A Patient Perception as a Nursing Care in Emergency Sector

The work process by nurses in the emergency sector is comprised of two complementary dimensions, managing and caring. Therefore,the aim of this study was Know the perception of patients to the support of the nursing assistance in Emergency sector. This is a field research, exploratory, descriptive qualitative approach. The survey was conducted in Dr. Luiz Milton Arêa Leão Hospital - Satélite, located in the city of Teresina - PI, Brazil, which caters exclusively by the Unified Health System, and reference in its coverage area.We interviewed thirteen (13) patients who remained in observation in the emergency sector in that hospital. For this study was used as a criterion for inclusion of service users who entered the emergency sector in the periodMarch-April 2014 and who remained in the sector at the time of the interview.  A pilot test was conducted with the instrument to validate and suitability for the target audience, which is excluded from the sample. Ethical aspects were respected, as provided for in Resolution 466/2012 of the National Health Council, Brazil (2013). In this sense, we observed through the reports of the participants carrying out a qualified nursing care, where it identified a good conduct of professionals to provide the necessary assistance. A nursing care and systematic termination  during the stay of patients in hospital was evidenced. It is perceived  that there is a satisfaction from patients and the care of thenursing team, which is performed through actions inherent to these professionals, such as goodwill, the act of providing a welcoming atmosphere, with technical scientific background, and ability in dealing with conflict situations and ethical

Immune and spermatogenesis-related loci are involved in the development of extreme patterns of male infertility

We conducted a genome-wide association study in a large population of infertile men due to unexplained spermatogenic failure (SPGF). More than seven million genetic variants were analysed in 1,274 SPGF cases and 1,951 unaffected controls from two independent European cohorts. Two genomic regions were associated with the most severe histological pattern of SPGF, defined by Sertoli cell-only (SCO) phenotype, namely the MHC class II gene HLA-DRB1 (rs1136759, P = 1.32E-08, OR = 1.80) and an upstream locus of VRK1 (rs115054029, P = 4.24E-08, OR = 3.14), which encodes a protein kinase involved in the regulation of spermatogenesis. The SCO-associated rs1136759 allele (G) determines a serine in the position 13 of the HLA-DR beta 1 molecule located in the antigen-binding pocket. Overall, our data support the notion of unexplained SPGF as a complex trait influenced by common variation in the genome, with the SCO phenotype likely representing an immune-mediated condition. A GWAS in a large case-control cohort of European ancestry identifies two genomic regions, the MHC class II gene HLA-DRB1 and an upstream locus of VRK1, that are associated with the most severe phenotype of spermatogenic failure

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Le mythe français au Portugal du point de vue de la lexicographie

Alors que la vie politique portugaise, au tournant du XVIIIe siècle, est marquée par la gallophobie, le domaine lexicographique illustre quant à lui les tendances gallomanes des auteurs et du monde de l’édition portugais. À partir du XIXe siècle, les premiers dictionnaires bilingues français-portugais compacts voient le jour : pratiques, transportables, moins chers afin de toucher un public élargi, ces dictionnaires sont construits par des lexicographes à la fois gallomanes et lusophiles, souhaitant transporter d’une nation à l’autre ce qu’elles offraient de meilleur. Nous voyons ainsi que les plus importants dictionnaires monolingues portugais ou bilingues portugais-français sont construit sur le modèle français ou directement à partir de la langue française, s’inspirant du corpus lexicographique rassemblé par les plus grands savants du monde du dictionnaire français.While the Portuguese political life at the turn of the eighteenth century was marked by Gallophobia, the field of lexicography illustrates trends of Francophilia among Portuguese authors and publishers. From the nineteenth century, the first compact French-Portuguese bilingual dictionaries emerge: practical and less expensive, able to reach a wider audience, these dictionaries are made by lexicographers both Francophile and Lusophile, wishing to carry from a nation to another what they offered the best. Thus we see that the most important Portuguese monolingual dictionaries and bilingual Portuguese-French are built on the French model or directly from the French language, based on the lexicographic corpus collected by leading scholars in the world of French dictionary

Kinetics of Xist-induced gene silencing can be predicted from combinations of epigenetic and genomic features

To initiate X-Chromosome inactivation (XCI), the long noncoding RNA Xist mediates chromosome-wide gene silencing of one X Chromosome in female mammals to equalize gene dosage between the sexes. The efficiency of gene silencing is highly variable across genes, with some genes even escaping XCI in somatic cells. A gene's susceptibility to Xist-mediated silencing appears to be determined by a complex interplay of epigenetic and genomic features; however, the underlying rules remain poorly understood. We have quantified chromosome-wide gene silencing kinetics at the level of the nascent transcriptome using allele-specific Precision nuclear Run-On sequencing (PRO-seq). We have developed a Random Forest machine-learning model that can predict the measured silencing dynamics based on a large set of epigenetic and genomic features and tested its predictive power experimentally. The genomic distance to the Xist locus, followed by gene density and distance to LINE elements, are the prime determinants of the speed of gene silencing. Moreover, we find two distinct gene classes associated with different silencing pathways: a class that requires Xist-repeat A for silencing, which is known to activate the SPEN pathway, and a second class in which genes are premarked by Polycomb complexes and tend to rely on the B repeat in Xist for silencing, known to recruit Polycomb complexes during XCI. Moreover, a series of features associated with active transcriptional elongation and chromatin 3D structure are enriched at rapidly silenced genes. Our machine-learning approach can thus uncover the complex combinatorial rules underlying gene silencing during X inactivation

Gallomanie et gallophobie

Au cours de la phase de Nation building qui définit l’Europe au XIXe siècle, l’image de la France a eu un rôle particulier : modèle ou contre-modèle de civilisation, exemple de nationalisme littéraire et politique à imiter ou à combattre, vivier de stéréotypes nationaux déclinés dans l’Europe entière. Pour construire leur propre identité, les différents pays et les différentes régions se sont à un moment ou à un autre interrogés sur le mythe français et ont pris position pour assoir leur légitimité ou mieux cerner leur différence. Le volume réunit dix-huit articles rédigés par des spécialistes de différentes disciplines (histoire, littérature française et étrangère, sciences politiques), en provenance de toute l’Europe, qui étudient et analysent les représentations de la France à l’étranger. Les auteurs se sont penchés sur les différentes manifestations de sentiments pro-français et anti-français dans les textes littéraires et politiques, l’iconographie, les manuels d’histoire et d’enseignement, les articles de journaux, les mémoires, les dictionnaires, afin d’apporter une nouvelle pierre à l’histoire des représentations nationales. Les articles qui composent le volume analysent chacun une facette du « mythe français » et montrent la circulation des mêmes thèmes dans différentes aires culturelles européennes ; ils donnent ainsi un aperçu représentatif des usages en vigueur et des réflexions individuelles qui ont alimenté le débat international sur l’élaboration des identités nationales

Núcleos de Ensino da Unesp: artigos 2008

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved