Nursing beliefs and actions in exercising patient advocacy in a hospital context

AbstractOBJECTIVEAnalyzing beliefs and actions of nurses in exercising patient advocacy in a hospital context.METHODA quantitative cross-sectional exploratory and descriptive study, conducted with 153 nurses from two hospitals in southern Brazil, one public and one philanthropic, by applying Protective Nursing Advocacy Scale - Brazilian version. Data were analyzed using descriptive statistics and analysis of variance.RESULTSNurses believe they are advocating for patients in their workplaces, and agree that they should advocate, especially when vulnerable patients need their protection. Personal values and professional skills have been identified as major sources of support for the practice of advocacy.CONCLUSIONNurses do not disagree nor agree that advocating for patients in their working environments can bring them negative consequences. It is necessary to recognize how the characteristics of public and private institutions have helped or not helped in exercising patient advocacy by nurses.

Iowa Biodiesel and Ethanol Processing Plants, January 2006

Maps of Iowa's Biodiesel and Ethanol Processing Plants.

Characterization of NALP2 and NALP3 IL-1β processing inflammasomes

Résumé II y a cinq ans, la découverte d'un nouveau domaine, le PYD domaine, lié aux domaines de la mort, a permis la description de la nouvelle famille des NALP protéines. L'analyse structurelle de cette famille de protéines révéla la présence de deux autres domaines, impliqués dans l'oligomerisation, NACHT, et la détection des ligands, Leucine rich repeats ou LRR. Cette architecture protéique est homologue à celle qui est décrite pour les NODs, les Tol1 récepteurs et tes protéines de résistance chez les plantes. Cette homologie suggère une possible implication des NALPs dans la régulation de l'immunité innée. Premièrement, nous avons décrit les composants minimaux qui permettent à l'inflammasomeNALP3 d'activer la caspase pro-inflammatoire, caspase-1. En comparaison à NALP1, NALP3 ne contient pas de FIIND domaine, ni de CARD domaine en C-terminus et n'interagit pas avec caspase-5. Nous avons découvert une protéine très homologue au C-terminus de NALP1, Cardinal, qui se lie au NACHT domaine de NALP2 et NALP3 par l'intermédiaire de son FIIND domaine. Cardinal possède la capacité d'interagir avec caspase-l, mais seul ASC semble être nécessaire à la maturation de la prointerleukine-1β suite à la stimulation de NALP3. Deuxièmement, notre étude s'est concentrée sur la nature du stimulus capable d'induire la formation et l'activation de l'inflammasome-NALP3. Nous avons démontré que l'ajout de muramyl dipeptide (MDP), produit à partir de la digestion enzymatique de peptidoglycaris bactériens, induit à la fois l'expression de la proIL-1β par la voie NOD2 et sa maturation en IL-1β active par la voie NALP3. Bien que le MDP active l'inflammasome-NALP3, il est incapable d'induire la sécrétion de l'IL-1β mature dans la lignée cellulaire THP1, comparé aux monocytes primaires humains. Cette différence pourrait être liée à l'absence, dans les THP1, de la protéine Filamin, qui est proposée d'interagir avec Cardinal. L'implication de NALP3 dans la maturation de l'IL-lb est confirmée suite à la découverte de mutations sur le gène CIAS1/NALP3/cryopyrin associées à trois maladies auto-inflammatoires : le syndrome de Muckle-Wells (MWS), l'urticaire familial au froid (FCU) et le syndrome CINCA/NOMID. Une élévation constitutive de la maturation et de la sécrétion de la proIL-1β en absence de stimulation MDP est détectée dans les macrophages des patients Muckle-Wells. En conclusion, nos études ont démontré que l'inflammasome-NALP3 doit être finement régulé pour éviter une activité incontrôlée qui représente la base moléculaire des symptômes associés aux syndromes auto-inflammatoires liés à NALP3. Summary Five years ago, the description of the NALP family originated from the discovery of a new death-domain fold family, the PYD domain. NALP contains aprotein-protein interaction domain (PYD), an oligomerization domain (NACHT) and a ligand-sensing domain, leucine rich repeats or LRR. This protein architecture shares similarity with receptors involved in immunity, such as NODS, Toll receptors (TLRs) and related plant resistance proteins, and points to an important role of NALPs in defense mechanisms. We first described the minimal complex involved in the pro-inflammatory Interleukin-1beta (IL-1β) cytokine maturation, called the inflammasome, which contains NALP3. In contrast to NALP1, NALP3, like other members of the NALP family, is devoid of C-terminal FIIND and CARD domains and does not interact with the pro-inflammatory caspase-5. Interestingly, a homolog of the C-terminal portion of NALP1 was found in the human genome and was named Cardinal. We found that NALP2 and NALP3 interact with the CARD-containing proteins Cardinal. Cardinal is able to bind to caspase-1 but is not required for IL-1β maturation through NALP3 activation, as demonstrated for the adaptor ASC. Secondly, our study focused on the stimuli involved in the activation of the NALP3 inflammasome. MDP was shown to induce the expression of proIL1β through NOD2 and then the maturation into active IL-1β by activation of the NALP3 inflammasome. However, in the monocytic THP1 cell line, secretion of IL-1β upon MDP stimulation seems to be independent of the inflammasome activation compared to human primary monocytes. This difference might be linked to a Cardinal-interacting protein, filamin. Until now, the role of Cardinal and filamin is still unknown and remains to be elucidated. Finally, mutations in the NALP3/cryopyrin/CIAS1 gene are associated with three autoinflammatory diseases: Muckle-Wells syndrome, familial cold autoinflammatory syndrome, and CINCA. Constitutive, elevated IL-1β maturation and secretion, even in the absence of MDP stimulation, was observed in macrophages from Muckle-Wells patients and confirmed a key role for the NALP3 inflammasome in innate immunity In conclusion, our studies describes the formation of the NALP3 inflammasome and suggests that this complex has to be tightly regulated to avoid an increased deregulated inflammasome activity that is the molecular basis for the symptoms associated with NALP3-dependent autoinflammatory disorders.

The role of awareness, information gathering and processing in school choice

This paper studies the determinants of school choice, focusing on the role of information. Weconsider how parents' search efforts and their capacity to process information (i.e., tocorrectly assess schools) affect the quality of the schools they choose for their children. Usinga novel dataset, we are able to identify parents' awareness of schools in their neighborhoodand measure their capacity to rank the quality of the school with respect to the officialrankings. We find that parents education and wealth are important factors in determiningtheir level of school awareness and information gathering. Moreover, these search effortshave important consequences in terms of the quality of school choice.

Bilateral dorsal and ventral fiber pathways for the processing of affective prosody identified by probabilistic fiber tracking.

Dorsal and ventral pathways for syntacto-semantic speech processing in the left hemisphere are represented in the dual-stream model of auditory processing. Here we report new findings for the right dorsal and ventral temporo-frontal pathway during processing of affectively intonated speech (i.e. affective prosody) in humans, together with several left hemispheric structural connections, partly resembling those for syntacto-semantic speech processing. We investigated white matter fiber connectivity between regions responding to affective prosody in several subregions of the bilateral superior temporal cortex (secondary and higher-level auditory cortex) and of the inferior frontal cortex (anterior and posterior inferior frontal gyrus). The fiber connectivity was investigated by using probabilistic diffusion tensor based tractography. The results underscore several so far underestimated auditory pathway connections, especially for the processing of affective prosody, such as a right ventral auditory pathway. The results also suggest the existence of a dual-stream processing in the right hemisphere, and a general predominance of the dorsal pathways in both hemispheres underlying the neural processing of affective prosody in an extended temporo-frontal network.

Aplicação dos Sistemas de Informação Geográfica em Estudos de Caracterização Biofísica da Ilha de Santo Antão em Cabo Verde

Com características morfológicas e edafo-climáticas extremamente diversificadas, a ilha de Santo Antão em Cabo Verde apresenta uma reconhecida vulnerabilidade ambiental a par de uma elevada carência de estudos científicos que incidam sobre essa realidade e sirvam de base à uma compreensão integrada dos fenómenos. A cartografia digital e as tecnologias de informação geográfica vêm proporcionando um avanço tecnológico na colecção, armazenamento e processamento de dados espaciais. Várias ferramentas actualmente disponíveis permitem modelar uma multiplicidade de factores, localizar e quantificar os fenómenos bem como e definir os níveis de contribuição de diferentes factores no resultado final. No presente estudo, desenvolvido no âmbito do curso de pós-graduação e mestrado em sistemas de Informação geográfica realizado pela Universidade de Trás-os-Montes e Alto Douro, pretende-se contribuir para a minimização do deficit de informação relativa às características biofísicas da citada ilha, recorrendo-se à aplicação de tecnologias de informação geográfica e detecção remota, associadas à análise estatística multivariada. Nesse âmbito, foram produzidas e analisadas cartas temáticas e desenvolvido um modelo de análise integrada de dados. Com efeito, a multiplicidade de variáveis espaciais produzidas, de entre elas 29 variáveis com variação contínua passíveis de influenciar as características biofísicas da região e, possíveis ocorrências de efeitos mútuos antagónicos ou sinergéticos, condicionam uma relativa complexidade à interpretação a partir dos dados originais. Visando contornar este problema, recorre-se a uma rede de amostragem sistemática, totalizando 921 pontos ou repetições, para extrair os dados correspondentes às 29 variáveis nos pontos de amostragem e, subsequente desenvolvimento de técnicas de análise estatística multivariada, nomeadamente a análise em componentes principais. A aplicação destas técnicas permitiu simplificar e interpretar as variáreis originais, normalizando-as e resumindo a informação contida na diversidade de variáveis originais, correlacionadas entre si, num conjunto de variáveis ortogonais (não correlacionadas), e com níveis de importância decrescente, as componentes principais. Fixou-se como meta a concentração de 75% da variância dos dados originais explicadas pelas primeiras 3 componentes principais e, desenvolveu-se um processo interactivo em diferentes etapas, eliminando sucessivamente as variáveis menos representativas. Na última etapa do processo as 3 primeiras CP resultaram em 74,54% da variância dos dados originais explicadas mas, que vieram a demonstrar na fase posterior, serem insuficientes para retratar a realidade. Optou-se pela inclusão da 4ª CP (CP4), com a qual 84% da referida variância era explicada e, representando oito variáveis biofísicas: a altitude, a densidade hidrográfica, a densidade de fracturação geológica, a precipitação, o índice de vegetação, a temperatura, os recursos hídricos e a distância à rede hidrográfica. A subsequente interpolação da 1ª componente principal (CP1) e, das principais variáveis associadas as componentes CP2, CP3 e CP4 como variáveis auxiliares, recorrendo a técnicas geoestatística em ambiente ArcGIS permitiu a obtenção de uma carta representando 84% da variação das características biofísicas no território. A análise em clusters validada pelo teste “t de Student” permitiu reclassificar o território em 6 unidades biofísicas homogéneas. Conclui-se que, as tecnologias de informação geográfica actualmente disponíveis a par de facilitar análises interactivas e flexíveis, possibilitando que se faça variar temas e critérios, integrar novas informações e introduzir melhorias em modelos construídos com bases em informações disponíveis num determinado contexto, associadas a técnicas de análise estatística multivariada, possibilitam, com base em critérios científicos, desenvolver a análise integrada de múltiplas variáveis biofísicas cuja correlação entre si, torna complexa a compreensão integrada dos fenómenos.

A Gestão da Formação na Sucursal da Mundiserviços em Cabo Verde

O presente Relatório de Estágio insere-se no âmbito da Unidade Curricular de Estágio, realizado na empresa MundiServiços, Consultoria de Gestão e Formação, Sucursal de Cabo Verde, conducente ao grau de Mestre em Ciências da Educação com especialização na área de Formação de Adultos. A Sucursal da MundiServiços em Cabo Verde centra a sua intervenção no mercado cabo-verdiano essencialmente em dois eixos: Consultoria na área de Gestão de Recursos Humanos e Formação Profissional. O meu Projecto de Estágio tem a sua incidência na área da Formação Profissional e visa responder a uma solicitação da ARFA - Agência de Regulação e Supervisão de Produtos Farmacêuticos e Alimentares - organização cliente da MundiServiços em Cabo Verde. Neste contexto, o Projecto de Estágio tem como finalidade a realização de um Estudo de Diagnóstico de Necessidades de Formação e a Elaboração de um Plano Estratégico de Formação que possa satisfazer as necessidades organizacionais, profissionais e pessoais da Agência e dos seus trabalhadores. Este trabalho enquadra-se numa medida estratégica da entidade, que passa pelo desenvolvimento de competências chave dos seus recursos humanos, como forma de responder a novos desafios estratégicos e organizacionais e de aumentar a motivação e satisfação interna dos seus trabalhadores. De acordo com os objectivos pré-estabelecidos para a execução deste estudo, tentou-se combinar as metodologias qualitativa e quantitativa, com recurso a diferentes técnicas de recolha, análise e tratamento de dados, com a principal finalidade de obter informações que permitam responder, de forma efectiva, à solicitação da agência, transformando as necessidades formativas dos trabalhadores em potencialidades.

O ensino e o uso do conjuntivo no terceiro ciclo em Cabo Verde: estudo de caso realizado na escola secundaria Manuel Lopes - Praia

Neste trabalho analisamos um conteúdo gramatical - o modo conjuntivo num contexto de aprendizagem formal, seguindo duas vias: a teórica, em que fizemos uma abordagem sobre as perspectivas de vários gramáticos; a prática, que se traduz na análise de um corpus. Desenvolvemos esta análise com base nas produções escritas dos aprendentes do terceiro ciclo, na Escola Secundária Manuel Lopes, Praia, com o objectivo de fazer uma abordagem crítica respeitante ao ensino do Português Língua Segunda, em particular, ao ensino e uso do conjuntivo na supracitada língua em Cabo Verde. Com efeito, foram abordadas questões relativas às teorias de aquisição/aprendizagem segundo as perspectivas de diversos autores. A análise dos textos escritos orientou-nos para o levantamento e estudo dos erros de uso do conjuntivo e para termos uma noção do perfil sociolinguístico dos aprendentes. A descrição linguística efectuada conduziu-nos a uma reflexão sobre as formas de tratamento e de recuperação dos erros . Os resultados sugerem que o insucesso na aprendizagem do Português Língua Segunda deve-se a factores vários, entre os quais, sociolinguísticos e políticos. Nesta sequência, perspectivamos a superação de erros mediante estratégias e sugestões metodológicas para um ensino eficaz do conjuntivo em Português Língua Segunda, neste país.

Respiration, metabolic balance, and attention in affective picture processing

The jointly voluntary and involuntary control of respiration, unique among essential physiological processes, the interconnection of breathing with and its influence on the autonomic nervous system, and disease states associated with the interface between psychology and respiration (e.g., anxiety disorders, hyperventilation syndrome, asthma) make the study of the relationship between respiration and emotion both theoretically and clinically of great relevance. However, the respiratory behavior during affective states is not yet completely understood. We studied breathing pattern responses to 13 picture series varying widely in their affective tone in 37 adults (18 men, 19 women, mean age 26). Time and volume parameters were recorded with the LifeShirt system (VivoMetrics Inc., Ventura, California, USA, see image). We also measured end-tidal pCO2 (EtCO2) with a Microcap Handheld Capnograph (Oridion Medical 1987 Ltd., Jerusalem, Israel) to determine if ventilation is in balance with metabolic demands and spontaneous eye-blinking to investigate the link between respiration and attention. At the end of each picture series, the participants reported their subjective feeling in the affective dimensions of pleasantness and arousal. Increasing self-rated arousal was associated with increasing minute ventilation but not with decreases in EtCO2, suggesting that ventilatory changes during picture viewing paralleled variations in metabolic activity. EtCO2 correlated with pleasantness, and eye-blink rate decreased with increasing unpleasantness in line with a negativity bias in attention. Like MV, inspiratory drive (i.e., mean inspiratory flow) increased with arousal. This relationship reflected increases in inspiratory volume rather than shortening of the time parameters. This study confirms that respiratory responses to affective stimuli are organized to a certain degree along the dimensions of pleasantness and arousal. It shows, for the first time, that during picture viewing, ventilatory increases with increasing arousal are in balance with metabolic activity and that inspiratory volume is modulated by arousal. MV emerges as the most reliable respiratory index of self-perceived arousal. Finally, end-tidal pCO2 is slightly lower during processing of negative as compared to positive picture contents, which is proposed to enhance sensory perception and reflect a negativity bias in attention.

Mineralogical, petrographic and geochemical characterisation of white and coloured Iberian marbles in the context of the provenancing of some artefacts from Thamusida (Kenitra, Morocco)

A multi-analytical study has been carried out on a collection of white and coloured Iberian marbles. A total of 135 marble specimens were collected in Spain and Portugal from the Betic chain (Alhaurin de la Torre, Mijas, Macael), Ossa Morena (Alconera, Almaden de la Plata and Viana do Alentejo), and the Estremoz Anticline (Bencatel, Borba and Estremoz) areas. X-ray diffractometry and carbon and oxygen stable isotope analysis were carried out on these samples; 38 samples were also investigated by optical and scanning electron microscopy. The results provide a set of diagnostic parameters that allow discriminating the sampled marble quarries. The carbonate minerals composition is distinctive for the Mijas and Alhaurin de la Torre marbles; the isotopic analysis allows discriminating also between these two dolomitic marble quarries. The Ossa Morena and Estremoz Anticline marbles share a similar stable isotope composition; the accessory mineral content, the maximum grain size (MGS) and the fabric are particularly useful in the distinction between them. In the framework of archaeometric provenance studies on Thamusida (Kenitra, Morocco) Roman marble artefacts, a specific comparison between this new Iberian database and archaeological findings has been carried out. The hypothesis of commercial exchanges between the Iberian regions and Roman Morocco is supported by the results of the provenance study, which suggested the Almaden de la Plata and Mijas quarries as possible sources of raw materials for the production of archaeological artefacts.

The role of proteolytic processing and the stable signal peptide in expression of the Old World arenavirus envelope glycoprotein ectodomain.

Maturation of the arenavirus GP precursor (GPC) involves proteolytic processing by cellular signal peptidase and the proprotein convertase subtilisin kexin isozyme 1 (SKI-1)/site 1 protease (S1P), yielding a tripartite complex comprised of a stable signal peptide (SSP), the receptor-binding GP1, and the fusion-active transmembrane GP2. Here we investigated the roles of SKI-1/S1P processing and SSP in the biosynthesis of the recombinant GP ectodomains of lymphocytic choriomeningitis virus (LCMV) and Lassa virus (LASV). When expressed in mammalian cells, the LCMV and LASV GP ectodomains underwent processing by SKI-1/S1P, followed by dissociation of GP1 from GP2. The GP2 ectodomain spontaneously formed trimers as revealed by chemical cross-linking. The endogenous SSP, known to be crucial for maturation and transport of full-length arenavirus GPC was dispensable for processing and secretion of the soluble GP ectodomain, suggesting a specific role of SSP in the stable prefusion conformation and transport of full-length GPC.

Characterization of intonation in Karṇāṭaka music by parametrizing context-based Svara Distributions

Intonation is a fundamental music concept that has a special relevance in Indian art music. It is characteristic of the rāga and intrinsic to the musical expression of the performer. Describing intonation is of importance to several information retrieval tasks like the development of rāga and artist similarity measures. In our previous work, we proposed a compact representation of intonation based on the parametrization of the pitch histogram of a performance and demonstrated the usefulness of this representation through an explorative rāga recognition task in which we classified 42 vocal performances belonging to 3 rāgas using parameters of a single svara. In this paper, we extend this representation to employ context-based svara distributions, which are obtained with a different approach to find the pitches belonging to each svara. We quantitatively compare this method to our previous one, discuss the advantages, and the necessary melodic analysis to be carried out in future.

Clinicopathologic and molecular analysis of a choroidal pigmented schwannoma in the context of a PTEN hamartoma tumor syndrome.

PURPOSE: To report the first case of choroidal schwannoma in a patient affected by PTEN hamartoma tumor syndrome (PHTS) and investigate the molecular involvement of the phosphatase and tensin homolog (PTEN) and neurofibromin 2 (NF2) genes in this rare intraocular tumor. DESIGN: Observational case report. PARTICIPANT: A 10-year-old girl diagnosed with PHTS. METHODS: The enucleated specimen underwent histologic, immunohistochemical, and transmission electronic microscopy. The expression of PTEN and NF2 and their protein products were evaluated by reverse transcription-polymerase chain reaction and immunohistochemistry. Somatic mutations of PTEN and NF2, as well as allelic loss, were investigated by direct sequencing of DNA extracted from the tumor. PTEN epigenetic silencing was investigated by pyrosequencing. MAIN OUTCOME MEASURES: Histopathologic and molecular characterization of a choroidal pigmented schwannoma. RESULTS: Histopathologic, immunohistochemical, and electron microscopic analysis demonstrated features consistent with a pigmented cellular schwannoma of the choroid. We found no loss of heterozygosity at the genomic level for the PTEN germline mutation and no promoter hypermethylation or other somatic intragenic mutations. However, we observed an approximate 40% reduction of PTEN expression at both the mRNA and the protein level, indicating that the tumor was nonetheless functionally deficient for PTEN. Although DNA sequencing of NF2 failed to identify any pathologic variants, its expression was abolished within the tumor. CONCLUSIONS: We report the first description of a pigmented choroidal schwannoma in the context of a PHTS. This rare tumor showed a unique combination of reduction of PTEN and absence of NF2 expression.