953 resultados para mandatory arrest
Resumo:
The checkpoint kinase Chk2 has a key role in delaying cell cycle progression in response to DNA damage. Upon activation by low-dose ionizing radiation (IR), which occurs in an ataxia telangiectasia mutated (ATM)dependent manner, Chk2 can phosphorylate the mitosis-inducing phosphatase Cdc25C on an inhibitory site, blocking entry into mitosis, and p53 on a regulatory site, causing G, arrest. Here we show that the ATM-dependent activation of Chk2 by gamma- radiation requires Nbs1, the gene product involved in the Nijmegen breakage syndrome (NBS), a disorder that shares with AT a variety of phenotypic defects including chromosome fragility, radiosensitivity, and radioresistant DNA synthesis. Thus, whereas in normal cells Chk2 undergoes a time-dependent increased phosphorylation and induction of catalytic activity against Cdc25C, in NBS cells null for Nbs1 protein, Chk2 phosphorylation and activation are both defective. Importantly, these defects in NBS cells can be complemented by reintroduction of wild-type Nbs1, but neither by a carboxy-terminal deletion mutant of Nbs1 at amino acid 590, unable to form a complex with and to transport Mre11 and Rad50 in the nucleus, nor by an Nbs1 mutated at Ser343 (S343A), the ATM phosphorylation site. Chk2 nuclear expression is unaffected in NBS cells, hence excluding a mislocalization as the cause of failed Chk2 activation in Nbs1-null cells, interestingly, the impaired Chk2 function in NBS cells correlates with the inability, unlike normal cells, to stop entry into mitosis immediately after irradiation, a checkpoint abnormality that can be corrected by introduction of the wild-type but not the S343A mutant form of Nbs1, Altogether, these findings underscore the crucial role of a functional Nbs1 complex in Chk2 activation and suggest that checkpoint defects in NBS cells may result from the inability to activate Chk2.
Resumo:
We studied the foraging habitat of the endangered black-breasted button-quail (Turnix melanogaster) in 13 rainforest patches of an agricultural landscape (23.4 km(2)) in eastern Australia to assess its use of fragmented habitats outside conservation reserves. The species foraged only in the three largest patches (17.4, 40.0, 63.8 ha in size), all of which were connected to open eucalypt forest, and in intact rainforest. Occurrence of birds was greatest in the largest patch. The maximum number of individuals within the study area was estimated to be 22. Radio-tracking of nine birds revealed that three were resident in the largest patch for periods of over 100 days; no movements between patches were detected. Three radio-tagged birds were taken by avian and mammalian predators. Our results indicated that the long-term future of the species in agricultural landscapes is bleak and that management action is urgently needed to arrest its decline in these ecosystems, (C) 2001 Elsevier Science Ltd. All rights reserved.
Resumo:
Amiodarone has been used as an anti-arrhythmic drug since the 1970s and has an established role in the treatment of ventricular tachyarrhythmias. Although considered to be a class III anti-arrhythmic, amiodarone also has class I, II and IV actions, which gives it a unique pharmacological and anti-arrhythmic profile. Amiodarone is a structural analogue of thyroid hormone and some of its anti-arrhythmic properties and toxicity may be attributable to interactions with nuclear thyroid hormone receptors. The lipid solubility of amiodarone gives it an exceptionally long half-life. Oral amiodarone takes days to work in ventricular tachyarrhythmias, but iv. amiodarone has immediate effect and can be used in life threatening ventricular arrhythmias. Intravenous amiodarone administered after out-of-hospital cardiac arrest due to ventricular fibrillation improves survival to hospital admission. Many survivors of myocardial infarction (MI) die during the subsequent year, probably due to ventricular arrhythmia. Amiodarone reduces sudden death after MI and this benefit is predominantly observed in patients with preserved cardiac function. Sudden cardiac death, predominantly due to ventricular arrhythmias, is also commonly seen in patients with heart failure. The Grupo de Estudio de la Sobrevida en lsuficiencia Cardiaca en Argentina (GESICA) and Estudio Piloto Argentino de Muerte Subita y Amiodarona (EPAMSA) trials showed survival benefit of amiodarone in heart failure, whereas Congestive Heart Failure-Survival Trial of Anti-arrhythmic Therapy (CHF-STAT) did not. Subsequent meta-analysis established a survival benefit of amiodarone in heart failure. Implanted Cardioverter Defibrillators (ICDs) also give survival benefit to patients at risk of sudden death. In patients with a history of ventricular fibrillation or haemodynamically-compromising ventricular tachycardia, ICDs have been shown to be superior to anti-arrhythmic drugs, principally amiodarone. Further analysis has been undertaken to ascertain which patients are most likely to benefit from ICDs, as these are more expensive than treatment with amiodarone. Patients with severely depressed ejection fractions should be the first to be considered for ICDs. A new indication for amiodarone is atrial fibrillation or flutter. Amiodarone is effective in chronic and recent onset atrial fibrillation and orally or iv. for atrial fibrillation after heart surgery. In atrial fibrillation amiodarone is more than or equi-effective with flecainide, quinidine, racemic sotalol, propafenone and diltiazem and therefore should be considered for first line therapy. Amiodarone is also safe and effective in controlling refractory tachyarrhythmias in infants and is safe after cardiac surgery.
Resumo:
Germline mutations of the PTEN tumor-suppressor gene, on 10q23, cause Cowden syndrome, an inherited hamartoma syndrome with a high risk of breast, thyroid and endometrial carcinomas and, some suggest, melanoma. To date, most studies which strongly implicate PTEN in the etiology of sporadic melanomas have depended on cell lines, short-term tumor cultures and noncultured metastatic melanomas. The only study which reports PTEN protein expression in melanoma focuses on cytoplasmic expression, mainly in metastatic samples. To determine how PTEN contributes to the etiology or the progression of primary cutaneous melanoma, we examined cytoplasmic and nuclear PTEN expression against clinical and pathologic features in a population-based sample of 150 individuals with incident primary cutaneous melanoma. Among 92 evaluable samples, 30 had no or decreased cytoplasmic PTEN protein expression and the remaining 62 had normal PTEN expression. In contrast, 84 tumors had no or decreased nuclear expression and 8 had normal nuclear PTEN expression. None of the clinical features studied, such as Clark's level and Breslow thickness or sun exposure, were associated with cytoplasmic PTEN expressional levels. An association with loss of nuclear PTEN expression was indicated for anatomical site (p = 0.06) and mitotic index (p = 0.02). There was also an association for melanomas to either not express nuclear PTEN or to express p53 alone, rather than both simultaneously (p = 0.02). In contrast with metastatic melanoma, where we have shown previously that almost two-thirds of tumors have some PTEN inactivation, only one-third of primary melanomas had PTEN silencing. This suggests that PTEN inactivation is a late event likely related to melanoma progression rather than initiation. Taken together with our previous observations in thyroid and islet cell tumors, our data suggest that nuclear-cytoplasmic partitioning of PTEN might also play a role in melanoma progression. (C) 2002 Wiley-Liss, Inc.
Resumo:
This study investigates whether fee dependence within the audit firms' offices jeopardises auditor independence. Fee dependence is examined at both the national audit firm level as well as the local office level and in a setting where public disclosure of fees is mandatory. We focus our tests on audit fee dependence and at the same time we control for the effects of non-audit service fee dependence post the 1989 mergers. We operationalise the exercise of independent judgement in auditing by the propensity to issue qualified audit opinions. If fee dependence affects auditors' independent judgement, then auditors are less likely to qualify the accounts. The study's results show that the level of auditor fee dependence does not affect auditor propensity to issue unqualified audit opinions. The findings remain robust to a number of sensitivity tests including the analyses controlling for the effects of non-audit service fee dependence and other settings in which there is heightened pressure on auditors to confront the effects of fee dependence on exercising independent audit judgement. (C) 2002 Elsevier Science B.V. All rights reserved.
Resumo:
If a dental patient develops chest pain it must always be managed promptly and properly, i.e., the practitioner immediately stops the procedure and, being aware of the patients's medical history, questions the patient regarding the nature of the pain to help determine the likely diagnosis. It will most likely be a manifestation of coronary artery disease (synonymous with ischaemic heart disease), i.e., angina pectoris or acute myocardial infarction, most usually the former. Angina will usually resolve with proper intervention whereas up to about one-half of myocardial infarction cases will develop cardiac arrest, mostly in the first few hours, and this will be fatal in up to two-thirds of cases. As health care professions, dental practitioners have an inherent duty of care to be able to initiate appropriate care if such a medical emergency occurs.
Resumo:
This review discusses the issues to be considered in establishing new or extending existing high dependency unit (HDU) services. A defined high dependency service becomes cost-effective when patient care requires more than one nurse for three patients. Professional guidelines for HDUs vary and there are no national accreditation criteria. Casemix and service delivery specifications for the HDU need to be defined and agreed upon within the institution. Establishing a new HDU service requires changes to care delivery. Many potential HDU patients are currently managed in general wards or in the intensive care unit. The service should be discussed widely and marketed within the institution, and the development of defined working relationships with the ICU and primary care teams oil the wards is mandatory.
Resumo:
Members of the community contribute to survival from out-of-hospital cardiac arrest by contacting emergency medical services and performing cardiopulmonary resuscitation (CPR) prior to the arrival of an ambulance. In Australia there is a paucity of information of the extent that community members know the emergency telephone number and are trained in CPR. A survey of Queensland adults (n = 4490) was conducted to ascertain current knowledge and training levels and to target CPR training. Although most respondents (88.3%) could state the Australian emergency telephone number correctly, significant age differences were apparent (P < 0.001). One in five respondents aged 60 years and older could not state the emergency number correctly. While just over half the respondents (53.9%) had completed some form of CPR training, only 12.1% had recent training. Older people were more likely to have never had CPR training than young adults. Additional demographic and socio-economic differences were found between those never trained in CPR and those who were. The results emphasise the need to increase CPR training in those aged 40 and over, particularly females, and to increase the awareness of the emergency telephone number amongst older people. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.
Resumo:
The concept of a basic (i.e., essential) medical emergency kit suitable for a general dental practitioner varies somewhat between different authorities. A practitioner's choice is also dependant on the proximity of medical aid and the nature of the dental practice. Over recent years the trend has been to restrict the items to a minimum, in the interest of both common sense and safety, for example, just oxygen, adrenaline 1:1000, an oral carbohydrate source, glyceryl trinitrate and aspirin as first options. Ancillary equipment should include an oxygen therapy facemask, a pocket mask and a set of oral (Guedel) airways. Two further medication options for consideration are an aerosol bronchodilator and, in certain circumstances, an injectable antihypoglycaemic agent. This paper provides a selective overview of the subject. An absolute necessity is for dentists to be competent in Basic Life Support skills, and to maintain a complete and current medical history for all patients.
Resumo:
The objectives of this study are to (1) quantify prior cardiopulmonary resuscitation (CPR) training in households of patients presenting to the Emergency Department (ED) with or without chest pain or ischaemic heart disease (IHD); (2) evaluate the willingness of household members to undertake CPR training; and (3) identify potential barriers to the learning and provision of bystander CPR. A cross-sectional study was conducted by surveying patients presenting to the ED of a metropolitan teaching hospital over a 6-month period. Two in five households of patients presenting with chest pain or IHD had prior training in CPR. This was no higher than for households of patients presenting without chest pain or IHD. Just under two in three households of patients presenting with chest pain or IHD were willing to participate in future CPR classes. Potential barriers to learning CPR included lack of information on CPR classes, perceived lack of intellectual and/or physical capability to learn CPR and concern about causing anxiety in the person at risk of cardiac arrest. Potential barriers to CPR provision included an unknown cardiac arrest victim and fear of infection. The ED provides an opportunity for increasing family and community capacity for bystander intervention through referral to appropriate training. (C) 2003 Published by Elsevier Science Ireland Ltd.
Resumo:
Este estudo objetiva analisar o tema Licitações Sustentáveis, as quais se destinam a integrar preocupações ambientais e sociais às aquisições públicas, no contexto do debate e da busca pela sustentabilidade. Foi realizado um estudo de caso para investigar como a Prefeitura Universitária da Universidade Federal do Espírito Santo (PU/UFES) está operacionalizando e lidando com a obrigatoriedade de adoção das licitações sustentáveis nas contratações de serviços efetuadas, considerando o período de 2010 a 2013. O principal intuito desta pesquisa foi identificar se essas contratações estão em harmonia com as diretrizes de sustentabilidade vigentes nas legislações nacionais, a partir da Instrução Normativa MPOG nº 01/2010 e, sobretudo, no que se refere ao Decreto nº 7.746/2012 e seus desdobramentos posteriores. Com isso, objetivou-se também apontar dificuldades operacionais e propor um Plano de Intervenção para melhorar a implementação de critérios sustentáveis nas referidas contratações. Em relação à metodologia utilizada, os métodos empregados foram o dedutivo e o estudo de caso. A pesquisa foi aplicada - quanto à natureza; qualitativa – quanto à forma de abordagem; descritiva e exploratória – quanto ao objetivo geral; e bibliográfica/documental – quanto aos procedimentos técnicos. O questionário/formulário e a entrevista semiestruturada foram os instrumentos utilizados para a coleta de dados. Os resultados da análise do estudo de caso realizado na PU/UFES revelam que apenas menos de um terço dos editais investigados apresentam critérios de sustentabilidade. As principais causas encontradas se dividem na falta de conhecimento dos atores envolvidos e na ausência de interesses, iniciativas e colaboração de setores relacionados. Com isso, o trabalho aponta para a necessidade de avanços em direção ao cumprimento das obrigações legais em vigor e à promoção da sustentabilidade nas contratações licitadas.
Resumo:
This thesis is dedicated to the study of disclosure about derivative instruments and their determinants, by Portuguese companies. We have defined the following as our main research objectives: to identify the extent of disclosure relating to derivative instruments presented by Portuguese companies; to analyze the developments in the level of disclosure; and to identify the determinants of the level of disclosure. To this end, we have examined the information that has been disclosed by listed companies, for the period 2003–2009, and by companies belonging to the banking sector and insurance sector (hereinafter identified as financial firms), for 2009. We were able to conclude, in our first phase of research, that the number of disclosing firms has evolved positively, during the period 2003–2009, and that the level of disclosure has also evolved positively. On the other hand, the values obtained in the disclosure index indicate that companies are worried about compliance with accounting standards which became mandatory in 2005 and in 2007. This indicates that the adoption of the IASB’s standards since 2005 and the mandatory adoption of International Financial Reporting Standard (IFRS) No. 7, since 2007, have influenced the level of disclosure.
Resumo:
Purpose – this paper has two main purposes: (1)explore if government agencies more oriented to NPM postulates are more willing to use PM practices and to improve their performance; and (2) investigate whether the fit between the use of PM practices and the organizationa performance is dependent upon from the capacity of agencies to adapt its structures to changes introduced by NPM reforms. Design/methodology/approach - this paper is based on the survey method and provides empirical evidence from Portuguese government agencies.Findings (mandatory) - Our findings suggest that government agencies that made structural arrangements under the NPM reforms are more willing to use PM practices and will perform better than other agencies. In addition, this paper show that therelationship between the use of PM practices and the organizational performance is dependent upon from the agencies capacity to adopt new structural arrangements under the NPM reforms.Practical implications – this paper has three main contributions: (1) contribute to knowledge about the relationship between the introduction of NPM changes in the use of PM practices; (2) contribute to clarify whether agencies more oriented to NPM postulates are improving performance; and (3) help to clarify the way the organizations should adapt their structures for to be more effective in the use of PM practices. Originality/value - The quantitative empirical research, based on the unique survey applied to Portuguese government agencies on this field, allow us to add to prior research mainly based on case studies and oriented to local governments (Budding, 2004).
Resumo:
A presente pesquisa faz uma análise sobre o reconhecimento da necessidade da Música na Escola, levando em consideração o caráter interdisciplinar, lúdico e as restantes propriedades da música, capazes de promover cada vez mais sinapses, fato este comprovado pela Neurociência, em que o aluno passa a estar mais motivado, através da constante e percetível ativação de diversas áreas cerebrais distintas das áreas específicas do tratamento da informação musical. O ponto de partida para esta pesquisa foi a Lei 11.769/08 do Governo Federal Brasileiro que trata da obrigatoriedade do ensino da música na educação básica, a partir deste momento, houve grandes perspetivas e projetos direcionados ao retorno da música à sala de aula, focalizando a atenção para a melhor organização dos espaços, nomeadamente, estruturas, materiais e pessoal, de forma a garantir o sucesso do ensino através da música. Tendo em conta a implementação desta lei, houve a necessidade de analisar na prática, os benefícios da música na aprendizagem, bem como a formação do docente para esta atividade. Deste modo, fez-se o enquadramento teórico com base nos conhecimentos já existentes sobre políticas educativas públicas e o ensino artístico, especificamente a presença da Música no currículo escolar. Este enquadramento serviu de base para a realização de um estudo no município de Coelho Neto no Maranhão – Brasil, com base na temática: ―A Importância da Música na Motivação do Aluno‖, que demonstrou a falta de preparação dos docentes no que concerne à música. Assim, esta investigação-ação levou-nos à elaboração do Projeto ―Formar para melhor ensinar‖, no sentido de ajudar os professores a superar esta lacuna. Este projeto será implementado no próximo ano letivo.