Effects of circadian disruption on physiology and pathology: from bench to clinic (and back)

Nested within the hypothalamus, the suprachiasmatic nuclei (SCN) represent a central biological clock that regulates daily and circadian (i.e., close to 24 h) rhythms in mammals. Besides the SCN, a number of peripheral oscillators throughout the body control local rhythms and are usually kept in pace by the central clock. In order to represent an adaptive value, circadian rhythms must be entrained by environmental signals or zeitgebers, the main one being the daily light?dark (LD) cycle. The SCN adopt a stable phase relationship with the LD cycle that, when challenged, results in abrupt or chronic changes in overt rhythms and, in turn, in physiological, behavioral, and metabolic variables. Changes in entrainment, both acute and chronic, may have severe consequences in human performance and pathological outcome. Indeed, animal models of desynchronization have become a useful tool to understand such changes and to evaluate potential treatments in human subjects. Here we review a number of alterations in circadian entrainment, including jet lag, social jet lag (i.e., desynchronization between body rhythms and normal time schedules), shift work, and exposure to nocturnal light, both in human subjects and in laboratory animals. Finally, we focus on the health consequences related to circadian/entrainment disorders and propose a number of approaches for the management of circadian desynchronization.Fil: Chiesa, Juan José. Universidad Nacional de Quilmes. Departamento de Ciencia y Tecnología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Duhart, José Manuel. Universidad Nacional de Quilmes. Departamento de Ciencia y Tecnología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Casiraghi, Leandro Pablo. Universidad Nacional de Quilmes. Departamento de Ciencia y Tecnología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Paladino, Natalia. Universidad Nacional de Quilmes. Departamento de Ciencia y Tecnología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Bussi, Ivana Leda. Universidad Nacional de Quilmes. Departamento de Ciencia y Tecnología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Golombek, Diego Andrés. Universidad Nacional de Quilmes. Departamento de Ciencia y Tecnología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Ancestral sleep.

While we do not yet understand all the functions of sleep, its critical role for normal physiology and behaviour is evident. Its amount and temporal pattern depend on species and condition. Humans sleep about a third of the day with the longest, consolidated episode during the night. The change in lifestyle from hunter-gatherers via agricultural communities to densely populated industrialized centres has certainly affected sleep, and a major concern in the medical community is the impact of insufficient sleep on health [1,2]. One of the causal mechanisms leading to insufficient sleep is altered exposure to the natural light-dark cycle. This includes the wide availability of electric light, attenuated exposure to daylight within buildings, and evening use of light-emitting devices, all of which decrease the strength of natural light-dark signals that entrain circadian systems [3]

Satisfação dos usuários com os cuidados dos enfermeiros

Objetivo: Avaliar a satisfação dos usuários com os cuidados dos enfermeiros.Métodos: Estudo transversal com abordagem quantitativa, realizado na clínica médica do Hospital Universitário da UFMA/HU/UFMA, com 150 usuários no período de outubro de 2013 a agosto de 2014, através de formulário de identificação e do Instrumento de Satisfação do Paciente. Na análise dos dados, utilizou-se o Teste t de Student, Kruskal-Wallis e Correlação Linear de Spearman.Resultados: Os usuários relataram alto nível de satisfação com todos os itens e domínios, sendo a maior média de satisfação relacionada ao domínio técnico-profissional, seguido do domínio confiança, resultando em consistência interna satisfatória em todos os domínios. As variáveis sexo e nível de escolaridade influenciaram positivamente na satisfação do paciente.Conclusão: Evidenciou-se que a satisfação dos usuários internados na clínica médica tem relação com as habilidades técnicas, com o conhecimento científico e com a individualização da assistência prestada pelos enfermeiros.Palavras-chave: Enfermagem. Satisfação do paciente. Hospitalização

The politics of the new history school textbooks in the Russian Federation

The chapter examines the ideologically articulated shifts, the images of transformation, and the nation-building process presented in the new generation of school history textbooks in Russia. It analyzes the new content of postSoviet history textbooks used in Russian secondary schools that represents various transformations from communism to a Western-style democracy. It discusses the resultant issues of searching for a new national identity and citizenship during the present transitional period. It critiques the new versions of Russia’s postSoviet history taught in schools, and evaluates their officially defined status as instruments in the Russian process of ideological transformation, and nation-building, currently closely monitored by the state. In other countries, including Australia, these processes are still present but in less formal and more ad hoc ways

The effect of sunlight exposure on interleukin-6 levels in depressive and non-depressive subjects

Background: The objective of this epidemiological study was to evaluate the effect of length of sunlight exposure on interleukin 6 (IL-6) levels in depressive and non-depressive subjects. Methods: This was a cross-sectional study with 154 subjects (54 males, mean age: 43.5 ± 12.8 years) who were living in a rural area in south Brazil. Chronobiological and light parameters were assessed using the Munich Chronotype Questionnaire. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index. Depressive symptoms were assessed with the Beck Depression Inventory. Plasma levels of inflammatory cytokines (IL-2, IL-4, IL-6, IL-10, tumor necrosis factor-α, and interferon) were collected during the daytime and measured. Results: IL-6 levels showed a positive correlation with light exposure (r = 0.257; p < 0.001) and a negative correlation with the mid-sleep phase on work-free days (r = −0.177; p = 0.028). Multiple linear regression analysis showed that only the length of light exposure was an independent factor for predicting IL-6 levels (ß = 0.26; p = 0.002). In non-depressed subjects, exposure to a different intensity of light did not affect IL-6 levels (t = −1.6; p = 0.1). However, when the two depressive groups with low and high light exposure were compared, the low light exposure group had lower levels of IL-6 compared with the high light exposure group (t = −2.19 and p = 0.0037). Conclusions: The amount of time that participants are exposed to sunlight is directly related to their IL-6 levels. Additionally, depressed subjects differ in their IL-6 levels if they are exposed to light for differing amounts of time