Caracterização dos estádios de desenvolvimento do girassol e sua relação com alguns parâmetros climáticos.

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International Law of Regional Organizations: A Comparative Perspective

This article provides a comparative analysis of the law and practice of regional international organizations (rio s). Drawing upon the International Law Association (ila) study and individual regional reports, the article offers a cross-regional account of organizations located in Europe, Eurasia, the Middle East, Africa, Latin America and the Caribbean, and the Asia-Pacific. The article focuses on the main conceptual questions that emerged during the study and reflects on some of the main insights gleaned from the cross-cutting comparisons. The article discusses the concept of ‘regional international organization’ and the debates about the appropriate definition to be used in the Study. The article discusses how international law applies to, and within, regional international organizations, examining issues such as the autonomy of the organization’s internal law. The article shows how regional international organizations have influenced the development of international law, by concluding treaties, contributing or catalysing relevant practice to the formation of customary international law, and producing authoritative ‘subsidiary means’ to identify the law. The comparative assessment allows us to offer reflections on the ‘openness’ of regional international organizations and the conditions under which they can shape, and be shaped by, international law. The article concludes with some starting points for further research on the place of regional international organizations

Influenza vaccination and absenteeism among healthy working adults: a cost-benefit analysis

Seasonal influenza is a highly contagious infection that might lead to serious clinical complications and incurs a conspicuous socio-economic impact. Influenza vaccination is currently recommended only for specific groups of healthy adults (such as healthcare workers) even though it was demonstrated to be effective in reducing absenteeism and decreased workers' productivity during flu epidemic period. The main purpose of this study is to analyse the extent of absences due to illness following a voluntary flu immunization program among the Komatsu Italia Manufacturing company's personnel during the flu season 2017-2018. Secondly, we aimed at performing a cost-benefit analysis of the vaccination campaign from the company's perspective

La ricerca finalizzata in Area Medica: approfondimenti assistenziali dell’Associazione A.N.Í.M.O.

Introduzione Il gruppo di ricerca dell’Associazione ANÍMO La ricerca infermieristica Obiettivo del lavoro Metodi Metodologia operativa e ambiti di attività I livelli di approfondimento metodologici • Approfondimento metodologico Evidence-Report il cateterismo vescicale • Approfondimento metodologico Evidence-Report il cateterismo venoso periferico a breve termine • Approfondimento metodologico Evidence-Report il dolore cronico in medicina interna Risultati Evidence-Report: i risultati da Revisioni di Linee Guida • Il cateterismo vescicale a permanenza • Il cateterismo venoso periferico a breve termine • La gestione del dolore cronico in medicina  Evidence-Based Care-sheet: What we know e what we can do • Le lipodistrofie associate alla pratica iniettiva • La nutrizione nel paziente con polimorbilità • Scompenso cardiaco e fine vita • Terapia anticoagulante orale e processi educativi: il ruolo dell’infermiere • La somministrazione di liquidi per via sottocutanea • L’ictus cerebrale: rischi e prevenzione Focus di approfondimento, the most updated research • La somministrazione dei farmaci per os in pazienti disfagici e/o portatori di SNG o PEG • Il dolore cronico nei pazienti con disturbi cognitivi • Le cadute negli anziani • Il monitoraggio dei parametri vitali • Il Lock dei cateteri venosi centrali: quale soluzione? Quali evidenze? • La responsabilità del professionista infermiere nella terapia farmacologica • La mancata aderenza alle prescrizioni: un problema da non sottovalutare in medicina interna • La gestione della stipsi nelle degenze di area medica: ruolo dell’infermiere • La malnutrizione in ospedale • L’uso della contenzione è un indicatore di buona pratica assistenziale e di buona cultura?  • Riposo a letto o mobilizzazione precoce? • L’uso delle checklist in area medica • La flebite da infusione • La sorveglianza infermieristica: una competenza necessaria in medicina interna • Umidità e calore della miscela di aria nei trattamenti di ventilazione non invasiva: quali evidenze? • Diabete, intervento educativo, ruolo dell’infermiere • La terapia anticoagulante e il ruolo dell’infermiere: alcune evidenze • Il ritorno dell’ipodermoclisi: quali evidenze? • Gli aspetti assistenziali prevalenti nelle cure infermieristiche alla persona colpita da ictus • Lo scompenso cardiaco: epidemiologia e interventi assistenziali Conclusioni Bibliografi

Interactional positioning and narrative self-construction in the first session of psychodynamic-interpersonal psychotherapy

The purpose of this study is to identify possible session one indicators of end of treatment psychotherapy outcome using the framework of three types of interactional positioning; client’s self-positioning, client’s positioning between narrated self and different partners, and the positioning between client and therapist. Three successful cases of 8-session psychodynamic-interpersonal (PI) therapy were selected on the basis of client Beck Depression Inventory scores. One unsuccessful case was also selected against which identified patterns could be tested. The successful clients were more descriptive about their problems and demonstrated active rapport-building, while the therapist used positionings expressed by the client in order to explore the positionings developed between them during therapy. The unsuccessful case was characterized by lack of positive self-comment, minimization of agentic self-capacity, and empathy-disrupting narrative confusions. We conclude that the theory of interactional positioning has been useful in identifying patterns worth exploring as early indicators of success in PI therapy

Mental health and violence among sixth grade students from a city in the state of São Paulo

OBJECTIVE: To analyze risk and protective factors for mental health problems among adolescents. METHODS: Cross-sectional study with a random sample (N=327; attrition rate=6.9%) of sixth grade students from all public and private schools in the city of Barretos, Southeastern Brazil, conducted in 2004. The factors studied were: exposure to intrafamilial and urban violence, family socioeconomic level, sex, motherless household, participation in social activities (protective factor). All the independent risk and protective factors were included in the initial logistic regression model. Only the variable with a significance level of p<0.05 remained in the model. RESULTS: It was observed that exposure to violence was the only factor associated with mental health problems in the final logistic regression model (p=0.02, 95% CI: 1.12;4.22). In addition, adolescents exposed to intrafamilial violence were three times more likely to have problems than those exposed to urban violence (p=0.04; 95% CI: 1.03;7.55). CONCLUSIONS: Intrafamilial violence was associated with mental heath problems among adolescents studied and it could be more important than urban violence in medium-sized cities.OBJETIVO: Analisar fatores de proteção e de risco para problemas de saúde mental entre adolescentes. MÉTODOS: Estudo transversal realizado com amostra aleatória (N=327; perda=6,9%) de estudantes da sexta série de todas as escolas públicas e privadas de Barretos, SP, em 2004. Os fatores examinados foram: exposição à violência doméstica e urbana, nível socioeconômico familiar, sexo, morar sem a mãe, participar de atividades sociais (fator de proteção). As associações entre esses fatores e problemas de saúde mental foram analisadas por meio de modelos de regressão logística. Todos os fatores de risco e proteção independentes foram incluídos no modelo inicial de regressão logística, permanecendo no modelo final apenas a variável com nível de significância inferior a 0,05. RESULTADOS: Verificou-se que apenas exposição à violência permaneceu no modelo final como fator associado a problemas de saúde mental (p=0,02; IC 95%: 1,12;4,22). Crianças expostas à violência doméstica tinham três vezes mais chances de apresentarem estes problemas do que aquelas expostas à violência urbana (p=0,04; IC 95%: 1,03;7,55). CONCLUSÕES: A violência doméstica associou-se a problemas de saúde mental nos adolescentes do estudo, podendo ser mais importante que a violência urbana em cidades de médio porte.Universidade Presbiteriana Mackenzie Programa de Pós-graduação em Distúrbios do DesenvolvimentoUniversidade Federal de São Paulo (UNIFESP) Departamento de Psiquiatria Setor de Psiquiatria SocialUNIFESP Departamento de Psiquiatria Unidade de Psiquiatria da Infância e AdolescênciaUNIFESP, Depto. de Psiquiatria Setor de Psiquiatria SocialUNIFESP, Depto. de Psiquiatria Unidade de Psiquiatria da Infância e AdolescênciaSciEL

MKP-1 mediates glucocorticoid-induced ERK1/2 dephosphorylation and reduction in pancreatic beta-cell proliferation in islets from early lactating mothers

Maternal pancreatic islets undergo a robust increase of mass and proliferation during pregnancy, which allows a compensation of gestational insulin resistance. Studies have described that this adaptation switches to a low proliferative status after the delivery. the mechanisms underlying this reversal are unknown, but the action of glucocorticoids (GCs) is believed to play an important role because GCs counteract the pregnancy-like effects of PRL on isolated pancreatic islets maintained in cell culture. Here, we demonstrate that ERK1/2 phosphorylation (phospho-ERK1/2) is increased in maternal rat islets isolated on the 19th day of pregnancy. Phospho-ERK1/2 status on the 3rd day after delivery (L3) rapidly turns to values lower than that found in virgin control rats (CTL). MKP-1, a protein phosphatase able to dephosphorylate ERK1/2, is increased in islets from L3 rats. Chromatin immunoprecipitation assay revealed that binding of glucocorticoid receptor (GR) to MKP-1 promoter is also increased in islets from L3 rats. in addition, dexamethasone (DEX) reduced phospho-ERK1/2 and increased MKP-1 expression in RINm5F and MIN-6 cells. Inhibition of transduction with cycloheximide and inhibition of phosphatases with orthovanadate efficiently blocked DEX-induced downregulation of phospho-ERK1/2. in addition, specific knockdown of MKP-1 with siRNA suppressed the downregulation of phosphoERK1/2 and the reduction of proliferation induced by DEX. Altogether, our results indicate that downregulation of phospho-ERK1/2 is associated with reduction in proliferation found in islets of early lactating mothers. This mechanism is probably mediated by GC-induced MKP-1 expression.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de PesquisaCoordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Univ São Paulo, Inst Biomed Sci, Dept Physiol & Biophys, BR-05508 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Biol Sci, Diadema, SP, BrazilUniv Estadual Campinas, Fac Med Sci, Dept Pharmacol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Biol Sci, Diadema, SP, BrazilWeb of Scienc

Intravaginal testicular torsion in newborns. To fix or not to fix the contralateral testis

Scrotal swelling suggesting testicular torsion is a rare urological emergency which requires a clinical urgent evaluation and most of the times must be managed surgically. In newborns it can occur in the postnatal period, usually within the twenty-eighth day of life, or more frequently in utero, during the descent of the testis into the scrotum. Usually its poor fixedness allows the testis an abnormal mobility inside the scrotum, configuring the framework of extravaginal torsion. On the contrary during the perinatal period a twist that takes place inside the tunica vaginalis, known as intravaginal torsion, is extremely uncommon and only few cases are well documented in the literature. Authors present a rare case of intravaginal testicular torsion occurred in perinatal period. In this situation only the early surgical exploration of the scrotum may allow the rescue of the gonad, although in rare cases. Timing of surgical treatment and need for contralateral testicular fixation remain controversial. However since the anatomical defect of the tunica vaginalis can be bilateral the surgical fixation even of the contralateral testis is important, now or later, in order to prevent any future torsion of this gonad. The authors also present a brief review of recent literature on the subject