Présentation de la méthode de revue systématique BEST

Séance de travail de la Direction des Soins, CHUV, Lausanne

Catheterisation. Indwelling catheters in adults. Urethral and suprapubic. Evidence-based guidelines for best practice in urological health care

The EAUN Guidelines Working Group for indwelling catheters have prepared this guideline document to help nurses assess the evidence-based management of catheter care and to incorporate the guidelines’ recommendations into their clinical practice. These guidelines are not meant to be proscriptive, nor will adherence to these guidelines guarantee a successful outcome in all cases. Ultimately, decisions regarding care must be made on a case-by-case basis by healthcare professionals after consultation with their patients using their clinical judgement, knowledge and expertise.

Endovascular Versus Open Abdominal Aortic Aneurysm: Best Decision.

Since the first implantation of an endograft in 1991, endovascular aneurysm repair (EVAR) rapidly gained recognition. Historical trials showed lower early mortality rates but these results were not maintained beyond 4 years. Despite newer-generation devices, higher rates of reintervention are associated with EVAR during follow-up. Therefore, the best therapeutic decision relies on many parameters that the physician has to take in consideration. Patient's preferences and characteristics are important, especially age and life expectancy besides health status. Aneurysmal anatomical conditions remain probably the most predictive factor that should be carefully evaluated to offer the best treatment. Unfavorable anatomy has been observed to be associated with more complications especially endoleak, leading to more re-interventions and higher risk of late mortality. Nevertheless, technological advances have made surgeons move forward beyond the set barriers. Thus, more endografts are implanted outside the instructions for use despite excellent results after open repair especially in low-risk patients. When debating about AAA repair, some other crucial points should be analysed. It has been shown that strict surveillance is mandatory after EVAR to offer durable results and prevent late rupture. Such program is associated with additional costs and with increased risk of radiation. Moreover, a risk of loss of renal function exists when repetitive imaging and secondary procedures are required. The aim of this article is to review the data associated with abdominal aortic aneurysm and its treatment in order to establish selection criteria to decide between open or endovascular repair.

'And the best essay is...' : Extended contact and cross-group friendships at school

We conducted one experimental intervention based on extended contact principles aimed at fostering the formation of cross-group friendships within educational settings. Italian school children took part in a school competition for the best essay on personal experiences of cross-group friendships with immigrants, to be written in small groups. This manipulation was intended to favour the exchange of personal positive cross-group experiences, thus capitalizing on the benefits of extended contact. In the control condition, participants wrote an essay on friendship, without reference to cross-group relations. Results revealed that children who took part in the intervention reported a higher number of outgroup friends 3 months later. This indirect effect was sequentially mediated by pro-contact ingroup and outgroup norms and by outgroup contact behavioural intentions. This study provides experimental evidence that interventions based on extended contact can foster cross-group friendship formation. Theoretical and practical implications of the findings are discussed.

Best practice report on policy learning infrastructures in innovative labour market policies

This report synthesizes the findings of 11 country reports on policy learning in labour market and social policies that were conducted as part of WP5 of the INSPIRES project, which is funded by the 7th Framework Program of the EU-Commission. Notably, this report puts forward objectives of policy learning, discusses tools, processes and institutions of policy learning and presents the impacts of various tools and structures of the policy learning infrastructure for the actual policy learning process. The report defines three objectives of policy learning: evaluation and assessment of policy effectiveness, vision building and planning, and consensus building. In the 11 countries under consideration, the tools and processes of the policy learning, infrastructure can be classified into three broad groups: public bodies, expert councils, and parties, interest groups and the private sector. Finally, we develop four recommendations for policy learning: Firstly, learning processes should keep the balance between centralisation and plurality. Secondly, learning processes should be kept stable beyond the usual political business cycles. Thirdly, policy learning tools and infrastructures should be sufficiently independent from political influence or bias. Fourth, Policy learning tools and infrastructures should balance out mere effectiveness, evaluation and vision building.

The farthest need the best. Human capital composition and development-specific economic growth

We provide robust and compelling evidence of the marked impact of tertiary education on the economic growth of less developed countries and of its the relatively smaller impact on the growth of developed ones. Our results argue in favor of the accumulation of high skill levels especially in technologically under-developed countries and, contrary to common wisdom, independently of the fact that these economies might initially produce lower-technology goods or perform technology imitation. Our results are robust to the different measures used in proxying human capital and to the adjustments made for cross-country differences in the quality of education. Country-specific institutional quality, as well as other indicators including legal origin, religious fractionalization and openness to trade have been used to control for the robustness of the results. These factors are also shown to speed up technology convergence thereby confirming previous empirical studies. Our estimates tackle problems of endogeneity by adopting a variety of techniques, including instrumental variables -for both panel and cross-section analyses- and the two-step efficient dynamics system GMM.

Body donations today and tomorrow: What is best practice and why?

There is considerable agreement that the use of human bodies for teaching and research remains important, yet not all universities use dissection to teach human gross anatomy. The concept of body donation has evolved over centuries and there are still considerable discrepancies among countries regarding the means by which human bodies are acquired and used for education and research. Many countries have well-established donation programs and use body dissection to teach most if not all human gross anatomy. In contrast, there are countries without donation programs that use unclaimed bodies or perhaps a few donated bodies instead. In several countries, use of cadavers for dissection is unthinkable for cultural or religious reasons. Against this background, successful donation programs are highlighted in the present review, emphasizing those aspects of the programs that make them successful. Looking to the future, we consider what best practice could look like and how the use of unclaimed bodies for anatomy teaching could be replaced. From an ethical point of view, countries that depend upon unclaimed bodies of dubious provenance are encouraged to use these reports and adopt strategies for developing successful donation programs. In many countries, the act of body donation has been guided by laws and ethical frameworks and has evolved alongside the needs for medical knowledge and for improved teaching of human anatomy. There will also be a future need for human bodies to ensure optimal pre- and post-graduate training and for use in biomedical research. Good body donation practice should be adopted wherever possible, moving away from the use of unclaimed bodies of dubious provenance and adopting strategies to favor the establishment of successful donation programs. Clin. Anat. 29:11-18, 2016. © 2015 Wiley Periodicals, Inc.

Produção de dióxido de manganês eletrolítico para uso em baterias de lítio

The e phase of electrolytic manganese dioxide (EMD) is the structural form most easily converted in the LiMn2O4 spinel used as cathode in lithium batteries. Thus, employing titanium as anode, a study of electrolysis parameters was carried out in order to determine the best conditions to produce an e-EMD suitable for that spinel preparation. The influence of solution temperature (65oC and 90oC) and current density (between 1 mA/cm2 and 17.5 mA/cm2) on the anode potential and the EMD properties was investigated using an aqueous 2.0 mol/L MnSO4 + 0.30 mol/L H2SO4 solution. In any of the electrolysis conditions tested only the e-EMD structure was obtained, but its specific surface area varied with the applied current density and temperature. Drying the e-EMD at temperatures between 60oC and 120oC did not cause any phase changes. To produce a suitable EMD at the highest current density possible without passivation of the titanium anode, the best electrolysis parameters were determined to be 90oC and 15 mA/cm2. The e-EMD thus obtained had a specific surface area (BET) of ca. 65 m2/g.

Defining a framework model to determine total costs of managed desktops using ITIL best practices

In modern day organizations there are an increasing number of IT devices such as computers, mobile phones and printers. These devices can be located and maintained by using specialized IT management applications. Costs related to a single device accumulate from various sources and are normally categorized as direct costs like hardware costs and indirect costs such as labor costs. These costs can be saved in a configuration management database and presented to users using web based development tools such as ASP.NET. The overall costs of IT devices during their lifecycle can be ten times higher than the actual purchase price of the product and ability to define and reduce these costs can save organizations noticeable amount of money. This Master’s Thesis introduces the research field of IT management and defines a custom framework model based on Information Technology Infrastructure Library (ITIL) best practices which is designed to be implemented as part of an existing IT management application for defining and presenting IT costs.

Uso da cinza da casca do arroz (CCA) obtida da geração de energia térmica como adsorvente de Zn(II) em soluções aquosas

The removal study was conducted using 1.00 g of the rice husk ash (RHA) and 20.0 mL solution with concentrations in the range of 10-1000 mg/L of Zn(II). The influence of contact time, initial metal concentration, agitation and pH of the removal process was investigated. Superior removals to 95% were obtained at the end of 24 h of contact. The agitation increased in 20% the removal of Zn(II), being needed only 5 min to reach the equilibrium. The adsorption process was studied by the models of isotherms of Langmuir, Freundlich and BET, obtaining results of R L and 1/n for a process favorable of adsorption. BET isotherm best represents the equilibrium adsorption. The results showed that the RHA has the largest capacity and affinity for the removal of Zn(II).

Estudo da reação de oxidação preferencial do co sobre o sistema CuO/CeO2-TiO2

Cu catalysts supported on CeO2, TiO2 and CeO2/TiO2 were prepared by precipitation method and used for preferential oxidation of carbon monoxide contained in a hydrogen flow generated by methane steam reforming. The samples were characterized by XRD, BET and TPR techniques. The catalytic properties were studied in the 50-330ºC range by using a quartz micro-reactor vertically positioned on an electrical furnace. The results showed that the small copper particles generated with the lower metal content are the most easily reducible and give the best catalytic performance. In respect of support effect, the strong metal-support interaction and the redox characteristics of the CuOx-CeO2 series resulted in the best catalytic results, especially with the sample with 1% copper content.

Efeito da adição de lantânio em catalisadores de Ni/ZrO2 aplicados na reação de reforma a vapor de etanol

The catalytic performance of Ni/ZrO2 catalysts loaded with different lanthanum content for steam reforming of ethanol was investigated. Catalysts were characterized by BET surface area, X-ray diffraction, UV-vis spectroscopy, temperature programmed reduction, and X-ray absorption fine structure techniques. Results showed that lanthanum addition led to an increase in the degree of reduction of both NiO and nickel surface species interacting with the support, due to the higher dispersion effect. The best catalytic performance at 450 ºC was found for the Ni/12LZ catalyst, which exhibited an effluent gaseous mixture with the highest H2 yield.

Nanotubos de TiO2 dopados com nitrogênio: comparação das atividades fotocatalíticas de materiais obtidos através de diferentes técnicas

TiO2 nanotubes were synthesized by hydrothermal method and doped with three nitrogen compounds to enhance photocatalytic activity under visible light. Catalysts were characterized by X-ray diffraction (XRD), transmission electron microscopy (TEM), diffuse reflectance spectroscopy (DRS) and specific surface area and pore volume determined by BET and BJH methods, respectively. Photocatalytic activity was evaluated by photodegradation of rhodamine B under visible and UV radiations. Results showed doped-nanotubes were more efficient under visible light. The best photocatalytic activity was for sample NTT-7-600/NH3I, being 30% higher than the non-doped sample.