A multi-centre open-label randomised non-inferiority trial comparing watchful waiting to antibiotic treatment for acute otitis media without perforation in low-risk urban Aboriginal and Torres Strait Islander children (the WATCH trial): study protocol for a randomised controlled trial

Background Treatment guidelines recommend watchful waiting for children older than 2 years with acute otitis media (AOM) without perforation, unless they are at high risk of complications. The high prevalence of chronic suppurative otitis media (CSOM) in remote Aboriginal and Torres Strait Islander communities leads these children to be classified as high risk. Urban Aboriginal and Torres Strait Islander children are at lower risk of complications, but evidence to support the subsequent recommendation for watchful waiting in this population is lacking. Methods/Design This non-inferiority multi-centre randomised controlled trial will determine whether watchful waiting is non-inferior to immediate antibiotics for urban Aboriginal and Torres Strait Islander children with AOM without perforation. Children aged 2 − 16 years with AOM who are considered at low risk for complications will be recruited from six participating urban primary health care services across Australia. We will obtain informed consent from each participant or their guardian. The primary outcome is clinical resolution on day 7 (no pain, no fever of at least 38 °C, no bulging eardrum and no complications of AOM such as perforation or mastoiditis) as assessed by general practitioners or nurse practitioners. Participants and outcome assessors will not be blinded to treatment. With a sample size of 198 children in each arm, we have 80 % power to detect a non-inferiority margin of up to 10 % at a significance level of 5 %, assuming clinical improvement of at least 80 % in both groups. Allowing for a 20 % dropout rate, we aim to recruit 495 children. We will analyse both by intention-to-treat and per protocol. We will assess the cost- effectiveness of watchful waiting compared to immediate antibiotic prescription. We will also report on the implementation of the trial from the perspectives of parents/carers, health professionals and researchers. Discussion The trial will provide evidence for the safety and effectiveness of watchful waiting for the management of AOM in Aboriginal and Torres Strait Islander children living in urban settings who are considered to be at low risk of complications.

DIY/DIWO media architecture: The InstaBooth

Building on previous discourse regarding the ability of media architecture to be more open and accessible for the purposes of community engagement (Caldwell & Foth, 2014), this chapter explores a particular case study that was designed, constructed and implemented with the intention of allowing city users to participate in the development and creation of media architecture, the InstaBooth. In this chapter, we first explore DIY (do it yourself) and DIWO (do it with others) phenomena to examine what motivates the DIY cultures, communities, and practices. Secondly, in this chapter, we define and discuss our implementation of a DIY / DIWO media architecture example, the InstaBooth. The InstaBooth project pro-vides an opportunity to question the effectiveness of a DIY driven media architec-ture artefact to see to what extent it impacts on the experience of its users and for what benefit.

Adaptive Mesh Refinement FEM for Damage Evolution of Heterogeneous Brittle Media

Damage evolution of heterogeneous brittle media involves a wide range of length scales. The coupling between these length scales underlies the mechanism of damage evolution and rupture. However, few of previous numerical algorithms consider the effects of the trans-scale coupling effectively. In this paper, an adaptive mesh refinement FEM algorithm is developed to simulate this trans-scale coupling. The adaptive serendipity element is implemented in this algorithm, and several special discontinuous base functions are created to avoid the incompatible displacement between the elements. Both the benchmark and a typical numerical example under quasi-static loading are given to justify the effectiveness of this model. The numerical results reproduce a series of characteristics of damage and rupture in heterogeneous brittle media.

Potential Application of Adsorptive Media to Enhance Phosphorus Uptake in Stormwater Basins and Wetlands at Lake Tahoe : literature review. Report to the University of California Davis Tahoe Research Group

Phosphorus removal by wetlands and basins in Lake Tahoe may be improved through designing these systems to filter storm water through media having higher phosphorus removal capabilities than local parent material. Substrates rich in iron, aluminum and calcium oftentimes have enhanced phosphorus removal. These substrates can be naturally occurring, byproducts of industrial or water treatment processes, or engineered. Phosphorus removal fundamentally occurs through chemical adsorption and/or precipitation and much of the phosphorus can be irreversibly bound. In addition to these standard media, other engineered substrates are available to enhance P removal. One such substrate is locally available in Reno and uses lanthanum coated diatomaceous earth for arsenate removal. This material, which has a high positive surface charge, can also irreversibly remove phosphorus. Physical factors also affect P removal. Specifically, specific surface area and particle shape affect filtration capacity, contact area between water and the surface area, and likelihood of clogging and blinding. A number of substrates have been shown to effectively remove P in case studies. Based upon these studies, promising substrates include WTRs, blast furnace slag, steel furnace slag, OPC, calcite, marble Utelite and other LWAs, zeolite and shale. However, other nonperformance factors such as environmental considerations, application logistics, costs, and potential for cementification narrow the list of possible media for application at Tahoe. Industrial byproducts such as slags risk possible leaching of heavy metals and this potential cannot be easily predicted. Fly ash and other fine particle substrates would be more difficult to apply because they would need to be blended, making them less desirable and more costly to apply than larger diameter media. High transportation costs rule out non-local products. Finally, amorphous calcium products will eventually cementify reducing their effectiveness in filtration systems. Based upon these considerations, bauxite, LWAs and expanded shales/clays, iron-rich sands, activated alumina, marble and dolomite, and natural and lanthanum activated diatomaceous earth are the products most likely to be tested for application at Tahoe. These materials are typically iron, calcium or aluminum based; many have a high specific surface area; and all have low transportation costs. (PDF contains 21 pages)

Social Media Marketing como herramienta del mix de comunicación

[ES]El presente TFG plantea un análisis de la utilización de las redes sociales dentro de la estrategia de comunicación de las organizaciones empresariales. Para ello, se estudia el contexto comunicacional actual, caracterizado por la fragmentación y dispersión de las audiencias, la saturación, la pérdida de la eficacia de la publicidad tradicional, los nuevos hábitos de consumo de medios y la explosión de la conectividad, y el papel de las distintas herramientas de comunicación en entornos digitales: página web, blog corporativo, email marketing, gestión multimedia, mobile marketing, E-commerce y Social Media Marketing. En este contexto y por su relevancia, nos centramos en el estudio de las estrategias de Social Media Marketing. Para ello abordamos las ventajas e inconvenientes de la utilización de redes sociales, cómo efectuar la planificación de la comunicación en redes sociales (objetivos, público, contenidos, plataformas, plan de acción e indicadores), y las nuevas profesiones ligadas a su gestión. Un aspecto relevante que también se analiza es la gestión de la reputación online y las implicaciones que el uso de redes sociales tiene sobre ella, así como los protocolos de actuación ante posibles crisis derivadas de la presencia en estos canales. En las redes sociales se encuentran prácticamente todos los stakeholders de las empresas/marcas, fuente de información continua para mejorar sus negocios. Su utilización, dentro de una comunicación integral de marketing, permite fortalecer la imagen corporativa y lograr un posicionamiento claro y a largo plazo.

Gismo: A Generator of Internet Streaming Media Objects and Workloads

This paper presents a tool called Gismo (Generator of Internet Streaming Media Objects and workloads). Gismo enables the specification of a number of streaming media access characteristics, including object popularity, temporal correlation of request, seasonal access patterns, user session durations, user interactivity times, and variable bit-rate (VBR) self-similarity and marginal distributions. The embodiment of these characteristics in Gismo enables the generation of realistic and scalable request streams for use in the benchmarking and comparative evaluation of Internet streaming media delivery techniques. To demonstrate the usefulness of Gismo, we present a case study that shows the importance of various workload characteristics in determining the effectiveness of proxy caching and server patching techniques in reducing bandwidth requirements.

Three-mode entanglement by interlinked nonlinear interactions in optical chi((2)) media

We address the generation of fully inseparable three-mode entangled states of radiation by interlinked nonlinear interactions in chi((2)) media. We show how three-mode entanglement can be used to realize symmetric and asymmetric telecloning machines, which achieve optimal fidelity for coherent states. An experimental implementation involving a single nonlinear crystal in which the two interactions take place simultaneously is suggested. Preliminary experimental results showing the feasibility and the effectiveness of the interaction scheme with a seeded crystal are also presented. (C) 2004 Optical Society of America.

Facts, Hacks and Turbines: Media Analysis of Irish Wind Energy

Wind energy projects face increasing opposition from host communities throughout the western world. Governments have responded in a range of ways, including enhanced local control over consenting (England), reform of planning regulations (Australia) or community ownership (Denmark). However, there is no effective mechanism for monitoring levels of social acceptance and thus, no means of evaluating the effectiveness of these approaches. There have been attempts to understand how social framing of wind energy in the media (e.g. Van de Velde et al 2010, Barry and Ellis, 2008, Hindmarsh 2014), highlighting how this changes over time. However, no research has focussed on Ireland and critically, none have examined whether this can help monitor overall levels of social acceptance. In order to explore this, this paper will present a media analysis of wind energy in the Republic of Ireland, which witnessed a rapid increase in wind energy capacity and has the highest energy penetration of wind in the world (19%). However, this has been accompanied by increasing public opposition and (assumed) declining levels of social acceptance.

This paper will describe the results of analysing over 8000 articles on wind energy that have appeared in three Irish newspapers. These are assessed through historical-diachronic (over time) and comparative –synchronic (differences between newspapers) analyses (Carvalho 2007) to highlight changing trends in framing wind energy and changing concerns over wind energy in Ireland. The paper will consider whether such media analysis could form a tool for monitoring the trends in social acceptance of wind energy.

Learning a procedural task: effectiveness of multimedia presentations

Three experiments investigated the effectiveness of presenting procedural information through different media and their combinations. Experiment 1 examined the effectiveness of text, line drawings, text and line drawings, video. and video stills for learning a first aid task. The results showed an advantage of text and line drawings and of the video presentation over the other three conditions for both bandaging performance and answering questions about the task. Experiment 2 showed that the beneficial effect of the combination of text and pictures could not be accounted for simply in terms of a dual coding explanation. Rather, the effectiveness of the media and their combinations was influenced by the extent to which they conveyed action information. Finally, Experiment 3 showed no evidence of a contiguity effect: text and pictures were as effective when presented together on the same screen as when they were presented separately. Copyright © 2000 John Wiley & Sons, Ltd.

Assessment of the presence of Salmonella spp. in Egyptian dairy products using various detection media

Aims: To make a preliminary assessment of the incidence of Salmonella in Egyptian dairy products, and to investigate the effectiveness of various protocols for the detection of the pathogen in these products. Methods and Results: Samples of milk and related dairy products were randomly collected from local markets and examined for the presence of Salmonella. While most samples were free of the organism, isolates of Salmonella enterica subsp. enterica serovar Typhimurium PT 8 could be recovered from 'matared' cream specimens. These isolates were susceptible to antibiotics usually used to challenge infections caused by Salmonella. A combination of buffered peptone water, Muller-Kauffman tetrathionate broth, and brilliant green phenol red agar gave the best results for the detection of the pathogen. Selenite-cystine broth and Hektoen enteric agar were ineffective as an enrichment and a plating medium, respectively, in the isolation of Salmonella. A modified identification strategy that reduces the burden of serological testing of presumptive isolates is proposed. Conclusions, Significance and Impact of the Study: 'Matared' cream could be a vehicle for transmitting Salmonella. Using the above combination of media, beside the suggested modified confirmatory procedure, should increase the effectiveness and ease of the detection of Salmonella in milk and dairy products.

Evaluation of three enrichment broths and five plating media for Salmonella detection in poultry

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Effectiveness of Microwave Sterilization on Three Hard Chairside Reline Resins

Purpose: The aim of this study was to evaluate the effectiveness of microwave irradiation sterilization on hard chairside reline resins. Materials and Methods: Specimens of three reline resins (Kooliner, Tokuso Rebase, and Ufi Gel Hard) were fabricated and subjected to ethylene oxide sterilization. The specimens were then individually inoculated (107 cfu/mL) with Tryptic Soy Broth media containing one of the tested microorganisms (C albicans, S aureus, B subtilis, and P aeruginosa). After 48 hours at 37°C, the samples were vortexed for 1 minute and allowed to stand for 9 minutes, followed by a short vortex to resuspend any organisms present. After inoculation, 40 specimens of each material were immersed in 200 mL of water and subjected to microwave irradiation at 650 W for 6 minutes. Forty non-irradiated specimens were used as positive controls. Replicate specimens (25 μL) of suspension were plated at dilutions of 10-3 to 10-6 on plates of selective media appropriate for each organism. All plates were incubated at 37°C for 48 hours. After incubation, colonies were counted, and the data were statistically analyzed by the Kruskal-Wallis test. Twelve specimens of each material were prepared for SEM. Results: All immersed specimens showed consistent sterilization of all the individual organisms after microwave irradiation. SEM examination indicated an alteration in cell morphology after microwave irradiation. Conclusion: Microwave sterilization for 6 minutes at 650 W proved to be effective for the sterilization of hard chairside reline resins.

Effectiveness of microwave irradiation on the disinfection of complete dentures

Purpose: The purpose of this study was to evaluate the effectiveness of microwave irradiation on the disinfection of simulated complete dentures. Materials and Methods: Eighty dentures were fabricated in a standardized procedure and subjected to ethylene oxide sterilization. The dentures were individually inoculated (10 7 cfu/mL) with tryptic soy broth (TSB) media containing one of the tested microorganisms (Candida albicans, Streptoccus aureus, Bacillus subtilis, and Pseudomonas aeruginosa). After 48 hours of incubation at 37°C, 40 dentures were individually immersed in 200 mL of water and submitted to microwave irradiation at 650 W for 6 minutes. Forty nonirradiated dentures were used as positive controls. Replicate aliquots (25 μL) of suspensions were plated at dilutions of 10 -3 to 10 -6 on plates of selective media appropriate for each organism. All plates were incubated at 37°C for 48 hours. TSB beakers with the microwaved dentures were incubated at 37°C for 7 more days. After incubation, the number of colony-forming units was counted and the data were statistically analyzed by Kruskal-Wallis test (α = .05). Results: No evidence of growth was observed at 48 hours for S aureus, B subtilis, and C albicans. Dentures contaminated with P aeruginosa showed small growth on 2 plates. After 7 days incubation at 37°C, no growth was visible in the TSB beakers of S aureus and C albicans. Turbidity was observed in 3 broth beakers, 2 from P aeruginosa and 1 from B subtilis. Conclusion: Microwave irradiation for 6 minutes at 650 W produced sterilization of complete dentures contaminated with S aureus and C albicans and disinfection of those contaminated with P aeruginosa and B subtilis.

Evaluation of Three Formulations of Culture Media for Isolation of Brucella spp. regarding Their Ability to Inhibit the Growth of Contaminating Organisms

Three culture media (Brucella agar, Farrell medium, and CITA) were compared for their effectiveness in inhibiting contamination and for isolating Brucella spp. One hundred lymph nodes from pigs (n = 50) and wild boars (n = 50) with lymphadenitis were collected in slaughterhouses in the State of Sao Paulo and were assessed on these three selective media for Brucella spp. All of the samples were negative for Brucella spp. on the three culture media. On the agar medium, fungal (70 plates) and Gram-positive bacterial (59 plates) contaminants were observed; in the CITA medium, the absence of fungal and Gram-positive bacteria on 15 plates was observed; no bacterial or fungal growth was observed on the Farrell media. The results demonstrated that the CITA and Farrell media inhibited the growth of contaminants better than the Brucella agar.

Hydroxyurea in the sickle cell anemia: toxicity and effectiveness

Objective: to evaluate the use of hydroxyurea with regard to effectiveness and toxicity in people with sickle cell anemia. Method: this is a retrospective descriptive study, developed with 57 medical records of patients with sickle cell anemia, treated at the University Hospital Center of Campo Grande (Mato Grosso do Sul, Brazil), from 1993 to 2005. Inclusion criteria: electrophoresis of hemoglobin in medical record; regular use of drugs, for an average of 196 weeks; dosage; and hematological analyses before starting treatment. Exclusion criteria: living with other hemoglobinopathies. The variables evaluated were: neutrophils count; platelets; leukocytes; hemoglobin; time using hydroxyurea; drug response to the optimal dosage; and number and type of episodes of hospitalization. The research protocol was approved by the Ethics Committee of Universidade Federal de Mato Grosso do Sul, under the Protocol 645. Results: of the 57 medical records, 3 cases were evaluated. Comparing the hematological values, according to Portaria 872, enacted on 11/12/2002, it was found that: cases A, B, and C present an use of hydroxyurea (500 mg/day) for four years, with an average of 196 weeks. Case A, female, decreased painful episodes and frequency of hospitalization, keeping hematological values with no toxicity. In Case B, female, there was one hospitalization due to pain crises and important hemolysis. It stood out, in case C, male, neutropenia with hematological values < 2,000/mm3 . Conclusion: in the cases analyzed, we observed a drop in the number of hospitalizations with the decrease in painful crises from three to one a year, and there was no toxicity with regard to the dosage and time using hydroxyurea, in all three cases. For more comprehensive results, one suggests further study on this therapy with significant samples of this clientele.