Fever, hyperglycaemia and swallowing dysfunction management in acute stroke: A cluster randomised controlled trial of knowledge transfer

Background: Hyperglycaemia, fever, and swallowing dysfunction are poorly managed in the admission phase of acute stroke, and patient outcomes are compromised. Use of evidence-based guidelines could improve care but have not been effectively implemented. Our study aims to develop and trial an intervention based on multidisciplinary team-building to improve management of fever, hyperglycaemia, and swallowing dysfunction in patients following acute stroke. Methods and design: Metropolitan acute stroke units (ASUs) located in New South Wales, Australia will be stratified by service category (A or B) and, within strata, by baseline patient recruitment numbers (high or low) in this prospective, multicentre, single-blind, cluster randomised controlled trial (CRCT). ASUs then will be randomised independently to either intervention or control groups. ASUs allocated to the intervention group will receive: unit-based workshops to identify local barriers and enablers; a standardised core education program; evidence-based clinical treatment protocols; and ongoing engagement of local staff. Control group ASUs will receive only an abridged version of the National Clinical Guidelines for Acute Stroke Management. The following outcome measures will be collected at 90 days post-hospital admission: patient death, disability (modified Rankin Score); dependency (Barthel Index) and Health Status (SF-36). Additional measures include: performance of swallowing screening within 24 hours of admission; glycaemic control and temperature control. Discussion: This is a unique study of research transfer in acute stroke. Providing optimal inpatient care during the admission phase is essential if we are to combat the rising incidence of debilitating stroke. Our CRCT will also allow us to test interventions focussed on multidisciplinary ASU teams rather than individual disciplines, an imperative of modern hospital services

Eukaryotic Protein Kinases (ePKs) of the Helminth Parasite Schistosoma mansoni

<p>Abstract</p> <p>Background</p> <p>Schistosomiasis remains an important parasitic disease and a major economic problem in many countries. The <it>Schistosoma mansoni </it>genome and predicted proteome sequences were recently published providing the opportunity to identify new drug candidates. Eukaryotic protein kinases (ePKs) play a central role in mediating signal transduction through complex networks and are considered druggable targets from the medical and chemical viewpoints. Our work aimed at analyzing the <it>S. mansoni </it>predicted proteome in order to identify and classify all ePKs of this parasite through combined computational approaches. Functional annotation was performed mainly to yield insights into the parasite signaling processes relevant to its complex lifestyle and to select some ePKs as potential drug targets.</p> <p>Results</p> <p>We have identified 252 ePKs, which corresponds to 1.9% of the <it>S. mansoni </it>predicted proteome, through sequence similarity searches using HMMs (Hidden Markov Models). Amino acid sequences corresponding to the conserved catalytic domain of ePKs were aligned by MAFFT and further used in distance-based phylogenetic analysis as implemented in PHYLIP. Our analysis also included the ePK homologs from six other eukaryotes. The results show that <it>S. mansoni </it>has proteins in all ePK groups. Most of them are clearly clustered with known ePKs in other eukaryotes according to the phylogenetic analysis. None of the ePKs are exclusively found in <it>S. mansoni </it>or belong to an expanded family in this parasite. Only 16 <it>S. mansoni </it>ePKs were experimentally studied, 12 proteins are predicted to be catalytically inactive and approximately 2% of the parasite ePKs remain unclassified. Some proteins were mentioned as good target for drug development since they have a predicted essential function for the parasite.</p> <p>Conclusions</p> <p>Our approach has improved the functional annotation of 40% of <it>S. mansoni </it>ePKs through combined similarity and phylogenetic-based approaches. As we continue this work, we will highlight the biochemical and physiological adaptations of <it>S. mansoni </it>in response to diverse environments during the parasite development, vector interaction, and host infection.</p

Gestión escolar y la política nacional de educación especial: las barreras para la implementación de una política pública

Esse antigo objetivou identificar, segundo os diretores de escola, as barreiras que mais interferem na implementação das políticas relativas à Inclusão. A pesquisa contou com a participação de 22 (vinte e dois) diretores que atuavam nas escolas de um município localizado na grande São Paulo. De acordo com os diretores entrevistados, a barreira que mais interfere na implementação das políticas inclusivas está relacionada à formação docente, da equipe gestora, dos funcionários da escola e da comunidade. Verificar a visão dos diretores de escola frente à Política Nacional de Educação Especial na Perspectiva da Educação Inclusiva permitiu uma reflexão sobre a visão desse agente social diante da política pública.The former aimed to identify, according to school principals, the barriers that most interfere with the implementation of Inclusion policies. The research had the participation of 22 (twenty two) directors who worked in the schools of a municipality located in the greater São Paulo. According to the interviewed directors, the barrier that most interferes in the implementation of inclusive policies is related to teacher training, the management team, the school staff and the community. To verify the vision of the school principals in front of the National Policy of Special Education in the Perspective of the Inclusive Education allowed a reflection on the vision of this social agent before the public policy.Este antiguo objetivó identificar, según los directores de escuela, las barreras que más interfieren en la implementación de las políticas relativas a la Inclusión. La investigación contó con la participación de 22 (veintidós) directores que actuaban en las escuelas de un municipio ubicado en la gran São Paulo. De acuerdo con los directores entrevistados, la barrera que más interfiere en la implementación de las políticas inclusivas está relacionada a la formación docente, del equipo gestora, de los funcionarios de la escuela y de la comunidad. Verificar la visión de los directores de escuela frente a la Política Nacional de Educación Especial en la Perspectiva de la Educación Inclusiva permitió una reflexión sobre la visión de ese agente social ante la política pública

Towards a comprehension of an intuition: criteria to distinguish verbal complementation from adjunction

A distinção entre argumentos e adjuntos verbais é fundamental para alicerçar diferentes teorias linguísticas. Entretanto, ainda que nossa intuição seja segura para analisar os casos mais prototípicos, ela falha no julgamento de algumas relações verbais. Precisamos, pois, de um critério seguro (e não apenas intuitivo) que seja capaz de diferenciar todos os casos de complementação dos de adjunção verbal. Portanto, o objetivo deste trabalho é apresentar e discutir alguns dos principais testes que buscam diferenciar argumentos de adjuntos verbais (JACKENDOFF, 1977; DOWTY, 1982; CAPPELEN; LEPORE, 2005; HAEGEMAN, 2006; KENEDY, 2013; MIOTO; FIGUEIREDO SILVA; LOPES, 2013), especialmente quando temos os papéis temáticos de benefactivo e de locativo – pois são papéis que ocorrem tanto na posição de argumento interno quanto na de adjunto. Vamos apresentar os seguintes testes: (i) opcionalidade do termo, (ii) subcategorização, (iii) s-seleção, (iv) acarretamento e (v) retomada anafórica, e tentar mostrar quais são os problemas que cada um deles enfrenta. Surpreendentemente, a distinção argumento–adjunto parece não encontrar suporte consistente e definitivo em nenhum teste proposto pela literatura. O último deles, entretanto, a retomada anafórica, é o único que parece capturar essa distinção, embora diagnostique como transitivos alguns verbos classicamente considerados inergativos (como viajar e telefonar).The distinction between verbal arguments and adjuncts is essential to ground various linguistic theories. However, although we may have reliable intuitions regarding prototypical cases, such intuitions fail us in the judgment of certain verbal relations. We are, thus, in need of a reliable criterion (beyond mere intuition) that is capable of differentiating verb complementation from adjunction. Therefore, our goal here is to present and to discuss some of the main tests that purport to distinguish verb arguments from adjuncts (JACKENDOFF, 1977; DOWTY, 1982; CAPPELEN; LEPORE, 2005; HAEGEMAN, 2006; KENEDY, 2013; MIOTO; FIGUEIREDO SILVA; LOPES, 2013), especially concerning the thematic roles of beneficiary and locative – because they occur both in internal argument and in adjunct positions. We are going to present the following tests: (i) term optionality, (ii) subcategorization, (iii) s-selection, (iv) entailment and (v) anaphora, and try to indicate what problems each one of them faces. Surprisingly, the argument–adjunct distinction does not seem to find any consistent and definitive support in any of the tests found in the literature. The last one, however, anaphora, is the only one that seems capable of capturing this distinction, although it diagnoses as transitives some verbs usually considered to be unergative (like “to travel” (viajar) and “to phone” (telefonar))

The organic agriculture as activities niche for agricultural family in Brazil: difficulties and possibilities

O objetivo deste trabalho é o de apresentar a relevância da agricultura orgânica como nicho alternativo para a inserção da Agricultura Familiar no Brasil. Embora a agricultura orgânica seja ainda modesta no Brasil, principalmente quando comparada a de outros países, os últimos anos têm testemunhado um crescimento dessa atividade e o interesse público em fortalecer esse tipo de agricultura, como expresso, por exemplo, pelo Plano Nacional de Agroecologia e Produção Orgânica (PLANAPO).This article highlights how public financing has changed public policies oriented to organic productions, specially in Brazil where this activity is related to familiar agriculture. We used methodology based on traditional literature about familiar agriculture and organic production in order to address their corelation and further implications on National Plan for Organic Production and Agroecology (PLANAPO)

The organic agriculture as activities niche for agricultural family in Brazil: difficulties and possibilities

O objetivo deste trabalho é o de apresentar a relevância da agricultura orgânica como nicho alternativo para a inserção da Agricultura Familiar no Brasil. Embora a agricultura orgânica seja ainda modesta no Brasil, principalmente quando comparada a de outros países, os últimos anos têm testemunhado um crescimento dessa atividade e o interesse público em fortalecer esse tipo de agricultura, como expresso, por exemplo, pelo Plano Nacional de Agroecologia e Produção Orgânica (PLANAPO).This article highlights how public financing has changed public policies oriented to organic productions, specially in Brazil where this activity is related to familiar agriculture. We used methodology based on traditional literature about familiar agriculture and organic production in order to address their corelation and further implications on National Plan for Organic Production and Agroecology (PLANAPO)

Políticas sociais sobre drogas: um objeto para Serviço Social brasileiro

Diferentes atores, interesses e idéias estão em discussão no campo político sobre qual é a melhor política de drogas a ser implementada pelo governo brasileiro. Uma combinação desigual de forças se explicita na atualidade em direções antagônicas: de um lado, aumentam-se os efeitos do proibicionismo às drogas e sua conseqüente política criminal associada às configurações da privatização do fundo público; e de outro, cresce a organização política para resistir e lutar para reinventar uma nova sociabilidade não criminalizada com os usos das drogas. A prática, investigação e lutas do Serviço Social brasileiro participam dessa crítica hegemonia da área das drogas