Current practices in the management of patients with ureteral calculi in the emergency room of a university hospital

OBJECTIVE: Urinary lithiasis is a common disease. The aim of the present study is to assess the knowledge regarding the diagnosis, treatment and recommendations given to patients with ureteral colic by professionals of an academic hospital. MATERIALS AND METHODS: Sixty-five physicians were interviewed about previous experience with guidelines regarding ureteral colic and how they manage patients with ureteral colic in regards to diagnosis, treatment and the information provided to the patients. RESULTS: Thirty-six percent of the interviewed physicians were surgeons, and 64% were clinicians. Forty-one percent of the physicians reported experience with ureterolithiasis guidelines. Seventy-two percent indicated that they use noncontrast CT scans for the diagnosis of lithiasis. All of the respondents prescribe hydration, primarily for the improvement of stone elimination (39.3%). The average number of drugs used was 3.5. The combination of nonsteroidal anti-inflammatory drugs and opioids was reported by 54% of the physicians (i. e., 59% of surgeons and 25.6% of clinicians used this combination of drugs) (p = 0.014). Only 21.3% prescribe alpha blockers. CONCLUSION: Reported experience with guidelines had little impact on several habitual practices. For example, only 21.3% of the respondents indicated that they prescribed alpha blockers; however, alpha blockers may increase stone elimination by up to 54%. Furthermore, although a meta-analysis demonstrated that hydration had no effect on the transit time of the stone or on the pain, the majority of the physicians reported that they prescribed more than 500 ml of fluid. Dipyrone, hyoscine, nonsteroidal anti-inflammatory drugs, and opioids were identified as the most frequently prescribed drug combination. The information regarding the time for the passage of urinary stones was inconsistent. The development of continuing education programs regarding ureteral colic in the emergency room is necessary.

An assessment of the business value of traceability practices in the italian fishery processing industry

Traceability is often perceived by food industry executives as an additional cost of doing business, one to be avoided if possible. However, a traceability system can in fact comply the regulatory requirements, increase food safety and recall performance, improving marketing performances and, as well as, improving supply chain management. Thus, traceability affects business performances of firms in terms of costs and benefits determined by traceability practices. Costs and benefits affect factors such as, firms’ characteristics, level of traceability and ,lastly, costs and benefits perceived prior to traceability implementation. This thesis was undertaken to understand how these factors are linked to affect the outcome of costs and benefits. Analysis of the results of a plant level survey of the Italian ichthyic processing industry revealed that processors generally adopt various level of traceability while government support appears to increase the level of traceability and the expectations and actual costs and benefits. None of the firms’ characteristics, with the exception of government support, influences costs and level of traceability. Only size of firms and level of QMS certifications are linked with benefits while precision of traceability increases benefits without affecting costs. Finally, traceability practices appear due to the request from “external“ stakeholders such as government, authority and customers rather than “internal” factors (e.g. improving the firm management) while the traceability system does not provide any added value from the market in terms of price premium or market share increase.

Educational mismathc in Italian an European labour markets (starting from the UK)

The present doctoral thesis is structured as a collection of three essays. The first essay, “SOC(HE)-Italy: a classification for graduate occupations” presents the conceptual basis, the construction, the validation and the application to the Italian labour force of the occupational classification termed SOC(HE)-Italy. I have developed this classification under the supervision of Kate Purcell during my period as a visiting research student at the Warwick Institute for Emplyment Research. This classification links the constituent tasks and duties of a particular job to the relevant knowledge and skills imparted via Higher Education (HE). It is based onto the SOC(HE)2010, an occupational classification first proposed by Kate Purcell in 2013, but differently constructed. In the second essay “Assessing the incidence and wage effects of overeducation among Italian graduates using a new measure for educational requirements” I utilize this classification to build a valid and reliable measure for job requirements. The lack of an unbiased measure for this dimension constitutes one of the major constraints to achieve a generally accepted measurement of overeducation. Estimations of overeducation incidence and wage effects are run onto AlmaLaurea data from the survey on graduates career paths. I have written this essay and obtained these estimates benefiting of the help and guidance of Giovanni Guidetti and Giulio Pedrini. The third and last essay titled “Overeducation in the Italian labour market: clarifying the concepts and addressing the measurement error problem” addresses a number of theoretical issues concerning the concepts of educational mismatch and overeducation. Using Istat data from RCFL survey I run estimates of the ORU model for the whole Italian labour force. In my knowledge, this is the first time ever such model is estimated on such population. In addition, I adopt the new measure of overeducation based onto the SOC(HE)-Italy classification.

'Listen, Rama’s Wife!’: Maithil Women’s Perspectives and Practices in the Festival of Sāmā-Cakevā

As a female-only festival in a significantly gender-segregated society, sāmā cakevā provides a window into Maithil women’s understandings of their society and the sacred, cultural subjectivities, moral frameworks, and projects of self-construction. The festival reminds us that to read male-female relations under patriarchal social formations as a dichotomy between the empowered and the disempowered ignores the porous boundaries between the two in which negotiations and tradeoffs create a symbiotic reliance. Specifically, the festival names two oppositional camps—the male world of law and the female world of relationships—and then creates a male character, the brother, who moves between the two, loyal to each, betraying, in a sense, each, but demonstrating, by his movements, the currents and avenues of power. This article makes available to other scholars of South Asian culture and society an extended description and analysis of this distinctive festival, while also contributing to the scholarly discussion of women’s expressive traditions.

Prevalence, motivations, and adverse effects of vaginal practices in Africa and Asia: findings from a multicountry household survey

Background: Women worldwide use various vaginal practices to clean or modify their vulva and vagina. Additional population-level information is needed on prevalence and motivations for these practices, characteristics of users, and their adverse effects. Methods: This was a household survey using multistage cluster sampling in Tete, Mozambique; KwaZulu-Natal, South Africa; Yogyakarta, Indonesia; and Chonburi, Thailand. In 2006–2007, vaginal practices and their motivations were examined using structured interviews with women 18–60 years of age (n=3610). Results: Prevalence, frequency, and motivations varied markedly. Two thirds of women in Yogyakarta and Chonburi reported one or more practices. In Yogyakarta, nearly half ingest substances with vaginal effects, and in Chonburi, external washing and application predominate. In Tete, half reported three or four current practices, and a quarter reported five or more practices. Labial elongation was near universal, and 92% of those surveyed cleanse internally. Two third's in KwaZulu-Natal practiced internal cleansing. Insertion of traditional solid products was rare in Chonburi and Yogyakarta, but one tenth of women in KwaZulu-Natal and nearly two thirds of women in Tete do so. Multivariate analysis of the most common practice in each site showed these were more common among less educated women in Africa and young urban women in Asia. Explicit sexual motivations were frequent in KwaZulu-Natal and Tete, intended for pleasure and maintaining partner commitment. Practices in Chonburi and Yogyakarta were largely motivated by femininity and health. Genital irritation was common at African sites. Conclusions: Vaginal practices are not as rare, exotic, or benign as sometimes assumed. Limited evidence of their biomedical consequences remains a concern; further investigation of their safety and sexual health implications is warranted.

Educational achievement in Swiss childhood cancer survivors compared with the general population

The objective of this study was to describe educational achievements of childhood cancer survivors in Switzerland compared with the general population. In particular, the authors investigated educational problems during childhood, final educational achievement in adulthood, and its predictors.

Toward a Global Organic Culture: Ethnographic Perspectives on Wwoofing Practices in Peru and New Zealand

In this thesis, I explore the meaning behind sustainable living among organic farmers and their families in two countries. It is based on original, ethnographic research that I conducted in New Zealand in fall 2012 and Peru in summer 2012 with support from the Department of Sociology and Anthropology Meerwarth Undergraduate Research Fund. In carrying out my research I relied on participant-observation, semi-structured interviews, focus groups, and writing ethnographic fieldnotes. Drawing on contemporary scholarship in the anthropology of food and the environment, my thesis contributes to cross-culturally understandings of sustainability and local and global foodways. Specifically, I will interpret the meaning and significance of my informants’ decision to live sustainably through their participation in wwoofing. The global network of wwoofing aims to connect volunteers interested in learning about organic farming techniques with farmers looking for labor assistance. Volunteers exchange work for food, accommodation, knowledge, and experience. As a method of farming and a subjective ideological orientation, this global movement allows travelers from all over the world to experience organic lifestyles worldwide. In my thesis, I connect my experiences of organic living in Peru and New Zealand. In comparing wwoofing practices in these two field sites, I argue that despite observable differences in organic practices, a global organic culture is emerging. Here I highlight some shared features of this global organic culture, such as food authenticity, sustainability of the earth, and a personal connection of individuals to the land. The global organic culture emphasizes a conscious awareness of what is going into one’s body and why. Using food as an expression of values and beliefs, organic farmers reconnect to the land and their food in attempts to construct an alternative identity. By focusing on food authenticity, my informants develop vast relationships with the land, which shapes their identity and creates new forms of self-enhancement.

Comparative Analysis of Educational Attainment in Transition Economies

The project compared several indicators of educational attainment across various groups of transition economies, and between transition economies and others. The indicators of education reflected both the quantity of schooling (e.g. average years of schooling, percentage not attending school at all, and adult literacy rates) and schooling quality (e.g. public expenditure on education, pupil-teacher ratios, repetition rates, dropout rates, and international test scores). The basic test used in the project was a t-test on differences in sample means. Among the transition economies, the indicators examined were most favourable for central European, high-income and advanced transition countries, although the differences between these countries and the remaining transition countries were not usually statistically significant. When compared with other world economies, the transition countries typically showed significantly better indicators than developing countries, but differences between transition and developed countries were not statistically significant. The project also examined the behaviour of the correlation coefficient between indicators of education and income, which, as expected, were usually positive.

Characterization of thermal and mechanical properties of polypropylene-based composites for fuel cell bipolar plates and development of educational tools in hydrogen and fuel cell technologies

In this project we developed conductive thermoplastic resins by adding varying amounts of three different carbon fillers: carbon black (CB), synthetic graphite (SG) and multi-walled carbon nanotubes (CNT) to a polypropylene matrix for application as fuel cell bipolar plates. This component of fuel cells provides mechanical support to the stack, circulates the gases that participate in the electrochemical reaction within the fuel cell and allows for removal of the excess heat from the system. The materials fabricated in this work were tested to determine their mechanical and thermal properties. These materials were produced by adding varying amounts of single carbon fillers to a polypropylene matrix (2.5 to 15 wt.% Ketjenblack EC-600 JD carbon black, 10 to 80 wt.% Asbury Carbon's Thermocarb TC-300 synthetic graphite, and 2.5 to 15 wt.% of Hyperion Catalysis International's FIBRILTM multi-walled carbon nanotubes) In addition, composite materials containing combinations of these three fillers were produced. The thermal conductivity results showed an increase in both through-plane and in-plane thermal conductivities, with the largest increase observed for synthetic graphite. The Department of Energy (DOE) had previously set a thermal conductivity goal of 20 W/m·K, which was surpassed by formulations containing 75 wt.% and 80 wt.% SG, yielding in-plane thermal conductivity values of 24.4 W/m·K and 33.6 W/m·K, respectively. In addition, composites containing 2.5 wt.% CB, 65 wt.% SG, and 6 wt.% CNT in PP had an in–plane thermal conductivity of 37 W/m·K. Flexural and tensile tests were conducted. All composite formulations exceeded the flexural strength target of 25 MPa set by DOE. The tensile and flexural modulus of the composites increased with higher concentration of carbon fillers. Carbon black and synthetic graphite caused a decrease in the tensile and flexural strengths of the composites. However, carbon nanotubes increased the composite tensile and flexural strengths. Mathematical models were applied to estimate through-plane and in-plane thermal conductivities of single and multiple filler formulations, and tensile modulus of single-filler formulations. For thermal conductivity, Nielsen's model yielded accurate thermal conductivity values when compared to experimental results obtained through the Flash method. For prediction of tensile modulus Nielsen's model yielded the smallest error between the predicted and experimental values. The second part of this project consisted of the development of a curriculum in Fuel Cell and Hydrogen Technologies to address different educational barriers identified by the Department of Energy. By the creation of new courses and enterprise programs in the areas of fuel cells and the use of hydrogen as an energy carrier, we introduced engineering students to the new technologies, policies and challenges present with this alternative energy. Feedback provided by students participating in these courses and enterprise programs indicate positive acceptance of the different educational tools. Results obtained from a survey applied to students after participating in these courses showed an increase in the knowledge and awareness of energy fundamentals, which indicates the modules developed in this project are effective in introducing students to alternative energy sources.