Sobre Ischnoplax pectinatus (Sowerby, 1840) e sua ocorrência no litoral sul do Brasil (Mollusca, Polyplacophora)

São indicadas novas localizações geográficas para Ischnoplax pectinatus (sowerby, 1840) no litoral sul do Brasil. Além disso são estudados sua morfologia e alguns aspectos biogeográficos.

Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008.

OBJECTIVE: To provide an update to the original Surviving Sepsis Campaign clinical management guidelines, "Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and Septic Shock," published in 2004. DESIGN: Modified Delphi method with a consensus conference of 55 international experts, several subsequent meetings of subgroups and key individuals, teleconferences, and electronic-based discussion among subgroups and among the entire committee. This process was conducted independently of any industry funding. METHODS: We used the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) system to guide assessment of quality of evidence from high (A) to very low (D) and to determine the strength of recommendations. A strong recommendation (1) indicates that an intervention's desirable effects clearly outweigh its undesirable effects (risk, burden, cost) or clearly do not. Weak recommendations (2) indicate that the tradeoff between desirable and undesirable effects is less clear. The grade of strong or weak is considered of greater clinical importance than a difference in letter level of quality of evidence. In areas without complete agreement, a formal process of resolution was developed and applied. Recommendations are grouped into those directly targeting severe sepsis, recommendations targeting general care of the critically ill patient that are considered high priority in severe sepsis, and pediatric considerations. RESULTS: Key recommendations, listed by category, include early goal-directed resuscitation of the septic patient during the first 6 hrs after recognition (1C); blood cultures before antibiotic therapy (1C); imaging studies performed promptly to confirm potential source of infection (1C); administration of broad-spectrum antibiotic therapy within 1 hr of diagnosis of septic shock (1B) and severe sepsis without septic shock (1D); reassessment of antibiotic therapy with microbiology and clinical data to narrow coverage, when appropriate (1C); a usual 7-10 days of antibiotic therapy guided by clinical response (1D); source control with attention to the balance of risks and benefits of the chosen method (1C); administration of either crystalloid or colloid fluid resuscitation (1B); fluid challenge to restore mean circulating filling pressure (1C); reduction in rate of fluid administration with rising filing pressures and no improvement in tissue perfusion (1D); vasopressor preference for norepinephrine or dopamine to maintain an initial target of mean arterial pressure > or = 65 mm Hg (1C); dobutamine inotropic therapy when cardiac output remains low despite fluid resuscitation and combined inotropic/vasopressor therapy (1C); stress-dose steroid therapy given only in septic shock after blood pressure is identified to be poorly responsive to fluid and vasopressor therapy (2C); recombinant activated protein C in patients with severe sepsis and clinical assessment of high risk for death (2B except 2C for postoperative patients). In the absence of tissue hypoperfusion, coronary artery disease, or acute hemorrhage, target a hemoglobin of 7-9 g/dL (1B); a low tidal volume (1B) and limitation of inspiratory plateau pressure strategy (1C) for acute lung injury (ALI)/acute respiratory distress syndrome (ARDS); application of at least a minimal amount of positive end-expiratory pressure in acute lung injury (1C); head of bed elevation in mechanically ventilated patients unless contraindicated (1B); avoiding routine use of pulmonary artery catheters in ALI/ARDS (1A); to decrease days of mechanical ventilation and ICU length of stay, a conservative fluid strategy for patients with established ALI/ARDS who are not in shock (1C); protocols for weaning and sedation/analgesia (1B); using either intermittent bolus sedation or continuous infusion sedation with daily interruptions or lightening (1B); avoidance of neuromuscular blockers, if at all possible (1B); institution of glycemic control (1B), targeting a blood glucose < 150 mg/dL after initial stabilization (2C); equivalency of continuous veno-veno hemofiltration or intermittent hemodialysis (2B); prophylaxis for deep vein thrombosis (1A); use of stress ulcer prophylaxis to prevent upper gastrointestinal bleeding using H2 blockers (1A) or proton pump inhibitors (1B); and consideration of limitation of support where appropriate (1D). Recommendations specific to pediatric severe sepsis include greater use of physical examination therapeutic end points (2C); dopamine as the first drug of choice for hypotension (2C); steroids only in children with suspected or proven adrenal insufficiency (2C); and a recommendation against the use of recombinant activated protein C in children (1B). CONCLUSIONS: There was strong agreement among a large cohort of international experts regarding many level 1 recommendations for the best current care of patients with severe sepsis. Evidenced-based recommendations regarding the acute management of sepsis and septic shock are the first step toward improved outcomes for this important group of critically ill patients.

Numerical Taxonomy of Old World Phlebotominae (Diptera: Psychodidae): 1. Considerations of Morphological Characters in the Genus Phlebotomus Rondani & Berté 1840

Numerical analyses (correspondence analysis, ascending hierarchical classification, cladistic approach) were applied to the morphological characters of the adults of the genus Phlebotomus Rondani & Berté 1840. They confirm the reliability of the classic classifications, and also redefine the taxonomic and phylogenetic position of certain taxa. Thus, Spelaeophlebotomus Theodor 1948, Idiophlebotomus Quate & Fairchild 1961 and Australophlebotomus Theodor 1948 deserve generic rank. Among the vectors of leishmaniasis, the subgenus Phlebotomus Rondani & Berté 1840 is probably ancient. The results attribute an intermediate taxonomic and phylogenetic position to the taxa Euphlebotomus Theodor 1948 and Anaphlebotomus Theodor 1948, and reveal the probable artificial nature of the latter. The comparatively large numbers of species of subgenera Paraphlebotomus Theodor 1948, Synphlebotomus Theodor 1948 and, above all, Larroussius Nitzulescu 1931 and Adlerius Nitzulescu 1931, suggest that they are relatively recent. The development of adult morphological characters, the validity of their use in taxonomy and proposals for further studies are discussed.

Translating and analysing songs: three songs in the context of communist Romania

Songs were the means used by the Romanian Communist Party to ‘educate’ Romanians. Through them, Romanians were told what they had to appreciate, how grateful they were supposed to be to the regime, how great President Ceausescu was and how they had to work harder and harder so that they could be even better Communists. This paper comprises the translation of three songs composed, performed and broadcast in Communist Romania and their analysis from the point of view of communication. In translating the song, I have chosen to translate closest to the original possible meaning and meanwhile to respect to the best of my ability Low’s ‘pentathlon principle’: singability, rhyme, rhythm, naturalness and fidelity to the sense of the source text

La encuadernación artística catalana 1840-1929

S'ha intentat reunir en aquest petit estudi, la major informació, exacta i precisa del funcionament dels tallers amb nom propu que exercien una tasca professional a Barcelona.

Sunbeds campaign poster

The Sunbeds campaign communicates the long term health effects of sunbeds, including skin cancer and pre-mature ageing, to sunbed users and the wider public. Particularly those under the age of 35 who are at an increased risk of developing melanoma skin cancer from sunbed use. For moreinformation on this issuevisit www.careinthesun.orgThe sunbeds campaign poster highlights that using a sunbed before the age of 35 increases your risk of skin cancer by up to 75%.

'Under the surface' mental health campaign posters

The posters highlight some signs and symptoms that indicate that something is having a negative effect on your mental health and promote the website www.mindingyourhead.info� as a source of help for anyone finding it difficult coping with their feelings.

Stroke campaign - Leaflet, posters and wallet card

The F.A.S.T materials (poster/leaflet/wallet card) convey the signs and symptoms of stroke, and the call to action, that it's a medical emergency to call 999 immediately if you see any one of these signs. A fast response to the signs and symptoms of stroke can reduce the long term health consequences such as disability and death. Attached below are the�public information leaflets (male and female version), posters and wallet card available as part of the campaign.

Evaluation of a Public Information Campaign on Organ Donation

In June 2013, the PHA surveyed the Northern Ireland public about their attitudes towards organ donation. At the same time, a process of stakeholder engagement took place with organ donation charities, those on the transplant waiting list, recipients, donor families, and Health and Social Care staff, to inform the direction of a public information campaign that would encourage organ donation in Northern Ireland.

Ideologia, política i llenguatge de classes en el primer sindicalisme, 1840-1870

Estudi del sindicalisme a Espanya des dels seus orígens i fins el 1870. L’autor planteja dues qüestions: la ideologia elaborada pel sindicalisme entre 1840 i 1856, i en segon lloc alguns aspectes de les relacions entre sindicalisme i política, i l’elaboració d’un llenguatge de classes

Impact of a community-based bug-hunting campaign on Chagas disease control: a case study in the department of Jalapa, Guatemala

Chagas disease control requires an innovative approach to strengthen community participation in vector surveillance. This paper presents a case study of a community-based bug-hunting campaign in Guatemala. The campaign was implemented in 2007 in the following three stages: (i) a four week preparation stage to promote bug-hunting, (ii) a one week bug-hunting stage to capture and collect bugs and (iii) a 10 week follow-up stage to analyse the bugs and spray insecticide. A total of 2,845 bugs were reported, of which 7% were Triatominae vectors, such as Rhodnius prolixus and Triatoma dimidiata. The bug-hunting campaign detected a five-six-fold higher amount of vectors in one week than traditional community-based surveillance detects in one year. The bug-hunting campaign effectively detected vectors during a short period, provided information to update the vector infestation map and increased community and political awareness regarding Chagas disease. This approach could be recommended as an effective and feasible strategy to strengthen vector surveillance on a larger scale.