Neuroversion: a possible mechanism of action of ECT in acute mania

The first-line treatments for acute mania are lithium, antiepileptic moodstabilizers, and antipsychotic drugs. Electroconvulsive therapy (ECT) is reserved for drug-resistant patients, although it is the first-line treatment for severe or delirious mania with life-threatening physical exhaustion. Contrary to depression, there is a paucity of evidence for the use of ECT in acute mania. However, available literature indicates that ECT seems effective in treating acute mania, with response rates between 80% and 90%, even in drug-resistant patients. Yet, its electrophysiological and molecular pathways remain unknown. We present the curious case of a 63-year-old woman, followed at our psychiatric outpatient clinic for bipolar disorder type I, admitted to our inpatient unit in a manic state with psychotic features. Due to bradycardia episodes secondary to the psychiatric medication, she was submitted to ECT. After a single session, her symptoms improved, despite no evoked seizures. We compare this curious phenomenon to the well-known procedure of cardioversion and name it neuroversion e in other words, a possible normalization of brain activity and behavior triggered by a unique session of electrical stimulation. However, we acknowledge that further research, including randomized clinical trials, are needed to study this reported event.info:eu-repo/semantics/publishedVersio

"As long as they eat"? Therapist experiences, dilemmas and identity negotiations of Maudsley and family-based therapy for anorexia nervosa

Background: Maudsley Family Therapy and its manualised version Family-Based Therapy for Anorexia Nervosa (FBT-AN) have accrued the most significant research evidence-base for the treatment of adolescent Anorexia Nervosa (AN). A tradition of seeking augmentations for this treatment has also been established to enhance efficacy. There exists, however, a gap in the uptake of this form of manualised treatment into the “real world” of clinicians who work with adolescent AN. Aims: This research study investigated the key experiences and identity negotiations of a group of nine Australian clinicians who were interested in contributing to research into ways that Maudsley and FBT-AN might be improved. Methods: Nine clinicians, who at the time of the interview practised or had previously practised, FBT-AN participated in a semi-structured interview. A critical discursive analysis of interview transcripts generated a thematic map of these therapists’ experiences and identity negotiations in their practice of FBT-AN. Results: These therapists experienced the structure of FBT-AN as both a secure map for therapy, yet also constraining at times, in their work with adolescents and their families. Additionally, their professional identities were both invested and troubled by the identity position of themselves as evidence-based practitioners, particularly where evidence-based practice (EBP) meant strict fidelity to the manual and restrained them from tailoring a broader range of therapeutic interventions to an individual adolescent and their family. Within their narratives, these therapists refashioned alternative identity positions around what it meant to be an evidence-based practitioner through listening to and drawing on their clinical expertise of what works in therapeutic practice with an individual adolescent and their family. Conclusions: These therapists narratives highlight the power of the dominant discourse of EBP that works to privilege the research evidence over other forms of evidence that include clinician expertise and client preferences. The dilemmas faced by these therapists questioned not only the strict application of FBT-AN for adolescent AN across diverse therapeutic contexts, but also the effects of supervisory practices that paralleled this strict fidelity to the model. Further research is needed into therapeutic interventions and supervisory practices that give greater scope for clinicians to draw on their expertise in the flexible tailoring of treatments to the unique needs and preferences of the individual adolescent and their family

Humanização e voluntariado hospitalar: um estudo de caso

O trabalho que se apresenta tem como propósito compreender a prática do voluntariado hospitalar, a noção de humanização no hospital e a forma como estes dois temas se entrecruzam, partindo dos significados e percepções atribuídos por alguns voluntários e coordenadores de voluntariado. Para dar cumprimento ao que se propõe, realizou-se um estudo de caso tendo sido realizadas entrevistas a alguns membros do Corpo de Voluntariado da Liga de Amigos do Hospital Garcia de Orta e procedeu-se à pesquisa e análise de vários documentos. Os resultados obtidos demonstram que o conceito de humanização hospitalar se relaciona com o voluntariado praticado nos hospitais. O trabalho dos voluntários centra-se, principalmente, em actuações do foro humano, afectivo e emocional, beneficiando não só os utentes como os profissionais de saúde. Assim, é valorizada a componente de diferenciação dos voluntários ao enaltecerem e contribuírem para a humanização hospitalar, evidenciando-se o facto de que a gestão dos hospitais tem de ter como um dos focos principais o bem-estar dos utentes.The purpose of this work is to understand the practice of volunteering in hospitals, the concept of hospital humanization and how these two subjects are related to each other. It has as a starting point the meanings and perceptions of some volunteers and volunteering coordinators. To achieve these goals, a study case has been applied. A few members of the Volunteering Body of Liga de Amigos do Hospital Garcia de Orta have been interviewed and several documents were researched and analyzed. The results show that the hospital humanization concept relates to volunteering in hospitals. The work of volunteers has its focal point, mainly, in human, affective and emotional activities that not only benefits hospital users but also health professionals. Therefore, the differentiation aspect of volunteers is valued by giving emphasis and contribution to hospital humanization and it is also highlighted the fact that hospital management ought to focus on the hospital users’ well-being

Análisis DAFO de herramientas tecnológicas para el área de Música

El objetivo de este trabajo es realizar una comparación crítica de tres herramientas tecnológicas disponibles en el mercado para facilitar la posterior toma de decisiones respecto a la elección y uso futuro en el aula de Música. Tras su utilización en una clase del Máster de Profesor/a en Educación Secundaria compuesta por 42 alumnos titulados superiores en Música, se ha realizado un análisis DAFO. Los resultados muestran que los tres programas promueven el aprendizaje de contenidos musicales a través de las TIC,favoreciendo el aprendizaje musical significativo por la motivación y la proximidad al alumnado

ADOÇÃO DE PRINCÍPIOS DE BOA GOVERNANÇA NA PREVIDÊNCIA SOCIAL DO BRASIL: CONHECENDO AS DIRETRIZES DA ISSA

O presente estudo tem como objetivo apresentar como as diretrizes da International Social Security Association (ISSA) podem promover a adoção de princípios de boa governança na previdência social do Brasil. A partir da análise e dos propósitos do ISSA Guidelines for Social Security Administration (2013) e do Caderno de Governança Corporativa (2015), divulgado pelo Ministério da Previdência Social do Brasil, verificou-se que a ISSA coleta e compartilha boas práticas das organizações de previdência social, apoiando administrativamente as atividades das suas instituições-membro de seguridade social, e que todas as diretrizes da ISSA podem ser relacionadas com os direcionadores estratégicos do caderno desenvolvido pelo Governo brasileiro. Desta forma, os achados da pesquisa permitem inferir que o guia da ISSA pode se apresentar como um importante instrumento para o fortalecimento da previdência social brasileira

A importância do pensamento lógico para o cuidado clínico de enfermagem

Objetivo: Apresentar uma reflexão sobre a importância do pensamento lógico para o cuidado clínico de enfermagem.Método: Estudo de reflexão.Reflexão: Pensar em exercer o cuidado clínico eficaz remete à necessidade de um pensamento lógico e raciocínio adequado para a realização de práticas de enfermagem seguras e eficazes. Para tanto, considera-se inquestionável a formação baseada nos princípios filosóficos que estimulem o incremento do pensamento lógico e crítico, assegurando aos profissionais a sistematização da assistência com aplicação do processo de enfermagem a partir do entendimento científico e argumentos sólidos abalizados pelo caminho da verdade, moral, ética e autocrítica, de forma a favorecer a valorização das práticas clínicas.Considerações finais: Ratifica-se a importância do pensamento lógico para o cuidado de enfermagem fundamentando a Sistematização da Assistência de Enfermagem e as etapas do Processo de Enfermagem. Desta forma, o enfermeiro pode fazer uso do raciocínio clínico propiciando uma atuação profissional humana, ética e eficaz. Palavras-chave: Enfermagem. Lógica. Tomada de decisão clínica

Hexachlorobenzene promotes angiogenesis in vivo, in a breast cancer model and neovasculogenesis in vitro, in the human microvascular endothelial cell line HMEC-1

Exposure to environmental pollutants may alter proangiogenic ability and promotes tumor growth. Hexachlorobenzene (HCB) is an organochlorine pesticide found in maternal milk and in lipid foods, and a weak ligand of the aryl hydrocarbon receptor (AhR). HCB induces migration and invasion in human breast cancer cells, as well as tumor growth and metastasis in vivo. In this study, we examined HCB action on angiogenesis in mammary carcinogenesis. HCB stimulates angiogenesis and increases vascular endothelial growth factor (VEGF) expression in a xenograft model with the human breast cancer cell line MDA-MB-231. Human microvascular endothelial cells HMEC-1 exposed to HCB (0.005, 0.05, 0.5 and 5 μM) showed an increase in cyclooxygenase-2 (COX-2) and VEGF protein expression involving AhR. In addition, we found that HCB enhances VEGF-Receptor 2 (VEGFR2) expression, and activates its downstream pathways p38 and ERK1/2. HCB induces cell migration and neovasculogenesis in a dose-dependent manner. Cells pretreatment with AhR, COX-2 and VEGFR2 selective inhibitors, suppressed these effects. In conclusion, our results show that HCB promotes angiogenesis in vivo and in vitro. HCB-induced cell migration and tubulogenesis are mediated by AhR, COX-2 and VEGFR2 in HMEC-1. These findings may help to understand the association among HCB exposure, angiogenesis and mammary carcinogenesis.Fil: Pontillo, Carolina Andrea. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Bioquímica Humana; ArgentinaFil: Español, Alejandro Javier. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos; Argentina. Universidad de Buenos Aires. Facultad de Medicina; ArgentinaFil: Chiappini, Florencia Ana. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Bioquímica Humana; Argentina. Universidad de Buenos Aires. Facultad de Medicina; ArgentinaFil: Miret, Noelia Victoria. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Bioquímica Humana; ArgentinaFil: Cocca, Claudia Marcela. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Físico Matemática; ArgentinaFil: Alvarez, Laura. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Bioquímica Humana; ArgentinaFil: Kleiman, Diana Leonor. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Bioquímica Humana; ArgentinaFil: Sales, Maria Elena. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos; Argentina. Universidad de Buenos Aires. Facultad de Medicina; ArgentinaFil: Randi, Andrea Silvana. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Bioquímica Humana; Argentin

Uso da tecnologia Blockchain como instrumento de governança eletrônica no setor público

A partir da década de 1990, na era New Public Management, o Estado procurou dar mais eficiência as suas atividades. Neste processo de busca por eficiência, as tecnologias de informação e comunicação foram ganhando cada vez mais espaço na administração pública, principalmente por proporcionar ganho de eficiência e qualidade as atividades públicas. A grande aposta tecnológica do século é a tecnologia blockchain, que segundo Mettler (2016), está gerando expectativas altas e otimismo que raramente foi visto, tendo seu impacto tecnológico comparado à invenção da roda, do motor a vapor ou da Internet. Neste sentido, o presente trabalho apresenta-se como um ensaio teórico sobre os potenciais benefícios da tecnologia blockchain para a governança eletrônica no setor público, tendo por objetivo apresentar os achados da literatura sobre a governança eletrônica no setor público e a tecnologia blockchain e analisar o uso da tecnologia blockchain como instrumento de governança eletrônica no setor público.From the 1990s, in the New Public Management age, the state sought to make its activities more efficient. In this process of searching for efficiency, information and communication technologies have been gaining more and more space in public administration, mainly for providing efficiency gains and quality public activities. The big technological bet of the century is blockchain technology, which according to Mettler (2016), is generating high expectations and optimism that has rarely been seen, having its technological impact compared to the invention of the wheel, the steam engine or the Internet. In this sense, the present paper is presented as a theoretical essay about the potential benefits of blockchain technology for electronic governance in the public sector, aiming to present the findings of the literature on electronic governance in the public sector and blockchain technology and analyse the use of blockchain technology as an instrument of electronic governance in the public sector

Antioxidant and anti-inflammatory extracts from sea cucumbers and tunicates induce a pro-osteogenic effect in Zebrafish Larvae

Bone metabolic disorders such as osteoporosis are characterized by the loss of mineral from the bone tissue leading to its structural weakening and increased susceptibility to fractures. A growing body of evidence suggests that inflammation and oxidative stress play an important role in the pathophysiological processes involved in the rise of these conditions. As the currently available therapeutic strategies are often characterized by toxic effects associated with their long-term use, natural antioxidants and anti-inflammatory compounds such as polyphenols promise to be a valuable alternative for the prevention and treatment of these disorders. In this scope, the marine environment is becoming an important source of bioactive compounds with potential pharmacological applications. Here, we explored the bioactive potential of three species of holothurians (Echinodermata) and four species of tunicates (Chordata) as sources of antioxidant and anti-inflammatory compounds with a particular focus on polyphenolic substances. Hydroethanolic and aqueous extracts were obtained from animals' biomass and screened for their content of polyphenols and their antioxidant and anti-inflammatory properties. Hydroethanolic fractions of three species of tunicates displayed high polyphenolic content associated with strong antioxidant potential and anti-inflammatory activity. Extracts were thereafter tested for their capacity to promote bone formation and mineralization by applying an assay that uses the developing operculum of zebrafish (Danio rerio) to assess the osteogenic activity of compounds. The same three hydroethanolic fractions from tunicates were characterized by a strong in vivo osteogenic activity, which positively correlated with their anti-inflammatory potential as measured by COX-2 inhibition. This study highlights the therapeutic potential of polyphenol-rich hydroethanolic extracts obtained from three species of tunicates as a substrate for the development of novel drugs for the treatment of bone disorders correlated to oxidative stress and inflammatory processes.info:eu-repo/semantics/publishedVersio

Eugenol mitigated acute lung but not spermatic toxicity of C60 fullerene emulsion in mice

C60 fullerene (C60) is a nano-pollutant that can damage the respiratory system. Eugenol exhibits significant anti-inflammatory and antioxidant properties. We aimed to investigate the time course of C60 emulsion-induced pulmonary and spermatic harms, as well as the effect of eugenol on C60 emulsion toxicity. The first group of mice (protocol 1) received intratracheally C60 emulsion (1.0 mg/kg BW) or vehicle and were tested at 12, 24, 72 and 96 h (F groups) thereafter. The second group of mice (protocol 2) received intratracheally C60 emulsion or vehicle, 1 h later were gavaged with eugenol (150 mg/kg) or vehicle, and experiments were done 24 h after instillation. Lung mechanics, morphology, redox markers, cytokines and epididymal spermatozoa were analyzed. Protocol 1: Tissue damping (G) and elastance (H) were significantly higher in F24 than in others groups, except for H in F72. Morphological and inflammatory parameters were worst at 24 h and subsequently declined until 96 h, whereas redox and spermatic parameters worsened over the whole period. Eugenol eliminated the increase in G, H, cellularity, and cytokines, attenuated oxidative stress induced by C60 exposure, but had no effect on sperm. Hence, exposure to C60 emulsion deteriorated lung morphofunctional, redox and inflammatory characteristics and increased the risk of infertility. Furthermore, eugenol avoided those changes, but did not prevent sperm damage