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The objective of the present study is to determine the knowledge, attitudes and beliefs regarding breastfeeding of final-year nutrition and dietetic students. A cross-sectional survey of final-year nutrition and dietetic students at a leading Australian university was conducted using an emailed questionnaire of 50 multiple-choice questions on knowledge, attitudes, beliefs and future intentions to support and promote breastfeeding. The frequency of response to all questions was determined. Twenty-seven of the 38 eligible students completed the survey. Significant deficits were identified relating to breastfeeding knowledge. Ninety-two per cent of respondents reported a future intention to breastfeed or support their partner to do so; yet 69% felt bottle feeding was more socially acceptable and 23% believed that using artificial formula was easier for the mother. Although 85% of respondents believed they could influence breastfeeding initiation and duration rates, no students perceived that their studies had provided a significant amount of information on this subject, while only 8% of respondents had a strong interest in work relating to breastfeeding in the future. Improvements in the curriculum in this context may be required to ensure new graduates have the appropriate knowledge and are motivated to take positive action so that breastfeeding is properly supported. Further research is needed to determine if this issue applies in other nutrition courses and to assess the need to adopt an industry position paper on breastfeeding and associated competency standards for vocational training.

Leaders in engineering education reform advocate integrating “real world” expertise into the undergraduate training, but these calls encompass a dizzying array of both skills and methods to develop them. The authors give form to the debate by sketching out the pedagogical value of one specific type of real world experience – practical learning with one’s hands – and situating it within in the longer historical context of the mental/manual divide that characterizes U.S. engineering practice and education. Engineering by Doing (EbD), an initiative at the Colorado School of Mines, exemplifies this kind of learning by bringing together non-traditional students, with practical skills, and traditional engineering students, with solid grounding in mathematics and sciences, to work on projects with a specific practical, hands-on element. Making the background knowledge and experiences of nontraditional students visible and valued within the curriculum has the potential to improve recruitment and retention among low income and first generation students and thereby broaden participation in engineering.

In this second article on childhood enuresis, the author examines the management and treatment of the condition by school nurses. Following the holistic assessment outlined in the first article, effective individualized management strategies can be formulated.

Enuresis (bed-wetting) has a profound effect on the life of the affected child and his or her family. This series of articles will examine the aetiology and management of enuresis, starting with an overview of the causes and assessment of the condition.

This chapter discusses the challenges, characteristics, and transitional roles of adult learners. Implications for student services professionals are presented.

Elizabeth Cox and Tekla Hendrickson describe how they achieved the training to enable 320 women volunteers to become village birth attendants and community sexual health educators in the East Sepik Women and Children's Health Project, Papua New Guinea. Development (2003) 46, 101–104. doi:10.1057/palgrave.development.1110455

Prescription opioid (PO) dependence is a critical health problem. Although examination of drug cue reactivity paradigms has advanced the understanding of risk factors for relapse for a variety of substances (e.g., cocaine, alcohol, nicotine), no PO specific drug cue paradigm has been developed. The current study addressed this gap in the literature and evaluated the ability of a newly developed PO drug cue paradigm to elicit subjective, physiological, and neuroendocrine changes among PO-dependent participants (n = 20) as compared to controls (n = 17). The drug cue paradigm included an induction script, viewing and handling paraphernalia (e.g., bottle of oxycontin pills, pill crusher) and watching a video depicting people using POs as well as places related to POs (e.g., pharmacies). Consistent with hypotheses, the PO group demonstrated significant pre- to post-cue increases on subjective ratings of craving, difficulty resisting POs, stress, and anger. The control group did not demonstrate significant changes on any of the subjective measures. Both the PO group and the control group evidenced significant pre- to post-cue increases in physiological responses (e.g., blood pressure, skin conductance), as expected given the arousing nature of the drug cue stimuli. The PO group, but not the control group, evidenced a significant pre- to post-cue increase in heart rate and salivary cortisol levels. The development and validation of a drug cue paradigm for POs may help inform future research and treatment development efforts for patients with PO dependence.

The research described in this article examines parents’ and carers of children with bedwetting (enuresis) problems’ attitudes to, and knowledge of, enuresis and enuresis services in southern Derbyshire. A specialist enuresis service was already running in this area and the continence nurse advisor (children’s services) had noted a high number of referrals complaining about lack of knowledge prior to attending clinic and a lack of clarity and continuity of advice given by other health professionals. The specialist continence service needed to be needs-led and validated as an appropriate and adequate service. Following a literature search and pilot study, a questionnaire was sent to parents of children who had been referred to the clinic in the previous year. Analysis was performed using the SPSS statistical package. Results showed a high value being given to the specialist nurse-led service by parents and children and a high amount of conflicting, non-evidence based advice being given to parents and carers from various health professionals prior to referral to the specialist nurse. The results of the study lead to the formulation of recommendations to improve services available to children with enuresis, their parents and carers.

“Family Snapshots” are 100-words-or-less descriptive memories of times in the lives of families that highlight poignant moments. They complement other exercises within a family counseling course, including the use of genograms. Modeled after the Washington Post Magazine 's series “Life Is Short: Autobiography as Haiku,” these snapshots give writers awareness and insight because of their focus on telling a story rather than being didactic. Family snapshots have the potential for use in family counseling and in academic courses for family therapists. Examples of family snapshots are given along with interpretations of, reactions to, and limitations of this technique.

While variations in neonatal distress vocalizations have long been shown to reflect the integrity of nervous system development following a wide range of prenatal and perinatal insults, a paucity of research has explored the neurobiological basis of these variations. To address this, virgin Sprague-Dawley rats were bred and divided into three groups: [1] untreated, [2] chronic-cocaine treated (30 mg/kg/day, gestation days (GDs) 1-20); or [3] chronic saline treated (2 mg/kg/day, GDs 1-20). Pregnant dams were injected with Bromodeoxyuridine (10 mg/kg) on GDs 13-15 to label proliferating cells in limbic regions of interest. Ultrasonic vocalizations (USVs) were recorded on postnatal days (PNDs) 1, 14, and 21, from one male and female pup per litter. Variations in acoustic properties of USVs following cocaine-exposure were age and sex-dependent including measures of total number, total duration and amplitude of USVs, and percent of USVs with at least one harmonic. Following USV testing brains were stained with standard fluorescent immunohistochemistry protocols and examined for variations in neuronal development and if variations were associated with acoustic characteristics. Limbic region developmental differences following cocaine-exposure were sex- and age-dependent with variations in the ventral medial hypothalamus and central amygdala correlating with variations in vocalizations on PND 14 and 21. Results suggest maturation of the ventral medial hypothalamus and central amygdala may provide the basis for variations in the sound and production of USVs. As vocalizations may serve as a neurobehavioral marker for nervous system integrity, understanding the neurobiological basis of neonatal vocalizations may provide the basis for early intervention strategies in high-risk infant populations.

A two-and-a-half-year study was conducted to compare the performance of sibling diploid and triploid Sydney rock oysters Saccostrea commercialis (Iredale and Roughley) at three intertidal and one subtidal site in Port Stephens, New South Wales (N.S.W.). The triploid Sydney rock oysters were on average 41% heavier than their diploid siblings after 2.5 years of growth. The triploid oysters also maintained higher dry meat weight and higher condition index (CI) values than their diploid siblings at all sites during the final 10 months' growth to market size (40 to 60 whole weight). The triploid oysters at the subtidal site had the highest CI values recorded in this study. When exposed to the protistan parasite Mikrocytos roughleyi which causes winter mortality disease, no differences in mortality between diploid and triploid groups occurred. These findings have major implications for the N.S.W. oyster industry as triploid Sydney rock oysters can reach market size 6–18 months faster and maintain better meat condition than diploid oysters without an increased risk of winter mortality.

Objectives: This study examined the association between prenatal cocaine exposure and children’s self-regulation at 3 years of child age. In addition to direct effects of prenatal cocaine exposure on children’s self-regulation, we hypothesized there would be indirect associations between cocaine exposure and self-regulation via higher maternal harshness and poor autonomic regulation in infancy. Methods: The sample consisted of 216 mother–infant dyads recruited at delivery from local area hospitals (116 cocaine-exposed, 100 non-exposed). Infant autonomic regulation was measured at 7 months of age during an anger/frustration task, maternal harshness was coded from observations of mother–toddler interactions at 2 years of age, and children’s self-regulation was measured at 3 years of age using several laboratory paradigms. Results: Contrary to hypotheses, there were no direct associations between maternal cocaine use during pregnancy and children’s self-regulation. However, results from testing our conceptual model including the indirect effects via maternal harshness or infant parasympathetic regulation indicated that this model fit the data well, χ2 (23) = 34.36, p > 0.05, Comparative Fit Index = 0.95, RMSEA = 0.05. Cocaine using mothers displayed higher intensity of harshness toward their toddlers during lab interactions across a variety of tasks at 2 years of age (β = 0.23, p

This article is part of a series of interviews with a range of professionals working with children and young people. This month, Elizabeth Cox, paediatric continence nurse specialist (retired), offers advice on supporting children and young people with nocturnal enuresis.

Clofarabine has significant single-agent activity in patients with indolent and aggressive non-Hodgkin lymphoma and synergizes with DNA-damaging drugs. Treatment, however, may be associated with severe and prolonged myelosuppression. We conducted a phase I trial to determine the maximum tolerated dose (MTD) of clofarabine in combination with high-dose etoposide and cyclophosphamide followed by autologous peripheral blood stem cell transplantation in patients with refractory non-Hodgkin lymphoma (NHL). Patients received clofarabine at 30-70 mg/m(2)/day on days -6 to -2 in successive cohorts, in combination with etoposide 60 mg/kg (day -8), and cyclophosphamide 100 mg/kg (day -6), followed by filgrastim-mobilized PBSC on day 0. Sixteen patients of median age 57 (range: 32-67) years with diffuse large B cell (n = 8), follicular (n = 5), or mantle cell (n = 3) lymphoma that was either primary refractory (n = 2) or relapsed and refractory (n = 14) were treated at 5 clofarabine dose levels: 30 (n = 3), 40 (n = 3), 50 (n = 3), 60 (n = 3), and 70 mg/m(2)/day (n = 4) in combination with etoposide and cyclophosphamide. All patients had grade 4 neutropenia and thrombocytopenia. Grade 3-4 nonhematologic toxicity was evenly distributed across all 5 dose levels, and included diarrhea (n = 3), mucositis (n = 1), nausea (n = 1), reversible elevation of alanine aminotranferease/aspartate aminotransferase (AST/ALT) (n = 1) or bilirubin (n = 1), and hemorrhagic cystitis (n = 1); all resolved by day +30 following transplantation. The MTD was not reached. No treatment-related deaths occurred. At day +30, 13 patients achieved a complete remission (CR) or unconfirmed CR (CR(U)), and 2 patients achieved a partial response, for an overall response rate of 94%. After a median follow-up of 691 days, the 1-year progression-free survival (PFS) and overall survival (OS) were 63% (95% confidence interval [CI]: 43%-91%) and 68% (95% CI: 49%-96%), respectively. We recommend clofarabine 70 mg/m(2)/day × 5 days as a phase II dose in combination with high-dose etoposide and cyclophosphamide for further testing as a preparative regimen in NHL patients undergoing autologous PBSC transplantation.

Little is known about mechanisms underlying female rodent aggression during the late postpartum period with no pups present. Studies of aggression, dominance, and oxytocin (OT) response in cocaine-treated females are sparse.This study was designed to examine dominance (drinking success) and aggression in a limited-access drinking model of water competition. Acute OT level measures were made on postpartum day (PPD) 36 in several brain regions of interest. Chronic and intermittent cocaine- and saline-treated and untreated rats 10 days post-weaning were tested (without pups) over PPDs 31-35 following cessation of cocaine treatment 10-30 days before testing.Subjects were water-deprived overnight, and triads consisting of an untreated control (UN), a chronic continuous saline-treated (CS), and chronic continuous cocaine-treated (CC; 30 mg/kg/day throughout gestation) or a UN, an intermittent saline-treated (IS), and an intermittent cocaine-treated (IC; 30 mg/kg two consecutive days every 4 days throughout gestation until PPD 20) female were tested for aggression and drinking behavior during 5 min sessions on five consecutive days. The amygdala, medial preoptic area (MPOA), and ventral tegmental area were assayed for OT levels.CC and IC females were more aggressive than controls, but only IC females drank more often than controls. OT levels were lower in the MPOA of IC and CC females than in controls.Findings demonstrate that long after cessation of treatment, CC- and IC-treated non-lactating females (no pups present) had higher rates of aggression, altered drinking behavior, and acutely lower MPOA OT levels.

A total of 50 consecutive patients (median age, 57.5 years) with AML (n=30) or myelodysplasia (MDS, n=20) underwent HLA matched related donor (MRD, n=27) or unrelated donor (MUD, n=23) peripheral blood hematopoietic cell transplantation after nonmyeloablative CY/fludarabine (Flu) conditioning. GVHD prophylaxis included CsA (n=19)+/-mycophenolate mofetil (n=31). At a median follow-up of 59 months, 21 patients (42%) were alive without evidence of disease. By Kaplan-Meier analysis, year 1-4 disease-free survival (DFS) and OS estimates were 0.50/0.58, 0.40/0.46, 0.37/0.43 and 0.37/0.41. MUD recipients were engrafted quickly (13.5 days) compared to MRD recipients (16 days) and relapsed/progressed less frequently (P=0.005). Overall grade 3/4 acute GVHD (aGVHD) occurred in 26% in the absence of antecedent mucositis and was associated with chronic GVHD (cGVHD) and poor OS. Extensive cGVHD developed in 51.2% of 100 day survivors. Rates of aGVHD, cGVHD and survival were similar between MRD and MUD recipients. Of 14 survivors with cGVHD, 5 (35.7%) experienced resolution off immunosuppression, suggesting that tolerance with HLA matched grafts is possible at an advanced age by this method. This study provides further evidence for prolonged DFS after CY/Flu MRD allotransplantation for AML/MDS, and extends the findings to older patients and those with unrelated donors.

Prior research reported decreased oxytocin levels in specific brain regions correlated with disruptions in maternal care following gestational cocaine treatment in rats. Similarly, prenatal exposure to cocaine impaired subsequent maternal behavior in adulthood, but behavioral alterations were not associated with decreases in oxytocin levels in the same brain regions as were found in their cocaine-treated rat dams. To determine if other aspects of the oxytocin system are disrupted by cocaine treatment or prenatal exposure to cocaine during critical time points associated with maternal care, oxytocin mRNA transcription and receptor binding were examined on postpartum day two in relevant brain regions following gestational treatment with, or prenatal exposure to, either cocaine or saline. We hypothesized that oxytocin mRNA levels and receptor binding would be differentially affected by cocaine in the early postpartum period of dams and their offspring. Our findings indicate that gestational cocaine treatment resulted in significant increases in oxytocin mRNA levels in only the paraventricular nucleus of cocaine-treated dams, with almost significant increases in both generations in the supraoptic nucleus, but no significant effects of cocaine on receptor binding in either generation of dams. These findings indicate that in addition to oxytocin levels, cocaine treatment or prenatal exposure primarily affects oxytocin mRNA synthesis, with little effect on receptor binding in specific brain regions associated with maternal behavior in the early postpartum period of the rat.

Aminoacylated phosphatidylglycerols (PG) are common lipids in the cytoplasmic membranes of Gram-positive bacteria. Their presence in staphylococcal membranes has been linked to increased resistance to a number of antibacterial agents, including antimicrobial peptides. Most commonly, the PG headgroup is esterified to lysine, which converts anionic PG into a cationic lipid with a considerably increased headgroup size. In the present work, we investigated the interactions of two well-studied antimicrobial peptides, cecropin A and mastoparan X, with lipid vesicles composed of 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine (POPC) and 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphoglycerol (POPG), containing varying fractions of an aminoacylated phosphatidylethanolamine (PE), a stable analog of the corresponding PG-derivative. To differentiate between the effects of headgroup charge and size on peptide-lipid interactions, we synthesized two different derivatives. In one, the headgroup was modified by the addition of lysine, and in the other, by glutamine. The modification by glutamine results in a phospholipid with a headgroup size comparable to that of lysylated version. However, whereas lysyl-PE is cationic, glutamyl-PE is zwitterionic. We found that as long as the concentration of aminoacylated PEs did not exceed ∼30 mol%, binding of either peptide was not significantly altered. These observations are understood through the interplay between lipid charge and headgroup size and their effect on membrane binding and peptide-induced release of content from lipid vesicles.

The team met for one 6-hour day and one 3-hour day. The team developed a workplan andmet each month until the room opened. A core group of nurses from the PACU volunteered and were chosen to learn how to provide the care needed for pre-, intraand post-care. The PACU staff went to the CPC to learn how to pull sheaths and to learn about the supplies, process and monitoring. The core group of nurses also attended additional training to learn the new computerized documentation system. Standard operational procedures were developed. When the room construction was completed, the PACU and OR staff did rehearsals of the process. They walked through each step to ensure that when the first patient was scheduled for a procedure, the process would be smooth and safe. Evaluation and Outcomes: The first day and first patient’s procedure went safely and effectively. The OR and PACU staff truly worked as a team to provide excellent care. The vascular physicians were pleased with how smooth and on time the process was and continues to be.