Antimicrobial use and incidence of multidrug-resistant Pseudomonas aeruginosa in a teaching hospital: an ecological approach

Introduction: Multidrug-resistant Pseudomonas aeruginosa is a major threat in healthcare settings. The use of antimicrobials can influence the incidence of resistant strains by direct and indirect mechanisms. The latter can be addressed by ecological studies. Methods: Our group attempted to analyze the relation between the use of antipseudomonal drugs and the incidence of MDR-PA among 18 units from a 400-bed teaching hospital. The study had a retrospective, ecological design, comprising data from 2004 and 2005. Data on the use of four antimicrobials (amikacin, ciprofloxacin, ceftazidime and imipenem) were tested for correlation with the incidence of MDR-PA (defined as isolates resistant to the four antimicrobials of interest) in clinical cultures. Univariate and multivariate linear regression analyses were performed. Results: Significant correlations were determined between use and resistance for all antimicrobials in the univariate analysis: amikacin (standardized correlation coefficient = 0.73, p = 0.001); ciprofloxacin (0.71, p = 0.001); ceftazidime (0.61, p = 0.007) and imipenem (0.87, p < 0.001). In multivariate analysis, only imipenem (0.67, p = 0.01) was independently related to the incidence of multidrug-resistant strains. Conclusions: These findings share similarities with those reported in individual-based observational studies, with possible implications for infection control.

Multidisciplinary approach in the teaching of dental sculpture and anatomy

The purpose of the Dental Sculpture and Anatomy discipline is to introduce undergraduate students to the study of the anatomic and morphological characteristics of permanent and primary human dentition, through classes, books and cognitive and psychomotor activities. This discipline supports the teaching of specific knowledge necessary for a more extensive education, involving interdisciplinarity as a means of knowledge exchange among several areas of dentistry, to achieve comprehensive professional education. Students must recognize the dental morphology from samples of preserved teeth, and reproduce the morphology through three-dimensional models made of stone or wax blocks. In this article, the authors describe the process for producing teeth collars and macro dental models made of stone, their importance and benefits of utilization. The purpose of the study was to encourage the teaching of Dental Sculpture and Anatomy toundergraduate students of the Bauru School of Dentistry, University of Sao Paulo, through activities that would associate theory, practice and the development of manual skills.

VIBRATIONAL ANALYSIS OF COORDINATION COMPOUNDS OF NICKEL (II): AN APPROACH TO THE TEACHING OF POINT GROUPS

VIBRATIONAL ANALYSIS OF COORDINATION COMPOUNDS OF NICKEL (II): AN APPROACH TO THE TEACHING OF POINT GROUPS. This paper presents an IR and Raman experiment executed during the teaching of the course "Chemical Bonds" for undergraduated students of Science and Technology and Chemistry at the Federal University of ABC, in order to facilitate and encourage the teaching and learning of group theory. Some key aspects of this theory are also outlined. We believe that student learning was more significant with the introduction of this experiment, because there was an increase in the discussions level and in the performance during evaluations. This work also proposes a multidisciplinary approach to include the use of quantum chemistry tools.

Approach to Food and Nutrition issues in Teaching Materials in Elementary School: interface with food and nutritional security and national curriculum parameters

Food and Nutrition Security (FNS) must be ensured to everybody. The school environment is favorable to the formation of healthy habits and citizenship. The National Curriculum Parameters (PCNs) guide the promotion of health concepts in a transversal way in the school curriculum. This study aimed to identify and analyze the approach used for food and nutrition themes in Fundamental Education's teaching material and its interface with the concept of FNS and the PCNs. Documental research was conducted on the teaching material from 5th to 8th grades of Fundamental Education in Public School of the state of Sao Paulo. The diffuse presence of food and nutrition themes was found in most disciplines in all bimesters in the four series, which shows the interdisciplinarity in health. It was found that the PCNs are related to the concept of SAN in its various aspects and that most subjects include topics that approach this relationship. In the correlation between themes, there is emphasis to health promotion and food production. The methodology used in the teaching material presents the theme, but not the correspondent content, what made the analysis of its suitability impossible. We conclude that there is the approach of the issues related to food and nutrition in the teaching material, some of them in an inconsistent way; it is the educators' task to select the contents and the appropriate strategy, doing an effort of constant update. This isbeing proposed by the State, however it is not accessible to all professionals and therefore still depends on the initiative of each teacher.

The lexical approach: collocability, fluency and implications for teaching

[EN] [EN] The lexical approach identifies lexis as the basis of language and focuses on the principle that language consists of grammaticalised lexis. in second language acquisition, over the past few years, this approach has generated great interest as an alternative to traditional grammar-based teaching methods. From a psycholinguistic point of view, the lexical approach consists of the capacity of understanding and producing lexical phrases as non-analysed entities (chunks). A growing body of literature concerning spoken fluency is in favour of integrating automaticity and formulaic language units into classroom practice. in line with the latest theories on SlA, we recommend the inclusion of a language awareness component as an integral part of this approach. The purpose is to induce what Schmidt (1990) calls noticing , i.e., registering forms in the input so as to store themin memory. This paper, which is in keeping with the interuniversity Research Project “Evidentialityin a multidisciplinary corpus of English research papers” of the University of las Palmas de Gran Canaria, provides a theoretical overview on theresearch of this approach taking into account both the methodological foundationson the subject and its pedagogical implications for SLA

Teaching and learning stance in specialized English for computing. A corpus linguistics approach

[EN]The use of large corpora in the study of languages is a well established tradition. In the same vein, scholarship is also well represented in the case of the study of corpora for making grammars of languages. This is the case of the COBUILD grammar and dictionary and the case of the Longman Grammar of Spoken and Written English. This means that corpora have been analyzed in order to identify patterns in languages that can be later practised by learners following those patterns described and exemplified with real instances.

Emergency skill training--a randomized controlled study on the effectiveness of the 4-stage approach compared to traditional clinical teaching

The "4-stage approach" has been widely accepted for practical skill training replacing the traditional 2 stages ("see one, do one"). However, the superior effectiveness of the 4-stage approach was never proved.

E-learning - an approach to teaching art history in the Internet age

Der erste Universitätskurs in Norwegen, der komplett via Internet unterrichtet wird, wird in Kunstgeschichte angeboten. Dieses Projekt wurde im März 2000 mit einem Einführungskurs in die Kunstgeschichte gestartet. Aufgrund seiner modularen Struktur, visuell ansprechender Präsentationen, fachbezogener Ansätze sowie Möglichkeiten eines zweiseitigen Kommunikationsaustausches, kann das Interesse und der Einbezug der Studenten während der zweijährigen Dauer des Kurses aufrecht erhalten werden.

A model-driven approach to teaching concurrency

We present an undergraduate course on concurrent programming where formal models are used in different stages of the learning process. The main practical difference with other approaches lies in the fact that the ability to develop correct concurrent software relies on a systematic transformation of formal models of inter-process interaction (so called shared resources), rather than on the specific constructs of some programming language. Using a resource-centric rather than a language-centric approach has some benefits for both teachers and students. Besides the obvious advantage of being independent of the programming language, the models help in the early validation of concurrent software design, provide students and teachers with a lingua franca that greatly simplifies communication at the classroom and during supervision, and help in the automatic generation of tests for the practical assignments. This method has been in use, with slight variations, for some 15 years, surviving changes in the programming language and course length. In this article, we describe the components and structure of the current incarnation of the course?which uses Java as target language?and some tools used to support our method. We provide a detailed description of the different outcomes that the model-driven approach delivers (validation of the initial design, automatic generation of tests, and mechanical generation of code) from a teaching perspective. A critical discussion on the perceived advantages and risks of our approach follows, including some proposals on how these risks can be minimized. We include a statistical analysis to show that our method has a positive impact in the student ability to understand concurrency and to generate correct code.

Teaching writing through reading: a text-centred approach

Se comparan y contrastan las destrezas requeridas para la comprensión lectora con aquellas que se necesitan para la producción de escritos correctos, en inglés, coherentes y bien cohesionados. Se comentan las actividades didácticas relacionadas con ello.The aim of this article is to establish the relevance of teaching reading and writing skills to students at Madrid Polytechnic University, and to show the relationship and interdependence of these activities in EAP courses. The skills involved in reading and writing processes for academic purposes for L2 students are compared and commented on from a rhetorical point of view. Learning tasks based on text-type analysis are recommended as adequate activities to build schemata for writing and represent a synthesis of the teaching objectives proposed for reading and writing English courses.

Managing daily surgery schedules in a teaching hospital: a mixed-integer optimization approach

Background: This study examined the daily surgical scheduling problem in a teaching hospital. This problem relates to the use of multiple operating rooms and different types of surgeons in a typical surgical day with deterministic operation durations (preincision, incision, and postincision times). Teaching hospitals play a key role in the health-care system; however, existing models assume that the duration of surgery is independent of the surgeon's skills. This problem has not been properly addressed in other studies. We analyze the case of a Spanish public hospital, in which continuous pressures and budgeting reductions entail the more efficient use of resources. Methods: To obtain an optimal solution for this problem, we developed a mixed-integer programming model and user-friendly interface that facilitate the scheduling of planned operations for the following surgical day. We also implemented a simulation model to assist the evaluation of different dispatching policies for surgeries and surgeons. The typical aspects we took into account were the type of surgeon, potential overtime, idling time of surgeons, and the use of operating rooms. Results: It is necessary to consider the expertise of a given surgeon when formulating a schedule: such skill can decrease the probability of delays that could affect subsequent surgeries or cause cancellation of the final surgery. We obtained optimal solutions for a set of given instances, which we obtained through surgical information related to acceptable times collected from a Spanish public hospital. Conclusions: We developed a computer-aided framework with a user-friendly interface for use by a surgical manager that presents a 3-D simulation of the problem. Additionally, we obtained an efficient formulation for this complex problem. However, the spread of this kind of operation research in Spanish public health hospitals will take a long time since there is a lack of knowledge of the beneficial techniques and possibilities that operational research can offer for the health-care system.