β-Lactams: chemical structure, mode of action and mechanisms of resistance

This synopsis summarizes the key chemical and bacteriological characteristics of β-lactams, penicillins, cephalosporins, carbanpenems, monobactams and others. Particular notice is given to first-generation to fifth-generation cephalosporins. This reviewalso summarizes the main resistancemechanism to antibiotics, focusing particular attention to those conferring resistance to broad-spectrum cephalosporins by means of production of emerging cephalosporinases (extended-spectrum β-lactamases and AmpC β-lactamases), target alteration (penicillin-binding proteins from methicillin-resistant Staphylococcus aureus) and membrane transporters that pump β-lactams out of the bacterial cell.

Democratic dialogue and collective learning in the context of self-managed teams

This paper provides a longitudinal, empirical view of the multifaceted and reciprocal processes of organizational learning in a context of self-managed teams. Organizational learning is seen as a social construction between people and actions in a work setting. The notion of learning as situated (Brown & Duguid 1989, Lave& Wenger 1991, Gherardi & al. 1998, Easterby-Smith & Araujo 1999, Abma 2003) opens up the possibility for placing the focus of research on learning in the community rather than in individual learning processes. Further, in studying processes in their social context, we cannot avoid taking power relations into consideration (Contu & Willmott 2003). The study is based on an action research with a methodology close to the ‘democratic dialogue’ presented by Gustavsen (2001). This gives a ground for research into how the learning discourse developed in the case study organization over a period of 5 years, during which time the company abandoned a middle management level of hierarchy and the teams had to figure out how to work as self-managed units. This paper discusses the (re)construction of power relations and its role in organizational learning. Power relations are discussed both in vertical and horizontal work relations. A special emphasis is placed on the dialectic between managerial aims and the space for reflection on the side of employees. I argue that learning is crucial in the search for the limits for empowerment and that these limits are negotiated both in actions and speech. This study unfolds a purpose-oriented learning process, constructing an open dialogue, and describes a favourable context for creative, knowledge building communities.

Influence of the use of recycled concrete aggregates from different sources on structural concrete

This paper intends to evaluate the capacity of producing concrete with a pre-established performance (in terms of mechanical strength) incorporating recycled concrete aggregates (RCA) from different sources. To this purpose, rejected products from the precasting industry and concrete produced in laboratory were used. The appraisal of the self-replication capacity was made for three strength ranges: 15-25 MPa, 35-45 MPa and 65-75 MPa. The mixes produced tried to replicate the strength of the source concrete (SC) of the RA. Only total, (100%) replacement of coarse natural aggregates (CNA) by coarse recycled concrete aggregates (CRCA) was tested. The results show that, both in mechanical and durability terms, there were no significant differences between aggregates from controlled sources and those from precast rejects for the highest levels of the target strength. Furthermore, the performance losses resulting from the RA's incorporation are substantially reduced when used medium or high strength SC's. (C) 2014 Elsevier Ltd. All rights reserved.

Performance of concrete made with aggregates recycled from precasting industry waste: influence of the crushing process

The aim of this paper is to evaluate the influence of the crushing process used to obtain recycled concrete aggregates on the performance of concrete made with those aggregates. Two crushing methods were considered: primary crushing, using a jaw crusher, and primary plus secondary crushing (PSC), using a jaw crusher followed by a hammer mill. Besides natural aggregates (NA), these two processes were also used to crush three types of concrete made in laboratory (L20, L45 e L65) and three more others from the precast industry (P20, P45 e P65). The coarse natural aggregates were totally replaced by coarse recycled concrete aggregates. The recycled aggregates concrete mixes were compared with reference concrete mixes made using only NA, and the following properties related to the mechanical and durability performance were tested: compressive strength; splitting tensile strength; modulus of elasticity; carbonation resistance; chloride penetration resistance; water absorption by capillarity; water absorption by immersion; and shrinkage. The results show that the PSC process leads to better performances, especially in the durability properties. © 2014 RILEM

The effect of superplasticizers on the mechanical performance of concrete made with fine recycled concrete aggregates

It is considered that using crushed recycled concrete as aggregate for concrete production is a viable alternative to dumping and would help to conserve abiotic resources. This use has fundamentally been based on the coarse fraction because the fine fraction is likely to degrade the performance of the resulting concrete. This paper presents results from a research work undertaken at Institut Superior Tecnico (IST), Lisbon, Portugal, in which the effects of incorporating two types of superplasticizer on the mechanical performance of concrete containing fine recycled aggregate were evaluated. The purpose was to see if the addition of superplasticizer would offset the detrimental effects associated with the use of fine recycled concrete aggregate. The experimental programme is described and the results of tests for splitting tensile strength, modulus of elasticity and abrasion resistance are presented. The relative performance of concrete made with recycled aggregate was found to decrease. However, the same concrete with admixtures in general exhibited a better mechanical performance than the reference mixes without admixtures or with a less active superplasticizer. Therefore, it is argued that the mechanical performance of concrete made with fine recycled concrete aggregates can be as good as that of conventional concrete, if superplasticizers are used to reduce the water-cement ratio of the former concrete.

Coral snake venoms: mode of action and pathophysiology of experimental envenomation

Coral snakes, the New World Elapidae, are included in the genera Micniroides and Micrurus. The genus Mlcrurus comprises nearly all coral snake species and those which are responsible for human snake-bite accidents. The following generalizations concerning the effects induced by their venoms, and their venom-properties can be made. Coral snake venoms are neurotoxic, producing loss of muscle strenght and death by respiratory paralysis. Local edema and necrosis are not induced nor blood coagulation or hemorrhages. Proteolysis activity is absent or of very low grade. They display phospholipase A2 activity. Nephrotoxic effects are not evoked. The main toxins from elapid venoms are postsynaptic and presynaptic neurotoxins and cardiotoxins. Phospholipases A2 endowed with myonecrotic or cardiotoxin-like properties are important toxic components from some elapid venoms. The mode of action of Micrurus frontalis, M. lemniscatus, M. corallinus and M. fulvius venoms has been investigated in isolated muscle preparations and is here discussed. It is shown that while M. frontalis and M. lemniscatus venoms must contain only neurotoxins that act at the cholinergic end-plate receptor (postsynaptic neurotoxins), M. corallinus venom also inhibits evoked acetylcholine release by the motor nerve endings (presynaptic neurotoxin-like effect) and M. fulvius induces muscle fiber membrane depolarization (cardiotoxin-like effect). The effects produced by M. corallinus and M. fulvius venoms in vivo in dogs and M. frontalis venom in dogs and monkeys are also reported.

Reusability assessment of thermoset polymeric composite wastes as reinforcement and filler replacement for polymer concrete materials

The development and applications of thermoset polymeric composites, namely fiber reinforced polymers (FRP), have shifted in the last decades more and more into the mass market [1]. Production and consume have increased tremendously mainly for the construction, transportation and automobile sectors [2, 3]. Although the many successful uses of thermoset composite materials, recycling process of byproducts and end of lifecycle products constitutes a more difficult issue. The perceived lack of recyclability of composite materials is now increasingly important and seen as a key barrier to the development or even continued used of these materials in some markets.

Recycling of pultrusion production waste into innovative concrete-polymer composite solutions

In this study, the added value resultant from the incorporation of pultrusion production waste into polymer based concretes was assessed. For this purpose, different types of thermoset composite scrap material, proceeding from GFRP pultrusion manufacturing process, were mechanical shredded and milled into a fibrous-powdered material. Resultant GFRP recyclates, with two different size gradings, were added to polyester based mortars as fine aggregate and filler replacements, at various load contents between 4% up to 12% in weight of total mass. Flexural and compressive loading capacities were evaluated and found better than those of unmodified polymer mortars. Obtained results highlight the high potential of recycled GFRP pultrusion waste materials as efficient and sustainable admixtures for concrete and mortar-polymer composites, constituting an emergent waste management solution.

Mechanical performance of concrete made with aggregates from construction and demolition waste recycling plants

This research aims at analysing the mechanical performance of concrete with recycled aggregates (RA) from construction and demolition waste (CDW) from various locations in Portugal. First the characteristics of the various aggregates (natural and recycled) used in the production of concrete were thoroughly analysed. The composition of the RA was determined and several physical and chemical tests of the aggregates were performed. In order to evaluate the mechanical performance of concrete, compressive strength (in cubes and cylinders), splitting tensile strength, modulus of elasticity and abrasion resistance tests were performed. Concrete mixes with RA from CDW from several recycling plants were evaluated, in order to understand the influence that the RA's collection point, and consequently their composition, has on the characteristics of the mixes produced. The analysis of the mechanical performance allowed concluding that the use of RA worsens most of the properties tested, especially when fine RA are used. On the other hand, there was an increase in abrasion resistance when coarse RA were used. In global terms, the use of this type of aggregates, in limited contents, is viable from a mechanical viewpoint. (C) 2015 Elsevier Ltd. All rights reserved.

Performance of concrete made with aggregates recycled from precasting industry waste: influence of the crushing process

The aim of this paper is to evaluate the influence of the crushing process used to obtain recycled concrete aggregates on the performance of concrete made with those aggregates. Two crushing methods were considered: primary crushing, using a jaw crusher, and primary plus secondary crushing (PSC), using a jaw crusher followed by a hammer mill. Besides natural aggregates (NA), these two processes were also used to crush three types of concrete made in laboratory (L20, L45 e L65) and three more others from the precast industry (P20, P45 e P65). The coarse natural aggregates were totally replaced by coarse recycled concrete aggregates. The recycled aggregates concrete mixes were compared with reference concrete mixes made using only NA, and the following properties related to the mechanical and durability performance were tested: compressive strength; splitting tensile strength; modulus of elasticity; carbonation resistance; chloride penetration resistance; water absorption by capillarity; water absorption by immersion; and shrinkage. The results show that the PSC process leads to better performances, especially in the durability properties.

Influence of the crushing process of recycled aggregates on concrete properties

This work intends to evaluate the (mechanical and durability) performance of concrete made with coarse recycled concrete aggregates (CRCA) obtained using two crushing processes: primary crushing (PC) and primary plus secondary crushing (PSC). This analysis intends to select the most efficient production process of recycled aggregates (RA). The RA used here resulted from precast products (P), with strength classes of 20 MPa, 45 MPa and 65 MPa, and from laboratory-made concrete (L) with the same compressive strengths. The evaluation of concrete was made with the following tests: compressive strength; splitting tensile strength; modulus of elasticity; carbona-tion resistance; chloride penetration resistance; capillary water absorption; and water absorption by immersion. These findings contribute to a solid and innovative basis that allows the precasting industry to use without restrictions the waste it generates. © (2015) Trans Tech Publications, Switzerland.

Performance of concrete made with recycled aggregates from Portuguese CDW recycling plants

The objective of this research is the production of concrete with recycled aggregates (RA) from various CDW plants around Portugal. The influence of the RA collection location and consequently of their composition on the characteristics of the concrete produced was analysed. In the mixes produced in this research RA from five plants (Valnor, Vimajas, Ambilei, Europontal and Retria) were used: in three of them coarse and fine RA were analysed and in the remaining ones only coarse RA were used. The experimental campaign comprised two tests in fresh concrete (cone of Abrams slump and density) and eight in hardened concrete (compressive strength in cubes and cylinders, splitting tensile strength, modulus of elasticity, water absorption by immersion and capillarity, carbonation and chloride penetration resistance). It was found that the use of RA causes a quality decrease in concrete. However, there was a wide results scatter according to the plant where the RAs were collected, because of the variation in composition of the RA. It was also found that the use of fine RA causes a more significant performance loss of the concrete properties analysed than the use of coarse RA. © (2015) Trans Tech Publications, Switzerland.

Mental health promotion during pregnancy and early childhood : an action- research project in primary health care

ABSTRACT – Background: Primary Health Care (PHC) is usually the first contact with the health system, and health professionals are key mediators for enabling citizens to take care of their health. In Portugal, great improvements have been achieved in the biometric indicators of maternal and child health during the last decades. Nevertheless, scant attention has been paid to the mental health dimension, in spite of the recognition of its importance, being pregnancy and early childhood crucial opportunities in the lifecycle for mental health promotion, especially in the early years of life, with a strong impact in the health of the child. The impact of early attachment between mother and baby on maternal and child health has long been recognized. This attachment can be influenced by some factors, as the mother’s emotional adjustment. Attention to these factors may facilitate implementation of both positive conditions and preventative measures. Family support during the transition to parenthood has been highlighted as an effective measure and PHC professionals are in a privileged position as information sources as well as mediators. Aims: The project we present describes an action-research process developed together among academic researchers and health professionals to embrace these issues. We intend to enable health professionals to support families in the transition to parenthood thereby promoting children’s mental health. Approach: The project is driven by a participatory approach intended to lead to reorganization of health care during pregnancy and early childhood. Effective change happens when those involved are interested and motivated, what makes their participation so important. Reflection about current practices and needs, and knowledge about evidence-based interventions have been guiding the selection of changes to introduce in clinical practice for family support and development of parenthood skills and self-confidence. Development: We summarize the main steps in development: the initial assessment and the picture taken from the community under study; the decision making process; the training programme of PHC professionals in action; the review of the protocols of maternal consultation, home visits and antenatal education; the implementation planning; the plan for evaluation the effectiveness of the changes introduced in the delivery of maternal and child health care units. The already developed work has shown that motivation, leadership and organizational issues are decisive for process development.-------------------------- RESUMO - Os Cuidados de Saúde Primários são habitualmente o primeiro contacto com o sistema de saúde e os profissionais de saúde são mediadores chave na capacitação dos cidadãos para cuidarem da sua saúde. Em Portugal, nas últimas décadas, têm-se alcançado grandes melhorias nos indicadores biométricos de saúde materno-infantil. Contudo, tem-se dedicado pouca atenção à dimensão de saúde mental, apesar do reconhecimento da sua importância. A gravidez e primeira infância têm sido apontadas como uma oportunidade crucial no ciclo de vida para a promoção da saúde mental. É dado especial enfoque aos primeiros tempos de vida, dado o forte impacto na saúde da criança. O impacte da vinculação precoce entre a mãe e o bebé na saúde da mãe e da criança há muito que é reconhecido. Esta vinculação pode ser influenciada por vários factores, nomeadamente pelo ajustamento emocional da mãe. A focalização nestes aspectos pode facilitar a criação de condições favoráveis e a implementação de medidas preventivas. O suporte familiar durante o período de transição para a parentalidade tem sido enfatizado como uma medida eficaz e os Cuidados de Saúde Primários estão numa posição privilegiada como fontes de informação e como mediadores. O projecto que apresentamos descreve um processo de investigação- acção desenvolvido em parceria entre investigadores académicos e profissionais de saúde para abordar os aspectos referidos. Pretende-se capacitar os profissionais de saúde para apoiarem as famílias na transição para a parentalidade, promovendo assim a saúde mental das crianças. O projecto baseia-se numa abordagem participativa, direccionada para a reorganização dos cuidados durante a gravidez e primeiros tempos de vida. A mudança efectiva acontece quando os envolvidos estão interessados e motivados, o que torna a sua participação tão importante. A reflexão acerca das práticas e necessidades actuais e o conhecimento acerca de intervenções baseadas na evidência têm guiado a selecção das alterações a introduzir na prática clínica, no sentido de promover o suporte familiar e o desenvolvimento de competências parentais e auto-confiança. Neste artigo, apresentamos as etapas principais do desenvolvimento do projecto: avaliação inicial da comunidade em estudo; processo de tomada de decisão; programa de formação dos profissionais dos Cuidados de Saúde Primários; revisão dos protocolos da consulta de saúde materna, visita domiciliária e educação pré-natal; planeamento da implementação; plano de avaliação da efectividade das alterações introduzidas na prestação de cuidados. O trabalho já desenvolvido tem mostrado que a motivação, liderança e aspectos

Robustness of corroded reinforced concrete structures

Short Term Scienti c Mission, COST ACTION TU-0601

Effect of C282Y Genotype on Self-Reported Musculoskeletal Complications in Hereditary Hemochromatosis

OBJECTIVE: Arthropathy that mimics osteoarthritis (OA) and osteoporosis (OP) is considered a complication of hereditary hemochromatosis (HH). We have limited data comparing OA and OP prevalence among HH patients with different hemochromatosis type 1 (HFE) genotypes. We investigated the prevalence of OA and OP in patients with HH by C282Y homozygosity and compound heterozygosity (C282Y/H63D) genotype. METHODS: A total of 306 patients with HH completed a questionnaire. Clinical and demographic characteristics and presence of OA, OP and related complications were compared by genotype, adjusting for age, sex, body mass index (BMI), current smoking and menopausal status. RESULTS: In total, 266 of the 306 patients (87%) were homozygous for C282Y, and 40 (13%) were compound heterozygous. The 2 groups did not differ by median age [60 (interquartile range [IQR] 53 to 68) vs. 61 (55 to 67) years, P=0.8], sex (female: 48.8% vs. 37.5%, P=0.18) or current smoking habits (12.4% vs. 10%, P=0.3). As compared with compound heterozygous patients, C282Y homozygous patients had higher median serum ferritin concentration at diagnosis [1090 (IQR 610 to 2210) vs. 603 (362 to 950) µg/L, P<0.001], higher median transferrin saturation [80% (IQR 66 to 91%) vs. 63% (55 to 72%), P<0.001]) and lower median BMI [24.8 (22.1 to 26.9) vs. 26.2 (23.5 to 30.3) kg/m2, P<0.003]. The overall prevalence of self-reported OA was significantly higher with C282Y homozygosity than compound heterozygosity (53.4% vs. 32.5%; adjusted odds ratio [aOR] 2.4 [95% confidence interval 1.2-5.0]), as was self-reported OP (25.6% vs. 7.5%; aOR 3.5 [1.1-12.1]). CONCLUSION: Patients with C282Y homozygosity may be at increased risk of musculoskeletal complications of HH.