Extent and nature of unlicensed and off-label medicine use in hospitalised children in Palestine

Objective of the study To determine the extent and nature of unlicensed/off-label prescribing patterns in hospitalised children in Palestine. Setting Four paediatric wards in two public health system hospitals in Palestine [Caritas children’s hospital (Medical and neonatal intensive care units) and Rafidia general hospital (Medical and surgical units)]. Method A prospective survey of drugs administered to infants and children <18 years old was carried out over a five-week period in the four paediatric wards. Main outcome measure Drug-licensing status of all prescriptions was determined according to the Palestinian Registered Product List and the Physician’s Desk Reference. Results Overall, 917 drug prescriptions were administered to 387children. Of all drug prescriptions, 528 (57.5%) were licensed for use in children; 65 (7.1%) were unlicensed; and 324 (35.3%) were used off-label. Of all children, 49.6% received off-label prescriptions, 10.1% received unlicensed medications and 8.2% received both. Seventy-two percent of off-label drugs and 66% of unlicensed drugs were prescribed for children <2 years. Multivariate analysis showed that patients who were admitted to the neonatal intensive care unit and infants aged 0–1 years were most likely to receive a greater number of off-label or unlicensed medications (OR 1.80; 95% CI 1.03–3.59 and OR 1.99; 95% CI 0.88–3.73, respectively). Conclusion The present findings confirmed the elevated prevalence of unlicensed and off-label paediatric drugs use in Palestine and strongly support the need to perform well designed clinical studies in children.

The Design and Analysis of Context-Aware, Secure Workflow Systems

Workflows are set of activities that implement and realise business goals. Modern business goals add extra requirements on workflow systems and their management. Workflows may cross many organisations and utilise services on a variety of devices and/or supported by different platforms. Current workflows are therefore inherently context-aware. Each context is governed and constrained by its own policies and rules to prevent unauthorised participants from executing sensitive tasks and also to prevent tasks from accessing unauthorised services and/or data. We present a sound and multi-layered design language for the design and analysis of secure and context aware workflows systems.

Distance Learning Education of Software Engineering: Principles and Experiences

Whether distance learning spells the end of traditional campuses, as some maintain, or whether distance learning instead represents a powerful addition to a growing array of delivery options for higher education, its impact on higher education is great and growing. Distance learning is creating alternative models of teaching and learning, new job descriptions for faculty, and new types of higher education providers. The advent of Distance and Distributed Learning has raised numerous questions about quality and quality assurance: ² How do established distance learning institutions ensure quality? ² What more needs to be done? ² How do quality assurance agencies view the distinction between on- and off-campus teaching and learning? This talk discusses these issues from the viewpoints of funding organisa- tion, quality assurance agencies and the learners.

Модел за изследване на креативното мислене и действие на ученици

Veselina Valkanova, Stanimir Stoyanov, Hussein Zedan, Ivan Popchev - In the paper a theoretical model for investigation of creative thinking and action of student is presented. The model extends the formal system called Creativity Map. Furthermore, an experiment for applying this model in the secondary school is explained. Although the experiment will be implemented during the mathematics lessons, the theoretical model can be applied in different subjects.

CD4+ T cell surface alpha enolase is lower in older adults

To identify novel cell ageing markers in order to gain insight into ageing mechanisms, we adopted membrane enrichment and comparison of the CD4+ T cell membrane proteome (purified by cell surface labelling using Sulfo-NHS-SS-Biotin reagent) between healthy young (n=9, 20-25y) and older (n=10; 50-70y) male adults. Following two-dimensional gel electrophoresis (2DE) to separate pooled membrane proteins in triplicates, the identity of protein spots with age-dependent differences (p<0.05 and >1.4 fold difference) was determined using liquid chromatography-mass spectrometry (LC-MS/MS). Seventeen protein spot density differences (ten increased and seven decreased in the older adult group) were observed between young and older adults. From spot intensity analysis, CD4+ T cell surface α-enolase was decreased in expression by 1.5 fold in the older age group; this was verified by flow cytometry (n=22) and qPCR with significantly lower expression of cellular α-enolase mRNA and protein compared to young adult CD4+ T cells (p<0.05). In an independent age-matched case-control study, lower CD4+ T cell surface α-enolase expression was observed in age-matched patients with cardiovascular disease (p<0.05). An immune-modulatory role has been proposed for surface α-enolase and our findings of decreased expression suggest that deficits in surface α-enolase merit investigation in the context of immune dysfunction during ageing and vascular disease.

Inverse space-dependent force problems for the wave equation

The determination of the displacement and the space-dependent force acting on a vibrating structure from measured final or time-average displacement observation is thoroughly investigated. Several aspects related to the existence and uniqueness of a solution of the linear but ill-posed inverse force problems are highlighted. After that, in order to capture the solution a variational formulation is proposed and the gradient of the least-squares functional that is minimized is rigorously and explicitly derived. Numerical results obtained using the Landweber method and the conjugate gradient method are presented and discussed illustrating the convergence of the iterative procedures for exact input data. Furthermore, for noisy data the semi-convergence phenomenon appears, as expected, and stability is restored by stopping the iterations according to the discrepancy principle criterion once the residual becomes close to the amount of noise. The present investigation will be significant to researchers concerned with wave propagation and control of vibrating structures.

Food and beverage management

Abstract and faculty adviser information are not available for this thesis.

Possibilidades de enfoque CTS para o ensino superior de química: proposta de uma abordagem para ácidos e bases

Scientific education has been passing by redefinitions, contestations and new contributions from the research on science teaching. One contribution is the idea of science and technology literacy, allowing the citizens not only knowing science but also understand aspects on the construction and motivation of scientific and technological research. In accordance with this idea, there is the Science-Technology-Society (STS) studies which, since the 1970s, has been contributing for science teaching and learning according to the comprehension of the relationships with society in the Western countries of the North. In Brazil, this approach began to gain projection from the 1990s when the first essays on the theme were published. Currently, there is a clear influence of this approach on the national curriculum guidelines, especially for the area of Natural Sciences, and also on the textbooks chosen by the High School National Program (Programa Nacional do Ensino Médio). However, there seems to be a gap in relation to the discussion on the specific curricular component seen in college on this approach. Thus, this study aims at adopting the approach STS, face to the preparation of complimentary educational material on acid and bases concepts studied in the course of General Chemistry of the Natural Sciences graduation program. To this end, it was performed a bibliographical research aiming at making the state-of-the-art in in these concepts in specific literature to science teaching. It is divided in two stages: systematic study (with sixteen journals chosen according to Qualis-Capes and an unsystematic study with direct search in databases and references in the papers of the systematic study. The studies had their content analyzed and the categories chosen a priori were the level of education, the acid-base theory adopted, and the strategy/theoretical frame of reference adopted. A second stage aimed at identifying attitudes and beliefs on STS (Science-Technology-Society) and CSE (Chemistry-Society-Environment) of students in the teacher and technologist training course in three diferent institutions: UTFPR, UFRN and IFRN. In this study, it was used two questionnaires, composed of a Likert scale, semantic differential scale and open questions. The quantitative data reliability was estimated through Cronbach’s alpha method, and tha data were treated according to classic statistics, using the mean as the centrality measures, and the mean deviation as dispersion. The qualitative data were treated according to the content analysis with categories taken from the reading of answers. In the third stage, it was analyzed the presence of STS and CSE content in chapters on acid and bases concepts of nine General Chemistry textbooks, frequently used in graduation programs in public institutions of the state of Rio Grande do Norte. The results showed that there are few proposals of acid and bases teaching, and they are generally aimed at High School or at instrumentation for teaching courses, and no course for General Chemistry. The student’s attitudes and beliefs show the presence of a positivist point of view based on the concept of Science and Technology neutrality and the salvation of its mediation. The books analysis showed just a few content on STS and CSE are found in the studied chapters, and they are generally presented disjointedly in relation to the rest of the main text. In the end, as suggestion to solve the absence of proposals STS in General Chemistry books, as well as the student’s positivist attitudes, it was developed some educational material to be used in the course of General Chemistry at College. The material is structured to introduce a historical view of the concepts preparation, present the use of materials, the industrial and technological processes, and social and environmental consequences of this activities

Química em cena: uma proposta para formação inicial de professores de química

In educational observed difficulty in train teachers to meet the medium and higher education needs, and one reason for this is the different experiences in the training of educators in relation to those found in the classroom. So often arise criticisms related to relevance and efficiency of degree courses, as regards the performance of its natural mission, which weakens the teacher training. Thus, improving the quality of education is very dependent on the initiatives of teachers, creating teaching alternatives to strengthen their performance in school. From this reflection, it is concluded that teacher training needs new educational proposals that qualify, and so can promote the formation of his students more adequately. Among the educational proposals as alternatives to initial teacher training may use the scientific theater (TC). Considering this possibility, this work has been proposed as investigate and discuss the influence of TC combined with experimentation in the initial training of future teachers in Chemistry who participate in the Groups Fanatics chemistry Theatre (UERN) and Chemistry on Stage (UFRN). Therefore, there was, in a first stage, theatrical essays based on the theater of the oppressed, and written dramaturgical scripts, a collaborative proposal. To incorporate experimentation in chemistry to theater rehearsals, there was a systematic literature search and after content analysis, were selected categories, materials and reagents easily accessible, easy procedures and implementation with low risk of accidents and easy care chemical waste. In the second part we identified: a) the beliefs of student teachers in the use of TC ally trial for initial training of chemistry teachers; b) the influence of TC ally to trial on learning of chemical concepts of high school students who attended the shows; c) the reasons for using or not TC ally to trial by chemistry teachers who participated in the TC group and currently work in the classroom. In this study, questionnaires and interviews were used, compounds, respectively, by a Likert scale and open questions. Quantitative data were analyzed by classical statistics the media, using as centrality measures the average, the concordance argument and the average deviation. Qualitative data were discussed according to content analysis, with categories that emerged from reading the answers. These analyzes concluded that the licensees have a positive view on the use of scientific theater for disclosure of the chemical for use in the learning of chemical concepts, pedagogical and disciplinary knowledge, and to form promotion strategy for research and extension at the University. They credit improvements in their initial training on the use of scientific theater combined with experimentation. The TC provides motivation for the construction of conceptual thinking in an informal way of chemical communication, allowing the student to expand their knowledge, not only favoring the phenomenological approach, but also the construction of chemical knowledge and the internalization of scientific concepts.

Études des méthodes d'immobilisation d'enzyme (trypsine) sur un support solide pour la cartographie peptidique par microréacteur

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Études des méthodes d'immobilisation d'enzyme (trypsine) sur un support solide pour la cartographie peptidique par microréacteur

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Antimicrobial susceptibility of Pseudomonas aeruginosa isolated from cystic fibrosis patients through Northern Europe

Pseudomonas aeruginosa is a major cause of morbidity and mortality in cystic fibrosis patients. This study compares the antimicrobial susceptibility of 153 P. aeruginosa isolates from the United Kingdom (UK) (n=58), Belgium (n=44), and Germany (n=51) collected from 120 patients during routine visits over the 2006-2012 period. MICs were measured by broth microdilution. Genes encoding extended spectrum β-lactamases (ESBL), metallo-β-lactamases and carbapenemases were detected by PCR. Pulsed Field Gel Electrophoresis and Multi-Locus Sequence Typing were performed on isolates resistant to ≥ 3 antibiotic classes among penicillins/cephalosporins, carbapenems, fluoroquinolones, aminoglycosides, polymyxins. Based on EUCAST/CLSI breakpoints, susceptibility was ≤ 30%/≤ 40% (penicillins, ceftazidime, amikacin, ciprofloxacin), 44-48%/48-63% (carbapenems), 72%/72% (tobramycin), and 92%/78% (colistin) independently of patient's age. Sixty percent of strains were multidrug resistant (MDR; European Centre for Disease prevention and Control criteria). Genes encoding ESBL (most prevalent BEL, PER, GES, VEB, CTX-M, TEM, SHV, and OXA), metallo β-lactamases (VIM, IMP, NDM), or carbapenemases (OXA-48, KPC) were not detected. The Liverpool Epidemic Strain (LES) was prevalent in UK isolates only (75% of MDR isolates). Four MDR ST958 isolates were found spread over the three countries. The other MDR clones were evidenced in ≤ 3 isolates and localized in a single country. A new sequence type (ST2254) was discovered in one MDR isolate in Germany. Clonal and non-clonal isolates with different susceptibility profiles were found in 21 patients. Thus, resistance and MDR are highly prevalent in routine isolates from 3 countries, with carbapenem (meropenem), tobramycin and colistin remaining the most active drugs.

Stress på akutmottagningen ur ett sjuksköterskeperspektiv : En litteraturstudie

Sjuksköterskor som arbetar på akutmottagningar utsätts regelbundet för stress. Det medför psykiska och fysiska besvär för sjuksköterskor och försämrad omvårdnad för patienten. Studien avser att utifrån vetenskaplig litteratur sammanställa de faktorer som leder till stress för sjuksköterskor som arbetar på akutmottagningar och hur vården påverkas av stressade sjuksköteskor. Syfte Syftet med litteraturstudien var att beskriva vilka faktorer på akutmottagningen som upplevdes bidra till stress för sjuksköterskor som arbetar på en akutmottagning och hur stressen påverkar sjuksköterskors möjligheter att erbjuda en god vård för patienter på akutmottagningen. Metod Studien har genomförts som en litteraturstudie. I studien användes 15 artiklar som bestod av både kvalitativ och kvantitativ ansats. Materialet hämtades i databaserna CINAHL och PubMed. Resultat Resultatet visar att det finns flera olika faktorer som bidrar till stress för sjuksköterskor på akutmottagningen. Stressande faktorer visade sig utifrån studierna i resultatet vara; hög arbetsbelastning och låg bemanning, avsaknad av tid för reflektion för sjuksköterskan, att vårda barn i stressade situationer, hot och våld på akutmottagningen, kommunikation samt smärta och lidande. Hur vården påverkas av sjuksköterskors stress på akutmottagningen var utifrån studierna att patientsäkerheten blev försämrad och att vårdrelationen påverkades. Slutsats Författarna drar slutsatsen att stress påverkar sjuksköteskors arbetsuppgifter på akutmottagningen. Patienters möjlighet till patientsäker och god vård på akutmottagningen påverkas negativt av stressade sjuksköterskor. För att komma till rätta med sjuksköterskebristen på akutmottagningar så är det av betydelse för sjukhusledningen att arbeta preventivt mot stressade sjuksköterskor.

Risk Factors for Maternal Vitamin D Deficiency within the United Arab Emirates

Introduction: Vitamin D deficiency during pregnancy is a public health problem and it has been associated with negative pregnancy outcomes for both mothers and infants. Aim: To estimate the prevalence of vitamin D deficiency in pregnant women in the United Arab Emirates (UAE) and to identify the contribution of risk factors to the 25(OH)D levels. Methods: It is a cross-sectional study in which vitamin D levels of 1088 adult pregnant women were assessed. Information on vitamin D intake was available in a sub-sample of 266 women. Results: The mean serum 25(OH)D was 26.2 nmol/L (95% CI 25.2-27.1 range 5-129.1 nmol/L) with 69% of women being vitamin D deficient (<30 nmol/L). In the bivariate analysis, showed that no predictors could have been indicated as no values exceeded significance (p<0.2). Stepwise multiple linear regression analysis could not be applied to identify predictors of vitamin D levels as no values exceeded p=0.2. Conclusion: Due to the high prevalence of vitamin deficiency in UAE, there is an urge for interventions focusing on supplementation, fortification and diet diversity for preventing health consequences during a critical period of development.

A bio-coke for anode production and the manufacturing method thereof

Dans l’industrie de l’aluminium, le coke de pétrole calciné est considéré comme étant le composant principal de l’anode. Une diminution dans la qualité du coke de pétrole a été observée suite à une augmentation de sa concentration en impuretés. Cela est très important pour les alumineries car ces impuretés, en plus d’avoir un effet réducteur sur la performance des anodes, contaminent le métal produit. Le coke de pétrole est aussi une source de carbone fossile et, durant sa consommation, lors du processus d’électrolyse, il y a production de CO2. Ce dernier est considéré comme un gaz à effet de serre et il est bien connu pour son rôle dans le réchauffement planétaire et aussi dans les changements climatiques. Le charbon de bois est disponible et est produit mondialement en grande quantité. Il pourrait être une alternative attrayante pour le coke de pétrole dans la fabrication des anodes de carbone utilisées dans les cuves d’électrolyse pour la production de l’aluminium. Toutefois, puisqu’il ne répond pas aux critères de fabrication des anodes, son utilisation représente donc un grand défi. En effet, ses principaux désavantages connus sont sa grande porosité, sa structure désordonnée et son haut taux de minéraux. De plus, sa densité et sa conductivité électrique ont été rapportées comme étant inférieures à celles du coke de pétrole. L’objectif de ce travail est d’explorer l’effet du traitement de chaleur sur les propriétés du charbon de bois et cela, dans le but de trouver celles qui s’approchent le plus des spécifications requises pour la production des anodes. L’évolution de la structure du charbon de bois calciné à haute température a été suivie à l’aide de différentes techniques. La réduction de son contenu en minéraux a été obtenue suite à des traitements avec de l’acide chlorhydrique utilisé à différentes concentrations. Finalement, différentes combinaisons de ces deux traitements, calcination et lixiviation, ont été essayées dans le but de trouver les meilleures conditions de traitement.