as a valid measure for detecting trauma for this population. [ABSTRACT FROM AUTHOR]

Isolated aneurysms of the iliac arteries comprise less than 2% of abdominal aneurysms. The internal iliac artery is involved in 10-30% of cases. In most cases patients are asymptomatic, unless rupture occurs. They can be diagnosed by Doppler ultrasonography, magnetic resonance imaging or, preferably, angiotomography. Significant expansion, diameter of 3 cm or greater, and symptomatic cases are indications for surgery. We present the case of a patient with an incidental ultrasonographic finding of bilateral aneurysm of the internal iliac arteries, both with indications for surgery. The patient was successfully treated with endovascular techniques, first repairing the right internal iliac with a branched iliac stent graft, preserving patency, then embolizing the left internal iliac artery. Knowledge of the various different techniques and devices and their limitations is fundamental to adequate planning of endovascular treatment, even in rare cases. [ABSTRACT FROM AUTHOR]

Hemophagocytic lymphohistiocytosis (HLH) is a rare condition with high mortality. We report an extremely premature girl, born in the 24th gestational week (BW 732 g), that during her second month developed a severe HLH subsequent to a Serratia marcescens septicemia, with hepatosplenomegaly, cytopenias, hyperbilirubinemia (mostly conjugated, total bilirubin 916 μmol/L), hypertriglyceridemia, hypofibrinogenemia, hyperferritinemia (21266 μg/L), and elevated sIL-2 receptor levels. Genetic analysis revealed no PRF1, STX11 or UNC13D gene mutations. Treatment was provided according to the HLH-2004 protocol with etoposide, dexamethasone, and immunoglobulin, but no cyclosporin because of immature kidneys. She recovered fully from the HLH but developed a severe retinopathy as well as green teeth secondary to the hyperbilirubinemia. We conclude that secondary, bacteria-associated HLH can develop in premature infants, and that HLH can be treated with cytotoxic therapy also in premature infants. It is important to be aware of HLH in premature infants, since it is treatable. [ABSTRACT FROM AUTHOR]

When immobilising wildlife, adverse side effects can include hypoxaemia, acidosis and hypertension. Pulmonary gas exchange and acid–base status were evaluated during immobilisation of 25 free-ranging and one boma-held black rhinoceros (Diceros bicornis) in Zimbabwe. The effect of different body positions on arterial oxygenation was evaluated. A combination of the following drugs was used: an opioid (etorphine or thiafentanil), azaperone and an a2-adrenoceptor agonist (detomidine or xylazine). Respiratory and heart rates, rectal temperature and pulse oximetry–derived haemoglobin oxygen saturation were recorded. Serial arterial blood samples were analysed immediately in the field. Marked hypoxaemia and hypercapnia were recorded in immobilised free-ranging black rhinoceroses. Arterial oxygenation was higher during sternal compared to lateral recumbency. Most rhinoceroses developed acidaemia of respiratory and metabolic origin. Initially high lactate concentrations in free-ranging rhinoceroses decreased during immobilisation. Pulse oximetry was unreliable in the detection of hypoxaemia. Positioning in sternal recumbency and routine use of oxygen supplementation are recommended in the management of immobilised rhinoceroses as measures to improve arterial oxygenation. [ABSTRACT FROM AUTHOR]

Background Angiotensin converting enzyme inhibitors (ACE-Is) and angiotensin receptor blockers (ARBs) are recommended in heart failure with reduced ejection fraction (HFREF), but there is limited data on ARB vs. ACE-I and their combination in unselected populations. The purpose of this study was to compare the associations between the use of ACE-I, ARB and their combination, and outcomes in HFREF. Methods and results We prospectively studied 22,947 patients with HFREF (ejection fraction < 40%) enrolled in the Swedish Heart Failure Registry who received ACE-I but not ARB (n = 15,801, 69%), ARB but not ACE-I (n = 4335, 19%), their combination (n = 571, 2%) or neither (n = 2240, 10%). As compared with ACE-I alone, the hazard ratios (HRs) for ARB alone for all-cause mortality was 0.97 (95% CI = 0.91–1.03; p = 0.27), for HF hospitalization 1.08 (CI = 1.02–1.15; p < 0.01) and for the composite outcome 1.03 (CI = 0.99–1.08; p = 0.15). ACE-I and ARB combination had for death HR = 0.98 (95% CI = 0.84–1.14; p = 0.76), for HF hospitalization HR = 1.49 (CI = 1.33–1.68; p < 0.01) and for the composite outcome HR = 1.35 (CI = 1.21–1.50; p < 0.01). Use of neither ACE-I nor ARB was associated with HR for death 1.41 (CI = 1.33–1.50; p < 0.01), for HF hospitalization 1.16 (CI = 1.08–1.25; p < 0.01) and for the composite outcome 1.28 (CI = 1.21–1.35; p < 0.01). Conclusion This large generalizable analysis confirms the current recommendation of using ACE-I as first choice in HFREF. ARB can be considered an alternative in patients who cannot use ACE-I but should not routinely replace ACE-I. The combination of ACE-I and ARB was not associated with additional benefit over either one alone, and may potentially be harmful. [ABSTRACT FROM AUTHOR]

The authors comment on a study which examines whether the increase in Follicular helper T (Tfh) cells can be detected early after diagnosis of Type 1 diabetes (T1D) and before the onset of the disease. Topics include the detection of elevated Tfh prior to the onset of T1D, the symbiotic relationship of T-cells and B-cells and the potential role of Tfh in the pathogenesis of T1D.

Aims To analyse the long-term outcome, risk factor panorama, and treatment pattern in patients with heart failure (HF) with and without type 2 diabetes (T2DM) from a daily healthcare perspective Methods and results Patients with (n=8809) and without (n=27 465) T2DM included in the Swedish Heart Failure Registry (S-HFR) 2003-2011 due to a physician-based HF diagnosis were prospectively followed for long-term mortality (median follow-up time: 1.9 years, range 0-8.7 years). Left ventricular function expressed as EF did not differ between patients with and without T2DM. Survival was significantly shorter in patients with T2DM, who had a median survival time of 3.5 years compared with 4.6 years (P <0.0001). In subjects with T2DM. unadjusted and adjusted odds ratios (ORs) for mortality were 1.37 [95% confidence interval (CI) 1.30-1.44) and 1.60 (95% CI 1.50-1.71), and T2DM predicted mortality in all age groups. Ischaemic heart disease was an important predictor for mortality (OR 1.68, 95% CI 1.47-1.94), more abundant in patients with T2DM (59% vs. 45%) among whom only 35% had been subjected to coronary angiography and 32% to revascularization. Evidence-based pharmacological HF treatment was somewhat more extensive in patients with T2DM. Conclusion The combination of T2DM and HF seriously compromises long-term prognosis. Ischaemic heart disease was identified as one major contributor; however, underutilization of available diagnostic and therapeutic facilities for ischaemic heart disease was obvious and may be an important area for future improvement in patients with T2DM and HF. [ABSTRACT FROM AUTHOR]

Eighteen female New Zealand White rabbits (3.9 ± 0.4 kg) were anaesthetized with sufentanil–midazolam by intravenous infusion (SUF–MID, n = 9) or isoflurane (ISO, n = 9) for bilateral creation of an osteochondral defect in the medial femur condyle. Subcutaneous premedication with 0.1 mg/kg medetomidine and anaesthesia induction by intravenous infusion of 1.1 µg/kg sufentanil and 0.2 mg/kg midazolam were identical in both groups. During surgery (60 min), the effects on respiratory and circulatory variables serum lactate, total protein and blood glucose were examined. Intermittent positive pressure ventilation (IPPV) was initiated if apnoea lasted>30 s or if end-tidal CO2 ≥8 kPa. The righting reflex was lost in 3 min. IPPV was necessary during most of the anaesthesia for most of the rabbits. Maintenance doses during surgery were 2.0 µg/kg/h sufentanil and 0.4 mg/kg/h midazolam, and 1.4% isoflurane, respectively. Mean arterial blood pressure (MAP) was higher in group SUF–MID than group ISO during surgery (63 ± 12 vs 50 ± 8 mmHg). In group ISO the heart rate was higher during surgery than before anaesthesia (197 ± 26 vs 158 ± 40 bpm) as was blood glucose (9 ± 2 vs 12 ± 3 mmol/L). Serum lactate levels remained unchanged whereas total protein decreased in both groups. Time to recover from anaesthesia did not differ between groups (20 min). Intravenous sufentanil–midazolam infusion provided surgical anaesthesia with a higher MAP than isoflurane anaesthesia. The protocol can be useful in situations in which gas anaesthesia cannot be used or in animals with limited cardiovascular reserves. However, IPPV is necessary. [ABSTRACT FROM PUBLISHER]

Objective To assess oxygenation, ventilation-perfusion (V/Q) matching and plasma endothelin (ET-1) concentrations in healthy horses recovering from isoflurane anaesthesia administered with or without pulse-delivered inhaled nitric oxide (iNO). Study Design Prospective experimental trial. Animals Healthy adult Standardbred horses. Methods Horses were anaesthetized with isoflurane in oxygen and placed in lateral recumbency. Six control (C group) horses were anaesthetized without iNO delivery and six horses received pulse-delivered iNO (NO group). After 2.5 hours of anaesthesia isoflurane and iNO were abruptly discontinued, inhaled oxygen was reduced from 100% to approximately 30%, and the horses were moved to the recovery stall. At intervals during a 30-minute period following the discontinuation of anaesthesia, arterial and mixed venous blood gas values, shunt fraction ( Q̇s/Q̇t), plasma ET-1 concentration, pulse rate and respiratory rate were measured or calculated. Repeated measures anova and a Bonferroni post hoc test was used to analyze data with significance set at p < 0.05. Results At all time points in the recovery period, NO horses maintained better arterial oxygenation (oxygen partial pressure: NO 13.2 ± 2.7-11.1 ± 2.7 versus C 6.7 ± 1.1-7.1 ± 1.1 kPa) and better V/Q matching ( Q̇s/Q̇t NO 0.23 ± 0.05-0.14 ± 0.06 versus C 0.48 ± 0.03-0.32 ± 0.08%) than C horses. Mixed venous oxygenation was higher in NO for 25 minutes following the discontinuation of anaesthesia (NO 6.3 ± 0.2-4.5 ± 0.07 versus C 4.7 ± 0.6-3.7 ± 0.3 kPa). In both groups of horses arterial oxygenation remained fairly stable; venous oxygenation declined over this time period in the NO group but still remained higher than venous oxygen in the C group. ET-1 concentrations were higher at most time points in C than NO. Changes in other parameters were either minor or absent. Conclusions and Clinical Relevance Delivery of iNO to healthy horses during anaesthesia results in better arterial and venous oxygenation and V/Q matching (as determined by lower Q̇s/ Q̇t) and lower ET-1 concentrations throughout a 30-minute anaesthetic recovery period. [ABSTRACT FROM AUTHOR]

The January 12, 2010 earthquake in Haiti severely undermined HIV service provision in the country. Almost 10 percent of Haitians were displaced and now live in temporary tent communities. Little is known about how HIV services are being provided to Haitians with HIV in these encampments. This study addresses this lacuna by conducting a process evaluation of the manner in which a collaboration among Haitian community-based HIV service providers, a US-based HIV service provider, and a US-based academic research team resurrected HIV services in the encampments. Efforts to set up HIV services in the encampments proceeded through three stages: (i) an initial crisis response that activated established networks and identified feasible goals; (ii) the development of services by building research capacity, conducting needs assessments, addressing logistical challenges, and establishing community-based services; and (iii) the sustaining of the initiative by targeting resources and negotiating in the political arena. Implications of the protocol for future efforts are discussed. Key Practitioner Message: ● Resurrecting HIV services in post-disaster zones; ● Utilizing cross-country, provider-academic partnerships to develop service capacity; ● Targeting structural barriers to establish HIV services in resource-poor settings. [ABSTRACT FROM AUTHOR]

In this research we examined how the conditions of Haiti’s tent communities, inhabited by those displaced by the January 10, 2010, earthquake, shaped access and adherence to highly active antiretroviral treatment (HAART) for Haitians with HIV. Conditions in the encampments were marked by unhygienic and cramped living spaces, exposure to the elements, a lack of privacy, unavailability of food and clean water, and a dependence on poorly functioning aid agencies. These conditions shaped access and adherence to HAART by (a) exacerbating the stigma of being HIV positive and undermining mental health; (b) presenting logistical challenges to accessing medical care, storing pills, and ingesting them safely and privately; and (c) sustaining a political economy of aid characterized by unequal treatment in major HAART-dispensing centers, unequal circulation of international funds, and the emergence of alternative medical institutions within encampments that could improve future treatment. Policy and intervention implications are discussed. [ABSTRACT FROM PUBLISHER]

Background: Anaesthesia in rabbits is associated with a high mortality rate, compared to that in cats and dogs. Total intravenous anaesthesia (TIVA) with drugs that provide cardiovascular stability and are rapidly metabolised could be of benefit for use in rabbits. The aim was to evaluate cardiorespiratory effects of TIVA with sufentanil-midazolam in eight New Zealand White rabbits. Subcutaneous premedication with medetomidine (0.1 mg/kg BW) was followed by IV administration of a mixture of 2.5 μg/mL sufentanil and 0.45 mg/mL midazolam at a rate of 0.3 mL/kg BW/h for anaesthetic induction. Additionally, intravenous boluses of 0.1 mL of the mixture were administered every 20 s until the righting reflex was lost. Following endotracheal intubation, anaesthesia was maintained for 60 min with an infusion rate adjusted to supress the pedal withdrawal reflex. Air and oxygen (1:2) were delivered at 3 L/min. Physiological variables were recorded before induction and at predefined time points during and after anaesthesia. Results: Righting and pedal withdrawal reflexes were lost within 3 and 5 min, respectively. Doses of sufentanil and midazolam were 0.48 μg/kg BW and 0.09 mg/kg BW for induction, and 0.72 μg/kg BW/h and 0.13 mg/kg BW/h for maintenance. Apnoea occurred in two rabbits. Induction of anaesthesia caused a significant increase in heart rate, cardiac output and arterial CO2 partial pressure and a decrease in mean arterial pressure, respiratory rate and pH. Mean time from stopping the infusion to endotracheal extubation was 5 min, and to return of the righting reflex 7 min. Anaesthesia was characterized by induction and recovery without excitation, with muscle relaxation, and absence of the pedal withdrawal reflex. Conclusions: TIVA with sufentanil-midazolam provided smooth induction and recovery of anaesthesia in rabbits but with marked hypotension and respiratory depression, requiring mechanical ventilation. Further evaluation is needed to establish if the protocol is useful for rabbits undergoing surgery [ABSTRACT FROM AUTHOR]

The article presents a study which examines the endorvascular treatment of a 54-year-old man with endotension using Excluder endoprosthesis. It outlines the endovascular intervention of the patient using a right aorto-mono-iliac Zenith endoprosthesis for the left iliac artery. However, the patient's computed tomography (CT) scan showed a small growth of the aneursymal sac which prompted physicians to perform endovascular approach due to avoid complications due to his heart failure history and poorly controlled cardiac arrhythmia. Furthermore, it points out that endovascular treatment is the best way to efficiently to reline endotension with dacron stent graft

Aims: Biventricular pacing (BiP) is an effective treatment in systolic heart failure (HF) patients with prolonged QRS. However, approximately 35% of the patients receiving BiP are classified as non-responders. The aim of this study is to evaluate the acute effects of VV-optimization on systolic heart function. Methods: Twenty-one HF patients aged 72 (46-88) years, QRS 154 (120-190) ms, were studied with echocardiography, Tissue Doppler Imaging (TDI) and 3D-echo the first day after receiving a BiP device. TDI was performed; during simultaneous pacing (LV-lead pacing 4 ms before the RV-lead) and during sequential pacing (LV 20 and 40 ms before RV and RV 20 and 40 ms before LV-lead pacing). Systolic heart function was studied by tissue tracking (TT) for longitudinal function and systolic maximal velocity (SMV) for regional contractility and signs of dyssynchrony assessed by time-delays standard deviation of aortic valve opening to SMV, AVO-SMV/SD and tissue synchronization imaging (TSI). Results: The TT mean value preoperatively was 4,2 ± 1,5 and increased at simultaneous pacing to 5,0 ± 1,2 mm (p < 0,05), and at best VV-interval to 5,4 ± 1,2 (p < 0,001). Simultaneous pacing achieved better TT distance compared with preoperative in 16 patients (76%). However, it was still higher after VV-optimization in 12 patients 57%. Corresponding figures for SMV were 3,0 ± 0,7, 3,5 ± 0,8 (p < 0,01), and 3,6 ± 0,8 (p < 0,001). Also dyssynchrony improved. Conclusions: VV-optimization in the acute phase improves systolic heart function more than simultaneous BiP pacing. Long-term effects should be evaluated in prospective randomized trials. [ABSTRACT FROM AUTHOR]

Aims: Guidelines on how to diagnose and treat patients with heart failure (HF) are published regularly. However, many patients do not fulfil the diagnostic criteria and are not treated with recommended drugs. The Swedish Heart Failure Registry (S-HFR) is an instrument which may help to optimize the handling of HF patients. [ABSTRACT FROM PUBLISHER]

Background: Surgical treatment of primary varicose veins of the lower limbs might contribute to venous stasis relief by preventing evolution of the venous disease to worse severity stages. Objective: To study venous hemodynamic changes in patients with primary varicose veins of the lower limbs during the pre- and postoperative period using air plethysmography. Method: Sixty-three lower limbs of 39 patients (35 females and four males, mean age of 46.3 years) were evaluated. They were all operated at Hospital das Clinicas, Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo, between January 2001 and December 2004. Lower limbs were classified according to the CEAP classification: clinical criteria = C2 to C6 (C2 = 6, C3 = 32, C4 = 15, C5 = 7 and C6 = 3), etiologic criteria = Ep, anatomic criteria = As, and pathophysiological criteria = Pr. The patients were submitted to pre- and postoperative clinical examination, preoperative duplex scan and pre- and postoperative air plethysmography. Results: Improvement in venous hemodynamicswas observed after surgery, confirmed by reduction in the venous filling index and residual volume fraction and increase in the ejection fraction in the lower limbs submitted to varicose vein surgery. Conclusion: Superficial varicose vein stripping contributed to venous stasis relief and provided appropriate treatment, preventing pathophysiological evolution of chronic venous disease independently of clinical severity. [ABSTRACT FROM AUTHOR]

Background: Muscle metabolism in horses has been studied mainly by analysis of substances in blood or plasma and muscle biopsy specimens. By using microdialysis, real-time monitoring of the metabolic events in local tissue with a minimum of trauma is possible. There is limited information about muscle metabolism in the early recovery period after anaesthesia in horses and especially in the colic horse. The aims were to evaluate the microdialysis technique as a complement to plasma analysis and to study the concentration changes in lactate, pyruvate, glucose, glycerol, and urea during anaesthesia and in the recovery period in colic horses undergoing abdominal surgery and in healthy horses not subjected to surgery. Methods: Ten healthy university-owned horses given anaesthesia alone and ten client-owned colic horses subjected to emergency abdominal surgery were anaesthetised for a mean (range) of 230 min (193-273) and 208 min (145-300) respectively. Venous blood samples were taken before anaesthesia. Venous blood sampling and microdialysis in the gluteal muscle were performed during anaesthesia and until 24 h after anaesthesia. Temporal changes and differences between groups were analysed with an ANOVA for repeated measures followed by Tukey Post Hoc test or Planned Comparisons. Results: Lactate, glucose and urea, in both dialysate and plasma, were higher in the colic horses than in the healthy horses for several hours after recovery to standing. In the colic horses, lactate, glucose, and urea in dialysate, and lactate in plasma increased during the attempts to stand. The lactate-to-pyruvate ratio was initially high in sampled colic horses but decreased over time. In the colic horses, dialysate glycerol concentrations varied considerably whereas in the healthy horses, dialysate glycerol was elevated during anaesthesia but decreased after standing. In both groups, lactate concentration was higher in dialysate than in plasma. The correspondence between dialysate and plasma concentrations of glucose, urea and glycerol varied. Conclusion: Microdialysis proved to be suitable in the clinical setting for monitoring of the metabolic events during anaesthesia and recovery. It was possible with this technique to show greater muscle metabolic alterations in the colic horses compared to the healthy horses in response to regaining the standing position. [ABSTRACT FROM AUTHOR]

Glucan phosphorylating enzymes are required for normal mobilization of starch in leaves of Arabidopsis (Arabidopsis thaliana) and potato (Solanum tuberosum), but mechanisms underlying this dependency are unknown. Using two different activity assays, we aimed to identify starch degrading enzymes from Arabidopsis, whose activity is affected by glucan phosphorylation. Breakdown of granular starch by a protein fraction purified from leaf extracts increased approximately 2-fold if the granules were simultaneously phosphorylated by recombinant potato glucan, water dikinase (GWD). Using matrix-assisted laser-desorption ionization mass spectrometry several putative starch-related enzymes were identified in this fraction, among them β-AMYLASE1 (BAM1; At3g23920) and ISOAMYLASE3 (ISA3; At4g09020). Experiments using purified recombinant enzymes showed that BAM1 activity with granules similarly increased under conditions of simultaneous starch phosphorylation. Purified recombinant potato ISA3 (StISA3) did not attack the granular starch significantly with or without glucan phosphorylation. However, starch breakdown by a mixture of BAM1 and StISA3 was 2 times higher than that by BAM1 alone and was further enhanced in the presence of GWD and ATP. Similar to BAM1, maltose release from granular starch by purified recombinant BAM3 (At4g17090), another plastid-localized β-amylase isoform, increased 2- to 3-fold if the granules were simultaneously phosphorylated by GWD. BAM activity in turn strongly stimulated the GWD-catalyzed phosphorylation. The interdependence between the activities of GWD and BAMs offers an explanation for the severe starch excess phenotype of GWD-deficient mutants. [ABSTRACT FROM AUTHOR]

BACKGROUND: Antibodies with anti-M specificity are detected in 10 percent of pregnant women with a positive antibody screen, but anti-M is only rarely associated with hemolytic anemia in the fetus. STUDY DESIGN AND METHODS: This study reports on three pregnancies in one family that all resulted in severe fetal anemia. The first fetus died in utero with hydrops fetalis during the 20th gestational week and the second child was delivered after 28 weeks of gestation with hydrops fetalis and a hemoglobin level of 16 g per L whereas the third affected child was treated with intrauterine red cell (RBC) transfusions before delivery at 28 weeks of gestation. RESULTS: The direct antiglobulin test was negative but anti-M in a low titer was detected through the three pregnancies, and its clinical relevance, which initially was uncertain, was confirmed by pronounced in vivo hemolysis in maternal blood of chromate (51Cr)-labeled M+ RBCs and normal survival of 51Cr labeled M– RBCs. CONCLUSION: It is concluded that anti-M immunization in a few cases may cause severe fetal hemolytic anemia and intrauterine death. It remains to be elucidated why a normally clinically insignificant antibody is this aggressive in a small proportion of cases. Because the condition is treatable, anti-M must be considered as a possible cause of fetal anemia and intrauterine death. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: To assess factors of importance for long term prognosis in patients with acute myocardial infarction (AMI) and heart failure and normal or mildly reduced left ventricular systolic function. Subjects and methods: Seventy-one consecutive AMI-survivors with clinical or radiological signs of heart failure and an echocardiographically determined wall motion score >1.2 (EF >35–40%) were followed during 11 years for mortality, heart failure readmissions and new ischemic events. Results: Seventeen patients died (24%) while the combined endpoint of death or a new ischemic event (MI or hospitalisation for angina pectoris) occurred in 40 (56%) and fatal or non-fatal heart failure in 20 (28%) patients, respectively. A pre-discharge echocardiographic assessment of diastolic function was obtained in 67 patients out of whom 56 (84%) had diastolic dysfunction, most frequently relaxation abnormalities (43%). Wall motion score did not differ between survivors and non-survivors (1.48±0.20 vs. 1.44±0.18; p =0.46). Adjusting for age, sex and wall motion score N-terminal pro-ANP, prolongation of the isovolumic relaxation time and exercise induced ST-depressions at discharge (global χ 2 =26.2; p <0.0001) remained as independent mortality predictors while re-admission for heart failure was predicted by wall motion score, N-terminal pro-ANP and previous heart failure (global χ 2 =23.7; p <0.001). Death or new ischemic events were associated with low Doppler A-wave flow velocity and male sex (global χ 2 =14.0; p <0.01). Conclusions: Evaluation of diastolic function and a natriuretic peptide adds prognostically important information in AMI-patients with clinical heart failure and normal or mildly reduced left ventricular systolic function. Isovolumic relaxation time is an independent predictor of long term mortality and N-terminal pro-ANP of mortality and heart failure. [Copyright &y& Elsevier]

Aim: To compare known risk factors for sudden infant death syndrome (SIDS) amongst infants with apparent life threatening events (ALTE) with their matched controls, and ALTE infants who subsequently died of SIDS with infants surviving an ALTE.Methods: Questionnaires with replies were obtained from 58 ALTE infants and 56 sex and age matched ALTE control infants. 244 SIDS cases and 868 SIDS controls were used as comparison.Results: The incidence of ALTE was found to be 1.9% among SIDS controls, but 7.4% among infants who later on died of SIDS. The parents sought medical advice in 0.9% vs 3.7%. ALTE infants did not differ from their matched controls. In the ALTE group 13.3% of the survivors had the combination of prone sleeping and maternal smoking compared with 33.3% of those who became SIDS victims.Conclusions: Our results show some major differences between the ALTE infants and SIDS victims not supporting that these conditions belong to the same entity. However, we cannot exclude the possibility that there is a subpopulation of ALTE infants who did not die in SIDS due to that they were sleeping on the back and not exposed to nicotine. [ABSTRACT FROM AUTHOR]

Background: Many colic horses are compromised due to the disease state and from hours of starvation and sometimes long trailer rides. This could influence their muscle energy reserves and affect the horses' ability to recover. The principal aim was to follow metabolic parameter before, during, and up to 7 days after anaesthesia in healthy horses and in horses undergoing abdominal surgery due to colic. Methods: 20 healthy horses given anaesthesia alone and 20 colic horses subjected to emergency abdominal surgery were anaesthetised for a mean of 228 minutes and 183 minutes respectively. Blood for analysis of haematology, electrolytes, cortisol, creatine kinase (CK), free fatty acids (FFA), glycerol, glucose and lactate was sampled before, during, and up to 7 days after anaesthesia. Arterial and venous blood gases were obtained before, during and up to 8 hours after recovery. Gluteal muscle biopsy specimens for biochemical analysis of muscle metabolites were obtained at start and end of anaesthesia and 1 h and 1 day after recovery. Results: Plasma cortisol, FFA, glycerol, glucose, lactate and CK were elevated and serum phosphate and potassium were lower in colic horses before anaesthesia. Muscle adenosine triphosphate (ATP) content was low in several colic horses. Anaesthesia and surgery resulted in a decrease in plasma FFA and glycerol in colic horses whereas levels increased in healthy horses. During anaesthesia muscle and plasma lactate and plasma phosphate increased in both groups. In the colic horses plasma lactate increased further after recovery. Plasma FFA and glycerol increased 8 h after standing in the colic horses. In both groups, plasma concentrations of CK increased and serum phosphate decreased post-anaesthesia. On Day 7 most parameters were not different between groups. Colic horses lost on average 8% of their initial weight. Eleven colic horses completed the study. Conclusion: Colic horses entered anaesthesia with altered metabolism and in a negative oxygen balance. Muscle oxygenation was insufficient during anaesthesia in both groups, although to a lesser extent in the healthy horses. The post-anaesthetic period was associated with increased lipolysis and weight loss in the colic horses, indicating a negative energy balance during the first week post-operatively. [ABSTRACT FROM AUTHOR]

Abstract: We have combined differential absorption lidar (DIAL) measurements of mercury concentrations downwind of a chlor-alkali plant (Rosignano Solvay) with measurements of wind profiles made with a Doppler Lidar based on modern fibre-optic technology. Since the flux of pollutant is equal to the cross-wind integral of the product of concentration and wind speed, this should permit us to make a more precise estimate of the fugitive emission of mercury from the plant than could be obtained by using anemometer measurements of the wind. The flux was estimated to be 54gHgh−1 using an anemometer on the plant building; 49gHgh−1 using an anemometer on a nearby 10m mast; and 48gHgh−1 using wind speed corrections estimated from the Doppler Lidar measurements. Because of difficulties with the range resolution of the Doppler Lidar, the precision of this estimate was not as good as it should have been, though the difference from the rooftop anemometer remains statistically significant. Corrections of this magnitude are irrelevant to the Rosignano plant, where the emission rate varies strongly with the meteorological conditions. Where a precise estimate of a steady flux is required, however, reliable measurements of the wind profile in the wake of the source are essential. Doppler Lidar provides a possible method for acquiring such measurements. [Copyright &y& Elsevier]

D-GLYCERATE 3-KINASE (GLYK; EC 2.7.1.31) catalyzes the concluding reaction of the photorespiratory C2 cycle, an indispensable ancillary metabolic pathway to the photosynthetic C3 cycle that enables land plants to grow in an oxygencontaining atmosphere. Except for GLYK, all other enzymes that contribute to the C2 cycle are known by their primary structures, and the encoding genes have been identified. We have purified and partially sequenced this yet missing enzyme from Arabidopsis thaliana and identified it as a putative kinase-annotated single-copy gene At1g80380. The exclusive catalytic properties of the gene product were confirmed after heterologous expression in Escherichia coli. Arabidopsis T-DNA insertional knockout mutants show no GLYK activity and are not viable in normal air; however, they grow under elevated CO2, providing direct evidence of the obligatory nature of the ultimate step of the C2 cycle. The newly identified GLYK is both structurally and phylogenetically distinct from known glycerate kinases from bacteria and animals. Orthologous enzymes are present in other plants, fungi, and some cyanobacteria. The metabolic context of GLYK activity in fungi and cyanobacteria remains to be investigated. [ABSTRACT FROM AUTHOR]

Abstract: It is important that congestive heart failure (CHF) patients know how to monitor and manage disease-associated signs and symptoms. CHF patients were randomised to follow-up at a nurse-based outpatient clinic (intervention group (IG); n = 103), or to follow-up in primary healthcare (control group (CG); n = 105). Patient knowledge of CHF and self-care were assessed by a questionnaire and cognitive function by a Mini Mental State Examination (MMSE) at baseline and at six months. Men knew more about CHF as compared to females at baseline (p &#60; 0.01). However, females in the IG increased their knowledge of self-care between baseline and six months as compared to CG females (p &#60; 0.05). Patients with cognitive dysfunction (MMSE &#60; 24) presented lower scores on knowledge as compared to those with a MMSE of >24 at baseline (p &#60; 0.01). These differences disappeared after the intervention. Thus, females seemed to gain more than men from a nurse-based management program and patients with in-hospital signs of cognitive dysfunction should be encouraged to participate. [Copyright &y& Elsevier]

Abstract: Mercury emission measurements from the Idrija mercury mine in Slovenia were performed during an early November 2003 campaign, where the differential lidar technique was used to map mercury concentrations and an attempt was made to quantify the total mercury flux from the most contaminated area, the abandoned cinnabar roasting oven complex. Lidar concentration data were compared with data recorded with a Zeeman modulated atomic absorption instrument, operated from a vehicle equipped with a GPS localization system. Concentrations and fluxes were comparatively low due to low temperature and rainfall. The average flux from the distillation plant was measured to approximately 2gh−1. [Copyright &y& Elsevier]

To compare the effects of spontaneous breathing and mechanical ventilation on haemodynamic variables, including muscle and skin perfusion measured with laser Doppler flowmetery, in horses anaesthetized with isoflurane.Prospective controlled study.Ten warm-blood trotter horses (five males, five females). Mean mass was 492 kg (range 420–584 kg) and mean age was 5 years (range 4–8 years).After pre-anaesthetic medication with detomidine (10 μg kg−1) anaesthesia was induced with intravenous (IV) guaifenesin and thiopental (4–5 mg kg−1 IV) and maintained using isoflurane in oxygen. The horses were positioned in dorsal recumbency. In five animals breathing was initially spontaneous (SB) while the lungs of the other five were ventilated mechanically using intermittent positive pressure ventilation (IPPV). Total anaesthesia time was 4 hours with the ventilatory mode changed after 2 hours. During anaesthesia, heart rate (HR) cardiac output (&Qdot;t) stroke volume (SV) systemic arterial blood pressures (sAP), and pulmonary arterial pressure (pAP) were recorded. Peripheral perfusion was measured in the semimembranosus and gluteal muscles and on the tail skin using laser Doppler flowmetry. Arterial (a) and mixed venous (&vmacr;) blood gases, pH, haemoglobin concentration [Hb], haematocrit (Hct), plasma lactate concentration and muscle temperature were measured. Oxygen content, venous admixture (&Qdot;s/&Qdot;t) oxygen delivery (DO2) and oxygen consumption (&Vdot;O2) were calculated.During mechanical ventilation, HR, sAP, pAP,&Qdot;t, SV,&Qdot;s/&Qdot;tand PaCO2 were lower and PaO2 was higher compared with spontaneous breathing. There were no differences between the modes of ventilation in the level of perfusion, DO2,&Vdot;O2, [Hb], (Hct), or plasma lactate concentration. After the change from IPPV to SB, left semimembranosus muscle and skin perfusion improved, while muscle perfusion tended to decrease when SB was changed to IPPV. Low-frequency flow motion was seen twice as frequently during IPPV compared with SB.Mechanical ventilation impaired cardiovascular function compared with SB in horses during isoflurane anaesthesia. Muscle and skin perfusion changes occurred with ventilation, although further studies are needed to elucidate the underlying mechanisms. [ABSTRACT FROM AUTHOR]

During anaesthesia in the horse, muscle blood flow has been found to be reduced, possibly leading to hypoxia or ischaemia in the muscle. The aim of this study was to use the muscle biopsy and microdialysis techniques to determine whether long-term inhalation anaesthesia in laterally recumbent horses induces metabolic changes in gluteal muscle indicative of anaerobic metabolism. Muscle biopsies and plasma samples were taken from seven horses at the start and end of halothane anaesthesia. In six isoflurane-anaesthetised horses, given three pharmacological provocations (dobutamine, detomidine, acepromazine), repeated blood samples and microdialysis was performed during anaesthesia and muscle biopsies were taken before and at the end of anaesthesia. Adenosine triphosphate (ATP), adenosine diphosphate, adenosine monophosphate, inosine monophosphate (IMP) creatine phosphate and lactate concentrations did not differ between dependent and non-dependent muscles at either sampling time. Creatine phosphate decreased in both the halothane (−38%) and isoflurane (−28%) group. In the halothane group, ATP was decreased (−15%) at the end of anaesthesia, while IMP was increased (+32%). Lactate in muscle and plasma increased in both groups. Lactate in dialysate increased after induction and remained elevated above plasma concentrations. These results show that long-term inhalation anaesthesia in horses is associated with an anaerobic metabolic response within the muscle and that microdialysis can be used to detect metabolic changes within the muscle during equine anaesthesia. [ABSTRACT FROM AUTHOR]

In addition to clinical risk markers, indices of left ventricular (LV) systolic function are valuable prognostic markers after acute myocardial infarction (MI). Previous studies have also suggested that LV diastolic function may contribute with prognostic information. The present study assessed whether this assumption applies to a large population of patients with acute MI who underwent thrombolytic therapy.520 out of 608 patients participating in the ATTenuation by Adenosine of Cardiac Complications (ATTACC) study, with an ST-elevation acute MI underwent two-dimensional and Doppler echocardiographic examination at 4 (range 2–10) days after admission. During the follow-up period of 31 (S.D.±11) months, cardiovascular death occurred in 57 (11%) patients, nonfatal acute MI occurred in 77 (15%), and 124 (24%) patients suffered a combined cardiovascular end-point (either nonfatal acute MI or cardiovascular death). Univariate regression analysis showed that all indices of LV systolic function predicted cardiovascular death and combined cardiovascular end-points. Regarding LV diastolic function only a restrictive filling pattern predicted cardiovascular death. In a multistep multivariate regression analysis in which the variables were introduced in a hierarchic order age, history of systemic hypertension, wall motion score index (WMSi), and history of previous MI and diabetes mellitus were independent predictors of cardiovascular death. A history of systemic hypertension or congestive heart failure were independent predictors of nonfatal acute MI, while a history of systemic hypertension, wall motion score index and diabetes mellitus independently predicted combined cardiovascular end-points.The results of this study confirmed that clinical risk indicators and LV systolic function were the most important independent predictors of cardiovascular death and combined cardiovascular end-points. LV diastolic function assessed by Doppler-echocardiography did not provide additional prognostic information. [Copyright &y& Elsevier]

Atmospheric mercury species/fractions were measured near a chlor-alkali plant in Sweden during August 28 to September 4, 2001. The concentration of total gaseous mercury in the plume from the plant was measured using TEKRAN and GARDIS instruments. Gaseous elemental mercury was measured using a light detection and ranging (LIDAR) technique. From vertical LIDAR sweeps through the plume from the chlor-alkali plant mercury emission rates could be calculated. The concentrations of reactive gaseous mercury (RGM) in the plume and also inside the cell house were measured using annular KCl coated denuders. The RGM emission constitutes 0.5–1.0% of the total mercury emitted from the plant. The mercury concentration adsorbed on particles was measured as well as the mercury flux from soil. The data presented also include an intercomparison showing an excellent agreement between TEKRAN/GARDIS and LIDAR gaseous mercury measurements. [Copyright &y& Elsevier]

Aim: To determine instantaneous cardiac variability responses to increased carbon dioxide (CO2) during quiet sleep in infants who may be at risk for the Sudden Infant Death syndrome (SIDS).Methods: The cardiac rate variability before, during and after a CO2 challenge was examined in 41 infants who had experienced an apparent life-threatening event (ALTE) and 41 gender- and age-matched control infants.Results: The ALTE infants responded to CO2 breathing with a significant increase in R-R intervals, i.e. decreases in heart rate, compared to the controls (45.1% increase in R-R intervals vs. 41.4%; p = 0.005). The differences between ALTE infants and controls depended primarily on the boys' responses.Conclusion: ALTE infants, particularly ALTE boys, have an autonomic dysfunction-lower sympathetic stimulation and/or inhibited vagal withdrawal when stressed with CO2. The outcome might provide clues to the mechanisms underlying the cardiovascular processes contributing to the terminal event in SIDS. [ABSTRACT FROM AUTHOR]

Examines the U.S. federalism through the perspective of the surface transportation program. History of the grants-in-aid program; Discussion of the experiences of the program under the Intermodal Surface Transportation Efficiency Act of 1991and the Transportation Equity Act for the 21st Century of 1998; Description of the changing federal role in transportation.

Introduces several articles on federalism and surface transportation in the U.S.

Unlabelled: Heart rate variability (HRV) is often used as an index of sympatho-vagal balance. A decreased HRV has been observed in patients with central hypoventilation and in infants who have later succumbed to sudden infant death syndrome (SIDS). The aim of the present study was to investigate whether HRV is altered in infants with apparent life-threatening events (ALTE), a group with an increased risk of SIDS. Fifty infants with ALTE were compared with 50 age- and sex-matched controls. ECG was recorded overnight in all infants. Two sequences of RR intervals free of artefacts were selected from each sleep state and spectral analysis of RR variability was performed. The mean and SD of RR and the low (LFPow) and high (HFPow) frequency power were analysed. In active sleep (AS) the LF/HF ratio was lower in ALTE infants, but no differences were seen in either the LFPow or the HFPow. In quiet sleep (QS), however, ALTE infants had higher SD-RR (p = 0.006), greater HFPow (p = 0.02) and VLFPow (very low frequency power, p = 0.02) than the control infants. The same results were seen when the two sleep states were combined for analysis, ALTE infants had higher SD-RR (p = 0.004), HFPow (p = 0.006) and VLFPow (p = 0.04).Conclusion: The different HRV pattern in ALTE infants compared to healthy controls suggests an altered autonomic control. [ABSTRACT FROM AUTHOR]

The author explores the studies about the clinical management of atherosclerotic disease of the carotid.

Illustrates the double taxation of city residents, who pay for services from both the county and the city but mainly receive them from the city. General issues of double-taxation analysis; Double taxation; Case study of law enforcement in Clackamas County, Oregon; Connections between case study and general methods.

In the Cooperative New Scandinavian Enalapril Survival Study (CONSENSUS II), in which enalapril treatment was initiated intravenously within 24 h after acute myocardial infarction, there was a neutral effect on 6-month mortality, whereas a beneficial effect on the progression of congestive heart failure was noted. We studied the effect of enalapril on left ventricular systolic function in terms of cardiac output and mean acceleration time measured by pulsed-wave Doppler in the left ventricular outflow tract and peripheral resistance. Early angiotensin-converting enzyme inhibition after acute myocardial infarction did not result in a general improvement of cardiac output. However, a small increase in cardiac output was observed in a subgroup of enalapril-treated patients with ejection fraction ≥45%, probably due to a reduction in peripheral resistance in these patients. [ABSTRACT FROM AUTHOR]

Reports on the use of a mobile differential absorption lidar (DIAL) remote sensing system in the monitoring of industrial pollutant emissions. Need for the development of measurement techniques for air pollutant emissions; Use of light detection and ranging technique for detecting the backscattered light from molecules and aerosol.

Abstract. The total fluxes of sulphur dioxide from the Italian volcanoes Etna, Stromboli, and Vulcano were studied using optical remote sensing techniques in three shipbornefield experiments (1992, 1994, and 1997). The main purpose of the experiments was to compare active (laser) techniques with passive monitoring. Differential absorption lidar (DIAL) measurements were implemented by placing the Swedish mobile lidar system on board the Italian research vessel Urania,sailing under the volcanic plumes. Simultaneously, the passive differential optical absorption spectroscopy (DOAS) technique was used for assessing the total overhead gas burden. Finally, correlation spectroscopy (COSPEC) was also implemented in one of the campaigns. Differences in integrated gas column assessment are expected and observed, mostly connected to complex scattering conditions influencing the passive measurements. Since such measurements are much employed in routine volcanic monitoring it is of great interest to model and provide corrections to the raw data obtained. Lidar measurements proved to be quite useful for this purpose. By combining the integrated gas concentration overthe plume cross section with wind velocity data, SO[sub 2] fluxes ofthe order of 1000, 100, and 10 tonnes/day were measured for Mt. Etna, Stromboli, and Vulcano, respectively. [ABSTRACT FROM AUTHOR]

Objective/Background: The Insomnia Severity Index (ISI) is an insomnia self-report measure used to identify individuals at risk for insomnia disorder. Although the full ISI is only seven questions, a briefer version would allow more efficient and pragmatic administration in routine practice settings. Reliable and valid brief measures can support measurement-based care. The present study was a proof-of-concept study that developed a brief version of the ISI, the ISI-3, in a sample of older adult veterans with posttraumatic stress disorder (PTSD), a group which is at increased risk for insomnia. Patients/Methods: Participants included 86 older veterans with combat- or military-related PTSD. Veterans completed a clinician-administered PTSD diagnostic interview, self-report measures of insomnia and other psychosocial questionnaires, and two neuropsychological assessments. The factor structure of the ISI was examined to reduce the measure into a brief version. The reliability and validity of the ISI-3 were examined. Results: Principal axis factoring yielded a one-factor solution, which reproduced 59% of the item variance. Item reduction procedures resulted in three items, which best represented this factor ("Insomnia Impact;" ISI-3). For the ISI-3, internal consistency was good (α =.89). Convergent validity was demonstrated via moderate to high positive correlations between the ISI-3 and other measures of sleep disturbance. Divergent validity was demonstrated via non-significant correlations between the ISI-3 and unrelated measures and moderate correlations with self-reported depression. Conclusions: The ISI-3 is a psychometrically valid brief version of the ISI. Clinicians can administer the ISI-3 to screen for insomnia and monitor changes in insomnia during treatment. [ABSTRACT FROM AUTHOR]

A new model for the location and distribution of carbonate ions in carbonated apatite was used to assign the IR spectra of A- and AB-carbonated apatites. The percentage of total carbonate as measured by the mass loss in the TGA of these compounds is in good agreement with the percentage obtained by combustion analysis. The decomposition of pure A-type carbonate appears at temperatures of 985–1123 °C, whereas the decomposition of AB-type carbonated apatites occurs in the range of 600–800 °C. This difference is attributed to changes in the environment of channel carbonate brought about by B-type substitution of carbonate for phosphate. In the presence of sodium ions, the channel is changed by substitution of sodium for calcium in order to accommodate the difference between the charge of the carbonate and phosphate ions. A thermodynamic cycle is introduced to rationalize the differences in decomposition temperatures of A- and B-type carbonate. Preferential loss of B-type carbonate upon heating to 600 °C also suggests the migration of B-type carbonate to A-sites. [ABSTRACT FROM AUTHOR]

Aim: To evaluate children's experiences of and responses to animal-assisted therapy using a therapy dog as complementary treatment in paediatric hospital care.Methods: The study was performed using mixed methods, by means of qualitative and quantitative data. Fifty children in a paediatric surgery ward, at a tertiary hospital in Sweden, were included between February 2016 to May 2017. Children answered questions about feelings of well-being and experiences of the hospital stay before and after animal-assisted therapy, and experiences of their interaction with a therapy dog.Results: The children's well-being increased from moderately good before to very good after animal-assisted therapy, and the children assessed the hospital stay as better after than before. The vast majority of the children (93%) assessed the interaction with the dog as very good. The children described mixed experiences before and mainly positive aspects of joy, satisfaction and pain relief after animal-assisted therapy.Conclusion: The children's responses before interaction, of both a positive and negative nature, show a focus shift after the interaction with a therapy dog to mainly positive nature regarding self-reported feeling of well-being and experiences of the hospital stay. Using a therapy dog in paediatric hospital care is suitable complementary treatment. [ABSTRACT FROM AUTHOR]