Epistatic Relationships between sarA and agr in Staphylococcus aureus Biofilm Formation

Background: The accessory gene regulator (agr) and staphylococcal accessory regulator (sarA) play opposing roles in Staphylococcus aureus biofilm formation. There is mounting evidence to suggest that these opposing roles are therapeutically relevant in that mutation of agr results in increased biofilm formation and decreased antibiotic susceptibility while mutation of sarA has the opposite effect. To the extent that induction of agr or inhibition of sarA could potentially be used to limit biofilm formation, this makes it important to understand the epistatic relationships between these two loci. Methodology/Principal Findings: We generated isogenic sarA and agr mutants in clinical isolates of S. aureus and assessed the relative impact on biofilm formation. Mutation of agr resulted in an increased capacity to forma biofilmin the 8325-4 laboratory strain RN6390 but had little impact in clinical isolates S. aureus. In contrast, mutation of sarA resulted in a reduced capacity to form a biofilm in all clinical isolates irrespective of the functional status of agr. This suggests that the regulatory role of sarA in biofilm formation is independent of the interaction between sarA and agr and that sarA is epistatic to agr in this context. This was confirmed by demonstrating that restoration of sarA function restored the ability to form a biofilm even in the corresponding agr mutants. Mutation of sarA in clinical isolates also resulted in increased production of extracellular proteases and extracellular nucleases, both of which contributed to the biofilm-deficient phenotype of sarA mutants. However, studies comparing different strains with and without proteases inhibitors and/or mutation of the nuclease genes demonstrated that the agr-independent, sarA-mediated repression of extracellular proteases plays a primary role in this regard. Conclusions and Significance: The results we report suggest that inhibitors of sarA-mediated regulation could be used to limit biofilm formation in S. aureus and that the efficacy of such inhibitors would not be limited by spontaneous mutation of agr in the human host

Depressão em idosos portadores de insuficiência renal crônica em tratamento hemodialítico Depresión en personas ancianas con insuficiencia renal crónica en tratamiento de hemodiálisis Depression in the elderly on hemodialysis for chronic renal failure

OBJETIVOS: Caracterizar idosos com insuficiência renal crônica submetidos à hemodiálise em um hospital escola e identificar níveis de depressão na população estudada. MÉTODOS: Trata-se de uma pesquisa descritiva - exploratória, de natureza quantitativa utilizando a Geriatric Depression Scale (GDS) e questionário de caracterização populacional, sendo entrevistados 61 pacientes. Na análise dos dados foi utilizado método quantitativo progressivo (porcentagem) e correlação de Spearmann. RESULTADOS: A média de idade foi de 69,97±7,51 anos, 57% eram do sexo masculino, 79% de cor branca, 72% eram casados, sendo 26% analfabetos. A média de respostas depressivas foi 10,43±4,37, o que sugere humor normal-levemente deprimido na população em geral. CONCLUSÃO: Houve correlação estatisticamente significativa entre renda mensal familiar e escolaridade (valor p=0, 004) e escore GDS e analfabetismo (p=0,028), mostrando que os analfabetos apresentaram mais respostas depressivas, sugerindo menor capacidade de adaptabilidade/resiliência desses indivíduos à doença e suas implicações.<br>OBJETIVOS: Caracterizar a personas ancianas con insuficiencia renal crónica sometidos a hemodiálisis en un hospital docente e identificar niveles de depresión en la población estudiada. MÉTODOS: Se trata de una investigación descriptiva - exploratoria, de naturaleza cuantitativa en la cual se utilizó la Geriatric Depression Scale (GDS) y el cuestionario de caracterización poblacional, siendo entrevistados 61 pacientes. En el análisis de los datos se utilizó el método cuantitativo progresivo (porcentaje) y la correlación de Spearmann. RESULTADOS: El promedio de edad fue de 69,97±7,51 años, el 57% era del sexo masculino, el 79% de raza blanca, el 72% era casado, siendo el 26% analfabetos. El promedio de respuestas depresivas fue 10,43±4,37, lo que sugiere humor normal-levemente deprimido en la población en general. CONCLUSIÓN: Hubo correlación estadísticamente significativa entre el ingreso mensual familiar y la escolaridad (valor p=0, 004) y escore GDS y analfabetismo (p=0,028), mostrando que los analfabetos presentaron más respuestas depresivas, sugiriendo menor capacidad de adaptabilidad/resiliencia de esas personas a la enfermedad y sus implicancias.<br>OBJECTIVES: This study aimed to characterize the elderly on hemodialysis for chronic renal failure in a teaching hospital and to describe their levels of depression. METHODS: This is a descriptive exploratory study with 61 patients. A socio-demographic questionnaire and the geriatric depression scale (GDS) were used to collect the data. Data analysis consisted of descriptive statistics and Spearman rho correlations. RESULTS: The mean age of patients was 69.97±7.51. The majority was white (79%), married (72%), and male (57%). Approximate a quarter of the patients (26%) were illiterate. The mean depression score was 10.43±4.37, suggesting the presence of normal to slightly depressive symptoms. CONCLUSIONS: There were statistically significant correlation coefficients between family monthly income and education (p value=0.004) and between depressive symptoms and illiteracy (p=0.028). This last finding indicates that the illiterate patients had more depressive symptoms, suggesting they have less adaptation capacity or resilience to cope with the disease and its implications

Diagnósticos de enfermagem em pacientes no período pós-operatório de cirurgias cardíacas

Objetivo: Identificar, em conjunto com enfermeiras de uma Unidade de Tratamento Intensivo Pós-Operatória Cardiológica, diagnósticos de enfermagem presentes em pacientes no período pós-operatório de cirurgias cardíacas, com vistas à futura implementação do processo de enfermagem nessa unidade. Métodos: Trata-se de um estudo qualitativo, ancorado na pesquisa convergente-assistencial. Os dados foram obtidos, nos registros de enfermagem de 20 pacientes submetidos à cirurgia cardíaca, no mês de abril de 2008, acrescidos da experiência profissional de seis enfermeiras participantes do grupo de convergência reunido durante cinco encontros. Resultados: Foram estabelecidos 15 diagnósticos, segundo a Taxonomia II da North American Nursing Diagnosis Association, corroborados por outros autores. Conclusão: Identificar diagnósticos de enfermagem comuns em pacientes no pós-operatório de cirurgias cardíacas permite um direcionamento da assistência de enfermagem e subsidia o estabelecimento de intervenções fundamentadas e adequadas às necessidades individuais apresentadas por esses pacientes.Objective: To identify - together with working nurses at a Postoperative Cardiac Intensive Care Unit - the nursing diagnoses of patients in the postoperative period of cardiac surgery, with the intention of, in the future, implement the nursing process on that unit. Methods: This is a qualitative study based on convergent-care research. Data were obtained from nursing records of 20 patients who underwent surgery in April 2008, plus the professional experience of six participating nurses from the convergence group who met for five sessions. Results: 15 diagnoses were established according to Taxonomy II of the North American Nursing Diagnosis Association, which were corroborated by other authors. Conclusion: The identification of standard nursing diagnoses, in postoperative cardiac surgery patients, can guide the nursing care and subsidize the development of interventions that have solid basis and are appropriate to individual needs that patients have.Objetivo: Identificar en conjunto con las enfermeras, de una Unidad de Tratamiento Intensivo Postoperatorio Cardiológico, los diagnósticos de enfermería realizados en pacientes en el período postoperatorio de cirugías cardíacas, con la finalidad de, futuramente, implementar el proceso de enfermería en esa unidad. Métodos: Se trata de un estudio cualitativo, basado en la investigación convergente-asistencial. Los datos fueron obtenidos de los registros de enfermería de 20 pacientes sometidos a cirugía cardíaca, en el mes de abril de 2008, acrecidos de la experiencia profesional de seis enfermeras participantes del grupo de convergencia que se reunió durante cinco encuentros. Resultados: Fueron establecidos 15 diagnósticos, según la Taxonomía II de la North American Nursing Diagnosis Association, corroborados por otros autores. Conclusión: La identificación de diagnósticos estándar de enfermería en pacientes en el postoperatorio de cirugías cardíacas permite orientar la asistencia de enfermería y subsidiar el establecimiento de intervenciones que tiene sólidas bases y son adecuadas a las necesidades individuales que tienen esos pacientes

Female entrepreneurship and management in the immigrants reception sector in Italy

The aim of this paper is to verify whether relational capital allows increasing the information inherent in the process of the network of female cooperative micro-enterprises. The focus on Italy is justified on the grounds that the phenomenon of immigration in Italy has become a central theme in the political and social debate. Based on the literature on the subject and on previous research results it is useful to ask the following research question: does the network affect the competitive advantage of female micro-enterprises operating in the field of immigrant reception in Italy? To gather data for our study, a qualitative research methodology was adopted using a case study approach based on examining in depth current events of real life (Yin in Case study research: design and methods. Sage Publications, Thousand Oaks, 2009). The survey has involved two enterprises, Formland and Altea, which are two out of the ten business realities committed to immigrants’ reception within the area of the Italian region Lazio. The first one is a female-run business, which includes eight reception centers scattered throughout the territory (four in the province of Frosinone, two in the province of Caserta and two in that of Naples), the second one is an entirely female-owned enterprise and counts around forty reception structures. The structure of the interviews reflects the need to examine the personal features of female managers, the organizational aspects and the style of leadership, the task environment in which the enterprise works and the main possible benefits, or obstacles, they might obtain, or face. The paper develops the CAOS model of micro-entrepreneurship, examining the personal characteristics of a female entrepreneur (C), the environment in which a micro-enterprise operates (A), organizational and managerial aspects (O) and the motivations for starting a new business (S). Using this model, the authors are able to correlate these factors, classify different types of connections, and to identify the kind of existing relationships. The analysis shows a predominant use of networks characterized by informal and permanent relationships, supporting the need to reconcile work and family and to involve relatives and friends in the network. This emphasizes the lack of strategy in the female-run micro-enterprises. Given that female management is regarded as central to the development and welfare of economies, deepening the knowledge of how women managers lead business can contribute to improving the effectiveness of policies aimed at promoting the participation of female managers in the economy