Antimicrobial use and incidence of multidrug-resistant Pseudomonas aeruginosa in a teaching hospital: an ecological approach

INTRODUCTION: Multidrug-resistant Pseudomonas aeruginosa is a major threat in healthcare settings. The use of antimicrobials can influence the incidence of resistant strains by direct and indirect mechanisms. The latter can be addressed by ecological studies. METHODS: Our group attempted to analyze the relation between the use of antipseudomonal drugs and the incidence of MDR-PA among 18 units from a 400-bed teaching hospital. The study had a retrospective, ecological design, comprising data from 2004 and 2005. Data on the use of four antimicrobials (amikacin, ciprofloxacin, ceftazidime and imipenem) were tested for correlation with the incidence of MDR-PA (defined as isolates resistant to the four antimicrobials of interest) in clinical cultures. Univariate and multivariate linear regression analyses were performed. RESULTS: Significant correlations were determined between use and resistance for all antimicrobials in the univariate analysis: amikacin (standardized correlation coefficient = 0.73, p = 0.001); ciprofloxacin (0.71, p = 0.001); ceftazidime (0.61, p = 0.007) and imipenem (0.87, p < 0.001). In multivariate analysis, only imipenem (0.67, p = 0.01) was independently related to the incidence of multidrug-resistant strains. CONCLUSIONS: These findings share similarities with those reported in individual-based observational studies, with possible implications for infection control.

Genetic diversity in rosewood saplings (Aniba rosaeodora ducke, Lauraceae): an ecological approach

This article takes an ecological approach to the genetic diversity of Rosewood (Aniba rosaeodora Ducke) in a central Amazonian terra firme forest north of Manaus. Planted Rosewood setting, under partial shaded canopy, were assessed in terms of fruiting production, frugivory, and seed dispersal. Using RAPD molecular analysis procedures, the influence of the spatial distribution of adult trees on the genetic diversity (polymorphism) of saplings was assessed with genetic samples from 34 reproductive trees and 60 saplings. The density and distribution patterns the reproductive trees did not modify the sapling"s diversity (1.86%, AMOVA). Two types of adult tree dispersion were identified; i) clumped and ii) more widely dispersed. Polymorphism (77.5%) and gene flow were high between these. Although more sapling genetic variability in areas with a higher density of mature plants was not as high as expected, density did not affect the genetic diversity of samplings, indicating a high incidence of gene flow amongst trees. In planted Rosewood population (surrounded by low disturbed forest), fruiting trees experienced a high level of removal of seeds by toucans (Rhamphastidae), about of 50%. The high gene flow found among native trees suggested that toucans, promoting seed rain at short and long distances from maternal trees, actively contribute to the maintenance of genetic diversity within wild rosewood populations.

The metazoan parasites of Stellifer minor (Tschudi, 1844): an ecological approach

A quantitative and qualitative analysis of the parasite fauna of the sciaenid Stellifer minor (Tschudi) from Chorrillos, Peru, was made. Some characteristics of the infectious processes, in terms of intensity and prevalence of infection, as a function of host sex and size, are given. Moreover, comments on the characteristics of the parasite fauna, related with host role in the marine food webs are included. The parasite fauna of Stellifer minor taken of Chorrillos, Peru, include the monogeneans Pedocotyle annakohni, Pedocotyle bravoi, Rhamnocercus sp. and Cynoscionicola sp., the digenean Helicometra fasciata, the adult acantocephalan Rhadinorhynchus sp. and the larval Corynosoma sp., the nematode Procamallanus sp., the copepods Caligus quadratus, Clavellotis dilatata and Bomolochus peruensis and one unidentified isopod of the family Cymothoidae. A distinctive characteristic of the parasite fauna (Metazoa) of S. minor is the almost absence of larval forms.

An Investigation of the Role of Attention in the Cross-Race Effect: An Ecological Approach

The current set of studies was conducted to examine the cross-race effect (CRE), a phenomenon commonly found in the face perception literature. The CRE is evident when participants display better own-race face recognition accuracy than other-race recognition accuracy (e.g. Ackerman et al., 2006). Typically the cross-race effect is attributed to perceptual expertise, (i.e., other-race faces are processed less holistically; Michel, Rossion, Han, Chung & Caldara, 2006), and the social cognitive model (i.e., other-race faces are processed at the categorical level by virtue of being an out-group member; Hugenberg, Young, Bernstein, & Sacco, 2010). These effects may be mediated by differential attention. I investigated whether other-race faces are disregarded and, consequently, not remembered as accurately as own-race (in-group) faces. In Experiment 1, I examined how the magnitude of the CRE differed when participants learned individual faces sequentially versus when they learned multiple faces simultaneously in arrays comprising faces and objects. I also examined how the CRE differed when participants recognized individual faces presented sequentially versus in arrays of eight faces. Participants’ recognition accuracy was better for own-race faces than other-race faces regardless of familiarization method. However, the difference between own- and other-race accuracy was larger when faces were familiarized sequentially in comparison to familiarization with arrays. Participants’ response patterns during testing differed depending on the combination of familiarization and testing method. Participants had more false alarms for other-race faces than own-race faces if they learned faces sequentially (regardless of testing strategy); if participants learned faces in arrays, they had more false alarms for other-race faces than own-races faces if ii i they were tested with sequentially presented faces. These results are consistent with the perceptual expertise model in that participants were better able to use the full two seconds in the sequential task for own-race faces, but not for other-race faces. The purpose of Experiment 2 was to examine participants’ attentional allocation in complex scenes. Participants were shown scenes comprising people in real places, but the head stimuli used in Experiment 1 were superimposed onto the bodies in each scene. Using a Tobii eyetracker, participants’ looking time for both own- and other-race faces was evaluated to determine whether participants looked longer at own-race faces and whether individual differences in looking time correlated with individual differences in recognition accuracy. The results of this experiment demonstrated that although own-race faces were preferentially attended to in comparison to other-race faces, individual differences in looking time biases towards own-race faces did not correlate with individual differences in own-race recognition advantages. These results are also consistent with perceptual expertise, as it seems that the role of attentional biases towards own-race faces is independent of the cognitive processing that occurs for own-race faces. All together, these results have implications for face perception tasks that are performed in the lab, how accurate people may be when remembering faces in the real world, and the accuracy and patterns of errors in eyewitness testimony.

New media technologies, law, and society: an ecological approach

Joyce Tam de l'Université McGill est récipiendaire du 3ème prix du concours de la bourse d'initiation à la recherche offerte par le Regroupement Droit et changements aux étudiants du baccalauréat en droit.

Antimicrobial use and incidence of multidrug-resistant Pseudomonas aeruginosa in a teaching hospital: an ecological approach

Introduction: Multidrug-resistant Pseudomonas aeruginosa is a major threat in healthcare settings. The use of antimicrobials can influence the incidence of resistant strains by direct and indirect mechanisms. The latter can be addressed by ecological studies. Methods: Our group attempted to analyze the relation between the use of antipseudomonal drugs and the incidence of MDR-PA among 18 units from a 400-bed teaching hospital. The study had a retrospective, ecological design, comprising data from 2004 and 2005. Data on the use of four antimicrobials (amikacin, ciprofloxacin, ceftazidime and imipenem) were tested for correlation with the incidence of MDR-PA (defined as isolates resistant to the four antimicrobials of interest) in clinical cultures. Univariate and multivariate linear regression analyses were performed. Results: Significant correlations were determined between use and resistance for all antimicrobials in the univariate analysis: amikacin (standardized correlation coefficient = 0.73, p = 0.001); ciprofloxacin (0.71, p = 0.001); ceftazidime (0.61, p = 0.007) and imipenem (0.87, p < 0.001). In multivariate analysis, only imipenem (0.67, p = 0.01) was independently related to the incidence of multidrug-resistant strains. Conclusions: These findings share similarities with those reported in individual-based observational studies, with possible implications for infection control.

Marine Protected Areas in Brazil: An ecological approach regarding the large marine ecosystems

The objective of this study was to address the importance of implementing Coastal and Marine Protected Areas in Brazil and to examine their distribution, based on the delimitation of Large Marine Ecosystems. Out of a total of 336 protected areas identified in Brazilian coastal and marine areas, the North Platform has the largest protected area, but the ecosystem with the largest number of protected area, predominantly sustainable areas, was the East Coast followed by the South Platform. One of the reasons the eastern coast of Brazil to have more protected areas is the fact that there is a largest amount of coral reefs. Additionally there was political opportunities for the creation of protected areas for sustainable use. The coastal region of Brazil has achieved the goal proposed by the Seventh Conference of the Parties to the Convention on Biological Diversity - 7, but only then through the category V of the International Union for Conservation of Nature, which is not the best efficient means of conserving resources. The goal for marine conservation shows only the area above the recommended under protection in North Platform. The Marine portion of the East Coast and the South Platform has few protected areas, regardless of category management. We consider the coastal region the range of 12 nautical miles from baselines determined in accordance with the United Nations Convention on the Law of the Sea. As for the number of strategies permitted by law and used for the conservation of coastal and marine systems, coastal systems show a higher number when compared with the marine system. We suggest that the Brazilian government should specify strategies for the protection of marine systems and expand the protected areas of all Large Marine Ecosystems. © 2013 Elsevier Ltd.

An ecological approach to anomaly detection: the EIA Model.

The presented work proposes a new approach for anomaly detection. This approach is based on changes in a population of evolving agents under stress. If conditions are appropriate, changes in the population (modeled by the bioindicators) are representative of the alterations to the environment. This approach, based on an ecological view, improves functionally traditional approaches to the detection of anomalies. To verify this assertion, experiments based on Network Intrussion Detection Systems are presented. The results are compared with the behaviour of other bioinspired approaches and machine learning techniques.

From the human rights-based approach to an ecological approach on how to achieve successful inclusion in international disability education

The barriers that people with disabilities face around the world are not only inherent to the limitations resulting from the disability itself, but, more importantly, these barriers rest with the societal technologies of exclusion. Using a mixed methodology approach, I conduct a quest to revealing several societal factors that limit full participation of people with disabilities in their communities, which will contribute to understanding and developing a more comprehensive framework for full inclusion of people with disabilities into the society. First, I conduct a multiple regression analysis to seek whether there is a statistical relationship between the national level of development, the level of democratization, and the level of education within a country’s population on one hand, and expressed concern for and preparedness to improve the quality of life for people of disabilities on another hand. The results from the quantitative methodology reveal that people without disabilities are more prepared to take care of people with disabilities when the level of development of the country is higher, when the people have more freedom of expression and hold the government accountable for its actions, and when the level of corruption is under control. However, a greater concern for the well-being of people with disabilities is correlated with a high level of country development, a decreased value of political stability and absence of violence, a decreased level of government effectiveness, and a greater level of law enforcement. None of the dependent variables are significantly correlated with the level of education from a given country. Then, I delve into an interpretive analysis to understand multiple factors that contribute to the construction of attitudes and practices towards people with disabilities. In doing this, I build upon the four main principles outlined by the United Nations as strongly recommended to be embedded in all international programmes: (1) identification of claims of human rights and the corresponding obligations of governments, hence, I assess and analyze disability rights in education, looking at United Nation, United States, and European Union Perspectives Educational Rights Provisions for People with Disabilities (Ch. 3); (2) estimated capacity of individuals to claim their rights and of governments to fulfill their obligations, hence, I look at the people with disabilities as rights-holders and duty-bearers and discuss the importance of investing in special capital in the context of global development (Ch. 4); (3) programmes monitor and evaluate the outcomes and the processes under the auspices of human rights standards, hence, I look at the importance of evaluating the UN World Programme of Action Concerning People with Disabilities from multiple perspectives, as an example of why and how to monitor and evaluate educational human rights outcomes and processes (Ch. 5); and (4) programming should reflect the recommendations of international human rights bodies and mechanisms, hence, I focus on programming that fosters development of the capacity of people with disabilities, that is, planning for an ecology of disabilities and ecoducation for people with disabilities (Ch. 6). Results from both methodologies converge to a certain point, and they further complement each other. One common result for the two methodologies employed is that disability is an evolving concept when viewed in a broader context, which integrates the four spaces that the ecological framework incorporates. Another common result is that factors such as economic, social, legal, political, and natural resources and contexts contribute to the health, education and employment opportunities, and to the overall well-being of people with disabilities. The ecological framework sees all these factors from a meta-systemic perspective, where bi-directional interactions are expected and desired, and also from a human rights point of view, where the inherent value of people is upheld at its highest standard.

Texture and composition of the Rosa Marina beach sands (Adriatic coast, southern Italy): a sedimentological/ecological approach

Beach sands from the Rosa Marina locality (Adriatic coast, southern Italy) were analysed mainly microscopically in order to trace the source areas of their lithoclastic and bioclastic components. The main cropping out sedimentary units were also studied with the objective to identify the potential source areas of lithoclasts. This allowed to establish how the various rock units contribute to the formation of beach sands. The analysis of the bioclastic components allows to estimate the actual role of organisms regarding the supply of this material to the beach. Identification of taxa that are present in the beach sands as shell fragments or other remains was carried out at the genus or family level. Ecologi- cal investigation of the same beach and the recognition of sub-environments (mainly distinguished on the basis of the nature of the substrate and of the water depth) was the key topic that allowed to establish the actual source areas of bioclasts in the Rosa Marina beach sands. The sedimentological analysis (including a physical study of the beach and the calculation of some statistical parameters concerning the grain-size curves) shows that the Rosa Marina beach is nowadays subject to erosion.

An intervention mapping approach: Identification of human trafficking victims by health professionals

Background. Today modern day slavery is known as human trafficking and is a growing pandemic that is a grave human rights violation. Estimates suggest that 12.3 million people are working under conditions of force, fraud or coercion. Working toward eradication is a worthy effort; it would free millions of humans from slavery, mostly women and children, as well as uphold basic human rights. One tactic to eradicating human trafficking is to increase identification of victims among those likely to encounter victims of human trafficking.^ Purpose. This study aims to develop an intervention that improves certain stakeholders' ability, in the health clinic setting, to appropriately identify and report victims of human trafficking to the National Human Trafficking Resource Center.^ Methods. The Intervention Mapping (IM) process was used by program planners to develop an intervention for health professionals. This methodology is a six step process that guides program planners to develop an intervention. Each step builds on the others through the execution of a needs assessment, and the development of matrices based on performance objectives and determinants of the targeted health behavior. The end product results in an ecological, theoretical, and evidence based intervention.^ Discussion. The IM process served as a useful protocol for program planners to take an ecological approach as well as incorporate theory and evidence into the intervention. Consultation with key informants, the planning group, adopters, implementers, and individuals responsible for institutionalization also contributed to the practicality and feasibility of the intervention. Program planners believe that this intervention fully meets recommendations set forth in the literature.^ Conclusions. The intervention mapping methodology enabled program planners to develop an intervention that is appropriate and acceptable to the implementer and the recipients.^