La culture morale aux divers degrés de l'enseignement public / par Arthur Bauer,... ; avec extrait du rapport de M. Gabriel Compayré

Collection : Bibliothèque sociologique internationale ; 50

Blood samples drawn for culture as a surrogate marker for case-mix adjustment of hospital antibiotic use

Résumé de l'étude La surveillance de la prescription des antibiotiques en milieu hospitalier est une des mesures recommandées pour prévenir l'émergence de bactéries résistantes. La consommation d'antibiotiques est généralement exprimée en termes de DDD (defined daily dose) rapporté au taux d'occupation (jours patients). Cette mesure ne tient cependant pas compte de la variation de la casuistique d'un service au cours du temps. La consommation d'antibiotiques est influencée par l'incidence des infections, qui peut être saisonnière ou varier selon les circonstances épidémiologiques, ainsi que par les habitudes des médecins en termes de prescription. Une échelle de mesure adaptée à ces paramètres est donc capitale pour rendre compte de la consommation d'antibiotiques au sein d'un service et identifier de possibles dérivations dans les habitudes de prescriptions. Nous avons émis l'hypothèse que le nombre de demandes d'hémocultures pouvait servir d'indicateur de la charge infectieuse d'un service. Une analyse préliminaire a permis d'établir une bonne relation entre ce paramètre et l'incidence d'événements infectieux en comparaison à d'autres paramètres testés (nombre de prélèvements microbiologiques provenant de sites stériles ou nombre total de prélèvements microbiologiques). Sur la base de cette hypothèse, nous avons analysé la consommation d'antibiotiques d'une unité de médecine générale (Service de Médecine Interne du CHUV) sur seize trimestres consécutifs en comparant deux échelles de mesures : la méthode standard en DDD par jours patients et une échelle ajustée à la charge infectieuse (DDD par nombre de demandes d'hémocultures). L'échelle ajustée aux hémocultures a permis d'identifier trois trimestres avec une consommation anormalement élevée qui n'avaient pas été classés comme tels par l'échelle standard (consommation dans les normes en DDD par jours patients). Une analyse détaillée d'un de ces trimestres a confirmé une incidence d'infections moins élevée en comparaison à un trimestre de référence (proche de la norme selon les deux échelles), alors que la corrélation entre infections et demandes d'hémocultures était similaire pour les deux périodes. De même, l'échelle ajustée ä la charge infectieuse a démontré une consommation dans la norme pour un trimestre avec une consommation en apparence trop élevée selon l'échelle standard en raison d'une incidence d'infections plus élevée pour cette période. Cette étude a donc permis une identification plus performante et plus précise de périodes avec des dérivations dans la pratique de la prescription des antibiotiques en utilisant une échelle de mesure ajustée à la charge infectieuse d'un service au cours du temps. Nous avons démontré que le nombre d'hémocultures prélevées était un indicateur stable de la charge infectieuse dans un service de médecine générale. Ceci ne permet cependant pas de généraliser l'usage de cet indicateur pour tous les types de service. La pratique des hémocultures peut, en effet, varier d'une unité à l'autre, ou entres différentes institutions. ll convient donc de tester la validité de ce paramètre dans un service avant de l'appliquer.

Aminogenesis control in fermented sausages manufactured with pressurized meat batter and starter culture

The application of high hydrostatic pressure (200 MPa) to meat batter just before sausage fermentation and the inoculation of starter culture were studied to improve the safety and quality of traditional Spanish fermented sausages (fuet and chorizo). Higher amounts of biogenic amines were formed in chorizo than in fuet. Without interfering with the ripening performance in terms of acidification, drying and proteolysis, hydrostatic pressure prevented enterobacteria growth but did not affect Gram-positive bacteria significantly. Subsequently, a strong inhibition of diamine (putrescine and cadaverine) accumulation was observed, but that of tyramine was not affected. The inoculated decarboxylase-negative strains, selected from indigenous bacteria of traditional sausages, were resistant to the HHP treatment, being able to lead the fermentation process, prevent enterococci development and significantly reduce enterobacteria counts. In sausages manufactured with either non-pressurized or pressurized meat batter, starter culture was the most protective measure against the accumulation of tyramine and both diamines.

Assessment of high hydrostatic pressure and starter culture on the quality properties of low-acid fermented sausages

The addition of starter culture and high pressure processing after ripening improved the microbial quality of low-acid fermented sausages (fuet and chorizo). The use of Lactobacillus sakei CTC6626 and Staphylococcus xylosus CTC6013 as starter culture significantly reduced Enterobacteriaceae and Enterococcus levels in the finished sausages. Moreover, the addition of starter culture produced sausages of similar quality to traditional low-acid fermented sausages. Slightly lower pH values and higher cohesiveness were obtained for both fuet and chorizo with starter culture. Sensory analysis showed no differences between lots of chorizo whereas starter fuet was more acid and gummy. High pressure induced an additional reduction of Enterobacteriaceae in non-starter sausages. An increase of textural properties was observed after pressurization. No other differences were observed between non-treated and pressurized sausages.

Evolutionarily stable learning schedules and cumulative culture in discrete generation models.

Individual learning (e.g., trial-and-error) and social learning (e.g., imitation) are alternative ways of acquiring and expressing the appropriate phenotype in an environment. The optimal choice between using individual learning and/or social learning may be dictated by the life-stage or age of an organism. Of special interest is a learning schedule in which social learning precedes individual learning, because such a schedule is apparently a necessary condition for cumulative culture. Assuming two obligatory learning stages per discrete generation, we obtain the evolutionarily stable learning schedules for the three situations where the environment is constant, fluctuates between generations, or fluctuates within generations. During each learning stage, we assume that an organism may target the optimal phenotype in the current environment by individual learning, and/or the mature phenotype of the previous generation by oblique social learning. In the absence of exogenous costs to learning, the evolutionarily stable learning schedules are predicted to be either pure social learning followed by pure individual learning ("bang-bang" control) or pure individual learning at both stages ("flat" control). Moreover, we find for each situation that the evolutionarily stable learning schedule is also the one that optimizes the learned phenotype at equilibrium.

A Survey of Traffic Safety Culture Among Iowa Adults, TS-1101, 2012

Iowa’s traffic safety culture is influenced by laws and policies, enforcement methods, driver education, roadway engineering, and drivers’ behaviors. The Center for Social and Behavioral Research at the University of Northern Iowa was contracted by the Iowa Department of Transportation to conduct a general population survey of adult Iowans. Telephone interviews were conducted with 1,088 adult Iowans from October to December 2011. A dual-frame (cell phone and landline) sampling design was used. The interview covered a wide range of traffic safety topics (e.g., traffic safety policies, enforcement techniques, and distracted driving). Most Iowans said driving in Iowa is about as safe now as it was 5 years ago; however, one-fourth said driving in Iowa is less safe now. There are a number of driving-related behaviors many adult Iowans consider serious threats to traffic safety and never acceptable to do while driving. Yet, many Iowans report often seeing other drivers engaging in these behaviors and admit engaging in some themselves. For example, nearly 1 in 5 adult Iowa drivers said they have sent or read a text message or email while driving in the past 30 days despite this being prohibited since July of 2011. A slight majority said they support using cameras on highways, interstates, and city streets to automatically ticket drivers for speeding, with even stronger support for red light cameras. A comprehensive approach to traffic safety in Iowa is required to encourage protective factors that enhance traffic safety and reduce the impact of detrimental factors.

La Babele in cui viviamo. Traduzioni, riscritture, culture

Secondo Ludwig Wittgenstein occorre accettare come ovvia l'inconfrontabilità, e non la confrontabilità. E i due termini del confronto possibile o impossibile sono innanzi tutto le lingue. La traduzione svolge dunque una funzione decisiva nella vita del linguaggio. Nella traduzione le lingue si scambiano (e rubano) significati, rompono chiusura e provincialismo e comunicano la propria specifica forza significante. Silvana Borutti e Ute Heidmann riflettono sulla traduzione come esperienza di conoscenza, modello di rapporto tra lingue, letterature e culture, accesso conoscitivo, comunicativo e affettivo alla differenza. Si tratti di un testo o di un intero sistema simbolico, l'alterità non è mai un'entità data, bensì una forma dinamica che solo quando esce da sé riesce a misurare la complessità della propria relazione originaria di appartenenza e a realizzare il proprio potenziale di senso. Tradurre è allora un'operazione innovativa di attraversamento, trasmissione e metamorfosi. Per la vivibilità stessa del mondo, siamo sempre intenti a farlo: al limite, traduciamo noi a noi stessi, atto necessario per uscire dal narcisismo primario che ci trattiene in un orizzonte limitato e immediato.

Optimal culture incubation time in orthopedic device-associated infections: a retrospective analysis of prolonged 14-day incubation.

Accurate diagnosis of orthopedic device-associated infections can be challenging. Culture of tissue biopsy specimens is often considered the gold standard; however, there is currently no consensus on the ideal incubation time for specimens. The aim of our study was to assess the yield of a 14-day incubation protocol for tissue biopsy specimens from revision surgery (joint replacements and internal fixation devices) in a general orthopedic and trauma surgery setting. Medical records were reviewed retrospectively in order to identify cases of infection according to predefined diagnostic criteria. From August 2009 to March 2012, 499 tissue biopsy specimens were sampled from 117 cases. In 70 cases (59.8%), at least one sample showed microbiological growth. Among them, 58 cases (82.9%) were considered infections and 12 cases (17.1%) were classified as contaminations. The median time to positivity in the cases of infection was 1 day (range, 1 to 10 days), compared to 6 days (range, 1 to 11 days) in the cases of contamination (P < 0.001). Fifty-six (96.6%) of the infection cases were diagnosed within 7 days of incubation. In conclusion, the results of our study show that the incubation of tissue biopsy specimens beyond 7 days is not productive in a general orthopedic and trauma surgery setting. Prolonged 14-day incubation might be of interest in particular situations, however, in which the prevalence of slow-growing microorganisms and anaerobes is higher.

Harmonisation of short-term in vitro culture for the expansion of antigen-specific CD8(+) T cells with detection by ELISPOT and HLA-multimer staining.

Ex vivo ELISPOT and multimer staining are well-established tests for the assessment of antigen-specific T cells. Many laboratories are now using a period of in vitro stimulation (IVS) to enhance detection. Here, we report the findings of a multi-centre panel organised by the Association for Cancer Immunotherapy Immunoguiding Program to investigate the impact of IVS protocols on the detection of antigen-specific T cells of varying ex vivo frequency. Five centres performed ELISPOT and multimer staining on centrally prepared PBMCs from 3 donors, both ex vivo and following IVS. A harmonised IVS protocol was designed based on the best-performing protocol(s), which was then evaluated in a second phase on 2 donors by 6 centres. All centres were able to reliably detect antigen-specific T cells of high/intermediate frequency both ex vivo (Phase I) and post-IVS (Phase I and II). The highest frequencies of antigen-specific T cells ex vivo were mirrored in the frequencies following IVS and in the detection rates. However, antigen-specific T cells of a low/undetectable frequency ex vivo were not reproducibly detected post-IVS. Harmonisation of the IVS protocol reduced the inter-laboratory variation observed for ELISPOT and multimer analyses by approximately 20 %. We further demonstrate that results from ELISPOT and multimer staining correlated after (P < 0.0001 and R (2) = 0.5113), but not before IVS. In summary, IVS was shown to be a reproducible method that benefitted from method harmonisation.