Photodynamic Antimicrobial Chemotherapy (PACT) in combination with antibiotics for treatment of Burkholderia cepacia complex infection

This study aimed to determine if Photodynamic Antimicrobial Chemotherapy (PACT) was effective in the treatment of Burkholderia cepacia complex infection and whether a synergistic effect was evident if PACT was used in combination with antibiotics. The susceptibility of both planktonic and biofilm cultures of B. cepacia complex strains to methylene blue (MB) and meso-tetra(n-methyl-4-pyridyl)porphine tetra-tosylate (TMP)-mediated PACT was determined alone and in combination with antibiotics used in the treatment of Cystic Fibrosis pulmonary infection caused by these bacteria. When B. cepacia complex strains were grown planktonically, high levels of kill of were achieved with both TMP and MB-mediated PACT with strain and photosensitizer specific differences apparent. When strains were grown in biofilm, antibiotic treatment alone was bactericidal in 17/36 (47%) strain/antibiotic combinations tested. When antibiotic treatment was combined with PACT, bactericidal activity was apparent for 33/36 (92%) strain/antibiotic combinations. No antagonism was detected between PACT and antibiotic treatment with the combination synergistic for 6/36 (17%) and indifferent for 30/36 (83%) strain/antibiotic combinations. PACT could be a viable treatment option, either alone or in combination with antibiotics for treatment of B. cepacia complex pulmonary infection.

Breaking the silence : exploring the workplace experiences of six women with learning disabilities

In the current economic climate, employees are expected to upgrade their skills in order to remain productive and competitive in the workplace, and many women with learning disabilities! may feel doubly challenged when dealing with such expectations. Although the number of people with reported learning disabilities who enter the workforce is expected to increase, a dearth of research focuses on work-related experiences of women with learning disabilities; consequently, employers and educators often are unaware ofthe obstacles and demands facing such individuals. This qualitative narrative study sheds light on the work experiences of women with diagnosed or suspected learning disabilities. The study used semistructured interviews to explore their perspectives and reflections on learnlng in order to: (a) raise awareness of the needs of women with learning disabilities, (b) enhance their opportunities to learn in the workplace, and (c) draw attention to the need for improvement of inclusiveness in the workplace, especially for hidden disabilities. Study findings reveal that participants' learning was influenced by work relationships, the learning environments, self-determination, and taking personal responsibility. Moreover, the main accommodation requested was to have supportive and understanding work relationships and environments. Recommendations are made for future research and workplace improvements, most notably that no employees should be left behind through an employee-centered approach.

University Faculty Members’ Understanding of Their Role: Identity, Power, and Silence

This qualitative study was conducted to explore tenured faculty members’ understandings of their roles as professors. Tenure is an institutional means to enact academic freedom, which allows tenured faculty members to investigate topics of their choosing free from external influence. Academic freedom also enables faculty members to be public intellectuals who shape and critique social policies and make knowledge assertions. In effect, the faculty members are institutionally protected to speak truth to power. Purposeful sampling of 9 participants from 2 universities yielded 3 major themes: professorial identity (shaped by such factors as career stage, university culture, and faculty affiliation), professorial power (powers that participants experienced as well as the ways in which they exercised power), and professorial silencing (as a response to fiscal realities coupled with numerous governance issues). While participants were cognizant of the powers that affected their freedoms, they were less aware of the ways in which their position afforded them powers. Subtle but more potent forms of power were at play for tenured professors, but the participants saw themselves as having to work within institutional and financial constraints that limited their freedom to speak out on controversial issues. Faculty members were, thus, silenced and at times chose to self-silence. The context of the present-day university, governance models, and the financial issues affecting universities and departments worked in concert to silence this critical voice in society.

"Breaking the Silence: International conference on the Indian residential schools commission of Canada" ; "Briser le silence: Colloque international sur la commission de vérité et de réconciliation sur les pensionnats indiens".

This is the full audio recording of the "Breaking the silence : International conference on the Indian residential schools commission of Canada" that took place at the University of Montreal on September 26-27, 2008. Enregistrement audio complets du colloque "Briser le silence" sur la Commission de vérité et de réconciliation sur les pensionnats indiens, ayant eu lieu à Montréal les 26 et 27 septembre 2008.

Into the silence of the objects : analyzing Samuel Beckett’s nothingness

Os objetos têm sempre desempenhado um papel fundamental nas nossas vidas, pela forma como eles, passivamente, fazem-nos companhia e transmitem tacitamente a sua quietude inata. Contudo, o que acontece quando os objetos se tornam uma presença tão poderosa que, como resultado, dominam a vida das pessoas? Noutras palavras, o que é que acontece quando os objetos sobrecarregam as pessoas com as suas potentes (falando literalmente, sempre lá) presenças? No silêncio dos objetos há um lugar onde nos tornamos conscientes da nossa insignificância, da nossa crise de identidade,ansiedade de linguagem e entorpecimento. Mas nas peças Endgame e Act without Words I de Samuel Beckett, o dramaturgo gradualmente capta a inutilidade da vida das personagens principais e a transformação das suas mentes e corpos numa coleção de objetos arquivados. Sem interagir com outras pessoas e por se autoencarcerarem estas personagens de Beckett esquecem-se o que é ser humano e tornam-se «uma não-coisa, nada». Pode haver um facto perturbador nesta realização, e, sem dúvida, até mesmo uma infeliz aliteração; mesmo assim, o que é ainda mais chocante é que estas personagens são paradigmáticas em relação ao que significa ter pisado uma aniquilação prematura ontológica e existencial. Estas são agora objetos abandonados entre outros objetos, uma espécie de coleção ineficaz. Com base nestes argumentos, este ensaio mostra uma tremenda influência de Beckett no desenvolvimento da teoria da descarnalizaçao e da desmaterialização do corpo e mente do povo, culminando na revolução tecnológica onde queremos ser empilhados dentro de incontáveis arquivos de computador. O principal argumento propõe uma reflexão sobre como podemos pôr em perigo a nossa sofisticação emocional e social, jogando este complicado «jogo» digital.

Delineating difference and spaces of resistance : reading the Nana’s Silence in Rosario Castellanos’ ''Balún Canán''

A escritora mexicana Rosario Castellanos incorpora silêncios em suas obras de uma forma que permite ao leitor a questionar o próprio significado da agência e da natureza da subjetividade de uma protagonista feminina. Silêncios tendem a criar brechas no texto, iluminando as diferenças sociais e raciais que a narração em primeira pessoa foge. Além disso, é revelado que o sujeito se imagina em oposição ao silêncio de mulheres menos privilegiadas, e que realmente não existe um local em que o subalterno pode falar. Este projecto se centra em seu romance Balún Canan (1957), em que a babá Indígena de uma menina complica o desejo de ascender dentro da estrutura patriarcal da sua família mais privilegiada, como a menina descobre que o que faria sua vida confortável é a causa da subjugação de sua “outra mãe.” O texto é desenvolvido em torno de um desejo de falar a partir das margens, e há um esforço claro para dar voz aos subalternos. No entanto, a relação entre a menina e sua babá não é nem romântica nem idealizada; a presença da mulher colonizada resiste a marginalização e ressalta que está sendo coberto no processo de desenvolvimento individual. Ansiedadesurge dentro da narração da menina como ela percebe seu privilégio como membro da classe latifundiária, e a escrita navega entre diferentes manifestações de silêncio: o silenciamento da babá em uma replicação de violência colonial, e a manutenção do silêncio como uma barreira respeitosa.

Decentralization and regionalization: dynamics and conditioning factors for the implementation of the Health Pact in Brazil

Decentralization and regionalization represent constitutional guidelines for the organization of the Unified Health System, which in the last 20 years has required the adoption of mechanisms to coordinate and accommodate federative tensions in Brazil's healthcare sector. This paper analyzes the national implementation of the Health Pact between 2006 and 2010 involving a strategy that reconfigures intergovernmental relations in the sector. The study involved the analysis of documents, official data and interviews with federal, state and municipal managers in the Brazilian states. The content of the national proposal is initially discussed, including its implications for health policy. The different rhythms and degrees of implementation of the Health Pact are then reviewed, with respect to adherence by states and municipalities and the formation of Regional Management Boards. Lastly, the conditioning factors for the multiplicity of experiences observed in the country are identified and the challenges facing progress toward a decentralized and regionalized health system in Brazil are discussed.

Metropolitan and regional health planning: dilemmas of the Pact for Health in the Baixada Santista Metropolitan Area, Sao Paulo State, Brazil

This paper focuses on the relationship between metropolitan and regional health planning based on the processes of regionalization and the Pact for Health in the Baixada Santista Metropolitan Area, Sao Paulo State, Brazil. The method used was a case study in two stages, namely during initial implementation of the Pact for Health (2007) and the Regional Administration Committees (CGR) and in 2010. Municipal and regional health systems managers and the director of the Metropolitan Agency were interviewed, and records were analyzed from ten years of meetings of the Regional Inter-Administration Committee and the Regional Development Council. Four issues emerged: financing and infrastructure; health services utilization; inefficiency of the Regional Health Administration's instruments and decision-making levels; and the relationship between different levels in the Administration. Metropolitan health management remained as an underlying issue, appearing only incidentally or tangentially to regional management. Despite some limitations, the CGR has been legitimized as a space for regional health management.

Construction and validation of an instrument that breaks the silence: the impact of domestic and/or sexual violence on women's health, as shown during climacterium

Objective: The aim of this study was to construct and to validate a measure of the consequences of domestic violence on women's health during climacterium. Methods: A questionnaire was administered at the Outpatient Climacterium Clinic to 124 women aged 40 to 65 years who were the victims of domestic and/or sexual violence (experimental group). They were divided into three groups: (1) those who were victims of violence exclusively during childhood/adolescence, (2) those who were victims of violence exclusively during adulthood, and (3) those who were victims of violence throughout their lives. The instrument included 34 items evaluating the beginning, frequency, and type of violence; the search for health assistance and reporting of the violence; the violence and the number of comorbidities; and violence and the Kupperman Menopausal Index. We also included a control group composed of perimenopausal and postmenopausal women who did not experience any violence (n = 120). Results: The instrument presented a Cronbach alpha = 0.82, good reliability among the examiners (+0.80), and a good possibility of reproducibility. The mean age of menopause was 45.4 years, and the mean age in the control group was 48.1 years. Group 1 showed a mean of 5.1 comorbidities, Group 2 had 4.6, and Group 3 had 4.4. Sexual violence (43.5%) and other types of violence both presented average comorbidities (4.60) but represented a significant impairment in the victim's sexual life. There were significant associations in group 3 and a high Kupperman Menopausal Index score. In the experimental group, 80.6% did not seek health services for the violence they experienced. Conclusions: The questionnaire presented good internal consistency and a validated construction. It can be easily reproduced and is indicated to evaluate the consequences of domestic and/or sexual violence on women's health during climacterium.

Marked Silence, Neo-Feudalistic Reactions and the Stabilized Moral Regime – The Current De- and Reformation of „the Social“

The German chancellor and leader of the German conservative party, Angela Merkel, said in an interview a few weeks ago: “Nobody could have imagined a few months ago to what extent we would be pushed into state intervention programs. Of course, Merkel spoke on, this intervention is not easy for anybody. Therefore, she recommended turning back to the former course as soon as possible” (tagesschau.de, 11. März 2008, zit. nach Bildzeitungsinterview mit Angela Merkel, own translation). The worldwide celebrated new president of the United States, Barack Obama, said in an interview on CBS-News a few weeks before Merkel: “(...) there's no doubt that we have not been able yet to reset the confidence in the financial markets and in the consumer markets and among businesses that allow the economy to move forward in a strong way. And my job as president is gonna be to make sure that we restore that confidence“ (CBS News, 16. November 2008, Obama On Economic Crisis, Transition; http://www.cbsnews.com/stories/2008/11/16/60minutes/main4607893.shtml; Stand: 16. April 2009).

Archaeological silence and ecorefuges: arid events in the Puna of Atacama during the Middle Holocene

This paper briefly summarizes presearch concerning the mid-Holocene in the western slope of the puna de Atacama (20–25°S). Proxy data and dates from palynological, limnological, geomorphological archives were compared with data recovered from the archaeological sites in high altitude basins, intermediate ravines and piemontane paleowetlands. Due to exceptionally favorable conditions, numerous Early Holocene archaeological sites were found. In contrast, the lack of occupations in previously populated areas suggests a decline in human activity during the arid mid-Holocene. In this context, two key concepts are introduced: ecorefuge or ecological refuge, and archaeological silence (silencio arqueológico). The first refers to the particular favorable locations occupied by human groups during the mid-Holocene. The second provides a better understanding about the impact of the arid interval during this period on human adaptations in the most barren territories of the New World.