Feasibility study to inform the design of a UK multi-centre randomised controlled trial of prophylactic antibiotics for the prevention of recurrent cellulitis of the leg

Background: This paper describes the results of a feasibility study for a randomised controlled trial (RCT). Methods: Twenty-nine members of the UK Dermatology Clinical Trials Network (UK DCTN) expressed an interest in recruiting for this study. Of these, 17 obtained full ethics and Research & Development (R&D) approval, and 15 successfully recruited patients into the study. A total of 70 participants with a diagnosis of cellulitis of the leg were enrolled over a 5-month period. These participants were largely recruited from medical admissions wards, although some were identified from dermatology, orthopaedic, geriatric and general surgery wards. Data were collected on patient demographics, clinical features and willingness to take part in a future RCT. Results: Despite being a relatively common condition, cellulitis patients were difficult to locate through our network of UK DCTN clinicians. This was largely because patients were rarely seen by dermatologists, and admissions were not co-ordinated centrally. In addition, the impact of the proposed exclusion criteria was high; only 26 (37%) of those enrolled in the study fulfilled all of the inclusion criteria for the subsequent RCT, and were willing to be randomised to treatment. Of the 70 participants identified during the study as having cellulitis of the leg (as confirmed by a dermatologist), only 59 (84%) had all 3 of the defining features of: i) erythema, ii) oedema, and iii) warmth with acute pain/tenderness upon examination. Twenty-two (32%) patients experienced a previous episode of cellulitis within the last 3 years. The median time to recurrence (estimated as the time since the most recent previous attack) was 205 days (95% CI 102 to 308). Service users were generally supportive of the trial, although several expressed concerns about taking antibiotics for lengthy periods, and felt that multiple morbidity/old age would limit entry into a 3-year study. Conclusion: This pilot study has been crucial in highlighting some key issues for the conduct of a future RCT. As a result of these findings, changes have been made to i) the planned recruitment strategy, ii) the proposed inclusion criteria and ii) the definition of cellulitis for use in the future trial.

„Schulinterne Unterstützungs- und Beratungsteams“ (SUBs) - konzeptionelle Skizzierungen im Kontext inklusiver Schulentwicklung, in Anlehnung an das kanadische Modell der Methods & Resource Teams

Mit der Ratifizierung der UN-Behindertenrechtskonvention verpflichtet sich Deutschland seit 2009, ein inklusives Bildungssystem einzurichten. Vor diesem Hintergrund ist auf schulorganisatorischer Ebene ein heterogenes, multiprofessionelles Team mit entsprechenden Unterstützungsmaßnahmen und Unterstützungsrollen notwendig, das sich strukturell und personell abbildet. In diesem Beitrag werden - auf Basis des kanadischen "Methods & Resource Teams" - Überlegungen zu einer schulinternen und systemisch ausgerichteten Unterstützungrolle in Schule und Unterricht in Deutschland vorgestellt, die in die Konzeption eines "Schulinternen Unterstützungs- und Beratungsteams" (SUB) münden. (Autor)

Inclusion in an age of mobility

Learning with mobiles in UK universities is not new and is not novel. It is, in fact, at least 10 years old, well-documented and comparable to activity in universities elsewhere in Western Europe, America and Asia Pacific. Continued and dramatic changes in the ownership, access and expectations of mobiles amongst university students and equally across UK society have suddenly propelled learning with mobiles to centre-stage as a feasible proposition but, it is now argued, only if students can bring-your-own-device. This has already catalysed discussion about authority, agency and control within university settings but the equally significant and profound implications for the inclusion agenda have not been articulated. This paper begins that process. A theoretical framework for social inclusion in this context is considered, identified and discussed. The paper reviews the progress and problems of the substantial and unique programme of mobile learning across UK higher education since 2000 in relation to its stance on inclusion, where this is apparent. These are all well-documented in academic and official sources; the paper does however also draw on the author's involvement in many of the events and initiatives. The paper raises however significant questions about this programme's meaning and direction in a world where now there is more, better, cheaper, faster, newer but different digital technology in the hands of students, potential students and everyone else than there is routinely in the educational institutions themselves. This digital technology, mobile technology, now allows learners to create, own, transform, discuss, discard, share, store and broadcast ideas, opinions, images and information, and to create and transform identities and communities. The paper argues that this epistemological revolution may mean that universities and colleges are no longer credible and authoritative gatekeepers to knowledge and its technologies and so the meaning and relevance of inclusion are much less clear. The paper proposes a new stance on inclusion.

Performing inclusion and exclusion in the peer group. Children's social organization and peer socializing practices in the classroom

This PhD thesis investigates children’s peer practices in two primary schools in Italy, focusing on the ordinary and the Italian L2 classroom. The study is informed by the paradigm of language socialization and considers peer interactions as a ‘double opportunity space’, allowing both children’s co-construction of their social organization and children’s sociolinguistic development. These two foci of attention are explored on the basis of children’s social interaction and of the verbal, embodied, and material resources that children agentively deploy during their mundane activities in the peer group. The study is based on a video ethnography that lasted nine months. Approximately 30 hours of classroom interactions were video-recorded, transcribed, and analyzed with an approach that combines the micro-analytic instruments of Conversation Analysis and the use of ethnographic information. Three main social phenomena were selected for analysis: (a) children’s enactment of the role of the teacher, (b) children’s reproduction of must-formatted rules, and (c) children’s argumentative strategies during peer conflict. The analysis highlights the centrality of the institutional frame for children’s peer interactions in the classroom. Moreover, the study illustrates that children socialize their classmates to the linguistic, social, and moral expectations of the context in and through various practices. Notably, these practices are also germane to the local negotiation of children’s social organization and hierarchy. Therefore, the thesis underlines that children’s peer interactions are both a resource for children’s sociolinguistic development and a potentially problematic locus where social exclusion is constructed and brought to bear. These insights are relevant for teachers’ professional practice. Children’s peer interactions are a resource that can be integrated in everyday didactics. Nevertheless, the role of the teacher in supervising and steering children’s peer practices appears crucial: an acritical view of children’s autonomous work, often implied in teaching methods such as peer tutoring, needs to be problematized.

An Integrated Framework To Improve The Concept Of Resource Specialisation.

Resource specialisation, although a fundamental component of ecological theory, is employed in disparate ways. Most definitions derive from simple counts of resource species. We build on recent advances in ecophylogenetics and null model analysis to propose a concept of specialisation that comprises affinities among resources as well as their co-occurrence with consumers. In the distance-based specialisation index (DSI), specialisation is measured as relatedness (phylogenetic or otherwise) of resources, scaled by the null expectation of random use of locally available resources. Thus, specialists use significantly clustered sets of resources, whereas generalists use over-dispersed resources. Intermediate species are classed as indiscriminate consumers. The effectiveness of this approach was assessed with differentially restricted null models, applied to a data set of 168 herbivorous insect species and their hosts. Incorporation of plant relatedness and relative abundance greatly improved specialisation measures compared to taxon counts or simpler null models, which overestimate the fraction of specialists, a problem compounded by insufficient sampling effort. This framework disambiguates the concept of specialisation with an explicit measure applicable to any mode of affinity among resource classes, and is also linked to ecological and evolutionary processes. This will enable a more rigorous deployment of ecological specialisation in empirical and theoretical studies.

Infertility Care And The Introduction Of New Reproductive Technologies In Poor Resource Settings.

The overall prevalence of infertility was estimated to be 3.5-16.7% in developing countries and 6.9-9.3% in developed countries. Furthermore, according to reports from some regions of sub-Saharan Africa, the prevalence rate is 30-40%. The consequences of infertility and how it affects the lives of women in poor-resource settings, particularly in developing countries, has become an important issue to be discussed in reproductive health. In some societies, the inability to fulfill the desire to have children makes life difficult for the infertile couple. In many regions, infertility is considered a tragedy that affects not only the infertile couple or woman, but the entire family. This is a position paper which encompasses a review of the needs of low-income infertile couples, mainly those living in developing countries, regarding access to infertility care, including ART and initiatives to provide ART at low or affordable cost. Information was gathered from the databases MEDLINE, CENTRAL, POPLINE, EMBASE, LILACS, and ICTRP with the key words: infertility, low income, assisted reproductive technologies, affordable cost, low cost. There are few initiatives geared toward implementing ART procedures at low cost or at least at affordable cost in low-income populations. Nevertheless, from recent studies, possibilities have emerged for new low-cost initiatives that can help millions of couples to achieve the desire of having a biological child. It is necessary for healthcare professionals and policymakers to take into account these new initiatives in order to implement ART in resource-constrained settings.

Comparative analysis of adverse events between infliximab and adalimumab in Crohn's disease management: a Brazilian single-centre experience

INTRODUCTION: Data is scarce regarding adverse events (AE) of biological therapy used in the management of Crohn's Disease (CD) among Brazilian patients. OBJECTIVES: To analyse AE prevalence and profile in patients with CD treated with Infliximab (IFX) or Adalimumab (ADA) and to verify whether there are differences between the two drugs. METHOD: Retrospective observational single-centre study of CD patients on biological therapy. Variables analysed: Demographic data, Montreal classification, biological agent administered, treatment duration, presence and type of AE and the need for treatment interruption. RESULTS: Forty-nine patients were analysed, 25 treated with ADA and 24 with IFX. The groups were homogeneous in relation to the variables studied. The average follow-up period for the group treated with ADA was 19.3 months and 21.8 months for the IFX group (p = 0.585). Overall, 40% (n = 10) of patients taking ADA had AE compared with 50% (n = 12) of IFX users (p = 0.571). There was a tendency towards higher incidence of cutaneous and infusion reactions in the IFX group and higher incidence of infections in the ADA treated group, although without significant difference. CONCLUSIONS: No difference was found in the AE prevalence and profile between ADA and IFX CD patients in the population studied.

Avaliação e conduta em escolares portadores de visão subnormal atendidos em sala de recursos

Purpose: To identify improvement in visual performance of low vision students after assessment and management conducted at the Low Vision Service of State University of Campinas (UNICAMP). Method: Fourteen low vision students aged six to 30 years, attended in a room with resources for visual deficiency in Americana and Santa Bárbara d'Oeste -- SP during 1998 received complete ophthalmologic examination, specialized low vision assessment and educational intervention. Results: The most prevalent cause of vision loss was operated congenital cataract with four cases (28.6%), followed by congenital bilateral toxoplasmic macular scars and eye malformation, both with two cases (14.3%) cases each. Eight students (57.2%) had acuity classified as severe vision loss, four (28.6%) profound, one (7.1%) moderate and one (7.1%) nearly normal vision. Twelve (85.7%) were behind expected school grade. Optical aids were prescribed for 12 (85.8%) students but only 7 (58.3%) acquired the aids thus improving significantly their school performance. Conclusion: All students improved school performance even considering that 12 (85.7%) had severe to profound vision loss. As a group their performance could even be better if the optical aid prescriptions were acquired by all. This indicates the need of a social work to support such needs. For good results at school and effective student inclusion a partnership between school, family and specialized education is necessary. We recommend to promote the benefits of the resource room.

Educação física e inclusão educacional : entender para atender = Physical education and educational inclusion : understanding to attend

Universidade Estadual de Campinas . Faculdade de Educação Física

Reflexões sobre a Educação Fisica para portadores de necessidades educacionais especiais a luz da individualização

Universidade Estadual de Campinas . Faculdade de Educação Física

A educação fisica na rede publica do municipio de São João da Boa Vista - SP e o portador de necessidade especiais

Universidade Estadual de Campinas. Faculdade de Educação Física

Exposições em museus de ciências: reflexões e critérios para análise

Hoje, no que diz respeito à sua interface direta com o público, os museus são considerados, em teoria, instituições com objetivos variados, como educação, lazer, informação e inclusão social. Neste contexto, as exposições aparecem como elemento fundamental da relação entre museus e sociedade, e a expografia torna-se, portanto, ferramenta de comunicação essencial para a efetividade do processo de divulgação. Mas, como se dá a comunicação nestes espaços? Trata-se o presente, de uma reflexão acerca das estratégias de comunicação nas exposições em museus de ciências e sua eficácia. Foram selecionadas três temáticas, a primeira delas é a dos tipos de exposição, e entre as numerosas possibilidades de categorização, optou-se por aquelas descritas por Dean (2003) e Davallon (1986 e 1989). Outra questão discutida é a do uso do objeto, tido, dentre as diferentes mídias a que se pode recorrer em uma exposição, como o diferencial do museu. Por fim, discute-se a questão da interatividade, por vezes reduzida à manipulação, a partir dos níveis propostos por Wagensberg (2000). Apontam-se exemplificações dessas temáticas na exposição de longa duração Pesquisa em Zoologia: a biodiversidade sob o olhar do zoólogo, inaugurada pelo Museu de Zoologia da Universidade de São Paulo em setembro de 2002.

Mothers’ birth care experiences in a Brazilian birth centre

Objective: to explore the reasons why women with previous hospital experience seek care at a birth centre, and their perceptions related to the care received in both settings. Design, setting and participants in-depth interviews focusing on the care experiences of 18 women who received birth care in a birth centre of the Brazilian public health system. Findings: three key themes emerged from the analysis: ‘Confrontation with strong problems in the hospital setting’, ‘Reasons to seek the birth centre’ and ‘Satisfaction related to birth centre care’. The main aspects that the mothers mentioned in the first and third themes were related to the institutional structure and system of care. Key conclusions and implications for practice mothers’ narratives suggested that their previous experience of problems in the hospital setting was the main motive for seeking care at the birth centre. The most important components of birth care were attention, meeting personal care demands and establishment of an adequate interpersonal relationship. More sensitive birthing care in the hospital setting is necessary, and this can be promoted through continuing professional education

State-of-the-Art and Future Directions for Green Human Resource Management: Introduction to the Special Issue

The topic of environmental sustainability is generating increased concern among business executives, governments, consumers, and management scholars. As these stakeholders struggle with the challenges and opportunities presented by an array of environmental issues, HRM scholars and practitioners alike have been relatively slow to engage in the ongoing discussions and debates. Through this special issue on Green FIRM, we seek to stimulate the field of HRM to expand its role in the pursuit of environmentally sustainable business. In this introduction to the special issue, we first provide an overview of the articles that appear in the special issue. Next we present a detailed discussion of research questions that arise from a consideration of several functional HRM practices, including performance management; training, development, and learning; compensation and rewards; and organizational culture. We conclude by describing opportunities for research at the intersection of strategic HRM and environmental management. If pursued with vigor, research addressing this extensive agenda could begin to establish a healthy field of Green FIRM scholarship.

Spiral-like structure at the centre of nearby clusters of galaxies

Context. X-ray data analysis have found that fairly complex structures at cluster centres are more common than expected. Many of these structures have similar morphologies, which exhibit spiral-like substructure. Aims. It is not yet well known how these structures are formed or maintained. Understanding the origin of these spiral-like features at the centre of some clusters is the major motivation behind this work. Methods. We analyse deep Chandra observations of 15 nearby galaxy clusters ( 0.01 < z < 0.06), and use X-ray temperature and substructure maps to detect small features at the cores of the clusters. Results. We detect spiral-like features at the centre of 7 clusters: A85, A426, A496, Hydra A cluster, Centaurus, Ophiuchus, and A4059. These patterns are similar to those found in numerical hydrodynamic simulations of cluster mergers with non-zero impact parameter. In some clusters of our sample, a strong radio source also occupies the inner region of the cluster, which indicates a possible connection between the two. Our investigation implies that these spiral-like structures may be caused by off-axis minor mergers. Since these features occur in regions of high density, they may confine radio emission from the central galaxy producing, in some cases, unusual radio morphology.