Antibiotic Therapy for Very Low BirthWeigh Newborns in NICU

Background: Prolonged empiric antibiotics therapy in neonates results in several adverse consequences including widespread antibiotic resistance, late onset sepsis (LOS), necrotizing enterocolitis (NEC), prolonged hospital course (HC) and increase in mortality rates. Objectives: To assess the risk factors and the outcome of prolonged empiric antibiotic therapy in very low birth weight (VLBW) newborns. Materials and Methods: Prospective study in VLBW neonates admitted to NICU and survived > 2 W, from July 2011 - June 2012. All relevant perinatal and postnatal data including duration of antibiotics therapy (Group I < 2W vs Group II > 2W) and outcome up to the time of discharge or death were documented and compared. Results: Out of 145 newborns included in the study, 62 were in group I, and 83 in Group II. Average duration of antibiotic therapy was 14 days (range 3 - 62 days); duration in Group I and Group II was 102.3 vs 25.510.5 days. Hospital stay was 22.311.5 vs 44.3 14.7 days, respectively. Multiple regression analysis revealed following risk factors as significant for prolonged empiric antibiotic therapy: VLBW especially < 1000 g, (P < 0.001), maternal Illness (P = 0.003), chorioamnionitis (P = 0.048), multiple pregnancy (P = 0.03), non-invasive ventilation (P < 0.001) and mechanical ventilation (P < 0.001). Seventy (48.3%) infants developed LOS; 5 with NEC > stage II, 12 (8.3%) newborns died. Infant mortality alone and with LOS/NEC was higher in group II as compared to group I (P < 0.002 and < 0.001 respectively). Conclusions: Prolonged empiric antibiotic therapy caused increasing rates of LOS, NEC, HC and infant mortality

Diagnóstico ecotoxicológico dos efluentes lançados no complexo estuarino do Jundiaí/Potengi, Natal/RN

Untreated effluents that reach surface water affect the aquatic life and humans. This study aimed to evaluate the wastewater s toxicity (municipal, industrial and shrimp pond effluents) released in the Estuarine Complex of Jundiaí- Potengi, Natal/RN, through chronic quantitative e qualitative toxicity tests using the test organism Mysidopsis Juniae, CRUSTACEA, MYSIDACEA (Silva, 1979). For this, a new methodology for viewing chronic effects on organisms of M. juniae was used (only renewal), based on another existing methodology to another testorganism very similar to M. Juniae, the M. Bahia (daily renewal).Toxicity tests 7 days duration were used for detecting effects on the survival and fecundity in M. juniae. Lethal Concentration 50% (LC50%) was determined by the Trimmed Spearman-Karber; Inhibition Concentration 50% (IC50%) in fecundity was determined by Linear Interpolation. ANOVA (One Way) tests (p = 0.05) were used to determinate the No Observed Effect Concentration (NOEC) and Low Observed Effect Concentration (LOEC). Effluents flows were measured and the toxic load of the effluents was estimated. Multivariate analysis - Principal Component Analysis (PCA) and Correspondence Analysis (CA) - identified the physic-chemical parameters better explain the patterns of toxicity found in survival and fecundity of M. juniae. We verified the feasibility of applying the only renewal system in chronic tests with M. Juniae. Most efluentes proved toxic on the survival and fecundity of M. Juniae, except for some shrimp pond effluents. The most toxic effluent was ETE Lagoa Aerada (LC50, 6.24%; IC50, 4.82%), ETE Quintas (LC50, 5.85%), Giselda Trigueiro Hospital (LC50, 2.05%), CLAN (LC50, 2.14%) and COTEMINAS (LC50, IC50 and 38.51%, 6.94%). The greatest toxic load was originated from ETE inefficient high flow effluents, textile effluents and CLAN. The organic load was related to the toxic effects of wastewater and hospital effluents in survival of M. Juniae, as well as heavy metals, total residual chlorine and phenols. In industrial effluents was found relationship between toxicity and organic load, phenols, oils and greases and benzene. The effects on fertility were related, in turn, with chlorine and heavy metals. Toxicity tests using other organisms of different trophic levels, as well as analysis of sediment toxicity are recommended to confirm the patterns found with M. Juniae. However, the results indicate the necessity for implementation and improvement of sewage treatment systems affluent to the Potengi s estuary

Comunidades zooplanctônicas como bioindicadoras da qualidade da água de quatro reservatórios da região semi-árida do Rio Grande do Norte

The response of zooplankton assemblages to variations in the water quality of four man-made lakes, caused by eutrophication and siltation, was investigated by means of canonical correspondence analysis. Monte Carlo simulations using the CCA eingenvalues as test statistics revealed that changes in zooplankton species composition along the environmental gradients of trophic state and abiogenic turbidity were highly significant. The species Brachionus calyciflorus, Thermocyclops sp. and Argyrodiaptomus sp. were good indicators of eutrophic conditions while the species Brachionus dolabratus, Keratella tropica and Hexarthra sp. were good indicators of high turbidity due to suspended sediments. The rotifer genus Brachionus was the most species-rich taxon, comprising five species which were associated with different environmental conditions. Therefore, we tested whether this genus alone could potentially be a better biological indicator of these environmental gradients than the entire zooplankton assemblages or any other random set of five species. The ordination results show that the five Brachionus species alone did not explain better the observed pattern of environmental variation than most random sets of five species. Therefore, this genus could not be selected as a target taxon for more intensive environmental monitoring as has been previously suggested by Attayde and Bozelli (1998). Overall, our results show that changes in the water quality of man-made lakes in a tropical semi-arid region have significant effects on the structure of zooplankton assemblages that can potentially affect the functioning of these ecosystems

Retinal tissue thickness is reduced in diabetic peripheral neuropathy

AIM: To investigate the relationship between diabetic peripheral neuropathy (DPN) and retinal tissue thickness.

METHODS: Full retinal thickness in the central retinal, parafoveal, and perifoveal zones and thickness of the ganglion cell complex and retinal nerve fiber layer (RNFL) were assessed in 193 individuals (84 with type 1 diabetes, 67 with type 2 diabetes, and 42 healthy controls) using spectral domain optical coherence tomography. Among those with diabetes, 44 had neuropathy defined using a modified neuropathy disability score recorded on a 0-10 scale. Multiple regression analysis was performed to investigate the relationship between diabetic neuropathy and retinal tissue thickness, adjusted for the presence of diabetic retinopathy (DR), age, sex, duration of diabetes, and HbA1c levels.

RESULTS: In individuals with diabetes, perifoveal thickness was inversely related to the severity of neuropathy (p < 0.05), when adjusted for age, sex, duration of diabetes, and HbA1c levels. DR was associated with reduced thickness in parafovea (p < 0.01). The RNFL was thinner in individuals with greater degrees of neuropathy (p < 0.04).

CONCLUSIONS: DPN is associated with structural compromise involving several retinal layers. This compromise may represent a threat to visual integrity and therefore warrants examination of functional correlates.

Correlation of throwing velocity to the results of lower-body field tests in male college baseball players

Baseball-specific athleticism, potential, and performance have been difficult to predict. Increased muscle strength and power can increase throwing velocity but the majority of research has focused on the upper body. The present study sought to determine if bilateral or unilateral lower-body field testing correlates with throwing velocity. Baseball throwing velocity scores were correlated to the following tests: medicine ball (MB) scoop toss and squat throw, bilateral and unilateral vertical jumps, single and triple broad jumps, hop and stop in both directions, lateral to medial jumps, 10- and 60-yd sprints, and both left and right single-leg 10-yd hop for speed in 42 college baseball players. A multiple regression analysis (forward method), assessing the relationship between shuffle and stretch throwing velocities and lower-body field test results determined that right-handed throwing velocity from the stretch position was most strongly predicted by lateral to medial jump right (LMJR) and body weight (BW; R = 0.322), whereas lateral to medial jump left (LMJL; R = 0.688) predicted left stretch throw. Right-handed shuffle throw was most strongly predicted by LMJR and MB scoop (R = 0.338), whereas LMJL, BW, and LMJR all contributed to left-handed shuffle throw (R = 0.982). Overall, this study found that lateral to medial jumps were consistently correlated with high throwing velocity in each of the throwing techniques, in both left-handed and right-handed throwers. This is the first study to correlate throwing velocity with a unilateral jump in the frontal plane, mimicking the action of the throwing stride.

The consequences of intergroup ideologies and prejudice control for discrimination and harmony

In the present study, we investigated two literature bases by way of a community survey across Australia. We investigated four acculturation orientations (assimilation, multiculturalism, color-blind, and polyculturalism ideologies) and the motivations to respond without prejudice. We examined what predicted support for Harmony Day as well as explicit discrimination. Multiculturalism, polyculturalism, and internal motivation to respond without prejudice correlated with positive attitudes in both scenarios. External motivation to respond without prejudice was positively correlated with discrimination. Conversely, color-blind ideology had no effect, and assimilation ideology related positively to explicit discrimination and negatively with Harmony Day. Using a multiple regression analysis, there was a difference in emphasis in different contexts. Our findings provide antiprejudice practitioners with material for discussions which can promote positive intergroup relations.

Inclusion, organisational justice and employee well-being

Purpose: The purpose of this paper is to examine the relationship between employee perceived well-being and the four dimensions of organisational justice, namely, procedural, distributive, interpersonal and informational justice, and how dimensions of organisational justice affect employee well-being in the Australian tourism industry. Design/methodology/approach: The sample is selected from employees who work in the tourism industry in Australia, and the survey was conducted online (n=121). Factor analysis is used to identify key items related to perceived organisational justice, followed by multiple regression analysis to assess the magnitude and strength of impacts of different dimensions of organisational justice on employee well-being. Findings: The results support the established view that organisational justice is associated with employee well-being. Specifically, informational justice has the strongest influence on tourism employee well-being, followed by procedural justice, interpersonal justice and distributive justice. Research limitations/implications: The authors acknowledge key limitations in the study such as a relatively small sample size and gender imbalance in the sample. Practical implications: The authors provide strategies for managers to increase levels of organisational justice in the tourism sector such as workgroup interactions, a consultation process, team culture and social support. Originality/value: This study builds on limited literature in the area of inclusion and organisational justice in tourism organisations. The study provides a new path to effective organisational management within the context of a diverse workforce, adding to the current debate on which dimensions of organisational justice contribute to improving employee well-being.

Differences Among Undergraduate and Graduate Nursing Students’ Cultural Competency

This study examined differences in cultural competency levels between undergraduate and graduate nursing students (age, ethnicity, gender, language at home, education level, program standing, program track, diversity encounters, and previous diversity training). Participants were 83% women, aged 20 to 62; 50% Hispanic/Latino; with a Bachelor of Science in Nursing (n = 82) and a Master of Science in Nursing (n = 62). Degrees included high school diplomas, associate/diplomas, bachelors’ degrees in or out of nursing, and medical doctorate degrees from outside the United States. Students spoke English (n = 82) or Spanish (n = 54). The study used a cross-sectional design guided by the three-dimensional cultural competency model. The Cultural Competency Assessment (CCA) tool is composed of two subscales: Cultural Awareness and Sensitivity (CAS) and Culturally Competent Behaviors (CCB). Multiple regressions, Pearson’s correlations, and ANOVAs determined relationships and differences among undergraduate and graduate students. Findings showed significant differences between undergraduate and graduate nursing students in CAS, p <.016. Students of Hispanic/White/European ethnicity scored higher on the CAS, while White/non-Hispanic students scored lower on the CAS, p < .05. One-way ANOVAs revealed cultural competency differences by program standing (grade-point averages), and by program tracks, between Master of Science in Nursing Advanced Registered Nurse Practitioners and both Traditional Bachelor of Science in Nursing and Registered Nurse-Bachelor of Science in Nursing. Univariate analysis revealed that higher cultural competency was associated with having previous diversity training and participation in diversity training as continuing education. After controlling for all predictors, multiple regression analysis found program level, program standing, and diversity training explained a significant amount of variance in overall cultural competency (p = .027; R2 = .18). Continuing education is crucial in achieving students’ cultural competency. Previous diversity training, graduate education, and higher grade-point average were correlated with higher cultural competency levels. However, increased diversity encounters were not associated with higher cultural competency levels.

Financial constraints and stock returns — evidence from Australia

Using multiple discriminant analysis, we construct an index thatmeasures firms' external financial constraints in an Australian setting.We form portfolios of firms based on our financial constraints index andfind that financially constrained firms earn lower return than theirunconstrained counterparts. Moreover, stock returns of financiallyconstrained firms are found to move together, indicating the potentialexistence of a financial constraints factor. Neither the variation nor themean return of the constraints factor are well explained by existing assetpricing models, suggesting an independent role for our financialconstraints factor in affecting stock returns.

Monitor objectivity with important clients: evidence from auditor opinions around the world

We examine whether monitors are likely to compromise their monitoring objectivity in the face of economically important clients in international business settings. In the context of external auditing and assurance services, we measure monitor objectivity by whether auditors are more (or less) likely to issue to their important clients modified audit opinions, that is, audit opinions provided to outside investors about the firm that demotes explicit areas of concern. Using a large cross-country sample, we document that auditors are more likely to issue modified opinions to their economically important clients relative to other clients. Furthermore, we find that this association is stronger (1) for Big N auditors, (2) for multinational audit clients, and (3) in countries with stronger legal regimes. These results suggest that monitors prioritize the protection of their reputation over lucrative economic relationships, and such information certification function is more pronounced for international auditors, multinational client firms, and in strong legal regimes.

‘Care in a chair’ – The impact of an overcrowded emergency department on the time to treatment and length of stay of self-presenting patients with abdominal pain

Objectives The aim in this study was to investigate the impact of overcrowding on the Australasian Triage Score’s (ATS) time to treatment target and the National Emergency Access Target (NEAT) for patients who self-present to the Emergency Department (ED) with abdominal pain. Background The causes and effects of ED overcrowding have been well described in the literature. It is a widespread phenomenon throughout the world and it can cause serious harm to patients and have a negative impact on access to emergency care. There is however, little research investigating the effect of overcrowding when patients self-present to the ED and experience a delay in being allocated a cubicle. Methods A retrospective analysis of 12-months of computerised records was carried out in order to determine if self-presenting patients with abdominal pain allocated a category 3 triage score who were required to ‘queue’ for a cubicle would meet ATS target and NEAT requirements. A multiple regression analysis was used to determine whether or not queuing for an ED cubicle, age and gender were predictors of meeting the ATS guidelines and NEAT requirements. Results Three hundred and five patients met the inclusion criteria and were included in the study. Of these 149 patients waited more than 15 min to be allocated a cubicle while 156 did not experience any delay. A multiple regression analysis revealed that gender and age were not predictive of meeting the ATS target and NEAT requirements, while delay in allocation to a cubicle was a significant predictor of not being assessed within 30 min and discharged within 4 h. Furthermore, 61.2% of patients allocated to the waiting room queue for any amount of time were admitted to the ward. Conclusion Queuing in the waiting room for an ED bed was a significant predictor of whether or not category three patients with abdominal pain had treatment commenced within 30 min of presentation and was associated with a longer total ED length of stay.

The relationship between house prices and demographic variables: an Australian case study

Purpose – The process for examining the value of house prices in an urban city has given limited attention, if any, to demographic variables associated with urban geography. Although the disciplines of property/real estate and demography have moved closer, little progress has been made when modelling house prices using population-related data in the field of urban geography to explain the level of house prices.

Design/methodology/approach – This paper proposes an innovative model to examine the influence of population variables on the level of house prices. It used a two-stage approach as follows: principal components analysis (PCA) identified social dimensions from a range of demographic variables, which were then retained for further analysis. This information was sourced from two Australian Bureau of Statistics censuses undertaken involving all Melbourne residents during 1996, 2001, 2006 and 2011; multiple regression analysis examined the relationship between the retained factor scores from the PCA (as independent variables) and established residential house prices (as the dependent variable).

Findings – The findings confirm the demographic profile of each household, which is directly related to their decisions about housing location and house prices. Based on a case study of Melbourne, Victoria, it was demonstrated that households with specific demographic characteristics are closely related to a certain level of house prices at the suburban level.

Originality/value – This is an innovative study which has not been previously undertaken for an extended period of time to facilitate an analysis of change over time.

Traços desadaptativos da personalidade, sintomas depressivos e afectividade positiva e negativa: Uma amostra com estudantes universitários

Pretendemos estudar quais os traços desadaptativos de personalidade que se relacionam com os sintomas depressivos, a afectividade positiva e negativa, numa amostra de 187 estudantes universitários, entre os 18 e os 43 anos. Calculámos as correlações entre as escalas de padrões de personalidade e as escalas de padrões graves de personalidade do Inventário Multiaxial clínico de Millon II (MCMI-II) com os sintomas depressivos avaliados pela Escala de Depressão do Centro de Estudos Epidemiológicos e com a afectividade positiva e negativa avaliadas pela Escala de Afectividade Positiva e Afectividade Negativa. Realizámos uma análise da regressão múltipla utilizando as escalas de padrões de personalidade do MCMI-II como predictores e o resultado na CES-O, como variável dependente. Obtivemos uma correlação significativa entre os padrões de personalidade borderline, masoquista, esquizotípico, negativista e evitante e paranóide e os sintomas depressivos. A afectividade negativa apresenta-se também positivamente correlacionada com os padrões dependente e esquizóide. A afectividade positiva correlacionou-se significativa e positivamente com os padrões histriónico e narcisista e negativamente com os padrões esquizóide, esquizotípico, negativista, borderline, evitante e masoquista. Na análise de regressão, o padrão borderline prevê a presença de sintomas depressivos e os padrões sádico e dependente também, mas num sentido negativo. /ABSTRACT: We intendend to study wich personality traits relate to depressiva symptoms, and positive and negative affectivity, in a sample of 187 university students, between 18 and 43 years. We did the correlation between the personality patterns scales and the personality patterns of severe personality with the depressive symptoms measured by the Center for Epidemiologic Studies Depression Scale and the positive and negative affectivity measured by the Positive Affect and Negative Affect Shedule. We did a multiple regression analysis using the personality patterns scale of Millon Clinical Multiaxial lnventory (MCMI-II) as predictors and the result of CES-D, as dependent variable. We obtained a significant correlation between the borderline, masochist, schizotypal, negativistic, avoidant and paranoid personality patterns and the depressive symptoms. Negative affectivity relates also positively with dependent and schizoid patterns. Positive affectivity correlated significant and positively with histrionic and narcissistic personality patterns and negatively with schizoid, schizotypal, negativistic, borderline, avoidant and masochist personality patterns. ln the regression analysis, the borderline pattern predicts the presence of depressive symptoms as well as the sadistic and dependent, but in the negative sense.

Necessidades interpessoais e risco de suicídio numa amostra clínica de idosos

O objetivo desta investigação é testar o contributo das necessidades interpessoais - os sentimentos de não pertença e a perceção de ser um fardo – para o risco de suicídio, avaliado através da ideação suicida. Também se pretende investigar a possível interação entre as necessidades interpessoais e respetivos efeitos quadráticos, controlando o impacto de um conjunto de variáveis que apresentam, muitas vezes, uma correlação significativa com a ideação suicida. Neste estudo participaram 80 utentes idosos em recuperação de uma doença aguda. De acordo com os resultados, os sentimentos de não pertença e a perceção de ser um fardo correlacionam-se com a ideação suicida. No entanto, quando numa análise da regressão múltipla se considera simultaneamente o efeito de ambas as variáveis, apenas os sentimentos de não pertença contribuem significativamente na previsão da ideação suicida. Não se verificaram efeitos de interação nem efeitos quadráticos entre as variáveis necessidades interpessoais; Abstract: “Interpersonal needs and suicide risk in a sample of elderly patients” The aim of this study is to test the contribution of interpersonal needs - thwarted belongingness and perceived burdensomeness - to the risk of suicide, assessed by the presence of suicidal ideation. It also intends to investigate the possible interaction between interpersonal needs and the respective quadratic effects, by controlling the impact of a set of variables which have, many times, a significant correlation with suicidal ideation. In this study participated 80 elderly patients recovering from an acute medical condition. According to the results, thwarted belongingness and perceived burdensomeness are correlated with suicidal ideation. However, when in a multiple regression analysis we considerate simultaneously the effect of both variables, only thwarted belongingness contributes significatively to suicide ideation prediction. No interactions effects or quadratic effects were observed between interpersonal needs variables.

Stereo correspondence estimation using multiwavelets scale-space representation-based multiresolution analysis

A multiresolution technique based on multiwavelets scale-space representation for stereo correspondence estimation is presented. The technique uses the well-known coarse-to-fine strategy, involving the calculation of stereo correspondences at the coarsest resolution level with consequent refinement up to the finest level. Vector coefficients of the multiwavelets transform modulus are used as corresponding features, where modulus maxima defines the shift invariant high-level features (multiscale edges) with phase pointing to the normal of the feature surface. The technique addresses the estimation of optimal corresponding points and the corresponding 2D disparity maps. Illuminative variation that can exist between the perspective views of the same scene is controlled using scale normalization at each decomposition level by dividing the details space coefficients with approximation space. The problems of ambiguity, explicitly, and occlusion, implicitly, are addressed by using a geometric topological refinement procedure. Geometric refinement is based on a symbolic tagging procedure introduced to keep only the most consistent matches in consideration. Symbolic tagging is performed based on probability of occurrence and multiple thresholds. The whole procedure is constrained by the uniqueness and continuity of the corresponding stereo features. The comparative performance of the proposed algorithm with eight famous existing algorithms, presented in the literature, is shown to validate the claims of promising performance of the proposed algorithm.