Strategic choice of the subsidiaries : contextual and operational factors

Considering the subsidiaries of multinational companies, a study of the conditions affecting the strategic choice is conducted. Beginning with an analysis of the taxonomies of subsidiaries, two strategic models were selected to test three hypotheses: one, regarding the variables that influence the strategic choice; a second, about the relationship between the two classification models and a third, about the influence of the type of subsidiary on performance. This study involved five European countries, namely the United Kingdom, France, Germany, Sweden and Portugal. It concludes that nation based variables have important influence in the determination of subsidiary strategic roles. This influence is present especially in terms of national culture with variables like individualism and uncertainty avoidance, while analyzing relationships, and age and technological capacity, while analyzing functions. We also found that both models used are independent, suggesting that they are complementary models and not substitutes.info:eu-repo/semantics/publishedVersio

Vascular Mural Cells Promote Noradrenergic Differentiation of Embryonic Sympathetic Neurons

The sympathetic nervous system controls smooth muscle tone and heart rate in the cardiovascular system. Postganglionic sympathetic neurons (SNs) develop in close proximity to the dorsal aorta (DA) and innervate visceral smooth muscle targets. Here, we use the zebrafish embryo to ask whether the DA is required for SN development. We show that noradrenergic (NA) differentiation of SN precursors temporally coincides with vascular mural cell (VMC) recruitment to the DA and vascular maturation. Blocking vascular maturation inhibits VMC recruitment and blocks NA differentiation of SN precursors. Inhibition of platelet-derived growth factor receptor (PDGFR) signaling prevents VMC differentiation and also blocks NA differentiation of SN precursors. NA differentiation is normal in cloche mutants that are devoid of endothelial cells but have VMCs. Thus, PDGFR-mediated mural cell recruitment mediates neurovascular interactions between the aorta and sympathetic precursors and promotes their noradrenergic differentiation

A prática educativa docente sobre o Projeto Político Pedagógico: um relato de experiência junto à pós-graduação em enfermagem

O objetivo deste estudo foi relatar a experiência de pós-graduandas na elaboração e aplicação de uma prática educativa sobre o Projeto Político Pedagógico (PPP), adequado ao ensino de graduação, utilizando metodologias ativas de ensino-aprendizagem. A atividade foi apresentada para pós-graduandos no contexto de uma disciplina de pós-graduação, sob orientação das docentes responsáveis. A aula ocorreu em 2015, teve a duração de três horas, contou com a participação de 35 pós-graduandos e teve como proposta desenvolver nos alunos condições de conceituar o PPP; entender sua importância, seus princípios e estrutura; compreender os processos que envolvem a sua elaboração e desenvolver pensamentos críticos e reflexivos sobre os desafios de sua implementação nas instituições de ensino. A aula foi desenvolvida em três etapas. Na primeira, disponibilizou-se aos alunos um texto com uma situação-problema fictícia que tratava da elaboração de um PPP para resolver dificuldades de uma instituição de ensino. Na segunda, adaptou-se a metodologia da Aprendizagem Baseada em Problemas (ABP) ao objetivo proposto, buscando os conhecimentos prévios dos alunos acerca do PPP. E na terceira, utilizaramse tarjas de cartolina que continham as etapas de construção de um PPP, para que os alunos as discutissem e as dispusessem em sequência correta. A atividade foi avaliada como satisfatória. Para as pós-graduandas, a experiência de planejar e aplicar metodologias ativas no contexto de ensino-aprendizagem possibilitou: compreender a relevância de um PPP, construir coletivamente sua concepção e desenvolver a formação docente.The objective of this study was to report the experience of postgraduates in the elaboration and application of an educational practice on the Pedagogical Political Project (PPP), suitable for undergraduate education, using active teaching-learning methodologies. The activity was presented to postgraduate students in the context of a postgraduate course, under the guidance of the responsible professors. The class took place in 2015, lasted three hours, with the participation of 35 postgraduate students and had as a proposal to develop in the students conditions to conceptualize the PPP; understand its importance, its principles and structure; understand the processes involved in its elaboration and develop critical and reflective thoughts about the challenges of its implementation in educational institutions. The class was developed in three stages. In the first, the students were given a text with a fictitious problem situation that dealt with the elaboration of a PPP to solve difficulties of an educational institution. In the second, the methodology of Problem-Based Learning (PBL) was adapted to the proposed objective, seeking the previous knowledge of the students about the PPP. And in the third one, strips of card that contained the steps of construction of a PPP were used, so that the students discussed them and arranged them in correct sequence. The activity was evaluated as satisfactory. For postgraduate students, the experience of planning and applying active methodologies in the teaching-learning context made it possible to: understand the relevance of a PPP, to constructively construct its conception and to develop teacher training

Proposta de antibioticoterapia empírica para tratamento de SEPSE primária em CTI / Empirical antibiotic therapy proposal for the treatment of primary SEPSIS in the ICU

Os antimicrobianos se apresentam como uma das principais drogas utilizadas nos centros de terapia intensiva (CTIs). Contudo, sua indicação ainda é preocupantemente caracterizada por tratamentos inadequados, apresentando um consequente aumento de bactérias multirresistentes. Nesse contexto, tem-se a antibioticoterapia empírica como importante ferramenta para redução de taxas de mortalidade em quadros de sepse primária. Assim, este estudo objetiva avaliar o perfil de sensibilidade antimicrobiana dos agentes etiológicos de sepse primária em CTI de adultos, embasando terapia empírica para tratamento dessa complicação e, por conseguinte, contribuindo para a elaboração de estratégias de uso racional dos antimicrobiano

CD4+ T Cell Profile and Activation Response in Sickle Cell Disease Patients with Osteonecrosis

Recent evidence suggests that abnormalities involving CD4+T lymphocytes are associated with the pathophysiology of osteonecrosis (ON); however, few studies have addressed the CD4+T cells in ON related to sickle cell disease (SCD/ON). In addition, T cells producing multiple cytokines simultaneously are often present in the inflammatory milieu and may be implicated in the immune response observed in SCD/ON. In the present study, we aimed to characterize the functional status of CD4+T cells in SCD by simultaneously determining the frequency of IFN-γ+, IL-4+, and IL-17+ CD4+T in cell cultures under exogenous stimuli. Peripheral blood mononuclear cells (PB-MNCs) from 9 steady-state SCD patients, 15 SCD/ON patients, and 19 healthy controls had functional status of CD4+T cells analyzed. Bone marrow mononuclear cells (BM-MNCs) from 24 SCD/ON patients (SCD BM) and 18 patients with ON not related to SCD (non-SCD BM) were also analyzed. We found that PB-MNC of SCD patients with or without ON presented significantly reduced TCD4+, TCD8+, and TCD4+ naïve cell frequencies and increased frequency of circulating CD4+T cells able to simultaneously produce IFN-γ+/IL4+ and IL-17+/IL4+ compared to healthy controls. Conversely, the polyclonal stimulation of BM-MNC induced an increased frequency of CD4+IFN-γ+ and CD4+IL-17+ in SCD BM compared to non-SCD BM. The increased proportion of CD4+ T cells able to produce a broad spectrum of proinflammatory cytokines after a strong stimulus indicates that the immune system in SCD/ON patients presents an expressive pool of partially differentiated cells ready to take on effector function. It is possible that this increased subpopulation may extend to inflammatory sites of target organs and may contribute to the maintenance of inflammation and the pathophysiology of osteonecrosis in sickle cell disease

Condições de saúde bucal em pessoas de 60 anos ou mais no Município de São Paulo (Brasil)

As condições de saúde bucal no grupo populacional com 60 anos ou mais é estudada, na cidade de São Paulo em 1989. Com base em dados referentes à cárie dental, doenças periodontais, necessidade e uso de prótese e prevalência de alterações em tecidos duros e moles, conclui-se que este grupo apresenta um nível muito precário de saúde bucal. Recomenda-se a definição de política e de programas odontológicos específicos para a terceira idade

Condições de saúde bucal em pessoas de 60 anos ou mais no Município de São Paulo (Brasil) Oral health condition of people of 60 years of age or above in S. Paulo city, Brazil

As condições de saúde bucal no grupo populacional com 60 anos ou mais é estudada, na cidade de São Paulo em 1989. Com base em dados referentes à cárie dental, doenças periodontais, necessidade e uso de prótese e prevalência de alterações em tecidos duros e moles, conclui-se que este grupo apresenta um nível muito precário de saúde bucal. Recomenda-se a definição de política e de programas odontológicos específicos para a terceira idade.<br>The oral health status of people aged 60 years or over in S. Paulo in 1989 is discussed. According to data relating to dental caries, periodontal diseases, need and use of prothesis and prevalence of hard and soft oral tissue pathologies, this study concludes that elder people present a very bad oral health status. The definition of a policy and dental care programs addressed to the aged are recommended

Quantification and Comprehensive Analysis of Mesenchymal Stromal Cells in Bone Marrow Samples from Sickle Cell Disease Patients with Osteonecrosis

The potential use of bone marrow mesenchymal stromal cells (BM-MSCs) for the treatment of osteonecrosis in sickle cell disease (SCD) patients is increasing. However, convenient BM-MSC quantification and functional property assays are critical factors for cell-based therapies yet to be optimized. This study was designed to quantify the MSC population in bone marrow (BM) samples from SCD patients with osteonecrosis (SCD group) and patients with osteoarticular complications not related to SCD (NS group), using flow cytometry for CD271+CD45-/low cell phenotype and CFU-F assay. We also compared expanded BM-MSC osteogenic differentiation, migration, and cytokine secretion potential between these groups. The mean total cell number, CFU-F count, and CD271+CD45-/low cells in BM mononuclear concentrate were significantly higher in SCD than in NS patients. A significant correlation between CD271+CD45-/low cell number and CFU-F counts was found in SCD (r=0.7483; p=0.0070) and NS (r=0.7167; p=0.0370) BM concentrates. An age-related quantitative reduction of CFU-F counts and CD271+CD45-/low cell number was noted. Furthermore, no significant differences in the morphology, replicative capacity, expression of surface markers, multidifferentiation potential, and secretion of cytokines were found in expanded BM-MSCs from SCD and NS groups after in vitro culturing. Collectively, this work provides important data for the suitable measurement and expansion of BM-MSC in support to advanced cell-based therapies for SCD patients with osteonecrosis

Use of autologous bone marrow stem cell implantation for osteonecrosis of the knee in sickle cell disease: a preliminary report

Abstract Background The purpose of our study was to evaluate safety, feasibility and clinical results of bone marrow mononuclear cell (BMC) implantation for early-stage osteonecrosis of the knee (OK) secondary to sickle cell disease. Methods Thirty-three SCD patients (45 knees) with OK treated with BMC implantation in the osteonecrotic lesion were clinically and functionally evaluated through the American Knee Society Clinical Score (KSS), Knee Functional Score (KFS) and Numeric Rating Scale (NRS) pain score. MRI and radiographic examinations of the knee were assessed during a period of five years after intervention. Results No complications or serious adverse event were associated with BMC implantation. From preoperative assessment to the latest follow-up, there was a significant (p < 0.001) improvement of clinical KSS (64.3 ± 9.7, range: 45–80 and 2.2 ± 4.1, range: 84–100, respectively), KFS (44.5 ± 8.0, range: 30–55 and 91.6 ± 5.8, range: 80–100, respectively) and reduction of NRS pain score (6.7 ± 1.2, range: 4–9 and 3.4 ± 1.0, range: 2–5, respectively). In total, 87% of patients (29/33) consistently experienced improvements in joint function and activity level as compared to preoperative score. No patient had additional surgery following BMC implantation. Radiographic assessment showed joint preservation and no progression to subchondral collapse at most recent follow-up. Conclusions The technique of BMC implantation is a promising, relatively simple and safe procedure for OK in SCD patients. Larger and long-term controlled trials are needed to support its clinical effectiveness. Trial registration ClinicalTrials.gov NCT02448121. Retrospectively registered 19 May 2015