Hurdles at work: perceptions of hospital food handlers

Abstract Background Food handlers have a very important role in preventing food contamination during its preparation and distribution. This responsibility is even greater in hospitals, since a large number of patients have low immunity and consequently food contamination by pathogenic bacteria could be particularly harmful. Therefore, a good working environment and periodic training should be provided to food handlers by upper management. Methods This study is qualitative research by means of focus group and thematic content analysis methodologies to examine, in detail, the statements by food handlers working in the milk and specific-diet kitchens in a hospital to understand the problems they face in the workplace. Results We found that food handlers are aware of the role they play in restoring patients' health; they consider it important to offer a good-quality diet. However, according to their perceptions, a number of difficulties prevent them from reaching this aim. These include: upper management not prioritizing human and material resources to the dietetic services when making resource allocation decisions; a perception that upper management considers their work to be of lesser importance; delayed overtime payments; lack of periodic training; managers lacking administrative skills; insufficient dietitian staff assistants, leading to overwork, at the same time as there is an excess of dietitians; unhealthy environmental working conditions – high temperature, high humidity, loud and constant noise level, poor ventilation; lack of food, and kitchen utensils and equipment; and relationship conflicts with chief dieticians and co-workers. Conclusion From these findings, improvement in staff motivation could be achieved by considering non-financial incentives, such as improvement in working conditions and showing appreciation and respect through supervision, training and performance appraisal. Management action, such as investments in intermediary management so that managers have the capacity to provide supportive supervision, as well as better use of performance appraisal and access to training, may help overcome the identified problems.

A light in the shadow: the use of Lucifer Yellow technique to demonstrate nectar reabsorption

Abstract Background Nectar reabsorption is a widely known phenomenon, related to the strategy of resource-recovery and also to maintain the nectar homeostasis at the nectary. The method currently performed to demonstrate nectar being reabsorbed involves the use of radioactive tracers applied to the nectary. Although this method works perfectly, it is complex and requires specific supplies and equipment. Therefore, here we propose an efficient method to obtain a visual demonstration of nectar reabsorption, adapting the use of Lucifer Yellow CH (LYCH), a fluorescent membrane-impermeable dye that can enter the vacuole by endocytosis. Results We applied a LYCH solution to the floral nectary (FN) of Cucurbita pepo L., which is a species known for its ability of nectar reabsorption, and to the extrafloral nectary (EFN) of Passiflora edulis Sims which does not reabsorb the secreted nectar. In all tests performed, we observed that LYCH stained the nectary tissues differentially according to the reabsorption ability of the nectary. The treated FN of C. pepo presented a concentrated fluorescence at the epidermis that decreased at the deeper nectary parenchyma, until reaching the vascular bundles, indicating nectar reabsorption in the flowers of the species. In contrast, treated EFN of P. edulis presented fluorescence only at the cuticle surface, indicating that nectar is not reabsorbed by that particular tissue. Conclusion LYCH is an efficient marker to demonstrate nectar reabsorption.

A rigorous approach to facilitate and guarantee the correctness of the genetic testing management in human genome information systems

Abstract Background Recent medical and biological technology advances have stimulated the development of new testing systems that have been providing huge, varied amounts of molecular and clinical data. Growing data volumes pose significant challenges for information processing systems in research centers. Additionally, the routines of genomics laboratory are typically characterized by high parallelism in testing and constant procedure changes. Results This paper describes a formal approach to address this challenge through the implementation of a genetic testing management system applied to human genome laboratory. We introduced the Human Genome Research Center Information System (CEGH) in Brazil, a system that is able to support constant changes in human genome testing and can provide patients updated results based on the most recent and validated genetic knowledge. Our approach uses a common repository for process planning to ensure reusability, specification, instantiation, monitoring, and execution of processes, which are defined using a relational database and rigorous control flow specifications based on process algebra (ACP). The main difference between our approach and related works is that we were able to join two important aspects: 1) process scalability achieved through relational database implementation, and 2) correctness of processes using process algebra. Furthermore, the software allows end users to define genetic testing without requiring any knowledge about business process notation or process algebra. Conclusions This paper presents the CEGH information system that is a Laboratory Information Management System (LIMS) based on a formal framework to support genetic testing management for Mendelian disorder studies. We have proved the feasibility and showed usability benefits of a rigorous approach that is able to specify, validate, and perform genetic testing using easy end user interfaces.

The double task of preventing malnutrition and overweight: a quasi-experimental community-based trial

Background: The Maternal-Child Pastoral is a volunteer-based community organization of the Dominican Republic that works with families to improve child survival and development. A program that promotes key practices of maternal and child care through meetings with pregnant women and home visits to promote child growth and development was designed and implemented. This study aims to evaluate the impact of the program on nutritional status indicators of children in the first two years of age. Methods: A quasi-experimental design was used, with groups paired according to a socioeconomic index, comparing eight geographical areas of intervention with eight control areas. The intervention was carried out by lay health volunteers. Mothers in the intervention areas received home visits each month and participated in a group activity held biweekly during pregnancy and monthly after birth. The primary outcomes were length and body mass index for age. Statistical analyses were based on linear and logistic regression models. Results: 196 children in the intervention group and 263 in the control group were evaluated. The intervention did not show statistically significant effects on length, but point estimates found were in the desired direction: mean difference 0.21 (95%CI −0.02; 0.44) for length-for-age Z-score and OR 0.50 (95%CI 0.22; 1.10) for stunting. Significant reductions of BMI-for-age Z-score (−0.31, 95%CI −0.49; -0.12) and of BMI-for-age > 85th percentile (0.43, 95%CI 0.23; 0.77) were observed. The intervention showed positive effects in some indicators of intermediary factors such as growth monitoring, health promotion activities, micronutrient supplementation, exclusive breastfeeding and complementary feeding. Conclusions: Despite finding effect measures pointing to effects in the desired direction related to malnutrition, we could only detect a reduction in the risk of overweight attributable to the intervention. The findings related to obesity prevention may be of interest in the context of the nutritional transition. Given the size of this study, the results are encouraging and we believe a larger study is warranted.

PReS-FINAL-2170: Work disability in adult patients with juvenile idiopathic arthritis (JIA)

Introduction Approximately 20% JIA patients enters adulthood with clinically active disease and disabled, therefore work condition may be affected. Objectives To assess the prevalence of work disability among adult patients with JIA regularly attending a tertiary heumatology center and to determine possible associated risk factors. Methods This was a cross-sectional study that enrolled 43 JIA patients according to 2004 revised ILAR criteria. A questionnaire was developed in order to evaluate working status and labor activity: occupation, current/previous work, employment status and withdrawal rate were actively searched. Demographic data, JIA characteristics, clinical activity (DAS28>2.6), therapeutic intervention, comorbidities, physical activity, sedentarism (WHO definitions), functional class (1991 ACR criteria), HAQ and SF-36 were recorded. The prevalence of work disability was calculated using 95% confidence interval, and compared to all parameters; qualitative variables were analyzed using tests of association (chi-square test) and quantitative variables by Mann-Whitney or student test. Results Patients' mean age was 29+7.4 yrs (range 19-41) with mean JIA duration = 17.2+12.3 yrs (range 3-33); 63% were males and 37% females. JIA subtypes were 64% polyarticular, 11% oligoarticular, 9% systemic, 9% ERA, 2% extended oligoarticular, 2% psoriatic arthritis; 7% had uveitis. Serum RF was positive in 21% and ANA in 21%. The majority (72%, n = 31) of JIA patients were employed, whereas 28% (n = 12) were currently not working. In the latter group, 83% (10/12) were retired due to JIA related disability. Further analysis comparing those currently working vs. Those not working revealed similar age (25,3 yrs vs.29,5 yrs, p = 0,09). Although not significantly, most patients currently working had Poly onset JIA (22 vs. 6 p = 0,37), higher frequencies of good education level >12 yrs of school (31 vs.9, p = 0,38), functional class I (p = 0,96), practiced regular physical activity (9 vs. 0, p = 0,89), were singles (26 vs. 8, p = 0,15). Both groups had comparable HAQ and DAS 28 scores (0,62 vs. 0.59, p = 0,47 and 2,51 vs.2,07, p = 0,64) and similar arthroplasty rate (8 vs. 4, p = 0,427). Frequencies of hypertension (3 vs.1, p = 0,999), dyslipidemia (1 vs. 1, p = 0,125), diabetes (1 vs. 0 p = 0,999), depression (1 vs. 0, p = 0,999) and smokers (3 vs. 1, p = 0,99) were alike in both groups. Remarkably, employed patients had higher SF 36 mental health component (84.0 vs. 70.42, P = 0.01). Conclusion High prevalence of almost 1/3 work disability and of retirement due to disease related incapacity remain major problems for adult JIA individuals. We also identified worse mental health in employed patients indicating that further research is needed, in addition to intense affirmative disability actions in order to remove possible disabling barriers and to adapt restrictive environments for these patients. Moreover, enhanced strategies and policy for inclusion of JIA patients in the job market is urged.

Architettura e verità. Emil Steffann architetto di chiese

La ricerca pone al suo centro lo studio dell'opera architettonica di Emil Steffann (1899-1968) la cui produzione realizzata consta, nel breve arco temporale che va dal 1950 al 1968, del ragguardevole numero di trentanove chiese, rappresentando un caso emblematico di progettazione e costruzione di edifici per il culto cristiano in grado di raffigurarne concretamente i principi fondativi liturgici, estetici e morfologici. L'architettura di Steffann, profondamente ispirata dallo spirito religioso, legata a figure primigenie che plasmano lo stare-insieme della comunità nella qualità corporea della materia, dove la presenza liturgica e monumentale si esprime nel silenzio e nella disponibilità di uno spazio circoscritto dai muri e direzionato dalla luce, concorre a definire nell'oggettivo amore per il vero la percezione estetico-teologica e la poetica formativa che connaturano, a nostro parere, progetto e segno della chiesa. Il testo concretizza il primo studio monografico completo di questo corpus architettonico e si basa sulla ricognizione diretta delle opere di Steffann; ne è derivata una narrazione non conseguente a un ordine cronologico o di presupposta importanza degli edifici, bensì che ricerca ed evidenzia corrispondenze tra nodi di una rete ideativa la quale, con diversi gradi di finitezza, in punti non sempre omogenei del tempo e dello spazio, denota un'esperienza autentica del comporre e del costruire. Il racconto individua gli oggetti architettonici, ne discute la consistenza aprendosi a riferimenti altri (in particolare il pensiero ecclesiologico-liturgico di Romano Guardini e quello estetico-teologico di Hans Urs von Balthasar) in grado di illuminarne la genesi e la manifestazione, li lega infine in sequenze analogiche. Una serie di tavole fotografiche originali, parte ineludibile e integrante della ricerca, testimonia dello stato attuale dei luoghi, connotando ulteriormente l'aspetto info-rappresentativo della loro composizione architettonica. In chiusura, la sintesi architetturale vuole essere uno strumento di verifica e progetto, quindi di trasposizione futura, correlato all'elaborazione documentaria.

Making research works visible and stimulating a research milieu in the field of social work - The European Resource Centre for Social Work Research (CERTS)

The project to create a European Resource Centre for Social Work Research (CERTS) has been agreed in December 2001 by the General Research Board of the European Commission within the framework programme 'Accompanying Measures for the improving the Human research potential and the Socio Economic Knowledge Base'.

Idiomatic Différance: Reflections on Intranslatability in the Works of Gerhard Richter

Translatability of a work of art, according to Walter Benjamin, is an essential ability to allow a translation to take on »a specific significance inherent in the original« so that it will retain a close relationship to the original. In contrast, Gerhard Richter's photo-based paintings show such an auratic significance of the original in its innate deficiency or intranslatability. As Rosemary Hawker puts it, the striking effect of blur in his paintings represents itself at once as a unique photographic idiom and a distinctive shortcoming of photography which impedes the medium from providing viewers with clearly perceivable images; the blur creates a site of différance in which both media come to a common understanding of one another’s idioms by telling what those idioms always fail to achieve. In this short essay, I will examine ways in which Richter’s photographic and pictorial works, including early monochrome paintings and recent abstract works based on microscopic photographs of molecular structures, attempt to untranslate photographic idioms in order to see painting’s (in)abilities simultaneously. In doing so, I intend to observe in the artist’s pictorial practice an actual phenomenon that the image can designate certain facts or truths only through its inherent plurality, faultiness, and partiality.

Idiomatic Différance: Reflections on Intranslatability in the Works of Gerhard Richter

Translatability of a work of art, according to Walter Benjamin, is an essential ability to allow a translation to take on »a specific significance inherent in the original« so that it will retain a close relationship to the original. In contrast, Gerhard Richter's photo-based paintings show such an auratic significance of the original in its innate deficiency or intranslatability. As Rosemary Hawker puts it, the striking effect of blur in his paintings represents itself at once as a unique photographic idiom and a distinctive shortcoming of photography which impedes the medium from providing viewers with clearly perceivable images; the blur creates a site of différance in which both media come to a common understanding of one another’s idioms by telling what those idioms always fail to achieve. In this short essay, I will examine ways in which Richter’s photographic and pictorial works, including early monochrome paintings and recent abstract works based on microscopic photographs of molecular structures, attempt to untranslate photographic idioms in order to see painting’s (in)abilities simultaneously. In doing so, I intend to observe in the artist’s pictorial practice an actual phenomenon that the image can designate certain facts or truths only through its inherent plurality, faultiness, and partiality.

Leader–member exchange (LMX), job autonomy, and creative work involvement

Researchers have claimed that high quality of supervisor–employee relationships (i.e., leader– member exchange; LMX) fosters creativity at work. Moreover, researchers have acknowledged that this relationship is not clear-cut but rather complex. The present study focused on the moderating role of job autonomy in the LMX-creative work involvement relationship. Longitu-dinal field survey data (N = 144) collected in a high-technology firm revealed a positive asso-ciation between LMX and creative work involvement and confirmed our assumptions on the moderating role of job autonomy. The positive relationship between LMX and creative work involvement was stronger when employees experienced greater job autonomy. Our findings point to the importance of considering the interplay of both, the leader–member relationship and job design issues for increasing employees' creative work involvement.

William Osler: Original Papers 1907-1919

Part 1: 1907-1908 The Royal Medical Society of Edinburg, 1907 On the Library of a Medical School, 1907 On Telangiectasis Circumscripta Universalis, 1907 A Clinical Lecture on Abdominal Tumours Associated with Disease of the Testicle, 1907 A Clinical Lecture on Erythraemia, 1908 Vienna after Thirty-Four Years, 1908 Endocardites Infectieuses Chroniques, 1908 Part 2: 1909 Chronic Infectious Endocarditis, 1909 What the Public Can Do in the Fight Against Tuberculosis, 1909 Annual Oration on the Occasion of the Opening of the New Building of the Medical and Chirurgical Faculty of the State of Maryland, May 13, 1909 The Medical Library in Post-Graduate Work, 1909 The Treatment of Disease, 1909 Part 3: 1910-1911 The Pupil Symptoms in Thoracic Aneurysm, 1910 The Lumleian Lectures on Angina Pectoris, 1910 Certain Vasomotor, Sensory, and Muscular Phenomena Associated with Cervical Rib, 1910 An Address on the Hospital Unit in University Work, 1911 Sulle Telangiectasie Emorragiche Ereditarie, 1911 Transient Attacks of Aphasia and Paralyses in States of High Blood Pressure and Arterio-Sclerosis, 1911 The Pathological Institute of a General Hospital, 1911 Part 4: 1912-1914 An Address on High Blood Pressure: its Associations, Advantages, and Disadvantages, 1912 Specialism in the General Hospital, 1913 Syphilis of the Liver with the Picture of Banti’s Disease, 1913 An Introductory Address on Examinations, Examiners, and Examinees, 1913 The Medical Clinic: a retrospect and a Forecast, 1914 Part 5: 1915-1919 Remarks on the Diagnosis of Polycystic Kidney, 1915 The War and Typhoid Fever, 1914/15 The Cerebro-Spinal Fever in Camps and Barracks, 1915 Remarks on Arterio-Venous Aneurysm, 1915 Nerve & “Nerves”, 1915 Intensive Work in Science at the Public Schools in Relation to the Curriculum, 1916 Creators, Transmuters, and Transmitters, 1916 Annual Oration on the Campaign Against Syphilis, 1917 The First Printed Documents relating to Modern Surgical Anaesthesia, 1918 Observations on the Severe Anaemias of Pregnancy and the Post-Partum State, 1919 Typhoid Spine, 1919

¿Dónde sucede la literatura? Libro, manuscrito y archivo en Manuel Puig y Mario Bellatin

El artículo problematiza la noción de literatura ligada a la cultura del libro, a través del enfoque geneticista y de las obras de dos autores. Manuel Puig que, desde un proyecto creador ligado a la cultura del libro, abrió las fronteras de la intertextualidad hacia la intermedialidad; y Mario Bellatin, cuya obra excede la noción de libro cerrado en tanto cada uno de sus libros reformula y reconstituye fragmentos textuales que pueden aparecer en otros libros. La noción de archivo, vista como máquina social de lectura y de construcción de memoria, puede ser útil para comprender las nuevas propuestas estéticas y revisar otras más tradicionales

¿Dónde sucede la literatura? Libro, manuscrito y archivo en Manuel Puig y Mario Bellatin

El artículo problematiza la noción de literatura ligada a la cultura del libro, a través del enfoque geneticista y de las obras de dos autores. Manuel Puig que, desde un proyecto creador ligado a la cultura del libro, abrió las fronteras de la intertextualidad hacia la intermedialidad; y Mario Bellatin, cuya obra excede la noción de libro cerrado en tanto cada uno de sus libros reformula y reconstituye fragmentos textuales que pueden aparecer en otros libros. La noción de archivo, vista como máquina social de lectura y de construcción de memoria, puede ser útil para comprender las nuevas propuestas estéticas y revisar otras más tradicionales

¿Dónde sucede la literatura? Libro, manuscrito y archivo en Manuel Puig y Mario Bellatin

El artículo problematiza la noción de literatura ligada a la cultura del libro, a través del enfoque geneticista y de las obras de dos autores. Manuel Puig que, desde un proyecto creador ligado a la cultura del libro, abrió las fronteras de la intertextualidad hacia la intermedialidad; y Mario Bellatin, cuya obra excede la noción de libro cerrado en tanto cada uno de sus libros reformula y reconstituye fragmentos textuales que pueden aparecer en otros libros. La noción de archivo, vista como máquina social de lectura y de construcción de memoria, puede ser útil para comprender las nuevas propuestas estéticas y revisar otras más tradicionales

Probability sampling protocol of classification maps from spaceborne/airborne image

To deliver sample estimates provided with the necessary probability foundation to permit generalization from the sample data subset to the whole target population being sampled, probability sampling strategies are required to satisfy three necessary not sufficient conditions: (i) All inclusion probabilities be greater than zero in the target population to be sampled. If some sampling units have an inclusion probability of zero, then a map accuracy assessment does not represent the entire target region depicted in the map to be assessed. (ii) The inclusion probabilities must be: (a) knowable for nonsampled units and (b) known for those units selected in the sample: since the inclusion probability determines the weight attached to each sampling unit in the accuracy estimation formulas, if the inclusion probabilities are unknown, so are the estimation weights. This original work presents a novel (to the best of these authors' knowledge, the first) probability sampling protocol for quality assessment and comparison of thematic maps generated from spaceborne/airborne Very High Resolution (VHR) images, where: (I) an original Categorical Variable Pair Similarity Index (CVPSI, proposed in two different formulations) is estimated as a fuzzy degree of match between a reference and a test semantic vocabulary, which may not coincide, and (II) both symbolic pixel-based thematic quality indicators (TQIs) and sub-symbolic object-based spatial quality indicators (SQIs) are estimated with a degree of uncertainty in measurement in compliance with the well-known Quality Assurance Framework for Earth Observation (QA4EO) guidelines. Like a decision-tree, any protocol (guidelines for best practice) comprises a set of rules, equivalent to structural knowledge, and an order of presentation of the rule set, known as procedural knowledge. The combination of these two levels of knowledge makes an original protocol worth more than the sum of its parts. The several degrees of novelty of the proposed probability sampling protocol are highlighted in this paper, at the levels of understanding of both structural and procedural knowledge, in comparison with related multi-disciplinary works selected from the existing literature. In the experimental session the proposed protocol is tested for accuracy validation of preliminary classification maps automatically generated by the Satellite Image Automatic MapperT (SIAMT) software product from two WorldView-2 images and one QuickBird-2 image provided by DigitalGlobe for testing purposes. In these experiments, collected TQIs and SQIs are statistically valid, statistically significant, consistent across maps and in agreement with theoretical expectations, visual (qualitative) evidence and quantitative quality indexes of operativeness (OQIs) claimed for SIAMT by related papers. As a subsidiary conclusion, the statistically consistent and statistically significant accuracy validation of the SIAMT pre-classification maps proposed in this contribution, together with OQIs claimed for SIAMT by related works, make the operational (automatic, accurate, near real-time, robust, scalable) SIAMT software product eligible for opening up new inter-disciplinary research and market opportunities in accordance with the visionary goal of the Global Earth Observation System of Systems (GEOSS) initiative and the QA4EO international guidelines.