518 resultados para Gabriella de Lucca


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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Angiotensin II (Ang II) exerts an acute bimodal effect on proximal tubule NHE3: while low doses stimulate the exchanger, high doses inhibit it. In the present study, we have investigated the chronic effects of Ang II on NHE3 expression and transcriptional regulation. Treatment of a tubular epithelial cell line, OKP, with Ang II 10(-11) M significantly increased NHE protein expression and mRNA levels, without evidence of bimodal effect. No change in mRNA half-life was detected, but transient transfection studies showed a significant increase in NHE3 promoter activity. Binding sites for Sp1/Egr-1 and AP2 transcription factors of the NHE3 proximal promoter were mutated and we observed that the Sp1/Egr-1 binding site integrity is necessary for Ang II stimulatory effects. Inhibition of cytochrome P450, PI3K, PKA and MAPK pathways prevented the Ang II stimulatory effect on the NHE3 promoter activity. Taking all the results together, our data reveal that chronic Ang II treatment exerts a stimulatory effect on NHE3 expression and promoter activity. The Ang II up-regulation of the NHE3 promoter activity appears to involve the Sp1/Egr-1 binding site and the interplay of several intracellular signaling pathways. (C) 2011 Elsevier Inc. All rights reserved.

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Autosomal recessive spastic paraplegia with thinning of corpus callosum (ARHSP-TCC) is a complex form of HSP initially described in Japan but subsequently reported to have a worldwide distribution with a particular high frequency in multiple families from the Mediterranean basin. We recently showed that ARHSP-TCC is commonly associated with mutations in SPG11/KIAA1840 on chromosome 15q. We have now screened a collection of new patients mainly originating from Italy and Brazil, in order to further ascertain the spectrum of mutations in SPG11, enlarge the ethnic origin of SPG11 patients, determine the relative frequency at the level of single Countries (i.e., Italy), and establish whether there is one or more common mutation. In 25 index cases we identified 32 mutations; 22 are novel, including 9 nonsense, 3 small deletions, 4 insertions, 1 in/del, 1 small duplication, 1 missense, 2 splice-site, and for the first time a large genomic rearrangement. This brings the total number of SPG11 mutated patients in the SPATAX collection to 111 cases in 44 families and in 17 isolated cases, from 16 Countries, all assessed using homogeneous clinical criteria. While expanding the spectrum of mutations in SPG11, this larger series also corroborated the notion that even within apparently homogeneous population a molecular diagnosis cannot be achieved without full gene sequencing. (C) 2008 Wiley-Liss, Inc.

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Three plant proteinase inhibitors BbKI (kallikrein inhibitor) and BbCI (cruzipain inhibitor) from Bauhinia bouhinioides, and a BrTI (trypsin inhibitor) from B. rufa, were examined for other effects in Callosobruchus maculatus development; of these only BrTI affected bruchid emergence. BrTI and BbKI share 81% identities in their primary sequences and the major differences between them are the regions comprising the RGD and RGE motifs in BrTI. These sequences were shown to be essential for BrTI insecticidal activity, since a modified BbKI [that is a recombinant form (BbKIm) with some amino acid residues replaced by those found in BrTI sequence] also strongly inhibited insect development. By using synthetic peptides related to the BrTI sequence, YLEAPVARGDGGLA-NH(2) (RGE) and IVYYPDRGETGL-NH(2) (RGE), it was found that the peptide with an RGE sequence was able to block normal development of C. maculatus larvae (ED(50) 0.16% and LD(50) 0.09%), this being even more effective than the native protein. (C) 2009 Elsevier Ltd. All rights reserved.

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I denna undersökning är syftet att ta reda på hur ipad implementeras i förskolan. Med utgångspunkt i detta har jag lagt fokus på de verksamma pedagogernas uppfattning och vad ipad kan betyda gällande barns utveckling i förskolans verksamhet. Hur pedagogerna ser på ipaden som ett eventuellt utvecklande hjälpmedel är också grundläggande för denna studie.  Studiens teoretiska utgångspunkt är ett sociokulturellt perspektiv på lärandeDenna undersökning grundar sig i första hand i en kvantitativ metod i form av enkäter, där 27 pedagoger på 6 olika förskolor har delat med sig utav sina tankar gällande ipad. Enkäten är konstruerad med både fasta och öppna svarsalternativ, vilket erbjudit empiriska data för tolkningsbar fördjupad information. Resultatet visade på att implementering av ipad i förskolan upplevs som positivt av pedagogerna. Deras utsagor handlade om att ipaden ofta betraktas som ett stimulerande verktyg som kunnat bidra till att påverka utvecklat lärande i exempelvis matematik, språk och naturorienterade ämnen. Enkätsvaren visade att verksamhet med ipad till övervägande del väckte barnens lust och intresse. Men det rådde delade meningar om ipadens fördelar och nackdelar. Bland annat ansåg pedagogerna att den inte fick ta överhanden från de övriga aktiviteterna i verksamheten, och det betonades att pedagogerna borde vara med och styra upp arbetet. Det förekom hos en del pedagoger även tankar kring faktorer som eventuella effekter av trådlöst nätverk och strålning vilket barnen kan utsättas för. Enkätstudien visade vidare på brister i kompetensutveckling i samband med införandet av ipaden. De pedagoger som ville ha mer kompetens önskande mer grundläggande insikter om hur ipaden kunde användas i verksamheten för att utveckla barns lärande.  Huvudsaklig slutsats från studien är att vid implementering av nya verktyg såsom ipad är kommuners satsning på kompetensutveckling en grundläggande faktor. Didaktiskt fördjupad kunskap behövs för att implementering utifrån en sociokulturell syn ska kunna äga rum. Men studien visar också på en positiv inställning och vilja hos pedagogerna. 

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Denna systematiska litteraturstudie utfördes för att undersöka vilken typ av resonemang som främjas när undervisning bedrivs i form av undersökande arbetssätt. I resultatet presenteras teorier om undersökande arbetssätt från vetenskapliga artiklar publicerade år 2000 eller senare. Definitioner av imitativa och kreativa resonemang används i resultatavsnittet för att analysera de valda artiklarnas innehåll utifrån tidigare forskning. Resultaten visar att även om intentionerna är att elever ska vara kreativa och undersökande när de arbetar med matematik är det inte alltid tydligt om undervisningen innebär att elever skapar egna lösningsmetoder och förväntas argumentera för lösningar, vilka är faktorer som är betydelsefulla för vilken typ av resonemang som främjas. Även lärares agerande tycks ha betydelse för vilken typ av resonemang som främjas när undervisning bedrivs i form av undersökande arbetssätt.

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Lärare är personen som planerar, genomför och utvärderar undervisning. Eftersom att elevers matematiska resonemang, enligt aktuella styrdokument, ska utvecklas i undervisningen har läraren en given roll som påverkar hur eleven ges möjlighet att utveckla resonemangskompetens. Hur lärare uppfattar matematiska resonemang blir därmed en nyckelkomponent i vad som sker i undervisningen. Kan elevers förmåga att resonera påverkas om lärare uppfattar matematiska resonemang på skilda sätt? I denna studie diskuteras aktuell forskning om matematiska resonemang och dess betydelse i undervisningen. Två lärare har intervjuats och deras utsagor jämförs med den aktuella forskningen. Dessa kvalitativa intervjuer i relation till forskningen har visat sig öppna dörren för mer omfattande forskning inom detta ämnesområde då intressanta slutsatser har dragits, utan att dessa har generaliserats. I resultaten har det framkommit att elevers förmåga att resonera påverkas i en hög utsträckning av lärarens val att antingen ge elever en redan fungerande strategi eller att låta eleverna själva kämpa med en uppgift. Av intervjumaterialet med två lärare har det framkommit att frågeställningen varför saknas helt medan frågeställningen hur är vanligt förekommande. I denna studie har lärarnas utlåtanden blivit intressanta då forskning har visat att om elevers förmåga att argumentera för egna strategival ska utvecklas är frågeställningen varför avgörande. Därmed påverkar lärares uppfattningar om matematiska resonemang elevers förmåga att föra matematiska resonemang.

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The number of persons with dementia (PWD) is increasing rapidly worldwide. Cognitive impairments and communication difficulties are common among PWD. Therefore, gaining mutual togetherness in caring relation between PWD and their caregivers is important. This study was to investigate the effects of music therapeutic care (MTC) during morning care situations on improving verbal and nonverbal communication behaviors in people with dementia. An observation study with 10 PWD participating. Videotaped interactions (VIO) between PWD and their caregivers were conducted during eight weekly sessions, four recordings consisted of usual morning care and four recordings were of morning care with MTC intervention. The Verbal and Nonverbal Interaction Scale was used to analyze the recorded interactions at a later time. The unsociable verbal variable Cursing decreased significantly (P=.037) during MTC when compared with the baseline measurement. A significant (P=.000) reduction was observed for the unsociable nonverbal variable Does not respond to question. MTC significantly (P=.01) increased the mean score for the sociable nonverbal variable – Calm – relaxed. For sociable verbal communication, significant differences were observed for the variables Use coherent communication (P=.012), Use relevant communication (P=.009), Responds to questions (P=.000), Humming (P=.004), Singing (P=.000). MTC during morning care situations can be an effective non-pharmacological treatment, as well as nursing intervention in order to improve sociable communication behaviors, as well as reduce unsociable communication behaviors of PWDs

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Music therapeutic caregiving', when caregivers sing for or together with persons with severe dementia during care situations, has been suggested as a way to reduce problematic behaviors in dementia care. The present study implemented this technique as an intervention in dementia care. Six caregivers participated in group interviews about their experiences of morning care situations without and with'Music therapeutic caregiving'. Through a qualitative content analysis two themes emerged.'Being in a different reality' was based on'usual' morning care situations. The caregivers' experienced the persons with dementia as absent-minded; communication and cooperation were difficult. The second theme,'Being present', was based on morning care situations with the intervention. The caregivers described communication as enhanced; the persons with dementia expressed themselves more appropriately, making cooperation possible. The results indicate that'Music therapeutic caregiving' might lead to a more positive experience of the person with dementia and seems to increase receptivity to caregiving.  

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Objective: ‘Music Therapeutic Caregiving’, when caregivers sing for or together with persons with dementia during morning care situations, has been shown to increase verbal and nonverbal communication between persons with dementia and their caregivers, as well as enhance positive and decrease negative emotions in persons with dementia. No studies about singing during mealtimes have been conducted, and this pilot project was designed to elucidate this. However, since previous studies have shown that there is a risk that persons with dementia will start to sing along with the caregiver, the caregiver in this study hummed such that the person with dementia did not sing instead of eat. The aim of this pilot project was threefold: to describe expressed emotions in a woman with severe dementia, and describe communication between her and her caregivers without and with the caregiver humming. The aim was also to measure food and liquid intake without and with humming. Method: The study was constructed as a Single Case ABA design in which the ordinary mealtime constituted a baseline which comprised a woman with severe dementia being fed by her caregivers in the usual way. The intervention included the same woman being fed by the same caregiver who hummed while feeding her. Data comprised video observations that were collected once per week over 5 consecutive weeks. The Verbal and Nonverbal Interaction Scale and Observed Emotion Rating Scale were used to analyze the recorded interactions. Results: A slightly positive influence of communication was shown for the woman with dementia, as well as for the caregiver. Further, the women with dementia showed a slight increase in expressions of positive emotions, and she ate more during the intervention. Conclusion: Based on this pilot study no general conclusions can be drawn. It can be concluded, however, that humming while feeding persons with dementia might slightly enhance communication, and positive expressed emotions in persons with dementia. To confirm this, more studies on group levels are needed. Because previous studies have found that caregiver singing during caring situations influences persons with dementia positively it might be desirable to test the same during mealtime.

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International evidence on health promotion indicates the importance of regular physical activity for preventing and reducing the incidence of obesity and chronic diseases. This study investigated the relationship between physical activity and the social milieu of young Muslim women in the United Arab Emirates. This participatory action research project included semi-structured in-depth interviews and focus groups and yielded qualitative data. Set within a context of rapid social change, perceived barriers to daily exercise influenced participants’ physical activity levels and overall well-being. Results indicated a lack of physical exercise and strategies were proposed for implementation by college staff and students.

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Objective: To investigate the role of medical emergency teams in end-of-life care planning.

Design: One month prospective audit of medical emergency team calls.

Setting: Seven university-affiliated hospitals in Australia, Canada, and Sweden.

Patients: Five hundred eighteen patients who received a medical emergency team call over 1 month.

Interventions: None.

Measurements and Main Results: There were 652 medical emergency team calls in 518 patients, with multiple calls in 99 (19.1%) patients. There were 161 (31.1%) patients with limitations of medical therapy during the study period. The limitation of medical therapy was instituted in 105 (20.3%) and 56 (10.8%) patients before and after the medical emergency team call, respectively. In 78 patients who died with a limitation of medical therapy in place, the last medical emergency team review was on the day of death in 29.5% of patients, and within 2 days in another 28.2%. Compared with patients who did not have a limitation of medical therapy, those with a limitation of medical therapy were older (80 vs. 66 yrs; p < .001), less likely to be male (44.1% vs. 55.7%; p .014), more likely to be medical admissions (70.8% vs. 51.3%; p < .001), and less likely to be admitted from home (74.5% vs. 92.2%, p < .001). In addition, those with a limitation of medical therapy were less likely to be discharged home (22.4% vs. 63.6%; p < .001) and more likely to die in hospital (48.4% vs. 12.3%; p < .001). There was a trend for increased likelihood of calls associated with limitations of medical therapy to occur out of hours (51.0% vs. 43.8%, p .089).

Conclusions: Issues around end-of-life care and limitations of medical therapy arose in approximately one-third of calls, suggesting a mismatch between patient needs for end-of-life care and resources at participating hospitals. These calls frequently occur in elderly medical patients and out of hours. Many such patients do not return home, and half die in hospital. There is a need for improved advanced care planning in our hospitals, and to confirm our findings in other organizations.

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How selected next generation technologies support collaborative participation between higher education students and educators within a virtual socially networked e-learning landscape and encourage the interaction of communities of learners in multiple modes, ranging from text and images accessed within the Deakin Studies Online learning management system to a constructed virtual world in which the user’s creative imagination transports them to the “other side” of their computer screens is discussed in this paper. These constructed environments enable multiple simultaneous participants to access graphically built 3D environments, interact with digital artifacts and various functional tools and represent themselves through avatars, to communicate with other participants and engage in collaborative art learning.

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In this work we study the relation between restricted dissimilarity functions-and, more generally, dissimilarity-like functions- and penalty functions and the possibility of building the latter using the former. Several results on convexity and quasiconvexity are also considered.

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Background:
Most studies of Rapid-Response Teams (RRTs) assess their effect on outcomes of all hospitalised patients. Little information exists on RRT activation patterns or why RRT calls are needed. Triage error may necessitate RRT review of ward patients shortly after hospital admission. RRT diurnal activation rates may reflect the likely frequency of caregiver visits.

Objectives:
To study the timing of RRT calls in relation to time of day and day of week, and their frequency and outcomes in relation to days after hospital admission.

Methods:
We prospectively studied RRT calls over 1 month in seven hospitals during 2009, collecting data on patient age, sex, admitting unit, admission source, limitations of medical therapy (LOMTs), and admission and discharge dates. We assessed the timing of RRT calls in relation to hospital admission and circadian variation; and differences in characteristics and outcomes of calls occurring early (Days 0 and 1) versus late (after Day 7) after hospital admission.

Results:
There were 652 RRT calls for 518 patients. Calls were more likely on Mondays (P=0.018) and during work hours (P<0.0001) but less likely on weekends (P=0.003) or overnight (P<0.001). There were 177 early calls (27.1%) and 198 late calls (30.4%). Early calls involved younger patients (median ages, 67.5 years [early calls] v 73 years [late calls]; P= 0.01), fewer LOMTs (P=0.029), and lower in hospital mortality (12.8% [early calls] v 32.3% [late calls]; P<0.0001). The mortality difference remained in patients without LOMTs (5.6% [early calls] v 19.6% [late calls]; P=0.003).

Conclusions:
About one-quarter of RRT calls occurred shortly after hospital admission, and were more common when caregivers were around. Early calls may partially reflect suboptimal triage, though the associated mortality appeared low. Late calls may reflect suboptimal end-of-life care planning, and the associated mortality was high. There is a need to further assess the epidemiology of RRT calls at different phases of the hospital stay.