742 resultados para Virtual communities of practice


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Aims and background. In 2002, a survey including 1759 patients treated from 1980 to 1998 established a "benchmark" Italian data source for prostate cancer radiotherapy. This report updates the previous one. Methods. Data on clinical management and outcomes of 3001 patients treated in 15 centers from 1999 through 2003 were analyzed and compared with those of the previous survey. Results. Significant differences in clinical management (-10% had abdominal ma-gnetic resonance imaging; +26% received ≥70 Gy, +48% conformal radiotherapy, -20% pelvic radiotherapy) and in G3-4 toxicity rates (-3.8%) were recorded. Actuarial 5-year overall, disease-specific, clinical relapse-free, and biochemical relapse-free survival rates were 88%, 96%, 96% and 88%, respectively. At multivariate analysis, D'Amico risk categories significantly impacted on all the outcomes; higher radiotherapy doses were significantly related with better overall survival rates, and a similar trend was evident for disease-specific and biochemical relapse-free survival; cumulative probability of 5-year late G1-4 toxicity was 24.8% and was significantly related to higher radiotherapy doses (P <0.001). Conclusions. The changing patterns of practice described seem related to an improvement in efficacy and safety of radiotherapy for prostate cancer. However, the impact of the new radiotherapy techniques should be prospectively evaluated.

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Os conceitos de desenvolvimento sustentável e de educação para o desenvolvimento sustentável estão ainda em evolução o que torna pertinente, hoje, a tentativa de uma clarificação conceptual e sua posterior operacionalização. Além de promover a definição e uso correto dos termos, compete também ao ensino criar e desenvolver as competências necessárias para a sua operacionalidade. Esta investigação pretende contribuir para a autoformação de professores, nomeadamente de professores de Física e Química, em educação para o desenvolvimento sustentável. Pretende que os professores, e aqueles que beneficiam da sua ação, possam ser cidadãos críticos e responsáveis, numa sociedade local e simultaneamente global, que vive num tempo concreto mas, cada vez mais, consciente das repercussões futuras das suas ações e decisões. Tendo por base este objetivo criou-se uma comunidade de prática virtual constituída por professores de Física e Química de Portugal e de países africanos de língua oficial portuguesa. A formação em educação para o desenvolvimento sustentável constituiu o domínio da comunidade de prática. A água foi o tema motivador e aglutinador, pois sendo essencial à vida, torna-se no contexto educativo, e concretamente em educação para o desenvolvimento sustentável, num desafio ético, simultaneamente social, económico, ambiental e político. A prática reflexiva constituiu uma ferramenta fundamental da atividade da comunidade. Da análise da prática desta comunidade, que constituiu o objeto desta investigação, verificámos que os diferentes contextos geográficos, educacionais, culturais e de desenvolvimento dos professores proporcionaram uma participação diversificada na comunidade de prática. Esta participação permitiu, aos membros da referida comunidade, a criação e/ou o desenvolvimento das competências requeridas em educação para o desenvolvimento sustentável. Apesar da pertinência do tema confrontámo-nos com a falta de projetos de investigação semelhantes ao desta investigação, o que constituiu um maior desafio à sua realização.

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BACKGROUND: There are guidelines on how to develop a food challenge protocol, but at present there is no gold standard guidance on method, and separate units produce differing protocols. METHODS: We performed a retrospective analysis of 200 patients' data from the paediatric allergy units in Lausanne and Geneva, Western Switzerland, and St Thomas' Hospital (STH), UK. RESULTS: St Thomas' Hospital has a younger cohort with a lower overall mean spIgE (2.36 kU/l vs 8.00 kU/l, P = 0.004). The target peanut protein volumes differed: Switzerland 4.4 g vs STH 8.4 g. Despite this, the dose actually achieved in positive challenges was not significantly different (2.33 g vs 1.49 g, P = 0.16). 26% of challenges reacted at 4 g or more of peanut protein. CONCLUSIONS: The differences in results highlight how the variation in reasoning behind food challenge alters the outcome. Standardization of food challenges would allow easy comparison between hospitals and geographical areas for research purposes.

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Communities of arbuscular mycorrhizal fungi (AMF) were surveyed in different South Australian ecosystems. The soil was wet-sieved for spore extraction, followed by the determination of presence and abundance of AMF species as well as the percentage of root colonization. Mycorrhizal associations were common and there was substantial fungal diversity in different ecosystems. Spores were most abundant in the permanent pasture system and less abundant under continuous wheat. The incidence of mycorrhizal associations in different plant species and the occurrence of Arum and Paris type colonization generally conformed with previous information. Spores of seventeen AMF were verified throughout seasonal changes in 1996 and 1997 in the permanent pasture and on four host species (Lolium perenne, Plantago lanceolata, Sorghum sp. and Trifolium subterraneum) , set up with the same soils under greenhouse conditions. Glomus mosseae was the dominant spore type at all sampling times and in all trap cultures. Mycorrhizal diversity was significantly affected by different sampling times in trap cultures but not in field-collected soil. P. lanceolata, Sorghum sp. and T. subterraneum as hosts for trap cultures showed no differences in richness and diversity of AMF spores that developed in association with their roots. Abundance and diversity were lowest, however, in association with L. perenne , particularly in December 1996. Results show that the combination of spore identification from field-collected soil and trap cultures is essential to study population and diversity of AMF. The study provides baseline data for ongoing monitoring of mycorrhizal populations using conventional methods and material for the determination of the symbiotic effectiveness of AMF key members.

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Evidence-based information on travel associated mortality is scarce. Perception, intuition and the availability of interventions such as vaccinations and chemoprophylaxis often guide pre-travel advice. Important risks including accidents and cardiovascular events are not routinely included in pre-travel consultations although they cause more fatalities and costs than infectious diseases. The increased risk of sustaining a road accident in poor economy countries should always be mentioned. The general practitioner is further best placed to discuss possible problems of travellers with chronic diseases before travel.

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Frequently the choice of a library management program is conditioned by social, economic and/or political factors that result in the selection of a system that is not altogether suitable for the library’s needs, characteristics and functions. Open source software is quickly becoming a preferred solution, owing to the freedom to copy, modify and distribute it and the freedom from contracts, as well as for greater opportunities for interoperability with other applications. These new trends regarding open source software in libraries are also reflected in LIS studies, as evidenced by the different courses addressing automated programs, repositorymanagement, including the Linux/GNU operating system, among others. The combination of the needs of the centres and the new trends for open source software is the focus of a virtual laboratory for the use of open source software for library applications. It was the result of a project, whose aim was to make a useful contribution to the library community, that was carried out by a group of professors of the School of Library and Information Science of the University of Barcelona, together with a group of students, members of a Working Group on Open Source Software for Information Professionals, of the Professional Library Association of Catalonia.

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Developed as a more detailed follow up at a 2009 briefing document,Building Sustainable Pavement with Concrete, this guide provides a clear, concise and cohesive discussion of pavement sustainability concepts and of recommended practices for maximizing the sustainability of concrete pavements. The intended audience includes decisions makers and practitioners in both owner-agencies and supply, manufacturing consulting and contractor businesses. Readers will find individual chapters with the most recent technical information and best practices related to concrete pavement deign, materials, construction, use/operations, renewal and recycling. In addition, they will find chapters addressing issues specific to pavement sustainability in the urban environment and to the evaluation of pavement sustainability.

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Sustainable Concrete Pavements: A Manual of Practice is a product of the National Concrete Pavement Technology Center at Iowa State University’s Institute for Transportation, with funding from the Federal Highway Administration (DTFH61-06-H-00011, Work Plan 23). Developed as a more detailed follow-up to a 2009 briefing document, Building Sustainable Pavement with Concrete, this guide provides a clear, concise, and cohesive discussion of pavement sustainability concepts and of recommended practices for maximizing the sustainability of concrete pavements. The intended audience includes decision makers and practitioners in both owner-agencies and supply, manufacturing, consulting, and contractor businesses. Readers will find individual chapters with the most recent technical information and best practices related to concrete pavement design, materials, construction, use/operations, renewal, and recycling. In addition, they will find chapters addressing issues specific to pavement sustainability in the urban environment and to the evaluation of pavement sustainability. Development of this guide satisfies a critical need identified in the Sustainability Track (Track 12) of the Long-Term Plan for Concrete Pavement Research and Technology (CP Road Map). The CP Road Map is a national research plan jointly developed by the concrete pavement stakeholder community, including Federal Highway Administration, academic institutions, state departments of transportation, and concrete pavement–related industries. It outlines 12 tracks of priority research needs related to concrete pavements. CP Road Map publications and other operations support services are provided by the National Concrete Pavement Technology Center at Iowa State University. For details about the CP Road Map, see www.cproadmap. org/index.cfm.

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Appendix: List of species found in boundaries

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OBJECTIVES: In 2002, the canton of Fribourg, Switzerland, implemented a coordinated pharmaceutical care service in nursing homes to promote rational drug use. In the context of this service, a project was conducted to develop recommendations for the pharmacological management of behavioral and psychological symptoms of dementia (BPSD) in nursing home residents. DESIGN AND METHODS: Selected evidence-based guidelines and meta-analysis sources related to the management of depression, insomnia, and agitation in dementia patients were systematically searched and evaluated. Evidence and controversies regarding the pharmacological treatment of the most common BPSD symptoms were reviewed, and treatment algorithms were developed. RESULTS: Ten evidence-based guidelines and meta-analyses for BPSD management were identified, with none specifically addressing issues related to nursing home residents. Based on this literature, recommendations were developed for the practice of pharmacological management of depression, sleep disturbances, and agitation in nursing home residents. For depression, SSRIs are considered the first choice if an antidepressant is required. No clear evidence has been found for sleep disturbances; the underlying conditions need to be investigated closely before the introduction of any drug therapy. Many drugs have been investigated for the treatment of agitation, and if necessary, antipsychotics could be used, although they have significant side effects. Several areas of uncertainty were identified, such as the current controversy about typical and atypical antipsychotic use or the appropriateness of cholinesterase inhibitors for controlling agitation. Treatment algorithms were presented to general practitioners, pharmacists, and medical directors of nursing homes in the canton of Fribourg, and will now be implemented progressively, using educational sessions, pharmaceutical counseling, and monitoring. CONCLUSION: Based on existing evidence-based studies, recommendations were developed for the practice of pharmacological management of depression, sleep disturbances, and agitation in nursing home residents. It should be further studied whether these algorithms implemented through pharmaceutical care services will improve psychotropic drug prescriptions and prevent drug-related problems in nursing home residents

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The objective of this work was to determine the shifts on the PCR-DGGE profiles of bacterial communities associated to the rhizosphere of potato cultivars, in order to generate baseline information for further studies of environmental risk assessment of genetically modified potato plants. A greenhouse experiment was carried out with five potato cultivars (Achat, Bintje, Agata, Monalisa and Asterix), cultivated in pots containing soil from an integrated system for agroecological production. The experiment was conducted in a split plot randomized block design with five cultivars, three sampling periods and five replicates. Rhizosphere samples were collected in three sampling dates during plant development. DNA of rhizosphere microorganisms was extracted, amplified by PCR using bacterial universal primers, and analyzed through DGGE. Shifts on the rhizosphere bacterial communities associated to rhizosphere of different cultivars were related to both cultivar and plant age. Differences among rhizosphere bacterial communities were clearest at the earliest plant age, tending to decrease in later stages. This variation was detected among bacterial communities of the five tested cultivars. The characterization of soil microbial communities can be part of plant breeding programs to be used on studies of environmental risk assessment of genetically modified potatoes.

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This report presents a national synthesis of rural expressway, two-way stop -controlled (TWSC) intersection safety strategies and intersection designs and an analysis of Iowa expressway TWSC intersection crash characteristics. A rural expressway is a multi-lane highway with a divided median and with mostly at -grade intersections, although some intersections may be grade separated. The synthesis of intersection strategies is conducted in two parts. The first is a literature review and the second part is a national survey of strategies currently being applied by state transportation agencies. The characterization of crash patterns at TWSC expressway intersections is examined through the analysis of 5 years of crash data at 644 intersections.