Nosocomial infections in a neonatal intensive care unit during 16 years: 1997-2012

Introduction Surveillance of nosocomial infections (NIs) is an essential part of quality patient care; however, there are few reports of National Healthcare Safety Network (NHSN) surveillance in neonatal intensive care units (NICUs) and none in developing countries. The purpose of this study was to report the incidence of NIs, causative organisms, and antimicrobial susceptibility patterns in a large cohort of neonates admitted to the NICU during a 16-year period. Methods The patients were followed 5 times per week from birth to discharge or death, and epidemiological surveillance was conducted according to the NHSN. Results From January 1997 to December 2012, 4,615 neonates, representing 62,412 patient-days, were admitted to the NICU. The device-associated infection rates were as follows: 17.3 primary bloodstream infections per 1,000 central line-days and 3.2 pneumonia infections per 1,000 ventilator-days. A total of 1,182 microorganisms were isolated from sterile body site cultures in 902 neonates. Coagulase-negative staphylococci (CoNS) (34.3%) and Staphylococcus aureus (15.6%) were the most common etiologic agents isolated from cultures. The incidences of oxacillin-resistant CoNS and Staphylococcus aureus were 86.4% and 28.3%, respectively. Conclusions The most important NI remains bloodstream infection with staphylococci as the predominant pathogens, observed at much higher rates than those reported in the literature. Multiresistant microorganisms, especially oxacillin-resistant staphylococci and gram-negative bacilli resistant to cephalosporin were frequently found. Furthermore, by promoting strict hygiene measures and meticulous care of the infected infants, the process itself of evaluating the causative organisms was valuable.

Bibliotecas públicas, responsabilidade social e cidadania

Este trabalho de investigação visa estudar e compreender a responsabilidade social de três bibliotecas públicas da margem sul do Tejo, analisando de que forma estas contribuem para o desenvolvimento de cidadãos civicamente mais ativos. Neste sentido, determina-se que modelo de responsabilidade social aplicam, que meios utilizam para incentivar o envolvimento cívico e que parcerias estabelecem. O método de recolha de dados utilizado foi a entrevista, tendo esta sido realizada aos responsáveis de cada bibliotecas em análise. Os resultados evidenciam que não existe uma política formal de responsabilidade social, mas sim ações que se assemelham a modelos práticos de RS que se classificam nas Teorias Integrativas. Relativamente às iniciativas desenvolvidas pelas bibliotecas públicas para a promoção da cidadania, estas vão de encontro ao Manifesto da IFLA/UNESCO para as Bibliotecas Públicas, podendo dizer-se que as suas ações se encontram confinadas à responsabilidade legal da organização. As bibliotecas identificam os seus stakeholders, mas é necessário que estes possuam um papel mais ativo no desenvolvimento de iniciativas que respondam às suas expetativas e necessidades. Efetuam-se cinco recomendações para melhorar o desempenho das bibliotecas públicas no domínio da responsabilidade social e da cidadania: implementar políticas de responsabilidade social; respeitar os interesses dos stakeholders; apostar na formação em responsabilidade social; investir na aprendizagem ao longo da vida; e inovar, no sentido de desenvolver atividades que vão além do cumprimento do Manifesto da IFLA/UNESCO para as Bibliotecas Públicas.

Thermo-compression molding of chitosan with a deep eutectic mixture for biofilms development

Supplementary information available at: http://www.rsc.org/suppdata/c5/gc/c5gc02231b/c5gc02231b1.pdf

O procedimento relativo aos défices excessivos na União Económica e Monetária

Dissertação de mestrado em Direito da União Europeia

Inactivation of PNKP by mutant ATXN3 triggers apoptosis by activating the DNA damage-response pathway in SCA3.

Spinocerebellar ataxia type 3 (SCA3), also known as Machado-Joseph disease (MJD), is an untreatable autosomal dominant neurodegenerative disease, and the most common such inherited ataxia worldwide. The mutation in SCA3 is the expansion of a polymorphic CAG tri-nucleotide repeat sequence in the C-terminal coding region of the ATXN3 gene at chromosomal locus 14q32.1. The mutant ATXN3 protein encoding expanded glutamine (polyQ) sequences interacts with multiple proteins in vivo, and is deposited as aggregates in the SCA3 brain. A large body of literature suggests that the loss of function of the native ATNX3-interacting proteins that are deposited in the polyQ aggregates contributes to cellular toxicity, systemic neurodegeneration and the pathogenic mechanism in SCA3. Nonetheless, a significant understanding of the disease etiology of SCA3, the molecular mechanism by which the polyQ expansions in the mutant ATXN3 induce neurodegeneration in SCA3 has remained elusive. In the present study, we show that the essential DNA strand break repair enzyme PNKP (polynucleotide kinase 3'-phosphatase) interacts with, and is inactivated by, the mutant ATXN3, resulting in inefficient DNA repair, persistent accumulation of DNA damage/strand breaks, and subsequent chronic activation of the DNA damage-response ataxia telangiectasia-mutated (ATM) signaling pathway in SCA3. We report that persistent accumulation of DNA damage/strand breaks and chronic activation of the serine/threonine kinase ATM and the downstream p53 and protein kinase C-d pro-apoptotic pathways trigger neuronal dysfunction and eventually neuronal death in SCA3. Either PNKP overexpression or pharmacological inhibition of ATM dramatically blocked mutant ATXN3-mediated cell death. Discovery of the mechanism by which mutant ATXN3 induces DNA damage and amplifies the pro-death signaling pathways provides a molecular basis for neurodegeneration due to PNKP inactivation in SCA3, and for the first time offers a possible approach to treatment.

The role of the mammalian DNA end-processing enzyme polynucleotide kinase 3'-phosphatase in spinocerebellar ataxia Type 3 pathogenesis

DNA strand-breaks (SBs) with non-ligatable ends are generated by ionizing radiation, oxidative stress, various chemotherapeutic agents, and also as base excision repair (BER) intermediates. Several neurological diseases have already been identified as being due to a deficiency in DNA end-processing activities. Two common dirty ends, 3'-P and 5'-OH, are processed by mammalian polynucleotide kinase 3'-phosphatase (PNKP), a bifunctional enzyme with 3'-phosphatase and 5'-kinase activities. We have made the unexpected observation that PNKP stably associates with Ataxin-3 (ATXN3), a polyglutamine repeat-containing protein mutated in spinocerebellar ataxia type 3 (SCA3), also known as Machado-Joseph Disease (MJD). This disease is one of the most common dominantly inherited ataxias worldwide; the defect in SCA3 is due to CAG repeat expansion (from the normal 14-41 to 55-82 repeats) in the ATXN3 coding region. However, how the expanded form gains its toxic function is still not clearly understood. Here we report that purified wild-type (WT) ATXN3 stimulates, and by contrast the mutant form specifically inhibits, PNKP's 3' phosphatase activity in vitro. ATXN3-deficient cells also show decreased PNKP activity. Furthermore, transgenic mice conditionally expressing the pathological form of human ATXN3 also showed decreased 3'-phosphatase activity of PNKP, mostly in the deep cerebellar nuclei, one of the most affected regions in MJD patients' brain. Finally, long amplicon quantitative PCR analysis of human MJD patients' brain samples showed a significant accumulation of DNA strand breaks. Our results thus indicate that the accumulation of DNA strand breaks due to functional deficiency of PNKP is etiologically linked to the pathogenesis of SCA3/MJD.

A orçamentação por programas, a Informação de desempenho e as políticas públicas:tendências, perspetivas e desafios

Dissertação de Mestrado em Gestão e Políticas Públicas

Derechos de participación e información en programas dirigidos a adolescentes en escuelas secundarias de la Ciudad de Córdoba: cumplimiento progresivo y estrategias de promoción. Participation and information rights in programs for adolescents in secondary schools in Cordoba City: progressive implementation and promotion strategies.

Abordar la infancia desde el enfoque de derechos (ED) implica una lectura de los derechos de los cuales los niños, niñas y adolescentes (NNA) son titulares y de las acciones estatales que se implementan para viabilizar el ejercicio concreto de ellos. Esta perspectiva exige comprender los contenidos de las políticas púb,el grado de participación que se les asigna y los sentidos que ellas toman en términos de progresividad de los derechos. Los cambios de concepción de la infancia desde la Convención Internacional de los Derechos del Niño (CIDN) y los cambios legislativos interpelan al Estado y la sociedad a modificar la visión hegemónica. Nuestra hipótesis gira alrededor de las siguientes considerac.: se han producido algunas modificaciones en las políticas y acciones estatales, aún no se dan las transformaciones necesarias de las lógicas institucionales y de los operadores que estimulen la participación de NNA en el ámbito escolar. Esto se visualiza en la ausencia de análisis cuali de los contenidos de las acc. y la falta de ftes estadísticas específicas, que muestren la orientac.de los contenidos en los principios de la protecc.integral. Estos presupuestos plantean interrogantes que delimitan el problema de investigación: ¿cómo se construye y reconstruye el ejercicio de la ciudadanía a través de la participación de los NNA, en su paso por la escuela, y cuáles son las lógicas institucionales que habilitan u obstaculizan ese ejercicio? Y ¿cuáles son los recursos institucionales que permitan que los programas y acciones redunden en el ejercicio efectivo de los derechos?.Obj.gral: Describir, analizar e interpretar la progresividad en el ejercicio de los derechos de participación e informacióin que tienen los adolescentes en escuelas secundarias de la cd de Cba, durante 2005 / 2010, para promover espacios públicos de construcción de ciudadanía. Se analizarán tres escuelas de Córdoba, escuela pública provincial, púb. nacional y privada. Obj. Espec.: Analizar las prácticas participativas formales e informales en las escuelas seleccionadas.- Aplicar indicadores cuanti y cualitativos del “Sistema de Indicadores para los derechos de la Infancia” Describir y analizar los recursos materiales y humanos. Elaborar y proponer procedim. para la confec. de registros de datos estadísticos - Elaborar y proponer lineamientos para la elaborac.e implementac.de acciones. Diseñar herramientas de difusión sobre los ds de participación e información.Esta investigac. es de carácter descriptivo e interpretativo, analizará diferentes ftes de informac.con técnicas cuanti y cualitativas, durante período la promulgación de la Ley 26061/05 y la adhesión prov. 9396/07. Se tomarán del Sistema de Indicadores, el derecho a la educación, el tema transversal “Acceso a la información y participación”, y las categorías de análisis “Recepción del Derecho y Capacidades estatales”. Se trabajaran indicadores cuanti y señales de progreso (cualitativos): estructurales, proceso y resultados. Serán analizados los Programas implementados durante el período de estudio. Estrategias cuali observac. participante, entrevistas, grupos focales, talleres de sensibilización, etc .Otras ftes de info: doc. institucionales, registros, evaluac, contenidos de programas y campañas y de difusión, prensa escrita, legislaciones, etc. La info se analizará a través Programa Atlas Ti, y del análisis estadístico. Algunos resultados esperados: Evaluac.y ajuste del Sistema de indicadores, la sensibilizac. desde el EF de autorid. escol. para la formulac. de planes y programas para el monitoreo adecuado de los mismos y para la rendic. de ctas de su gestión. Estimular la participac. de NNA en la escuela. Realizac.de documental. Brindar herramientas al Edo para superv de la aplicación progresiva del ejercicio de los derechos de participación e información de NNA Promov la continua evaluac. de los programas y acc.desde el ED para estimular el reconoc. de la nec.de ajuste de la política. The issue of children from the rights focus implies a reading of the rights in which children and adolescents are the holders and the state actions that are implemented to enable the exercise of them. This perspective requires understanding the contents of the public policies, the participation level that is assigned, and the senses that they take in terms of rights progressivity of. The conception changes about children since the International Convention on the Rights of the Child and legislative changes challenge to the State and society to modify hegemony vision. Our hypothesis revolves around the following considerations: there have been some public policies and state actions changes, but they not turn out, yet, transformations in logical institutional and actors whose are encourages children participation in school. This could be reflects in the absence of qualitative analysis in the actions contents and the lack of sources specific statistics, that will be showing the control of the principal contents of integral protection. These, raise the questions that delimit our problem research: how is built citizenship exercise through children and adolescent’s participation in the school, and what are the institutional logical that empowers or turns difficult that exercise? And What are the institutional resources that make possible the effective exercise of the rights, through different programs and actions?. General Objective: To describe, analyze and interpret exercise progressivity participation and information rights that have the adolescents in secondary schools in Córdoba City during 2005 / 2010, in order to promote public spaces for the construction of citizenship. It will analyze three schools in Cordoba, provincial public school, national public school and private school. . Obj. Specifics: To analyze the formal and informal participative practices in the schools selected. - To apply quantitative and qualitative indicators of the “Indicators System for Infa

Maternal Factors and Adverse Perinatal Outcomes in Women with Preeclampsia in Maceió, Alagoas

Abstract Background: Preeclampsia has been associated with several risk factors and events. However, it still deserves further investigation, considering the multitude of related factors that affect different populations. Objective: To evaluate the maternal factors and adverse perinatal outcomes in a cohort of pregnant women with preeclampsia receiving care in the public health network of the city of Maceió. Methods: Prospective cohort study carried out in 2014 in the public health network of the city with a sample of pregnant women calculated based on a prevalence of preeclampsia of 17%, confidence level of 90%, power of 80%, and ratio of 1:1. We applied a questionnaire to collect socioeconomic, personal, and anthropometric data, and retrieved perinatal variables from medical records and certificates of live birth. The analysis was performed with Poisson regression and chi-square test considering p values < 0.05 as significant. Results: We evaluated 90 pregnant women with preeclampsia (PWP) and 90 pregnant women without preeclampsia (PWoP). A previous history of preeclampsia (prevalence ratio [PR] = 1.57, 95% confidence interval [95% CI] 1.47 - 1.67, p = 0.000) and black skin color (PR = 1.15, 95% CI 1.00 - 1.33, p = 0.040) were associated with the occurrence of preeclampsia. Among the newborns of PWP and PWoP, respectively, 12.5% and 13.1% (p = 0.907) were small for gestational age and 25.0% and 23.2% (p = 0.994) were large for gestational age. There was a predominance of cesarean delivery. Conclusion: Personal history of preeclampsia and black skin color were associated with the occurrence of preeclampsia. There was a high frequency of birth weight deviations and cesarean deliveries.

Allgemeine Naturgeschichte für alle Stände / von Professor Oken.

Bd.3:pt.2: Botanik pt.2

IPH response to EU Commission consultation on EU role in global health

The European Commission launced a public consultation iin October 2009 on stakeholder views regarding the rationale, scope and strategic objectives for an EU role in global health. The Institute of Public Health in Ireland (IPH) aims to improve health on the island of Ireland by working to combat health inequalities and influence public policies in favour of health.  The Institute promotes cooperation between Northern Ireland and the Republic of Ireland in public health research, training and policy advice. IPH also contributes to a number of European networks and projects and is a member of the International Association of National Public Health Institutes (IANPHI). IPH welcomes the opportunity to respond to the European Commission consultation on the role of the EU in global health.

Health Inequalities Intervention Toolkit

This Health Inequalities Intervention Toolkit, developed jointly by the Association of Public Health Observatories and the Department of Health, focuses on improving life expectancy and infant mortality rates, especially in disadvantaged areas. Based on local authority boundaries, it is designed to assist evidence-based local service planning and commissioning, including Joint Strategic Needs Assessments. The Toolkit does this by providing information on the diseases, which are causing low life expectancy in individual areas, enabling good local priority setting. The Toolkit was originally designed to support achievement of the national Public Service Agreement target to: "Reduce health inequalities by 10% by 2010 as measured by infant mortality and life expectancy at birth." Although the PSA target has now ended, the Toolkit should still be useful to the NHS and local government, supporting planning to narrow inequalities in life expectancy and infant mortality