Ample research has been found to suggest that there is no substitute, either nutritionally or emotionally, that can replace the benefits of human milk for human infants. Despite this recognition, the attitude still exists that infant formula is a reasonable alternative. The American Academy of Pediatrics (AAP), World Health Organization (WHO), and United Nation Children's Fund (UNICEF) share policy statements endorsing human milk as the optimal infant nutrition for the first 15 months. Accordingly, WHO and UNICEF launched The Baby-friendly Hospital Initiative established in 1991 to protect, promote, and support breastfeeding. Despite this unilateral support of breastfeeding, nursing and physician educational curriculums do not include lactation education, which limits the knowledge of those who provide care to the mother and newborn dyad. The purpose of this project is to promote staff lactation education and training on the infant feeding practices by encouraging breastfeeding in a hospital setting. This project includes lactation education and hands-on training for staff. A 20-hour didactic lactation education course will meet the requirements to ensure that staff training will assist in supporting patients with the early initiation of breastfeeding. Furthermore, training will include clinical competencies to evaluate the knowledge, practice patterns, and confidence of the staff. Lactation education for providers will be provided through an online course designed to improve their ability to support breastfeeding among their patients. The result of this project will assist hospital leadership to determine specific education and training for staff in increasing exclusive breastfeeding rates among their patient population.

Purpose: Thestudy's purpose is to with the help of interviews and conversations with children and teachers, examine the educational activities of the preschool on unsocial hours from a child's perspective, focusing on children's participation. Question at issue: How do children talk about their stay in the Ob-kindergarten? How does the teachers' responses relate to what the children tell? Method: Qualitative methods, interview, grounded theory Main theoretical connection: postmodernism, attachment theory. Conclusion:We have concluded that very little is known about the swedish preschool on unsocial hours(from now on uh-preschool). Based on the responses we received during our interviews, we see that children's attitudes and their willingness to be on uh-preschoolisvery much depending on the relationship between them and the teachers. We see that children who feel that they are being listened to and respected, is over all more favorable to reside inthe uh-preschool.

The Ob is the third largest Eurasian river supplying heat and freshwater to the Arctic Ocean. These inputs influence water salinity, ice coverage, ocean temperatures and ocean circulation, and ultimately the global climate system. Variability of Ob River flow on long time scales is poorly understood, however, because gaged flow records are short. Eleven tree-ring width chronologies of Pinus sibirica and Larix sibirica are developed from the floodplain of the Lower Ob River, analyzed for hydroclimatic signal and applied as predictors in a regression model to reconstruct 8-month average (December-July) discharge of the Ob River at Salekhard over the interval 1705-2012 (308 yrs). Correlation analysis suggests the signal for discharge comes through air temperature: high discharge and floodplain water levels favor cool growing-season air temperature, which limits tree growth for the sampled species at these high latitudes. The reconstruction model (R-2 = 0.31, 1937-2009 calibration period) is strongly supported by cross validation and analysis of residuals. Correlation of observed with reconstructed discharge improves with smoothing. The long-term reconstruction correlates significantly with a previous Ob River reconstruction from ring widths of trees outside the Ob River floodplain and extends that record by another century. Results suggest that large multi-decadal swings in discharge have occurred at irregular intervals, that variations in the 20th and 21st centuries have been within the envelope of natural variability of the past 3 centuries, and that discharge data for 1937-2009 underestimate both the variability and persistence of discharge in the last 3 centuries. The reconstruction gives ecologists, climatologists and water resource planners a long-term context for assessment of climate change impacts.

Nous cheminerons vers la possibilité pour la parole d’exprimer malgré l’usure du langage sous la quotidienneté qui arase le sens, l’intuition d’une complétude qui lui échappe et la laisse parcellaire au monde face à l’incommensurable altérité de celui qui l’écoute ou qui la lit. Avec Camus, mais aussi Nietzsche et Bataille, nous comprendrons la pensée comme une expérience; une transgression des frontières vers une extériorité irréductible de l’être. La pensée de la nuit, du neutre et du rien questionneront alors la possibilité même d’une pensée dans le cadre d'un rapport. Pensée devenue expérience de pensée, fragmentée dans et par une extériorité intrinsèque, ilots de sens disséminés qui disent plus dans le non- dit et la résonnance ; la pensée est confrontée à son propre ob-scène. L’approche heideggérienne de l’oeuvre d’art puis de la parole ainsi que la pensée de Blanchot qualifient dès lors la parole poétique comme seule parole pouvant penser et dire cette solitude essentielle du penser; mais en le maintenant suspendu dans le champ de l’indicible, de l’absence, du sens retenu et de l’écart entre être et exister. / We first question the possibility for the speech to express despite the day-to-day existence which flattens the meaning and despite the perception of a fleeing integrity which lets it into pieces face the scene of the world as the deep alterity of whom is listening. Then, walking with Camus, Nietzsche and Bataille, we will understand the thinking as an experience that has to break boundaries up to the inextinguishable exteriority of Being. Helped by the concepts of the Night (Hegel and Bataille), of the Neuter (Blanchot) or of the Nothing (Heidegger), we will from there interrogate the possibility left for the thought to build itself out of a frame of relations from the otherness. The thought broken up in as by its self-otherness faces its own ob-scene. Islets of meanings, speaking more in what stays unsaid or by reverberations the thought finds in the poetic diction, as approched by heidegger and Blanchot, the only speech qualified to think and deliver the essential seclusion of the act of thinking. Though this parole lets it straddling the fence of what is unutterable, of the absence, of the meaning keept unsaid as the irreducible gap between being and existing.

Massive young star clusters and OB associations (M > 10 000 Msun) dominate the energetic feedback from stars into the interstellar medium. They contain the most massive and luminous stars in the Galaxy, which shape their environments through winds, ionizing flux, radiation pressure, and eventually supernovae, destroying their natal molecular clouds and inflating superbubbles. Few such clusters have been identified in our Galaxy. We systematically investigate the most luminous H II regions, which we identify using the WMAP foreground maps. We find that the 13 most luminous sources produce one-third of the Galaxy’s total ionizing luminosity, all with expected powering populations of M > 40 000 Msun. These populations are grouped in small numbers of clusters or associations for each WMAP source. The emission from these regions is dominated by the diffuse component at large radii (∼10-70 pc) indicating a high leaking fraction of ionizing photons. Using 8 μm maps from Spitzer GLIMPSE and published radio recombination line observations, we resolve the large (> 1◦) WMAP sources into 40 star forming complexes (SFCs) exhibiting shell morphology with evidence of expansion due to a central powering source. We develop a method, based on differential extinction of the galactic disk, to identify the SFC’s powering cluster candidates with 2MASS. We identify 22 cluster candidates within the 40 SFCs having extinctions consistent with their distances. With near-infrared spectroscopy from the New Technology Telescope, we have confirmed the existence of the most massive of these associations, the Dragonfish Association, with M = 100 000 Msun. Of the 50 sampled stars, we identify 2 Luminous Blue Variable candidates, a Wolf-Rayet, and 15 O-type stars, consistent with the yield expected from the candidate contamination rate, verifying the candidate cluster identification method. This investigation doubles the number of massive young star clusters and OB associations known and produces the most complete picture of the upper end of the Galaxy’s cluster mass function to date.

Telomeres are the physical ends of linear chromosomes in eukaryotes. Telomeres not only protect chromosome ends from being recognized as double-strand breaks but also maintain the chromosome terminal sequences. These processes involve a number of telomere-related proteins. A major challenge in the field is to elucidate the full constitution of telomere-associated proteins and to understand how different protein complexes are regulated at chromosome termini. Here, I report the identification and characterization of STN1 (Suppressor of cdc thirteen, 1), CTC1 (Conserved Telomere maintenance Component 1) and TEN1 (Telomeric pathways in association with Stn1, 1) in Arabidopsis. CTC1/STN1/TEN1 (CST) forms a trimeric complex that specifically associates with telomeres. Loss of any component of the CST induces catastrophic telomere loss, disrupted telomere end architecture, and massive chromosome end-to-end fusions. Thus, CST plays an essential role in chromosome end protection. I also show that CST function at telomeres is independent of a previously characterized capping complex KU70/KU80, and that ATR is responsible for a checkpoint response in plants lacking CTC1/STN1. Additionally, I present data showing that Arabidopsis POT1a (Protection Of Telomere 1, a) has evolved as a telomerase recruitment factor. Unlike POT1 in other eukaryotes which binds and protects ss telomeric DNA, AtPOT1a interacts with telomerase RNA (TER). Based on an evolutionary analysis, we found that the POT1a lineage is under positive selection in the Brassicaceae family in which Arabidopsis belongs. Mutations of two positive selection sites significantly reduce POT1a?s activity in vivo. These data suggest POT1a is under pressure to evolve from a telomeric DNA binding protein to a TER binding protein. I also discovered that POT1a interacts with the novel telomere capping protein CTC1 in vitro and in vivo. Thus, I hypothesize that POT1a acts as a telomerase recruitment factor linking this enzyme to the chromosome termini via interacting with TER and CTC1. Finally, I dissected the functional domains of POT1a and demonstrated that both the N-terminus and the C-terminus of POT1a are required for its function in vivo. In summary, my work has uncovered several new and essential telomereassociated proteins that provide new insight into mechanisms of chromosome end protection and maintenance.

Thesis (Ph. D.)--Joint Program in Oceanography (Massachusetts Institute of Technology, Dept. of Earth, Atmospheric, and Planetary Sciences; and the Woods Hole Oceanographic Institution), 2002. / Includes bibliographical references.

Massive young star clusters and OB associations (M > 10 000 Msun) dominate the energetic feedback from stars into the interstellar medium. They contain the most massive and luminous stars in the Galaxy, which shape their environments through winds, ionizing flux, radiation pressure, and eventually supernovae, destroying their natal molecular clouds and inflating superbubbles. Few such clusters have been identified in our Galaxy. We systematically investigate the most luminous H II regions, which we identify using the WMAP foreground maps. We find that the 13 most luminous sources produce one-third of the Galaxy’s total ionizing luminosity, all with expected powering populations of M > 40 000 Msun. These populations are grouped in small numbers of clusters or associations for each WMAP source. The emission from these regions is dominated by the diffuse component at large radii (∼10-70 pc) indicating a high leaking fraction of ionizing photons. Using 8 μm maps from Spitzer GLIMPSE and published radio recombination line observations, we resolve the large (> 1◦) WMAP sources into 40 star forming complexes (SFCs) exhibiting shell morphology with evidence of expansion due to a central powering source. We develop a method, based on differential extinction of the galactic disk, to identify the SFC’s powering cluster candidates with 2MASS. We identify 22 cluster candidates within the 40 SFCs having extinctions consistent with their distances. With near-infrared spectroscopy from the New Technology Telescope, we have confirmed the existence of the most massive of these associations, the Dragonfish Association, with M = 100 000 Msun. Of the 50 sampled stars, we identify 2 Luminous Blue Variable candidates, a Wolf-Rayet, and 15 O-type stars, consistent with the yield expected from the candidate contamination rate, verifying the candidate cluster identification method. This investigation doubles the number of massive young star clusters and OB associations known and produces the most complete picture of the upper end of the Galaxy’s cluster mass function to date.

Πολλές μελέτες έχουν συνδέσει τη λεπτίνη με την παθοφυσιολογία των νεοπλασιών. Εμείς ερευνήσαμε την άμεση επίδραση της λεπτίνης σε κακοήθη αιματοποιητικό ιστό που περιελάμβανε κύτταρα οξείας μυελογενούς λευχαιμίας (AML) και λευχαιμικές κυτταρικές σειρές. Τα PBMC, τα Τ κύτταρα, τα Β κύτταρα και τα μονοκύτταρα από υγιείς δότες χρησιμοποιήθηκαν ως δείγματα αναφοράς. Προσδιορίσαμε τα πρότυπα έκφρασης των OB-R ισομορφών στα AML κύτταρα και σε λευχαιμικές κυτταρικές σειρές σε σύγκριση με τα κύτταρα αναφοράς με RT-PCR. Η ανασυνδυασμένη λεπτίνη αύξησε την έκφραση του OB-R και την ενδογενή λεπτίνη στους AML βλάστες και σε συγκεκριμένες κυτταρικές σειρές, μα όχι στα κύτταρα αναφοράς. Η CBA ανάλυση προ- και αντι-φλεγμονωδών κυτταροκινών έδειξε ότι η ανανσυνδυασμένη λεπτίνη αυξάνει την έκφραση της IL-6 από τα ΑΜL κύτταρα, πολλών κυτταροκινών από τις λευχαιμικές κυτταρικές σειρές που εξετάστηκαν, και έκκριση της IL-10 από τα PBMC κύτταρα. Ανάλυση western αποκάλυψε ότι η επίδραση της ανασυνδυασμένης λεπτίνης ήταν ανεξάρτητη από τα JAK-2/phospho-JAK-2 πρωτεϊνικά επίπεδα. Προτείνουμε πως το σύστημα λεπτίνης/ υποδοχέα επιδρά άμεσα και ισχυρά στην υποστήριξη ανάπτυξης αιματοποιητικών ανωμαλιών. / Several studies have implicated leptin in the pathophysiology of neoplasias. We investigated the direct effect of leptin on malignant hematopoietic tissue that included primary acute myeloid leukemia (AML) cells και leukemic cell lines. PBMC, T-cells, B-cells and monocytes from healthy subjects served as controls. We defined the patterns of OB-R isoform expression in AML cells and leukemic cell lines in comparison to control cells by RT-PCR. rLeptin upregulated the expression of OB-R and endogenous leptin in AML blasts and certain cell lines but not in control cells. Cytometric Bead Array analysis of pro- and anti-inflammatory cytokines showed that rleptin upregulates IL-6 secretion by AML cells, various cytokines by the leukemic cell lines tested and IL-10 secretion by control PBMC, contributed by monocytes. Western immunoblotting revealed that the effect of rleptin was independent of JAK-2/phospho-JAK-2 protein levels. We propose that the leptin/OB-R system is strongly and directly involved in supporting the growth of hematopoietic malignancies.

Η λεπτίνη είναι μια ορμόνη 16 kD που κωδικοποιείται απότογονίδιο obκαι παράγεται από τα λιποκύτταρα ρυθμίζοντας το ενεργειακό ισοζύγιο. Τα επίπεδα λεπτίνης στο πλάσμα είναι ανάλογα με το δείκτη σωματικής μάζας (BMI), ενώ η έκφρασή της εξαρτάται από τη νηστεία και τη σίτιση, την ινσουλίνη, τα γλυκοκορτικοειδή, καθώς και από προφλεγμονώδεις κυτταροκίνες, κύριως τον TNF-α και την IL-1. Το μόριο της λεπτίνης παρουσιάζει ομοιότητες με τη μακριά έλικα των κυτταροκινών και δρά μέσω του υποδοχέα της (OB-R), ο οποίος ανήκει στην υπεροικογένεια των υποδοχέων των κυτταροκινών και εμφανίζεται σε ποικιλία ισομορφών ενώ εκφράζεται σε διάφορους ιστούς και κύτταρα του νευροενδοκρινικού, αναπαραγωγικού, αιματοποιητικού και ανοσοποιητικού συστήματος. Η λεπτίνη εμπλεκεται και σε αυτοάνοσες καταστάσεις με το να προάγει τη διατήρηση παθογόνων Th1 κυτταρικών υποπληθυσμών. Στην παρούσα μελέτη προκειμένου να διερευνήσουμε το ρόλο της λεπτίνης σε αυτοάνοσες καταστάσεις μετρήσαμε τα επίπεδα αυτής και του υποδοχέα της σε ασθενείς με ρευματοειδή αρθρίτιδα, μια χρόνια συστεμική αυτοάνοση νόσο, για να δούμε εάν αυτά σχετίζονται με το στάδιο της νόσου ή τη θεραπεία. Ακόμη μελετήθηκε η εμπλοκή της λεπτίνης στην έκφραση προ- και αντιφλεγμονωδών κυτταροκινών στον ορό ασθενών και μαρτύρων. Τα αποτελέσματα δείχνουν πως τα επίπεδα λεπτίνης είναι υψηλά στους ασθενέις με ΡΑ. Επιπλέον τα επίπεδα λεπτίνης δεν βρέθηκε να σχετίζονται με το στάδιο της νόσου ή τη χορηγούμενη θεραπεία. Παρόλα αυτά τα αυξημένα επίπεδα λεπτίνης σε ασθενείς με ρευματοειδή αρθρίτιδα καταδεικνύουν ενδεχομένως έναν παθογενετικό ρόλο της λεπτίνης. / Leptin is a 16 kD peptide hormone, encoded by the ob gene and synthesized mainly by adipocytes to regulate the energy balance. In humans, leptin plasma levels are strongly correlated with body mass index (BMI) and the expression of leptin is regulated by fasting and feeding, insulin, glucocorticoids and pro-inflammatory cytokines, mainly TNFa and IL-1. Leptin is structurally similar to long-chain helical cytokines and it signals through its receptor, OB-R, which is a member of the cytokine receptor superfamily. OB-R comes in a variety of protein isoforms, and is expressed in several tissues and cells of the neuroendocrine system as well as the reproductive, hematopoietic and immune systems. Leptin has also been implicated in the pathogenesis of autoimmunity. It has also been suggested that leptin may promote the expansion and maintenance of pathogenic Th1-cell populations in autoimmune diseases. In this study to investigate the role of leptin in human autoimmunity, we measured leptin and OB-Rs levels inthe sera of patients suffering from rheumatoid arthritis (RA), a common chronicsystemic inflammatory disease, and tested for a possible correlation with disease activity and type of treatment. In addition, we studied whether leptin has an effect on the expression patterns of pro- and anti-inflammatory cytokine genes in PBMC isolated from RA patients and controls.Our results showed significantly elevated serum leptin levels in the rheumatoid population compared to the healthy controls.In addition, there was an absence of correlation between serum leptin levels and disease activity, as well as the nature and quantity of the medications administered to the patients. The absence of correlation between serum leptin levels and disease activity, coupled with the significantly and stably elevated levels of this hormone in the rheumatoid sera compared to the controls, are probably indicative of an insiduous pathogenetic role of leptin in rheumatoid arthritis.