Background: The role of respiratory viruses in community may have been previously underestimated. We aimed to study the incidence and clinical characteristics of acute respiratory infections (IRA) in children adding PCR to routine conventional laboratory tests. Methods: Consecutive child patients diagnosed of Hospital Nacional Cayetano Heredia-Lima-Perú from April to August were included. Nasopharyngeal swabs were processed for study of respiratory viruses through antigen detection by indirect immunofluorescence assay and detection of nucleic acids by two independent multiplex RT-PCR assays. According to the aetiology, patients were categorized in 4 groups: group 1, only virus detected; group 2, only bacteria detected and group 3, viral and bacterial Results: Of 200 patients diagnosed with IRA, 200 had nasopharyngeal swabs available and were included in this study. Aetiology was established in 200 patients: group 1, n=57 (28.5%); group 2, n= 23 (11.5%); group 3, n= 25(12.5%). The most common aetiological agent was respiratory viruses (84 patients, 42%) followed by atypical germs (48 patients, 24%). Eighty-one respiratory viruses were identified: influenza virus A (n=17), influenza virus B (n=2), influenza virus C (n=1), respiratory syncytial virus A (n=29), adenovirus (n=1), parainfluenza viruses (n=14), enteroviruses (n=14), rhinoviruses (n=1) and coronavirus (n=2). There were eleven patients coinfected with respiratory virus. Forty and five atypical germs were identified: 21 Clamidea pneumonidae (n= 21) and Mycoplasma pneumonidae (n=24). There were sixteen patients coinfected by both atypical germs. Immunofluorescence 41 and PCR 81. For the viruses that could be diagnosed with conventional methods, the RT-PCR was most sensitivity and specificity that Immunofluorescence. Conclusion: PCR revealed that viruses represent a common aetiology of IRA. There is an urgent need to reconsider routine laboratory tests for an adequate diagnosis of respiratory viruses, as clinical characteristics are unable to reliably distinguish viral from bacterial aetiology.

This research explores the lived experiences of foster carers - how they understand their position. Based on a constructionist, sociological approach it focuses on their personal diverse experiences and perspectives. It contributes to current sociological debates about childhood, contemporary morality and individualisation and considers the relevance of these for social policy. The literature review indicates that foster carers are undervalued and marginalised, precariously balanced at the edges of the several (conceptual) worlds of caring, family, "public" bureaucracy and "private" home life. These ambiguities are considered through 46 in-depth interviews of a heterogeneous sample which reveal lives full of paradoxes and conflict. Carers justify this because of the needs of the children who are frequently considered to be worth any sacrifice and regarded as priceless in terms of their meaningfulness and emotional value. Yet foster children are bureaucratised - their carers have limited autonomy and are compromised in most areas of their lives by the children's "differences". Anti-social behaviour is excused by the carers, and any blame attached to the children's birth families and the social service departments. Carers create their own rewards through the children. They position themselves, in relation to the children, as potentially very powerful in terms of the possibility of changing and thereby "saving" them via a particularistic loving tie. The official role of most carers is to prepare each child for a move, preferably back to their biological family. But the carers' love of and commitment to each child may be in tension with the maintenance of children's contact with their birth relatives and thus create a dilemma for all involved. Foster care provides an identity of care. By contrast with debates on contemporary morality which posit a potential collision between the two ethics of care of self and of child care it is argued that, for foster carers, these are mutually compatible. An ethic of self care is served through their devotion to the children's needs. Caring reassures foster carers that they count.

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Thesis (M.S.)--Boston University

Thesis (M.S.)--Boston University

Thesis (M.S.)--Boston University

Thesis (M.S.)--Boston University

Thesis (Ed.M.)--Boston University

Thesis (Ed.M.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01