938 resultados para Requests


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This article presents the data-rich findings of an experiment with enlisting patron-driven/demand-driven acquisitions (DDA) of ebooks in two ways. The first experiment entailed comparison of DDA eBook usage against newly ordered hardcopy materials’ circulation, both overall and ebook vs. print usage within the same subject areas. Secondly, this study experimented with DDA ebooks as a backup plan for unfunded requests left over at the end of the fiscal year.

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This article presents the data-rich findings of an experiment with enlisting patron-driven/demand-driven acquisitions (DDA) of ebooks in two ways. The first experiment entailed comparison of DDA eBook usage against newly ordered hardcopy materials’ circulation, both overall and ebook vs. print usage within the same subject areas. Secondly, this study experimented with DDA ebooks as a backup plan for unfunded requests left over at the end of the fiscal year.

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Background: The identification of patterns of inappropriate antimicrobial prescriptions in hospitals contributes to the improvement of antimicrobial stewardship programs (ASP). Methods: We conducted a cross-sectional study to identify predictors of inappropriateness in requests for parenteral antimicrobials (RPAs) in a teaching hospital with 285 beds. We reviewed 25% of RPAs for therapeutic purposes from y 2005. Appropriateness was evaluated according to current guidelines for antimicrobial therapy. We assessed predictors of inappropriateness through univariate and multivariate models. RPAs classified as 'appropriate' or 'probably appropriate' were selected as controls. Case groups comprised inappropriate RPAs, either in general or for specific errors. Results: Nine hundred and sixty-three RPAs were evaluated, 34.6% of which were considered inappropriate. In the multivariate analysis, general predictors of inappropriateness were: prescription on week-ends/holidays (odds ratio (OR) 1.67, 95% confidence interval (CI) 1.20-2.28, p = 0.002), patient in the intensive care unit (OR 1.57, 95% CI 1.11-2.23, p = 0.01), peritoneal infection (OR 2.15, 95% CI 1.27-3.65, p = 0.004), urinary tract infection (OR 1.89, 95% CI 1.25 -2.87, p = 0.01), combination therapy with 2 or more antimicrobials (OR 1.72, 95% CI 1.15-2.57, p = 0.008) and prescriptions including penicillins (OR 2.12, 95% CI 1.39-3.25, p = 0.001) or 1(st) generation cephalosporins (OR 1.74, 95% CI 1.01-3.00, p = 0.048). Previous consultation with an infectious diseases (ID) specialist had a protective effect against inappropriate prescription (OR 0.34, 95% CI 0.24-0.50, p < 0.001). Factors independently associated with specific prescription errors varied. However, consultation with an ID specialist was protective against both unnecessary antimicrobial use (OR 0.04, 95% CI 0.01-0.26, p = 0.001) and requests for agents with an insufficient antimicrobial spectrum (OR 0.14, 95% CI 0.03-0.30, p = 0.01). Conclusions: Our results demonstrate the importance of previous consultation with an ID specialist in assuring the quality of prescriptions. Also, they highlight prescription patterns that should be approached by ASP policies.

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As a consequence of domestication, dogs have a special readiness for communication with humans. We here investigate whether a dog might be able to acquire and consistently produce a set of arbitrary signs in her communication with humans, as was demonstrated in ""linguistic"" individuals of several species. A female mongrel dog was submitted to a training schedule in which, after basic command training and after acquiring the verbal labels of rewarding objects or activities, she learned to ask for such objects or activities by selecting lexigrams and pressing keys on a keyboard. Systematic records taken during spontaneous interaction with one of the experimenters showed that lexigrams were used in an appropriate, intentional way, in accordance with the immediate motivational context. The dog only utilized the keyboard in the experimenter`s presence and gazed to him more frequently after key pressing than before, an indication that lexigram use did have communicative content. Results suggest that dogs may be able to learn a conventional system of signs associated to specific objects and activities, functionally analogous to spontaneous soliciting behaviors and point to the potential fruitfulness of the keyboard/lexigram procedure for studying dog communication and cognition. This is the first report to systematically analyze the learning of arbitrary sign production in dogs.

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Introduction C-reactive protein (CRP) levels rise during inflammatory processes and have been ordered for rheumatic disease follow-up since the 1950s. The number of tests ordered in the emergency setting has increased, but without evident improvement in medical care quality. Objective To determine the pattern of CRP determinations in the emergency department (ED) of a university hospital in Sao Paulo, Brazil, and to evaluate the effect of an intervention with staff and students about the best use of the test in the ED. Methods Data regarding CRP testing requests, related diagnoses and the number of monthly consultations in the hospital ED were analysed before and after the intervention. Because of an increase in CRP measurement requests from 2007 to 2009, the author started discussing the role of CRP determinations in the medical decision-making process in early 2010. Staff and faculty members openly discussed the pattern of requests in the hospital and related current medical literature. During 2010, the medical staff worked as multipliers to change the behaviour of new students and residents. The results of the first 4 months after the intervention were presented at another general meeting in July 2010. Results From 2007 to 2009, there were 11 786 CRP measurement requests with a clear exponential trend. After the intervention, during the calendar year 2010, there was a 48% reduction in adjusted annual CRP requests. Pneumonia, fever and urinary tract infections were the most common reasons for CRP requests. Discussion Inexpensive, well-directed, interactive educational interventions may affect professional behaviour and curb rates of laboratory tests.

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The central aim of our project is to explore the handling of e-mail request from customers by tourist organisations and to explain the perceived behaviour. For this purpose, we designed a qualitative empirical study which consists basically of two stages. The first stage consists of a black-box test where we employ the setting of a qualitative experiment to measure the behaviour of the organisation to an e-mail request. The second stage comprises a with-box test where we want to look into the tourist organizations and analyse the relevant information processes. This study should give as some insight in the internal processing of e-mail requests and thus should help to explain the reactions that we registered.

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One important steps in a successful project-based-learning methodology (PBL) is the process of providing the students with a convenient feedback that allows them to keep on developing their projects or to improve them. However, this task is more difficult in massive courses, especially when the project deadline is close. Besides, the continuous evaluation methodology makes necessary to find ways to objectively and continuously measure students' performance without increasing excessively instructors' work load. In order to alleviate these problems, we have developed a web service that allows students to request personal tutoring assistance during the laboratory sessions by specifying the kind of problem they have and the person who could help them to solve it. This service provides tools for the staff to manage the laboratory, for performing continuous evaluation for all students and for the student collaborators, and to prioritize tutoring according to the progress of the student's project. Additionally, the application provides objective metrics which can be used at the end of the subject during the evaluation process in order to support some students' final scores. Different usability statistics and the results of a subjective evaluation with more than 330 students confirm the success of the proposed application.

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The interaction between globally available information and public library users is a changing one. Global information is readily available yet provider and user struggle to find efficiencies of time and resources. As a primary resource of global information the Denver Public Library (DPL) is approaching this challenge by providing changing technology to a changing user and by providing a customized approach to immigrant populations. DPL provides global information to library users through collections, programs and Internet. Internet and collections global information usage cannot be directly measured due to privacy restrictions. Only 12.5% of general user programs focus on global information. Four percent of budget serves the immigrant users. This is greater than national averages.