A equipe de enfermagem e a comunicação com o paciente traqueostomizado

OBJETIVO: identificar as percepções da equipe de enfermagem acerca da importância da comunicação no cuidado ao paciente traqueostomizado, de modo a auxiliá-lo na sua recuperação. MÉTODOS: estudo de abordagem quantitativa e qualitativa. A amostra do estudo foi constituída por 51 integrantes da equipe de enfermagem (auxiliares de enfermagem, técnicos e enfermeiros), das Clínicas Médica Feminina e Masculina, Centro de Terapia Semi-Intensiva e Intensiva Adulto, e Neurocirurgia, de um hospital de ensino em Curitiba/PR. As informações foram coletadas por meio de questionário com questões fechadas e abertas. Na associação entre variáveis quantitativas foram considerados o teste Qui-Quadrado, valores de p < 0,05 indicaram significância estatística, os dados qualitativos foram submetidos à proposta de análise de conteúdo. RESULTADOS: os dados mostram que os participantes têm vivências variadas em sua área de atuação e constatam na sua prática cotidiana a necessidade e a importância da interação com o paciente traqueostomizado para sua recuperação. Os resultados apontam que os Auxiliares e Técnicos, desenvolvem mais orientações do que o enfermeiro (p=0,028). CONCLUSÃO: evidenciou-se no estudo que na impossibilidade de comunicação verbal pelo paciente, os participantes do estudo se utilizam de estratégias diferenciadas de comunicação, como gestos, sinalização e comunicação escrita

First report of field evolved resistance to agrochemicals in dengue mosquito, Aedes albopictus (Diptera: Culicidae), from Pakistan

<p>Abstract</p> <p>Background</p> <p>Agrochemicals have been widely used in Pakistan for several years. This exposes mosquito populations, particularly those present around agricultural settings, to an intense selection pressure for insecticide resistance. The aim of the present study was to investigate the toxicity of representative agrochemicals against various populations of <it>Aedes albopictus </it>(Skuse) collected from three different regions from 2008-2010.</p> <p>Results</p> <p>For organophosphates and pyrethroids, the resistance ratios compared with susceptible Lab-PK were in the range of 157-266 fold for chlorpyrifos, 24-52 fold for profenofos, 41-71 fold for triazofos, and 15-26 fold for cypermethrin, 15-53 fold for deltamethrin and 21-58 fold for lambdacyhalothrin. The resistance ratios for carbamates and new insecticides were in the range of 13-22 fold for methomyl, 24-30 fold for thiodicarb, and 41-101 fold for indoxacarb, 14-27 fold for emamectin benzoate and 23-50 fold for spinosad. Pair wise comparisons of the log LC_50sof insecticides revealed correlation among several insecticides, suggesting a possible cross resistance mechanism. Moreover, resistance remained stable across 3 years, suggesting field selection for general fitness had also taken place for various populations of <it>Ae. albopictus</it>.</p> <p>Conclusion</p> <p>Moderate to high level of resistance to agrochemicals in Pakistani field populations of <it>Ae. albopictus </it>is reported here first time. The geographic extent of resistance is unknown but, if widespread, may lead to problems in future vector control.</p

A Genome Scan for Positive Selection in Thoroughbred Horses

Thoroughbred horses have been selected for exceptional racing performance resulting in system-wide structural and functional adaptations contributing to elite athletic phenotypes. Because selection has been recent and intense in a closed population that stems from a small number of founder animals Thoroughbreds represent a unique population within which to identify genomic contributions to exercise-related traits. Employing a population genetics-based hitchhiking mapping approach we performed a genome scan using 394 autosomal and X chromosome microsatellite loci and identified positively selected loci in the extreme tail-ends of the empirical distributions for (1) deviations from expected heterozygosity (Ewens-Watterson test) in Thoroughbred (n = 112) and (2) global differentiation among four geographically diverse horse populations (FST). We found positively selected genomic regions in Thoroughbred enriched for phosphoinositide-mediated signalling (3.2-fold enrichment; P<0.01), insulin receptor signalling (5.0-fold enrichment; P<0.01) and lipid transport (2.2-fold enrichment; P<0.05) genes. We found a significant overrepresentation of sarcoglycan complex (11.1-fold enrichment; P<0.05) and focal adhesion pathway (1.9-fold enrichment; P<0.01) genes highlighting the role for muscle strength and integrity in the Thoroughbred athletic phenotype. We report for the first time candidate athletic-performance genes within regions targeted by selection in Thoroughbred horses that are principally responsible for fatty acid oxidation, increased insulin sensitivity and muscle strength: ACSS1 (acyl-CoA synthetase short-chain family member 1), ACTA1 (actin, alpha 1, skeletal muscle), ACTN2 (actinin, alpha 2), ADHFE1 (alcohol dehydrogenase, iron containing, 1), MTFR1 (mitochondrial fission regulator 1), PDK4 (pyruvate dehydrogenase kinase, isozyme 4) and TNC (tenascin C). Understanding the genetic basis for exercise adaptation will be crucial for the identification of genes within the complex molecular networks underlying obesity and its consequential pathologies, such as type 2 diabetes. Therefore, we propose Thoroughbred as a novel in vivo large animal model for understanding molecular protection against metabolic disease

Observation of a New Excited Beauty Strange Baryon Decaying to Ξb- π+π-

The Ξb-π+π- invariant mass spectrum is investigated with an event sample of proton-proton collisions at s=13 TeV, collected by the CMS experiment at the LHC in 2016-2018 and corresponding to an integrated luminosity of 140 fb-1. The ground state Ξb- is reconstructed via its decays to J/ψΞ- and J/ψΛK-. A narrow resonance, labeled Ξb(6100)-, is observed at a Ξb-π+π- invariant mass of 6100.3±0.2(stat)±0.1(syst)±0.6(Ξb-) MeV, where the last uncertainty reflects the precision of the Ξb- baryon mass. The upper limit on the Ξb(6100)- natural width is determined to be 1.9 MeV at 95% confidence level. The low Ξb(6100)- signal yield observed in data does not allow a measurement of the quantum numbers of the new state. However, following analogies with the established excited Ξc baryon states, the new Ξb(6100)- resonance and its decay sequence are consistent with the orbitally excited Ξb- baryon, with spin and parity quantum numbers JP=3/2-