The relationship between nurse managers' leadership style and patients' perception of the quality of the care provided by nurses: Cross sectional survey.

BACKGROUND: In healthcare systems, human resources play a strategic role that has a significant impact on the whole caring process. When the wellbeing of professionals is low their performance decreases, counterproductive work behaviours may became more likely, and as a result the quality of care is compromised. Studies have shown that leadership style is particularly relevant in relation to the quality of work environments in healthcare organizations. OBJECTIVE: The main purpose of this study is to test a model that investigates the relationships between nurse managers' leadership style and patients' perception of the quality of the care provided by the nurses, through the mediation of the quality of the working environment (in terms of burnout, interpersonal strain and counterproductive work behaviour). DESIGN: A multi-centre cross-sectional study was conducted. SETTING: The study was conducted in five hospitals located two in the north, two in the centre and one in the south of Italy. PARTICIPANTS: Participants were 479 registered nurses (working as staff nurses, while head nurses and nurse managers were excluded) and 829 patients aged 18 years or older, able to read and write Italian and hospitalized for at least 3 days. Severely ill or mentally disabled patients who were not able to fill in the questionnaire were excluded. METHODS: The data were collected through two different questionnaires, one for the nurses and one for the patients. A multilevel analysis was conducted to examine the hypothesized model. RESULTS: Results confirmed the hypothesis that, when nurses were satisfied with leadership, they felt less burned-out and strained in interpersonal relationships, they engaged less in misbehaviour, and, in turn, patients were more satisfied with the quality of the care provided by the nurses. CONCLUSIONS: The results of this study showed that the characteristics of the organizational context, the leadership, and the behaviours of nurses, influenced patients' perceptions of nurses' care. Therefore, managers of healthcare services should take these results into account seriously in order to improve the quality of care provided to patients.

Atividade Antimicrobiana da Uncaria Tomentosa (Willd) D. C. / Antimicrobial activity of Uncaria tomentosa (Willd) DC

A Uncaria tomentosa (Willd) D. C. (unha de gato) é uma planta amplamente utilizada na medicina popular, originária da Amazônia. Possui atividades biológicas, como anti-inflamatória, antimutagênica e antioxidante. O objetivo deste trabalho foi avaliar a atividade antimicrobiana do extrato de U. tomentosa, seco e hidroalcoólico, obtido comercialmente, utilizando-se 12 cepas de microrganismos (6 Gram-positvas e 6 Gram-negativas). Os testes antimicrobianos foram realizados em ágar BHI pela técnica de difusão em ágar. Também foram determinadas a Concentração Inibitória Mínima (CIM) e Concentração Microbicida Mínima (CMM). Os testes demonstraram que os extratos inibiram o crescimento de bactérias Gram-positivas e Gram-negativas, sendo o extrato hidroalcoólico mais eficiente que o extrato seco. Conclui-se que o extrato de U. tomentosa possui atividade antimicrobiana podendo ser utilizado como uma alternativa terapêutica de baixo custo...

The plant Uncaria tomentosa (Willd) DC. (cat's claw), found in the Amazon region and widely used in popular medicine, has anti-inflammatory, antimutagenic and antioxidant activities. The aim of this study was to test the antimicrobial activity of two commercially prepared extracts of U. tomentosa, one dried extract of bark and the other hydroalcoholic leaf extract, against 12 strains of bacteria (6 Gram-positive and 6 Gram-negative). The antimicrobial tests were conducted by diffusion in BHI agar. The Minimum Inhibitory Concentration (MIC) and the Minimum Microbicidal Concentration (MMC) were also determined. The tests showed that both extracts inhibited the growth of Gram-positive bacteria, but the hydroalcoholic extract was more effective and also inhibited Gram-negative bacteria. It is concluded that the U. tomentosa extract has an antimicrobial activity and can be used as a low-cost alternative treatment...

Atividade biológica do extrato hidroalcoólico de Bauhinia forficata Link sobre Herpetomonas samuelpessoai (Galvão. ) Roitman / Biologic activity of the hydroalcoholic extract of Bauhinia forficata Link on Herpetomonas samuelpessoai (Galvão. ) Roitman

Inúmeros esforços têm sido dirigidos para conferir às plantas seu real papel e valor na terapia. Este estudo teve como objetivo avaliar a atividade antimicrobiana, mutagênica, toxicidade, e os efeitos no crescimento e diferenciação de Herpetomonas samuelpessoai, do extrato hidroalcoólico de Bauhinia forficata. Para avaliar a atividade antimicrobiana foi realizado o teste de difusão em ágar, bem como a determinação das concentrações inibitória (CIM) e microbicida mínimas (CMM). O potencial clastogênico e/ou aneugênico, in vivo, foi avaliado usando o teste do micronúcleo em medula óssea de camundongos Swiss albinus. Foi determinada também a dose letal média (DL50). O extrato inibiu o crescimento de oito bactérias, mostrando-se mais ativo para Gram-positivas e não foi eficiente para os fungos, tendo sido ativo nas concentrações de 2000, 1000, 500 e 250 mg/mL contra os microrganismos testados. Os resultados mostraram que nas concentrações administradas (500, 1000 e 2000 mg/Kg), não houve aumento estatisticamente significativo de micronúcleos. Não houve ação no crescimento e diferenciação de Herpetomonas samuelpessoai nas concentrações testadas. Com relação a DL50, o extrato não apresentou toxicidade.

Numerous efforts have been directed to discover the role and the value of plants in therapy. This work aimed to evaluate the antimicrobial activity, mutagenicity, toxicity and effects on growth and differentiation of Herpetomonas samuelpessoai of the hydroalcoholic extract of Bauhinia forficata. To evaluate the antimicrobial activity it was performed the agar diffusion test, minimum inhibitory (MIC) and microbicidal (MMC) concentrations. The in vivo clastogenic and / or aneugênic potential was evaluated using the micronucleus test in mice bone marrow Swiss albinus. It was also determined the median lethal dose (LD50). The extract inhibited the growth of eight bacteria, being more active against Gram-positiveones, and was not active against fungi. The microorganisms tested had MIC concentrations of 2000, 1000, 500 and 250 mg / mL. The results showed that the tested concentrations (500, 1000 and 2000 mg / kg) had no statistically significant increasedthe micronucleus. There was no action on the growth and differentiation of Herpetomonas samuelpessoai at the concentrations tested. In respect to the LD50, the extract showed no toxicity.

Efeitos clínicos e microbiológicos do óleo de copaíba (copaifera officinalis) sobre bactérias formadoras de placa dental em cães / Clinical and microbiological effects of copaiba oil (copaifera officinalis) on dental plaque forming bacteria in dogs

O potencial de uso do óleo de copaíba (Copaifera officinalis) na prevenção da doença periodontal, eliminando seu agente etiológico, foi avaliado em 18 cães sem raça definida, distribuídos homogeneamente em três grupos: teste, (contendo óleo de copaíba) controle positivo e controle negativo. Os tratamentos ocorreram três vezes ao dia, durante oito dias. Ao nono dia, os animais receberam aplicação tópica de fucsina básica 0,5 por cento para evidenciação do biofilme. Mudanças na halitose e gengivite foram avaliadas diariamente por inspeção visual. Adicionalmente, foram realizados testes laboratoriais de inibição de aderência de Streptococcus mutans e ensaio antimicrobiano de difusão em ágar, sobre bactérias formadoras de placa dental. Os resultados da placa evidenciada apontaram áreas de cobertura microbiana nos dentes de 53,4±8,8 por cento, 28,5±5,4 por cento, e 22,3±5,3 por cento para os grupos negativo, positivo e teste, respectivamente, indicando diferença entre o controle negativo e os demais grupos (P<0,05). Quanto à melhora nos aspectos clínicos, halitose e gengivite, o grupo teste respondeu melhor quando comparado ao grupo controle negativo (P<0,05). A análise dos ensaios de difusão e inibição de aderência mostrou superioridade do grupo da copaíba (teste) em relação aos outros grupos (P<0,05). Os resultados sugerem o uso do óleo de copaíba na prevenção da doença periodontal e como um possível substituto da clorexidina na terapia antimicrobiana oral.

The copaiba oil (Copaifera officinalis) potential was evaluated in preventing periodontal disease and reducing its etiology. For that 18 mongrel dogs were homogeneously distributed in three groups: test (copaiba oil), positive control (chlorexidine) and negative control. The treatments were carried out three times a day, during eight days. On the 9th day, the animals were tested with a 0.5 percent basic solution of fuchsin for the detection of biofilm. Changes in halitosis and gingivitis were daily observed. In addition, the following laboratory tests were done: inhibition of the adherence of Streptococcus mutans, and plaque forming bacteria antimicrobial assays by the agar diffusion method. The results of the fuchsin test showed that dental plaque reached areas of 53.4±8.8 percent, 28.5±5.4 percent, and 22.3±5.3 percent in the negative control, positive control, and test groups, respectively, showing differences between dogs from the negative control group and dogs from the other two groups (P<0.05). Furthermore, halitosis and gingivitis decreased in the copaiba group animals when compared with the negative group (P<0.05). The results of the attachment inhibition and agar diffusion tests showed that copaiba induced better effects against the microorganisms as compared to the results of the other groups (P<0.05). These findings suggest that copaiba oil may effectively replace chlorexidine for oral antimicrobial therapy and prevention of periodontal disease.

Phosphorus concentration and solubility in dairy feces: variability and affecting factors.

Recent data from phosphorus (P) feeding trials have demonstrated that P concentration in dairy feces is directly affected by P levels in diets and that farm P surpluses as well as potential environmental losses can be reduced through dietary manipulation. The current study was conducted to examine the variability of fecal P under farm conditions and to elucidate factors affecting the concentration and solubility of fecal P. Feed and fecal samples from >30 commercial dairies in the Northeast and Mid-Atlantic regions were analyzed. Dietary P concentrations ranged from 3.45 to 5.78 g/kg of feed DM (DM), and P determined in acid digests (TP) of feces from 5.84 to 12.84 g/kg of fecal DM. On average, 50% of fecal TP was water soluble; of the latter, 83% was inorganic (Pi). Across-farm variability (n=33) had CV averaging 18.9% for fecal TP and >20% for Pi and total P (Pt) in water extracts. Within-farm variability based on multiple samples per herd had the same magnitude as across-farm and was independent of sample numbers from individual farms (n=7 to 30). Of all fecal parameters determined, pH and DM had the lowest variability (CV <10%), water-soluble Pi, Pt, and Ca the highest (CV of 20 to 30%), and total P, Ca, and Mg determined by acid digests were intermediate (CV 10 to 20%). Water-soluble Pi concentrations determined in dried-ground fecal samples were lower than in wet samples. The drying-grinding process changes Pi solubility and the change is not linear. This study confirms that dietary P concentration is the dominating factor affecting fecal P excretion; however, Ca concentration, DIM, and fecal pH also made small, but statistically significant contributions, although some of the mechanisms remain to be thoroughly investigated.

Phosphorus feeding levels and critical control points on dairy farms.

A viable and cost-effective approach to managing P on dairy farms is to minimize excess P in diets, which in turn leads to less excretion of P in manure without impairing animal performance. A questionnaire survey was conducted, coupled with on-site feed and fecal sample collection and analysis on dairy farms in New York, Pennsylvania, Delaware, Maryland, and Virginia. The purpose was to assess dietary P levels and to identify critical control points pertaining to P feeding management. Survey responses, 612 out of 2500 randomly selected farms, revealed a wide range of dietary P concentrations for lactating cows, from 3.6 to 7.0 g/kg of feed DM. The mean was 4.4 g/kg, which was 34% above the level recommended by the NRC for 27.9 kg milk/d, the mean milk yield in the survey. Higher P concentrations in diets were not associated with higher milk yields (n = 98, R2 = 0.057 for the survey farms; n = 92, R2 = 0.043 for farms selected for on-site sampling). However, higher dietary P led to higher P excretion in feces (n = 75, R2 = 0.429), with much of the increased fecal P being water soluble. Phosphorus concentrations in diet samples matched closely with P concentrations in formulated rations, with 67% of the feed samples deviating <10% from the formulations. On 84% of the survey farms, ration formulation was provided by professionals rather than producers themselves. Most producers were feeding more P than cows needed because it was recommended in the rations by these consultants. In conclusion, P fed to lactating cows averaged 34% above NRC recommendations; to reduce excess dietary P, ration formulation is the critical control point.

Morphological, biochemical and molecular characterization of Herpetomonas samuelpessoai camargoi n. subsp., a trypanosomatid isolated from the flower of the squash Cucurbita moschata.

We report the morphological, biochemical and molecular characteristics of a trypanosomatid isolated from the flower of Cucurbita moschata. Although the trypanosomatid was isolated from a plant, the lack of recognition of Phytomonas-specific molecular markers based on spliced-leader and ribosomal genes as well as by monoclonal antibodies specific for Phytomonas argues against assigning it to this genus. Because the isolate displayed typical opisthomastigote forms in culture, it is assigned to the genus Herpetomonas. Analysis of randomly amplified polymorphic DNA (RAPD) patterns and characterization of ribosomal SSU and ITS markers suggest that it is more closely related to H. samuelpessoai than to any other species. However, the presence of spined flagellates in culture (displaying lateral expansions of the plasma membrane originating near the flagellar pocket) and isolate-specific RAPD fingerprints argue strongly that the trypanosomatid belongs to a new subspecies, for which the name Herpetomonas samuelpessoai camargoi n. subsp. is proposed.

Interspecies major histocompatibility complex-restricted Th cell epitope on foot-and-mouth disease virus capsid protein VP4.

T-cell epitopes within viral polypeptide VP4 of the capsid protein of foot-and-mouth disease virus were analyzed using 15-mer peptides and peripheral blood mononuclear cells (PBMC) from vaccinated outbred pigs. An immunodominant region between VP4 residues 16 and 35 was identified, with peptide residues 20 to 34 (VP4-0) and 21 to 35 (VP4-5) particularly immunostimulatory for PBMC from all of the vaccinated pigs. CD25 upregulation on peptide-stimulated CD4(+) CD8(+) cells-dominated by Th memory cells in the pig-and inhibition using anti-major histocompatibility complex class II monoclonal antibodies indicated recognition by Th lymphocytes. VP4-0 immunogenicity was retained in a tandem peptide with the VP1 residue 137 to 156 sequential B-cell epitope. This B-cell site also retained immunogenicity, but evidence is presented that specific antibody induction in vitro required both this and the T-cell site. Heterotypic recognition of the residue 20 to 35 region was also noted. Consequently, the VP4 residue 20 to 35 region is a promiscuous, immunodominant and heterotypic T-cell antigenic site for pigs that is capable of providing help for a B-cell epitope when in tandem, thus extending the possible immunogenic repertoire of peptide vaccines.

Evaluation of the allergenicity of spore and mycelia extracts of Pisolithus tinctorius.

The antigenic and allergenic chemical analysis of spore and mycelia extracts of Pisolithus tinctorius was carried out. The spores were collected from basidiocarps in plantations of Eucalyptus spp and the mycelia from culture in MNM medium. With basis on the fungus growth curve, the mycelia masses were obtained after 10, 20, 30, and 40 days of incubation, which correspond, respectively, to the beginning, middle and end of the log phase, and beginning of the decline phase. The mycelia masses, together with the spores, were submitted to the action of three extractors (Coca, Tris-HCl, and ammonium bicarbonate). The contents of carbohydrates and proteins were determined. The SDS-PAGE electrophoretical analysis revealed separate fractions in these extracts, besides common fractions, in function of cultivation time and extraction methods. The selected extracts for the allergic tests were the ones with the highest number of fractions. The prick-tests were conducted in 374 patients--rural workers, eucalyptus plantation workers, and college students. The positivity to the "prick test" with the antigenic extract of P. tinctorius was, respectively, 3.78%, 28.20% and 6.40%. Most prick-test positive patients (82.75%) also presented symptoms of respiratory allergy (asthma and rhinitis). There was no reactivity difference when the spore and mycelia extracts were employed. The analysis of the positive patients' sera revealed the presence of IgE specific to the P. tinctorius antigens. Since Pisolithus tinctorius is found as mycorrhiza of Eucalyptus spp, and this plant is used in reforestation in most countries, the importance of that fungus should be regarded as a possible cause of respiratory allergies, especially in occupationally exposed workers.

Membrane-associated polysaccharides composition, nutritional requirements and cell differentiation in Herpetomonas roitmani: influence of the endosymbiont.

Herpetomonas roitmani, a trypanosomatid containing a bacterial endosymbiont, was cured by high doses of chloramphenicol. Wild-type and cured flagellates were compared as to polysaccharide composition, nutritional requirements and cellular differentiation. Fucose (18.0%), xylose (15.7%), mannose (38.9%), galactose (10.8%), glucose (16.4%) and inositol (< 1.0%) were identified as polysaccharide components of cured H. roitmani as assessed by gas-liquid chromatography. However, the wild-type strain displayed a markedly different sugar profile, in that xylose was absent and inositol preferentially synthesized, whereas the other monosaccharide components remained unchanged. Variations in nutritional pattern also occurred between both strains. The bacterial endosymbiont seems to provide the flagellates with nutritional factors, including usual amino acids, vitamins, purine (as adenine) and hemin. The process of cell differentiation was also significantly influenced by the endosymbiont. Opisthomastigote forms predominate (72.0%) in cured as compared with wild-type H. roitmani (37.0%).

Axenic cultivation of a pathogenic Phytomonas species isolated from tomato fruit, and from its phytophagic insect vector, Phthia picta (Hemiptera: Coreidae).

Axenic cultures of Phytomonas sp. were obtained from naturally infected tomatoes and from Phthia picta, a predator of tomato plants, by using a biphasic medium with Roitman's complex medium overlaying rabbit blood-agar slants. Light and electron microscopy of both isolates showed a similarity of morphological characteristics among the flagellates in fresh material or after cultivation. Other properties, including their agglutinability with the haemolymph of Phthia picta, suggest that these isolates are virtually identical.

Herpetomonas roitmani (Fiorini et al., 1989) n. comb.: a trypanosomatid with a bacterium-like endosymbiont in the cytoplasm.

The trypanosomatid previously described as Crithidia roitmani is characterized here at the ultrastructural and biochemical levels. The data indicates that the parasite belongs to the Herpetomonas genus, and we therefore suggest the flagellate to be denominated as Herpetomonas roitmani n. comb. Cladistic analysis of isoenzyme data generated by eight different enzymes showed that the parasite presented a distinct banding pattern and could be grouped with some Herpetomonas spp., but not with Crithidia spp., used as reference strains. Accordingly, when the parasites were grown for longer periods in Roitman's defined medium, expontaneous differentiation from promastigotes to opisthomastigotes (typical of the Herpetomonas genus) occurred. Transmission electron microscopy revealed the presence of bacterium-like endosymbionts in the cytoplasm of all evolutive forms of the parasite. All morphological alterations characteristic of endosymbiont-bearing trypanosomatids could be observed.