RESUMO
Open, reproducible, and replicable research practices are a fundamental part of science. Training is often organized on a grassroots level, offered by early career researchers, for early career researchers. Buffet style courses that cover many topics can inspire participants to try new things; however, they can also be overwhelming. Participants who want to implement new practices may not know where to start once they return to their research team. We describe ten simple rules to guide participants of relevant training courses in implementing robust research practices in their own projects, once they return to their research group. This includes (1) prioritizing and planning which practices to implement, which involves obtaining support and convincing others involved in the research project of the added value of implementing new practices; (2) managing problems that arise during implementation; and (3) making reproducible research and open science practices an integral part of a future research career. We also outline strategies that course organizers can use to prepare participants for implementation and support them during this process.
RESUMO
In paediatric clinical care, what is said to a parent or carer as well as when, where, and how it is said, directly advances or diminishes parents' capacities to understand available options and to contribute to decisions about treatment for their child. This makes interprofessional and patient communication an ethical endeavour. Social workers are uniquely situated to observe, participate in, and provide an active link in the communication between families and other health team members. This article reports phenomenological research exploring ethical issues encountered by social workers in their everyday practice communicating with families and other health professionals in a paediatric hospital context in Australia. Data were collected via semi-structured interviews with nine social workers and analysed thematically. Participants described two main communication-based roles: to support families through information provision and to contribute collaboratively to the interprofessional team involved in caring for a child and family. We grouped participants' descriptions of conflict between these roles into five main "communication challenges": (1) holding troublesome knowledge; (2) the need for diplomacy; (3) conciliation; (4) every man and his dog in family meetings; and (5) systems and processes presenting a brick wall. The five communication challenges provide empirically derived examples of how communication occurring within interprofessional health teams and between individual clinicians and parents can act to diminish or enhance parents' experience of care for their hospitalised child. Identifying these challenges may help to inform how communication within interprofessional teams and between clinicians and patients can benefit children and their parents.
Assuntos
Comunicação , Hospitais Pediátricos/ética , Hospitais Pediátricos/organização & administração , Relações Interprofissionais , Serviço Social , Adulto , Austrália , Família/psicologia , Feminino , Processos Grupais , Humanos , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente , Relações Profissional-Família , Pesquisa QualitativaAssuntos
Acidentes de Trânsito , Air Bags/efeitos adversos , Queimaduras Químicas/etiologia , Túnica Conjuntiva/lesões , Conjuntivite/etiologia , Queimaduras Oculares/induzido quimicamente , Hidróxido de Sódio , Idoso , Antibacterianos/administração & dosagem , Antioxidantes/administração & dosagem , Ácido Ascórbico/administração & dosagem , Queimaduras Químicas/diagnóstico , Queimaduras Químicas/tratamento farmacológico , Cloranfenicol/administração & dosagem , Conjuntivite/diagnóstico , Conjuntivite/tratamento farmacológico , Edema da Córnea/diagnóstico , Edema da Córnea/tratamento farmacológico , Edema da Córnea/etiologia , Queimaduras Oculares/diagnóstico , Queimaduras Oculares/tratamento farmacológico , Feminino , Glucocorticoides/administração & dosagem , Humanos , Lubrificantes/administração & dosagem , Masculino , Soluções Oftálmicas/administração & dosagem , Prednisolona/administração & dosagem , Prednisolona/análogos & derivadosAssuntos
Úlcera da Córnea/etnologia , Infecções Oculares Bacterianas/etnologia , Infecções Oculares Fúngicas/etnologia , Havaiano Nativo ou Outro Ilhéu do Pacífico/etnologia , Adulto , Austrália/epidemiologia , Bactérias/isolamento & purificação , Córnea/microbiologia , Úlcera da Córnea/microbiologia , Infecções Oculares Bacterianas/microbiologia , Infecções Oculares Fúngicas/microbiologia , Feminino , Seguimentos , Fungos/isolamento & purificação , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco , Acuidade Visual/fisiologiaAssuntos
Fasciite/diagnóstico por imagem , Seio Frontal/patologia , Doenças Orbitárias/diagnóstico por imagem , Doenças dos Seios Paranasais/diagnóstico por imagem , Criança , Diagnóstico Diferencial , Diplopia/diagnóstico , Exoftalmia/diagnóstico , Fasciite/patologia , Fasciite/cirurgia , Osso Frontal/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Doenças Orbitárias/patologia , Doenças Orbitárias/cirurgia , Doenças dos Seios Paranasais/patologia , Doenças dos Seios Paranasais/cirurgia , Tomografia Computadorizada por Raios X , Acuidade Visual/fisiologiaAssuntos
Abscesso/microbiologia , Infecções Oculares Bacterianas/microbiologia , Nocardiose/microbiologia , Nocardia/isolamento & purificação , Doenças Retinianas/microbiologia , Abscesso/diagnóstico , Abscesso/tratamento farmacológico , Idoso de 80 Anos ou mais , Amicacina/uso terapêutico , Antibacterianos/uso terapêutico , Abscesso Encefálico/diagnóstico , Abscesso Encefálico/tratamento farmacológico , Abscesso Encefálico/microbiologia , Ceftriaxona/uso terapêutico , Quimioterapia Combinada , Infecções Oculares Bacterianas/diagnóstico , Infecções Oculares Bacterianas/tratamento farmacológico , Humanos , Imageamento por Ressonância Magnética , Masculino , Testes de Sensibilidade Microbiana , Havaiano Nativo ou Outro Ilhéu do Pacífico , Nocardiose/diagnóstico , Nocardiose/tratamento farmacológico , Doenças Retinianas/diagnóstico , Doenças Retinianas/tratamento farmacológico , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico , VitrectomiaRESUMO
Eicosanoids are cellular metabolites, which shape the immune response, including inflammatory processes in macrophages. The effects of these lipid mediators on inflammation and bacterial pathogenesis are not clearly understood. Certain eicosanoids are suspected to act as molecular sensors for the recruitment of neutrophils, while others regulate bacterial uptake. In this study, gene expression analyses indicated that genes involved in eicosanoid biosynthesis including COX-1, COX-2, DAGL, and PLA-2 are differentially regulated in THP-1 human macrophages infected with Salmonella enterica Typhimurium or Yersinia enterocolitica. By using targeted metabolomics approach, we found that the eicosanoid precursor, arachidonic acid (AA) as well as its derivatives, including prostaglandins (PGs) PGF2α or PGE2/PGD2, and thromboxane TxB2, are rapidly secreted from macrophages infected with these Gram-negative pathogenic bacteria. The magnitude of eicosanoid biosynthesis in infected host cells depends on the presence of virulence factors of Y. enterocolitica and S. Typhimurium strains, albeit in an opposite way in Y. enterocolitica compared to S. Typhimurium infection. Trials with combinations of EP2/EP4 PGE2 receptor agonists and antagonists suggest that PGE2 signaling in these infection models works primarily through the EP4 receptor. Downstream of EP4 activation, PGE2 enhances inflammasome activation and represses M2 macrophage polarization while inducing key M1-type markers. PGE2 also led to a decreased numbers of Y. enterocolitica within macrophages. To summarize, PGE2 is a potent autocrine/paracrine activator of inflammation during infection in Gram-negative bacteria, and it affects macrophage polarization, likely controlling bacterial clearance by macrophages.
RESUMO
BACKGROUND: Re-operative surgery is stressful for patients and is an additional burden to an already stretched public health system. Intraoperative confirmation of breast cancer metastases in sentinel lymph nodes (SLNs) provides the necessary information for the surgeon to proceed with immediate axillary dissection, avoiding the need for a second operation, its associated cost, morbidity and adjuvant treatment delays. Our challenge was to implement a technique that was rapid, inexpensive and had a negligible false positive rate. The aim of this study was to determine whether touch imprint cytology (TIC) could reduce returns to theatre without compromising patient safety and pathology department and operating theatre efficiency. METHODS: Intraoperative TIC was performed on bisected SLNs from 134 patients. Post-operatively, specimens were examined as haematoxylin and eosin-stained, paraffin-embedded 2-mm sections. Further sectioning and immunohistochemisty was performed on negative SLNs. RESULTS: The sensitivity of TIC for metastases was 23.8%, the specificity was 100% and the accuracy was 76.1%. Ten patients with macrometastases and none with micrometastastes were detected intraoperatively. The sensitivity of TIC for detecting macrometastases was 34.5%, the accuracy was 78.4% and the specificity was 100%. CONCLUSION: Ten patients avoided a subsequent surgery. The technique caused no theatre delays and the minimal cost was compensated for by the avoidance of a second procedure for a third of patients who definitively required axillary clearance. No patients had an unnecessary axillary clearance and no patients with micrometastases or isolated tumour cells were subjected to an immediate axillary clearance. It would be justifiable to continue this simple, low-cost and non-disruptive approach.