Pédiatrie. 1. Comment favoriser le développement de l'oralité en néonatologie [Pediatrics. How can we improve oral feeding in the neonatal intensive care unit?].

Preterm or sick neonates are frequently hampered in establishing a safe and efficient oral feeding. This can delay hospital discharge and impact on parent-child bonding, growth or neurodevelopment. Recent researches identified a pattern of interventions that could allow to reduce these troubles and to shorten hospital stays.

Cost-utility analysis of a three-month exercise programme vs usual care following multidisciplinary rehabilitation for chronic low back pain.

OBJECTIVE: To assess the cost-utility of an exercise programme vs usual care after functional multidisciplinary rehabilitation in patients with chronic low back pain. DESIGN: Cost-utility analysis alongside a randomized controlled trial. SUBJECTS/PATIENTS: A total of 105 patients with chronic low back pain. METHODS: Chronic low back pain patients completing a 3-week functional multidisciplinary rehabilitation were randomized to either a 3-month exercise programme (n = 56) or usual care (n = 49). The exercise programme consisted of 24 training sessions during 12 weeks. At the end of functional multidisciplinary rehabilitation and at 1-year follow-up quality of life was measured with the SF-36 questionnaire, converted into utilities and transformed into quality--adjusted life years. Direct and indirect monthly costs were measured using cost diaries. The incremental cost-effectiveness ratio was calculated as the incremental cost of the exercise programme divided by the difference in quality-adjusted life years between both groups. RESULTS: Quality of life improved significantly at 1-year follow-up in both groups. Similarly, both groups significantly reduced total monthly costs over time. No significant difference was observed between groups. The incremental cost-effectiveness ratio was 79,270 euros. CONCLUSION: Adding an exercise programme after functional multidisciplinary rehabilitation compared with usual care does not offer significant long-term benefits in quality of life and direct and indirect costs.

Whole-body vibration training: metabolic cost of synchronous, side-alternating or no vibrations.

Whole-body vibration training improves strength and can increase maximal oxygen consumption ([·V]O(2max)). No study has compared the metabolic demand of synchronous and side-alternating whole-body vibration. We measured [·V]O₂ and heart rate during a typical synchronous or side-alternating whole-body vibration session in 10 young female sedentary participants. The 20-min session consisted of three sets of six 45-s exercises, with 15 s recovery between exercises. Three conditions were randomly tested on separate days: synchronous at 35 Hz and 4 mm amplitude, side-alternating at 26 Hz and 7.5 mm amplitude (peak acceleration matched at 20 g in both vibration conditions), and no vibrations. Mean [·V]O₂ (expressed as %[·V]O(2max)) did not differ between conditions: 29.7 ± 4.2%, 32.4 ± 6.5%, and 28.7 ± 6.7% for synchronous, side-alternating, and no vibrations respectively (P = 0.103). Mean heart rate (% maximal heart rate) was 65.6 ± 7.3%, 69.8 ± 7.9%, and 64.7 ± 5.6% for synchronous, side-alternating, and no vibrations respectively, with the side-alternating vibrations being significantly higher (P = 0.019). When analysing changes over exercise sessions, mean [·V]O₂ was higher for side-alternating (P < 0.001) than for synchronous and no vibrations. In conclusion, side-alternating whole-body vibration elicits higher heart rate responses than synchronous or no vibrations, and could elevate [·V]O₂, provided the session lasts more than 20 min.

Traitement de l'asthme et de la rhinite durant la grossesse et l'allaitement [Treatment of asthma and rhinitis during pregnancy and breast feeding]

Inhaled therapies are preferred to systemic ones during pregnancy and breast feeding. A real paradox exists however between the necessity to ensure an optimal treatment for pregnant women with asthma, in order to prevent fetal hypoxia, and the precaution linked to any drug prescription during pregnancy. Thus, the use of topical corticosteroids remains the first choice for asthma as well as rhinitis. Inhaled beta2-agonists are also recommended. Systemic corticosteroids may however be prescribed without hesitation when their use is required for asthma treatment. It is also interesting to note that oral second-generation antihistamines are currently allowed during pregnancy and breast feeding. This type of antihistamines is indeed to be preferred to first-generation ones that generate more side-effects and generally are thus not to be prescribed during breast feeding.

Association between protein feeding and reproductive efficiency in the dairy cow : specific emphasis on protein feeding in Finland

Selostus: Lypsylehmien valkuaisruokinnan ja hedelmällisyyden yhteys: kirjallisuustutkimus valkuaisruokinnan vaikutuksista Suomen olosuhteissa

Effect of feeding level and diet type on the performance of crossbred suckler cows and their calves

Selostus: Ureoidun oljen soveltuvuus risteytysemojen talviruokintaan kahdella eri ruokintatasolla

Feeding levels during the growing phase affect the production of primiparous Finnish Landrace ewes

Selostus: Ruokinnan voimakkuuden vaikutus siitosuuhikaritsan tuotantoon

Does human capital stimulate investment in physical capital?: Evidence from a cost system framework

The direct effect of human capital on economic growth has been widely analysed in the economic literature. This paper, however, focuses on its indirect effect as a stimulus for private investment in physical capital. The methodological framework used is the duality theory, estimating a cost system aggregated with human capital. Empirical evidence is given for Spain for the period 1980-2000. We provide evidence on the indirect effect of human capital in making private capital investment more attractive. Among the main explanations forthis process, we observe that higher worker skill levels enable higher returns to be extracted from investment in physical capital.

Low-Cost Rural Surface Alternatives: Literature Review and Recommendations, TR-632, 2013

Freezing and thawing action induces damage to unbound gravel roads in Iowa resulting in maintenance costs for secondary road departments. Some approaches currently used by County Engineers to deal with this problem include temporarily spreading rock on the affected areas, lowering or improving drainage ditches, tiling, bridging the area with stone and geosynthetic covered by a top course of aggregate or gravel, coring boreholes and filling them with calcium chloride to melt lenses and provide drainage, and re-grading the crown to a slope of 4% to 6% to maximize spring drainage. However, most of these maintenance solutions are aimed at dealing with conditions after they occur. This study was tasked with identifying alternative approaches in the literature to mitigate the problem. An annotated bibliographic record of literature on the topic of frost-heave and thaw-weakening of gravel roads was generated and organized by topic, and all documents were assessed in terms of a suitable rating for mitigating the problem in Iowa. Over 300 technical articles were collected and selected down to about 150 relevant articles for a full assessment. The documents collected have been organized in an electronic database, which can be used as a tool by practitioners to search for information regarding the various repair and mitigation solutions, measurement technologies, and experiences that have been documented by selected domestic and international researchers and practitioners. Out of the 150+ articles, 71 articles were ranked as highly applicable to conditions in Iowa. The primary mitigation methods identified in this study included chemical and mechanical stabilization; scarification, blending, and recompaction; removal and replacement; separation, and reinforcement; geogrids and cellular confinement; drainage control and capillary barriers, and use of alternative materials. It is recommended that demonstration research projects be established to examine a range of construction methods and materials for treating granular surfaced roadways to mitigate frost-heave and thaw-weakening problems. Preliminary frost-susceptibility test results from ASTM D5916 are included for a range of Iowa materials.

Implementation of enhanced recovery after surgery (ERAS) in colorectal surgery is highly cost-effective

Objective: Enhanced Recovery After Surgery (ERAS) clinical pathways in¦colorectal surgery are known to reduce postoperative complications leading¦to shortened hospital stay. However, the implementation of such an ERAS¦pathway requires time and financial investment. This study evaluates whether¦the savings related to the reduction in the length of stay (LOS) outweigh the¦costs of implementing an ERAS pathway.¦Methods: An ERAS pathway was implemented in our institution for colorectal¦surgery. The first 50 consecutive patients subjected to this ERAS pathway¦(ERAS group) were compared to 50 consecutive patients that were operated one¦year before its introduction (control group). Primary LOS, readmission within¦30 days, and total costs based on costs per day were compared. The mean costs¦per day were: 3,263 CHF for intensive care, 1,152 CHF for intermediate care,¦and 728 CHF for basic care.¦Results: Primary LOS was shorter in the ERAS group than in the control¦group: median 7 (interquartile range 5-12·25) versus 10 (7-18) days (P =¦0·0025). The readmission within 30 postoperative days was similar in both¦groups (2 patients each). In the ERAS group, the added primary LOS was¦485 days (379 in basic care, 99 in intermediate care, 7 in intensive care) compared¦to 706 days in the control group (533 in basic care, 146 in intermediate care,¦27 in intensive care). The total costs were significantly lower for the 50 ERAS¦patients compared to the control group: 412,801 CHF versus 644,317 CHF (P <¦0·01). Investments required for the 50 first ERAS patients were approximately¦83,544 CHF, including 348 working hours as well a full-time ERAS dedicated¦nurse. The overall cost saving was approximately 2,959 CHF per patient.¦Conclusion: Implementation of an ERAS pathway significantly reduced LOS¦after colorectal surgery. The financial investment to introduce and maintain¦such a pathway is clearly inferior to the cost-saving of reduced hospital stay.

Low Cost Techniques of Base Stabilization, HR-312, 1994

This project was initiated in 1988 to study the effectiveness of four different construction techniques for establishing a stable base on a granular surfaced roadway. After base stabilization, the roadway was then seal coated, eliminating dust problems associated with granular surfaced roads. When monies become available, the roadway can be surfaced with a more permanent structure. A 2.8 mi (4.5 km) section of the Horseshoe Road in Dubuque County was divided into four divisions for this study. This report discusses the procedures used during construction of these different divisions. Problems and possible solutions have been analyzed to better understand the capabilities of the materials and construction techniques used on the project. The project had the following results: High structural ratings and soil K factors for the BIO CAT and Consolid bases did not translate to good roadway performance; the macadam base had the best overall performance; the tensar fabric had no noticeable effect on the macadam base; and the HFE-300 performed acceptably.

Low Cost Fly Ash - Sand Stabilized Roadway Des Moines County, HR-259, 1991

The objectives of this research were to develop a low cost fly ash-sand stabilized roadway and to correlate field performance with pavement design assumptions on a county road heavily trafficked by trucks hauling grain. The road was constructed during the summer of 1984. Three test sections comprised of different base thicknesses were incorporated in the roadway and were tested for compressive stength, structural rating, and rut depth. Annual crack surveys showed no appreciable difference in transverse cracking between the test sections and little to no rutting. The sandbase drainage characteristics beneath the roadway may have contributed to the satisfactory performance of the test sections. This project indicates that in spite of the inflated cost of construction due to the research nature of the work, a fly ash-sand base can be a viable alternative for roadway stabilization.

Low-cost microprocessed instrument for evaluating soil temperature profile

This paper describes a low-cost microprocessed instrument for in situ evaluating soil temperature profile ranging from -20.0°C to 99.9°C, and recording soil temperature data at eight depths from 2 to 128 cm. Of great importance in agriculture, soil temperature affects plant growth directly, and nutrient uptake as well as indirectly in soil water and gas flow, soil structure and nutrient availability. The developed instrument has potential applications in the soil science, when temperature monitoring is required. Results show that the instrument with its individual sensors guarantees ±0.25°C accuracy and 0.1°C resolution, making possible localized management changes within decision support systems. The instrument, based on complementary metal oxide semiconductor devices as well as thermocouples, operates in either automatic or non-automatic mode.

Evaluation of Gateway and Low-Cost Traffic-Calming Treatments for Major Routes in Small, Rural Communities, TR-523, 2007

Many rural communities have developed around highways or major county roads; as a result, the main street through small rural communities is often part of a high-speed rural highway. Highways and county roads are characterized by high speeds outside the city limits; they then transition into a reduced speed section through the rural community. Consequently, drivers passing through the community often enter at high speeds and maintain those speeds as they travel through the community. Traffic calming in small rural communities along major roadways is common in Europe, but the U.S. does not have experience with applying traffic-calming measures outside of major urban areas. The purpose of the project was to evaluate traffic-calming treatments on the major road through small Iowa communities using either single-measure low-cost or gateway treatments. The project was partially funded by the Iowa Highway Research Board (IHRB). The focus of the IHRB portion was to evaluate single-measure, low-cost, traffic-calming measures that are appropriate to major roads through small rural communities. Seven different low-cost traffic treatments were implemented and evaluated in five rural Iowa communities. The research evaluated the use of two gateway treatments in Union and Roland; five single-measure treatments (speed table, on-pavement “SLOW” markings, a driver speed feedback sign, tubular markers, and on-pavement entrance treatments) were evaluated in Gilbert, Slater, and Dexter.