Vacuum-assisted closure device: a useful tool in the management of severe intrathoracic infections.

Background. This study is an evaluation of the vacuum-assisted closure (VAC) therapy for the treatment of severe intrathoracic infections complicating lung resection, esophageal surgery, viscera perforation, or necrotizing pleuropulmonary infections.Methods. We reviewed the medical records of all patients treated by intrathoracic VAC therapy between January 2005 and December 2008. All patients underwent surgical debridement-decortication and control of the underlying cause of infection such as treatment of bronchus stump insufficiency, resection of necrotic lung, or closure of esophageal or intestinal leaks. Surgery was followed by intrathoracic VAC therapy until the infection was controlled. The VAC dressings were changed under general anesthesia and the chest wall was temporarily closed after each dressing change. All patients received systemic antibiotic therapy.Results. Twenty-seven patients (15 male, median age 64 years) underwent intrathoracic VAC dressings for the management of postresectional empyema (n = 8) with and without bronchopleural fistula, necrotizing infections (n = 7), and intrathoracic gastrointestinal leaks (n = 12). The median length of VAC therapy was 22 days (range 5 to 66) and the median number of VAC changes per patient was 6 (range 2 to 16). In-hospital mortality was 19% (n = 5) and was not related to VAC therapy or intrathoracic infection. Control of intrathoracic infection and closure of the chest cavity was achieved in all surviving patients.Conclusions. Vacuum-assisted closure therapy is an efficient and safe adjunct to treat severe intrathoracic infections and may be a good alternative to the open window thoracostomy in selected patients. Long time intervals in between VAC changes and short course of therapy result in good patient acceptance. (Ann Thorac Surg 2011;91:1582-90) (C) 2011 by The Society of Thoracic Surgeons

Diseño e implementación de 4SPPIces Tool: Una aplicación web para dar apoyo a la creación de actividades educativas colaborativas en entornos mezclados

La introducción de dispositivos tecnológicos como PDAs, móviles o portátiles, en la educación ofrece nuevas oportunidades para el aprendizaje. El uso apropiado de estas herramientas abre la posibilidad a un abanico de escenarios educativos colaborativos que no serían posibles sin la tecnología. Sin embargo, uno de los problemas principales que dificulta la adopción de estos dispositivos en entornos educativos reales es el comprender cómo aplicarlos de forma adecuada y beneficiosa para cubrir los objetivos de aprendizaje esperados. Para ello es necesario establecer vínculos entre educadores y tecnólogos para que este tipo de escenarios se puedan llevar a cabo. Por un lado, los educadores tienen conocimientos sobre prácticas educativas y, por otro lado, los tecnólogos pueden aportar con sus conocimientos acerca de las oportunidades que las tecnologías ofrecen. 4SPPIces es un modelo conceptual que tiene como objetivo establecer este puente entre las dos comunidades. Concretamente, se trata de un modelo que propone 4 factores interrelacionados que deben considerarse en el diseño de experiencias educativas colaborativas que combinen actividades dentro y fuera del aula: (1) el método pedagógico (Pedagiocal Method), (2) los participantes (Participants), (3) el espacio (Space) y (4) el historial (History). El objetivo de este proyecto es desarrollar una aplicación web para que educadores y tecnólogos colaboren en el diseño de escenarios basados en este modelo. Concretamente, este trabajo presenta el proceso de desarrollo de la aplicación así como algunas pruebas con usuarios para analizar la usabilidad y utilidad del sistema.

Advancing hypoxic training in team sports: from intermittent hypoxic training to repeated sprint training in hypoxia.

Over the past two decades, intermittent hypoxic training (IHT), that is, a method where athletes live at or near sea level but train under hypoxic conditions, has gained unprecedented popularity. By adding the stress of hypoxia during 'aerobic' or 'anaerobic' interval training, it is believed that IHT would potentiate greater performance improvements compared to similar training at sea level. A thorough analysis of studies including IHT, however, leads to strikingly poor benefits for sea-level performance improvement, compared to the same training method performed in normoxia. Despite the positive molecular adaptations observed after various IHT modalities, the characteristics of optimal training stimulus in hypoxia are still unclear and their functional translation in terms of whole-body performance enhancement is minimal. To overcome some of the inherent limitations of IHT (lower training stimulus due to hypoxia), recent studies have successfully investigated a new training method based on the repetition of short (<30 s) 'all-out' sprints with incomplete recoveries in hypoxia, the so-called repeated sprint training in hypoxia (RSH). The aims of the present review are therefore threefold: first, to summarise the main mechanisms for interval training and repeated sprint training in normoxia. Second, to critically analyse the results of the studies involving high-intensity exercises performed in hypoxia for sea-level performance enhancement by differentiating IHT and RSH. Third, to discuss the potential mechanisms underpinning the effectiveness of those methods, and their inherent limitations, along with the new research avenues surrounding this topic.

Identifying and Implementing Effective Training for Hispanic Craft Workers, American Supervisors, and DOT Inspectors: Phase III of the Hispanic Workforce Research Project, May 2006

The number of Hispanic workers in the U.S. construction industry has been steadily increasing, and language and cultural barriers have sometimes arisen on the jobsite. Due in part to these barriers, the number of fatalities among Hispanics at construction sites in 2001 jumped 24%, while construction fatalities overall dropped 3%. This study, which constitutes Phase III of the Hispanic Workforce Research Project, addresses these language and cultural barriers by investigating the most effective way to deliver training material developed in Phases I and II to Hispanic workers, American supervisors, and department of transportation (DOT) inspectors. The research methodology consisted of assessing the needs and interests of potential and current course participants in terms of exploring innovative ways to deliver the training. The training courses were then adapted and delivered to fit the specific needs of each audience. During Phase III of this project, the research team delivered the courses described in the Phase I and II reports to eight highway construction companies and two DOT groups. The courses developed in Phases I and II consist of four construction-focused language training courses that can be part of an effective training program to facilitate integration among U.S. and Hispanic workers, increase productivity and motivation at the jobsite, and decrease the existing high mortality rate for Hispanic workers. Moreover, the research team developed a course for the construction season called Toolbox Integration Course for Hispanic workers and American supervisors (TICHA), which consists of nine 45-minute modules delivered to one construction company over 11 weeks in the summer of 2005.

Genometrics as an essential tool for the assembly of whole genome sequences: the example of the chromosome of Bifidobacterium longum NCC2705.

BACKGROUND: Analysis of the first reported complete genome sequence of Bifidobacterium longum NCC2705, an actinobacterium colonizing the gastrointestinal tract, uncovered its proteomic relatedness to Streptomyces coelicolor and Mycobacterium tuberculosis. However, a rapid scrutiny by genometric methods revealed a genome organization totally different from all so far sequenced high-GC Gram-positive chromosomes. RESULTS: Generally, the cumulative GC- and ORF orientation skew curves of prokaryotic genomes consist of two linear segments of opposite slope: the minimum and the maximum of the curves correspond to the origin and the terminus of chromosome replication, respectively. However, analyses of the B. longum NCC2705 chromosome yielded six, instead of two, linear segments, while its dnaA locus, usually associated with the origin of replication, was not located at the minimum of the curves. Furthermore, the coorientation of gene transcription with replication was very low. Comparison with closely related actinobacteria strongly suggested that the chromosome of B. longum was misassembled, and the identification of two pairs of relatively long homologous DNA sequences offers the possibility for an alternative genome assembly proposed here below. By genometric criteria, this configuration displays all of the characters common to bacteria, in particular to related high-GC Gram-positives. In addition, it is compatible with the partially sequenced genome of DJO10A B. longum strain. Recently, a corrected sequence of B. longum NCC2705, with a configuration similar to the one proposed here below, has been deposited in GenBank, confirming our predictions. CONCLUSION: Genometric analyses, in conjunction with standard bioinformatic tools and knowledge of bacterial chromosome architecture, represent fast and straightforward methods for the evaluation of chromosome assembly.

Indoor Multipurpose Use and Training Facility Revenue Bond Funds, Iowa State University of Science and Technology, Independent Auditor's Report, Basic Financial Statements and Supplementary Information, June 30, 2006

State University Audit Report

Development of a specific control banding tool for nanomaterials : report

[Table des matières] 1. Introduction to the control banding method : Nanomaterials and occupational risk assessment; Alternative method known as control banding; Scope and limits of control banding. - 2. Control banding process applied to manufactured nanomaterials: General points; Operating principle. - 3. Implementation of control banding: Gathering of information; Hazard bands; Exposure bands; Allocation of risk control bands. - 4. Bibliography: Publications; Books, reports, opinions, bulletins; Standards and references; Legislation and regulations; Websites. - Annexes

Concrete Paving Training & Field Reference for Preventing Common Problems, August 2006

To ensure that high-quality materials are used in concrete mixing, all materials delivered to the site should be inspected to ensure that they meet specification requirements. All materials should be delivered with the proper certifications, invoices, or bill of lading. These records should indicate when the shipment arrived, the amount and identification of material delivered, and the laboratory report certification number, invoice number, and ticket number.

Precision of a new tool to measure visceral adipose tissue (VAT) using dual-energy X-Ray absorptiometry (DXA).

OBJECTIVE: A new tool to quantify visceral adipose tissue (VAT) over the android region of a total body dual-energy x-ray absorptiometry (DXA) scan has recently been reported. The measurement, CoreScan, is currently available on Lunar iDXA densitometers. The purpose of the study was to determine the precision of the CoreScan VAT measurement, which is critical for understanding the utility of this measure in longitudinal trials. DESIGN AND METHODS: VAT precision was characterized in both an anthropomorphic imaging phantom (measured on 10 Lunar iDXA systems) and a clinical population consisting of obese women (n = 32). RESULTS: The intrascanner precision for the VAT phantom across 9 quantities of VAT mass (0-1,800 g) ranged from 28.4 to 38.0 g. The interscanner precision ranged from 24.7 to 38.4 g. There was no statistical dependence on the quantity of VAT for either the inter- or intrascanner precision result (p = 0.670). Combining inter- and intrascanner precision yielded a total phantom precision estimate of 47.6 g for VAT mass, which corresponds to a 4.8% coefficient of variance (CV) for a 1 kg VAT mass. Our clinical population, who completed replicate total body scans with repositioning between scans, showed a precision of 56.8 g on an average VAT mass of 1110.4 g. This corresponds to a 5.1% CV. Hence, the in vivo precision result was similar to the phantom precision result. CONCLUSIONS: The study suggests that CoreScan has a relatively low precision error in both phantoms and obese women and therefore may be a useful addition to clinical trials where interventions are targeted towards changes in visceral adiposity.

DNR Interactive Mapping: A tool for Iowa Agriculture, 2006

The planning tools you need to improve both your farming operation and Iowa’s streams and lakes are right at your fingertips. With DNR interactive mapping online, you can access a large amount of information for free and without special software.

COMPETENCY-BASED TRAINING IN NURSING: LIMITS AND POSSIBILITIES

Objective To analyze the possibilities and limits of competency-based training in nursing. Method An integrative review of the literature on the subject was carried out, and an analysis was made of the results of a survey evaluating a nursing course based on areas of competency. A dialog was then established between the review and the results of the research. Results On the question of which theoretical type of competency the articles from the literature relate to, there is a predominance of the constructivist perspective, followed by the functionalist approach and the dialog-based approach. In the dialog between the literature and the research, limits and possibilities were observed in the development of a training by areas of competency. Conclusion The dialog-based approach to competency is the proposition that most approximates to the profile defined by the National Curriculum Guidelines for training in nursing, and this was also identified in the evaluation survey that was studied. However, it is found that there are aspects on better work is needed, such as: partnership between school and the workplace, the role of the teacher, the role of the student, and the process of evaluation.

Needs of psychopedagogical training for the care of children with chronic disease: perceptions of hospital nursing

OBJECTIVE To identify the psychopedagogical training needs of the pediatric nurses in the largest public hospital of the Balearic Islands, Spain. METHOD This study was developed with a quantitative and qualitative design, where 78 nurses (97.5% of the service) answered a questionnaire, and 15 participated in interviews that were analyzed via content analysis. RESULTS The quantitative results show gaps in the knowledge and psychopedagogical skills of the staff. These aspects could facilitate the development of tasks tailored to the personality and the psychoevolutional time of children with chronic diseases, as well as to the emotional state of families. The qualitative data was organized into four categories: family support; hospital and education; psychopedagogical training and difficulties in practice. The little communication between nurses and teachers is evident. CONCLUSION The data reinforces the need to implement training strategies and interdisciplinary work among health professionals, educators and families.