Cross-cultural Experiences during a Visiting Scholar Program: “…A Start[ing] not a Finishing Point”

Aim To describe the Visiting Scholar Program as a context for cross-cultural learning experiences and the development of intercultural competencies. Background In 2004, a Visiting Scholar Program (VSP) was developed between the Faculty of Nursing, University of Alberta (UA), Canada, and the University of São Paulo at Ribeirão Preto College of Nursing (USP-EERP), Brazil, with the goal to promote capacity building among nurse researchers. During a cross-cultural exchange program, participants are immersed in a foreign culture and language over an extended period of time, which offers them a potential opportunity to develop intercultural competence. Methods A qualitative design was utilized and data were collected in June 2011 through semi-structured in-depth interviews with scholars, supervisors and staff members from both institutions. Following data collection, an inductive process was used to analyze the data, following Morse’s (1994) taxonomy. Results At USP-EERP participants included 12 former scholars, two staff members from the International Office, one graduate student, and one former Dean. At the UA, 12 supervisors and 5 staff, affiliated with the VSP participated in an interview and two provided feedback by email. The central theme in the findings was the ‘Cross-Cultural Learning Process’, with three main sub-themes: challenges; benefits; and lessons learned. Conclusion Cross-cultural learning was a circular process that involved dealing with challenges, experiencing stress in a strange environment and building intercultural competencies. The VSP program enhanced scholars and supervisors’ awareness and sensitivity to cultural diversity and their openness to new cross-cultural experiences. Résumé Objectif Présenter le programme de chercheur invité comme une occasion de vivre des expériences d’apprentissage et de développer des compétences interculturelles. Contexte En 2004, un programme de chercheur invité (PCI) a été élaboré entre la Faculté des sciences infirmières de l’Université de l’Alberta (UA), au Canada, et l’École de sciences infirmières de Ribeirão Preto de l’Université de São Paulo (EERP-USP), au Brésil, dans le but d’encourager le renforcement des capacités parmi les chercheurs en sciences infirmières. Au cours de ce programme d’échange interculturel, les participants sont en immersion dans une culture et une langue étrangères pendant une longue période, ce qui leur donne la possibilité de développer des compétences interculturelles. Méthodes Une approche qualitative de recherche a été adoptée et des données ont été recueillies en juin 2011 au moyen d’entretiens en profondeur semi-dirigés avec les chercheurs, les superviseurs et les membres du personnel des deux institutions. Un processus inductif a ensuite été utilisé pour analyser les données, d’après la taxonomie de Morse (1994). Résultats À l’EERP-USP, les participants comprenaient douze anciens chercheurs, deux membres du personnel du Bureau international, une étudiante diplômée et un ancien doyen. À l’UA, douze superviseurs et cinq membres du personnel liés au PCI ont participé à un entretien et deux ont envoyé des commentaires par courriel. Le thème central des constatations était « le processus d’apprentissage interculturel », qui se divisait en trois sous-thèmes principaux : les défis, les avantages et les leçons apprises. Conclusion L’apprentissage interculturel dans ce cas particulier était un processus circulaire qui exigeait de relever des défis, de subir du stress dans un environnement étranger et de développer des compétences interculturelles. Le PCI a amélioré la sensibilisation et la sensibilité des chercheurs et des superviseurs à la diversité culturelle ainsi que leur ouverture à vivre de nouvelles expériences interculturelles

A triple-strand anatomic medial collateral ligament reconstruction restores knee stability more completely than a double-strand reconstruction: a biomechanical study in vitro.

BACKGROUND: There are many descriptions of medial collateral ligament (MCL) reconstruction, but they may not reproduce the anatomic structures and there is little evidence of their biomechanical performance. PURPOSE: To investigate the ability of "anatomic" MCL reconstruction to restore native stability after grade III MCL plus posteromedial capsule/posterior oblique ligament injuries in vitro. STUDY DESIGN: Controlled laboratory study. METHODS: Twelve cadaveric knees were mounted in a kinematic testing rig to impose tibial displacing loads while the knee was flexed-extended: 88-N anteroposterior translation, 5-N·m internal-external rotation, 8-N·m valgus-varus, and combined anterior translation plus external rotation (anteromedial rotatory instability). Joint motion was measured via optical trackers with the knee intact; after superficial MCL (sMCL), deep MCL (dMCL), and posterior oblique ligament transection; and then after MCL double- and triple-strand reconstructions. Double strands reproduced the sMCL and posterior oblique ligament and triple-strands the sMCL, dMCL, and posterior oblique ligament. The sMCL was placed 5 mm posterior to the epicondyle in the double-strand technique and at the epicondyle in the triple-strand technique. Kinematic changes were examined by repeated measures 2-way analysis of variance with posttesting. RESULTS: Transection of the sMCL, dMCL, and posterior oblique ligament increased valgus rotation (5° mean) and external rotation (9° mean). The double-strand reconstruction controlled valgus in extension but allowed 5° excess valgus in flexion and did not restore external rotation (7° excess). The triple-strand reconstruction restored both external rotation and valgus throughout flexion. CONCLUSION: In a cadaveric model, a triple-strand reconstruction including a dMCL graft restored native external rotation, while a double-strand reconstruction without a dMCL graft did not. A reconstruction with the sMCL graft placed isometrically on the medial epicondyle restored valgus rotation across the arc of knee flexion, whereas a reconstruction with a more posteriorly placed sMCL graft slackened with knee flexion. CLINICAL RELEVANCE: An MCL injury may rupture the anteromedial capsule and dMCL, causing anteromedial rotatory instability. Persistent MCL instability increases the likelihood of ACL graft failure after combined injury. A reconstruction with an anteromedial dMCL graft restored native external rotation, which may help to unload/protect an ACL graft. It is important to locate the sMCL graft isometrically at the femoral epicondyle to restore valgus across flexion

Antimicrobial activity of Piper arboreum and Piper tuberculatum (Piperaceae) against opportunistic yeasts

In the scope of our ongoing research on bioactive agents from natural sources, 24 extracts and fractions obtained from Piper arboreum Aub. and Piper tuberculatum Jacq. (Piperaceae) were screenedfor antifungal activity by using broth microdilution method. The current investigation reveals that P. arboreum extracts and fractions were more effective against Candida krusei and Candida parapsilosis than Cryptococcus neoformans. The growth of Candida albicans was weakly affected by all the tested extracts and fractions. The strongest effects were observed for hexane and ethyl acetate fractions from leaves of P. arboreum, with MIC values (in ìg/ml) of 15.6 and 31.2 ìg/ml against C. krusei, respectively. Additionally, phytochemical investigation of the hexane fraction of P. arboreum leaves furnished 3 pyrrolidine amides; piperyline, 4,5-dihydropiperyline and tetrahydropiperyline, which could be responsible, at least in part for the observed antifungal activity. The most active compound, tetrahydropiperyline, displayed MIC values of 15.6 ìg/ml against C. krusei, C. parapsilosis and C. neoformans

Effect of Stocking Density and Sex on Feathering, Body Injury and Breast Meat Quality of Broiler Chikens

The experiment was conducted at the College of Veterinary Medicine and Animal Production of UNESP-Botucatu Campus to evaluate the effect of stocking densities and sex on body injuries and breast meat quality. One thousand nine hundred and fifty day-old Ross chicks were reared until 42 days of age on a randomized factorial arrangement with three stock densities (10, 13 and 16 birds/m²) and two sexes. At 28, 35 and 42 days of age, 15 birds/treatment were sampled to determine feathering percentage related to body weight and 50 birds/treatment to evaluate score feathering. At 42 days of age, all broilers were processed to evaluate body injuries and breast meat quality. Increasing stocking densities decreased feathering and increased body injuries like breast blisters, dermatitis, bruises and scratches. Breast meat yield and breast length width and depth was negatively affected (p<.05) as stocking densities increased.O experimento foi conduzido nas instalações experimentais da Faculdade de Medicina Veterinária e Zootecnia - UNESP, Campus de Botucatu, SP, Brasil, com o objetivo de avaliar o efeito da densidade de criação e do sexo sobre o empenamento, incidência de lesões na carcaça e a qualidade de carne de peito de frangos de corte. Foram utilizados 1950 pintos de corte sexados, da linhagem Ross, distribuídos em um delineamento inteiramente casualizado, com esquema fatorial com 3 densidades (10, 13 e 16 aves/m²) e dois sexos com 5 repetições, sendo que uma foi destinada exclusivamente para reserva, criados até os 42 dias de idade. Aos 28, 35 e 42 dias foram amostradas 3 aves por repetição para a determinação do empenamento através da porcentagem de penas e 10 aves para a determinação do escore de empenamento. Também aos 42 dias de idade todas as aves foram identificadas na pata com anilhas numeradas e submetidas à avaliação da incidência de lesões na pele. Foram escolhidas ao acaso 5 aves por repetição para a determinação da qualidade da carne de peito. Pode-se concluir que o aumento na densidade de criação promoveu uma diminuição na velocidade de empenamento e, conseqüentemente, uma maior incidência de lesões na carcaça. O comprimento, a largura e a espessura do peito foram menores para as aves criadas na maior densidade, e a perda de peso por cozimento foi maior para as aves criadas na maior densidade.000

Hospital deaths and adverse events in Brazil

<p>Abstract</p> <p>Background</p> <p>Adverse events are considered a major international problem related to the performance of health systems. Evaluating the occurrence of adverse events involves, as any other outcome measure, determining the extent to which the observed differences can be attributed to the patient's risk factors or to variations in the treatment process, and this in turn highlights the importance of measuring differences in the severity of the cases. The current study aims to evaluate the association between deaths and adverse events, adjusted according to patient risk factors.</p> <p>Methods</p> <p>The study is based on a random sample of 1103 patient charts from hospitalizations in the year 2003 in 3 teaching hospitals in the state of Rio de Janeiro, Brazil. The methodology involved a retrospective review of patient charts in two stages - screening phase and evaluation phase. Logistic regression was used to evaluate the relationship between hospital deaths and adverse events.</p> <p>Results</p> <p>The overall mortality rate was 8.5%, while the rate related to the occurrence of an adverse event was 2.9% (32/1103) and that related to preventable adverse events was 2.3% (25/1103). Among the 94 deaths analyzed, 34% were related to cases involving adverse events, and 26.6% of deaths occurred in cases whose adverse events were considered preventable. The models tested showed good discriminatory capacity. The unadjusted odds ratio (OR 11.43) and the odds ratio adjusted for patient risk factors (OR 8.23) between death and preventable adverse event were high.</p> <p>Conclusions</p> <p>Despite discussions in the literature regarding the limitations of evaluating preventable adverse events based on peer review, the results presented here emphasize that adverse events are not only prevalent, but are associated with serious harm and even death. These results also highlight the importance of risk adjustment and multivariate models in the study of adverse events.</p

Could Public Restrooms Be an Environment for Bacterial Resistomes?

PMCID: PMC3547874This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

A systematic review and meta-analysis of heart rate variability in COPD

Background: Chronic obstructive pulmonary disease (COPD) is associated with disruption in autonomic nervous control of the heart rhythm. We present here quantitative evidence of the reduction in HRV measures as well as the challenges to clinical application of HRV in COPD clinics. Method: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we search in June 2022 Medline and Embase databases for studies reporting HRV in COPD patients using relevant medical subject headings (MeSH) terms. The quality of included studies was assessed using the modified version of the Newcastle–Ottawa Scale (NOS). Descriptive data were extracted, while standardized mean difference was computed for changes in HRV due to COPD. Leave-one-out sensitivity test was performed to assess exaggerated effect size and funnel plots to assess publication bias. Results: The databases search yielded 512 studies, of which we included 27 that met the inclusion criteria. The majority of the studies (73%) had a low risk of bias and included a total of 839 COPD patients. Although there were high between-studies heterogeneity, HRV time and frequency domains were significantly reduced in COPD patients compared with controls. Sensitivity test showed no exaggerated effect sizes and the funnel plot showed general low publication bias. Conclusion: COPD is associated with autonomic nervous dysfunction as measured by HRV. Both sympathetic and parasympathetic cardiac modulation were decreased, but there is still a predominance of sympathetic activity. There is high variability in the HRV measurement methodology, which affects clinical applicability