The Regional Study of Sleep-Related Behaviors of Nurse Anesthetists: Personal and Professional Implications: A Replication Study

Universally, anesthesia providers are expected to be knowledgeable, astutely responding to clinical challenges while maintaining a prolonged vigilance for administration of safe anesthesia and critical care. A fatigued anesthetist is the consequence of cumulative acuity manifesting as decreased motor and cognitive powers. This results in patient harm, impaired judgement, late and inadequate responses to clinical changes, poor communications, and medical errors. With increased expectations and medical-legal claims, anesthesiologists work to provide efficient and timely services, but are rendered sleep deprived themselves. It is the right time to address the issue of the health of anesthesia providers and the profession. The implications of sleep deprivation on patient safety are profound and preventive strategies are essential. The governing bodies of anesthesia providers must ensure mandatory practices to prevent the adverse outcomes of fatigue related errors and patient compromise

Estudo de invariantes em sistemas dinamicos continuos e não-lineares

Dissertação (mestrado) - Universidade Federal de Santa Catarina. Centro de Ciencias Fisicas e MatematicasNo presente trabalho investigamos vários aspectos relacionados com a existência de invariantes em sistemas dinâmicos contínuos e não-lineares. Apresentamos relações de recorrência para gerar os termos presentes nas densidades e fluxos da equação de Korteweg-de Vries e nas densidades da equação modificada de Korteweg-de Vries. Nossas relações são baseadas na observação empírica de que, para um dado rank r, o conjunto {P2r} de todas as partições do inteiro 2r contém todos os monômios de {Xr-1} e {Tr}. As relações são facilmente implementáveis em máquinas capazes de efetuar manipulações algébricas. Obtivemos, através de nossas relações de recorrência, quatro novos invariantes para a equação de Korteweg-de Vries e três para a equação modificada de Korteweg-de Vries. Testamos a validade de conjecturas estabelecidas recentemente por Torriani usando análise combinatorial. Além disso, analisamos três métodos encontrados na literatura recente para a obtenção de constante de movimento de equações de evolução não-lineares. São eles: uma relação entre constantes de movimento e equações variacionais; um procedimento para a obtenção de constantes de movimento associadas a cada simetria de Lie da equação diferencial que descreve o sistema; e a obtenção de novas constantes a partir de constantes conhecidas usando os operadores das transformações infinitesimais que deixam a equação de evolução invariante. São feitas aplicações destes métodos a equações conhecidas com ênfase em física atômica e óptica quântica

International Human Rights Law and the Accountability of Civil Society Organizations: the case of the INGO accountability charter/accountable now

The central objective of this Paper is to develop an analysis of the position occupied by civil society organizations in International Human Rights Law, specifically in human rights protection at the international level. In this regard, the proposed examination will focus on the discussion regarding the accountability of said organizations, at this level.  Introducing, from a historical perspective, the form of interaction of these actors with supranational organizations, it is possible to draw conclusions regarding its legitimacy and its accountability or lack thereof. By drawing on the concept of legitimacy as used in the international sphere, to which the idea of accountability is directly linked, it can be developed certain analytical tools that permit the identification of specific aspects of accountability that are fundamental in understanding the mode of operation of civil society organizations in International Human Rights Law. As a practical example, it is studied the case of the INGO Accountability Charter, currently known as Accountable Now.     Recebido em: agosto/2018.Aprovado em: dezembro/2018

Experiences and Perceptions of Novice Associate Degree Nursing Faculty Assuming a Classroom Instructors Role

The purpose of this research was to explore the classroom experiences and perceptions of novice faculty in the classroom setting of an Associate Degree of Nursing programs, located in community colleges. The transition from expert practitioner to novice teacher can be a difficult experience for new classroom nursing instructors. Novice nursing faculty often has very limited educational preparation or background in classroom instruction skills. Nursing research, typically conducted at university level, has minimal applicability for the community college nursing programs. Community colleges educate sixty percent of the graduate Registered Nurses in the United States and have scant research into their programs and faculties. Historically, faculty in registered nursing programs is hired for expert clinical skills in a specific area of nursing practice. Participant inclusion for this study was limited to novice faculty in Associate Degree of Nursing programs located in the community college setting. The study was specific to instructors with classroom lecture assignments and with less than four years teaching. The participants did not have prior instructional or educational experience in the college classroom instructor role. Participating community colleges in this investigative research were in southern Louisiana and Mississippi. Qualitative emergent research was conducted to explore the perceptions of the novice faculty prior to and after assumption of the teaching role. Lived experiences were described using semi-structured interviews that provided the opportunity for narratives which shared experiences of the transition to nursing educator process. Unexpected student cultures, attitudes, and uncivil behaviors, and lack of academic orientations were components of the findings in this research. However, the overall love of teaching and nursing education was communicated by all of the participants. I love to teach was the overwhelming reason the instructors had selected academics. The transition from the role clinical expert in the practice setting to the role of academic novice faculty in a community college setting can be chaotic and filled with unexpected issues. Effective preparation with administrative support and resources can enhance the career transition to produce a successful and confident nursing instructor

Aspectos Da Biologia De Megalobulimus Paranaguensis (gastropoda, Acavoidea) Na Planície Costeira Do Sudeste Brasileiro

We studied the reproductive biology of Megalobulimus paranaguensis (Pilsbry & Ihering, 1900), a large and long-lived land gastropod from the Atlantic Rainforest of Brazil. The study was conducted at an urban park in the city of Santos, state of São Paulo. For 4 years, we counted the egg postures and annual eclosion rate of 32 captive snails and looked for associations between egg posture and the climatical variables of the period. The annual mean posture of 8.7 eggs per snail obtained in our results is a small number, but typical of Brazilian macromollusks. The annual eclosion rate was 31%. The beginning of the annual activity period of snails occurred in the middle of March, and lasted 33.97±3.02 weeks. The dormancy period started in the beginning of November, and lasted 18.39±3.11 weeks. There were two egg posture peaks, a minor peak between March and May, and a major peak between August and November, with greater values in September. Megalobulimus paranaguensis has a well-defi ned seasonal reproductive pattern infl uenced by environmental temperature and temperature range. Furthermore, in this snail, reproduction is negatively infl uenced by temperature increasing and temperature range. © 2017; Fundacao Zoobotanica do Rio Grande do Sul. All rights reserved.10

Fucosylated chondroitin sulfate and an heparin analog effect on Plasmodium falciparum cytoadhesion and merozoite invasion

Orientador: Fabio Trindade Maranhão CostaTese (doutorado) - Universidade Estadual de Campinas, Instituto de BiologiaResumo: Acredita-se que o sequestro de eritrócitos infectados por Plasmodium falciparum (Pf-EIs) na microvasculatura de órgão vitais, contribua para a patogênese de síndromes graves da malária, como a malária cerebral (MC), síndrome da angústia respiratória grave, anemia grave e malária na gravidez. Apesar do tratamento com drogas antimaláricas eficazes, mortalidade significativa ainda é observada em casos graves da doença. Assim, tem sido sugerido o uso de terapias adjuvantes. Nesse sentido, polissacarídeos sulfatados, como a heparina, têm demonstrado capacidade em inibir a citoaderência de P. falciparum a vários receptores do hospedeiro, inibir a invasão de merozoítos e romper rosetas. A heparina foi utilizada no passado como tratamento para malária grave, no entanto o seu uso foi interrompido devido à ocorrência de efeitos colaterais graves, tais como hemorragia. Além disso, muitos desses polissacarídeos sulfatados são derivados de mamíferos, o que aumenta o risco de contaminação por agentes patogênicos, como príons. Apesar de muitos compostos terem sido testados como terapia adjuvante para diferentes aspectos patogênicos da malária grave, nenhum destes demonstrou evidência inequívoca de melhora dos pacientes nos testes clínicos. Sendo assim, nesse estudo, investigamos a ação de dois polissacarídeos sulfatados extraídos de invertebrados na citoadesão e desenvolvimento de P. falciparum. Já foi demonstrado que esses compostos; o condroitim sulfato fucosilado (FucCS), extraído do pepino-do-mar Ludwigothurea grisea, e o análogo da heparina (heparam sulfato), extraído do molusco bivalve Nodipecten nodosus; possuem ação anticoagulante e antitrombótica, porém em menor escala do que a heparina comercial. Além disso, apresentam efeito anti-inflamatório e antimetastático. Aqui, nós mostramos que o FucCS e o heparam sulfato (HS) de molusco foram eficazes em inibir a citoadesão de P. falciparum em condições estáticas e de fluxo a células endoteliais de pulmão humano (HLECs). Eles também foram capazes de inibir o desenvolvimento parasitário por interferir na invasão de merozoítos. Além de romper rosetas eficientemente. Ainda, o FucCS inibiu a adesão de Pf-EIs a criocortes de placenta. Finalmente, a remoção das cadeias de fucose sulfatadas presentes na estrutura do FucCS praticamente aboliu o efeito inibitório do composto, evidenciando a importância dessas cadeias para sua atividade. Sendo assim, sugerimos o FucCS e o HS de molusco como candidatos promissores a terapia adjuvante no tratamento da malária grave e na prevenção ao agravamento da doença, além de abrir perspectivas para continuação e aprofundamento do estudo desses compostos no tratamento da maláriaAbstract: It is believed that sequestration of Plasmodium falciparum-infected erythrocytes (Pf-iEs) in the microvasculature of vital organs, contributes to the pathogenesis of severe malaria syndromes such as, cerebral malaria (CM), severe respiratory distress, severe anemia and malaria in pregnancy (MiP). Despite treatment with effective antimalarial drugs, high mortality is still observed in severe cases of the disease. Thus, the use of adjuvant therapies has been suggested. Accordingly, sulfated polysaccharides, such as heparin, have been shown to prevent P. falciparum cytoadherence to several host receptors, inhibit merozoite invasion and disrupt rosettes. Heparin was used in the past as treatment for severe malaria, however its use was abandoned due to the occurrence of serious side effects such as bleeding. Moreover, many of these compounds are derived from mammals, which increase the risk of contamination by pathogens, such as prions. Although many compounds have been tested as adjunct therapy to different pathophysiological features of severe malaria, none of them showed clear evidence of patients¿ improvement in clinical trials. Therefore, in this study, we investigated the action of two sulfated compounds extracted from invertebrates in P. falciparum cytoadhesion and development. It has been shown that these compounds; chondroitin sulfate fucosylated (FucCS), extracted from the sea cucumber Ludwigothurea grisea, and the heparin analogue (heparan sulfate), extracted from the bivalve mollusk Nodipecten nodosus; have anticoagulant and antithrombotic action, but on a smaller scale than the commercial heparin. They also have anti-inflammatory and antimetastatic effect. Here, we show that FucCS and mollusk heparan sulfate (HS) were effective in inhibiting P. falciparum cytoadhesion, under static and flow conditions to human lung endothelial cells (HLECs). They were also able to block parasite development by interfering with merozoite invasion, and to disrupt rosettes efficiently. In addition, FucCS inhibited Pf-iEs adhesion to placenta cryosections. Finally, removal of sulfated fucose branches on the FucCS molecule virtually abolished its inhibitory effect, indicting a central role played by these structures. Then, we suggest FucCS and mollusk HS as promising candidates for adjunct therapy in the treatment of severe malaria and in preventing disease worsening. Also, we open new avenues to understand the mechanisms of action of these compounds in malaria treatmentDoutoradoImunologiaDoutora em Genética e Biologia Molecula