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Funder: Community Jameel Imperial College Covid‐19 Excellence Fund, Funder: NIHR Imperial College Healthcare NHS Trust Biomedical Research Centre, Funder: North West London Pathology Research Grant Commission, SARS-CoV-2, the causative agent of COVID-19, typically manifests as a respiratory illness, although extrapulmonary involvement, such as in the gastrointestinal tract and nervous system, as well as frequent thrombotic events, are increasingly recognised. How this maps onto SARS-CoV-2 organ tropism at the histological level, however, remains unclear. Here, we perform a comprehensive validation of a monoclonal antibody against the SARS-CoV-2 nucleocapsid protein (NP) followed by systematic multisystem organ immunohistochemistry analysis of the viral cellular tropism in tissue from 36 patients, 16 postmortem cases and 16 biopsies with polymerase chain reaction (PCR)-confirmed SARS-CoV-2 status from the peaks of the pandemic in 2020 and four pre-COVID postmortem controls. SARS-CoV-2 anti-NP staining in the postmortem cases revealed broad multiorgan involvement of the respiratory, digestive, haematopoietic, genitourinary and nervous systems, with a typical pattern of staining characterised by punctate paranuclear and apical cytoplasmic labelling. The average time from symptom onset to time of death was shorter in positively versus negatively stained postmortem cases (mean = 10.3 days versus mean = 20.3 days, p = 0.0416, with no cases showing definitive staining if the interval exceeded 15 days). One striking finding was the widespread presence of SARS-CoV-2 NP in neurons of the myenteric plexus, a site of high ACE2 expression, the entry receptor for SARS-CoV-2, and one of the earliest affected cells in Parkinson's disease. In the bone marrow, we observed viral SARS-CoV-2 NP within megakaryocytes, key cells in platelet production and thrombus formation. In 15 tracheal biopsies performed in patients requiring ventilation, there was a near complete concordance between immunohistochemistry and PCR swab results. Going forward, our findings have relevance to correlating clinical symptoms with the organ tropism of SARS-CoV-2 in contemporary cases as well as providing insights into potential long-term complications of COVID-19. © 2022 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.

Stimulus overselectivity remains an ill-defined concept within behavior analysis, because it can be difficult to distinguish truly restrictive stimulus control from random variation. Quantitative models of bias are useful, though perhaps limited in application. Over the last 50 years, research on stimulus overselectivity has developed a pattern of assessment and intervention repeatedly marred by methodological flaws. Here we argue that a molecular view of overselectivity, under which restricted stimulus control has heretofore been examined, is fundamentally insufficient for analyzing this phenomenon. Instead, we propose the use of the term “overselectivity” to define temporally extended patterns of restrictive stimulus control that have resulted in disproportionate populations of responding that cannot be attributed to chance alone, and highlight examples of overselectivity within the verbal behavior of children with autism spectrum disorder. Viewed as such, stimulus overselectivity lends itself to direct observation and measurement through the statistical analysis of single-subject data. In particular, we demonstrate the use of the Cochran Q test as a means of precisely quantifying stimulus overselectivity. We provide a tutorial on calculation, a model for interpretation, and a discussion of the implications for the use of Cochran’s Q by clinicians and researchers.

Despite overwhelming evidence in support of Direct Instruction, this research-validated curriculum has not been widely embraced by teachers or school administrators. The Direct Instruction model, developed and refined by Engelmann and colleagues over the past 50 years, has been the focus of numerous research studies, systematic reviews, and meta-analyses. Although its efficacy cannot be doubted, the significance of Direct Instruction’s impact may be misunderstood. We attempt to clarify the importance of Direct Instruction with help from the binomial effect-size display. Binomial effect-size displays allow for intuitive and informative data-based decision making by clearly conveying the real-world importance of treatment outcomes through a juxtaposition of the relative proportions of success. The limitations of analyzing effect sizes in absolute terms are discussed. Using the binomial effect-size display as a framework, we present a series of dichotomies in an attempt to answer the question: Just how effective is Direct Instruction?

Le dispositif de la Maison verte a ete cree en 1979 pour accueillir l’enfant entre 0 et 4 ans, accompagne par un adulte tutelaire et de facon anonyme. Ce dispositif est maintenu au fil des annees. L’anonymat est l’un des points organisateurs du fonctionnement qui permet aux familles frequentant le lieu de n’etre soumises a aucun controle. Les deux principes qui fondent le lieu sont la prevention des troubles relationnels precoces et la socialisation. Une vignette clinique illustrera un moment de l’accueil ou la circulation de la parole est possible.

BackgroundThe current coronavirus disease (COVID-19) has a great impact worldwide. Healthcare workers play an essential role and are one of the most exposed groups. Information about the psychosocial impact on healthcare workers is limited.Methods3109 healthcare workers completed a national, internet-based, cross-sectional 45-item survey between 9 and 19 April 2020. The objective is to assess the psychological impact of the COVID-19 pandemic in Spanish healthcare workers. A Psychological Stress and Adaptation at work Score (PSAS) was defined combining four modified versions of validated psychological assessment tests (A) Healthcare Stressful Test, (B) Coping Strategies Inventory, (C) Font-Roja Questionnaire and (D) Trait Meta-Mood Scale.ResultsThe highest psychosocial impact was perceived in Respiratory Medicine, the mean (S.D.) PSAS was 48.3 (13.6) and Geriatrics 47.6 (16.4). Higher distress levels were found in the geographical areas with the highest incidence of COVID-19 (>245.5 cases per 100 000 people), PSAS 46.8 (15.2); p < 0.001. The least stress respondents were asymptomatic workers PSAS, 41.3 (15.4); p < 0.001, as well as those above 60 years old, PSAS, 37.6 (16); p < 0.001. Workers who needed psychological therapy and did not receive it, were more stressed PSAS 52.5 (13.6) than those who did not need it PSAS 39.7 (13.9); p < 0.001.ConclusionsThe psychological impact in healthcare workers in Spain during COVID-19 emergency has been studied. The stress perceived is parallel to the number of cases per 100 000 people. Psychotherapy could have a major role to mitigate the experimented stress level.

Issue. New Mexico uses evidence-based approaches to help tobacco users quit, including a statewide free telephone quitline. The state Tobacco Use Prevention and Control program’s goals include identifying and eliminating disparities. Priority Population. About 500,000 of the state’s residents are Hispanic or Latino people who speak Spanish at home. Among them, about 16% of adults smoke cigarettes, meaning approximately 60,000 potentially need quitting support. Method. Data indicated gaps in utilization of Spanish-language quitline services. An equity-focused quality improvement approach was used to address this gap in collaboration with Nuestra Salud (“Our Health”), a community-based organization supporting Spanish-speaking people throughout New Mexico. Formative research in Spanish-speaking communities was conducted during 2013. Based on these findings, a culturally grounded DEJELO YA (“Quit Now”) media campaign was developed and launched in 2015. Nuestra Salud led complementary community-based outreach. Service intake data and a 7-month evaluation survey from 2014-2016 were assessed descriptively to evaluate changes. Results. Quitline call frequencies increased by 31% among Spanish-speaking Hispanic/Latinos from 2014 to 2015, in comparison to 3% among non- Hispanics. Successful quitting improved for Spanish speakers from 32.9% in 2014 to 46.4% in 2016, while remaining stable among all English speakers (31.3% in 2015). Satisfaction with services was similar and unchanged for Spanish and English services (80.0% and 78.1%, respectively, in 2015). Implications for Practice. Implementation of an organically developed Spanish-language campaign was associated with improved quitline service utilization. Collaboration with a community-based organization in a quality improvement process was key. Sustained progress requires resources and attention to service capacity.

Background: The pandemic caused by coronavirus disease 2019 (COVID-19) has substantially changed the activity in Spanish healthcare centers. Residents who face pandemics are vulnerable physicians with different knowledge and experience. Objectives: This study aimed to determine the impact of COVID-19 pandemic on the Anesthesia and Critical Care residents and to establish its formative and personal consequences. Methods: A 35-question digital survey was developed, and was distributed among Anesthesia and Critical Care residents in Spain. The quantitative variable "Objective Formative Impact Score" (PIOF) was defined, being proportional to the impact on formative routines. Results: Several parameters were associated to a higher formative impact, such as the exposition to patients with COVID-19 (P = 0,020), an increase in the autonomy (P = 0,001), fear to contagion due to lack of protective equipment (P = 0,003), working in higher incidence areas (P < 0,001), being assigned to COVID-19 critical care units (P < 0,001), or to other departments different from Anesthesia and Critical Care. Residents experienced feelings of loneliness from the social distancing or ethical conflicts when working in suboptimal conditions. Conclusions: COVID-19 pandemic has had a major impact on Anesthesia and Critical Care residents both personally and formatively. The designed parameter PIOF brings an objective value about residents' formation.

ObjectiveThis study aimed to analyze the prognostic factors for overall and progression-free survival in patients with vulvar cancer.MethodsThis international, multicenter, retrospective study included 2453 patients diagnosed with vulvar cancer at 100 different institutions. Inclusion criteria were institutional review board approval from each collaborating center, pathologic diagnosis of invasive carcinoma of the vulva, and primary treatment performed at the participating center. Patients with intraepithelial neoplasia or primary treatment at non-participating centers were excluded. Global survival analysis and squamous cell histology subanalysis was performed.ResultsAfter excluding patients due to incomplete data entry, 1727 patients treated for vulvar cancer between January 2001 and December 2005 were registered for analysis (1535 squamous, 42 melanomas, 38 Paget’s disease and 112 other histologic types). Melanomas had the worse prognosis (p=0.02). In squamous vulvar tumors, independent factors for increase in local recurrence of vulvar cancer were: no prior radiotherapy (p5 mm (p=0.001) were correlated with poor overall survival, and large case volume (≥9 vs ConclusionsAdvanced patient age, number of positive inguinal lymph nodes, and lack of adjuvant treatment are significantly associated with a higher risk of relapse in patients with squamous cell vulvar cancer. Case volume per treating institution, FIGO stage, and stromal invasion appear to impact overall survival significantly. Future prospective trials are warranted to establish these prognostic factors for vulvar cancer.

Importance Limited information on the transmission and dynamics of SARS-CoV-2 at the city scale is available. Objective To describe the local spread of SARS-CoV-2 in Valencia, Spain. Design, Setting, and Participants This single-center epidemiological cohort study of patients with SARS-CoV-2 was performed at University General Hospital in Valencia (population in the hospital catchment area, 364 000), a tertiary hospital. The study included all consecutive patients with COVID-19 isolated at home from the start of the COVID-19 pandemic on February 19 until August 31, 2020. Exposures Cases of SARS-CoV-2 infection confirmed by the presence of IgM antibodies or a positive polymerase chain reaction test result on a nasopharyngeal swab were included. Cases in which patients with negative laboratory results met diagnostic and clinical criteria were also included. Main Outcomes and Measures The primary outcome was the characterization of dissemination patterns and connections among the 20 neighborhoods of Valencia during the outbreak. To recreate the transmission network, the inbound and outbound connections were studied for each region, and the relative risk of infection was estimated. Results In total, 2646 patients were included in the analysis. The mean (SD) age was 45.3 (22.5) years; 1203 (46%) were male and 1442 (54%) were female (data were missing for 1); and the overall mortality was 3.7%. The incidence of SARS-CoV-2 cases was higher in neighborhoods with higher household income (β2 [for mean income per household] = 0.197; 95% CI, 0.057-0.351) and greater population density (β1 [inhabitants per km2] = 0.228; 95% CI, 0.085-0.387). Correlations with meteorological variables were not statistically significant. Neighborhood 3, where the hospital and testing facility were located, had the most outbound connections (14). A large residential complex close to the city (neighborhood 20) had the fewest connections (0 outbound and 2 inbound). Five geographically unconnected neighborhoods were of strategic importance in disrupting the transmission network. Conclusions and Relevance This study of local dissemination of SARS-COV-2 revealed nonevident transmission patterns between geographically unconnected areas. The results suggest that tailor-made containment measures could reduce transmission and that hospitals, including testing facilities, play a crucial role in disease transmission. Consequently, the local dynamics of SARS-CoV-2 spread might inform the strategic lockdown of specific neighborhoods to stop the contagion and avoid a citywide lockdown., This study was supported by the Innovation, Universities, Science and Digital Society Council through the Valencia Innovation Agency (AVI); grant 851255 from the European Research Council under the European Union’s Horizon 2020 research and innovation program (Dr Zanin); grant MDM-2017-0711 from the Spanish State Research Agency through the Severo Ochoa and María de Maeztu Program for Centers and Units of Excellence in Research and Development (Dr Zanin); and from the Universitat de Valencia (Drs Iftimi and Lozano).

L’adoption est une institution juridique qui pretend donner la possibilite a un mineur de recreer les liens familiaux et filiaux qui lui font defaut car l’enfant a ete abandonne par ses parents (ou est orphelin) et l’adoption se fait par le biais de l’Etat. Dans le cas des enfants appropries pendant la dictature militaire en Argentine (1976-1983), il n’y a pas eu abandon de la part de la famille d’origine et les institutions n’ont pas joue leur role de tiers mediateur. Cette difference est essentielle pour comprendre la dynamique subjective et la clinique differentielle des enfants abandonnes, de ceux adoptes et des enfants appropries.

Many mountain destinations receive the contribution of migrants from diverse cultures that generate enterprises and innovations. In general the literature has focused on analyzing social technologies present in process of innovation from the perspective

Submitted by ANGÉLICA MARÍA OTERO PATERNINA null (angelicaoterop@gmail.com) on 2016-08-24T19:56:48Z No. of bitstreams: 1 Tese Angélica Otero P.pdf: 1373854 bytes, checksum: 2779e34de4fa04966141c618413d8ac5 (MD5) Approved for entry into archive by Juliano Benedito Ferreira (julianoferreira@reitoria.unesp.br) on 2016-08-29T20:16:58Z (GMT) No. of bitstreams: 1 paternina_amo_dr_sjrp_par.pdf: 368657 bytes, checksum: 507112efb45da337b8f56752fbbc8f8c (MD5) Made available in DSpace on 2016-08-29T20:16:58Z (GMT). No. of bitstreams: 1 paternina_amo_dr_sjrp_par.pdf: 368657 bytes, checksum: 507112efb45da337b8f56752fbbc8f8c (MD5) Previous issue date: 2016-08-05 Na presente Tese, foi avaliada a contribuição dos cladóceros como fonte de alimento para os peixes, em seis lagoas marginais da planície de inundação do Rio Turvo- SP em três períodos do ciclo hidrológico da região - seca, intermediário e chuvosa. Para esta avaliação foram analisadas a contribuição dos cladóceros na dieta dos peixes, a composição dos cladóceros no ambiente e as taxas populacionais em cultivo das espécies de cladóceros mais consumidos pelos peixes. Desta forma, os resultados deste estudo são aqui apresentados, organizados em três capítulos: no Capitulo 1, foi estudada a composição e abundância de cladóceros das lagoas marginais, onde foram identificadas 37 espécies de cladóceros, sendo a família Chydoridae a mais representativa, com 16 espécies. Moina minuta foi à espécie que mostrou os maiores valores de abundância relativa nos três períodos estudados. A densidade média dos Cladocera não mostrou diferenças significativas entre os períodos avaliados. No Capitulo 2, foi analisada a dieta dos peixes e os resultados mostraram um amplo espectro alimentar, com um total de 15 itens consumidos, sendo que os cladóceros mostraram uma contribuição de 1 a 6% na dieta dos peixes; foram identificadas 28 espécies de cladóceros no conteúdo estomacal, constituídas principalmente por aquelas da família Chydoridae. O consumo de cladóceros variou significativamente entre os períodos, as espécies Macrothrix paulensis, Chydorus sp., e Alona sp., foram as mais consumidas no período seco, já no período intermediário as espécies Moina minuta e Bosmina tubicen predominaram nos estômagos e, no período chuvoso Diaphanosoma sp. foi a mais consumida. Os peixes consumiram cladóceros independente do habitat que ocupavam indicando que a ictiofauna presente nas lagoas aproveita a disponibilidade deste recurso. No Capitulo 3 foram avaliadas as taxas de crescimento de três espécies de cladócera Diaphanosoma birgei, Moina minuta e Macrothrix paulensis, as quais estavam presentes na dieta dos peixes e nas lagoas marginais. A espécie M. paulensis mostrou os melhores resultados no cultivo, com elevadas densidades, biomassa e produção secundária, e altas taxas de fecundidade. Já a espécie M. minuta apresentou o menor tempo na primeira reprodução e na frequência reprodutiva. A espécie M. paulensis pelas características apresentadas nas taxas de crescimento apresentam características favoráveis para produção de biomassa para alimentação de peixes. Com este estudo podemos concluir que os cladóceros podem representar importante item na dieta dos peixes em lagoas marginais e que estes não parecem selecionar as espécies de cladóceros, mas as consomem de acordo com a disponibilidade. Uma das espécies de cladócero bastante consumida pelos peixes, Macrothrix paulensis apresenta elevado potencial para cultivo para produção e biomassa. This thesis is dedicated to assess the contribution of cladocerans as a food source to fish in six oxbow lakes of the floodplain in Turvo River -SP in three periods of the hydrological cycle of the region: drought, intermediate, and rainy. In this assessment, the contribution of cladocerans in the fish’s diet was analyzed, the composition of the cladocerans in the environment, and the population rate farming of the species of cladocerans most consumed by the fish. So, the results of this study are presented herein organized in three sections: in Section 1, the composition and abundance of cladocerans in oxbow lakes were studied, and 37 species of cladocerans were identified, being the Chydoridae family the most representative, amounting to 16 species. Moina minuta was the species that showed the highest values of relative abundance in the three periods studied. The average density of Cladocera has not presented substantial differences between the assessed periods. In Section 2, the fish’s diet was analyzed and the results showed a wide food range, amounting to 15 consumed items, and the cladocerans showed a contribution from 1 to 6% in fish’s diet; 28 species of cladocerans were identified in the stomach content, comprised mainly by those of the Chydoridae family. The consumption of cladocerans varied substantially between periods. The following species – Macrothrix paulensis, Chydorus sp., e Alona sp., were the most consumed in the drought period. In the intermediate period, Moina minuta and Bosmina tubicen were the species that prevailed in stomachs. Finally, in the rainy period, Diaphanosoma sp. was the most consumed. Fish consumed cladocerans regardless the habitat they were located, suggesting that the fish fauna present in the lakes exploits the availability of this resource. In Section 3, the growth rate of three species of cladocerans, Diaphanosoma birgei, Moina minuta, and Macrothrix paulensis, were assessed; they were present in fish’s diet and in oxbow lakes. The species M. paulensis showed the best results in the farming, with high densities, biomass, and secondary production, in addition to high fertility rates. On the other hand, the species M. minuta showed the lowest time in the first reproduction and in the reproductive frequency. The species M. paulesnsis, for the characteristics presented in growth rates, presents favorable features for the biomass production in fish feeding. With this study, we can conclude that cladocerans represent an important item in fish’s diet in oxbow lakes, and they do not seem to select species of cladocerans, but they consume them according to the availability. One of the species of cladocerans largely consumed by fish, Macrothrix paulensis, presents a high potential in the farming for production and biomass.

Nous proposons de prendre la methode de l’anthropologie psychanalytique pour rendre compte des changements socioculturels des contenus de la novelisation adolescente. Novelisation qui participe de la desidealisation parentale, elle-meme soutien du progres social, dans la mesure ou elle oppose une generation a la suivante. Concernent la psychanalyse autant l’investigation de processus psychiques individuels (tels que la pulsion de recherche, les theories sexuelles infantiles ou le roman familial) que les variations de ladite activite pulsionnelle offerte par la culture a un moment donne. Les conditions culturelles d’une configuration sociale fournissent les materiaux signifiants que la psyche prendra afin de resoudre des conflits qui lui sont propres. Les exemples que nous rencontrons dans le travail analytique nous aident a connaitre la facon dont s’organise le psychisme.

Nous proposons de prendre la methode de l’anthropologie psychanalytique pour rendre compte des changements socioculturels des contenus de la novelisation adolescente. Novelisation qui participe de la desidealisation parentale, elle-meme soutien du progres social, dans la mesure ou elle oppose une generation a la suivante. Concernent la psychanalyse autant l’investigation de processus psychiques individuels (tels que la pulsion de recherche, les theories sexuelles infantiles ou le roman familial) que les variations de ladite activite pulsionnelle offerte par la culture a un moment donne. Les conditions culturelles d’une configuration sociale fournissent les materiaux signifiants que la psyche prendra afin de resoudre des conflits qui lui sont propres. Les exemples que nous rencontrons dans le travail analytique nous aident a connaitre la facon dont s’organise le psychisme.

In recent decades great advances have been made in surgical procedures for treating thoracic and thoracoabdominal aorta defects. Associated mortality and morbidity rates have dropped considerably, mainly in major reference centers, but nonetheless continue to be significant. The need for new strategies to reduce mortality and morbidity has made endovascular approaches an attractive alternative for high-risk surgical patients. The most feared complications of these procedures include paraparesis and paraplegia, which have devastating consequences on patients' quality of life. We provide an updated review of the pathophysiology of spinal cord ischemia in open and endovascular surgery, as well as perioperative measures designed to protect the spinal cord in both types of procedure.

Cervical cancer is a preventable disease resulting from infection with high-risk types of sexually transmitted human papillomaviruses (HPVs). Public knowledge of HPVs and their link to cervical cancer is limited. Participation in cervical cancer prevention programs, including Pap and HPV screening and HPV vaccine acceptance, is crucial for limiting the incidence of cervical cancer. Hispanic women suffer the highest cervical cancer incidence rates in the United States. In this study, we conducted community-based focus groups with Hispanic women to explore knowledge and attitudes relating to cervical cancer, HPV, HPV testing, and HPV vaccination. Study findings suggest a need to increase public health literacy in relation to HPV, the link between HPV and cervical cancer, and HPV primary and secondary prevention options. Health care providers should be prepared to share information with patients that supports and promotes informed decision making about HPV testing and vaccines and their complementary roles in cervical cancer screening and prevention.

Objective: We studied the long-term outcome after an anal sphincter tear. Study design: From a cohort of 4569 women who gave birth in 1982 to 1983, we identified 445 (9.7%) who sustained a sphincter tear and 445 controls. Eighteen years after the delivery, we mailed them a questionnaire and graded fecal incontinence with the Wexner score, a summary of incontinence to flatus, liquid, or solid stools; need to wear a pad; and lifestyle alterations. We predefined severe incontinence as a score above 4 of 20. Results: Five hundred forty of 890 women (61%) returned the questionnaire. Severe fecal incontinence was reported by 34 of 259 women (13.1%) after a sphincter tear and 22 of 281 controls (7.8%) (risk ratio 1.7, 95% confidence interval 1.0 to 2.8). Only 6.4% of the reports of fecal incontinence were attributable to a sphincter tear. Conclusion: Fecal incontinence is frequently reported, even by women who have not sustained an anal sphincter tear. Only a small fraction of fecal incontinence can be attributed to sphincter tears.

By examining three different institutional frameworks and performances, this paper portrays the challenges and potential for microfinance programmes to solve some of the key constraints in the field today. Tracing the growth of BancoSol, a new, private Bolivian commercial bank dedicated almost exclusively to microenterprise, many lessons about the institutional development of profitable micro-lending organizations emerge. The Kenya Rural Enterprise Programme provides evidence of the complementary roles technical assistance and other NGO services play in the strengthening of both microenterprises and microfinance programmes. Finally, the long track record and diverse lending programmes of Thailand's Bank for Agriculture and Agricultural Cooperatives draw lessons in the criteria and methods of effective financial intermediation. Elements of success and differences among the cases are highlighted.

13 p.-10 fig.-1 tab. Alén, Begoña O. et alt., The quest for therapeutic applications of obestatin involves, as a first step, the determination of its 3D solution structure and the relationship between this structure and the biological activity of obestatin. On this basis, we have employed a combination of circular dichroism (CD), nuclear magnetic resonance (NMR) spectroscopy, and modeling techniques to determine the solution structure of human obestatin (1). Other analogues, including human non-amidated obestatin (2) and the fragment peptides (6–23)-obestatin (3), (11–23)-obestatin (4), and (16–23)-obestatin (5) have also been scrutinized. These studies have been performed in a micellar environment to mimic the cell membrane (sodium dodecyl sulfate, SDS). Furthermore, structural-activity relationship studies have been performed by assessing the in vitro proliferative capabilities of these peptides in the human retinal pigmented epithelial cell line ARPE-19 (ERK1/2 and Akt phosphorylation, Ki67 expression, and cellular proliferation). Our findings emphasize the importance of both the primary structure (composition and size) and particular segments of the obestatin molecule that posses significant α-helical characteristics. Additionally, details of a species-specific role for obestatin have also been hypothesized by comparing human and mouse obestatins (1 and 6, respectively) at both the structural and bioactivity levels, This work was supported by grants from Ministerio de Economía y Competitividad (SAF2010-20451, CTQ2009-08536), Xunta de Galicia (INCITE09PXIB 918374PR) and Instituto de Salud Carlos III (Ministerio de Economía y Competitividad, Spain; PS09/02202, PS09/02075). CIBER is an initiative of Instituto de Salud Carlos III (Ministerio de Ciencia e Innovación, Spain). Instituto de Salud Carlos III and SERGAS fund the work of J.P. Camina, and Y. Pazos through a research-staff stabilization contract. Xunta de Galicia funds U. Gurriarán-Rodriguez through a research-staff contract Isabel Barreto

Collection development librarians both as administrators and as selectors are currently facing remendous changes in the way they do their work. informatio is now coming in a great variety of formats. Technology is a swiftly moving stream which tehy must be able to navigate successfully. In times of budgetary constraints, bibliographers must have the political wherewithal to present and defend their agenda in the larger university community

This article argues for the use of a financial systems approach in the provision of financial services to the poor. The experience of the last decade has produced a successful technology for credit delivery that utilizes sound financial principles as its basis, that is: understanding the needs of the client; increasing efficiency by cutting administrative costs; and using various techniques to motivate repayment. Savings receives equal emphasis as a financial service, and several principles for its provision are discussed. The institutional dimensions behind this approach focus on the need to achieve self-sufficiency, which the article frames as a four-stage process. Finally, the article outlines various factors related to creating financial institutions that reach the poor and the policy implications that these suggest.

Microenterprise programmes can be excellent vehicles to foster savings among poor populations, with considerable benefits both for those saving and for the programmes themselves. The purpose of this article is to explore issues related to savings mobilization from the vantage point of projects that seek to reach poor people who are self-employed in productive activities. Microenterprise development projects in particular are the focus of this study.The first section provides background for the discussion, asking why people save, and what sort of savings schemes prevail among poor populations. The second section turns to examples of savings mobilization in microenterprise programmes to identify the factors that contribute to success.Finally, the article identifies the circumstances under which mobilizing savings makes economic sense, and provides some approaches for future microenterprise lending programmes.

Objective We studied maternal health 18 years postpartum in women having sustained an anal sphincter tear and controls. Study design We assessed symptoms with the short form of the urogenital distress inventory, the female sexual function index, and physical and mental health with the Short Form-12 summary scales. Results Women with a sphincter tear had no increased risk of urinary symptoms (54 of 251, 22%, versus 51 of 273, 19%, risk ratio 1.2, 95% confidence interval 0.8 to 1.6) or sexual symptoms (84 of 223, 38%, versus 90 of 230, 39%, risk ratio 1.0, 95% confidence interval 0.8 to 1.2). Their physical health was also similar to controls (mean score ± SD, 47 ± 7 versus 47 ± 6), whereas their mental health was slightly lower (score 45 ± 6 versus 46 ± 6, difference 1, 95% confidence interval 0 to 2, P = .05). Conclusion Women who sustained an anal sphincter tear have no more urinary or sexual symptoms 18 years after delivery.

The purpose of this study was to describe the most frequent objective clinical manifestations found during the eruption of primary teeth and to assess the correlation between those symptoms and the eruption of various groups of teeth.The study was conducted in the Clinica Infantil Colsubsidio in Bogota, Colombia. Five hundred and eighty-five children participated in the study. One-hundred and forty-five children ages 4 to 36 months who had at least 1 erupting tooth were included in the study group. The other 357 children served as a control group. Parents were asked to complete a short questionnaire and children were then checked by one of the authors. Chi-square analysis was performed to analyze information obtained for the 2 groups. Level of significance was set at P.05.There were 81 girls (56%) and 64 boys (44%) in the study group, and 183 girls (54%) and 157 boys (46%) in the control group. The most frequent clinical manifestations were: drooling (15%), diarrhea (13%) and drooling-diarrhea (8%). The presence of fever and fever-diarrhea was shown in a lower percentage (8%). In the study group, boys demonstrated a higher prevalence of diarrhea than girls (P.05). No statistical significance regarding other clinical manifestations and gender were observed. In the control group, 93% of the children did not show any clinical manifestation.An association has been shown between general objective manifestations like drooling (the most prevalent), fever and diarrhea, and the eruption of primary teeth. Most manifestations appeared during the eruption of the primary incisors.