Palliative Cares To Older Person Under The Nurse's Optics

INTRODUCTION: Chronic-degenerative diseases need specialized health care, especially in palliative care, since from the beginning of the disease the elderly is in this classification. In this context, the study aimed to know the meaning of palliative care to the elderly person from the nurse METHODS: This is a descriptive, cross-sectional, qualitative study carried out in a private tertiary hospital in the Northeast of Brazil. The survey was conducted from March to June 2016, with 19 nurses. In the data collection, a semi-structured interview, with four questions were used: what does palliative care mean to you? What does care for the elderly in hospice care mean to you? What strategies do you adopt to promote palliative care for the elderly? Tell me about your experience in providing palliative care to the elderly. The technique of data analysis and organization was the Discourse of the Collective Subject. RESULTS: Four categories of palliative care were produced: meaning palliative care; Experience in providing palliative care to the elderly; Meaning of caring for the elderly in palliative care; Strategies to promote palliative care for the elderly. CONCLUSION: The meaning of palliative care was synonymous with comfort and quality of life. It is important to emphasize the patient-centered care and to carry out further studies on the subject to make nursing professionals aware of the importance of promoting adequate behavior in palliative care

Aedes fluviatilis cell lines as new tools to study metabolic and immune interactions in mosquito‑Wolbachia symbiosis

In the present work, we established two novel embryonic cell lines from the mosquito Aedes fluviatilis containing or not the naturally occurring symbiont bacteria Wolbachia, which were called wAflu1 and Aflu2, respectively. We also obtained wAflu1 without Wolbachia after tetracycline treatment, named wAflu1.tet. Morphofunctional characterization was performed to help elucidate the symbiont-host interaction in the context of energy metabolism regulation and molecular mechanisms of the immune responses involved. The presence of Wolbachia pipientis improves energy performance in A. fluviatilis cells; it affects the regulation of key energy sources such as lipids, proteins, and carbohydrates, making the distribution of actin more peripheral and with extensions that come into contact with neighboring cells. Additionally, innate immunity mechanisms were activated, showing that the wAflu1 and wAflu1.tet cells are responsive after the stimulus using Gram negative bacteria. Therefore, this work confirms the natural, mutually co-regulating symbiotic relationship between W. pipientis and A. fluviatilis, modulating the host metabolism and immune pathway activation. The results presented here add important resources to the current knowledge of Wolbachia-arthropod interactions

Perfil de conhecimento das mulheres quilombolas sobre o câncer de colo de útero no povoado Santana dos pretos / Knowledge profile of quilombola women about uterine cervical cancer in the village of Santana dos pretos

INTRODUÇÃO: O câncer de colo uterino (CCU) se destaca como uma das mais graves ameaças à vida das mulheres. As comunidades quilombolas vivenciam situações de extrema vulnerabilidade social, consequência das iniquidades nos fatores sociais, econômicos, políticos e de saúde, que irão refletir nos indicadores de saúde, desencadeando desigualdades raciais/de cor na utilização de serviços preventivos. OBJETIVO: Investigar o conhecimento das mulheres negras e quilombolas acerca do câncer de colo de útero (CCU) e formas de prevenção. MÉTODO: Estudo descritivo transversal, desenvolvido na comunidade Quilombola Santana dos Pretos, situa do      em Pinheiro, interior do estado do Maranhão. Participaram da pesquisa 80 mulheres, que se encaixaram nos critérios de inclusão estabelecidos. Para a coleta de dados foi utilizado questionário semi estruturado para levantamento de características sociodemográficas e relativas aos fatores de exposição ao CCU, e para avaliação do conhecimento um segundo instrumento com alternativas “verdadeiras ou falsas” foi aplicado. Os dados foram tabulados pelo programa Excel e analisados pelo Software Stata, versão 16. RESULTADOS: a maior parte das mulheres       continha 40-49 anos (22,5%), era casada (53,7%), parda (60%), com ensino fundamental completo (18,7%), trabalho relacionado a agricultura e pesca (51,2%), renda de até um salário mínimo (82,5%) e católicas (41,2%). As variáveis “último exame Papanicolau”, “recebimento de preventivo” e “número de gravidezes” associaram-se positivamente a realização do exame. O conhecimento foi considerado adequado em mais de 50% da amostra. CONSIDERAÇÕES FINAIS: Conclui- se que as mulheres quilombolas do povoado possuem conhecimento adequado em relação ao exame colpocitológico e os meios de prevenção contra o CCU

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Organization of Nursing work regarding the integration of family care for hospitalized children

Objective: to discuss the organization of Nursing technician’s work in the interface of the care of family members of hospitalized children and to identify their perception of the insertion of family in caring for this child. Methods: this is an exploratory descriptive study with a qualitative approach, undertaken in the pediatric inpatient unit of a university hospital with six Nursing technicians, through semi-structured interviews. Results: professionals realized the importance of the family’s presence for the child’s recovery; however, in basic care which was previously developed by Nursing, they were eventually delegated to be companions, with care for the child-family binomial forgotten by the professional. Conclusion: nursing technicians recognize the benefits and difficulties of the presence of a companion. However, it is perceived that there was a lack of professional preparation when considering the binomial of child-family during hospitalization