Background: The aim of surgical antibiotic prophylaxis (SAP) is to prevent surgical site infection (SSI) by administering an appropriate antimicrobial agent perioperatively. However, SAP may be associated with adverse effects and incurs added costs. The primary objective of this prospective study is to establish whether clinicians are adhering to existing perioperative antibiotic prophylaxis guidelines in terms of indication, dosage and timing of SAP. Secondary objectives are to determine the proportion of patients receiving inappropriate antibiotics; and to evaluate correct practice concerning re-dosing and duration of SAP. Methods: A cross-sectional prospective audit of the anaesthetic records and prescription charts of surgical patients was conducted at Groote Schuur Hospital, a tertiary level teaching hospital in Cape Town, South Africa, over a period of one week. Data were collected by anaesthetists – blinded to the study objectives – and the investigators; then captured on Excel spread sheets and compared to existing SAP guidelines. Descriptive statistics and binary logistic regression were used for analysis. Results: Of the 192 patients consented, 180 questionnaires were completed for data analysis. The median age of participants was 44.5 years (IQR: 31.5-58), with a preponderance of females (58.7%). SAP was administered in 149 cases (82.8%) and withheld in 31 (17.2%). This was appropriate in 91.9% (137/149) and 77.4% (24/31) respectively. Twelve patients (6.7%) received inappropriate antibiotics and in seven (3.9%) it was inappropriately withheld. Of the 156 patients who should have received SAP, choice of drug was correct in 121 (77.6%), dosage in 110 (70.5%) and timing in 87 (55.8%). Absolute compliance was achieved in 44.4% (80/180). Errors were mostly related to timing, re-dosing and duration of SAP. Conclusion: Anaesthetists and surgeons at Groote Schuur Hospital demonstrate variable adherence to surgical antibiotic prophylaxis guidelines. Interventions aimed at improving compliance are warranted.

Introduction: Dopamine agonists (DA) constitute primary treatment for prolactinomas.Recent international guidelines on prolactinoma management recommend use of cabergolineover other DAs and suggest attempting withdrawal after two years given certain criteria. Thelocal data on adherence to guidelines are scarce. Aim: This study aimed to compare local clinical practice to regional and internationalguidelines for prolactinomas and investigate management and outcome of patients with thisdiagnosis in a clinical setting in Örebro county. Methods: Medical records of patients with prolactinoma visiting the unit of endocrinology atÖrebro University Hospital between 2015-2019 were reviewed. Data on initial investigations,monitoring, treatment, and outcome were collected. Results: 91 patients with a median follow-up time of 69 months, were included. All patientshad initial investigations according to regional guidelines. 98.9% were ever treated with DA,and overall use of bromocriptine was higher than that of cabergoline. DA-withdrawal wasattempted in 40% of patients after a median treatment time of 6 years and was often successful.9.9% of patients had pituitary surgery. At last follow-up 37.4% of the patients were cured while20.9% had hypopituitarism. Treatment outcome differed significantly with adenoma size;microadenomas dominated among patients cured and macroadenomas among patients withremaining hypopituitarism (p<0.001). Conclusions:Local diagnostic prolactinoma care is in line with regional guidelines and patients are monitoredregularly. However, it is feasible that local practice concerning the choice of dopamine agonistand routines for its withdrawal could be revised and adjusted to international guidelines.

Philosophiae Doctor - PhD / Social workers employed by the Department of Social Development in South Africa are tasked with the provision of a broad spectrum of social services and may specialise in fields, such as welfare planning, which involves the capacity building, support and monitoring of welfare organisations. Early childhood development services fall in this category, as these services are monitored by social workers. Social workers employed by the Department of Social Development are the only group tasked with the mandate to capacitate, register partial care facilities and programmes, as well as monitor unregistered and registered facilities, on an on-going basis. Social workers adhere to these mandates amid many challenges. The aim of this study is to develop guidelines for social workers, who render services to Early Childhood Development (partial care) facilities. The objectives of this study are to explore the needs of social workers in the Early Childhood Development field in the Department of Social Development, identify challenges related to effective service delivery, explore the current methods of service delivery, develop guidelines and refined the draft guidelines, through a Delphi study. The Intervention Research design was used in this study, as it best suited the development of a tool; however, it was adapted to use only certain phases that were suitable for implementation for this study. The adaptation involved the use of the first four phases of the Intervention research method, combining of phase 1 and 2 to form a new phase 1 of the modified phases that linked to objectives one and two of the study. Therefore, this study only has three operational phases. A qualitative methodology was employed in this study to achieve the intended outcomes. Data collection occurred through semi-structured and telephonic interviews. Purposive sampling was used to select twenty (20) social workers from the Department of Social Development in the Western Cape and five (5) in the Eastern Cape. These participants engaged with Early Childhood Development facilities and interviews were conducted with them, while five (5) telephonic interviews were conducted with social workers in the Eastern Province. Conclusions from the analysed data were used to develop guidelines for DSD social workers within ECD settings. Two rounds of a Delphi study were employed to refine the proposed guidelines.

This mini-dissertation reports on the guidelines for digitisation that were developed for the University of Zimbabwe Library. A literature study and an empirical investigation were done in order to come up with the guidelines. The literature study was primarily used to inform the researcher on those aspects of digitisation for which guidelines could be developed. A qualitative research design was adopted in this study. Semi-structured interviews were used to collect data from five South African institutions that are involved in digitisation. Digitisation managers from the five institutions were interviewed in this study. The data from the interviews and the literature study were used to come up with the proposed guidelines for digitisation at the University of Zimbabwe Library. The guidelines that were developed as a result of this study specifically address digitisation standards and best practices, technologies for digitisation, costs and sustainability of digitisation, intellectual property issues, steps in digitisation, challenges in digitisation and the selection of materials for digitisation. Although some of the respondents expressed that digitisation can be used as a sustainable method of preservation, this research could not demonstrate that current practices would be reliable in the long term. / Mini Dissertation (MIT)--University of Pretoria, 2014. / Information Science / MIT

Orientador: Rossano César Bonatto / Resumo: Introdução. A síncope pode ser definida como a perda súbita e transitória autolimitada da consciência e do tônus postural, sendo uma queixa comum nos serviços de urgência e emergência. Ela engloba diversos diagnósticos diferenciais, dentre eles alguns que podem representar ameaça à vida. Objetivo. Este trabalho tem como objetivo discutir a diversidade de etiologias da síncope, e como conduzir uma investigação apropriada a partir da história e achados clínicos do paciente, otimizando os recursos disponíveis no serviço e evitando a realização de exames complementares desnecessários, através da padronização de um protocolo de investigação, diagnóstico e tratamento de síncope na faixa etária pediátrica, de acordo com a nossa realidade institucional, baseado nas melhores evidências disponíveis na literatura científica. Método. Estudo da revisão da literatura, realizado nas principais fontes: Pubmed, Embase, LILACs e Uptodate, com a utilização das palavras-chave: Síncope OR Desmaio OR Syncope, Criança OR Crianças OR Niño OR Child OR Children OR Protocolo OR Protocol OR Diretrizes OR Guidelines. 8 Conclusão. Foi elaborado protocolo de investigação, diagnóstico e tratamento para síncope, considerando as principais patologias que acometem a faixa etária pediátrica. Deve-se realizar anamnese detalhada, com descrição dos pródromos, da crise, dos antecedentes familiares e do exame físico, incluindo aferição da pressão arterial. É recomendada a realização de eletrocardiograma, principalme... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Background. Syncope can be defined as a transient loss of consciousness and postural tone, and it’s considered as a common complaint in urgency and emergency care settings. It encompasses many different diagnosis, among them some that may represent risk to life. Objective. This dissertation aims to discuss the diversity of syncope etiologies, and how to conduct a proper investigation based on history and clinical findings of the patient, optimizing available resources and avoiding unnecessary exams, through a standardized protocol for investigation, diagnosis and treatment of syncope for the pediatric age group, according to our institutional reality and based on the best evidence from scientific literature. Methods. Literature review study, done through the main databases: Pubmed, Embase, LILACs and Uptodate, using the keywords: Síncope OR Desmaio OR Syncope, Criança OR Crianças OR Niño OR Child OR Children OR Protocolo OR Protocol OR Diretrizes OR Guidelines. Conclusion. A protocol for investigation, diagnosis and treatment for syncope was elaborated, considering the main causes that affect the pediatric age group. A detailed anamnesis should be performed, describing prodrome, the episode and family history, and also a physical exam, including blood pressure measurement. It is recommended to perform an electrocardiogram (ECG), specially if the characteristics of syncope are not vasovagal. The other exams are indicated according to the diagnostic hypothesis. The majority of ... (Complete abstract click electronic access below) / Mestre

En el presente estudio se indican los resultados y la trayectoria de investigación de la autora referente al estudio de las técnicas constructivas propias de las fábricas de ladrillo en la zona de intramuros de la ciudad de Valencia (España), concretamente en los barrios de Velluters, la Seu-Xerea, el Carmen, el Mercat y San Francesc. El estudio se fundamenta en el trazado de un perfil socio, económico, cultural y técnico vinculado a la producción preindustrial del ladrillo y a su puesta en obra en Valencia. Se establecen los rasgos principales que vinculan la manufactura y el empleo de ladrillos preindustriales referidos a un entorno cronológico y geográfico determinado, desde la fundación de la ciudad hasta la llegada de producciones cerámicas industriales. En este marco, el registro pormenorizado de fábricas históricas de ladrillo refleja una serie de datos métricos y técnicos específicos. Por ello la investigación se ha concentrado en el estudio de 84 edificios históricos, tanto residenciales como monumentales. De esta manera, se han podido seleccionar 95 fábricas de ladrillo (cara a vista, agramilado, fingido, enlucido, tapia valenciana, aplantillado o vidriado). Todo ello ha generado una recopilación exhaustiva de fichas, que reflejan los aspectos técnicos, diagnósticos y analíticos de los ladrillos, con un estudio paralelo de fuentes arqueológicas, ordenadas en 19 registros de ladrillos romanos y medievales. A través de los resultados obtenidos con el estudio pormenorizado de fábricas, la recopilación de datos arqueológicos y el análisis de laboratorio de algunas muestras de ladrillo y mortero, se propone extraer una serie de datos estadísticos y reflexiones. A lo largo del estudio se describen sincronías, diacronías, pervivencia de técnicas vigentes en las fábricas que conducen a una propuesta cronotipológica para las fábricas urbanas y sus detalles (zócalos, vanos, dinteles, aleros entre los principales). / Cristini, V. (2012). El ladrillo en las fábricas del centro histórico de Valencia. Análisis cronotipológico y propuesta de conservación [Tesis doctoral]. Editorial Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/15665 / Palancia

In the past decades, the world has noticed complex changes in its climate. The resources available now as well as in the future could be said to be analogous to the decreasing circumference of a funnel. The wealthy population with the means to elect what goods they wish to consume are becoming aware of their impact both on nature as well as on the less fortunate people of the planet. As a consequence environmental and human-centered factors are of higher priority than ever before in the decisions made by companies, which in turn will decide the future. This thesis aims to investigate what set of criteria can be seen as most relevant for sustainable material selection at a manufacturing company. To be relevant for the future these design criteria are decided with a base in modern research from the past decade in the field of material selection. The company chosen as a case to study and collaborate with was IKEA Components AB. The research was conducted on-site at the company’s facilities in Älmhult, Småland, as well as at the Blekinge Institute of Technology in Karlskrona, Blekinge. The company vision for the future which IKEA is striving towards is focused on lowering carbon dioxide equivalents, from which a lion share of the emissions is a result of the material they are selecting for their products. Experts within various fields of the chosen company were consulted to gain perspective and knowledge while designing and testing prototypes of a tool to facilitate a sustainable material selection. The metal alloys were analyzed for toxicity based on the percentages of all elements they contained and scored based on chosen sustainability criteria. The plastics were judged on recyclability, renewability, and degradability apart from available numbers for emission factors. After this, the materials were placed in the excel tool which was then tested by engineers and evaluated in semi-structured interviews. Updates were made to make the tool as user-friendly as was possible and new tests were conducted. Overall, the tool was appreciated by the users who tested it and more improvements were planned to finalize the prototype. Results are detailed in the latter part of the report, discussing designs the engineers preferred over others, the current scale of sustainability tools used in the company and how the testers scored the tool. In the discussion, criteria are evaluated based on their multi-criteria compliance with sustainability factors. Drawing conclusions about the subject of sustainability criteria was accomplished by conducting literature studies in material criticality, making use of the methods for sustainable product development taught in the master of science, investigating material toxicity, testing solutions for sustainable material selection at a typical furniture component manufacturing company, receiving feedback from constructors and exploring connections for the selected methods to the principles of sustainability.

No description available.

Breast cancer is the most common nonskin cancer diagnosed among women in the United States and throughout the world, and the leading cause of cancer deaths. Screening recommendations and guidelines vary depending on the organization. Screening modalities include self breast examination, clinical breast examination, mammography, ultrasound, and magnetic resonance imaging. Screening guidelines vary based on individual risk assessment and age.

Patients with osteoporosis have an increased risk of sustaining fractures because of the low bone mineral density (BMD) and altered bone micro-architecture which are characteristic features of the disease. Although a good correlation exists between BMD and fracture risks, many other factors influence this relationship. While there is consensus that patients with osteoporosis should be investigated and treated, the issue is much less clear for patients with osteopenia. Because osteopenia is so prevalent, it would be unrealistic to treat all patients with this condition. Therefore, there is a need to identify those patients who are at risk of sustaining a fracture and would benefit most from the available therapy. Providing treatment to the appropriate risk group would not only reduce the number of fractures, but could also reduce the adverse effects associated with treatment, as treating patients earlier could shorten the treatment time. The availability of tools to select patients at risk of fracture should change the impact of the disease.