Prevalence of beta-hemolytic Streptococcus in children with special health care needs

Pharyngotonsillitis by beta-hemolytic Streptococcus mostly affects children and imunocompromissed, being Streptococcus pyogenes (Group A) the most common agent in bacterial pharyngotonsillitis. Aim: This work targeted the research of beta-hemolytic Streptococcus Group-A (SBHGA) and No-A (SBHGNA) in the oropharynx of individuals with special health needs from the APAE (Maceio-AL). Method: A prospective study with oropharynx samples from patients with Down syndrome and other mental disorders (test) and students from a private school (control) aged 5-15 years. Cultures in blood agar (5%) were identified through Gram/catalase tests and bacitracin/trirnethoprim-sulfamethoxazole disk diffusion method, applying the chi-squared statistical analysis. Results: A total of 222 bacterial colonies were isolated in 74 individuals from APAE and 65 in the control group. In the test group, previous episodes of pharyngotonsillitis were reported by 36.49% (27/74) and 9.46% (7/74) were diagnosed with symptoms and/or signs suggestive of oropharynx infection. No positive sample of S. pyogenes was confirmed at APAE, being all samples classified as SBHGNA, with 5 SBHGA in the control group. Conclusion: The early identification of beta-hemolytic Streptococcus is important for the fast treatment of pharyngotonsillitis and the absence of S. pyogenes avoid future suppurative or not-suppurative sequels in the group from APAE.

Prevalence of overweight preschool children in public day care centers: a cross-sectional study

CONTEXT AND OBJECTIVE: Brazil is undergoing a period of epidemiological transition associated with demographic and nutritional changes. The prevalence of obesity is also increasing in children and is causing numerous health problems that are becoming public health issues. The aim here was to evaluate the prevalence of overweight among children of two and three years of age. DESIGN AND SETTING: Cross-sectional study in municipal day care centers in Taubate, state of Sao Paulo, Brazil. METHODS: Weight and height measurements were made on 447 preschool children forming a probabilistic randomized sample. Their body mass index (BMI) was calculated. Their nutritional status was classified using the World Health Organization reference cutoff points (2006). Their mean weight, height and BMI were compared according to their age and sex. RESULTS: The mean values for the final sample (n = 447) were as follows: mean age: 38.6 months (+/- 3.5) and Z scores for: weight/height (W/H): 0.50 (+/- 1.22); height/age: -0.03 (+/- 1.07); weight/age (W/A): 0.51 (+/- 1.23); and BMI: 0.51(+/- 1.23). The prevalence of overweight children (BMI > 1 z) was 28.86%, while the prevalence of underweight children (BMI < -2 z) was 0.89%. There were no differences in mean BMI among the two and three-year age groups (P = 0.66). CONCLUSION: A high prevalence of overweight was observed in the sample of two and three-year-old children, with practically no malnutrition, thus showing that a significant nutritional transition may already be occurring, even in medium-sized cities of developing countries.

Toward Global Standards for Comparator Pharmaceutical Products: Case Studies of Amoxicillin, Metronidazole, and Zidovudine in the Americas

This study compared in vitro dissolution characteristics and other quality measures of different amoxicillin, metronidazole, and zidovudine products purchased in the Americas to a comparator pharmaceutical product (CPP). These three drugs are classified as Biopharmaceutics Classification System Class I drugs with the possibility that dissolution findings might be used to document bioequivalence. All investigated zidovudine products were found to be in vitro equivalent to the CPP. Only 3 of 12 tested amoxicillin products were found to be in vitro equivalent to the CPP. None of the tested metronidazole products were in vitro equivalent to the CPP. These findings suggest but do not confirm bioinequivalence where in vitro comparisons failed, given that an in vivo blood level study might have confirmed bioequivalence. At times, identifying a CPP in one of the selected markets proved difficult. The study demonstrates that products sold across national markets may not be bioequivalent. When coupled with the challenge of identifying a CPP in different countries, the results of this study suggest the value of an international CPP as well as increased use of BCS approaches as means of either documenting bioequivalence or signaling the need for further in vivo studies. Because of increased movement of medicines across national borders, practitioners and patients would benefit from these approaches.

Stethoscopes with hearing aid use: case studies

Introduction: Description for using stethoscopes adapted to hearing aids. Aim: To describe the adaptation of HAs to stethoscopes used by 2 students in the health field with bilateral hearing impairment. Case reports: Two subjects with hearing loss had their stethoscopes coupled to HAs because of the individual requirements of their professions (healthcare) to perform auscultation. Conclusion: The improvement was measured in situ, and satisfaction was evaluated using a subjective questionnaire. The use of a stethoscope coupled to an HA allowed students with hearing loss to perform auscultation.

Velocity structure and seismic anisotropy in the crust and upper mantle from Receiver Function analysis: three case studies in Italy

The research for this PhD project consisted in the application of the RFs analysis technique to different data-sets of teleseismic events recorded at temporary and permanent stations located in three distinct study regions: Colli Albani area, Northern Apennines and Southern Apennines. We found some velocity models to interpret the structures in these regions, which possess very different geologic and tectonics characteristics and therefore offer interesting case study to face. In the Colli Albani some of the features evidenced in the RFs are shared by all the analyzed stations: the Moho is almost flat and is located at about 23 km depth, and the presence of a relatively shallow limestone layer is a stable feature; contrariwise there are features which vary from station to station, indicating local complexities. Three seismic stations, close to the central part of the former volcanic edifice, display relevant anisotropic signatures­­­ with symmetry axes consistent with the emplacement of the magmatic chamber. Two further anisotropic layers are present at greater depth, in the lower crust and the upper mantle, respectively, with symmetry axes directions related to the evolution of the volcano complex. In Northern Apennines we defined the isotropic structure of the area, finding the depth of the Tyrrhenian (almost 25 km and flat) and Adriatic (40 km and dipping underneath the Apennines crests) Mohos. We determined a zone in which the two Mohos overlap, and identified an anisotropic body in between, involved in the subduction and going down with the Adiratic Moho. We interpreted the downgoing anisotropic layer as generated by post-subduction delamination of the top-slab layer, probably made of metamorphosed crustal rocks caught in the subduction channel and buoyantly rising toward the surface. In the Southern Apennines, we found the Moho depth for 16 seismic stations, and highlighted the presence of an anisotropic layer underneath each station, at about 15-20 km below the whole study area. The moho displays a dome-like geometry, as it is shallow (29 km) in the central part of the study area, whereas it deepens peripherally (down to 45 km); the symmetry axes of anisotropic layer, interpreted as a layer separating the upper and the lower crust, show a moho-related pattern, indicated by the foliation of the layer which is parallel to the Moho trend. Moreover, due to the exceptional seismic event occurred on April 6th next to L’Aquila town, we determined the Vs model for two station located next to the epicenter. An extremely high velocity body is found underneath AQU station at 4-10 km depth, reaching Vs of about 4 km/s, while this body is lacking underneath FAGN station. We compared the presence of this body with other recent works and found an anti-correlation between the high Vs body, the max slip patches and earthquakes distribution. The nature of this body is speculative since such high velocities are consistent with deep crust or upper mantle, but can be interpreted as a as high strength barrier of which the high Vs is a typical connotation.

Sea Level Variations from Decades to Millennia: A few Case Studies

The main goals of this Ph.D. study are to investigate the regional and global geophysical components related to present polar ice melting and to provide independent cross validation checks of GIA models using both geophysical data detected by satellite mission, and geological observations from far field sites, in order to determine a lower and upper bound of uncertainty of GIA effect. The subject of this Thesis is the sea level change from decades to millennia scale. Within ice2sea collaboration, we developed a Fortran numerical code to analyze the local short-term sea level change and vertical deformation resulting from the loss of ice mass. This method is used to investigate polar regions: Greenland and Antarctica. We have used mass balance based on ICESat data for Greenland ice sheet and a plausible mass balance for Antarctic ice sheet. We have determined the regional and global fingerprint of sea level variations, vertical deformations of the solid surface of the Earth and variations of shape of the geoid for each ice source mentioned above. The coastal areas are affected by the long wavelength component of GIA process. Hence understanding the response of the Earth to loading is crucial in various contexts. Based on the hypothesis that Earth mantle materials obey to a linear rheology, and that the physical parameters of this rheology can be only characterized by their depth dependence, we investigate the Glacial Isostatic Effect upon the far field sites of Mediterranean area using an improved SELEN program. We presented new and revised observations for archaeological fish tanks located along the Tyrrhenian and Adriatic coast of Italy and new RSL for the SE Tunisia. Spatial and temporal variations of the Holocene sea levels studied in central Italy and Tunisia, provided important constraints on the melting history of the major ice sheets.

Effects of Resources Exploitation on Water Quality: case studies in Salt Water Intrusion and Acid Mine Drainage

Throughout the world, pressures on water resources are increasing, mainly as a result of human activity. Because of their accessibility, groundwater and surface water are the most used reservoirs. The evaluation of the water quality requires the identification of the interconnections among the water reservoirs, natural landscape features, human activities and aquatic health. This study focuses on the estimation of the water pollution linked to two different environmental issues: salt water intrusion and acid mine drainage related to the exploitation of natural resources. Effects of salt water intrusion occurring in the shallow aquifer north of Ravenna (Italy) was analysed through the study of ion- exchange occurring in the area and its variance throughout the year, applying a depth-specific sampling method. In the study area were identified ion exchange, calcite and dolomite precipitation, and gypsum dissolution and sulphate reduction as the main processes controlling the groundwater composition. High concentrations of arsenic detected only at specific depth indicate its connexion with the organic matter. Acid mine drainage effects related to the tin extraction in the Bolivian Altiplano was studied, on water and sediment matrix. Water contamination results strictly dependent on the seasonal variation, on pH and redox conditions. During the dry season the strong evaporation and scarce water flow lead to low pH values, high concentrations of heavy metals in surface waters and precipitation of secondary minerals along the river, which could be released in oxidizing conditions as demonstrated through the sequential extraction analysis. The increase of the water flow during the wet season lead to an increase of pH values and a decrease in heavy metal concentrations, due to dilution effect and, as e.g. for the iron, to precipitation.

The role of collective action in the provision of agri-environmental public goods: theoretical development through case studies in Italy

The thesis aims at analysing the role of collective action as a viable alternative to the traditional forms of intervention in agriculture in order to encourage the provision of agri-environmental public goods. Which are the main benefits of collective action, in terms of effectiveness and efficiency, compared to traditional market or public intervention policies? What are the drivers that encourage farmers to participate into collective action? To what extent it is possible to incorporate collective aspects into policies aimed at providing agri-environmental public goods? With the objective of addressing these research questions, the thesis is articulated in two levels: a theoretical analysis on the role of collective action in the provision of public goods and a specific investigation of two local initiative,s were an approach collective management of agro-environmental resources was successfully implemented. The first case study concerns a project named “Custodians of the Territory”, developed by the local agency in Tuscany “Comunità Montana Media Valle del Serchio”, which settled for an agreement with local farmers for a collective provision of environmental services related to the hydro-geological management of the district. The second case study is related to the territorial agri-environmental agreement experimented in Valdaso (Marche), where local farmers have adopted integrated pest management practices collectively with the aim of reducing the environmental impact of their farming practices. The analysis of these initiatives, carried out through participatory methods (Rapid Rural Appraisal), allowed developing a theoretical discussion on the role of innovative tools (such as co-production and co-management) in the provision of agri-environmental public goods. The case studies also provided some recommendations on the government intervention and policies needed to promote successful collective action for the provision of agri-environmental public goods.

Rural governance and livelihoods systems diversification in the Western Balkans: comparative case studies of Bosnia and Herzegovina, Montenegro and Serbia

Agriculture is still important for socio-economic development in rural areas of Bosnia, Montenegro and Serbia (BMS). However, for sustainable rural development rural economies should be diversified so attention should be paid also to off-farm and non-farm income-generating activities. Agricultural and rural development (ARD) processes and farm activity diversification initiatives should be well governed. The ultimate objective of this work is to explore linkages between ARD governance and rural livelihoods diversification in BMS. The thesis is based on an extended secondary data analysis and surveys. Questionnaires for ARD governance and coordination were sent via email to public, civil society and international organizations. Concerning rural livelihood diversification, the field questionnaire surveys were carried out in three rural regions of BMS. Results show that local rural livelihoods are increasingly diversified but a significant share of households are still engaged in agriculture. Diversification strategies have a chance to succeed taking into consideration the three rural regions’ assets. However, rural households have to tackle many problems for developing new income-generating activities such as the lack of financial resources. Weak business skills are also a limiting factor. Fully exploiting rural economy diversification potential in BMS requires many interventions including improving rural governance, enhancing service delivery in rural areas, upgrading rural people’s human capital, strengthening rural social capital and improving physical capital, access of the rural population to finance as well as creating a favourable and enabling legal and legislative environment fostering diversification. Governance and coordination of ARD policy design, implementation and evaluation is still challenging in the three Balkan countries and this has repercussions also on the pace of rural livelihoods diversification. Therefore, there is a strong and urgent need for mobilization of all rural stakeholders and actors through appropriate governance arrangements in order to foster rural livelihoods diversification and quality of life improvement.

Linking rural tourism to agriculture. Evidences from comparative case studies in Kosovo, Italy and Spain

Rural tourism has been widely promoted in the European Union as an effective measure counteracting economic and social challenges facing rural areas especially those with declining agriculture economies. Particularly its role is seen in provision and maintenance of public goods which are more and more demanded by the public and considered in the policymaking. In Kosovo, rural tourism has been developed through the support of the international organizations and private sector initiatives, with primary aim to generate additional income for rural households and sustainable management of natural and cultural resources. Anyhow, it could be stated that the use of territorial capital to enhance the quality of the tourist offer and undertake promotion at wider circles of people has not been well explored so far, particularly possible links with agriculture that would satisfy visitors demand. In this regard this research study analyzes involvement of local stakeholders and use of territorial capital to develop tourist offer in rural areas of Kosovo. Beside, study applies comparative approach with other two areas of the European Union, Appennino Bolognese in Italy and Alpujara in Spain, to understand and compare the process of rural tourism development and demand characteristics between Kosovo and these areas. A survey has been conducted in all three study areas with rural tourism visitors to understand their preferences for public and private goods and services when visiting rural areas and the role of agriculture in sustaining rural tourism. Results show that there is a potential to link rural tourism with agriculture in Kosovo, which would help in sustaining agriculture and add additional value to local food products, which in return would enhance the tourist offer and make it more attractive for the visitors but also for the farmers as an additional revenue generating sector.

Ancient Greek harbours used as geo-archives for palaeotsunami research : case studies from Krane (Cefalonia), Lechaion (Gulf of Corinth) and Kyllini (Peloponnese)

Since historical times, coastal areas throughout the eastern Mediterranean are exposed to tsunami hazard. For many decades the knowledge about palaeotsunamis was solely based on historical accounts. However, results from timeline analyses reveal different characteristics affecting the quality of the dataset (i.e. distribution of data, temporal thinning backward of events, local periodization phenomena) that emphasize the fragmentary character of the historical data. As an increasing number of geo-scientific studies give convincing examples of well dated tsunami signatures not reported in catalogues, the non-existing record is a major problem to palaeotsunami research. While the compilation of historical data allows a first approach in the identification of areas vulnerable to tsunamis, it must not be regarded as reliable for hazard assessment. Considering the increasing economic significance of coastal regions (e.g. for mass tourism) and the constantly growing coastal population, our knowledge on the local, regional and supraregional tsunami hazard along Mediterranean coasts has to be improved. For setting up a reliable tsunami risk assessment and developing risk mitigation strategies, it is of major importance (i) to identify areas under risk and (ii) to estimate the intensity and frequency of potential events. This approach is most promising when based on the analysis of palaeotsunami research seeking to detect areas of high palaeotsunami hazard, to calculate recurrence intervals and to document palaeotsunami destructiveness in terms of wave run-up, inundation and long-term coastal change. Within the past few years, geo-scientific studies on palaeotsunami events provided convincing evidence that throughout the Mediterranean ancient harbours were subject to strong tsunami-related disturbance or destruction. Constructed to protect ships from storm and wave activity, harbours provide especially sheltered and quiescent environments and thus turned out to be valuable geo-archives for tsunamigenic high-energy impacts on coastal areas. Directly exposed to the Hellenic Trench and extensive local fault systems, coastal areas in the Ionian Sea and the Gulf of Corinth hold a considerably high risk for tsunami events, respectively.Geo-scientific and geoarcheaological studies carried out in the environs of the ancient harbours of Krane (Cefalonia Island), Lechaion (Corinth, Gulf of Corinth) and Kyllini (western Peloponnese) comprised on-shore and near-shore vibracoring and subsequent sedimentological, geochemical and microfossil analyses of the recovered sediments. Geophysical methods like electrical resistivity tomography and ground penetrating radar were applied in order to detect subsurface structures and to verify stratigraphical patterns derived from vibracores over long distances. The overall geochronological framework of each study area is based on radiocarbon dating of biogenic material and age determination of diagnostic ceramic fragments. Results presented within this study provide distinct evidence of multiple palaeotsunami landfalls for the investigated areas. Tsunami signatures encountered in the environs of Krane, Lechaion and Kyllini include (i) coarse-grained allochthonous marine sediments intersecting silt-dominated quiescent harbour deposits and/or shallow marine environments, (ii) disturbed microfaunal assemblages and/or (iii) distinct geochemical fingerprints as well as (iv) geo-archaeological destruction layers and (v) extensive units of beachrock-type calcarenitic tsunamites. For Krane, geochronological data yielded termini ad or post quem (maximum ages) for tsunami event generations dated to 4150 ± 60 cal BC, ~ 3200 ± 110 cal BC, ~ 650 ± 110 cal BC, and ~ 930 ± 40 cal AD, respectively. Results for Lechaion suggest that the harbour was hit by strong tsunami impacts in the 8th-6th century BC, the 1st-2nd century AD and in the 6th century AD. At Kyllini, the harbour site was affected by tsunami impact in between the late 7th and early 4th cent. BC and between the 4th and 6th cent. AD. In case of Lechaion and Kyllini, the final destruction of the harbour facilities also seems to be related to the tsunami impact. Comparing the tsunami signals obtained for each study areas with geo-scientific data from palaeotsunami events from other sites indicates that the investigated harbour sites represent excellent geo-archives for supra-regional mega-tsunamis.

Moisture and potential vorticity in medicanes: theoretical approach and case studies

Da poco più di 30 anni la comunità scientifica è a conoscenza dell’occasionale presenza di strutture cicloniche con alcune caratteristiche tropicali sul Mar Mediterraneo, i cosiddetti medicane. A differenza dei cicloni baroclini delle medie latitudini, essi posseggono una spiccata simmetria termica centrale che si estende per gran parte della troposfera, un occhio, talvolta privo di nubi, e una struttura nuvolosa a bande spiraleggianti. Ad oggi non esiste ancora una teoria completa che spieghi la loro formazione ed evoluzione. La trattazione di questa tesi, incentrata sull’analisi dei campi di vorticità potenziale e di umidità relativa, è sviluppata nell’ottica di una miglior comprensione delle dinamiche alla mesoscala più rilevanti per la nascita dei medicane. Lo sviluppo di tecniche avanzate di visualizzazione dei campi generati dal modello WRF, quali l’animazione tridimensionale delle masse d’aria aventi determinate caratteristiche, ha permesso l’individuazione di due zone di forti anomalie di due campi derivati dalla vorticità potenziale in avvicinamento reciproco, intensificazione e mutua interazione nelle ore precedenti la formazione dei medicane. Tramite la prima anomalia che è stata chiamata vorticità potenziale secca (DPV), viene proposta una nuova definizione di tropopausa dinamica, che non presenta i problemi riscontrati nella definizione classica. La seconda anomalia, chiamata vorticità potenziale umida (WPV), individua le aree di forte convezione e permette di avere una visione dinamica dello sviluppo dei medicane alle quote medio-basse. La creazione di pseudo immagini di vapore acqueo tramite la teoria del trasferimento radiativo e la comparazione di queste mappe con quelle effettivamente misurate nei canali nella banda del vapore acqueo dai sensori MVIRI e SEVIRI dei satelliti Meteosat hanno da un lato confermato l’analisi modellistica, dall’altro consentito di stimare gli errori spazio-temporali delle simulazioni. L’utilizzo dei dati di radianza nelle microonde, acquisiti dai sensori AMSU-B e MHS dei satelliti NOAA, ha aggiunto ulteriori informazioni sia sulle intrusioni di vorticità potenziale che sulla struttura degli elementi convettivi presenti sul dominio, in modo particolare sulla presenza di ghiaccio in nube. L’analisi dettagliata di tre casi di medicane avvenuti nel passato sul Mar Mediterraneo ha infine consentito di combinare gli elementi innovativi sviluppati in questo lavoro, apportando nuove basi teoriche e proponendo nuovi metodi di indagine non solo per lo studio di questi fenomeni ma anche per un’accurata ricerca scientifica su ciclogenesi di altro tipo.

Academic and non-academic conference presentations - are they the same genre? Five case studies.

Il presente elaborato si pone l’obiettivo di determinare se il genere del discorso di conferenza non accademica coincida con il genere del discorso di conferenza accademica, nello specifico per quanto riguarda le loro introduzioni. La prima parte della tesi si concentra sulle basi teoriche. In primo luogo è stata sviluppata una panoramica della letteratura esistente riguardo ai discorsi di conferenza accademica, dalla quale si è poi ristretto il campo sugli studi che hanno preso in esame solo la loro introduzione. Alla luce dell’assenza di pubblicazioni sulle conferenze non accademiche, e di conseguenza anche sui loro discorsi, si è cercato di definire il genere del discorso di conferenza non accademica, applicando il concetto di ‘comunità discorsiva’ sia ai discorsi di conferenza accademica sia a quelli di conferenza non accademica. Una volta stabilito che il contesto non accademico differisce da quello accademico, si è passati a definire l’introduzione dei discorsi di conferenza non accademica in quanto genere. Nella seconda parte dell’elaborato è stata svolta l’analisi di cinque case study, ovvero della trascrizione delle introduzioni di cinque discorsi di conferenza non accademica. A queste è stato applicato il modello di mosse retoriche delle introduzioni dei discorsi di conferenza accademica elaborato da Rowley-Jolivet e Carter-Thomas, per determinare se fosse valido anche per le introduzioni dei discorsi di conferenza non accademica. Una volta scoperto che non lo è, e che quindi le introduzioni dei discorsi di conferenza non accademica e quelle dei discorsi di conferenza accademica sono due 'sotto-generi' diversi, è stato proposto un nuovo modello di mosse retoriche. Infine sono stati avanzati dei suggerimenti riguardo all’applicabilità del suddetto modello, non solo in altri studi nel campo dell’analisi di genere, ma anche nel settore dell’interpretazione simultanea, con particolare riferimento alla preparazione dell’interprete e alla strategia di anticipazione.