Factors predictive of inappropriateness in requests for parenteral antimicrobials for therapeutic purposes: A study in a small teaching hospital in Brazil

Background: The identification of patterns of inappropriate antimicrobial prescriptions in hospitals contributes to the improvement of antimicrobial stewardship programs (ASP). Methods: We conducted a cross-sectional study to identify predictors of inappropriateness in requests for parenteral antimicrobials (RPAs) in a teaching hospital with 285 beds. We reviewed 25% of RPAs for therapeutic purposes from y 2005. Appropriateness was evaluated according to current guidelines for antimicrobial therapy. We assessed predictors of inappropriateness through univariate and multivariate models. RPAs classified as 'appropriate' or 'probably appropriate' were selected as controls. Case groups comprised inappropriate RPAs, either in general or for specific errors. Results: Nine hundred and sixty-three RPAs were evaluated, 34.6% of which were considered inappropriate. In the multivariate analysis, general predictors of inappropriateness were: prescription on week-ends/holidays (odds ratio (OR) 1.67, 95% confidence interval (CI) 1.20-2.28, p = 0.002), patient in the intensive care unit (OR 1.57, 95% CI 1.11-2.23, p = 0.01), peritoneal infection (OR 2.15, 95% CI 1.27-3.65, p = 0.004), urinary tract infection (OR 1.89, 95% CI 1.25 -2.87, p = 0.01), combination therapy with 2 or more antimicrobials (OR 1.72, 95% CI 1.15-2.57, p = 0.008) and prescriptions including penicillins (OR 2.12, 95% CI 1.39-3.25, p = 0.001) or 1(st) generation cephalosporins (OR 1.74, 95% CI 1.01-3.00, p = 0.048). Previous consultation with an infectious diseases (ID) specialist had a protective effect against inappropriate prescription (OR 0.34, 95% CI 0.24-0.50, p < 0.001). Factors independently associated with specific prescription errors varied. However, consultation with an ID specialist was protective against both unnecessary antimicrobial use (OR 0.04, 95% CI 0.01-0.26, p = 0.001) and requests for agents with an insufficient antimicrobial spectrum (OR 0.14, 95% CI 0.03-0.30, p = 0.01). Conclusions: Our results demonstrate the importance of previous consultation with an ID specialist in assuring the quality of prescriptions. Also, they highlight prescription patterns that should be approached by ASP policies.

Draft biennial programme of regional and international cooperation activities of the Statistical Conference of the Americas of ECLAC, 2007-2009

Includes bibliography

Construção e ancoragem ontológica do vocabulário básico bilíngë do turismo para fins didáticos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Analysis of cardiopulmonary and metabolic variables measured during laboratory and sport-specific incremental tests for table tennis performance prediction

Purpose. - The purposes of this study were: i) to compare the physiological responses measured during a specific table tennis incremental test with the physiological responses measured during cycling, arm cranking, and treadmill running tests; and ii) to verify the accuracy of table tennis performance prediction based on the physiological responses from these tests.Methods. - Eleven national level male table tennis players participated in the study and undertook incremental tests using ergometers. Table tennis performance was defined as the ranking obtained during a simulated tournament between the participants.Results. - In general, peak values for physiological variables (e.g., (V) over dotO(2PEAK) and [La]PEAK) were significantly lower (P < 0.05) in the specific test (e.g., (V) over dotO(2PEAK) = 39.9 +/- 1.5 ml.kg(-1) per minute and [La]PEAK = 6.4 +/- 0.5 mmol.L-1) than during cycling (e.g., (V) over dotO(2PEAK) = 41.3 +/- 1.4 ml.kg(-1) per minute and [La]PEAK = 10.2 +/- 0.7 mmol.L-1) or running (e.g., (V) over dotO(2PEAK) = 43.9 +/- 1.5 ml.kg(-1) per minute and [La]PEAK = 10.0 +/- 0.7 mmol.L-1), but higher than during arm cranking (e.g., (V) over dotO(2PEAK) = 26.6 +/- 1.6 ml.kg(-1) per minute and [La]PEAK = 8.9 +/- 0.6 mmol.L-1). At respiratory compensation point intensity (RCP), only the variables measured on arm cranking were lower (P < 0.05) than on the other ergometers. Stepwise multiple regression analysis showed significant correlation between table tennis performance and lactate concentration ([La]) and also rate of perceived effort (RPE) at RCP during cycling (r = 0.89; P < 0.05).Conclusion. - In conclusion, the significant differences obtained between the specific and laboratory ergometers demonstrate the need to use a specific test to measure physiological parameters in table tennis and the physiological parameters measured, independent of the ergometer used, are unable to predict table tennis performance. (C) 2013 Elsevier Masson SAS. All rights reserved.

Production and characterization of natural rubber-Ca/P blends for biomedical purposes

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Comparison of anaerobic threshold, oxygen uptake and heart rate between specific table

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Modal hedges in para-pharmaceutical product instructions: some examples from English and Serbian

[EN] The paper investigates how modal hedges (Coates 1983) understood as expressions of procedural meaning , i.e. expressions which instruct the addressee/reader how to process the propositional content of an utterance/statement (Watts 2004) are used in product descriptions, advertisements and consumer instructions leaflets for a number of products belonging to the Consumer Health Care category for the purposes of complying with consumer protection laws on the one hand and serving as an implicit disclaimer of manufacturer’s responsibility on the other. The analysis is carried out contrastively for two languages, English and Serbian. The results obtained are discussed and viewed as a matter of cultural variety and difference, especially taking into consideration the fact that consumer protection laws seem to be equally strict in US, UK and Commonwealth, Europe and Serbia.

The third language in English guidebooks and its translation into Spanish

[EN] This article focuses on a specific feature found in tourist guidebooks –the recurrent use of foreign expressions or “third language”. It presents the findings of a comparative analysis of a parallel corpus made up of twenty guidebooks: ten guidebooks originally written in English and their corresponding translated versions in Spanish, describing different countries and cities (all of them published by Lonely Planet), focusing on those chapters in which the writer includes practical information. The purpose of the study is to analyze the use of the third language in the English and Spanish versions and to determine and identify the translation strategies used by the translators to transfer these linguistic elements from one language to the other.

Teaching and learning english phonetics and phonology in the EHEA through design and creation of audiovisual material at the ULPGC

[ES]In this paper we describe the procedure followed in the design and recording of a set of videos for teaching and learning ‘English phonetics and phonology’, a second-year undergraduate course at Universidad de Las Palmas de Gran Canaria. The student’s L1 is Spanish. Two different types of technological support were used: screencast and Powerpoint® presentations. The traditional whiteboard together with the lecturer’s presence also contributed both to the integrated learning of certain acoustic/articulatory aspects of the course contents and to the use of specific software for speech analysis. This video production owns the advantage of being an interactive and autonomous tool which favours a continuous learning process on the student’s side.

Dark humour as a culture specific phenomenon: a study in screen translation

The present study aims at analyzing how dark humour as a cinematic genre travels cross-culturally through a specific mode of audiovisual translation, i.e. dubbing. In particular, it takes into consideration the processes involved in dubbing humour from English into Italian as observed in the English- and Italian-language versions of ten British and American dark comedies from the 1940s to the 2000s. In an attempt to identify some of the main mechanisms of the dark humour genre, the humorous content of the films was analyzed in terms of the elements on which specific scenes are based, mainly the non-verbal and verbal components. In the cases in which verbal elements were involved, i.e. the examples of verbally expressed humour, the analysis was concerned with whether they were adapted into Italian and to what effect. Quantification of the different kinds of dark humour revealed that in the sample of dark comedies verbal dark humour had a higher frequency (85.3%) than non-verbal dark humour (14.7%), which partially disconfirmed the first part of the research hypothesis. However, the significance of contextual elements in the conveying of dark humour, both in the form of Nsp VEH (54.31%) and V-V (V+VE) (21.68%), provided support for the hypothesis that, even when expressed verbally, dark humour is more closely linked to context-based rather than purely linguistic humour (4.9%). The second part of the analysis was concerned with an investigation of the strategies adopted for the translation of verbal dark humour elements from the SL (English) into the TL (Italian) through the filter of dubbing. Four translational strategies were identified as far as the rendering of verbal dark humour is concerned: i) complete omission; ii) weakening; iii) close rendering; and iv) increased effect. Complete omission was found to be the most common among these strategies, with 80.9% of dark humour examples being transposed in a way that kept the ST’s function substantially intact. Weakening of darkly humorous lines was applied in 12% of cases, whereas increased effect accounted for 4.6% and complete omission for 2.5%. The fact that for most examples of Nsp VEH (84.9%) and V-AC (V+VE) (91.4%) a close rendering effect was observed and that 12 out of 21 examples of V-AC (PL) (a combined 57%) were either omitted or weakened seemed to confirm, on the one hand, the complexity of the translation process required by cases of V-AC (PL) and V-AC (CS). On the other hand, as suggested in the second part of the research hypothesis, the data might be interpreted as indicating that lesser effort on the translator/adaptor’s part is involved in the adaptation of V-AC (Nsp VEH) and V-V (V+VE). The issue of the possible censorial intervention undergone by examples of verbal dark humour in the sample still remains unclear.

Subject-specific musculoskeletal models of the lower limbs for the prediction of skeletal loads during motion

The determination of skeletal loading conditions in vivo and their relationship to the health of bone tissues, remain an open question. Computational modeling of the musculoskeletal system is the only practicable method providing a valuable approach to muscle and joint loading analyses, although crucial shortcomings limit the translation process of computational methods into the orthopedic and neurological practice. A growing attention focused on subject-specific modeling, particularly when pathological musculoskeletal conditions need to be studied. Nevertheless, subject-specific data cannot be always collected in the research and clinical practice, and there is a lack of efficient methods and frameworks for building models and incorporating them in simulations of motion. The overall aim of the present PhD thesis was to introduce improvements to the state-of-the-art musculoskeletal modeling for the prediction of physiological muscle and joint loads during motion. A threefold goal was articulated as follows: (i) develop state-of-the art subject-specific models and analyze skeletal load predictions; (ii) analyze the sensitivity of model predictions to relevant musculotendon model parameters and kinematic uncertainties; (iii) design an efficient software framework simplifying the effort-intensive phases of subject-specific modeling pre-processing. The first goal underlined the relevance of subject-specific musculoskeletal modeling to determine physiological skeletal loads during gait, corroborating the choice of full subject-specific modeling for the analyses of pathological conditions. The second goal characterized the sensitivity of skeletal load predictions to major musculotendon parameters and kinematic uncertainties, and robust probabilistic methods were applied for methodological and clinical purposes. The last goal created an efficient software framework for subject-specific modeling and simulation, which is practical, user friendly and effort effective. Future research development aims at the implementation of more accurate models describing lower-limb joint mechanics and musculotendon paths, and the assessment of an overall scenario of the crucial model parameters affecting the skeletal load predictions through probabilistic modeling.

The creation and use of an international reference glossary specific for horror role-playing games

This thesis focuses on the technical approach to the translation of the Italian horror role-playing game Sine Requie into English. It aims to prove that both the role-playing and horror aspects of the genre are important to convey an enjoyable experience to the players, and that it is possible to create and international reference glossary to better translate the horror genre itself. Following a brief introduction of the history of role-playing games (RPGs), we will look at the RPG technical vocabulary in Sine Requie, and analyze which of these elements can be translated following the great models of the history of role-playing games. A brief introduction will follow regsrding the horror genre and its core characteristics based on the work of worldwide famous horror writer H.P. Lovecraft. Lastly, a description on how the international reference glossary for the horror genre was created will be presented along with a few examples of its practical use.

Romany Families in Romania: Intelligence and Personality of Children Cross-cultural and Specific Problems of Development

Psychogenetic research has emphasised the influence of social factors on a child's intellectual development. In her work, Ms. Dumitrascu examines two such factors; family size and order of birth. However, since these formal parameters tend to be unstable, other more informal factors should be taken into consideration. Of these, perhaps the most interesting is the "style" of parental education, which Ms. Dumitrascu regards as an expression of national traditions at the family level. This educational style is culture dependent. Only a comparative, cross-cultural study can reveal the real mechanism through which educational style influences the development of a child's intellect and personality. Ms. Dumitrascu conducted an experimental cross-cultural study aimed at examining the effects of the family environment on a child's intellectual development. Three distinct populations were involved in her investigation, each having quite a distinct status in their geographical area; Romanians, Romanies (Gypsies) from Romania, and Russians from the Republic of Moldova. She presented her research in the form of a series of articles written in English totalling 85 pages, and also on disc. A significant difference was revealed between the intelligence of a child living in a large family, and that of a child with no brothers or sisters. In the case of Romany children, the gap is remarkably large. Ms. Dumitrascu concludes that the simultaneous action of several negative factors (low socio-economic status, large family size, socio-cultural isolation of a population) may delay child development. Subjected to such a precarious environment, Romany children do not seek self-realisation, but rather struggle to survive the hardship. Most of them remain out of civilisation. Unfortunately, adult Romanies seldom express any concern regarding their children's successful social integration. The school as main socialisation tool has no value for most parents. Ms. Dumitrascu argues the need for a major effort aimed at helping Romany's social integration. She hopes this project will be of some help for psychologists, social workers, teachers, and all those who are interested in the integration into society of minority groups.

Place for video games : a theoretical and pedagogical framework for multiliteracies learning in English studies

Students are now involved in a vastly different textual landscape than many English scholars, one that relies on the “reading” and interpretation of multiple channels of simultaneous information. As a response to these new kinds of literate practices, my dissertation adds to the growing body of research on multimodal literacies, narratology in new media, and rhetoric through an examination of the place of video games in English teaching and research. I describe in this dissertation a hybridized theoretical basis for incorporating video games in English classrooms. This framework for textual analysis includes elements from narrative theory in literary study, rhetorical theory, and literacy theory, and when combined to account for the multiple modalities and complexities of gaming, can provide new insights about those theories and practices across all kinds of media, whether in written texts, films, or video games. In creating this framework, I hope to encourage students to view texts from a meta-level perspective, encompassing textual construction, use, and interpretation. In order to foster meta-level learning in an English course, I use specific theoretical frameworks from the fields of literary studies, narratology, film theory, aural theory, reader-response criticism, game studies, and multiliteracies theory to analyze a particular video game: World of Goo. These theoretical frameworks inform pedagogical practices used in the classroom for textual analysis of multiple media. Examining a video game from these perspectives, I use analytical methods from each, including close reading, explication, textual analysis, and individual elements of multiliteracies theory and pedagogy. In undertaking an in-depth analysis of World of Goo, I demonstrate the possibilities for classroom instruction with a complex blend of theories and pedagogies in English courses. This blend of theories and practices is meant to foster literacy learning across media, helping students develop metaknowledge of their own literate practices in multiple modes. Finally, I outline a design for a multiliteracies course that would allow English scholars to use video games along with other texts to interrogate texts as systems of information. In doing so, students can hopefully view and transform systems in their own lives as audiences, citizens, and workers.

BMP-2 induces the expression of chondrocyte-specific genes in bovine synovium-derived progenitor cells cultured in three-dimensional alginate hydrogel

OBJECTIVE: According to recent reports, the synovial membrane may contain mesenchymal stem cells with the potential to differentiate into chondrocytes under appropriate conditions. In order to assess the usefulness of synovium-derived progenitor cells for the purposes of cartilage tissue engineering, we explored their requirements for the expression of chondrocyte-specific genes after expansion in vitro. DESIGN: Mesenchymal progenitor cells were isolated from the synovial membranes of bovine shoulder joints and expanded in two-dimensions on plastic surfaces. They were then seeded either as micromass cultures or as single cells within alginate gels, which were cultured in serum-free medium. Under these three-dimensional conditions, chondrogenesis is known to be supported and maintained. Cell cultures were exposed either to bone morphogenetic protein-2 (BMP-2) or to isoforms of transforming growth factor-beta (TGF-beta). The levels of mRNA for Sox9, collagen types I and II and aggrecan were determined by RT-PCR. RESULTS: When transferred to alginate gel cultures, the fibroblast-like synovial cells assumed a rounded form. BMP-2, but not isoforms of TGF-beta, stimulated, in a dose-dependent manner, the production of messenger RNAs (mRNAs) for Sox9, type II collagen and aggrecan. Under optimal conditions, the expression levels of cartilage-specific genes were comparable to those within cultured articular cartilage chondrocytes. However, in contrast to cultured articular cartilage chondrocytes, synovial cells exposed to BMP-2 continued to express the mRNA for alpha1(I) collagen. CONCLUSIONS: This study demonstrates that bovine synovium-derived mesenchymal progenitor cells can be induced to express chondrocyte-specific genes. However, the differentiation process is not complete under the chosen conditions. The stimulation conditions required for full transformation must now be delineated.