Growth and survival of pacu Piaractus mesopotamicus (Holmberg, 1887) juveniles reared in ponds or at different initial larviculture periods indoors

Five-day-old pacu larvae (Piaractus mesopotamicus) with average length and weight of 5.96 mm and 0.42 mg, respectively, were reared as follows: in a semi-intensive system with larvae stocked directly into fertilized ponds (IL0)-and an initial intensive larviculture system with larvae maintained in a laboratory for 3 (IL3), 6 (IL6) and 9 (IL9) days, before being transferred to fertilized ponds. During the indoor phase, larvae were fed Artemia nauplii. Intensive-culture survivals were high (95.6%, 86.4% and 83.8% for IL3, IL6 and IL9, respectively) and at the end of the 45-day period, the longer the larvae were kept in the intensive system, the better the juvenile survival in the ponds. IL9 and IL6 survival rates were 54.0% and 45.4%, respectively, significantly higher (P < 0.05) than IL0 (11%) and IL3 presented an intermediate rate (25.3%). Due to the low survival rate of IL0, length and weight were higher (P < 0.05) when compared to IL6 and IL9; and the differences between their survival rates affected size distribution of juveniles among treatments. Treatments, which resulted in high survival (IL6 and IL9), presented a great number of small fish. In contrast, IL0 and IL3 produced many large and extra large individuals. In general, the results indicate that pacu juvenile production by initial intensive larviculture (IL6 and IL9) was the most efficient method. Therefore, further studies should be conducted in order to improve larval growth in the laboratory and handling techniques in both the laboratory and ponds. (C) 2003 Elsevier B.V. B.V. All rights reserved.

Economic evaluation of Piaractus mesopotamicus juvenile production in different rearing systems

In this study, the costs and gross income related to the production of pacu Piaractus mesopotamicus juveniles were evaluated. This evaluation took into consideration a semi-intensive rearing, with direct stocking of the larvae into fertilized ponds (IL 0), or an initial intensive larviculture system, in which the larvae were fed in the laboratory for 3 (IL 3), 6 (IL 6), or 9 days (IL 9) before being transferred to the ponds. After 45 days of rearing, a gradual increase in production costs was observed as intensive larviculture time increased. Gross income also increased due to better survival rates (11.0, 25.3, 45.4, and 54.0% for IL 0, IL 3, IL 6, and IL 9, respectively). Therefore, increased profits were obtained under intensive larviculture (US$ 0.27, US$ 6.07, US$ 11.99, and US$ 13.16 per one thousand larvae in treatments IL 0, IL 3, IL 6, and IL 9, respectively). In a larger scale production simulation, the results obtained with initial intensive larviculture also showed evident economic advantages, confirming the feasibility of this system in comparison with the direct stocking of larvae in ponds for the production of pacu juveniles. © 2004 Elsevier B.V. All rights reserved.

Água levemente salinizada aumenta a eficiência da larvicultura de peixes neotropicais

The objective of this work was to evaluate the effect of slightly saline water in an intensive larviculture of tambaqui, matrinxã, apaiari, and piau, during the initial days of active feeding. Larvae were reared in artificial saline water, at concentrations from 0 (freshwater) to 14 g L-1 NaCl (at a 2.0 g L-1), and fed with two portions of Artemia nauplii, following a specific protocol for each species, in a completely randomized design, with 3 replicates. Tambaqui, matrinxã and apaiari larvae can be reared at saline concentrations till 2 g L-1 without impairing growth and survival. Piau larvae were more tolerant and endured saline water until 4 g L-1. At saline concentrations above that, fish mortality increased and reached 100% at 6 g L-1, for matrinxã and apaiari, and at 10 g L-1, for tambaqui. Saline water at 2 g L-1 provided a higher survival for matrinxã, and higher growth for tambaqui, apaiari and piau. These last two species showed a better growth performance with the highest quantity of nauplii. Slightly saline water at 2 g L-1 is beneficial to these studied species, as it optimizes larval growth potential and the use of Artemia nauplii as live food.

Smoothing a Discrete Hazard Function for the Number of Patients Colonized with Methicillin-Resistance Staphylococcus Aureus in an Intensive Care Unit

A new method for estimating the time to colonization of Methicillin-resistant Staphylococcus Aureus (MRSA) patients is developed in this paper. The time to colonization of MRSA is modelled using a Bayesian smoothing approach for the hazard function. There are two prior models discussed in this paper: the first difference prior and the second difference prior. The second difference prior model gives smoother estimates of the hazard functions and, when applied to data from an intensive care unit (ICU), clearly shows increasing hazard up to day 13, then a decreasing hazard. The results clearly demonstrate that the hazard is not constant and provide a useful quantification of the effect of length of stay on the risk of MRSA colonization which provides useful insight.

Re-invent yourself: from London intensive care nursing and the Nigerian oil fields to an an academic library in Brisbane; a career change worth making.

A complete change of career forces a seismic shift in every aspect of your life. From day one, you have to face the loss of long held beliefs, behaviours, the known world of self, and security. We came from professions that themselves are poles apart, and many of the challenges we faced entering the profession were the same: juggling full-time work, part time study, and family commitmemts, taking a pay cut, and loss of social life. But over a short period of time we both transitioned to our new profession successfully. so what make our successful transition possible?

Human resource management and innovation: what are knowledge-intensive firms doing?

An undeniable shift in focus from traditional production companies to Knowledge-Intensive Firms (KIFs) poses challenges for academics and practioners alike. In particular, effective management of an organization's human resources has become a critical issue for ensuring sustained innovation capacity. The relationship between Human Resource Management (HRM) in KIFs is however still a largely unexplored arena. The objective of this paper is to explore this relationship in an effort to identify HRM practices that support innovation. To this end, the paper includes reviews of the literature relevant to HRM and innovation in KIFs and four case studies from companies in Denmark and Australia that have been recognized for excellence in innovation. On the basis of content analyses conducted on the case data, some preliminary conclusions are posited regarding the role of HRM in KIFs. More specifically, the findings from this study suggest that while there are commonalities between HRM practices in traditional manufacturing companies and KIFs, there are also important differences, especially in terms of staffing practices. The paper contributes by offering recommendations for management of HRM in innovative KIFs and potential avenues for research to further develop our understanding of how HRM can support innovation in KIFs.

Using a longitudinal model to estimate the effect of methicillin-resistant staphylococcus aureus infection on length of stay in an intensive care unit

Healthcare-associated methicillin-resistant Staphylococcus aureus(MRSA) infection may cause increased hospital stay or, sometimes, death. Quantifying this effect is complicated because it is a time-dependent exposure: infection may prolong hospital stay, while longer stays increase the risk of infection. We overcome these problems by using a multinomial longitudinal model for estimating the daily probability of death and discharge. We then extend the basic model to estimate how the effect of MRSA infection varies over time, and to quantify the number of excess ICU days due to infection. We find that infection decreases the relative risk of discharge (relative risk ratio = 0.68, 95% credible interval: 0.54, 0.82), but is only indirectly associated with increased mortality. An infection on the first day of admission resulted in a mean extra stay of 0.3 days (95% CI: 0.1, 0.5) for a patient with an APACHE II score of 10, and 1.2 days (95% CI: 0.5, 2.0) for a patient with an APACHE II score of 30. The decrease in the relative risk of discharge remained fairly constant with day of MRSA infection, but was slightly stronger closer to the start of infection. These results confirm the importance of MRSA infection in increasing ICU stay, but suggest that previous work may have systematically overestimated the effect size.

Intensive cognitive-behaviour therapy for depression : preliminary findings with four country residents

Describes a brief intensive program of cognitive therapy for depression that was designed for 4 adult residents of country towns in Australia, who resided some distance from treatment centers. Ss were assessed prior to treatment, at posttreatment, and at 4-wk, 8-wk, and 20-mo follow-ups. Treatments took place over 3 consecutive days for a total period of 15 hrs. Effects were highly consistent with the impact of group treatments delivered on a more traditional schedule. If confirmed in a controlled group study, these results suggest that cognitive therapy may be applied more economically and more widely than was previously realized.

A robust reactive scheduling model for intensive care units

The ICU is an integral part of any hospital and is under great load from patient arrivals as well as resource limitations. Scheduling of patients in the ICU is complicated by the two general types; elective surgery and emergency arrivals. This complicated situation is handled by creating a tentative initial schedule and then reacting to uncertain arrivals as they occur. For most hospitals there is little or no flexibility in the number of beds that are available for use now or in the future. We propose an integer programming model to handle a parallel machine reacting system for scheduled and unscheduled arrivals.

Cost effectiveness of antimicrobial catheters in the intensive care unit : Addressing uncertainty in the decision

Introduction: Some types of antimicrobial-coated central venous catheters (A-CVC) have been shown to be cost-effective in preventing catheter-related bloodstream infection (CR-BSI). However, not all types have been evaluated, and there are concerns over the quality and usefulness of these earlier studies. There is uncertainty amongst clinicians over which, if any, antimicrobial-coated central venous catheters to use. We re-evaluated the cost-effectiveness of all commercially available antimicrobialcoated central venous catheters for prevention of catheter-related bloodstream infection in adult intensive care unit (ICU) patients. Methods: We used a Markov decision model to compare the cost-effectiveness of antimicrobial-coated central venous catheters relative to uncoated catheters. Four catheter types were evaluated; minocycline and rifampicin (MR)-coated catheters; silver, platinum and carbon (SPC)-impregnated catheters; and two chlorhexidine and silver sulfadiazine-coated catheters, one coated on the external surface (CH/SSD (ext)) and the other coated on both surfaces (CH/SSD (int/ext)). The incremental cost per qualityadjusted life-year gained and the expected net monetary benefits were estimated for each. Uncertainty arising from data estimates, data quality and heterogeneity was explored in sensitivity analyses. Results: The baseline analysis, with no consideration of uncertainty, indicated all four types of antimicrobial-coated central venous catheters were cost-saving relative to uncoated catheters. Minocycline and rifampicin-coated catheters prevented 15 infections per 1,000 catheters and generated the greatest health benefits, 1.6 quality-adjusted life-years, and cost-savings, AUD $130,289. After considering uncertainty in the current evidence, the minocycline and rifampicin-coated catheters returned the highest incremental monetary net benefits of $948 per catheter; but there was a 62% probability of error in this conclusion. Although the minocycline and rifampicin-coated catheters had the highest monetary net benefits across multiple scenarios, the decision was always associated with high uncertainty. Conclusions: Current evidence suggests that the cost-effectiveness of using antimicrobial-coated central venous catheters within the ICU is highly uncertain. Policies to prevent catheter-related bloodstream infection amongst ICU patients should consider the cost-effectiveness of competing interventions in the light of this uncertainty. Decision makers would do well to consider the current gaps in knowledge and the complexity of producing good quality evidence in this area.

Methods and preliminary results for a data linkage project to determine long-term survival after intensive care unit admission

Aims: To describe a local data linkage project to match hospital data with the Australian Institute of Health and Welfare (AIHW) National Death Index (NDI) to assess longterm outcomes of intensive care unit patients. Methods: Data were obtained from hospital intensive care and cardiac surgery databases on all patients aged 18 years and over admitted to either of two intensive care units at a tertiary-referral hospital between 1 January 1994 and 31 December 2005. Date of death was obtained from the AIHW NDI by probabilistic software matching, in addition to manual checking through hospital databases and other sources. Survival was calculated from time of ICU admission, with a censoring date of 14 February 2007. Data for patients with multiple hospital admissions requiring intensive care were analysed only from the first admission. Summary and descriptive statistics were used for preliminary data analysis. Kaplan-Meier survival analysis was used to analyse factors determining long-term survival. Results: During the study period, 21 415 unique patients had 22 552 hospital admissions that included an ICU admission; 19 058 surgical procedures were performed with a total of 20 092 ICU admissions. There were 4936 deaths. Median follow-up was 6.2 years, totalling 134 203 patient years. The casemix was predominantly cardiac surgery (80%), followed by cardiac medical (6%), and other medical (4%). The unadjusted survival at 1, 5 and 10 years was 97%, 84% and 70%, respectively. The 1-year survival ranged from 97% for cardiac surgery to 36% for cardiac arrest. An APACHE II score was available for 16 877 patients. In those discharged alive from hospital, the 1, 5 and 10-year survival varied with discharge location. Conclusions: ICU-based linkage projects are feasible to determine long-term outcomes of ICU patients