Democratic leadership: a charming solution for nursing’s legitimacy crisis

Editorial regarding democratic leadership for nursing

Seal Occurrence and Habitat Use during Summer in Petermann Fjord, Northwestern Greenland

Ice-associated seals are considered especially susceptible and are potentially the first to modify distribution and habitat use in response to physical changes associated with the changing climate. Petermann Glacier, part of a unique ice-tongue fjord environment in a rarely studied region of northwestern Greenland, lost substantial sections of its ice tongue during major 2010 and 2012 calving events. As a result, changes in seal habitat may have occurred. Seal occurrence and distribution data were collected in Petermann Fjord and adjacent Nares Strait region over 27 days (2 to 28 August) during the multidisciplinary scientific Petermann 2015 Expedition on the icebreaker Oden. During 239.4 hours of dedicated observation effort, a total of 312 individuals were recorded, representing four species: bearded seal (Erignathus barbatus), hooded seal (Crystophora cristata), harp seal (Pagophilus groenlandicus), and ringed seal (Pusa hispida). Ringed seals were recorded significantly more than the other species (χ2 = 347.4, df = 3, p < 0.001, n = 307). We found significant differences between species in haul-out (resting on ice) behavior (χ2 = 133.1, df = 3, p < 0.001, n = 307). Bearded seals were more frequently hauled out (73.1% n = 49), whereas ringed seals were almost exclusively in water (93.9%, n = 200). Differences in average depth and ice coverage where species occurred were also significant: harp seals and bearded seals were found in deeper water and areas of greater ice coverage (harp seals: 663 ± 366 m and 65 ± 14% ice cover; bearded seals: 598 ± 259 m and 50 ± 21% ice cover), while hooded seals and ringed seals were found in shallower water with lower ice coverage (hooded seals: 490 ± 163 m and 38 ± 19% ice cover; ringed seals: 496 ± 235 m, and 21 ± 20% ice cover). Our study provides an initial look at how High Arctic seals use the rapidly changing Petermann Fjord and how physical variables influence their distribution in one of the few remaining ice-tongue fjord environments.Les phoques associés aux glaces sont considérés comme très susceptibles et sont potentiellement les premiers à modifier la répartition de leur population et la façon dont ils utilisent leur habitat en réponse aux changements physiques découlant des changements climatiques. Le glacier Petermann fait partie d’une langue glaciaire de fjord unique dans une région rarement étudiée du nord-ouest du Groenland. De gros blocs de glace se sont détachés du glacier Petermann pendant le vêlage de 2010 à 2012. Par conséquent, l’habitat des phoques aurait pu être modifié. Pendant 27 jours (du 2 au 28 août), des données sur la présence et la répartition des phoques ont été recueillies au fjord Petermann et dans la région adjacente du détroit de Nares dans le cadre de l’expédition scientifique multidisciplinaire Petermann 2015 sur le brise-glace Oden. Au cours de 239,4 heures d’observation soutenue, la présence d’un total de 312 phoques représentant quatre espèces a été notée : le phoque barbu (Erignathus barbatus), le phoque à capuchon (Crystophora cristata), le phoque du Groenland (Pagophilus groenlandicus) et le phoque annelé (Pusa hispida). La présence de phoques annelés est considérablement plus importante que celle des autres espèces (χ2 = 347,4, ddl = 3, p < 0,001, n = 307). Nous avons constaté une différence significative dans les comportements d’échouerie (repos sur la glace) des phoques selon les espèces (χ2 = 133,11, ddl = 3, p < 0,001, n = 307). Les phoques barbus étaient plus souvent hors de l’eau (73,1 %, n = 49), tandis que les phoques annelés se trouvaient presque exclusivement dans l’eau (93,9 %, n = 200). Des différences significatives en ce qui a trait à la présence des espèces selon la profondeur et la couverture glaciaire ont été notées. Les phoques du Groenland et les phoques barbus fréquentent les profondeurs d’eau moyennes (663 ± 366 m et 598 ± 259 m, respectivement) et les régions où la couverture de glace correspond à la moyenne supérieure (65 ± 14 % et 50 ± 21 %, respectivement), tandis que les phoques à capuchon et les phoques annelés fréquentent les eaux moins profondes (490 ± 163 m et 496 ± 235 m, respectivement) et les régions où la couverture de glace correspond à la moyenne inférieure (38 ± 19 % et 21 ± 20, respectivement). Notre étude présente un premier aperçu de la façon dont les phoques de l’Extrême-Arctique utilisent le fjord Petermann en évolution rapide et de l’influence des variables physiques sur leur répartition dans l’une des rares langues glaciaires de fjord restantes

DNMT3B (rs2424913) polymorphism is associated with systemic lupus erythematosus alone and with co-existing periodontitis in a Brazilian population

The association between Periodontitis and Systemic Lupus Erythematosus (SLE) has been primarily based on their similar pathophysiology and both are associated with genetic polymorphisms. Objectives: To investigate an association between the methylation-related gene polymorphisms DNMT3B (rs2424913) and MTHFR (rs1801133) to Systemic Lupus Erythematosus (SLE) and Periodontitis. Methodology: In total, 196 individuals of all genders aged 24 to 60 years old were allocated into four groups based on their systemic and periodontal status, namely: Healthy control (n=60), periodontitis (n=51), SLE (n=47), and SLE + periodontitis (n=38). Individuals with SLE were stratified according to disease activity (SLEDAI) in inactive or active. We performed polymorphism analysis using PCR-RFLP with genomic DNA from mouthwash. We analyzed data using Fisher’s Exact, Chi-square test, and regression models. Results: Periodontal status were similar in subjects with periodontitis alone and combined with SLE. SLE patients with periodontitis had a longer SLE diagnosis than SLE only (p=0.001). For DNMT3 B polymorphism, the periodontitis, SLE, and Inactive SLE + periodontitis groups showed a higher frequency of T allele and TT genotypes compared to healthy controls (p<0.05). Regression analyses showed that the TT genotype is a strong risk factor for periodontitis (OR=4.53; CI95%=1.13–18.05) and also for SLE without periodontitis (OR=11.57; CI95%=3.12–42.84) and SLE with periodontitis (OR=5.27; CI95%=1.25–22.11) when compared to control. Conclusion: SLE patients with periodontitis had a longer length of SLE diagnosis. The DNMT3B (rs2424913) polymorphism was associated with periodontitis and SLE alone or combined with periodontitis. Our study contributes to understanding the genetic mechanisms involved in periodontitis and SLE susceptibility

Identidade do professor de jovens e adultos : limites e possibilidades

Trabalho de Conclusão de Curso (especialização)—Universidade de Brasília, Universidade Aberta do Brasil, Faculdade de Educação, III Curso de Especialização em Educação na Diversidade e Cidadania, com Ênfase em Educação de Jovens e Adultos, 2015.O presente Projeto de Intervenção Local, de caráter bibliográfico e de estudo de campo, objetivou conhecer a realidade de trabalho dos professores da Educação de Jovens e Adultos, delimitado à Escola Municipal Ipanema, localizada em Valparaíso de Goiás. Por meio deste Projeto de Intervenção Local, reconhece-se a importância de se ter uma escola harmoniosa e coesa, na qual os profissionais desenvolvam ações que tornem o ambiente escolar mais interessante e motivador e, consequentemente, promova a qualidade do ensino para os alunos da EJA. A justificativa desta intervenção local encontra-se, fundamentalmente, na análise dos limites e das possibilidades do professor da EJA, na escola onde seu fazer pedagógico se desenvolve. Buscou-se, também, por meio deste estudo, conscientizar o professor sobre a importância da EJA para a vida global dos estudantes e isso requer currículos e programas significativos, que promovam a otimização do ensino. Importante salientar que os professores da EJA necessitam de uma capacitação contínua para trabalhar com o público de jovens e de adultos, uma vez que a maioria destes alunos procura a escola com expectativas de encontrar “a sua vez” no mercado de trabalho. Portanto, o professor precisa estar preparado para mediar um ensino eficiente e real para a EJA, pois, na era atual, diante de tantas tecnologias e de inúmeras informações, a escola precisa acompanhar os saberes diversificados dos novos tempos. Existem algumas limitações para se trabalhar na EJA, mas também há possibilidades... Um dos limites da EJA, segundo os professores entrevistados, é a violência no bairro, o que provoca o medo, a insegurança, o pânico, o estresse e até uma relativa desmotivação dos professores, pois muitos projetos são adiados devido aos constantes conflitos nos arredores e dependências da escola. Quanto às possibilidades destaca-se a gestão compartilhada e a coesão da equipe, o que favorece uma práxis pedagógica mais eficiente e compromissada em prol dos estudantes da EJA.The present Project of Local Intervention, that has bibliographic character and of field study, aimed to know the reality of work of Educação de Jovens e Adultos’ teachers, delimited to Escola Municipal Ipanema, in Valparaíso de Goiás. Based on this intervention, we recognize the importance of having a harmonious and cohesive school, in which the professionals develop actions that make the school environment more interesting and motivating and, consequently, promote the quality of teaching of EJA. This local intervention is justified in the analysis of the limits and the possibilities of EJA’s teachers and of the school in which their pedagogical know-how is built up. Also, we intended to aware teachers about the relevance of EJA to the students and this action requires significant curriculum and specific programs, which improve even more education optimization. It is important to highlight that EJA’s teachers need a continuous training to teach the youth and adults, since most of them look for the school expecting to find “their turn” in the job market. Thus, teachers need to be prepared to mediate an efficient and a real teaching to these ones, for in the current era, with so many technologies and innumerous sort of information, the school must follow the diversified knowledges of the modern time. There are some limitations to work with the adult and youth education, but there are also many possibilities. One of the EJA’s limits, according to the teachers interviewed, is the violence in the neighborhood where the students live on, that causes fear, insecurity, panic, stress and even relative teachers’ demotivation, because many projects are postponed due to constant conflicts in surrounding areas and inside the school. Concerning to the possibilities, the most important ones are de shared management and the team cohesion, which favors a more efficient and committed pedagogical praxis, so that EJA students’ can be helped

Comparação dos efeitos da ventilação mecânica não invasiva contínua e intermitente sobre parâmetros cardiorrespiratórios e modulação autonômica de indivíduos saudáveis

Modelo do estudo: Estudo transversal. Objetivo: Avaliar a influência da Ventilação Mecânica não Invasiva (VMNI) de forma contínua e intermitente sobre a modulação autonômica cardíaca e parâmetros cardiorrespiratórios em mulheres saudáveis. Métodos: Vinte voluntárias realizaram duas modalidades de VMNI: contínua por meio do CPAP e intermitente por meio do Reanimador de Muller. Inicialmente permaneceram em repouso em respiração espontânea por 20 minutos. Em seguida foram submetidas a 20 minutos de aplicação de VMNI com a técnica selecionada e por fim permaneceram 20 minutos em repouso em respiração espontânea. Os parâmetros cardiorrespiratórios e variabilidade da frequência cardíaca (VFC) foram mensurados em todos estes momentos. Resultados: Não houve diferenças significantes quando comparadas as duas técnicas. Observaram-se diferenças nos parâmetros cardiorrespiratórios e VFC quando analisadas individualmente. Menores valores de frequência cardíaca e frequência respiratória foram observados na modalidade contínua quando comparado os valores durante a ventilação com respiração espontânea (p<0,005). Em ambas técnicas observaram-se aumentos significantes de SpO2 durante a ventilação em comparação a respiração espontânea. Observou-se aumento da modulação parassimpática (RMSSD, HF ms2 e SD1) e da variabilidade global (SDNN, RR triangular e SD2) em ambas as técnicas quando comparado ventilação e respiração espontânea (p<0,005). Conclusão: Não houve diferença quando comparadas as duas modalidades de VMNI. Contudo, quando analisadas individualmente observam-se comportamento diferentes dos parâmetros cardiorrespiratórios e na modulação autonômicaStudy design: Cross-sectional study. Objective: To evaluate the influence of continuous and intermittent noninvasive mechanical ventilation (NIV) on cardiac autonomic modulation and cardiorespiratory parameters in healthy women. Methods: Twenty subjects performed two types of NIV: continuous through CPAP and intermittent through Müller Reanimator. Initially they remained at rest for 20 minutes in spontaneous breathing. Then volunteers were subjected to 20 minutes of NIV application with the selected technique and finally remained at rest for 20 minutes in spontaneous breathing. Cardiorespiratory parameters and heart rate variability (HRV) were measured in all these moments. Results: There were no significant differences when comparing the two techniques. Differences were observed in HRV and cardiorespiratory parameters when analyzed individually. Lower values of heart rate and respiratory rate were observed in continuous ventilation when compared to values during ventilation with spontaneous breathing (p <0.005). In both techniques we observed significant increases in SpO2 during ventilation compared to spontaneous breathing. We observed an increase in parasympathetic modulation (RMSSD, HF ms2 and SD1) and overall variability (SDNN, RR triangular and SD2) in both techniques when compared ventilation to spontaneous breathing (p <0.005). Conclusion: There was no difference comparing the two types of NIV. However, when analyzed individually we observe different behavior of cardiorespiratory parameters and autonomic modulatio

Comparison of hemodynamic responses between conventional and virtual reality therapies in patients with heart failure admitted to an emergency room

This study aimed to evaluate and to compare the acute response, due to semi-immersive virtual reality (VR) and conventional therapies (CT), of hemodynamic parameters in hospitalized individuals admitted to an emergency unity for heart failure (HF). This is a viability study with 11 individuals subjected to sessions with and without VR. At CT, stretching, active or active-assisted exercises, and fractional inspiration were performed. In VR therapy (VRT), VR box glasses were used to promote VR relaxation associated with CT. The hemodynamic parameters evaluated were heart rate, systolic and diastolic blood pressure, oxygen saturation, and double product. To analyze them, Student’s t- and Mann Whitney tests were used (p\u3c0.05). Comparing baseline and final evaluations showed no significant differences in the hemodynamic parameters of both groups (p\u3e0.05). Comparing absolute variations between CT and VRT also produced no significant differences between hemodynamic responses (p\u3e0.05). Results showed that administering VRT and CT promoted physiological changes in the responses of hemodynamic parameters in individuals with HF hospitalized in an emergency unit without significant differences between the two interventions. This study suggests that VRT is a hemodynamically safe method for treating patients in emergency units

Problems with adherence to treatment among adolescents with diabetes mellitus type 1

Introduction: Diabetes Mellitus type 1 (DM1) is a chronic degenerative disease with high impact on the lives of children and adolescents. The DM1 affects mainly children and young adults under 30 years old, with a predominance from 10 to 14 years old. As a chronic disease, involves changes in daily habits, being following the recommendations of health professionals one of the main conducts to achieve such changes, however, this follow-up is not easy and can directly infl uence the glycemic control and lead to complications. Objective: Identify the diffi culties of adolescent with DM1 to treatment adherence. The recommendations of this treatment are related to the blood glucose measurements, using a diet plan and insulin application. Methods: The study included 15 adolescent with DM1, of both genders, aged 10-19 years participating in a multidisciplinary group at an outpatient unit in São Paulo, Brazil, aged 13,93 ± 2.4 years, diagnosed with DM1 with an average time of 4.5 years. The following evaluations were employed:1) individual interviews for identifi cation and clinical characterization; 2) characterization of cardiovascular and metabolic parameters; 2) anthropometric assessment and 4) application of a questionnaire with questions about problems of blood glucose measurements, diet plan and insulin application. Data collection was performed before medical appointment with an endocrinologist in a hospital in São Paulo state. Results: The identifi ed diffi culties and cardio-metabolic variables showed the adolescents presented uncontrolled blood glucose levels, doing the rotation of insulin incompletely and face many daily diffi -culties to perform the appropriate treatment, being the most frequently reported the insulin application and proper nutrition. Conclusion: Adolescents with type 1 diabetes presented diffi culties in adherence to treatment, mainly o follow insulin treatment and proposals for changes in eating habits by following a diet. It is necessary that health professionals offer strategies and orientation to these individuals to improve the handling of their diffi culties that directly affect the course of the disease and leave them more susceptible to developing complications

Riding the Reciprocal Teaching Bus A teacher’s reflections on nurturing collaborative learning in a school culture obsessed by results

This article examines the author’s interactions with the teaching strategy known as Reciprocal Teaching, sometimes also called Reciprocal Reading, which involves students learning to read collaboratively in small groups. Reciprocal Teaching typically involves students teaching each other by following a rubric of activities that are aimed at primarily improving their comprehension skills. In brief, students read a text in a group and collectively try to understand it, using prescribed procedures. This article scrutinises the original research by Palinscar and Brown (1984) which created the strategy and questions some of its claims. While many other investigations into Reciprocal Teaching have aimed to prove or disprove its efficacy, this enquiry studies the discourses which inform the strategy, arguing that there are problems with its presentation in the original article which have affected subsequent representations of Reciprocal Teaching. The article shows how the author, an English teacher in a large secondary school, taught Reciprocal Teaching to teenagers for a year and argues that the presentation of Reciprocal Teaching he read in a well-regarded teaching handbook caused him to deploy Reciprocal Teaching problematically. It was only when he taught Reciprocal Teaching in a more imaginative fashion that he found greater success

Consumption, nicotine dependence and motivation for smoke cessation during early stages of COVID-19 pandemic in Brazil: A cross-sectional study

Introduction: The COVID-19 pandemic may have changed smoking habits. For the smoking population, information regarding smoking habits and the pandemic could potentially aid COVID-19 prevention and control measures. Our study aimed to analyze the effects of the COVID-19 pandemic on tobacco consumption, nicotine dependence levels, and motivation for smoking cessation. We also collected information from smokers regarding their awareness of the consequences of tobacco use and the increased risks smokers have for severe complications from COVID-19. Methods: In the survey for this observational cross-sectional study, 122 smokers responded to an online form. The participants provided general data about their smoking history, their smoking habits in the months of April and May 2020, and the effect of the pandemic on their smoking habits. They also completed a Fagerström test and were measured by the Wisconsin Smoking Withdrawal Scale. Results:When compared to pre-pandemic levels, the majority of smokers reported increased tobacco consumption of between 1 and 10 cigarettes per day (37.7%). Their motivation to quit smoking (59.8%) and desire to smoke (53.2%) were unchanged by the pandemic. Most participants demonstrated an awareness of the increased risks smokers have for severe COVID-19-related complications (p Conclusions: Most smokers are well aware of their increased risks for severe COVID- 19-related complications. In the early stages of the COVID-19 pandemic in Brazil, most smokers reported increased cigarette consumption. In addition, motivation to quit and desire to smoke were unchanged for the majority of smokers

ANÁLISE DO EQUILÍBRIO EM PACIENTES HEMIPARÉTICOS COM INTERVENÇÃO DA REABILITAÇÃO EQUESTRE

O objetivo desta pesquisa foi analisar através da Escala Funcional de Equilíbrio de Berg e SF- 36, a influência da reabilitação equestre no tratamento dos distúrbios do equilíbrio em pacientes hemiplégicos. Tratou-se de um relato de casos realizado no Centro de Reabilitação Equestre da UNOESTE, onde foram avaliados 3 indivíduos hemiplégicos com distúrbios de equilíbrio, antes e após 8 sessões de equoterapia, seguindo um mesmo protocolo de tratamento. Os resultados mostraram que houve uma melhora de 7,14% no indivíduo 1, representando 4 pontos do total da escala. O indivíduo 2 manteve-se dentro do nível de corte não podendo classificá-lo com déficit de equilíbrio significativo e o indivíduo 3 permaneceu abaixo do nível de corte como na avaliação inicial. A reabilitação equestre mostrou-se relevante no tratamento de distúrbios de equilíbrio em pacientes hemiplégicos