Incidence and risk factors for pulmonary exacerbation treatment failures in cystic fibrosis patients chronically infected with Pseudomonas aeruginosa

Background: Pulmonary exacerbations (PEx) are responsible for much of the morbidity and mortality associated with cystic fibrosis (CF). However, there is a paucity of data on outcomes in CF PEx and factors influencing outcomes.

Methods: We reviewed all PEx in patients infected with Pseudomonas aeruginosa treated with parenteral antibiotics over 4 years at our center. Treatment failures were categorized a priori as those PEx requiring antibiotic regimen change, prolongation of therapy > 20 days because of failure to respond, an early recurrent event within < 45 days, or failure to recover lung function to > 90% of baseline FEV1.

Results: A total of 101 patients were followed for 452 PEx. Treatment failures were observed in 125 (28%) of PEx; antibiotic regimen change was observed in 27 (6%), prolongation of therapy in 29 (6%), early recurrent events in 63 (14%), and failure to recover lung function to > 90% of baseline FEV1 in 66 (15%). Demographic factors associated with one or more treatment failures per year included advanced airways disease, use of enteric feeds, CF-related diabetes, and CF liver disease but did not include female sex or F508del homozygosity. Increased treatment failure risk was associated with lower admission FEV1 and increased markers of inflammation. At therapeutic completion, increased inflammatory markers correlated with treatment failure. Failure rates decreased with increasing number of active antimicrobial agents used based on in vitro susceptibility (zero, 28/65 [43%]; one, 38/140 [27%]; two, 59/245 [24%]; three, 0/2 [0%]; P = .02).

Conclusions: One-fourth of PEx fail to respond adequately to initial management. Patient demographic and episode-specific clinical information can be used to identify individuals at increased risk of initial management failure.

“Building performance evaluation: The case of McClay Library”

The government of the UK has set an ambitious target that all newly built homes be carbon neutral by 2016 and to achieving an overall 80% carbon emission by 2050. Carbon Trust in 2009 published a research revealing that non-domestic buildings accounted for 18% of the emissions in the UK. They argued that to achieve the targets of low carbon emission there is need for better building stock that are better used. The evaluation of the performance of buildings is therefore critical if the understanding of how they are used is to be known. This paper is a brief building performance evaluation of the newly build library at Queens University Belfast carried out during the summer of 2010. It employed the Post-Occupancy Evaluation (POE) methodology to assess its performance. The results reveal that despite the intelligent technologies in the building there was a mismatch between the measured data and the perception of users of its performance. The study suggests the need for further study for reasons of dichotomy of the data. Keywords: building performance evaluation, carbon reduction strategies, passive environmental design techniques, active renewable energy technologies, Northern Ireland

High-surface thermally stable mesoporous gallium phosphates constituted by nanoparticles as primary building blocks

In constant, search for micro/mesoporous materials, gallium phosphates, have attracted continued interest due to the large pore size reported for some of these solids in comparison with analogous aluminum phosphates. However up to now, the porosity of gallium phosphates collapsed upon template removal or exposure to the ambient moisture. In the present work, we describe high-surface thermally stable mesoporous gallium phosphates synthesized from gallium propoxide and PCl3 and different templating agents such as amines (dipropylamine, piperidine and aminopiperidine) and quaternary ammonium salts (C16H33(CH3)3NBr and C16PyCl). These highly reactive precursors have so far not been used as gallium and phosphate sources for the synthesis of gallophosphates. Conceptually, our present synthetic procedure is based on the fast formation of gallium phosphate nanoparticles via the reaction of gallium propoxide with PCl3 and subsequent construction of the porous material with nanoparticles as building blocks. The organization of the gallophosphate nanoparticles in stable porous structures is effected by the templates. Different experimental procedures varying the molar composition of the sol-gel, pH and the pretreatment of gallium precursor were assayed, most of them leading to satisfactory materials in terms of thermal stability and porosity. In this way, a series of gallium phosphates with surface are above 200 m(2) g(-1), and narrow pore size from 3 to 6 nm and remarkable thermal stability (up to 550 degrees C) have been prepared. In some cases, the structure tends to show some periodicity and regularity as determined by XRD. The remarkable stability has allowed us to test the catalytic activity of gallophosphates for the aerobic oxidation of alkylaromatics with notable good results. Our report reopens the interest for gallophosphates in heterogeneous catalysis. (C) 2010 Elsevier Inc. All rights reserved.

Capacity-building, representation and intracommunity conflict

This paper explores the nature of community capacity-building in the context of local development. It challenges some of the simplistic constructions of community as a distinctive stakeholder with a shared set of values and clear identity. Even in apparently homogeneous place-based communities such as in the Catholic Ardoyne area of North Belfast there are important differences in the way in which local people interact with the organised voluntary sector. The paper concludes by highlighting the need to reach deeper into the concerns of local people, rather than the priorities of statutory funders, as a basis for service provision and local planning.