The non-central chi-square chart with two-stage samplings

In this paper, we consider the non-central chi-square chart with two stage samplings. During the first stage, one item of the sample is inspected and, depending on the result, the sampling is either interrupted, or it goes on to the second stage, where the remaining sample items are inspected and the non-central chi-square statistic is computed. The proposed chart is not only more sensitive than the joint (X) over bar and R charts, but operationally simpler too, particularly when appropriate devices, such as go-no-go gauges, can be used to decide if the sampling should go on to the second stage or not. (c) 2004 Elsevier B.V. All rights reserved.

Mutagenic potential evaluation of the water of a river that receives tannery effluent using the Allium cepa test system

Several studies are being conducted to assess the toxicity and cytotoxicity of water bodies receiving industrial and domestic effluents, using the Allium cepa test. To assess the toxicity and mutagenicity of water possibly contaminated with chromium, derived from tannery activities, seasonal water samplings were performed in 2001 and 2002 at five different sites along the Sapucaizinho river, Municipality of Patrocinio Paulista, State of São Paulo, Brazil. A. cepa seeds were used as the test material and were submitted to germination in waters from the different collection sites, in Milli-Q water (negative control) and in aqueous solution of chromium (positive control). For the determination of cell division rates and mitotic irregularities, slides were prepared with root tip cells according to the standard Feulgen methodology. The results showed that the collection sites most heavily compromised by chromium emission presented low mitotic indices and a higher frequency of mitotic changes such as irregular anaphases (disorganized, multipolar, laggard), cells with chromosomal adherences, cells with micronuclei, and binucleate and/or multinucleate cells. © 2004 The Japan Mendel Society.

Bone mineralization among male adolescents: Critical years for bone mass gain

Objective: To verify the behavior of the mineral bone content and density in male adolescents according to age and secondary sexual characters. Methods: 47 healthy adolescents between 10 and 19 years old were assessed according to weight, height, body mass index, puberty stage, calcium intake, bone mineral density and content in the lumbar spine and in the proximal femur. The bone mass was measured through bone densitometries. The intake of calcium was calculated through a 3-day diet. The BMI (body mass index) was calculated with the Quetelet Index and the puberty stage was defined according to Tanner's criteria. The analysis used descriptive statistics such as average and standard deviation, and variance estimates to compare the different age groups. Moreover, the Tukey test was used to determine the significant differences. Results: It was evident that the calcium intake in the different ages assessed has not reached the minimum value of 800 mg. The bone mineral density and content showed an increase after the age of 14, as well as when the teenagers reached the sexual maturation stage G4. The mineralization parameters showed a high level when the teenagers were in the G3 stage, however, without statistical significance. Conclusion: The results indicate an important level of bone mineralization during adolescence. Maturation levels superior to G3 have shown more mineralization. This study proves that the critical years for bone mass gain start after the 14-15 years old or older. Copyright © 2004 by Sociedade Brasileira de Pediatria.

O Grande Mentecapto: romance carnavalizado

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Evidências à intervenção de enfermagem controle de infecção da classificação das intervenções de enfermagem: orientação e ensino sobre a lavagem das mãos

Pós-graduação em Enfermagem - FMB

Use of music and play in pediatric nursing care in the hospital context

Objective. To identify and analyze scientific publications on the use of music and play in pediatric nursing care in the hospital context. Method. In this bibliographic study, papers were sought that were published in Portuguese or English between 2004 and 2009 and included the descriptors: hospitalized child, childhood, child recreation, nursing team, nursing, pediatric nursing, alternatives therapies, music, music therapy, play and playthings, play therapy, playing. For the review, the bibliographic databases used were MEDLINE, ScIELO and LILACS. Results. Seventeen publications were obtained, among which: 59% adopted a quantitative method; mainly nursing developed the activities (88%); per type of article, reviews on the theme and assessments of clinical changes associated with the use of music and play were frequent (59% and 18%, respectively); and the utility of this kind of therapies in nursing care is acknowledged (94%). Conclusion. Play and music are useful therapies that can be used in nursing care for pediatric patients.

Restricted use of glycopeptides in paediatric cancer patients with fever and neutropenia

Until now, studies confirming the safety of glycopeptide restriction in the empirical treatment of prolonged fever and neutropenia included only nine children. In an open-label observational study, the use of teicoplanin in paediatric oncology patients was investigated. A period of unrestricted use (2001-2003) was compared with a second period (2004) following implementation of a restrictive treatment guideline. Empirical first-line treatment consisted of piperacillin/tazobactam; in 2004, fosfomycin was added after 72 h as the second-line combination instead of teicoplanin. In total, 213 episodes (n=163 in 2001-2003; n=50 in 2004) managed with teicoplanin or fosfomycin (only 2004) were eligible. Empirical treatment of fever of unknown origin with teicoplanin was reduced by 97%. In 2004, the mean length of stay was 0.4 days shorter, no infection-related death occurred and no vancomycin-resistant enterococci were detected. Restriction of empirical glycopeptides is safe in paediatric cancer patients after first-line treatment with piperacillin/tazobactam. Fosfomycin appears to offer a feasible and cost-saving alternative in second-line combination therapy.

Prognosis of Children with HIV-1 Infection Starting Antiretroviral Therapy in Southern Africa: A Collaborative Analysis of Treatment Programs

BACKGROUND: Prognostic models for children starting antiretroviral therapy (ART) in Africa are lacking. We developed models to estimate the probability of death during the first year receiving ART in Southern Africa. METHODS: We analyzed data from children ≤10 years old who started ART in Malawi, South Africa, Zambia or Zimbabwe from 2004-2010. Children lost to follow-up or transferred were excluded. The primary outcome was all-cause mortality in the first year of ART. We used Weibull survival models to construct two prognostic models: one with CD4%, age, WHO clinical stage, weight-for-age z-score (WAZ) and anemia and one without CD4%, because it is not routinely measured in many programs. We used multiple imputation to account for missing data. RESULTS: Among 12655 children, 877 (6.9%) died in the first year of ART. 1780 children were lost to follow-up/transferred and excluded from main analyses; 10875 children were included. With the CD4% model probability of death at 1 year ranged from 1.8% (95% CI: 1.5-2.3) in children 5-10 years with CD4% ≥10%, WHO stage I/II, WAZ ≥-2 and without severe anemia to 46.3% (95% CI: 38.2-55.2) in children <1 year with CD4% <5%, stage III/IV, WAZ< -3 and severe anemia. The corresponding range for the model without CD4% was 2.2% (95% CI: 1.8-2.7) to 33.4% (95% CI: 28.2-39.3). Agreement between predicted and observed mortality was good (C-statistics=0.753 and 0.745 for models with and without CD4% respectively). CONCLUSION: These models may be useful to counsel children/caregivers, for program planning and to assess program outcomes after allowing for differences in patient disease severity characteristics.

Measuring health state preferences for hemophilia: Development of a disease-specific utility instrument

Research has shown that disease-specific health related quality of life (HRQoL) instruments are more responsive than generic instruments to particular disease conditions. However, only a few studies have used disease-specific instruments to measure HRQoL in hemophilia. The goal of this project was to develop a disease-specific utility instrument that measures patient preferences for various hemophilia health states. The visual analog scale (VAS), a ranking method, and the standard gamble (SG), a choice-based method incorporating risk, were used to measure patient preferences. Study participants (n = 128) were recruited from the UT/Gulf States Hemophilia and Thrombophilia Center and stratified by age: 0–18 years and 19+. ^ Test retest reliability was demonstrated for both VAS and SG instruments: overall within-subject correlation coefficients were 0.91 and 0.79, respectively. Results showed statistically significant differences in responses between pediatric and adult participants when using the SG (p = .045). However, no significant differences were shown between these groups when using the VAS (p = .636). When responses to VAS and SG instruments were compared, statistically significant differences in both pediatric (p < .0001) and adult (p < .0001) groups were observed. Data from this study also demonstrated that persons with hemophilia with varying severity of disease, as well as those who were HIV infected, were able to evaluate a range of health states for hemophilia. This has important implications for the study of quality of life in hemophilia and the development of disease-specific HRQoL instruments. ^ The utility measures obtained from this study can be applied in economic evaluations that analyze the cost/utility of alternative hemophilia treatments. Results derived from the SG indicate that age can influence patients' preferences regarding their state of health. This may have implications for considering treatment options based on the mean age of the population under consideration. Although both instruments independently demonstrated reliability and validity, results indicate that the two measures may not be interchangeable. ^

El efecto Duchamp

En una literatura en la que ha desaparecido el valor y los fantasmas perdieron consistencia, el lenguaje es un ready made de clichés. Algunas novelas actuales, sin embargo, han merecido el epíteto de verdaderas" (Jarkowski 2008) o "auténticas" (Lemus 2004). La magia ha regresado, y los narradores, aunque sus relatos sean inconclusos, indiferentes e incluso frívolos, interpelan al lector como los grandes realistas (Lukács 1971) porque el efecto de los textos es indicial. Señalan -con brutalidad o con delicia- el desfasaje entre lo que se dice y lo que se hace o lo que se deja de hacer. Nombran así, con palabras comunes y sin ninguna distancia, deseos singulares: los suyos y los nuestros (Aira 1988: 59)

El efecto Duchamp

En una literatura en la que ha desaparecido el valor y los fantasmas perdieron consistencia, el lenguaje es un ready made de clichés. Algunas novelas actuales, sin embargo, han merecido el epíteto de verdaderas" (Jarkowski 2008) o "auténticas" (Lemus 2004). La magia ha regresado, y los narradores, aunque sus relatos sean inconclusos, indiferentes e incluso frívolos, interpelan al lector como los grandes realistas (Lukács 1971) porque el efecto de los textos es indicial. Señalan -con brutalidad o con delicia- el desfasaje entre lo que se dice y lo que se hace o lo que se deja de hacer. Nombran así, con palabras comunes y sin ninguna distancia, deseos singulares: los suyos y los nuestros (Aira 1988: 59)

El efecto Duchamp

En una literatura en la que ha desaparecido el valor y los fantasmas perdieron consistencia, el lenguaje es un ready made de clichés. Algunas novelas actuales, sin embargo, han merecido el epíteto de verdaderas" (Jarkowski 2008) o "auténticas" (Lemus 2004). La magia ha regresado, y los narradores, aunque sus relatos sean inconclusos, indiferentes e incluso frívolos, interpelan al lector como los grandes realistas (Lukács 1971) porque el efecto de los textos es indicial. Señalan -con brutalidad o con delicia- el desfasaje entre lo que se dice y lo que se hace o lo que se deja de hacer. Nombran así, con palabras comunes y sin ninguna distancia, deseos singulares: los suyos y los nuestros (Aira 1988: 59)