The parietal lobe has been shown to be one of the regions most affected by prenatal alcohol exposure. Functional domains dependent on intact parietal functioning, including mathematical and visuospatial ability, have been consistently implicated in fetal alcohol spectrum disorders. This thesis examines, in children, using blood oxygenation level dependent (BOLD) functional Magnetic Resonance Imaging, the effect of prenatal alcohol exposure on brain activation during symbolic and nonsymbolic number processing, and place learning in a virtual environment. These functional domains were investigated using tasks of proximity judgment and exact addition to assess neural correlates of symbolic number processing in 65 children (mean age ± SD = 9.45 ± 0.42 years), nonsymbolic number comparison at varying difficulties in 34 children (11.55 ± 1.15 years), and place learning in a virtual reality computer generated (CG) arena in 57 children (9.44 ± 0.42 years; 29 boys). In the symbolic number processing tasks greater prenatal alcohol exposure was related to less activation in the right horizontal intraparietal sulcus known to mediate mental representation and manipulation of quantity. Children with fetal alcohol syndrome and partial fetal alcohol syndrome appeared to compensate for this deficit by increased activation of the left angular gyrus during the proximity judgment task. Syndromal children with fetal alcohol syndrome or partial fetal alcohol syndrome also demonstrated poor recruitment of the right horizontal intraparietal sulcus during nonsymbolic number comparison, indicating that mental representation and manipulation of quantity are impaired in children with heavy prenatal alcohol exposure, irrespective of the representation format used. This impairment was compensated for by the left angular gyrus, with only exposed children needing to recruit the left angular gyrus to a greater extent as number comparison task difficulty increased. Further, reduced activation of the right posterior superior parietal lobule in children with increasing prenatal alcohol exposure suggests that exposed children may be less able to employ the attentional systems associated with number processing. Notably, activation of nonsyndromal heavily exposed children was impaired in the right posterior superior parietal lobule, but spared in the right horizontal intraparietal sulcus. In boys only, prenatal alcohol exposure was associated with poorer place learning and reduced activation during place learning in the precuneus and posterior cingulate, as well as parahippocampal gyrus, frontal and temporal lobes, caudate, insula, claustrum, lentiform nucleus and thalamus. In girls, prenatal alcohol exposure was not associated with place learning performance or activation during place learning in any regions. These results confirm that boys and girls use different navigation strategies that rely on different brain regions and suggest that the regions used by boys are more susceptible to alcohol damage, while the regions used by girls are relatively spared. In conclusion, all the tasks investigated showed prenatal alcohol exposure related alterations in parietal function, with the impairments being widespread throughout the parietal lobe bilaterally. Notably, activation of the bilateral precuneus was affected by prenatal alcohol exposure in both the spatial navigation and nonsymbolic number comparison tasks. It is possible that this is a key region linking the deficits in number processing and visuospatial skills in children with prenatal alcohol exposure.

The results of previous studies indicated that block grafts of fetal hippocampal tissue made into cavities produced by aspiration lesions of the hippocampus in rats given the neurotoxin trimethyltin (TMT) significantly worsened the TMT-induced deficit in water maze acquisition. The purpose of the present study was to test the hypothesis that a procedure for transplantation that produced less destruction to the host brain and resulted in transplants with less mass might produce recovery in a spatial learning task in TMT-exposed rats. Acquisition of an externally cued (spatial) version of the radial arm maze (RAM), an internally cued version of the RAM, and of a differential reinforcement of low rate (DRL) operant schedule was assessed in normal rats, rats given TMT, and rats given TMT and stereotaxic implants of either fetal Ammon's horn or entorhinal cortex. The rats receiving Ammon's horn transplants made significantly fewer reentries into the baited arms in both maze configurations and fewer reentries into the nonbaited arms in the spatial RAM than rats in the TMT-only and TMT/entorhinal cortex transplant groups. The rats receiving transplants of Ammon's horn made significantly fewer responses and received more reinforcements during training on the DRL-20 schedule than rats receiving just TMT or rats receiving TMT and transplants of fetal entorhinal cortex. These results support the proposal that transplantation procedures that cause less damage to the host brain and result in transplants that do not occupy a large extent of the ventricular space increase the probability of behavioral recovery.

Se realizó un estudio prospectivo, cuasi experimental, transversal, comparativo, en 60 pacientes de riesgo obstétrico del Instituto Materno Perinatal (IMP), en la Unidad de Medicina Fetal, entre los meses de octubre y diciembre del 2002. Este estudio corresponde en realizar un Test Estresante o de esfuerzo fetal, considerado como, un tipo de monitoreo electrónico fetal que nos da la información neurológica y cardiovascular fetal; mediante la premisa de la oxigenación fetal provocando un estrés fisiológico de una contracción uterina. El Test Estresante se puede realizar de varias formas, pero las que más se utilizan en la Unidad de Monitoreo Fetal del IMP son: el Test estresante con Oxitocina exógena, que se da por la infusión endovenosa de oxitocina de 10UI diluída en 1000cc de suero salino o solución glucosada; y el Test Estresante con oxitocina endógena, que se da por la estimulación mamaria. Nuestro estudio compara estos dos tipos de estimulación para un Test Estresante, con la finalidad de dar a conocer que el estímulo mamario es el más eficaz. Para este estudio se dividió la muestra en dos grupos: El primer grupo con 30 pacientes, a quienes se les realizó un Test Estresante con estímulo mamario; y el segundo grupo de 30 pacientes a quienes se les realizó un Test Estresante con oxitocina exógena. En el Test Estresante con estímulo mamario se tomó como referencia la técnica de estimulación mamaria empleada por la doctora Ayllon Bulner, Dr. José Huamán y Dra. Nelly Lam. (23) Se obtuvo como resultado, que el Test Estresante con estímulo mamario es más eficaz, hallando un tiempo de latencia de 1 a 4 minutos en el 96.43% de la muestra; en comparación con el Test estresante con Oxitocina exógena en el que se obtuvo un tiempo de latencia de 1 a 4 minutos en el 23.3% de la muestra; mientras que el 76.67% de la muestra, tuvo un tiempo de latencia igual o mayor de 5 minutos. Por lo tanto se encuentra que el tiempo de latencia fue menor en el test estresante con estímulo mamario. También, el tiempo de obtención del patrón de contracciones uterinas va influir en la eficacia del Test Estresante con estímulo mamario, encontrando un tiempo de 1 a 5 minutos en el 82.14% de la muestra, en comparación con el Test Estresante con oxitocina exógena en el que se obtuvo un tiempo de obtención del patrón de contracciones uterinas, de 1 a 5 minutos, en el 13.33% de la muestra. Mientras que el 86.67% obtuvo un tiempo de obtención del patrón de contracciones uterinas en un tiempo mayor o igual a 6 minutos. Por lo tanto se encuentra que el tiempo de obtención del patrón de contracciones uterinas fue menor en el test estresante con estímulo mamario. En el 80.47% del total de la muestra (60 gestantes), el parto se desencadenó dentro de las 48 horas después de terminar el trazado del Test Estresante. El estímulo mamario no sólo puede ser aplicado en un Test Estresante, también se puede emplear en el trabajo de parto, estimulando la liberación de Oxitocina endógena; teniendo en consideración que debe ser indicado a la gestante previa capacitación adecuada en el empleo de la técnica de estimulación mamaria, por supuesto que con un control obstétrico necesario para evitar cualquier eventualidad. / Tesis

Background: The field of perinatal palliative care aims to support the unique needs of parents who choose to continue pregnancy following the diagnosis of a life-limiting fetal condition (LLFC). As parents navigate this challenging trajectory, the support they receive from healthcare providers is crucial in shaping parental experiences. Objective: to critically reflect on existing literature and to reveal a deeper understanding of the experience of continuing pregnancy in the presence of a LLFC Design: Qualitative meta-synthesis Methods: The primary search strategy consisted of multiple searches within four electronic databases. The analysis was guided by thematic analysis. Results: This meta-synthesis included 29 qualitative studies. Three main themes were identified; time, uncertainty and relationships. These concepts exist concurrently within this trajectory and continuously influence each other as well as the overall experiences of parents. Conclusion: Nurses are encouraged to acknowledge the significance of the interconnectedness between these key concepts and to critically reflect on how their everyday interactions become part of parents’ lived experiences.

Alcohol is a major public health problem globally. According to the World Health Organization (WHO) report, alcohol accounts for 2.5 million deaths (4% of total) and 69.4 million (4.5% of total) of Disability-Adjusted Life Years (DALYs), (WHO, 2002, 2011). In South Africa, alcohol was found to be the third highest contributor to death and disability (Parry, 2007/8). Among the many far-reaching consequences of alcohol use in South Africa, Fetal Alcohol Syndrome (FAS) in certain regions in the country, rates among the highest in the world (May et al., 2007). Despite higher comparative levels of FAS in rural areas, almost one third of the population in urban sites (Gauteng) demonstrates that FAS is not exclusively a problem of South African rural areas. This study hypothesized that higher knowledge levels about the effects of alcohol on pregnancy may deter use among women. Employing secondary data analysis from a 2006 cross-sectional household survey, this study explored the prevalence of alcohol use among urban women (18-44 years) in the Tshwane Municipality, in general and in pregnancy. It also examined the relationship between knowledge of alcohol effects on pregnancy and alcohol use. A significant association was found between employment status, pregnancy outcome and general alcohol use among women. An almost significant association was found between knowledge of alcohol effects on pregnancy and past month alcohol use, knowledge levels and alcohol use during pregnancy. Findings partially support the hypothesis. However, knowledge of alcohol effects on pregnancy alone cannot deter women from using alcohol. Multiple influencing factors should be considered in planning prevention programmes for urban women’s alcohol use. Further research with larger sample sizes of pregnant women is suggested to explore the associations conclusively.

Aspects of white-tailed deer (Odocoileus virginianus) reproductive ecology remain understudied. The accuracy of the fetal age estimation equation in current use is unknown. Knowledge is also limited for female choice of secondary sexual traits like antlers and body size. To address previous fetal estimation equations, I developed a model that included litter characteristics using 110 fetuses with known ages of 54 to 175 days. To address female choice, I manipulated antler size and paired large and small males while controlling allometrically related traits. I then allowed estrus females to choose between pairs of segregated males with either large and small antlers or large and small bodies. My predictive fetal aging model generated more accurate fetal ages under a range of sample timing and composition variation. Using various behavioral indications of choice, I demonstrated that females prefer males with larger antlers and lack a preference for body size or age.

OBJECTIVE: Adrenal steroidogenesis is important for maturation of fetal organ systems and plays a role in triggering parturition in ovine pregnancies. Studies have suggested a differential increase in baseline cortisol between twin gestations near term. Our aim was to further delineate the mechanisms responsible for the differences between the hypothalamic- pituitary-adrenal axes of twin fetuses in vivo. STUDY DESIGN: Surgery was performed on pregnant ewes (n = 6) with twin gestations to implant fetal vascular catheters. After recovery but while the subjects were resting, plasma cortisol concentrations were similar in both fetuses. Fetuses received, intravenously, boluses of adrenocorticotropic hormone at 2 doses, and plasma samples were obtained for analysis of the cortisol response. This stimulation by adrenocorticotropic hormone was then repeated in the same fetuses approximately 4 days later, after the increase of resting daily cortisol values in one but not the other fetus. RESULTS: Cortisol responses to adrenocorticotropic hormone before changes in daily resting cortisol concentrations were indistinguishable between twins. However, after separation of daily resting cortisol values, fetuses in group A (elevated resting cortisol concentration) demonstrated a significantly increased response to stimulation by adrenocorticotropic hormone. CONCLUSION: These results suggest a differential development in response to stimulation by adrenocorticotropic hormone between twin fetuses in vivo as the mechanism responsible for the asynchronous elevation of one twin's resting plasma cortisol concentration.

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Within the context of medical ethics the term 'instrumentalism' is broadly understood as the practice of 'using people' to achieve some end, where the end is considered to be of some good. It is a practice that has recently come under fire in light of developments in medical research that propose to use fetal tissue obtained from elective abortions. Ethicists opposed to this kind of instrumentalism usually invoke Kant's dictum that one should never treat humanity only as a means but always as an end in itself, and allege that the instrumental use of others is 'dehumanizing' and immoral. Moreover, opponents of fetal instrumentalism claim that using fetal tissue in research is a morally tainted, 'doubly' offensive practice since it depends on tissue obtained from voluntary abortions. In this thesis, I challenge both of these claims and argue that using fetal tissue in medical research constitutes an acceptable kind of instrumentalism. Furthermore, I argue that the issue of abortion and the use of fetal tissue in research are two ethically separable issues that warrant distinct ethical judgments. My project begins with an analysis of instrumentalism, which is then applied to show how using the aborted fetus to attain valuable therapeutic goals is a morally justified instrumentalism. I then proceed with an evaluation of the arguments central to the instrumentalist debate, and show how the normative separation between abortion and fetal tissue use is possible. / Thesis / Master of Arts (MA)