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Improper handling of plastic waste and related chemical pollution has garnered much attention in recent years owing to the associated detrimental impacts on human health and the environment. This article reports an overview of the main interlinkages between persistent organic pollutants (POPs) and plastic in the waste management system of India. Both plastics and POPs share certain common traits such as persistence, resistance to biological degradation, and the ability to get transported over long distances. Throughout the processes of production, consumption, and disposal, plastics interact with and accumulate POPs through several mechanisms and end up co-existing in the environment. Plastic waste can undergo long-range transport through rivers and the oceans, break down into microplastics and get transported through the air, or remain locked in waste dump yards and landfills. Over time, environmental processes lead to the leaching and release of accumulated POPs from these plastic wastes. Plastic recycling in the Indian informal sector including smelting, scrubbing, and shredding of plastic waste, is also a potential major POPs source that demands further investigation. The presence of POPs in plastic waste and their fate in the plastic recycling process have not yet been elucidated. By enhancing our understanding of these processes, this paper may aid policy decisions to combat the release of POPs from different waste types and processes in India.

Background:Many children and adolescents with incurable cancer and their families prefer to receive end-of-life care and to die at home. This implies a transition of care from hospital to home and presupposes the establishment of a well-functioning collaboration between the family and professionals across health care sectors.Aim:To identify and explore key elements of home-based end-of-life care collaboration for children with cancer, as experienced by their parents and grandparents and the hospital- and community-based professionals involved.Design:Descriptive qualitative multiple-case study. Data were collected by semi-structured interviews and written responses to open-ended questions, and analyzed inductively across cases using qualitative content analysis.Setting/participants:Cases comprised a criterion sample of five children (aged Results:We identified five main themes, describing key elements of the end-of-life collaboration: Establishing the collaboration, Bolstering family life, Elucidating organization and integration, Managing challenges, and Closing the collaboration. These themes all came under the overarching theme: A mutual trust-based collaboration. On this basis, we developed the “Home-Based Pediatric End-of-Life Care Model for Children with Cancer.”Conclusions:By highlighting key elements in the family-centered, intersectoral and interprofessional end-of-life care collaboration, our “Home-Based Pediatric End-of-Life Care Model for Children with Cancer” offers a framework for further optimization of home-based end-of-life care services for children with cancer and their families.

CONTEXT: Although specialized pediatric palliative care (SPPC) teams increasingly provide home-based care, the evidence of its impact has not yet been systematically evaluated.OBJECTIVES: To examine the impact of home-based SPPC in children and adolescents with life-limiting conditions, regarding place of death, quality of life and symptom burden.METHODS: We searched Medline, EMBASE, CINAHL, PsycINFO, the Cochrane Central Register of Controlled Trials, Web of Science and Scopus for studies comparing children and adolescents with life-limiting conditions receiving home-based SPPC with children and adolescents not receiving home-based SPPC, or studies reporting before-and-after measurements. We included studies that reported on place of death, quality of life and/or symptoms. Two authors independently screened the articles, extracted data, and assessed quality. Results were synthesized as a systematic narrative synthesis and meta-analysis, using a random-effects model.RESULTS: We included five studies, which reported on 392 children and adolescents. Meta-analysis showed that receiving home-based SPPC was associated with a more than fourfold increased likelihood of home death (risk ratio 4.64, 95% confidence interval 3.06-7.04; 3 studies; n=296). Most studies reported improved quality of life and reduced symptom burden. The included studies were of low to moderate quality with a high risk of bias.CONCLUSION: This systematic review suggests that home-based SPPC is associated with increased likelihood of home death, and might be associated with improved quality of life and reduced symptom burden. The small number of studies and an overall high risk of bias, however, makes the overall strength of evidence low.

River systems are a key environmental recipient of macroplastic pollution. Understanding the sources of macroplastic to rivers and the mechanisms controlling fate and transport is essential to identify and tailor measures that can effectively reduce global plastic pollution. Several guidelines exist for monitoring macroplastic in rivers; yet, no single method has emerged representing the standard approach. This reflects the substantial variability in river systems globally and the need to adapt methods to the local environmental context and monitoring goals. Here we present a critical review of methods used to measure macroplastic flows in rivers, with a specific focus on opportunities for methods testing, harmonisation, and quality assurance and quality control (QA/QC). Several studies have already revealed important findings; however, there is significant disparity in the reporting of methodologies and data. There is a need to converge methods, and their adaptations, towards greater comparability. This can be achieved through: i) methods testing to better understand what each method effectively measures and how it can be applied in different contexts; ii) incorporating QA/QC procedures during sampling and analysis; and iii) reporting methodological details and data in a more harmonised way to facilitate comparability and the utilisation of data by several end users, including policy makers. Setting this as a priority now will facilitate the collection of rigorous and comparable monitoring data to help frame solutions to limit plastic pollution, including the forthcoming global treaty on plastic pollution.

To identify predictors for home death among children using socio-demographic factors and cause of death. It is a nationwide registry study. A cohort of children (1-17 years) who died between 1 January 2006 and 31 December 2016. It was set in Denmark, Europe. Predictors for home death were assessed: age, gender, diagnosis, region of residence, urbanicity, household income and immigrant status. Of 938 deceased children included, causes of death were solid tumours (17.3%), haematological cancers (8.5%) and non-cancerous conditions (74.2%). A total of 25% died at home. Compared to the lowest quartile, the groups with higher household income did not have a higher probability of dying at home (adjusted odds ratio (adj-OR) 0.8 (95% CI 0.5-1.2/1.3)). Dying of haematological cancers (adj-OR 0.3 (95% CI 0.2-0.7)) and non-cancerous conditions (adj-OR 0.5 (95% CI 0.3-0.7)) was associated with lower odds for home death compared to dying of solid tumours. However, being an immigrant was negatively associated with home death (adj-OR 0.6 (95% CI 0.4-0.9)). Moreover, a tendency was also found that being older, male, living outside the capital and in more urban areas were notable in relation to home death, however, not statistically significant.Conclusions: The fact that household income was not associated with dying at home may be explained by the Danish tax-financed healthcare system. However, having haematological cancers, non-cancerous conditions or being an immigrant were associated with lower odds for home death. Cultural differences along with heterogeneous trajectories may partly explain these differences, which should be considered prospectively. What is Known: • Prior studies have shown disparities in place-of-death of terminally ill children with diagnosis, ethnicity and socio-economic position as key factors. • Danish healthcare is tax-financed and in principle access to healthcare is equal; however, disparities have been found in the intensity of treatment of terminally ill children. What is New: • In a tax-financed, equal-access healthcare system, children died just as frequently at home in families with low as high household income. • Disparities in home death were related to diagnosis and immigrant status.

Med utgangspunkt i at ungdom i Norge i liten grad ser på seg selv som lesende på fritiden, er problemstillingen i denne masteroppgaven: «Hvordan forholder ungdom seg til medieinnhold på TikTok?» Ettersom bruken av sosiale medier øker og utviklingen av kritisk lesing ikke er åpenbar, blir det viktigere å forstå om andre typer literacies utvikles og brukes på plattformer som TikTok, mer spesifikt social media literacy. Målet med denne studien er derfor å se på hvordan ungdom forholder seg til ulike typer medieinnhold på TikTok, og hvilke aktiviteter og kompetanser de forbinder med å være der. Studien har et kvalitativt forskningsdesign med semistrukturerte individuelle forskningsintervjuer som metode for datainnsamling. Vi bruker både en induktiv og en deduktiv tilnærming i analysen og diskusjonen. Det analytiske rammeverket består av teorier om literacy, med særlig vekt på social media literacy. Et konseptuelt rammeverk for sosial mediekunnskap står sentralt, sammen med definisjoner av andre typer leseferdighet, og prinsipper for utdanning som omtalt i den generelle delen av læreplanen, LK20. Vi ser at ungdom kan innta en kritisk holdning til innholdet de møter. De er også klar over hva de gjør på TikTok, og de skiller denne plattformen fra andre sosiale medier som de bruker, som Snapchat og Instagram. Til sammen viser funnene at komplementære former for literacy dannes til tross for en opplevd mangel på lesing utenfor skolen. Starting from the fact that young people in Norway see themselves as reading in their spare time to a small extent, the problem statement in this master's thesis is: "How do young people relate to media content on TikTok?". As the use of social media increases and competencies in literacy gained from reading is not apparent, it becomes more important to understand whether other types of literacy are being developed and utilized on platforms such as TikTok, more specifically social media literacy. The objective of this study is therefore to look at how young people relate to different types of media content on TikTok, and which activities and competencies they associate with being there. The study uses a qualitative research design with semi-structured individual research interviews as the method for data collection. We utilize both an inductive and a deductive approach in the analysis and discussion. The analytical framework consists of theories about literacy, with particular emphasis on social media literacy. A conceptual framework for social media literacy is central, together with definitions of other types of literacy, and principles for education as discussed in the general part of the curriculum, LK20. We observe that young people can adopt a critical attitude toward the content they encounter. They are also aware of what they are doing on TikTok, and they distinguish this platform from other social media that they use, such as Snapchat and Instagram. Together, the findings show that complementary forms of critical literacy are formed despite a perceived lack of reading outside the school.

CONTEXT: Losing a child is the most burdensome event parents can experience involving risks of developing anxiety and depression.OBJECTIVES: To investigate anxiety and depression in bereaved parents during their child's life-limiting illness and imminent death and three to five years after the loss to target future interventions.METHODS: A Danish nationwide cross-sectional questionnaire survey. From 2012 to 2014, a register-based study identified causes of deaths of 951 children aged zero to 18 years. Potential palliative diagnoses were classified according to previously used classification. A total of 402 families were included. A modified version of the self-administered questionnaire "To lose a child" was used. Non-response surveys identified reasons for lack of response.RESULTS: In all, 136 mothers and 57 fathers completed a questionnaire, representing parents of 152 children (38%). Sixty-five percent of mothers and 63% of fathers reported moderate-to-severe anxiety during the child's illness. However, three to five years after their loss anxiety had decreased markedly. Thirty-five percent of mothers and 39% of fathers reported moderate-to-severe depression during the child's illness; three to five years after the loss they were suffering equivalently from depression. The Center for Epidemiologic Studies Depression Scale indicated that severe depression was significantly associated with lower education and being unmarried.CONCLUSION: The reporting of anxiety during the child's illness and prolonged depression in bereaved parents three to five years after the loss indicates a potential need for psychological interventions. In the process of implementing specialized pediatric palliative care in Denmark, our findings should be considered for future treatment programs.

ObjectiveTo investigate bereaved parents’ perception of end-of-life communication with healthcare professionals after losing a child due to life-limiting diagnoses.MethodsA national register identified the causes of death of 951 children aged 0–18 years during the period 2012–2014. A previously described classification of life-limiting diagnoses identified 402 children. A modified version of the self-administered questionnaire 'To Lose a Child' was distributed to the parents of these 402 children, capturing their perceptions of communication with the healthcare professionals throughout the child’s disease trajectory and imminent death.ResultsA total of 193 bereaved parents, representing 38% of the identified children, participated in the study. Overall, 98% of the parents expressed the view that physicians should immediately disclose when curatively intended treatment options were exhausted. Some 79% of parents reported that information about their child’s incurable illness was given in an appropriate manner; however, 42% said that information about the child's imminent death was given too late. Finally, 31% felt deprived of the option to say goodbye to their child in their preferred manner, and 56% said that their child’s death was “a shock”.ConclusionsParents request accurate and timely information. However, a substantial number of the parents surveyed reported that healthcare professionals communicated too late about palliative care and end-of-life issues. Even though healthcare professionals strive to communicate effectively with dying children and their parents, barriers were identified that may hinder even the best of intentions. National guidelines addressing communication issues and improved education of healthcare professionals should form part of any future agenda.

To identify predictors for home death among children using socio-demographic factors and cause of death. It is a nationwide registry study. A cohort of children (1-17 years) who died between 1 January 2006 and 31 December 2016. It was set in Denmark, Europe. Predictors for home death were assessed: age, gender, diagnosis, region of residence, urbanicity, household income and immigrant status. Of 938 deceased children included, causes of death were solid tumours (17.3%), haematological cancers (8.5%) and non-cancerous conditions (74.2%). A total of 25% died at home. Compared to the lowest quartile, the groups with higher household income did not have a higher probability of dying at home (adjusted odds ratio (adj-OR) 0.8 (95% CI 0.5-1.2/1.3)). Dying of haematological cancers (adj-OR 0.3 (95% CI 0.2-0.7)) and non-cancerous conditions (adj-OR 0.5 (95% CI 0.3-0.7)) was associated with lower odds for home death compared to dying of solid tumours. However, being an immigrant was negatively associated with home death (adj-OR 0.6 (95% CI 0.4-0.9)). Moreover, a tendency was also found that being older, male, living outside the capital and in more urban areas were notable in relation to home death, however, not statistically significant.Conclusions: The fact that household income was not associated with dying at home may be explained by the Danish tax-financed healthcare system. However, having haematological cancers, non-cancerous conditions or being an immigrant were associated with lower odds for home death. Cultural differences along with heterogeneous trajectories may partly explain these differences, which should be considered prospectively. What is Known: • Prior studies have shown disparities in place-of-death of terminally ill children with diagnosis, ethnicity and socio-economic position as key factors. • Danish healthcare is tax-financed and in principle access to healthcare is equal; however, disparities have been found in the intensity of treatment of terminally ill children. What is New: • In a tax-financed, equal-access healthcare system, children died just as frequently at home in families with low as high household income. • Disparities in home death were related to diagnosis and immigrant status.

Rivers have been identified as an important pathway for the release of plastic waste to the oceans, connecting land-based sources to the marine environment. Asian rivers, in particular, have been highlighted by several published studies as contributing a considerable proportion of global macro- and microplastic release. To evaluate this, several parallel projects (ASEANO, SINOPLAST, INOPOL) have commenced environmental monitoring of riverine plastic contamination in China, India, and several ASEAN countries. Monitoring is being undertaken in selected study catchments, which have been identified based on their geographical context and their relevance to global plastic contamination. They include several rivers that have been reported as being amongst the most contaminating systems in the world. Macroplastic flows in the active river channel will be assessed, as well as the role of the riverbank zone in the storage and transport of plastic waste. Monitoring of riverine microplastic contamination will also be included in some countries. The aims of this environmental monitoring is to: i) provide estimates for the flux of plastics to the ocean; ii) identify appropriate and optimum methods for routine monitoring of riverine plastic contamination; iii) supply qualitative and quantitative data on macroplastic flows and contamination to support social science research that is also taking place within these river catchments; and iv) provide data for the calibration and validation of riverine plastic transport models.This presentation will give an overview of monitoring plans and preliminary findings and experiences from these ongoing projects. This will include a discussion about the ways in which monitoring methods have been adapted to river systems with different morphologies and flow regimes, and to satisfy different research questions across the projects. The complexities associated with undertaking environmental monitoring in large river systems will also be addressed.

Several guidelines have been developed that describe methods for analysing riverine macroplastic flows. No single method has emerged as the standard approach for sampling plastic waste in rivers. This reflects the difficulty in establishing a global ‘one size fits all’ approach for river systems: there is significant variability in river morphology, hydrology, and geomorphology across the world and these differences necessitate adaptations of existing methods or the development of new approaches to assess macroplastic flows. In addition, there is a wide range of different potential objectives underpinning the monitoring of riverine macroplastic contamination, including assessments of plastic export, sources, transport, or accumulation. These generate different research questions, which require different solutions, and may necessitate the collection of data in different forms.Nevertheless, there is an international demand for generating monitoring datasets that are comparable and can be used to create a holistic picture of macroplastic contamination across the globe. For the reasons listed above, harmonisation – through thorough method validation and quality assurance and control (QA/QC) – is likely to be more important than standardisation in this context. Additionally, in some cases there remains a disconnect between the types of data that are produced in monitoring activities and those which are desired by potential end users of the data. It is valuable, therefore, to increase the communicability of datasets and establish a common language for riverine macroplastic contamination. This study undertakes a critical review of existing methodologies for assessing macroplastic flows in river systems and identifies: i) what component of the macroplastic load is measured by each technique; ii) how can these methods be validated; iii) what QA/QC procedures could be implemented to increase the quality, robustness, and harmonisation of monitoring outputs; and iv) how can outputs be tailored to different uses of monitoring data.

Complex and organic-rich solid substrates such as sludge and soil have been shown to be contaminated by microplastics; however, methods for extracting plastic particles have not yet been systemically tested or standardized. This study investigated four main protocols for the removal of organic material during analysis of microplastics from complex solid matrices: oxidation using H2O2, Fenton’s reagent, and alkaline digestion with NaOH and KOH. Eight common polymer types were used to assess the influence of reagent exposure on particle integrity. Organic matter removal efficiencies were established for test sludge and soil samples. Fenton’s reagent was identified as the optimum protocol. All other methods showed signs of particle degradation or resulted in an insufficient reduction in organic matter content. A further validation procedure revealed high microplastic extraction efficiencies for particles with different morphologies. This confirmed the suitability of Fenton’s reagent for use in conjunction with density separation for extracting microplastics. This approach affords greater comparability with existing studies that utilize a density-based technique. Recommendations for further method optimization were also identified to improve the recovery of microplastic from complex, organic-rich environmental samples.

Purpose Since the 1960s, pollution of the marine environment has been observed around the world, and a general awareness of the potential environmental hazards from contaminants arose. This general awareness was followed by implementation of environmental regulations at the national and international levels regarding industrial discharges, and forcing the development of management programs to improve the environmental quality. This overview focuses on the status of assessments, regulations, and remediation actions of contaminated marine sediments in four North European countries: Sweden, Norway, Finland, and Denmark. Results and discussion We found that the extent of assessment surveys and the implementation of sediment remediation actions vary between the countries, with Norway the most advanced. Norway has initiated national pilot remediation tests, followed by full-scale site remediation by dredging and in situ capping in several projects along the coast. Sweden is following Norway’s example, although with fewer completed projects. In Finland, the tradition of maintenance dredging is still very strong although the main purpose has not been cleanup actions. Accordingly, in Denmark, dredging is primarily used to maintain sailing depths. All four countries have implemented the Water Framework Directive in addition to national regulations that provide the authority for imposing and implementing sediment remediation measures. However, only Norway has implemented a national strategy on remediation of contaminated sediments. Conclusions This overview highlights the need for enhanced communication and exchange of experiences between the four Nordic countries of concern with regard to sediment remediation strategy and management.

The Nordic Council of Ministers have recognized the need to compile the knowledge of sediment remediation strategies and to evaluate different remediation approaches. The objective of this report i ...

ObjectiveSymptoms and problems (S&P) are under-reported in children in end-of-life care.To target future interventions, the primary aim was to examine S&P in children in end-of-life care.MethodsAll parents, who lost a child under the age of 18 years due to life-limiting diagnoses in the period 2012–2014 in Denmark, were invited to complete a self-administered questionnaire in 2017. In all, 152 (38%) children were represented by 136 mothers and 57 fathers. In the present study, parents’ assessments of S&P during the last month of life were restricted to children aged 3–18 years. Data were analyses by means of descriptive statistics.ResultsChildren ≥3 years at the time of death were represented by 71 parents (48 mothers and 23 fathers) representing 56 out of the 152 children. Physical fatigue (93%), sleepiness (90%), poor appetite (87%), pain (84%) and nausea (84%) were the five most frequent symptoms reported by the parents. In all, 65% of the parents reported that satisfactory pain relief was obtained and 64% of the parents reported that the healthcare services to a large extent reacted quickly, when the child and/or family needed help. However, 46% of the parents experienced ‘mess-ups’ or sloppy services in the primary ward and 27% experienced that the children suffered from fear of death.ConclusionAccording to the parents, children with life-limiting diagnosis are highly symptomatic and have substantial problems during end-of-life care. Our findings indicate that systematic screening of S&P in children should be considered.

The curriculum of the first occupational therapy programme in Zambia has been developed in partnership with people from different cultural backgrounds, different disciplines and different educational and work/clinical backgrounds. There are many challenges to such a partnership and this case study will highlight how the partnership met such challenges and, most importantly, the personal qualities and group dynamics that supported the process and enabled individual members to stay motivated and energised. Finally, reflections are shared on what has been learnt through the work of curriculum development for an occupational therapy programme in Zambia.

Activated carbon (AC) amendment has been shown to reduce bioavailability of hydrophobic contaminants in the bioactive layer of sediment. Unwanted secondary effects of AC amendment could be particularly undesirable for ecologically important seagrass meadows, but so far, only a few studies have been conducted on effects on submerged plants. The purpose of this study was to investigate effects on growth and cover of submerged macrophytes in situ after AC amendment. Test sites were established within a seagrass meadow in the severely contaminated Norwegian fjord Gunneklevfjorden. Here we show that AC amendment does not influence neither cover nor length of plants. Our study might indicate a positive effect on growth from AC in powdered form. Hence, our findings are in support of AC amendment as a low-impact sediment remediation technique within seagrass meadows. However, we recommend further studies in situ on the effects of AC on submerged vegetation and biota. Factors influencing seasonal and annual variation in plant species composition, growth and cover should be taken into consideration. An In Situ Experimental Study of Effects on Submerged Vegetation After Activated Carbon Amendment of Legacy Contaminated Sediments

There are contradicting results on the importance of legacy mercury (Hg) contaminated sediments to Hg fish tissue concentrations. Still, sediment remediation actions often aim at minimizing ecosystem exposure and human risk caused by the consumption of fish and seafood. The aim of this study was to investigate the possible influence of a permanently submerged meadow on the availability and transfer of Hg from sediment to biota, three decades after the Hg discharges was halted and the previous biota survey was carried out, in the severely contaminated brackish fjord Gunneklevfjorden in southern Norway. We examined total Hg (Tot-Hg) and methyl-Hg (MeHg) concentrations and stable isotopes of nitrogen (N) and carbon (C) in zooplankton, benthic invertebrates, and fish to map the food web and to investigate the trophic transfer of Hg. Sediment and water data were available from a previous study. Overlap in δ13C in benthos and fish reveals that benthos is a preferred prey to fish, though despite elevated Tot-Hg concentrations in benthos, fish predator (perch, pike and eel) Hg concentrations are comparable to concentrations reported in nearby lakes without contaminated sediments (mean 1.6 ± 1.3 mg Tot-Hg kg−1 dw). We propose that habitat reliance is an important factor controlling the uptake of Hg from sediments, as both benthos and fish prefer to forage within the meadow where sediment concentrations of Tot-Hg are lower than outside the macrophyte meadow, though %MeHg is higher than outside. Further, we propose that sediment remediation actions performed outside the meadow may have limited effect on the Hg concentrations in fish.

Microplastic (MP) contamination is ubiquitous in the environment and many species worldwide have been shown to contain MP. The ecological impact of MP pollution is still unknown, thus there is an urgent need for more knowledge. One key task is to identify species suitable as sentinels for monitoring in key eco-compartments, such as coastal waters. In Norway, mussels (Mytilus spp.) have been monitored for hazardous contaminants through OSPAR since 1981. Norway has the longest coastline in Europe and adding MP to the Norwegian Mussel Watch is therefore important in a European and global context. The present study reports MP data in mussels (332 specimens) collected from multiple sites (n = 15) spanning the whole Norwegian coastline. MPs were detected at all locations, except at one site on the west coast. Among the most surprising findings, mussels from the Barents Sea coastline in the Finnmark region, contained significantly more MPs than mussels from most of the southern part of the country, despite the latter sites being located much closer to major urban areas. Only mussels from a site located very close to Oslo, the capital, contained levels similar to those observed in the remote site in Finnmark. In total an average of 1.5 (+/- 23) particles ind(-1) and 0.97 (+/- 2.61) particles w.w. g(-1) was found. The most common MPs were

Macrophytes are shown to affect the microbial activity in different aqueous environments, with an altering of the sediment cycling of mercury (Hg) as a potential effect. Here, we investigated how a meadow with permanently submerged macrophytes in a contaminated brackish fjord in southern Norway influenced the conditions for sulfate reducing microbial activity, the methyl-Hg (MeHg) production and the availability of MeHg. Historically discharged Hg from a chlor-alkali plant (60–80 tons, 1947–1987) was evident through high Hg concentrations (491 mg Tot-Hg kg− 1, 268 μg MeHg kg− 1) in intermediate sediment depths (10–20 cm) outside of the meadow, with reduced concentrations within the meadow. Natural recovery of the fjord was revealed by lower sediment surface concentrations (1.9–15.5 mg Tot-Hg kg− 1, 1.3–3.2 μg MeHg kg− 1). Within the meadow, vertical gradients of sediment hydrogen sulfide (H2S) Eh and pH suggested microbial sulfate reduction in 2–5 cm depths, coinciding with peak values of relative MeHg levels (0.5% MeHg). We assume that MeHg production rates was stimulated by the supply and availability of organic carbon, microbial activity and a sulfide oxidizing agent (e.g. O2) within the rhizosphere. Following this, % MeHg in sediment (0–5 cm) within the meadow was approximately 10 × higher compared to outside the meadow. Further, enhanced availability of MeHg within the meadow was demonstrated by significantly higher fluxes (p < 0.01) from sediment to overlying water (0.1–0.6 ng m− 2 d− 1) compared to sediment without macrophytes (0.02–0.2 ng m− 2 d− 1). Considering the productivity and species richness typical for such habitats, submerged macrophyte meadows located within legacy Hg contaminated sediment sites may constitute important entry points for MeHg into food webs. The influence of permanently submerged macrophytes on sediment mercury distribution, mobility and methylation potential in a brackish Norwegian fjord

AIM: Specialised paediatric palliative care has not previously been a priority in Denmark. The aim of this study was to support its development and organisation, by examining why and where children died using official national data for 1994-2014.METHODS: We obtained data on 9462 children who died before the age of 18 from the Danish Register of Causes of Death. The causes of deaths were listed according to the codes in the International Classification of Diseases.RESULTS: The all-cause mortality rate decreased by 52% over the study period, and infants below one year accounted for 61% of all deaths. The decline in infant mortality (26%) primarily reflected fewer deaths due to congenital malformations and chromosomal abnormalities (68%) and perinatal deaths (30%). In children aged one year to 17 years, the substantial decrease (65%) was due to external causes (75%) and neoplasms (57%). The relative proportion of hospital deaths increased, while home deaths decreased.CONCLUSION: All-cause mortality rate decreased markedly, and the relative proportion of hospital deaths increased. The results may reflect more aggressive and effective treatment attempts to save lives, but some terminally ill children may be deprived of the option of dying at home.

The Danish parliament has decided to establish a four-year pilot scheme for medical treatment with cannabis. We increasingly experience requests from parents for medical treatment with cannabis of children and have the impression that a growing number of parents treat their children with illegally acquired cannabis products for various conditions. We summarize the sparse evidence regarding effects, side effects and long-term effects of medical treatment with cannabis in children and adolescents. At present, cannabis should very rarely be considered as part of medical treatment for children and adolescents.

This study investigates the role of inflammation in intrauterine growth retardation by exploring the levels of inflammatory markers in umbilical cord blood from neonates who were born small-for-gestational-age (SGA) and comparing them to neonates who were born appropriate-for-gestational-age (AGA). Interleukin 6 (IL-6), Tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) were measured by standard methods in term or near-term (gestational age36 weeks) neonates born SGA (n = 45) and a matched group of neonates born AGA (n = 45). Infants exposed to maternal chronic diseases, diabetes or pre-eclampsia were excluded. SGA was defined as two standard derivations below the expected for term and gender. In multivariate regression analyses significant elevation in cord blood concentration of IL-6 was demonstrated in the SGA group (mean 4.56 vs. 2.38, p = 0.002). The results indicate the presence of elevated inflammatory markers in the cord blood from SGA infants compared to AGA infants, and consequently the results suggest an inflammatory component in intrauterine growth restriction (IUGR).

The leukemia-associated ETV6-RUNX1-translocation frequently emerges prenatally. Reverse-transcriptase PCR screening may indicate presence of ETV6-RUNX1 transcripts in random cord blood samples. Subsequent cell enrichment validation finds significantly lower levels than validation applying fluorescence in situ hybridization (FISH) (

A lifestyle-oriented reformulation of food preparation in the family may serve as a vehicle for a transgression of the gender division of labour. Drawing on two qualitative studies of Norwegian and Danish dual-career couples, we identify three patterns of praxis in relation to food. The patterns are steps in a process of change towards a more gender-equal organization of family life. In the first pattern, the narratives expose feelings of shortcomings towards the ideal of equality. Food preparation is here a primarily female responsibility related to care for the family's wellbeing. From these narratives, a second pattern emerges, displaying different forms of masculine identification with food preparation. Drawing on either a practical or a ‘con amore’ orientation towards food preparation, these new masculine identifications create a departure from the cultural connotations connecting food, femininity and care. This change, in turn, paves the way for the third pattern, where food preparation becomes a ne...

The TEL-AML1 translocation, t(12;21)(p13;q22), is one of the most frequent genetic aberrations in childhood B-cell precursor acute lymphoblastic leukemia (ALL), where it occurs in 25% of all cases. In contrast, the translocation is seen in only 3% of adult ALL cases. Evidence suggests that the TEL-AML1 translocation occurs in utero in 1% of all newborn children at cell levels of 10 to 10. In this study, we explore the prevalence of TEL-AML1-positive cells in 2 cohorts of healthy blood donors by real-time and nested reverse transcription-polymerase chain reaction. Overall, TEL-AML1-positive cells were demonstrated in 10 of 2005 healthy donors, that is, a prevalence of 0.5% (95% confidence interval, 0.2-0.3%). The level of TEL-AML1-positive cells was estimated to 10 to 10. The observed prevalence of TEL-AML1-positive cells in healthy adults is of the same order of magnitude as the prevalence reported in healthy newborns, but the observed cell level of 10 to 10 is much lower. These data indicates that prenatal TEL-AML1 subclones does not persist throughout adult life at cell levels of 10 to 10. The findings are compatible with the risk of t(12;21)(p13;q22) ALL correlating with the total number of TEL-AML1-positive cells in peripheral blood in both childhood and adulthood.

Stability of cord blood RNA measured by house keeping transcripts: relevance for large-scale studies of childhood leukaemia

Obtaining cytological specimens by wire-guided endobiliary brushing at the time of endoscopic retrograde cholangiopancreatography (ERCP) is a convenient way to reach a diagnosis. Sensitivity for malignant disease is generally around 50% and specificity around 100%. The present study was designed to assess the reproducibility of the cytological examination.Samples were obtained from 55 consecutive patients with biliary duct strictures that eventually turned out to be caused by malignant disease in 41 patients (73%). The cytology specimens were evaluated twice in different random order with an interval of at least 4 months by two pathologists blinded to the final diagnoses. Suitability for diagnosis (suitable, suboptimal or unsuitable) and cytologic diagnosis (benign, atypical, suspicious for malignancy and malignant cells) were registered. Kappa analysis was applied.Regarding suitability for diagnosis, the two observers reproduced their findings in 84% (kappa 0.76) and 87% (0.59) (p0.05), while the interobserver variations on the two occasions were 76% and 78% (kappa 0.49 and 0.58, respectively) (p0.05). Five percent of samples were rated as inadequate for diagnosis in at least one reading; 18% were suboptimal and 62-82% were suitable. The observers reproduced their cytological diagnosis in 77% and 71% (weighted kappa 0.83 and 0.75) (p0.05), and agreed on the cytological diagnosis in 65% and 73% (weighted kappa 0.65 and 0.75) (p0.05).The intra- and interobserver agreement in cytological evaluation of endobiliary brushings from bile duct strictures is generally good. The rates of inadequate and suboptimal samples can probably be reduced by modifications of the brush design.

The article discusses theoretical and methodical approaches to masculinity and social change. The authors argue that a Nordic critical research on men and masculinities should develop analytical tools that enable us to grasp potentials for change in what they call "normal male" life patterns. Changes in Nordic masculinities are not necessarily attached to experiences of subordination or marginalisation in relation to a hegemonic masculinity. We should also seize potentials for change in the tensions generated within men's life world and their structural position in the gendered division of work. In this light, alternative approaches to seize the social change that are generated within the process of men's intimate life patterns are discussed. The authors point at two theoretical approaches that enable us to grasp the dialectic between limitations and possibilities of "normal male" life patterns. The first approach is the concept of manliness - unmanliness, which catches the opposed paradox between preserving the conception of manliness and the fear of giving it up and take up new life patterns. This is gathered in the meaning of "fear of falling". The other approach is based on the concept of social imagination developed by the German sociologist Ulrike Prokop. This concept has been redefined to cover men's perception of their own subjective needs and to explain - in relation to intimate life patterns - the potential longing for creating new practices of the gender division of labour. Methodically, the article points at a qualitative approach where several narrative spaces are established in the individual interview to ensure a dialogue between the interviewee and the interviewerabouttheunderstandingofthediscrepancies of the different descriptions of the interviewee himself.

BACKGROUND: Several large biobanks comprising umbilical cord blood samples have been established allowing efforts to characterize the prevalence and risk factors for preleukemic cell clones in healthy newborns. This study explores the feasibility of demonstrating translocation ETV6-RUNX1 transcripts by reverse transcription polymerase chain reaction in newborns enrolled in a large Danish National Birth Cohort. CONCLUSIONS: The study emphasizes the necessity of either storing viable cord blood cells or preparation of the RNA within 1 to 2 days of birth, in large scale studies of the natural history of childhood acute lymphoblastic leukemia. Finally, the estimated frequency of translocation ETV6-RUNX1-positive cells was below 10.

MPED-UTDLED

The neural cell adhesion molecule, NCAM, plays a key role in neural development and plasticity mediating cell adhesion and signal transduction. By screening a combinatorial library of synthetic peptides with NCAM purified from postnatal day 10 rat brains, we identified a nonapeptide, termed NCAM binding peptide 10 (NBP10) and showed by nuclear magnetic resonance analysis that it bound the NCAM IgI module of NCAM. NBP10 modulated cell aggregation as well as neurite outgrowth induced specifically by homophilic NCAM binding. Moreover, both monomeric and multimeric forms of NBP10 stimulated neurite outgrowth from primary hippocampal neurons. The neurite outgrowth response to NBP10 was inhibited by a number of compounds previously shown to inhibit neurite outgrowth induced by homophilic NCAM binding, including voltage-dependent calcium channel antagonists, suggesting that NBP10 induced neurite outgrowth by activating a signal transduction pathway similar to that activated by NCAM itself. Moreover, an inhibitor of intracellular calcium mobilization, TMB-8, prevented NBP10-induced neurite outgrowth suggesting that NCAM-dependent neurite outgrowth also requires mobilization of calcium from intracellular calcium stores in addition to calcium influx from extracellular sources. By single-cell calcium imaging we further demonstrated that NBP10 was capable of inducing an increase in intracellular calcium in PC12E2 cells. Thus, the NBP10 peptide is a new tool for the study of molecular mechanisms underlying NCAM-dependent signal transduction and neurite outgrowth, and could prove to be a useful modulator of regenerative processes in the peripheral and central nervous system.

The leukemia-associated ETV6-RUNX1-translocation frequently emerges prenatally. Reverse-transcriptase PCR screening may indicate presence of ETV6-RUNX1 transcripts in random cord blood samples. Subsequent cell enrichment validation finds significantly lower levels than validation applying fluorescence in situ hybridization (FISH) (10(-5) vs. 10(-3) to 10(-4)). Using three FISH probe sets, we screened 179,000 cells from ETV6-RUNX1-positive dilution series, healthy adults and random cord blood samples. The t(12;21) single fusion extra signal translocation probe and the ETV6 break apart probe gave false positive results mimicking ETV6-RUNX1-positive cell levels of 10(-3). This questions the paradigm that 1% of newborns have ETV6-RUNX1-positive cells at levels of 10(-3) to 10(-4).

Pediatric acute lymphoblastic leukemia (ALL) is characterized by preleukemic recurrent chromosomal translocations that emerge in utero. The translocation t(12;21) resulting in the formation of the chimeric transcription factor ETV6-RUNX1 is the most frequent structural aberration occurring in 25% of B-cell precursor patients. A previous study suggested that ETV6-RUNX1-positive preleukemic cells are present in every hundredth human newborn, thus exceeding the actually observed incidence of ETV6-RUNX1-positive ALL in children (1/10,000) by a factor of 100. This finding strongly indicated that secondary cooperating oncogenic hits were necessary for development of overt leukemia. However, later studies could not confirm this high frequency. To analyze the actual frequency of ETV6-RUNX1 preleukemic cells in newborns we developed a PCR-based method termed genomic inverse PCR for exploration of ligated breakpoints (GIPFEL) and applied this technique to a population-based retrospective screening of 300 cord blood samples from Danish newborns. The GIPFEL method is capable of detecting the most common gene fusions associated with childhood leukemia without prior knowledge of the exact breakpoint. In contrast to previously used RNA-based methods, it relies on DNA as sample material, which is more stable than RNA. In the case of ETV6-RUNX1-positive leukemia GIPFEL exploits the unique presence of a genomic fragment joining material from chromosome 12 and 21. These fragments can be digested and re-circularized by ligation creating a junction across the restriction site whose sequence can be predicted from published genome data. The ligation site is independent of the translocation point within the individual DNA circle. Digestion of the breakpoint regions of the ETV6 and RUNX1 gene with the restriction enzyme SacI generates fragments smaller than 50 kb. Primer pairs amplify the complete set of theoretically predicted circularized fragments requiring 37 primers for the ETV6-RUNX1 translocation. Genomic DNA was prepared from mononuclear cells from cord blood samples of 300 newborns that were cryopreserved within 24 h (median 12 h) from birth. After B cell enrichment and column purification of DNA, the DNA was subjected to SacI restriction digest, ligated and remaining linear DNA was removed by exonuclease III. After ethanol precipitation the reaction products were subjected to a partially multiplexed, semi-nested PCR to quantify all possible ligation/junction products specific for the translocation. Samples that screened positive underwent one further demultiplexed PCR, agarose gelelectrophoresis and Sanger sequencing to validate the result and to identify the breakpoint region. An internal RUNX1 genomic ligation product served as a quality control and allowed the relative quantification of the translocation product. In previously published proof-of-principle blinded studies we tested 61 samples obtained from ETV6-RUNX1-positive ALL patients. Without any unspecific result, 64% for ETV6-RUNX1 fusion genes were detected in that sample set. The sensitivity of the technique was estimated to be 10-4, i.e. one translocation carrying cell within 10,000 normal cells can theoretically be detected. Within the analyzed cohort of 300 healthy newborns 6 screened positive for the ETV6-RUNX1 translocation (2%) (Table 1). Further 700 cord blood samples are currently screened. Table 1: 6 of 300 cord blood samples from healthy newborns screened positive for the ETV6-RUNX1 translocation using the GIPFEL technique (Fueller E*, Schaefer D* et al. PloS One 2014, 9(8): e104419). Number of the positively tested healthy newborn within the cohort, used primers, and introns of RUNX1 and ETV6 affected by the translocation are presented. Our results indicate that the actual incidence of ETV6-RUNX1-positive cells in healthy newborns might be even higher than previously assumed, potentially due to instability of the ETV6-RUNX1 RNA transcript in preserved cord blood samples. This would hint at a comparably low penetrance and leukemia inducing potential of the chimeric transcription factor ETV6-RUNX1 in human newborns and further strengthen the importance of secondary environmentally caused or spontaneously occurring cooperating oncogenic lesions for ETV6-RUNX1-positive childhood leukemia to emerge. Table Table. Disclosures No relevant conflicts of interest to declare.

In aging brain, degenerative as well as compensatory regenerative processes are believed to occur. The neural cell adhesion molecule NCAM is involved in developmental and regenerative processes in the brain. However, the role of NCAM in aging brain has not been characterized. In this study, the expression of NCAM mRNAs and polypeptides was investigated in aging rat brain. The 7.4 and 6.7 kb NCAM mRNAs were selectively downregulated during postnatal development, and the 5.2 and 2.9 kb NCAM mRNAs were upregulated. However, from postnatal day 40 to old age no change in NCAM mRNA classes was observed. The fraction of NCAM mRNA containing the VASE exon increased postnatally but remained stable during adult life. VASE, which is believed to modulate the binding capacity, seemed to be relatively more abundant in the 7.4 and 6.7 kb NCAM mRNAs, encoding transmembrane NCAM forms, than in the 5.2 and 2.9 kb NCAM mRNAs, coding for glycosyl phosphatidylinositol (GPI) linked NCAM. Conversely, insertion of exons a and AAG between exons 12 and 13, a region containing two fibronectin type III repeats, seemed to be more pronounced in 5.2 and 2.9 kb NCAM mRNAs than in the 7.4 and 6.7 kb mRNAs. During postnatal development an increase in the fraction of 6.7 kb NCAM mRNA containing the exons a and AAG was observed. However, during aging the fraction of NCAM mRNAs containing this exon combination seemed constant. At the protein level, NCAM-A was downregulated both during development and aging. No changes were observed during aging in the composition of soluble NCAM forms in the brain, cerebrospinal fluid or blood plasma. The amount of NCAM in rat brain decreased during postnatal development, but remained at a constant level from postnatal day 40 to old age. To conclude, several changes in NCAM expression occur during early postnatal development emphasizing the important role of this molecule in the morphogenetic processes. During aging, a significant selective downregulation of NCAM-A was observed indicating that in general only minor regenerative processes occur in the brain.

Single NO[sub 2]-modified derivatives of plastocyanin, with modifications at Tyr83 (spinach) and Tyr83/Tyr62 (parsley, deletions at 57 and 58), have been prepared and characterized by peptide mapping. All three products give a TyrNO[sub 2] UV-vis absorbance band at 355 nm ([epsilon] = 3,900 M[sup [minus]1] cm[sup [minus]1]) at pH 9.0 due to acid dissociation of the phenolic group. Pulse radiolysis experiments in which the reductant CO[sub 2][sup [sm bullet][minus]] (or Cd[sup +]) is generated give with all three PCu[sup II]TyrNO[sub 2] derivatives one observable reaction step in which PCu[sup II] is reduced to PCu[sup II] is reduced to PCu[sup I]. Rate constants are of order of magnitude 10[sup 8] M[sup [minus]1] s[sup [minus]1] (CO[sub 2][sup [sm bullet][minus]]) and 10[sup 9] M[sup [minus]1] s[sup [minus]1] (Cd[sup +]). No PCu[sup II]TyrNO[sub 2][sup [sm bullet][minus]] radical intermediate absorbing at [approximately]300 nm ([epsilon] [approximately] 10[sup 4] M[sup [minus]1] cm[sup [minus]1]) is observed. However in studies with PCu[sup I]TyrNO[sub 2], reduction of the NO[sub 2] group is the only reaction step, with rate constants of the order of magnitude 10[sup 9] M[sup [minus]1] s[sup [minus]1] (Cd[sup +]), andmore » PCu[sup I]TyrNO[sub 2][sup [sm bullet][minus]] is a relatively long-lived product. There is no crystallographic or spectroscopic evidence to suggest any Cu interaction with the phenolate or vice versa (separation >8.6 [Angstrom]). If this is the case, it can be assumed that TyrNO[sub 2][sup [sm bullet][minus]] is generated at about the same rate in experiments on PCu[sup II]TyrNO[sub 2] and that rapid >10[sup 7] s[sup [minus]1] intramolecular electron transfer PCu[sup II]TyrNO[sub 2][sup [sm bullet][minus]] [yields] PCu[sup I]TyrNO[sub 2] follows. 45 refs., 12 figs., 2 tabs.« less