Predictors of incorrectness in antimicrobial prescription in the Bauru State Hospital (Bauru city, São Paulo State, Brazil)

The inappropriate use of antimicrobials in hospitals presents a negative impact on patient outcome and is associated with the emergence and spread of multidrug-resistant microorganisms. Antimicrobial stewardship programs (ASPs) have been instituted in order to improve the quality of prescriptions in hospitals. In this setting, the identification of patterns of inappropriate antimicrobial prescription is a valuable tool that allows ASPs to identify priorities for directing educative/restrictive policies. With this purpose, a study was conducted in the Bauru State Hospital, a teaching hospital with 285 beds affiliated to the Botucatu Medical School, São Paulo State University. The hospital maintains an active ASP since it was opened, in 2002. We selected 25% of the requests for parenteral antimicrobials (RPAs) from 2005 for analysis. Prescriptions for prophylactic purposes were excluded. All other RPAs were classified according to a modified Kunin and Jones categories. Univariate and multivariable analyses were performed to identify predictors of general inappropriateness and of specific prescription errors. Prescriptions classified as "appropriate'' or "probably appropriate" were selected as controls in all stages of the study. Among 963 RPAs included in our study, 34.6% were inappropriate. General predictors of inappropriateness were: prescription on weekends/holidays (OR = 1.67, 95% CI = 1.20-2.28, p = 0.002), patient from intensive care unit (OR = 1.57, 95% CI = 1.11-2.23, p = 0.01), peritoneal (OR = 2.15, 95% CI = 1.27-3.65, p = 0.004) or urinary tract infection (OR = 1.89, 95% CI = 1.25-2.87, p = 0.002), combined therapy with two or more antimicrobials (OR = 1.72, 95% CI = 1.15-2.57, p = 0.008) and prescriptions including penicillin (OR = 2.12, 95% CI = 1.39-3.25, p = 0.001) or first-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 insufficient spectrum (OR = 0.14, 95% CI = 0.03-0.30, p = 0.01). In conclusion, the analysis of factors predictive of inappropriateness in antimicrobial prescription allowed us to identify issues requiring intervention. Also, it provided a positive feedback of the ASP efficacy, demonstrating the importance of previous consultation with an ID specialist to assure the quality of antimicrobial prescriptions.

Knowledge Representation and Orthophemism: A Reflection Aiming to a Concept

Characteristics of speech, especially figures of speech, are used by specific communities or domains, and, in this way, reflect their identities through their choice of vocabulary. This topic should be an object of study in the context of knowledge representation once it deals with different contexts of production of documents. This study aims to explore the dimensions of the concepts of euphemism, dysphemism, and orthophemism, focusing on the latter with the goal of extracting a concept which can be included in discussions about subject analysis and indexing. Euphemism is used as an alternative to a non-preferred expression or as an alternative to an offensive attribution-to avoid potential offense taken by the listener or by other persons, for instance, pass away. Dysphemism, on the other hand, is used by speakers to talk about people and things that frustrate and annoy them-their choice of language indicates disapproval and the topic is therefore denigrated, humiliated, or degraded, for instance, kick the bucket. While euphemism tries to make something sound better, dysphemism tries to make something sound worse. Orthophemism (Allan and Burridge 2006) is also used as an alternative to expressions, but it is a preferred, formal, and direct language of expression when representing an object or a situation, for instance, die. This paper suggests that the comprehension and use of such concepts could support the following issues: possible contributions from linguistics and terminology to subject analysis as demonstrated by Talamo et al. (1992); decrease of polysemy and ambiguity of terms used to represent certain topics of documents; and construction and evaluation of indexing languages. The concept of orthophemism can also serves to support associative relationships in the context of subject analysis, indexing, and even information retrieval related to more specific requests.

Unbalanced Three-Phase Induction Motors Starting and Arc Welding Machines Short-Circuit Modeling

Three-Phase Induction Motors (TIM) and Arc Welding Machines (AWM) are loads of special behavior widely used in industrial and commercial installations, and therefore may contribute significantly to the deterioration of the quality of energy supplied by utilities. This paper proposes a modeling in constant power of the unbalanced TIM starting using Genetic Algorithm (GA) and AWM short-circuit based on their statics characteristics curves. The proposed models are compared with the conventional models in the literature. The results showed the good performance of the proposed models, allowing a more precise analysis of the real requests of these loads.

Variação temporal da resistividade elétrica em contaminação por gasolina

The definition of models and base parameters for application of investigation tools in environment with high complexity are a basic premise to any sciences. The geophysics is a science with solid theoretical base and applications in diversified areas of the sciences geological, astronomical, meteorological, among many others. Its application in environmental studies is relatively recent and needs further research. To understand the behavior of resident contaminants in a dynamic and complex environment as the geological, it requests studies in scale laboratorial, under control of factors seasonality variable. This work simulates a leak of gasoline in soil, under conditions and in laboratory scale, with the objective of monitoring the temporary behavior of the hydrocarbon under the optics of variation of the parameter physical electric resistivity. The results indicate increase of the resistivity in recent periods the contamination, followed for stability in the values and finally fall and return tendency to the natural conditions.

Efficiency and portability: Guidelines to develop websites

The use of the Internet as a means of ensuring greater visibility for products, services and information offered by companies is gaining strength in recent decades. However, it is known that to ensure satisfaction and subsequent virtual customer loyalty, it is necessary to guarantee the quality of the websites, allowing indiscriminate access regardless of the resources used, as well as rapid responses to possible requests. In order to assist this process, this paper presents a set of guidelines for the development of websites having quality characteristics, efficiency and portability as per ISO 9126 norms. An observational analysis of e-commerce websites was done which showed that they are inadequate as to the proposed guidelines, making them difficult to access available content. Therefore, the adoption of the proposed guidelines can greatly contribute to increasing the quality of websites and, consequently, enable quick and effective access regardless of the resources used.

Avaliação do tratamento com cefquinoma associada a curetagem em bovinos acometidos de processos sépticos podais profundos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Subregional preparations for the 2004 international meeting that will undertake a full and comprehensive review of the implementation of the SIDS POA to ensure the most effective participation of Caribbean SIDS

In Part XV (Implementation Monitoring and Review);, of the Programme of Action of Small Island Developing States (SIDS POA);, which was adopted at the United Nations Global Conference on the Sustainable Development of Small Island Developing States (UNGCSIDS);, 26 April- 6 May 1994, in its paragraph 117, it is provided that the Commission on Sustainable Development (CSD); should, inter alia: Carry out an initial review of the progress achieved and steps taken to implement the Programme of Action, to be undertaken by the Commission on Sustainable Development in 1996 in accordance with its Multi-Year Thematic Programme of Work. Furthermore, in 1997, when the Commission will carry out the overall review of Agenda 21 with a view to preparing for the 1997 special session of the General Assembly, the Commission should recommend specific modalities for the full review of the Programme of Action in 1999. That full review would include the question of the convening of a second global conference in accordance with chapter 17, Section G of Agenda 21. At the twenty-second special session which convened on 27-28 September 1999 to undertake a "review and appraisal of the implementation of the Programme of Action for the Sustainable Development of Small Island Developing States", it was recommended, inter alia, that: "Although periodic reviews of certain aspects of the Programme of Action are envisaged within the context of the work of the Commission on Sustainable Development, a full and comprehensive review of these decisions and the implementation of the Programme of Action would be useful and required in 2004." In the Plan of Implementation adopted at the World Summit on Sustainable Development (WSSD);, which convened in Johannesburg, South Africa, over the period, 26 August-4 Septemeber 2002, the relevant recommendation was as follows: "Undertake a full and comprehensive review of the implementation of the Barbados Programme of Action for the Sustainable Development of Small Island Developing States in 2004, in accordance with the provisions set forth in General Assembly resolution S-22/2, and in this context requests the General Assembly at its fifty-seventh session to consider convening an international meeting for the sustainable development of small island developing States."

Preditores de incorreçao na prescrição de antimicrobianos no Hospital Estadual Bauru (Bauru, São Paulo)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Alfabetização: dinâmica das práticas didáticas e as interações das crianças com a linguagem escrita

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Projeto Veredas: a experiência de formação a distância, proposta pelo governo de Minas Gerais como parte das políticas atuais para a formação de professores no Brasil

Pós-graduação em Educação - IBRC

Desenvolvimento de sistema computacional para pré-dimensionamento de turbinas para micro, mini e pequenas centrais hidrelétricas

Pós-graduação em Agronomia (Energia na Agricultura) - FCA

O faz-de-conta como atividade promotora de desenvolvimento infantil e algumas contribuições acerca de suas implicações para aprender a ler e escrever

Pós-graduação em Educação - FFC

Envolvimento dos usuários no processo de inovação por meio da web 2.0: um estudo de caso na indústria automobilística

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Análise da influência dos fatores posicionais na flexibilidade de uma rede do setor de calçados infantis

Pós-graduação em Engenharia de Produção - FEB

Produção, comércio e tensões nas vilas do norte da capitania de São Paulo (1788-1808)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)