The ADMIN-ICU survey: A survey on antimicrobial dosing and monitoring in ICUs

Objectives: There is little evidence and few guidelines to inform the most appropriate dosing and monitoring for antimicrobials in the ICU. We aimed to survey current practices around the world. Methods: An online structured questionnaire was developed and sent by e-mail to obtain information on local antimicrobial prescribing practices for glycopeptides, piperacillin/tazobactam, carbapenems, aminoglycosides and colistin. Results: A total of 402 professionals from 328 hospitals in 53 countries responded, of whom 78% were specialists in intensive care medicine (41% intensive care, 30% anaesthesiology, 14% internal medicine) and 12% were pharmacists. Vancomycin was used as a continuous infusion in 31% of units at a median (IQR) daily dose of 25 (25–30) mg/kg. Piperacillin/tazobactam was used as an extended infusion by 22% and as a continuous infusion by 7%. An extended infusion of carbapenem (meropenem or imipenem) was used by 27% and a continuous infusion by 5%. Colistin was used at a daily dose of 7.5 (3.9–9) million IU (MIU)/day, predominantly as a short infusion. The most commonly used aminoglycosides were gentamicin (55%) followed by amikacin (40%), with administration as a single daily dose reported in 94% of the cases. Gentamicin was used at a daily dose of 5 (5–6) mg/day and amikacin at a daily dose of 15 (15–20) mg/day. Therapeutic drug monitoring of vancomycin, piperacillin/tazobactam and meropenem was used by 74%, 1% and 2% of the respondents, respectively. Peak aminoglycoside concentrations were sampled daily by 28% and trough concentrations in all patients by 61% of the respondents. Conclusions: We found wide variability in reported practices for antibiotic dosing and monitoring. Research is required to develop evidence-based guidelines to standardize practices.

Like our page : using Facebook to support first year students in their transition to higher education

Facebook is approaching ubiquity in the social habits and practice of many students. However, its use in higher education has been criticised (Maranto & Barton, 2010) because it can remove or blur academic boundaries. Despite these concerns, there is strong potential to use Facebook to support new students to communicate and interact with each other (Cheung, Chiu, & Lee, 2010). This paper shows how Facebook can be used by teaching staff to communicate more effectively with students. Further, it shows how it can provide a way to represent and include beginning students’ thoughts, opinions and feedback as an element of the learning design and responsive feed-forward into lectures and tutorial activities. We demonstrate how an embedded social media strategy can be used to complement and enhance the first year curriculum experience by functioning as a transition device for student support and activating Kift’s (2009) organising principles for first year curriculum design.

An elegy for Greg Ham: Copyright law, the Kookaburra case, and remix culture

The ‘Kookaburra’ case was a tragic and controversial copyright dispute, highlighting the need for copyright law reform by the Australian Parliament. In the Kookaburra case, a copyright action was brought by Larrikin Records against Men at Work’s song ‘Down Under’, alleging copyright infringement of the ‘Kookaburra’ song composed by Marion Sinclair. The dispute raised a host of doctrinal matters. There was disquiet over the length of the copyright term. There were fierce contests as to the copyright ownership of the ‘Kookaburra’ song. The litigation raised questions about copyright infringement and substantiality – particularly in relation to musical works. The ‘Kookaburra’ case highlighted frailties in Australia’s regime of copyright exceptions. The litigation should spur the Australian Law Reform Commission to make recommendations for law reform in its inquiry Copyright and the Digital Economy. This article provides a critical evaluation of the options of a defence for transformative use; a defence for fair use; and statutory licensing. The ‘Kookaburra’ case also examines the question of appropriate remedies in respect of copyright infringement. The conclusion considers the implications of the Kookaburra case for other forms of musical works – including digital sampling, mash-ups, and creative remixes. It finishes with an elegy for Greg Ham – paying tribute to the multi-instrumentalist for Men at Work.

地下水数值模型界面Ground Water Vistas介绍——以美国Edwards含水层Barton泉稳定流模型为例

Ground Water Vistas软件是目前国际上盛行的三维地下水水流和溶质运移模拟的图形使用界面.本文介绍了Ground Water Vistas在三种模式下的功能,分析评述了它的优缺点.并以美国Edwards含水层Barton泉稳定流模型为实例,展示了Ground Water Vistas强大的前处理、后处理功能及其优良的三维可视化效果.Edwards含水层喀斯特发育程度极高,其模型研究对我国喀斯特地区地下水资源的评价与管理具有借鉴意义和指导作用.

Human progress through missions / by James L. Barton.

http://www.archive.org/details/humanprogressthr00bartuoft

The scramble for the seas : the ballad evidence of Sir Andrew Barton

The presence and importance of the sea as a factor that has helped shape the history of England since at least the Roman invasions of 55-54 BC (less successful, incidentally, than most of Caesar’s other military ventures ...) need no particular urging or demonstration. Nonetheless, a bird’s-eye view would necessarily survey the waves of invasions and settlements that, one after the other, came dashing over the centuries upon England’s shores; not to mention the requested invasion of 1688, Angles and Saxons, Scandinavians, Normans, they all crossed the whale’s path and cast anchor in England’s green and pleasant land. In the course of this retrospective voyage through the oceans of History, one would inevitably stop at the so-called ‘Discoveries’ of the 15th-16th centuries, meet their navigators, sailors and pirates extolled by Richard Hakluyt (1553?-1616), face an anonymous crowd of merchants and witness the huge expansion of trade, largely to the benefit of the ‘discovering’ countries as prescribed by the economic Gospel Adam Smith (1723-90) would later baptize as “mercantilism”.

Structural studies and gabbro mylonitization within the Barton Bay Deformation Zone, Geraldton, Ontario /

Structures related to ductile siMple shear parallel to the Bankf ield-Tonbill Fault, define a 5km wide zone, the Barton Bay Deformation Zone. Structures present within this zone Include; simple shear fabrics S, C and C , asymmetric Z shaped folds with rotated axes, boudinage and pinch and swell structures and a subhorlzontal extension llneation. The most highly deformed rock is a gabbro mylonite which occurs in the fault zone. The deformation of this gabbro has been traced in stages from a protomylonite to an ultramylonite In which feldspar and chlorite grainslze has been reduced from over 100 microns to as little as 5 microns. Evidence from the mylonite and the surrounding structure indicates that deformation within the Barton Bay Deformation Zone is related to a regional simple shear zone, the Bankf ield-Tombill Fault. Movement along this shear zone was in a south over north oblique strike slip fashion with a dextral sense of displacement.

Gravity: a new play by Greg Belanger

Gravity was first performed at Strider Theatre, Colby College in Waterville, Maine. It was directed by the author with the following cast: STEVEN: Harold Withee PAMELA: Sue Larsen JEREMY: Jason Reifler IXXTOR: Amanda Starr MOTHER: Catherine C. Coyne BREIT: Scott W. Cole TONI: Laura Smishkiss

Informe de la Primera Reunión del Grupo Regional sobre Energía Geotérmica (GREG)

Incluye Bibliografía