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At the onset of egg production, physiological changes governing calcium and phosphorus utilization must occur to meet demands for medullary bone formation and eggshell mineralization. The objective of this study was to identify these changes and determine if they are influenced by dietary supplementation with 1α-hydroxycholecalciferol (AlphaD3™, Iluma Alliance). Commercial laying hens fed either a control or AlphaD3-supplemented diet beginning at 18 weeks of age were sampled at 18 (n = 8) and 31 weeks (n = 8/diet) to evaluate mRNA expression associated with calcium and phosphorus utilization in kidney, shell gland, ileum, and liver, circulating vitamin D3 metabolites, and bone quality parameters in humerus, tibia, and keel bone. Though diet did not heavily influence gene expression at 31 weeks, several significant differences were observed between 18- and 31-week-old hens. Heightened sensitivity to hormones regulating calcium and phosphorus homeostasis was observed at 31 weeks, indicated by increased parathyroid hormone receptor 1, calcium-sensing receptor, calcitonin receptor, and fibroblast growth factor 23 receptors in several tissues. Increased renal expression of 25-hydroxylase and vitamin D binding protein ( DBP ) at 31 weeks suggests kidney participates in local vitamin D3 25-hydroxylation and DBP synthesis after egg production begins. Biologically active 1,25(OH)2D3 was higher at 31 weeks, with correspondingly lower inactive 24,25(OH)2D3. Increased expression of plasma membrane calcium ATPase 1 and calbindin in kidney, shell gland, and ileum suggests these are key facilitators of calcium uptake. Elevated renal inorganic phosphorus transporter 1 and 2 and sodium-dependent phosphate transporter IIa at 31 weeks suggests increased phosphorus excretion following hyperphosphatemia due to bone breakdown for eggshell formation. Diet did influence bone quality parameters. Bone mineral density in both humerus and tibia was higher in AlphaD3-supplemented hens at 31 weeks. Tibial bone mineral content increased between 18 and 31 weeks, with AlphaD3-supplemented hens increasing more than control hens. Moreover, control hens exhibited diminished tibial breaking strength at 31 weeks compared to hens at 18 weeks, while AlphaD3-supplemented hens did not. Together, these results indicate supplementation with AlphaD3 enhanced bone mineralization during the medullary bone formation period and elucidate the adaptive pathways regulating calcium and phosphorus utilization after the onset of lay. [ABSTRACT FROM AUTHOR]

Objective: To estimate the long-term and short-term effects on cigarette demand in Argentina based on changes in cigarette price and income per person >14 years old.

OBJECTIVE: To evaluate the processes and outcomes of tobacco litigation in Argentina and to analyse the strategies of the tobacco industry to oppose litigation using tobacco industry documents. METHODS: A systematic search of tobacco industry documents on the internet dating from 1978 to 2002. Law library searches using Argentinean official and unofficial reports systems were combined with computerised online searches. RESULTS: There have been at least 15 failed litigation cases in Argentina and the tobacco industry presented a concerted defence in every claim regardless of cost. We categorised 11 cases as product liability and nicotine addiction, two as health care reimbursement, and two as criminal law and secondhand smoke. Industry strategies included hiring legal consultants from prestigious international and Argentinean law firms and developing litigation prevention programmes. Industry monitored legal academic meetings, controlled the development of new product liability legislation, obtained favourable opinions from experts, and closely observed the development of litigation in Argentina. CONCLUSION: The strategies used by the industry have been successful in preventing recovery for tobacco injuries through litigation. Argentinean health advocates and lawyers need to be aware of the roles and strategies of the tobacco industry in order to develop effective litigation in Argentina.

In this article, the authors use recently collected data from the "Educatodos" program in Honduras to analyze attrition, an outcome that has received little attention in previous analyses of alternative school effectiveness. "Educatodos" began in the 1990s with radio courses in primary grades mainly for rural adults. Through the years the program has generated more than 350,000 person-years of education. Since 2001 it has also provided middle schooling through audiotape lessons delivered in local learning centers, and its rural focus on adults has given way to a more diverse profile that includes recent graduates of public primary schools. "Educatodos" is a good example of a complementary provider of education, although it does rely on a different teaching technology compared with the average public middle school. The central challenge facing the program is clear, however: to keep costs low enough to encourage participation among the poorest sectors of society and quality high enough to maintain enrollments. The steady growth in learning centers offering these grades suggests that the program is meeting this dual challenge. The overall impact of this expansion, however, has been tempered by evidence of high rates of attrition. It would be easy to attribute attrition in a program such as "Educatodos" to contextual forces related to poverty, but their data show that completion rates are not uniformly low in the program, even among the poorest participants. This suggests that specific features of program implementation affect continuation, a proposition that makes intuitive sense but is based on little empirical evidence in developing-country settings. (Contains 4 tables and 13 footnotes.)

The impact of attrition on Educatodos, an example of a complementary provider of education for middle schooling through audiotape lessens delivered in local learning centers is assessed. While there has been an increase in the number of learning centers offering this program, the overall impact of this expansion has to a certain extent been nullified by high rates of attrition which is a challenge that needs to be tackled in delivering real change in poor communities.

The United States of America (USA) has the largest international population of any nation in the world. Immigrants from Latin American countries, where intestinal parasites are endemic, comprise more than half of this population. This study aims to determine the prevalence of strongyloidiasis, a potentially deadly parasitic infection, in foreign-born individuals. We conducted a cross-sectional study in Washington, DC, to determine the seroprevalence of Strongyloides stercoralis infection using an NIE-ELISA IgG antibody assay. Multi-parallel quantitative real-time polymerase chain reaction (qPCR) was performed in stool samples of NIE-ELISA-positive patients to investigate possible polyparasitism. The NIE-ELISA assay detected an S. stercoralis prevalence of 4.2% in a group of 119 volunteers. Combining NIE-ELISA and qPCR detected a parasite prevalence of 5.0%. Our results underscore the relevance of systematic testing for gastrointestinal parasites in individuals from endemic regions. It also makes a case for a survey in the USA to identify immigrants' risk for strongyloidiasis and other gastrointestinal parasitic infections. [ABSTRACT FROM PUBLISHER]

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Abstract: Clostridium difficile is a bacillus Gram positive and spore form, anaerobic strictly, resistant to adverse conditions and transmitted by oral - fecal route, it was described by the first time in 1930, nevertheless it’s has been associated to disease in human beings in the decade of the seventies it identified as causal agent of pseudomembranous colitis. Its infection has related to diverse clinical manifestations such as diarrhea without complications, which lead to sepsis and inclusive the death. In the following clinical case we have a male infant 1 year old and 18 months patient, with precedents of hyperthermia and liquid depositions, after several days of antibiotics treatment, the symptoms increased with elimination of membranous rest in the faeces; reason why he is transferred to a hospital, in which the Clostridium difficile toxins test is realized, yielding positive results, therefore the diagnosis of pseudomembranous colitis is established metronidazole and vancomycin is given for 7 days having a favorable development. The use of antibiotics is a predisposing factor of pseudomembranous colitis for the affectation of the intestinal microbiota, in addition hospital stays and intrinsic factors. The literature describes a limited number of studies about this infection in pediatric patients, hence the importance of the case report. Resumen: Clostridium difficile es un bacilo Gram positivo esporulado, anaerobio estricto, resistente a condiciones adversas y transmitido por vía oral-fecal, se describió por primera vez en 1930; sin embargo, se asoció a enfermedad en humanos en la década de los setenta al identificarse como agente causal de colitis pseudomembranosa. Esta infección se ha relacionado con diversas manifestaciones clínicas que van desde diarrea sin complicaciones hasta sepsis e incluso la muerte. Se presenta un caso clínico de un paciente masculino de 1 año 8 meses, con antecedentes de hipertermia y deposiciones líquidas abundantes, tras varios días de tratamiento antibiótico los síntomas se incrementaron con eliminación de resto membranoso en heces, se refiere a un hospital; donde se realiza el estudio de toxinas de Clostridium difficile, resultando positivo, por lo cual, se establece el diagnostico de colitis pseudomembranosa. Se administra metronidazol y vancomicina por 7 días, con una evolución favorable. El uso de antibióticos es un factor predisponente de colitis pseudomembranosa por la afectación de la microbiota intestinal; además de la estancia hospitalaria y factores intrínsecos. En la literatura se describe un número reducido de estudios sobre esta infección en pacientes pediátricos de allí la importancia del reporte de caso.

Introduction: The relationship between poverty and tobacco consumption among adolescents has not been extensively studied, and what evidence exists has come almost entirely from developed countries. Moreover, the impact of contextual factors--such as school-level poverty--remains unclear.Methods: We obtained information about smoking behavior from the Global Youth Tobacco Survey in Argentina in 2007. School-level characteristics were derived by matching schools to census areas from the 2001 Census. Additional school-level information was obtained from the Ministry of Education. Random intercept models were used to evaluate the associations of school-level variables (poverty in the census area of the school, school receipt of social assistance, and public or private status) with current smoking, intention to quit, secondhand smoke exposure outside the home, support for smoke-free laws, purchase of single cigarettes among smokers, and susceptibility to smoking in 5 years among nonsmokers.Results: After controlling for age and sex, students attending schools receiving social assistance were more likely to smoke (odds ratio [OR] 1.35, 95% CI 1.02-1.80) and to purchase loose cigarettes (OR 1.66, 95% CI 1.08-2.54), whereas school poverty was significantly associated with secondhand smoke exposure (OR 1.27, 95% CI 1.04-1.58).Conclusion: This study shows that an association exists between unfavorable contextual school characteristics and tobacco consumption and related measures among youth in Argentina. Efforts to prevent smoking may need to address the school-level factors that place youth at higher risk. [ABSTRACT FROM AUTHOR]

HIV prevention community planning groups were formed to increase stakeholder participation and develop evidence-based comprehensive HIV prevention plans. To date, it is not well understood what factors affect group behavior as the planning group prepares for data-informed decision making. In this observational case study, the authors videotaped 18 meetings of a community planning group (CPG) to observe how a group's behavior changes over time in response to modifications in its structure and function. Discussions on authority and conflict were common, particularly during presentations on prioritized populations and interventions. Changes in the frequency of data-informed discussions were not statistically significant. Observed group conflict may have been an unintended consequence of efforts to improve equity. The authors suggest that formal and informal mechanisms to manage conflict and agreed-on procedures for decision making should be incorporated into the technical assistance offered to CPGs. Future studies should address whether data-informed decisions increase once contentious issues are resolved. [ABSTRACT FROM AUTHOR]

OBJECTIVE: We sought to study the optimal management of hyperglycemia in non-intensive care unit patients with type 2 diabetes, as few studies thus far have focused on the subject. RESEARCH DESIGN AND METHODS: We conducted a prospective, multicenter, randomized trial to compare the efficacy and safety of a basal-bolus insulin regimen with that of sliding-scale regular insulin (SSI) in patients with type 2 diabetes. A total of 130 insulin-naive patients were randomized to receive glargine and glulisine (n = 65) or a standard SSI protocol (n = 65). Glargine was given once daily and glulisine before meals at a starting dose of 0.4 units x kg(-1) x day(-1) for blood glucose 140-200 mg/dl or 0.5 units x kg(-1) x day(-1) for blood glucose 201-400 mg/dl. SSI was given four times per day for blood glucose >140 mg/dl. RESULTS: The mean admission blood glucose was 229 +/- 6 mg/dl and A1C 8.8 +/- 2%. A blood glucose target of <140 mg/dl was achieved in 66% of patients in the glargine and glulisine group and in 38% of those in the SSI group. The mean daily blood glucose between groups ranged from 23 to 58 mg/dl, with an overall blood glucose difference of 27 mg/dl (P < 0.01). Despite increasing insulin doses, 14% of patients treated with SSI remained with blood glucose >240 mg/dl. There were no differences in the rate of hypoglycemia or length of hospital stay. CONCLUSIONS: Treatment with insulin glargine and glulisine resulted in significant improvement in glycemic control compared with that achieved with the use of SSI alone. Our study indicates that a basal-bolus insulin regimen is preferred over SSI in the management of non-critically ill, hospitalized patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

The article reports the development of a rapid test that evaluates a coefficient, D, using 12 V. Rapid test coefficient (RTC) method was used to determine the chloride diffusion coefficient for normal and blended Portland cement mortars containing silica fume, fly ash, natural pozzolan, activated clay, and granulated blast slag, respectively. The RTC method was applied to determine chloride permeability when silica fume is incorporated into cement mixes. The porosity and absorptivity of these mortars and the corrosion activity of embedded reinforced specimens were also measured.

The Wiener-Hopf theory of optimum linear systems is applied to the determination of the stable pulse response of a monotone hydrologic system from coincident records of input and output in the form of discrete time series. In application to the rainfall runoff system, linear programming methods are used in the solution of the Wiener-Hopf equations to obtain physically realizable unit hydrographs. [ABSTRACT FROM AUTHOR]

The level of education in nursing has evolved as a response to the need of educating human capital capable of developing personal knowledge and promoting innovative change strategies in the domains of science and technology. Objectives: describe the overview of the doctoral education in nursing in Latin America, Colombia and the world, and ponder over its contributions to the discipline and the Colombian society. Methodology: the methodology is divided into three segments: worldwide overview of the doctoral education in nursing, current situation of doctoral programs in Colombia and pertinence of nursing doctors in Colombia. Results and discussion: findings show differences among the progress made regarding the doctoral education in nursing in the World, Latin America and Colombia. It is worth highlighting the growth of programs in Europe, Asia and Latin America, which is positive to achieve further development of the discipline.El nivel de la educación en enfermería ha evolucionado a través del tiempo, como respuesta a la necesidad de formar capital humano capaz de desarrollar conocimiento propio y de promover estrategias innovadoras de cambio en las áreas de ciencia y tecnología. Objetivos: describir el panorama de la formación doctoral en enfermería a escala mundial, latinoamericana y nacional, y reflexionar sobre sus aportes para la disciplina y la sociedad colombiana. Metodología: se desarrolla en tres partes: panorama mundial de la formación doctoral en enfermería, situación actual de los doctorados en Colombia y pertinencia de los doctores de enfermería en Colombia. Resultados y discusión: los hallazgos muestran diferencias entre los desarrollos de la formación doctoral enfermera mundial y latinoamericana y los generados en Colombia. Se destaca el crecimiento de programas en Europa, Asia y Latinoamérica, lo cual es positivo para el desarrollo de la disciplina.O nível da educação em enfermagem tem evoluído através do tempo, como resposta à necessidade de formar capital humano capaz de desenvolver conhecimento próprio e de promover estratégicas inovadoras de mudança nas áreas de ciência e tecnologia. Objetivos: descrever o panorama da formação doutoral em enfermagem a escala mundial, latino-americana e nacional, e refletir sobre seus contributos para a disciplina e a sociedade colombiana. Metodologia: a metodologia está dividida em três partes: panorama mundial da formação doutoral em enfermagem, situação atual dos cursos de doutorados na Colômbia e pertinência dos doutores em enfermagem na Colômbia. Resultados e discussão: os achados mostram diferenças entre os progressos da formação doutoral em enfermagem mundial e latino-americana e aqueles oferecidos na Colômbia. Vale a pena salientar o crescimento de programas na Europa, Ásia e América Latina, o qual é positivo para o desenvolvimento da disciplina.