Acute stroke predisposes to oral gram-negative bacilli - a cause of aspiration pneumonia?

Objectives: To assess any change in the oral flora in the mouths of stroke patients during the acute and rehabilitation phases and to determine whether this is related to episodes of aspiration pneumonia and clinical outcome. Materials and Methods: This observational study was carried out in hospital wards in a University teaching hospital. The subjects were patients immediately post-stroke and during the rehabilitation period, acute admissions and a group of healthy volunteers. An assessment of dentition and swallow in the presence or absence of oral aerobic gram-negative bacilli (AGNB) was correlated. Results: Of the acute stroke patients 52% had an unsafe swallow. AGNB carriage was documented in 34% of the acute stroke group. Of the 11 patients who died 55% had AGNB, 73% had an unsafe swallow and 36% had a combination of both. Conclusion: AGNB is a common finding in acute stroke patients. It is not a consequence of age or acute hospitalisation and is associated with an unsafe swallow and a higher mortality. Copyright (C) 2003 S. Karger AG, Basel.

Don’t aim too high for your kids: parental over-aspiration undermines students’ learning in mathematics

Previous research has suggested that parents’ aspirations for their children’s academic attainment can have a positive influence on children’s actual academic performance. Possible negative effects of parental over-aspiration, however, have found little attention in the psychological literature. Employing a dual-change score model with longitudinal data from a representative sample of German schoolchildren and their parents (N = 3,530; grades 5 to 10), we showed that parental aspiration and children’s mathematical achievement were linked by positive reciprocal relations over time. Importantly, we also found that parental aspiration that exceeded their expectation (i.e., over-aspiration) had negative reciprocal relations with children’s mathematical achievement. These results were fairly robust after controlling for a variety of demographic and cognitive variables such as children’s gender, age, intelligence, school type, and family SES. The results were also replicated with an independent sample of US parents and their children. These findings suggest that unrealistically high parental aspiration can be detrimental for children’s achievement.

The practice of sustainable facilities management: Design sentiments and the knowledge chasm

The construction industry with its nature of project delivery is very fragmented in terms of the various processes that encompass design, construction, facilities and assets management. Facilities managers are in the forefront of delivering sustainable assets management and hence further the venture for mitigation and adaptation to climate change. A questionnaire survey was conducted to establish perceptions, level of commitment and knowledge chasm in practising sustainable facilities management (FM). This has significant implications for sustainable design management, especially in a fragmented industry. The majority of questionnaire respondents indicated the importance of sustainability for their organization. Many of them stated that they reported on sustainability as part of their organization annual reporting with energy efficiency, recycling and waste reduction as the main concern for them. The overwhelming barrier for implementing sound, sustainable FM is the lack of consensual understanding and focus of individuals and organizations about sustainability. There is a knowledge chasm regarding practical information on delivering sustainable FM. Sustainability information asymmetry in design, construction and FM processes render any sustainable design as a sentiment and mere design aspiration. Skills and training provision, traditionally offered separately to designers and facilities managers, needs to be re-evaluated. Sustainability education and training should be developed to provide effective structures and processes to apply sustainability throughout the construction and FM industries coherently and as common practice.

The incidence of oral Gram-negative bacteria in patients with Parkinson's disease

Background: Parkinson's disease is a common neurodegenerative disorder that affects an increasing number of older people every year. Dysphagia is not only a common feature, but one that results in poor nutrition and an increased risk of bronchopneumonia. Previous work has suggested that the oral flora is altered in patients with oral pathology. Methods: Fifty patients were assessed to quantify the incidence of oral Gram-negative bacteria. Results: Sixteen of the patients with Parkinson's disease were found to have six different Gram-negative bacilli in their oral cavities. The 20 different Gram-negative bacteria present were Escherichia coli (n=7), Klebsiella spp. (n=3), Kluyvera spp. (n=3), Serratia spp. (n=3), Proteus spp. (n=2) and Enterobacter spp. (n=2). We found that the oral cavity of 16 (32%) of the patients with Parkinson's disease was abnormally colonised with Gram-negative bacteria and that Gram-negative bacteria were more likely to occur in those patients in whom oromuscular dysfunction was present (88% vs. 21%; p<0.05). Conclusion: Further work is required to determine the association between oral flora and the pathogenic organisms found in aspiration pneumonia as well as work on innovative treatments to reduce oral Gram-negative bacteria in those patients at particular risk of aspiration pneumonia.

Don't we care?: the ethics and emotional labour of early years professionalism

This paper argues that early childhood education and care (ECEC) has a legitimate aspiration to be a 'caring profession' like others such as nursing or social work, defined by a moral purpose. For example, practitioners often draw on an ethic of care as evidence of their professionalism. However, the discourse of professionalism in England completely excludes the ethical vocabulary of care. Nevertheless, it necessarily depends on gendered dispositions towards emotional labour, often promoted by training programmes as 'professional' demeanours. Taking control of the professionalisation agenda therefore requires practitioners to demonstrate a critical understanding of their practice as 'emotion work'. At the same time, reconceptualising practice within a political ethic of care may allow the workforce, and new trainees in particular, to champion 'caring' as a sustainable element of professional work, expressed not only in maternal, dyadic key-working but in advocacy for care as a social principle.

New governance approaches to environmental regulation: an example of the Code for Sustainable Homes (CSH)

Environmental policy in the United Kingdom (UK) is witnessing a shift from command-and-control approaches towards more innovation-orientated environmental governance arrangements. These governance approaches are required which create institutions which support actors within a domain for learning not only about policy options, but also about their own interests and preferences. The need for construction actors to understand, engage and influence this process is critical to establishing policies which support innovation that satisfies each constituent’s needs. This capacity is particularly salient in an era where the expanding raft of environmental regulation is ushering in system-wide innovation in the construction sector. In this paper, the Code for Sustainable Homes (the Code) in the UK is used to demonstrate the emergence and operation of these new governance arrangements. The Code sets out a significant innovation challenge for the house-building sector with, for example, a requirement that all new houses must be zero-carbon by 2016. Drawing upon boundary organisation theory, the journey from the Code as a government aspiration, to the Code as a catalyst for the formation of the Zero Carbon Hub, a new institution, is traced and discussed. The case study reveals that the ZCH has demonstrated boundary organisation properties in its ability to be flexible to the needs and constraints of its constituent actors, yet robust enough to maintain and promote a common identity across regulation and industry boundaries.

Pianos for the people: the manufacture, marketing and sale of pianos as consumer durables, 1850-1914

During the second half of the nineteenth century, British society experienced a rise in real incomes and a change in its composition, with the expansion of the middle classes. These two factors led to a consumer revolution, with a growing, but still segmented, demand for household goods that could express status and aspiration. At the same time technological changes and new ways of marketing and selling goods made these goods more affordable. This paper analyzes these themes and the process of mediation that took place between producers, retailers, and consumers, by looking at the most culturally symbolic of nineteenth century consumer goods, the piano.

Public sector applications of the system dynamics approach

The article discusses various reports published within the issue, including one by Carmine Bianchi on understanding public sector from different levels and perspectives, one by Mauro Lo Tennero on the aspiration and structure of Sicily to enforce public policy, and one by Nuno Videira and colleagues on the use of group model building in the public sector to concur sustainable policies.

Além da diferença: a mulher no Cinema da Retomada

This paper analyses the female participation in the Brazilian Film Revival of the 1990s beyond differences of sex, race, class, age and ethnicity. Its main contention is that the most decisive contribution brought about by the rise of women in recent Brazilian cinema has been the spread of team work and shared authorship, as opposed to a mere aspiration to the auteur pantheon, as determined by a notoriously male-oriented tradition.

Beyond difference: female participation in the Brazilian film revival of the 1990s

In this chapter, I will focus on the female participation in what became known as ‘The Retomada do Cinema Brasileiro’, or the Brazilian Film Revival, by thinking beyond differences of gender, class, age and ethnicity. I will first re-consider the Retomada phenomenon against the backdrop of its historical time, so as to evaluate whether the production boom of the period translated into a creative peak, and, if so, how much of this carried onto the present day. I will then look at the female participation in this phenomenon not just in terms of numerical growth of women film directors, admittedly impressive, but only partially reflective of the drastic changes in the modes of production and address effected by the neoliberal policies introduced in the country in the mid 1990s. I will argue that the most decisive contribution brought about by the rise of women in Brazilian filmmaking has been the spread of team work and shared authorship, as opposed to a mere aspiration to the auteur pantheon, as determined by a notoriously male-oriented tradition. Granted, films focusing on female victimisation were rife during the Retomada period and persist to this day, and they have been, and continue to be, invaluable for the understanding of women’s struggles in the country. However, rather than resorting to feminist readings of representational strategies in these films, I will draw attention to other, presentational aesthetic experiments, open to the documentary contingent and the unpredictable real, which, I argue, suspend the pedagogical character of representational narratives. In order to demonstrate that new theoretical tools are needed to understand the gender powers at play in contemporary world cinema, I will, to conclude, analyse an excerpt of the film, Delicate Crime (Crime delicado, Beto Brant, 2006), where team work comes out as a particularly effective female, and feminist, procedure.

Tracing client interests in the course of a project: why are some client interests incorporated whereas others are not?

Many construction professionals and policy-makers would agree that client expectations should be accommodated during a building project. However, this aspiration is not easy to deal with as there may be conflicting interests within a client organization and these may change over time in the course of a project. This research asks why some client interests, and not others, are incorporated into the development of a building project. Actor-Network Theory (ANT) is used to study a single building project on a University campus. The building project is analysed as a number of discussions and negotiations, in which actors persuade each other to choose one solution over another. The analysis traces dynamic client engagement in decision-making processes as available options became increasingly constrained. However, this relative loss of control was countered by clients who continued the control over the timing of participants' involvement, and thus the way to impose their interests even at the later stage of the project.