Educational interventions for preventing vascular catheter bloodstream infections in critical care: Evidence map, systematic review and economic evaluation

Background Bloodstream infections resulting from intravascular catheters (catheter-BSI) in critical care increase patients' length of stay, morbidity and mortality, and the management of these infections and their complications has been estimated to cost the NHS annually £19.1–36.2M. Catheter-BSI are thought to be largely preventable using educational interventions, but guidance as to which types of intervention might be most clinically effective is lacking. Objective To assess the effectiveness and cost-effectiveness of educational interventions for preventing catheter-BSI in critical care units in England. Data sources Sixteen electronic bibliographic databases – including MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, Cumulative Index to Nursing and Allied Health Literature (CINAHL), NHS Economic Evaluation Database (NHS EED), EMBASE and The Cochrane Library databases – were searched from database inception to February 2011, with searches updated in March 2012. Bibliographies of systematic reviews and related papers were screened and experts contacted to identify any additional references. Review methods References were screened independently by two reviewers using a priori selection criteria. A descriptive map was created to summarise the characteristics of relevant studies. Further selection criteria developed in consultation with the project Advisory Group were used to prioritise a subset of studies relevant to NHS practice and policy for systematic review. A decision-analytic economic model was developed to investigate the cost-effectiveness of educational interventions for preventing catheter-BSI. Results Seventy-four studies were included in the descriptive map, of which 24 were prioritised for systematic review. Studies have predominantly been conducted in the USA, using single-cohort before-and-after study designs. Diverse types of educational intervention appear effective at reducing the incidence density of catheter-BSI (risk ratios statistically significantly < 1.0), but single lectures were not effective. The economic model showed that implementing an educational intervention in critical care units in England would be cost-effective and potentially cost-saving, with incremental cost-effectiveness ratios under worst-case sensitivity analyses of < £5000/quality-adjusted life-year. Limitations Low-quality primary studies cannot definitively prove that the planned interventions were responsible for observed changes in catheter-BSI incidence. Poor reporting gave unclear estimates of risk of bias. Some model parameters were sourced from other locations owing to a lack of UK data. Conclusions Our results suggest that it would be cost-effective and may be cost-saving for the NHS to implement educational interventions in critical care units. However, more robust primary studies are needed to exclude the possible influence of secular trends on observed reductions in catheter-BSI.

Submission to the Senate Economics References Committee Inquiry into affordable housing 20 August 2014: De-risking development of medium density housing to improve housing affordability and boost supply

This submission addresses the problem of housing price inflation, the chronic under-supply of new housing stock, and the resultant decline in housing affordability for low and middle income households. It specifically focusses on the supply of medium density housing (multi-unit development) in Melbourne, although we believe that the observations made about housing in supply in Melbourne are relevant in other urban centres and to other types of housing supply. In terms of medium density housing (MDH) our concern also extends to the poor quality and design. Why the market tends to deliver generic apartments of poor quality and design which are uncompetitive with lower density housing and amenity despite planning objectives, and how this apparently intractable problem can be overcome is the topic of this submission...

A comparative study of multiple attribute tree and inverted file structures for large bibliographic files

A variety of data structures such as inverted file, multi-lists, quad tree, k-d tree, range tree, polygon tree, quintary tree, multidimensional tries, segment tree, doubly chained tree, the grid file, d-fold tree. super B-tree, Multiple Attribute Tree (MAT), etc. have been studied for multidimensional searching and related problems. Physical data base organization, which is an important application of multidimensional searching, is traditionally and mostly handled by employing inverted file. This study proposes MAT data structure for bibliographic file systems, by illustrating the superiority of MAT data structure over inverted file. Both the methods are compared in terms of preprocessing, storage and query costs. Worst-case complexity analysis of both the methods, for a partial match query, is carried out in two cases: (a) when directory resides in main memory, (b) when directory resides in secondary memory. In both cases, MAT data structure is shown to be more efficient than the inverted file method. Arguments are given to illustrate the superiority of MAT data structure in an average case also. An efficient adaptation of MAT data structure, that exploits the special features of MAT structure and bibliographic files, is proposed for bibliographic file systems. In this adaptation, suitable techniques for fixing and ranking of the attributes for MAT data structure are proposed. Conclusions and proposals for future research are presented.

"Do Not Celebrate Your Feast without Your Neighbours" : A Study of References to Feasts and Festivals in Non-Literary Documents from Ramesside Period Deir el-Medina

This dissertation is a study of the forms and functions of feasts and feasting in the ancient Egyptian village of Deir el-Medina in Thebes (modern Luxor). This particular village, during the New Kingdom (c. 1550 1069 BC), was inhabited by the men (and their families) who constructed the Royal Tombs in the Valley of the Kings and the Valley of the Queens. The royal artisans were probably more literate than the average Egyptians and the numerous Ramesside Period (c. 1295 1069 BC) non-literary texts found in the excavations of the village and its surroundings form the source material for this study. In this study, the methods used are mainly Egyptological and the references to feasts and feasting are considered in view of what is known of New Kingdom Egypt, Thebes, and Deir el-Medina. Nevertheless, it is the use of the methodological concept local vernacular religion that has resulted in the division of the research findings into two sections, i.e., references to feasts celebrated both in and outside the community and other references to feasts and feasting in the village. When considering the function of the feasts celebrated at Deir el-Medina, a functional approach to feasts introduced by anthropologists and archaeologists is utilized. The Deir el-Medina feasts which were associated with the official religion form a festival calendar of feasts celebrated annually on the same civil calendar day. The reconstructed festival calendar of Deir el-Medina reflects the feasts celebrated around Thebes or, at least, in Western Thebes. The function of the nationally and regionally observed feasts (which, at least at Deir el-Medina, resulted in a work-free day) may have been to keep people content so that they would continue to work which was to the advantage of the king and the elite surrounding him. Local feasts appear to have been observed more irregularly at Deir el-Medina or perhaps according to the lunar calendar. Feasts celebrated by the community as a whole served to maintain the unity of the group. In addition to feasts celebrated by the entire community, the inhabitants of Deir el-Medina could mark their own personal feasts and organize small gatherings during public feasts. Through such feasts, an individual man might form alliances and advance his chances of a favourable marriage or of acquiring a position on the work crew.

Total hip arthroplasty in young patients : with special references to patients under 55 years of age and to patients with developmental dysplasia of the hip

There is an ongoing controversy as to which methods in total hip arthroplasty (THA) could provide young patients with best long-term results. THA is an especially demanding operation in patients with severely dysplastic hips. The optimal surgical treatment for these patients also remains controversial. The aim of this study was to evaluate the long-term survival of THA in young patients (<55 years at the time of the primary operation) on a nation-wide level, and to analyze the long-term clinical and radio-graphical outcome of uncemented THA in patients with severely dysplastic joints. Survival of 4661 primary THAs performed for primary osteoarthritis (OA), 2557 primary THAs per-formed for rheumatoid arthritis (RA), and modern uncemented THA designs performed for primary OA in young patients, were analysed from the Finnish Arthroplasty Register. A total of 68 THAs were per-formed in 56 consecutive patients with high congenital hip dislocation between 1989-1994, and 68 THAs were performed in 59 consecutive patients with severely dysplastic hips and a previous Schanz osteotomy of the femur between 1988-1995 at the Orton Orthopaedic Hospital, Helsinki, Finland. These patients underwent a detailed physical and radiographical evaluation at a mean of 12.3 years and 13.0 years postoperatively, respectively. The risk of stem revision due to aseptic loosening in young patients with primary OA was higher for cemented stems than for proximally porous-coated or HA-coated uncemented stems implanted over the 1991-2001 period. There was no difference in the risk of revision between all-poly cemented-cups and press-fit porous-coated uncemented cups implanted during the same period, when the end point was defined as any revision (including exchange of liner). All uncemented stem designs studied in young patients with primary OA had >90% survival rates at 10 years. The Biomet Bi-Metric stem had a 95% (95% CI 93-97) survival rate even at 15 years. When the end point was defined as any revision, 10 year survival rates of all uncemented cup designs except the Harris-Galante II decreased to <80%. In young patients with RA, the risk of stem revision due to aseptic loosening was higher with cemented stems than with proximally porous-coated uncemented stems. In contrast, the risk of cup revision was higher for all uncemented cup concepts than for all-poly cemented cups with any type of cup revision as the end point. The Harris hip score increased significantly (p<0.001) both in patients with high con-genital hip dislocation and in patients with severely dysplastic hips and a previous Schanz osteotomy, treated with uncemented THA. There was a negative Trendelenburg sign in 92% and in 88% of hips, respectively. There were 12 (18%) and 15 (22%) perioperative complications. The rate of survival for the CDH femoral components, with revision due to aseptic loosening as the end point, was 98% (95% CI 97-100) at 10 years in patients with high hip dislocation and 92% (95% CI, 86-99) at 14 years in patients with a previous Schanz osteotomy. The rate of survival for press-fit, porous-coated acetabular components, with revision due to aseptic loosening as the end point, was 95% (95% CI 89-100) at 10 years in patients with high hip dislocation, and 98% (95% CI 89-100) in patients with a previous Schanz osteotomy. When revision of the cup for any reason was defined as the end point, 10 year sur-vival rates declined to 88% (95% CI 81-95) and to 69% (95% CI, 56-82), respectively. For young patients with primary OA, uncemented proximally circumferentially porous- and HA-coated stems are the implants of choice. However, survival rates of modern uncemented cups are no better than that of all-poly cemented cups. Uncemented proximally circumferentially porous-coated stems and cemented all-poly cups are currently the implants of choice for young patients with RA. Uncemented THA, with placement of the cup at the level of the true acetabulum, distal advancement of the greater trochanter and femoral shortening osteotomy provided patients with high congenital hip dislocation good long-term outcomes. Most of the patients with severely dysplastic hips and a previous Schanz osteotomy can be successfully treated with the same method. However, the subtrochanteric segmental shortening with angular correction gives better leg length correction for the patients with a previous low-seated unilateral Schanz osteotomy.

Implementing WWWISIS for Providing Web Access to Bibliographic Databases

CDS/ISIS, an advanced non-numerical information storage and retrieval software was developed by UNESCO. With the emergence of WWW technology, most of the information activities are becoming Web-centric. Libraries and information providers are taking advantage of these Internet developments to provide access to their resources/information on the Web. A number of tools are now available for publishing CDS/ISIS databases on the Internet. One such tool is the WWWISIS Web gateway software, developed by BIREME, Brazil. This paper illustrates porting of sample records from a bibliographic database into CDS/ISIS, and then publishing this database on the Internet using WWWISIS.

Bibliografía argentina de peces de agua dulce.

Espanol: En la presente lista bibliográfica fueron recopiladas las referencias sobre los peces continentales de la Argentina, del período comprendido entre mediados del siglo XVIII y fines del año 2005. Incluye las listas bibliográficas publicadas durante los años 1981 a 2004, y las citas no mencionadas en ellas. Se incluyeron el ISSN o ISBN según correspondiera, la abreviatura oficial y el lugar de origen de las publicaciones. En algunos casos, los ISSN, las abreviaturas de los nombres de las publicaciones o su procedencia, mencionados en los catálogos, no coinciden con los de la home page de la publicación. Una bibliografía puede ser muy rica y aún estar incompleta. Requiere de sus lectores algún interés histórico, y aún un interés profundo por su tema. Ante una bibliografía, muchos investigadores preferirían no encontrar algunas referencias, y de hecho, muchas son oportunamente olvidadas. Por no saber como hacerlo, o por menosprecio, estas listas raramente son citadas en los trabajos, aunque sobre algunos temas en particular, sería realmente difícil formarse una idea si las bibliografías no existieran. Aún desde el comienzo es complicado precisar un criterio de inclusiones. Por ejemplo, gran parte de la ictiofauna Argentina se encuentra también en Brasil. ¿Justifica esto incluir informes perdidos sobre artes de pesca en una cuenca distante? ¿Deben los clásicos, que todo el mundo conoce y el que se inicia encontrará sin dificultad, ser incluidos? Aún a un grupo que se dedicara full time a este trabajo, le sería difícil verificar la precisión de las citas antiguas, en las que fechas y autoría cambian según la investigación histórica. En una bibliografía más o menos general, la perfección atenta contra la publicación. Sin embargo, pensamos que es conveniente hacerlas. Una mirada a este volumen, muestra la enorme cantidad de desarrollos en muchos temas, y la regla que uno de nosotros ha mencionado desde hace tiempo: siempre hay más publicado sobre un tema de lo que uno cree. La sospecha de que con sólo mirar lo que está hecho, muchos subsidios podrían utilizarse para algo más útil que algunas evaluaciones repetidas de recursos o biodiversidad, es un poco pesimista y no haremos perder trabajos insistiendo en eso. Cada generación elige sus metas, su propia base epistemológica, sus trabajos preferidos y los que desecha. Aún en trabajos perdidos o de mala calidad, es posible encontrar datos valiosos. Ningún proyecto, por mejor diseñado que esté, podrá mostrar en el presente los organismos que vivían en el pasado en un lugar en el que las condiciones han cambiado, o lo hará en términos de otra disciplina. En los temas aplicados la información del pasado puede ser importantísima. Aún en una disciplina tan conservadora como la nomenclatura, los cambios pueden ser exasperantes; no pueden serlo menos en las que intrínsecamente, como la ecología, es lo que estudian. Para dar una idea más precisa del desarrollo de la ictiología en la Argentina, esta lista podría ir acompañada de una apreciación crítica. Entendemos que una tarea así exige un trabajo diferente, de cierta magnitud y con no pocos elementos históricos. Aunque tiene deficiencias, la ictiología argentina constituye una acumulación de conocimientos de considerable calidad y pertinencia para la historia natural de América del Sur. Dejamos a los lectores que cada uno haga la suya. English: For the present list, references on freshwater fishes of Argentina were compiled from the period between middle XVIII Century and the end of the year 2005. It includes previous lists published during 1981 to 2004, and references not mentioned therein. The ISSN o ISBN numbers were included, as well as the official abbreviations and the place of origin of the periodicals. In some cases, these data as quoted in catalogs, do not agree with those in the home page of the publication. A bibliography may be very rich and anyway never complete. It requires from its readers some historic interest and indeed a deep interest on his (her) subject. Browsing a bibliography, many researchers would prefer not to find some references, and in fact, sometimes they forget some of them. Not imagining how to do it, or because people do not concede importance to them, bibliographic lists are rarely quoted in papers, though some subjects would be rather difficult to understand if list of publications would not exist. Even from the beginning, it is difficult to precise a criterion of inclusions. For example, many Argentine fishes occur also in Brazil. Does this justify the inclusion of grey reports on a distant basin? Should classic works, that everybody knows and are easily found, be included? Is near impossible, even for a group dedicated full time to this work, to verify the precision of old citations, whose dates and authorship change according to authorities and historical research. In a more or less general bibliography, completeness is against publication. Nevertheless, we think that is convenient to prepare these lists. A look at this volume shows the enormous developments in many subjects, and the rule that one of us mentioned long ago: there are always more papers on any subject than one suspects. Looking at what has already been done raises the suspicion that many grants could be used for something more useful than repeated evaluations of biodiversity or resources. This is a bit pessimistic, and we do not want to erase working opportunities. Each generation chooses its targets, its own epistemological base, its preferred papers and those that rejects. Even in lost or bad quality papers, the possibility of finding valuable information exists. No project, whatever the appropriateness of its design, could show at present which organisms lived in the past in a place where environmental conditions have changed, or it will do it in terms of another discipline. In applied subjects, information from the past can be very important. Even in a conservative discipline as nomenclature, changes can be exasperating. They are not lesser in those like ecology, where change itself is studied. To provide a more precise idea of the development of ichthyology in Argentina, this list could be accompanied by a critical appreciation. We understood that such an aim requires a different work, with no few historical elements and of certain magnitude. In spite of some deficiencies, Argentine ichthyology, resulting from collaboration of both local and foreign people, constitutes a bulk of knowledge of considerable quality and pertinence for the natural history of South America. We leave each reader to make his (or her) own evaluation. (Texto en Espanol. PDF tiene cien setenta paginas.)

Bibliographic Data Roadmap Group Meeting 1

The first meeting of a Jisc convened group to discuss action in the area of bibliographic data.

Bibliographic Data Roadmap Group Meeting 2

Notes from the second meeting of the Bibliographic Data Roadmap Group to discuss action on bibliographic data for libraries

Framing digital capabilities for UK HE and FE staff: Resources and references

This list does not include the actual frameworks, specifications, standards etc reviewed for the Jisc digital capabilities programme. These are secondary resources - articles, reports, research outcomes and professional reviews - which are sometimes linked to specific frameworks. They were used to help plan the frameworks review, construct the new Jisc digital capabilities framework and to write the accompanying reports. Further down you will find a list of web sites, blog posts and professional resources which provide useful additional information and materials, not necessarily evidence-based and not always drawn on directly for this project.

Bibliographic Data Services and The National Monograph Strategy - Next Steps

This paper summarises the recommendations of a recent report produced by Sero Consulting & Associates that was commissioned (by Jisc) to examine the implications of pursuing specific bibliographic data strategies with reference to the recommendations of the National Monograph Strategy. It reflects input from representatives of RLUK, SCONUL, the British Library and others. It also sets out a brief response to the report from Jisc and some proposals for immediate next steps.

A review of the biology, ecology and management of Scirpus Olneyi. Volume 1: An annotated bibliography of selected references

This annotated bibliography of selected literature on Olney's three7square (Scirpus olneyi Gray )compiled basically for two reasons: 1) to assist a task force in its pursuit of an explanation for the substantial reduction in marsh acreage at the Blackwater National Wildlife Refuge in Dorchester County, Maryland, and 2) to serve as the author's foundation for the initiation of ecological research on this species as partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Botany Department of the University of Maryland. Both purposes are directly related in that the Author's research will be of use to the task force, along I with its other technical information and research results, in under-standing and possibly correcting the marshland loss problem at the Refuge. (PDF contains 100 pages)

Grandes túneis urbanos: uma proposta de gestão ambiental.

Este estudo objetiva a sistematização do conhecimento, através de uma abordagem multidisciplinar, de forma a conformar uma proposta inicial de protocolo de gestão ocupacional e ambiental em grandes túneis urbanos em âmbito nacional. Há na presente pesquisa uma atenção particular aos túneis urbanos dedicados ao tráfego de veículos automotores, devido às suas características físico-espaciais que os tornam especialmente perigosos e tóxicos aos seus usuários e aos funcionários envolvidos. A relativa carência de material bibliográfico de caráter sistêmico e específico no Brasil enseja à busca por referências em documentos desenvolvidos em outros países. Ainda que em nível preliminar, a compilação crítica de dados, normas e referências pesquisadas, à luz do contexto e dos instrumentos normativos brasileiros referentes ao tema, traduz-se no aspecto original desta proposta dissertativa, a ser possivelmente utilizada como ponto de partida para estudos mais extensos. São abordadas as seguintes disciplinas relativas ao objeto de pesquisa: a) Características físico-espaciais; b) Formas de uso; c) Sistema de ventilação e exaustão; d) Sistema de iluminação; e) Sistema de segurança contra sinistros e incêndio; f) Sistema de fiscalização e orientação de tráfego, comunicação e sinalização; g) Sistema de drenagem; h) Sistema de gerenciamento de resíduos sólidos. O túnel Rebouças (1962-1965) e o túnel Engenheiro Raymundo de Paula Soares (Linha Amarela) (1997), distanciados por mais de três décadas, foram escolhidos como estudos de caso, não tão somente devido aos seus portes, fluxos intensos de veículos etc., mas também devido aos contextos das evoluções normativas em que se inserem.