Patienten med demens behöver vårdas av personal med erforderlig utbildning. Omvårdnaden av dess patienter är i högsta grad lika viktig som den medicinska vården. I syfte att belysa omvårdnad som förebygger och åtgärdar oro och agitation hos patienter med demenssjukdom användes en systematisk litteraturstudie. Intresseområdet definierades och en fråga ställdes till litteraturen relaterad till syftet, kriterier för avgränsning av artiklar, fastställdes, sökningar genomfördes i databaser och genom manuell sökning i tidskrifter. Relevanta artiklar granskades utifrån kvalitet och bevisvärde. Följande kategorier framkom genom innehållsanalys: Integritets stödjande vård, Bemötande av plockbeteende, Patient centrerad omvårdnad, Minskande av tvång och konfrontation, Konkreta omvårdnadsåtgärder/strategier och teknik. Kommunikation som var anpassad till patientens nivå av kognitiv förmåga och omvårdnadsplan, var det viktigaste. En arbetsmetod som var tillbakadragande/avledande/lämna ifred teknik, var en användbar arbetsmetod som minskade oro och agitation. Det viktigaste var att ha ett bemötande, anpassat med den specifika kunskap i omvårdnad/bemötande som finns. / Patients with dementia are in need of care by educated personal with required knowledge. Nursing is indeed just as important as medical care. To highlight nursing as a way to prevent and measure anxiety and agitation in patients with dementia a systematic literature study was carried out. Subject of interest was defined and a question related to the aim of the study was put to the literature, inclusion criteria were chosen. The literature search was carried out in Databases and manually in magazines. Relevant articles were examined from the perspective of quality and degree of evidence. The following categories appeared thru content analyse: Support of integrity, Refutation of a picking behaviour, Patient centred care,, Reducing compulsion and confrontation, Tangible nursing measures, techniques and strategies. Communication adapt to the patients level of understanding and nursing planning was found most important. Attitude of withdrawal/diversion/leave alone were useful working methods that may less anxiety and agitation. The main thing is however an adjustable encounter with the patient, using the specific knowledge of nursing measures.

Bakgrund: Varje dag smittas i genomsnitt cirka 14 000 personer av HIV i världen. Ny behandling har gjort att dessa patienter idag lever längre. Sjukdomsförlopp samt komplikationer går inte att förutsäga utan är individuellt. Eftersom personer med HIV/AIDS-diagnos nu lever längre kommer behovet av arbetsterapeutiska insatser att öka. Syfte: Syftet med studien är att beskriva arbetsterapeutiska insatser för personer med HIV/AIDS samt vilken roll arbetsterapeuten har i arbetet kring dessa personer. Metod: En systematisk litteraturstudie gjordes för att få svar på syftet. Resultat: Vi har kommit fram till att arbetsterapeutiska insatser för personer med HIV/AIDS kan delas in i fem teman; Handledning, Hjälpmedel och anpassning, Undervisning, Förhållningssätt samt Existentiella frågor och andlighet. Arbetsterapeuten hjälper patienten att formulera målsättningar och att uppnå ökad självständighet genom att bland annat tillhandahålla hjälpmedel och bedriva utbildning. HIV/AIDS-patienters bakgrund är viktig att tänka på då den kan visa hur mottaglig en patient är för olika arbetsterapeutiska behandlingsmetoder. Slutsats: Arbetsterapeutiska insatser som används i arbetet med HIV/AIDS-patienter skiljer sig inte mot insatser riktade till andra patientgrupper.

El tracte dels pacients amb pneumonia adquirida en la comunitat (PNAC) que no responen al tractament antibiòtic inicial constitueix un repte per al clínic. Aquest estudi va investigar la utilitat dels canvis en els nivells de la proteïna C reactiva (PCR) per tal de discriminar entre el fracàs terapèuticc vertader i la resposta lenta al tractament. MÈTODES Aquest estudi multicèntric prospectiu observacionasl va investigar el comportament dels nivells de PCR en plasma els dies 1 i 4 en pacients adults hospitalitzats diagnosticats de PNAC. Es determinaren els nivells de PCR en sang els dies 1 i 4. En acabar el procés, els pacients que no respongueren (que no havien assolit l’estabilitat el dia 4), foren classificats en: a) fracàs terapèutic vertader, quan la teràpia antibiòtica s’hagué de canviar i/o es realitzaren procediments terapèutics invasius, o b) resposta lenta al tractament quan s’obtingué l’estabilitat clínica sense canvis respecte al tractament antibiòtic empíric inicial. RESULTATS Al dia 4, 78 (27,4%) de 285 pacients no assoliren l’estabilitat clínica. D’aquests, 56 (71,8%) pacients es curaren sense canvi en el tractament antibiòtic inicial (mortalitat del 0,0%), i en 22 (28,2%) pacients, el tractament inicial s’hagué de modificar (mortalitat 40,9%). Al dia 4, els nivells de PCR davallaren en 52 (92,9%) pacients amb resposta lenta al tractament i només en 7 (31,8%) pacients amb fracàs terapèutic vertader (p < 0,001). Un model desenvolupat que inclogué els valors de PCR i els de la freqüència respiratòria al dia 4, identificà els pacients amb fracàs terapèutic vertader. L’àrea sota la corba ROC obtinguda amb aquest model fou de 0,87 (IC 95% , 0,780 a 0,966). CONCLUSIÓ Els canvis dels valors de PCR són útils per a discriminar entre el fracàs terapèutic vertader i la resposta lenta al tractament, i poden ajudar el clínic a prendre decisions en el tracte dels pacients amb PNAC que no milloren. / INTRODUCCION El manejo de los pacientes con neumonía adquirida en la comunidad (NAC) que no responden al tratamiento antibiótico inicial constituye un reto para el clínico. Este estudio investigó la utilidad de los cambios en los niveles de la proteína C reactiva (PCR) para discriminar entre fracaso terapéutico verdadero y respuesta lenta al tratamiento. METODOS Este estudio multicéntrico prospectivo observacional, investigó el comportamiento de los niveles de PCR en plasma en los días 1 y 4 en pacientes adultos hospitalizados con diagnóstico de NAC . Se determinaron los niveles de PCR en sangre los días 1 y 4. Al finalizar el proceso, los pacientes no respondedores (que no habían alcanzado la estabilidad para el día 4) fueron clasificados en a) fracaso terapéutico verdadero, cuando la terapia antibiótica tuvo que ser cambiada y/o se realizaron procedimientos terapéuticos invasivos; o b) respuesta lenta al tratamiento cuando se alcanzó la estabilidad clínica sin cambios respecto al tratamiento antibiótico empírico inicial. RESULTADOS Al día 4, 78 (27,4%) de 285 pacientes no alcanzaron la estabilidad clínica. De estos, 56 (71,8%) pacientes se curaron sin cambio del tratamiento antibiótico inicial (mortalidad de 0,0%); y en 22 (28,2%) pacientes el tratamiento antibiótico inicial tuvo que ser modificado (mortalidad 40,9%). Al día 4, los niveles de PCR descendieron en 52 (92,9%) pacientes con respuesta lenta al tratamiento y solo en 7 (31,8%) pacientes con fracaso terapéutico verdadero (p<0.001). Un modelo desarrollado que incluyó los valores de PCR y los de la frecuencia respiratoria al día 4, identificó a los pacientes con fracaso terapéutico verdadero. El área bajo la curva ROC obtenida con este modelo fue de 0,87 (IC 95%, 0,780 a 0,966). CONCLUSION Los cambios de los valores de PCR son útiles para discriminar entre el fracaso terapéutico verdadero y la respuesta lenta al tratamiento; y pueden ayudar al clínico a tomar decisiones en el manejo de los pacientes con NAC que no mejoran. / BACKGROUND The management of patients with community-acquired pneumonia (CAP) who fail to improve constitutes a challenge for clinicians. This study investigated the usefulness of C-reactive protein (CRP) changes in discriminating true treatment failure from slow response to treatment. METHODS This prospective multicenter observational study investigated the behavior of plasma CRP levels on days 1 and 4 in hospitalized patients with CAP.We identified non-responding patients as those who had not reached clinical stability by day 4. Among them, true treatment failure and slow response situations were defined when initial therapy had to be changed or not after day 4 by attending clinicians, respectively. RESULTS By day 4, 78 (27.4%) out of 285 patients had not reached clinical stability. Among them, 56 (71.8%) patients were cured without changes in initial therapy (mortality 0.0%), and in 22 (28.2%) patients, the initial empirical therapy needed to be changed (mortality 40.9%). By day 4, CRP levels fell in 52 (92.9%) slow responding and only in 7 (31.8%) late treatment failure patients (p<0.001). A model developed including CRP behavior and respiratory rate at day 4 identified treatment failure patients with an area under the Receiver Operating Characteristic curve of 0.87 (CI 95%, 0.78–0.96). CONCLUSION Changes in CRP levels are useful to discriminate between true treatment failure and slow response to treatment and can help clinicians in management decisions when CAP patients fail to improve

Human cytomegalovirus (HCMV) is a betaherpesvirus that infects up to 80% of the population worldwide, and establishes latency in monocytes and bone marrow cells. Reactivated HCMV can become an opportunistic pathogen in individuals who are immunocompromised, such as those with acquired immunodeficiency syndrome (AIDS). HCMV infection of AIDS patients causes a sight-threatening retinitis that leads to vision loss and blindness in up to 46% of this population without antiretroviral treatment. Because untreated HIV-infected individuals exhibit the loss of cell-mediated immunity and alterations in CD4+ T-helper (Th) cell cytokines, including elevation of interleukin-4 (IL-4), IL-10, and IL-17, we sought to test the hypothesis that these cytokines play key roles in governing the susceptibility to AIDS-related HCMV retinitis. This hypothesis was tested utilizing a clinically relevant mouse model of experimental murine cytomegalovirus (MCMV) retinitis that occurs in C57BL/6 mice immunosuppressed by mouse retroviruses (MAIDS). Studies revealed that MAIDS progression was associated with increased levels of IL-4 and IL-10, cytokines whose production has been associated with diminished CD8+ T-cell-mediated immunity during HIV infection. However, MCMV–infected eyes of retinitis-susceptible IL-4-/- or IL-10-/- MAIDS mice exhibited frequency and severity of retinitis and viral titers equivalent to MCMV-infected eyes of wild-type MAIDS animals. These studies indicated that neither IL-4 nor IL-10 alone play key roles in increased susceptibility to MCMV retinitis. In comparison, IL-17, an inflammatory cytokine associated with the ocular autoimmune disease uveitis, was systemically increased during the progression of MAIDS, but MCMV-infected eyes of retinitis-susceptible MAIDS mice exhibited a significant reduction in IL-17. These findings suggested that IL-17 plays no direct role in the pathogenesis of experimental MCMV retinitis. However, these results also suggested the remarkable possibility that MCMV downregulates IL-17 production, a hypothesis supported by the observation that systemic MCMV infection of healthy and MAIDS mice resulted in the downregulation of IL-17. Mechanistic studies revealed that knockdown of IL-10 resulted in a partial recovery IL-17 levels during MCMV infection. We conclude that MCMV-induced IL-17 downregulation occurs via the stimulation of IL-10 and the suppressor of cytokine signaling (SOCS)-3. Taken together, our results add new information to the immunobiology of HCMV and to our basic understanding of the pathogenesis of AIDS-related HCMV retinitis.

Toxoplasmosis is an important cause of congenital disease, and it is one of the most common opportunistic infections in patients with acquired immunodeficiency syndrome. The need for a reliable experimental model of this infection is crucial not only for achieving a better understanding of the patho-physiology of the disease, but also for developing better methods for evaluating new therapeutic regimens. The purpose of the present study was to investigate the role of CD4+CD25+ T regulatory lymphocytes in mice infected with Toxoplasma gondii. T regulatory (Treg) cells have been shown to play an important role in our immune system in controlling the activity of other T lymphocytes. These cells are differentiated from other T lymphocyte populations based on the co-expression of CD4 and CD25 and expression of the Foxp3 gene. The results of several recent studies have suggested that certain pathogens may be able to increase their survival in the host by exploiting T reg cell activity. T regulatory cells have been shown to control the persistence of the protozoan parasite, Leishmania major, in mice; however, this population of cells plays only a limited role during murine infection with Trypanosoma cruzi. In the present study we have investigated the role of Treg cells during murine infection with the ME49 strain of T. gondii. In vivo depletion of Treg cells was accomplished by injecting mice with a monoclonal antibody (Mab) isolated from the 7D4 rat hybridoma cell line. This Mab is specific for the interleukin-2 receptor chain (also known as CD25). Female Swiss Webster mice of approximately 6-7 weeks of age were depleted of Treg cells by intraperitoneal injection of 400µg of Mab, mice were injected once 7days prior to infection, and a second time 1 day prior to infection, with 20 tissue cysts of T. gondii. Mouse weight and tissue cyst numbers were monitored to evaluate the impact of Treg depletion on the outcome of infection. Our results suggest that depletion of Treg cells has little measurable impact during the acute stage of infection with the ME49 strain of T. gondii. Further studies will be required to determine what role, if any, these cells play in the chronic stage of murine toxoplasmosis.

Most rice protection methods have currently used toxic chemicals to control pathogens and pests, which leads to environmental pollution. Systemic acquired resistance (SAR) taking advantage of natural defence reaction of plants could be proposed as an alternative, ecologically friendly approach for plant protection. Its application into rice production could minimize the chemicals quantity used and could contribute to the decrease of environmental pollution and the development of sustainable agriculture. The research was conducted to select the most effective chemical and suitable method to improve the health of rice plants infected by grassy stunt disease in net-house of Can Tho University. SAR chemicals were used at very low concentrations (in mM). Results showed that the height of rice plants treated with SAR chemicals was higher than that of plants untreated. Besides, the number of diseased plants was reduced and the ratio of firm grain and yield increased when plants were applied by SAR. Among the used substances, oxalic acid provided the best systemic acquired resistance. With oxalic acid, seed soaking was better than seed coating in systemic acquired resistance against rice grassy stunt disease. / Hầu hết các phương pháp sản xuất lúa hiện nay đều sử dụng các hóa chất độc hại trong việc phòng trừ bệnh và côn trùng gây hại, nên dẫn đến ô nhiễm môi trường. Kích thích tính kháng lưu dẫn giúp kích hoạt cơ chế tự nhiên kháng bệnh của cây có thể là giải pháp bảo vệ thực vật thay thế an toàn với môi trường. Việc ứng dụng tiến bộ này vào trong sản xuất lúa có thể làm giảm lượng hóa chất sử dụng, đóng góp vào việc giảm thiểu ô nhiễm môi trường và sự phát triển của một nền nông nghiệp bền vững. Nghiên cứu đã được thực hiện tại nhà lưới trường Đại học Cần Thơ để tuyển chọn hóa chất và phương pháp sử dụng hóa chất để tăng cường sức khỏe giúp cây lúa vượt qua bệnh vàng lùn. Hóa chất kích kháng được sử dụng ở một nồng độ rất thấp (đơn vị là mM). Kết quả cho thấy chiều cao cây lúa khi xử lý chất kích kháng tốt hơn so đối chứng không xử lý. Bên cạnh đó, số cây lúa nhiễm bệnh giảm, tỉ lệ hạt chắc và năng suất tăng khi cây lúa được xử lý với chất kích kháng. Trong số các chất kích kháng đã sử dụng, acid oxalic cho hiệu quả vượt trội. Với chất acid oxalic, phương pháp ngâm hạt cho hiệu quả kích kháng tốt hơn phương pháp áo hạt.

<p>This dissertation draws on the virtue ethics tradition in moral theology and moral philosophy for inquiries regarding the acquired and infused virtues, virtue's increase and remission, and virtue's relation to sacramental practice. I rely on two medieval texts to ask and answer these questions: the <italic>Summa Theologiae</italic> by Thomas Aquinas and <italic>Piers Plowman</italic> by William Langland. My arguments are primarily inter- and intra-textual with some attention to the texts' history of interpretation and the socio-historical Catholic culture in which they were written. I conclude that the texts share pedagogical features that teach their readers in what the perfection of virtue consists and show readers how to increase in that perfection.</p><p>This thesis follows from the work of David Aers, Stanley Hauerwas, Alasdair MacIntyre, Josef Pieper, and Eberhard Schockenhoff.</p> / Dissertation

Thesis (Ph.D.(Paediatrics))--University of Pretoria, 2009. / Abstract in English and Afrikaans. Includes bibliographical references.

Thesis (Ph. D.)--University of Washington, 2001. / Vita. Includes bibliographical references (leaves 193-209).

Thesis (Ph. D.)--University of Washington, 2001. / Vita. Includes bibliographical references (leaves 130-140).