One of the newest teaching modalities in nursing education is the use of human patient simulators (HPS). An HPS simulation scenario creates a software program vignette in which students interact with a manikin to practice caring for critical patients in a risk-free environment. Although used extensively in schools of nursing, there is little research that examines if these expensive simulators improve the clinical decision-making ability of nursing students. The purpose of this experimental differentiated treatment study was to assess if HPS technology leads to increased clinical decision-making ability and clinical performance more than the teaching modality of a paper and pencil case study. Students ( n = 133) from practical nursing programs in Pennsylvania were randomly assigned to one of 2 groups learning about the care of a patient with a myocardial infarction: an HPS simulation group or a paper and pencil case study group. One-tailed, independent t -tests were used to measure pre and post treatment exam and clinical performance scores measuring the care of a patient with a myocardial infarction. Results indicated that there was a statistically significant learning gain from the use of HPS technology compared to the paper and pencil case study ( p < 0.001). Students in the HPS simulation group also performed CPR more quickly than students in the case study group (p < 0.001). The research adds a rare control group study to the literature and confirms previous findings about the effectiveness of HPS technology. Nurse educators can benefit as the results validate the use of HPS technology in nursing education. Ultimately patients may benefit from increased quality and speed of care from practical nurses whose training was improved through the use of HPS technology.

In der vorliegenden Arbeit wurde der Einfluss von Insulin und IGF-1 auf den transepithelialen Natriumtransport über die Zellmembran von fetalen distalen Lungenepithelzellen der Ratte (fetal distal lung epithelia, FDLE) als Modell der Pneumozyten vom Typ II des späten Frühgeborenen untersucht. In Ussing-Kammer Messungen konnte eine insulinabhängige schnelle Steigerung des transepithelialen Natriumstroms gezeigt werden. Durch Western Blot-Untersuchungen sowie Inhibition spezifischer Kinasen wurden die intrazellulären Signaltransduktionsmechanismen der Insulin-induzierten Stimulation des Natriumtransports weiter charakterisiert. Es konnte eine Beteiligung der Phosphatidylinositol 3-Kinase, der Proteinkinase B, sowie von mTORC2 an den Signalwegen in den untersuchten Zellen nachgewiesen werden. Ähnliche Wirkungen auf den Natriumtransport wie Insulin hatte der Wachstumsfaktor IGF-1. Somit wurde der akute Einfluss des Insulin/IGF-1 Systems auf den epithelialen Natriumtransport in fetalen Alveolarzellen charakterisiert.

Thesis (M.S.)--Boise State University, 2010. / Includes abstract. Includes bibliographical references (leaves 73-75).

Thesis (M.S.)--Boise State University, 2010. / Title from t.p. of PDF file (viewed July 20, 2010). Includes abstract. Includes bibliographical references (leaves 73-75).

There is a gap in the treatment of preterm infants with respiratory distress syndrome. Despite addressing surfactant insufficiency and mechanical instability, currently available exogenous surfactant does not reduce the inflammation that results from aggressive ventilation and hyperoxia. Preterm infants are also deficient in anti-oxidant and anti-inflammatory defenses. All of these factors predispose the infant to bronchopulmonary dysplasia. Recombinant human Club Cell Secretory Protein 10 (rhCC10), known to inhibit sPLA2, has been used to reduce ventilator induced lung inflammation. The long-term goal of this study is to understand the impact of rhCC10 on the pro/anti-inflammatory balance during early development. We will interrogate the link between Toll-Like Receptors (TLR 4) and rhCC10 because TLRs are integral to lung inflammation. By measuring the mRNA expression, protein, and downstream signaling activity in rhCC10 treated preterm lamb lung and then in A549 cells, an alveolar epithelial cell-like system, the anti-inflammatory effect of rhCC10 will be differentiated. This research is significant because it will improve understanding of the effect of rhCC10 on pro/anti-inflammatory regulation and provide insight regarding potential co-therapies when treating with rhCC10. / Physiology

The Global Positioning System (Navstar-GPS) has modernized and allow greater ease in surveys related to activities that require placement in real time. This system consists of a constellation of satellites around the Earth providing a service for 24 hours three-dimensional positioning, velocity and time information to the users. However, certain atmospheric factors and other sources of error can affect the accuracy of GPS receivers. Thus, users can make more precise data collected with the Differential GPS (DGPS). It consists of a network of towers that receive the GPS signals and transmit the signals through fixed radio transmitters. It is effective to support activities which require continuous positioning in real time, which are required accuracies in the order of meters (1 to 3 m). In order for it be a medium to transmit the differential corrections, and the availability of this means there is not always easily and / or economic in Brazil, chose, for the development of this work, the RDS (Radio Data System) and NTRIP (Networked Transport of RTCM via Internet Protocol) for this purpose, using differential corrections transmitted by the format in its implementation DGPSBRDS simplified. It was analyzed statistically and compared it precision and accuracy or standard deviation or mean absolute deviation of the GPS positions with transmission of differential corrections in the RTCM (Radio Technical Commission for Maritime Services) with the surveys carried out by two systems: RDS and NTRIP. They also compared the methods of positioning, the absolute and differential. It was concluded that the differential positioning is obtained more satisfactory results with estimates of precision ranged from 1 to 3 m. The system met the goals of precision and accuracy was NTRIP, which has enabled coordinated in real time with greater accuracy. / O Sistema de Posicionamento Global (NAVSTAR-GPS) veio modernizar e permitir maior facilidade nos levantamentos relacionados às atividades que necessitam de posicionamento em tempo real. Este sistema é formado por uma constelação de satélites que envolvem a Terra fornecendo um serviço de posicionamento tridimensional durante 24 horas, informação de velocidade e tempo para seus utilizadores. Entretanto, certos fatores atmosféricos e outras fontes de erro podem afetar a precisão de receptores GPS. Desta forma, os usuários podem tornar os dados coletados mais precisos com o GPS Diferencial (DGPS). Ele consiste em uma rede de torres que recebem os sinais GPS e transmitem os sinais corrigidos por meio de transmissores de rádio. É eficaz para apoiar atividades nas quais se requer um posicionamento contínuo, em tempo real, onde são necessárias acurácias na ordem do metro (1 a 3 m). Tendo em vista que para ele é necessário um meio de comunicação para transmitir as correções diferenciais, e que a disponibilidade deste meio nem sempre existe de forma fácil e/ou econômica no Brasil, escolheu-se, para o desenvolvimento deste trabalho, o RDS (Radio Data System) e o NTRIP (Networked Transport of RTCM via Internet Protocol) para tal finalidade, utilizando correções diferenciais transmitidas por meio do formato DGPSBRDS em sua implementação simplificada. Analisou-se estatisticamente e comparou-se precisão ou desvio padrão e acurácia ou média dos desvios absolutos de posicionamentos GPS com transmissão de correções diferenciais no formato RTCM (Radio Technical Commission for Maritime Services) com os levantamentos efetuados pelos dois sistemas: RDS e NTRIP. Também foram comparados os modos de posicionamento, o absoluto e o diferencial. Concluiu-se que pelo posicionamento diferencial obtêm-se resultados mais satisfatórios cuja estimativa de precisão variou de 1 a 3 m. O sistema que satisfez os objetivos de precisão e acurácia foi o NTRIP, o qual permitiu obter coordenadas em tempo real com maior precisão.

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2016-08-02T11:33:16Z No. of bitstreams: 2 Dissertação - Andreia Alves de Andrade - 2016.pdf: 1386895 bytes, checksum: 6f80be3c2d79383a9a1b2a10381fbac7 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2016-08-02T11:36:03Z (GMT) No. of bitstreams: 2 Dissertação - Andreia Alves de Andrade - 2016.pdf: 1386895 bytes, checksum: 6f80be3c2d79383a9a1b2a10381fbac7 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2016-08-02T11:36:03Z (GMT). No. of bitstreams: 2 Dissertação - Andreia Alves de Andrade - 2016.pdf: 1386895 bytes, checksum: 6f80be3c2d79383a9a1b2a10381fbac7 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2016-02-29 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / Hepatitis C is the most common cause of chronic liver disease. Men who have sex with men (MSM) may be at increased risk of acquiring infections transmitted by parenteral and sexual routes, such as hepatitis C. Despite the relevance of this subject, only one investigation regarding hepatitis C virus (HCV) infection in MSM was conducted in Brazil. Therefore, this study aimed to investigate the prevalence of HCV infection and risk practices among men who have sex with men in the City of Goiânia, Goiás. Cross-sectional study conducted in 522 MSM in Goiania, recruited by respondent-method driven sampling (RDS), from March to November 2014. After signing the informed consent, participants were interviewed about sociodemographic and risk behaviors/practices for HCV infection and then blood samples collected. All samples were subjected to determine the levels of alanine aminotransferase and aspartate aminotransferase (ALT and AST) and anti-HCV marker detection. Samples that had high levels of ALT/AST and/or were anti-HCV positive were tested for HCV RNA by reverse transcription-polymerase chain reaction (RT-PCR), and the positive samples were genotyped by a line probe assay (LiPA). Of 522 samples, four were anti-HCV positive and 14 had high levels of ALT/AST. Of these, only two (Y-421/anti-HCV positive and Y-180/anti-HCV negative/elevated ALT and AST) were HCV RNA positive, and then were genotyped by LiPA as genotype 1, subtypes 1a and 1b. Thus, five samples were anti-HCV and/or HCV RNA positive, resulting in an adjusted prevalence of 1.71% (95% CI: 0.32-8.55) for HCV infection among MSM in Goiânia-GO. Despite it is a low prevalence, many risk behaviors/practices were reported by the studied individuals (tattoo/piercing, sharing of personal hygiene tools, illicit drug use, multiple sexual partners in lifetime, sex with more than one partner in the same relationship, sex with a drug user partner, non-use or occasional condom use during anal sex, alcohol/drug use during sex, among others), which may characterize the target population as potentially vulnerable to infectious diseases transmitted by parenteral and sexual routes. / A hepatite C é a causa mais frequente de doença hepática crônica. Homens que fazem sexo com homens (HSH) podem apresentar risco aumentado em adquirir infecções transmitidas pelas vias parenteral e sexual, como a hepatite C. Apesar da relevância desse tema, apenas uma investigação sobre a infecção pelo vírus da hepatite C (HCV) foi conduzida no Brasil em HSH. Assim, o presente estudo teve como objetivo investigar a prevalência da infecção pelo HCV e práticas de risco em homens que fazem sexo com homens na cidade de Goiânia, Goiás. Estudo de corte transversal conduzido em 522 HSH em Goiânia, recrutados pelo método respondent-driven sampling (RDS), de março a novembro de 2014. Após assinatura do termo de consentimento livre e esclarecido, os participantes foram entrevistados sobre dados sociodemográficos e comportamentos/práticas de risco para infecção pelo HCV e, em seguida, amostras sanguíneas coletadas. Todas as amostras foram submetidas à dosagem dos níveis de alanina aminotransferase e aspartato aminotransferase (ALT e AST) e à detecção do marcador anti-HCV. As amostras que apresentaram níveis de ALT/AST elevados e/ou anti-HCV positivas foram testadas para detecção do RNA viral pela reação em cadeia pela polimerase pós-transcrição reversa (RT-PCR), sendo as positivas genotipadas pelo line probe assay (LiPA). Das 522 amostras, quatro foram anti-HCV positivas e 14 apresentaram níveis elevados de ALT/AST. Destas, apenas duas (Y-421/anti-HCV positiva e Y-180/anti-HCV negativa/ALT e AST elevadas) foram RNA HCV positivas, sendo genotipadas pelo LiPA como do genótipo 1, subtipos 1a e 1b. Portanto, cinco amostras foram anti-HCV e/ou RNA HCV positivas, resultando em uma prevalência ajustada de 1,71% (IC 95%: 0,32-8,55) para infecção pelo HCV em HSH em Goiânia-GO. Apesar desta prevalência ser baixa, vários comportamentos/práticas de riscos foram relatados pelos individuos estudados (tatuagem/piercing, compartilhamento de objetos cortantes de higiene pessoal, uso de drogas ilícitas, múltiplos parceiros sexuais ao longo da vida, sexo com mais de um parceiro na mesma relação, sexo com parceiro usuário de drogas, não uso/uso ocasional de preservativo no sexo anal, relação sexual sob efeito de álcool/drogas, dentre outros), caracterizando a população-alvo como potencialmente vulnerável às doenças infecciosas transmitidas pelas vias parenteral e/ou sexual.

In der vorliegenden Arbeit wurde der Einfluss von Insulin und IGF-1 auf den transepithelialen Natriumtransport über die Zellmembran von fetalen distalen Lungenepithelzellen der Ratte (fetal distal lung epithelia, FDLE) als Modell der Pneumozyten vom Typ II des späten Frühgeborenen untersucht. In Ussing-Kammer Messungen konnte eine insulinabhängige schnelle Steigerung des transepithelialen Natriumstroms gezeigt werden. Durch Western Blot-Untersuchungen sowie Inhibition spezifischer Kinasen wurden die intrazellulären Signaltransduktionsmechanismen der Insulin-induzierten Stimulation des Natriumtransports weiter charakterisiert. Es konnte eine Beteiligung der Phosphatidylinositol 3-Kinase, der Proteinkinase B, sowie von mTORC2 an den Signalwegen in den untersuchten Zellen nachgewiesen werden. Ähnliche Wirkungen auf den Natriumtransport wie Insulin hatte der Wachstumsfaktor IGF-1. Somit wurde der akute Einfluss des Insulin/IGF-1 Systems auf den epithelialen Natriumtransport in fetalen Alveolarzellen charakterisiert.:Seite Inhaltsverzeichnis 3 Abkürzungsverzeichnis 4 1 Bibliografische Beschreibung 5 Referat 5 2 Einleitung 6 2.1 Der Epitheliale Natriumkanal 6 2.2 Die Rolle des Natriumtransports für die postnatale pulmonale Adaptation 8 2.3 Die Bedeutung von Insulin und IGF-1 für die Lunge 10 2.4 Insulin/IGF-1: Signaltransduktionsweg und Wirkung auf den Natriumtransport 12 3 Originalpublikation 16 4 Zusammenfassung 32 5 Einordnung der Ergebnisse 33 6 Quellenverzeichnis 35 6.1 Zeitschriftenartikel 35 6.2 Fachbücher 41 7 Erklärung über die eigenständige Abfassung der Arbeit 42 8 Curriculum vitae 43 9 Danksagungen 44

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