The incidence of oral Gram-negative bacteria in patients with Parkinson's disease

Background: Parkinson's disease is a common neurodegenerative disorder that affects an increasing number of older people every year. Dysphagia is not only a common feature, but one that results in poor nutrition and an increased risk of bronchopneumonia. Previous work has suggested that the oral flora is altered in patients with oral pathology. Methods: Fifty patients were assessed to quantify the incidence of oral Gram-negative bacteria. Results: Sixteen of the patients with Parkinson's disease were found to have six different Gram-negative bacilli in their oral cavities. The 20 different Gram-negative bacteria present were Escherichia coli (n=7), Klebsiella spp. (n=3), Kluyvera spp. (n=3), Serratia spp. (n=3), Proteus spp. (n=2) and Enterobacter spp. (n=2). We found that the oral cavity of 16 (32%) of the patients with Parkinson's disease was abnormally colonised with Gram-negative bacteria and that Gram-negative bacteria were more likely to occur in those patients in whom oromuscular dysfunction was present (88% vs. 21%; p<0.05). Conclusion: Further work is required to determine the association between oral flora and the pathogenic organisms found in aspiration pneumonia as well as work on innovative treatments to reduce oral Gram-negative bacteria in those patients at particular risk of aspiration pneumonia.

Don't we care?: the ethics and emotional labour of early years professionalism

This paper argues that early childhood education and care (ECEC) has a legitimate aspiration to be a 'caring profession' like others such as nursing or social work, defined by a moral purpose. For example, practitioners often draw on an ethic of care as evidence of their professionalism. However, the discourse of professionalism in England completely excludes the ethical vocabulary of care. Nevertheless, it necessarily depends on gendered dispositions towards emotional labour, often promoted by training programmes as 'professional' demeanours. Taking control of the professionalisation agenda therefore requires practitioners to demonstrate a critical understanding of their practice as 'emotion work'. At the same time, reconceptualising practice within a political ethic of care may allow the workforce, and new trainees in particular, to champion 'caring' as a sustainable element of professional work, expressed not only in maternal, dyadic key-working but in advocacy for care as a social principle.

New governance approaches to environmental regulation: an example of the Code for Sustainable Homes (CSH)

Environmental policy in the United Kingdom (UK) is witnessing a shift from command-and-control approaches towards more innovation-orientated environmental governance arrangements. These governance approaches are required which create institutions which support actors within a domain for learning not only about policy options, but also about their own interests and preferences. The need for construction actors to understand, engage and influence this process is critical to establishing policies which support innovation that satisfies each constituent’s needs. This capacity is particularly salient in an era where the expanding raft of environmental regulation is ushering in system-wide innovation in the construction sector. In this paper, the Code for Sustainable Homes (the Code) in the UK is used to demonstrate the emergence and operation of these new governance arrangements. The Code sets out a significant innovation challenge for the house-building sector with, for example, a requirement that all new houses must be zero-carbon by 2016. Drawing upon boundary organisation theory, the journey from the Code as a government aspiration, to the Code as a catalyst for the formation of the Zero Carbon Hub, a new institution, is traced and discussed. The case study reveals that the ZCH has demonstrated boundary organisation properties in its ability to be flexible to the needs and constraints of its constituent actors, yet robust enough to maintain and promote a common identity across regulation and industry boundaries.

Pianos for the people: the manufacture, marketing and sale of pianos as consumer durables, 1850-1914

During the second half of the nineteenth century, British society experienced a rise in real incomes and a change in its composition, with the expansion of the middle classes. These two factors led to a consumer revolution, with a growing, but still segmented, demand for household goods that could express status and aspiration. At the same time technological changes and new ways of marketing and selling goods made these goods more affordable. This paper analyzes these themes and the process of mediation that took place between producers, retailers, and consumers, by looking at the most culturally symbolic of nineteenth century consumer goods, the piano.

Public sector applications of the system dynamics approach

The article discusses various reports published within the issue, including one by Carmine Bianchi on understanding public sector from different levels and perspectives, one by Mauro Lo Tennero on the aspiration and structure of Sicily to enforce public policy, and one by Nuno Videira and colleagues on the use of group model building in the public sector to concur sustainable policies.

Além da diferença: a mulher no Cinema da Retomada

This paper analyses the female participation in the Brazilian Film Revival of the 1990s beyond differences of sex, race, class, age and ethnicity. Its main contention is that the most decisive contribution brought about by the rise of women in recent Brazilian cinema has been the spread of team work and shared authorship, as opposed to a mere aspiration to the auteur pantheon, as determined by a notoriously male-oriented tradition.

Beyond difference: female participation in the Brazilian film revival of the 1990s

In this chapter, I will focus on the female participation in what became known as ‘The Retomada do Cinema Brasileiro’, or the Brazilian Film Revival, by thinking beyond differences of gender, class, age and ethnicity. I will first re-consider the Retomada phenomenon against the backdrop of its historical time, so as to evaluate whether the production boom of the period translated into a creative peak, and, if so, how much of this carried onto the present day. I will then look at the female participation in this phenomenon not just in terms of numerical growth of women film directors, admittedly impressive, but only partially reflective of the drastic changes in the modes of production and address effected by the neoliberal policies introduced in the country in the mid 1990s. I will argue that the most decisive contribution brought about by the rise of women in Brazilian filmmaking has been the spread of team work and shared authorship, as opposed to a mere aspiration to the auteur pantheon, as determined by a notoriously male-oriented tradition. Granted, films focusing on female victimisation were rife during the Retomada period and persist to this day, and they have been, and continue to be, invaluable for the understanding of women’s struggles in the country. However, rather than resorting to feminist readings of representational strategies in these films, I will draw attention to other, presentational aesthetic experiments, open to the documentary contingent and the unpredictable real, which, I argue, suspend the pedagogical character of representational narratives. In order to demonstrate that new theoretical tools are needed to understand the gender powers at play in contemporary world cinema, I will, to conclude, analyse an excerpt of the film, Delicate Crime (Crime delicado, Beto Brant, 2006), where team work comes out as a particularly effective female, and feminist, procedure.

Tracing client interests in the course of a project: why are some client interests incorporated whereas others are not?

Many construction professionals and policy-makers would agree that client expectations should be accommodated during a building project. However, this aspiration is not easy to deal with as there may be conflicting interests within a client organization and these may change over time in the course of a project. This research asks why some client interests, and not others, are incorporated into the development of a building project. Actor-Network Theory (ANT) is used to study a single building project on a University campus. The building project is analysed as a number of discussions and negotiations, in which actors persuade each other to choose one solution over another. The analysis traces dynamic client engagement in decision-making processes as available options became increasingly constrained. However, this relative loss of control was countered by clients who continued the control over the timing of participants' involvement, and thus the way to impose their interests even at the later stage of the project.

Mosquito (Diptera: Culicidae) Diversity of a Forest-Fragment Mosaic in the Amazon Rain Forest

To study the impact of Amazonian forest fragmentation on the mosquito fauna, an inventory of Culicidae was conducted in the upland forest research areas of the Biological Dynamics of Forest Fragments Project located 60 km north of Manaus, Amazonas, Brazil. The culicid community was sampled monthly between February 2002 and May 2003. CDC light traps, flight interception traps, manual aspiration, and net sweeping were used to capture adult specimens along the edges and within forest fragments of different sizes (1, 10, and 100 ha), in second-growth areas surrounding the fragments and around camps. We collected 5,204 specimens, distributed in 18 genera and 160 species level taxa. A list of mosquito taxa is presented with 145 species found in the survey, including seven new records for Brazil, 16 new records for the state of Amazonas, along with the 15 morphotypes that probably represent undescribed species. No exotic species [Aedes aegypti (L.) and Aedes albopictus (Skuse)] were found within the sampled areas. Several species collected are potential vectors of Plasmodium causing human malaria and of various arboviruses. The epidemiological and ecological implications of mosquito species found are discussed, and the results are compared with other mosquito inventories from the Amazon region.

Les Attitudes des élèves concernant le travail sur les textes

Pour apprendre le français à l’école, en classe, on peut choisir plusieurs méthodes et stratégies différentes. Dans ce mémoire quatre différentes méthodes de travailler avec un texte en classe ont été examinées. Les attitudes des élèves concernant ces quatre méthodes ont été observées. Les élèves qui ont répondu aux questions ont fait des études de français au niveau 3 (steg 3), dans un lycée en Dalécarlie, en Suède. Dans leur manuel scolaire quatre textes courts ont été choisis. Les élèves ont lu les textes à la maison et en classe, pour ensuite travailler en classe avec le contenu. Pour le premier texte chaque élève a écrit un petit résumé, pour le deuxième texte ils ont répondu aux questions deux à deux, pour le troisième texte ils ont discuté le texte en petits groupes de quatre ou cinq personnes, et pour le quatrième et dernier texte ils ont répondu individuellement aux questions portant sur le texte.    L’aspect le plus intéressant de l'étude a été de prendre connaissance de ce qui était perçu comme positif ou négatif concernant les quatre méthodes. Il semble qu'il soit difficile pour certains élèves de concentrer leur attention sur le travail s’ils travaillent en groupe. Certains élèves parlent d’autres choses et ne prennent pas leur responsabilité pour le travail. Parfois les élèves les plus compétents dans le groupe font le travail très vite sans faire attention aux élèves moins compétents. Ainsi les élèves moins compétents ne participent pas au travail et n’apprennent rien. 

Dissonant Voices : Philosophy, Children's Literature, and Perfectionist Education

Dissonant Voices has a twofold aspiration. First, it is a philosophical treatment of everyday pedagogical interactions between children and their elders, between teachers and pupils. More specifically it is an exploration of the possibilities to go on with dissonant voices that interrupt established practices – our attunement – in behaviour, practice and thinking. Voices that are incomprehensible or expressions that are unacceptable, morally or otherwise. The text works on a tension between two inclinations: an inclination to wave off, discourage, or change an expression that is unacceptable or unintelligible; and an inclination to be tolerant and accept the dissonant expression as doing something worthwhile, but different. The second aspiration is a philosophical engagement with children’s literature. Reading children’s literature becomes a form of philosophising, a way to explore the complexity of a range of philosophical issues. This turn to literature marks a dissatisfaction with what philosophy can accomplish through argumentation and what philosophy can do with a particular and limited set of concepts for a subject, such as ethics. It is a way to go beyond philosophising as the founding of theories that justify particular responses. The philosophy of dissonance and children’s literature becomes a way to destabilise justifications of our established practices and ways of interacting. The philosophical investigations of dissonance are meant to make manifest the possibilities and risks of engaging in interactions beyond established agreement or attunements. Thinking of the dissonant voice as an expression beyond established practices calls for improvisation. Such improvisations become a perfectionist education where both the child and the elder, the teacher and the student, search for as yet unattained forms of interaction and take responsibility for every word and action of the interaction. The investigation goes through a number of picture books and novels for children such as Harry Potter, Garmann’s Summer, and books by Shaun Tan, Astrid Lindgren and Dr. Seuss as well narratives by J.R.R. Tolkien, Henrik Ibsen, Jane Austen and Henry David Thoreau. These works of fiction are read in conversation with philosophical works of, and inspired by, Ludwig Wittgenstein and Stanley Cavell, their moral perfectionism and ordinary language philosophy.

Avaliação do erro das coordenadas de localização estereotáctica guiada por tomografia computadorizada do encéfalo

São analisados 106 pacientes submetidos a localização estereotáctica. Os procedimentos variaram de biópsias cerebrais, orientação de craniotomias, colocação de cateter em cavidade tumoral, drenagem de hematoma intracerebral e drenagem de abscesso cerebral. As orientações de craniotomias foram para MAVs, tumores e processos inflamatórios, em 21 pacientes. As biópsias cerebrais estereotácticas para diagnóstico anatomopatológico apresentaram um índice de positividade de 87,50 % com complicações em 1,20 %, em 82 casos. São analisadas estatisticamente as variáveis como: idade, sexo, procedimento realizado, diagnóstico anatomopatológico e volume das lesões. É discutida a imprecisão na aquisição e cálculo das coordenadas estereotácticas com a TC do encéfalo e verificada a precisão do método estereotomográfico com a utilização de um phanton. O maior erro das coordenadas foi de 6,8 mm.

Determinação de prevalência de bactérias na efusão da orelha média de crianças submetidas à mmiringotomia

Introdução: A etiologia da otite média com efusão ainda não está completamente estabelecida, mas agentes infecciosos podem contribuir para sua patogênese. Demonstrou-se que a reação em cadeia da polimerase (PCR) é superior ao exame cultural para detectar espécies bacterianas. O conhecimento sobre a epidemiologia bacteriana da otite média com efusão em áreas geográficas distintas é essencial para a implementação de tratamentos racionais, quando necessários. Objetivos: Determinar a prevalência do Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis e Alloiococcus otitidis nas efusões de orelha média de crianças com otite média recorrente e otite média com efusão crônica que foram submetidas à miringotomia, comparar os resultados obtidos por cultura e PCR, comparar os achados bacteriológicos em crianças menores e maiores de dois anos e determinar o perfil de resistência à penicilina dos germes isolados. Métodos: Analisaram-se 128 amostras de efusões de orelha média de 75 crianças entre 11 meses e 9 anos e 4 meses de idade (média = 34,7 meses). Pacientes com otite média recorrente tinham efusão documentada por ≥ 6 semanas e aqueles com otite média com efusão crônica, por ≥3 meses. Os pacientes não tinham sinais de otite média aguda ou infecção do trato respiratório e não estavam sob antibioticoterapia no momento do procedimento. A aspiração do material foi realizada por timpanocentese, utilizando-se um coletor de Alden-Senturia. Os estudos bacteriológicos foram iniciados em menos de 15 minutos após a obtenção da efusão e uma parte da amostra foi armazenada a -20oC para análise posterior pela PCR. Utilizou-se um método de PCR simultânea para a detecção de quatro patógenos. A análise estatística foi efetivada com o teste χ2 de McNemar, teste χ2 com correção de Yates e teste exato de Fisher, quando apropriados. Resultados: Cultivaram-se bactérias em 32 (25,1%) das 128 amostras e os patógenos principais foram encontrados em 25 (19,6%). O A. otitidis não foi isolado em cultura. A PCR identificou bactérias em 110 (85,9%) das amostras, e os resultados positivos foram: 67 (52,3%) para A. otitidis, 50 (39,1%) para H. influenzae, 16 (12,5%) para S. pneumoniae e 13 (10,2%) para M. catarrhalis. Todas as amostras positivas por cultura foram positivas pela PCR, mas 85 (77,2%) das efusões com resultado positivo pela PCR foram negativas por cultura, para os germes estudados. A PCR foi significativamente mais sensível que a cultura (P<0,001). O S. pneumoniae foi encontrado mais freqüentemente em otite média recorrente do que em otite média com efusão crônica (P=0,038) e o H. influenzae foi encontrado mais vezes em crianças menores de dois anos (P=0,049). Quanto ao perfil de resistência, 100% das M. catarrhalis, 62,5% dos S. pneumoniae e 23% dos H. influenzae eram resistentes à penicilina. Conclusões: A prevalência das bactérias na otite média com efusão em um grupo de crianças brasileiras é semelhante àquelas relatadas em outros países, sendo o H. influenzae o mais encontrado dentre os patógenos principais da orelha média. Essa prevalência sugere que bactérias podem desempenhar um papel na patogênese da otite média com efusão. Os resultados mostram que a PCR é mais sensível na detecção de bactérias na efusão da orelha média, comparada com cultura, e é essencial para a identificação do A. otitidis. O elevado percentual de detecção do A. otitidis sugere mais investigações sobre sua atuação no início e no prolongamento de doenças da orelha média. O S. pneumoniae foi mais freqüente em otite média recorrente do que em otite média com efusão crônica e o H. influenzae foi mais encontrado em crianças menores de dois anos. A resistência à penicilina por parte do pneumococo e da moraxela é semelhante à relatada em outros países, ao passo que a produção de β-lactamase pelo hemófilo é mais baixa que aquela referida em bactérias isoladas em amostras de efusões de otite média com efusão.

Da orientação vocacional a educação para o trabalho: uma questão para a Escola Pública

Este e um trabalho que analisa a questão da atuação do Orientador Edu cacional, hoje, na área da Orientação Vocacional. Neste sentido realiza um estudo do caminho percorrido pela Orientação Vocacional nas escolas publi cas do Município do Rio de Janeiro e pelo órgão coordenador desta área na Secretaria Municipal de Educação. Inicialmente enfoca a direção dada à for mação do Orientador Educacional nos cursos de habilitação em Orientação Edu cacional, a qual determina, de modo geral, a forma de sua "açao na escola. Esta análise, inclui também a reformulação da Orientação Vocacional inicia da no final da decada de 70 e o exame critico dos fundamentos teóricos da Orientação Vocacional, assim como a mudança da prática do Orientador Educa cional nesta área, suas possibilidades e limites, a partir do contexto esco lar e da conjuntura sócio-econômica na qual se efetiva esta prática.

O projeto João de Barro: uma experiência oficial de educação popular no Maranhão

Ce travail presente une analyse de la proposition du Projet "João de Barro" élaboré par la Secretaria de Educação do Estado do Maranhão en 1967. 11 était destiné aux popul~ tions rurales de l'Etat et avait pour objectif: "par l'inter mêdiaire d'une dêmarche éducacionnelle totale et a un niveau primaire, intégrer l'homme de la terre au proces de dévelo~ pement socio-êconomique racionalisé". Le quadre thêorique qui dirige l'analyse fut élaboré basiquement et principalement ã. partir de la théorie de Gramsci pour expliquer la dynamique de la démarche éducative dans un état capitaliste. Les données êconomiques, sociales et polit~ ques de l'êpoque sont êgalement considérêes comme necessaires a une analyse d'un fait social. Considérant ce quadre de réfê rence thêorique et de conjonction on identifie dans l'éduca tion scolaire son rôle d'agent reproducteur de l'idêologie dQ minante. De cette maniere est produit un instrument util pour la consolidation de l'hêgêmonie des groupes dominants et dans cette même avancée est exaltée la contribution que peut ~pporter á l'autonomie des couches populaires. l'école Sans vouloir concluir d'une maniere définitive, ce travail souligne, malgrê tout, l'importance que l'éducation scolaire possede pour que les couches populaires utilisentmieux cet instrument de connaissance de la complexitê des re lations sociales au milieu desquelles elles_.~ont embourbées. De cette maniere elles pourront agir plus consciemment dans leurs .luttes pour la liberté. Dans ce sens, la naissance de n'importe quelle êcole, particulierement de l'êcole "João de Barro", est saluée avec espoir: qu'elle soit le germe de la vêritable école de l'avenir.