Monitoring of Air and Water Bacterial Load in the Operation Theatres and Intensive Care Units of Selected Hospitals in Dhaka city: A Cross-Sectional Study

Background: Hospital milieu monitoring is an essential component for controlling healthcare associated infections (HCAIs) as it serves as the reservoir for pathogenic microbes. Aim of this study was to identify the bacterial load in Intensive care units (ICU) and Operation theaters (OT) air and water sources of selected tertiary care hospitals. Material & Methods: The study was organized in Microbiology department, BIRDEM General Hospital. A sum total 28 air samples & 6 water samples were collected from three selected hospitals and those were processed according to the set of protocols. Results: From air sampling, highest load of bacteria was found 480 CFU/dm²/hr in Hospital C ICU, 38.40 ± 9.99 CFU/dm²/hr in pre-OT samples & 218.2±43.35 CFU/dm²/hr in intra OT samples of Hospital C. From water sampling, unacceptable level of coliforms was found in all three hospitals. Among the non-pathogens, 24% – 37% Micrococcus spp. (normal flora) and 2% -18% Bacillus spp. (contaminants) were found in the OTs. Whereas pathogens found were Acinetobacter spp. (20.7%) followed by Pseudomonas spp. (19.4%), Klebsiella spp. (12.1%) & S. aureus (9.2%) in the ICUs. Conclusion: It could be deduced from the study that environmental sources such as air and water contaminations with multidrug resistant pathogens are an ultimate risk factor for all related to the healthcare settings, specially the indoor patients.

Aspects épidémiologiques et cliniques des brûlures cutanées graves en milieu hospitalier en Côte d'Ivoire / Epidemiological and Clinical Aspects of severe Cutaneous Burns in Hospital in Cote d'Ivoire

Contexte et Objectif. Les brûlures cutanées graves constituent un véritable problème de santé publique à l'échelle mondiale. L'objectif de cette étude était de décrire le profi l épidémiologique et clinique des brûlures cutanées graves dans le but de mettre en place de mesures préventives effi cientes. Méthodes. Ils'agissait d'une étude transversale rétrospective à visée descriptive et analytique déroulée sur une période de 3 ans au sein du service de Dermatologie du CHU de Bouaké. Tous les malades quelque soit l'âge et le sexe reçus au service dermatologie pour brûlure cutanée grave ont été inclus. Les tests statistiques utilisés étaient les tests de Kruskal Wallis (KW) et de Mann whitney-Wilcoxon(MWW) Résultats. Sur la période d'étude, nous avons inclus 46 patients sur 6074 admissions soit une prévalence hospitalière de 0,75%. L'âge moyen était de 20,79 ans. Le sex-ratio était de3,18. 10,9% de nos patients avaient une condition socio-économique défavorable. Les antécédents les plus retrouvés étaient l'épilepsie (6,5%) et les troubles psychiatriques (4,3%). Les brûlures thermiques étaient majoritaires(95,7%), etles brûlures par fl amme (56,8%) et l'ébouillantement (43,2%)en constituaient les principales causes.Les membres étaient plus atteints (93,5%).Les brûlures étaient du premier degré (10,9%) et du deuxième degré (89,1%). L'étendue moyenne de la brûlure était de 23,91%. Les sujets d'âge plus jeunes étaient surtout brûlés par les liquides chauds. Il n'y'avait pas de lien entre l'âge et l'étendue des lésions ni entre l'agent causal et l'étendue des lésions. Conclusion. Les brûlures cutanées graves représentent un fl éau en Côte d'ivoire.Il est indispensable d'instaurer des mesures de prévention en vue de limiter les conséquences de celles-ci.

Municipalização das medidas socioeducativas em meio aberto: o CREAS na cena do debate / Municipalization of socio-educational measures in open field: debating CREAS / Municipalización de las medidas sociales y educativas en medio abierto: el CREAS en la escena del debate / La municipalisation des mesures socioeducatives dans un milieu ouvert: le CREAS sur la scene du debat

Objetiva-se compreender a estruturação e a operacionalização do serviço de proteção social aos adolescentes em cumprimento de medidas socioeducativas (MSE) em meio aberto nas unidades CREAS em quatro municípios do norte do Piauí. Trata-se de uma pesquisa descritiva-exploratória de tratamento qualitativo. Os dados provêm dos diários de campo e entrevistas semi-estruturadas realizadas com quatro profissionais nos meses de agosto e setembro de 2017. Os resultados assinalam que a estruturação do serviço em cada município, apesar dos entraves, passa por diferentes momentos de implantação. Os obstáculos mais mencionados foram: a morosidade no Judiciário; a estigmatização dos adolescentes; a pouca adesão da família no processo de acompanhamento; a precarização das condições de trabalho, e a fragilidade na rede intersetorial municipal. Ademais, o despreparo dos profissionais para atuarem no campo socioeducativo, no âmbito do CREAS, acaba reduzindo a dimensão política, pública e coletiva das MSE a aspectos de ordem individual, moral, comportamental e psicológico.

The aim of this work was to understand the structure and operations of the social protection services for adolescents in compliance with socio-educational measures (MSE) in open fields of CREAS unities, located in four cities in the north of Piauí (Brazil). This is descriptive-exploratory research with qualitative treatment. The data come from field journals and semi-structured interviews conducted with four professionals in the months of August and September 2017. The results indicate that the structuring of the service in each municipality, despite the obstacles, goes through different moments of implementation. The most mentioned obstacles were: Judiciary slowness, stigmatization of the adolescents, lack of family engagement in the process, poor working conditions and fragility of the municipal intersectoral network. In addition, the lack of preparation of professionals to work in the socio-educational field, within the framework of CREAS, leads to the reduction of the political, public and collective dimension of MSE to aspects of individual, moral, behavioral and psychological order.

Buscamos comprender la estructuración y la operacionalización del servicio de protección social a adolescentes en cumplimiento de medidas sociales y educativas (MSE) en medio abierto en las unidades CREAS, en cuatro municipios del norte de Piauí. Esta es una investigación de tratamiento cualitativo descriptivo-exploratorio. Los datos provienen de las revistas de campo y entrevistas semiestructuradas realizadas con cuatro profesionales en los meses de agosto y septiembre de 2017. Los resultados indican que la estructuración del servicio en cada municipio, a pesar de los obstáculos, pasa por diferentes tiempos de implementación. Los obstáculos más mencionados fueron: morosidad en el Judiciario, estigmatización de los adolescentes, adhesión de la familia en el proceso de acompañamiento, precarización de las condiciones de trabajo y fragilidad en la red intersectorial municipal. Además, la falta de preparación de profesionales termina reduciendo la dimensión política, pública y colectiva de las MSE a aspectos de orden individual, moral, de comportamiento y psicológico.

L'objectif est de comprendre la structuration et l'opérationnalisation du service de protection sociale aux adolescents en application avec les mesures socioéducatives (MSE) dans un milieu ouvert dans les unités CREAS dans quatre municipalités du Nord de Piauí. Il s'agit d'une recherche descriptive exploratoire de traitement qualitatif. Les données proviennent des journaux de terrain et d'entretiens semi-structurés menés avec quatre professionnels au cours des mois d'août et de septembre 2017. Les résultats indiquent que la structuration du service dans chaque municipalité, malgré les obstacles, traverse différents moments de déploiement. Les obstacles les plus cités étaient les suivants: lenteur du système judiciaire, la stigmatisation des adolescents, la faible adhésion de la famille au processus de suivi, les conditions de travail précaires et la fragilité du réseau intersectoriel municipal. En outre, le manque de préparation des professionnels à agir dans le domaine socioéducatif dans le cadre du CREAS se traduit par une réduction de la dimension politique, publique et collective du MSE à des aspects d'ordre individuel, moral, comportemental et psychologique.

Relationship between red blood cell distribution width and left atrial appendage thrombogenic milieu in old patients with non-valvular atrial fibrillation / 中华心血管病杂志

Objective@#To estimate the correlation between red cell distribution width (RDW) level and left atrial appendage thrombogenic milieu (LAATM) in elderly patients with non-valvular atrial fibrillation (NVAF).@*Methods@#This was a retrospective case-control study. A total of 782 NVAF patients (age>60 years old) who finished transesophageal echocardiography (TEE) from January 2010 to December 2016 at Chaoyang Hospital was retrospectively screened, and diveded into LAATM group (n=65) and non LAATM group (n=717). RDW level was compared between the two groups. Potential association between RDW and LAATM was analyzed using multivariate logistic regression analysis. The accuracy of RDW for detecting LAATM was evaluated through receiver operating curve (ROC) analysis.@*Results@#There were significant differences in age, history of heart failure, course of atrial fibrillation (AF), type of AF, NT-proBNP level, RDW level, left ventricular end systolic diameter, left ventricular end diastolic diameter, left ventricular ejection fraction (LVEF), left atrial diameter, CHADS2 score and CHA2DS2-VASc score between the two groups (P<0.05). RDW level in LAATM group was significant higher than non LAATM group (13.4% (12.6%, 14.1%) vs. 12.1% (11.2%,13.0%), P<0.001). Multivariate logistic regression showed that RDW level associated with LAATM (OR=4.07, 95%CI 2.09-7.91, P<0.001). In ROC analysis, area under the curve was 0.81 (95%CI 0.74-0.88, P<0.001). When RDW level was 13.1%, LAATM could be diagnosed (sensitivity was 73.1% and specificity was 80.5%).@*Conclusions@#RDW value is associated with the presence of LAATM in elderly NVAF patients. The RDW level has a certain reference value for predicting LAATM.

Interactivity between bodies and milieus within techno-aesthetic art objects / Interatividade entre corpos e meios em objetos tecno-estéticos de arte / La interactividad entre cuerpos y ambientes en objetos tecno-estéticos de arte

Abstract Relations consist of processual interactivity between bodies and milieus which do not differentiate between the natural and the artificial, human and non-human. Our paper seeks to problematize the experience of the encounter with an artwork seen as a techno-aesthetic object constitutive of interactivity and addresses the idea of degrees of interactivity as produced with and within an artwork as an associated milieu. In this sense, we posit various degrees of interactivity in a relational experience: mixtures, attractions, embodiments and perceptions. Thus, interactive processes are driven by an ethics of the potential of bodies to act by what a body can do in its intensity, in the dynamics of degrees of interactivity in the experience. These ideas emerge from the philosophical writings of Baruch Spinoza, Gilbert Simondon and Gilles Deleuze and are applied to the field of art in order to allow an understanding of the relations between bodies and associated milieus.

Resumo Entendemos que as relações são compostas por processos de interatividade entre corpos e meios, os quais não separam natural e artificial, humano e não-humano. Direcionamos tal abordagem a fim de problematizar como ocorrem as experiências no encontro com a obra de arte, esta entendida como um objeto tecno-estético, bem como o que constitui interatividade e seus graus produzidos entre obra e meio. Aponta-se que existem vários graus de interatividade em uma experiência: misturas, atrações, incorporações e percepções. Os processos interativos são movidos por uma Ética do potencial dos corpos para agir e o que pode um corpo em sua intensidade, na dinâmica com os graus de interatividade em uma experiência. Estas ideias surgem a partir dos escritos filosóficos de Spinoza, Simondon e Deleuze e são aplicadas à arte, a fim de compreender as relações entre corpos e meios.

Resumen Entendemos que las relaciones se componen de procesos interactivos entre los organismos y medios de comunicación que no distinguen entre lo natural y lo artificial, lo humano y lo no humano. Problematizamos como acontece el encuentro del espectador con una obra de arte-ésta entendida como un objeto técnico-estético-así como la constitución de la interactividad entre la obra y lo que aquí llamamos medio asociado: señalamos que se producen varios tipos y diferentes gradaciones de interactividad. Así, los procesos interactivos son guiados por lo que puede hacer un cuerpo con sus intensidades y por una ética de potenciales propia a los cuerpos en la dinámica de grados de interactividad en la experiencia. Os processos interativos são movidos por uma Ética do potencial dos corpos para agir e o que pode um corpo em sua intensidade, na dinâmica com os graus de interatividade em uma experiência. Estas ideas provienen de los escritos filosóficos de Spinoza, Simondon y Deleuze y las aplicamos al arte para mejor comprender la relación entre los cuerpos y los medios asociados.

Effect of environmental enrichment on cognitive function and the expressions of hypoxia inducible factor 1α and vascular endothelial growth factor in rats with chronic cerebral hypoperfusion / 中华老年医学杂志

Objective To observe effect of environmental enrichment on the learning and memory ability and the expressions of hypoxia inducible factor 1α (HIF-1a) and vascular endothelial growth factor (VEGF) in rats with chronic cerebral hypoperfusion.Methods A total of 40 rats were randomly divided into 3 groups: bilateral vascular occlusion (2VO) of the common carotid arteries group (n=14, 2VO group), 2VO + enriched environment (EE) group (n=14, 2VO+EE group) and sham group (n=12, SHAM group).Morris water maze, novel object recognition test, real-time reverse transcription-polymerase chain reaction (real-time RT-PCR), immunohistochemistry methods and Western blotting were used to detect changes in learning and memory ability of rats and HIF-1α and VEGF expression levels in hippocampus.Results Morris water maze showed that the escape latency was longer in the 2VO group than in the SHAM group at 3, 4 and 5 day during the training (all P＜0.05), while the 2VO+EE group spent significantly less time in finding the platform as compared with the 2VO group at 4 and 5 day (both P＜0.05).The time for space exploration in target quadrant was less in 2VO group than in SHAM group (P＜0.05), while it was longer in 2VO +EE group than in 2VO group (P＜0.05).Novel object recognition test showed that the 2VO operation impaired the priority index (PI) of time spending at exploring the novel object (P＜0.05), and environmental enrichment could improve the PI in 2VO group (P＜0.05).The real-time RT-PCR and Western blotting showed that the HIF-1α mRNA expression was higher in 2VO group than in SHAM group (P＜0.05).The VEGF mRNA and protein expressions were higher in 2VO+EE group than in 2VO group (both P＜0.05).The expression of HIF-1α in hippocampal CA1 area was higher in 2VO group than in SHAM group (P＜0.05).Conclusions Environmental enrichment can alleviate the damages of spatial and non-spatial learning and memory ability which are caused by chronic cerebral hypoperfusion.And HIF-1α and its downstream gene VEGF may be involved in the restoration of cognitive function by enriched environment.

Effect of Low-Level Laser Irradiation Preconditioning on Milieu of Infarcted Myocardium in Experimental Rats / 中国循环杂志

Objective: To explore the effect of low-level laser irradiation (LLLI) preconditioning on milieu of infarcted myocardium in experimental rats. Methods: The myocardial infarction (MI) model was established by left anterior descending (LAD) artery ligation in female rats. 3 weeks later, the qualified MI rats were randomly divided for 3 groups: ① LLLI preconditioning group, the rats received thoracotomy for LLLI by a 635nm, 5mW diode laser with the energy density of 0.96 J/cm2 for 150 seconds, n=26. ② Control group, the rats received thoracotomy for daylight irradiation, n=27. ③ Sham operation group, the rats received thoracotomy without LAD ligation, n=24. The Expressions of myocardial vascular endothelial growth factor (VEGF), glucose-regulated protein 78 (GRP78), superoxide dismutase (SOD) and malondialdehyde (MDA) were evaluate by real time-PCR, Western blot analysis and other relevant laboratory test at 1 hour, 1 day and 1 week after treatment. The myocardial cell apoptosis was examined by TUNEL staining, and left ventricular function was detected by echocardiography. Results: LLLI preconditioning obviously increased the myocardial VEGF, GRP78 expression and SOD activity, decreased MDA production; while it could not really improve the myocardial cell apoptosis at peri-infarcted area and left ventricular function in experimental rats. Conclusion: LLLI preconditioning may improve the milieu of infarcted myocardium via decreasing the oxidative stress in experimental rats.

Schizophrenia and Healing Environment

Treatment of schizophrenia is one of the most challenging areas in the field of psychiatry. There has been much improvement in psycho-pharmacotherapy, and at present, psycho-pharmacotherapy along with milieu therapy and social rehabilitation is the standard first-line treatment for schizophrenia. Healing environment, a concept which has arisen from the architectural field, has similarities in meaning to milieu therapy in psychiatry. In other words, healing environment may be an encountering point between psychiatry and architecture. In this encountering, each field can understand each other and expand its concept to aid the treatment of schizophrenia and to plan the build-up of the entire environment considering its social and psychological effects. In this paper, we aim to establish the basic concept of healing environment to alleviate the psychopathologies in schizophrenic patients. We worked under the premise that physical setting affects human behavior and mind, and that physical setting should play a role as a medium with therapeutic potential for patients with medical problems. The aims of this paper are as follows. First, theoretical discussion of the concept and the constructs of healing environment : second, understanding of the schizophrenic symptoms that may be affected by supporting environment : and third, discussion of supporting environment that may alleviate the symptoms of schizophrenia.

Bridging the Research and Cultural-Practice Gap in Early Language Intervention in Malaysia / Jurnal Sains Kesihatan Malaysia

“Following the child’s lead” and “collaborative consultation with parents” are solidly grounded in the best practice of early language intervention. However, the success of these two practices are based on assumptions that they are valued by families and that they can be feasibly implemented by the attending speech-language pathologist (SLP). Such assumptions can be unjustified in cultures that value the use of “adult-guided instructions” over following the child’s lead and when the work setting of the SLP does not readily accommodate those practices. This article takes the form of a position paper. Through review of the literature, the paper (1) identifies the research-cultural practice gap in early language intervention in Malaysia; (2) positions the two research-informed practices – following the child’s lead and collaborative consultation with parents, on the continuum of intrusiveness in early language intervention; and (3) proposes the techniques of Milieu Teaching as an approach to bridge the research-cultural practice gap in Malaysia.

Falso abuso sexual em varas de família: dilemas na elaboração do parecer psicossocial / False sexual abuse in family courts: dilemmas on the opinion psychosocial / Falso abuso sexual en la justicia de familia: dilemas en ela preparación de la evaluación psicossocial / Faux violence sexuelles dans les tribunaux de la famille: dilemmes sur l'opinion psychosocial

O artigo investiga os dilemas da atuação de profissionais da psicologia jurídica em casos de falsa acusação de abuso sexual. Está embasado em pesquisa qualitativa desenvolvida através da análise documental de pareceres psicossociais em varas de família e registro civil, e entrevistas com profissionais envolvidas com suas elaborações. O texto inicialmente discute a aproximação entre instâncias de gestão das populações e aparatos biomédicos, de modo a melhor compreender a entrada da Psicologia no sistema judiciário. Em um segundo momento, analisa o valor dos pareceres psicossociais para o judiciário, e suas repercussões nos próprios profissionais da psicologia. Finalizando, examina os dilemas relacionados à "verdade" e ao "poder", constituidores da profissão de psicólogo como ciência-intervenção.

This paper investigates professional legal psychology interventions in false accusation of sexual abuse cases. It is based on qualitative research conducted through psychosocial reports documentary analysis in family courts, and interviews with professionals involved in its elaborations. Initially, discusses the rapprochement between instances of population control and biomedical devices, to better understand the entry of psychology in the judiciary. In a second moment, examines the value of psychosocial intervention for the judiciary view and the impact of the reports to psychology professionals. Finally, discusses the dilemma related to the "truth" and "power", founder of the profession of psychology as a science-intervention.

El artículo investiga la actuación de profesionales de la psicología jurídica en los casos de falsa acusación de abuso sexual. El estudio se basa en investigación cualitativa realizada a través de análisis documental de dictámenes psicosociales en tribunales de familia, y entrevistas con profesionales involucradas en el proceso de elaboración. El texto examina en primer lugar el acercamiento entre la gestión de las poblaciones y los dispositivos biomédicos, de modo a entender mejor la entrada de la Psicología en el sistema judicial. En la segunda parte, examina el valor del asesoramiento del dictamen psicosocial para el jurídico, y su impacto en los propios profesionales de la psicología. Por último, se examinan los dilemas relacionados con la "verdad" y el "poder", constituidor de la profesión del psicólogo como una ciencia-intervención.

L'article examine les dilemes de la performance des professionnels de la psycologie légale dans les cas de fausse accusation d'abus sexuel. Il est fondée sur une recherche qualitative developpé par l'analyse des documents de conseils psychosociaux dans les tribunaux de la famille et des registres civil, et des entretiens avec les professionnels concernés par ses élaborations. Le texte aborde d'abord la connexion entre les instances de gestion de la population et des dispositifs biomédicaux, afin de mieux comprendre l'entrée de la psychologie dans le système judiciaire. Dans un deuxième temps nous analysons la valeur des avis psychosociaux à la magistrature et son impact sur les professionnels de la psychologie eux-mêmes. Enfin, il examine les dilemmes liés à la « vérité ¼ et « pouvoir ¼, constituants de la profession de psychologue comme science-intervention.

Políticas de desenvolvimento territorial no meio rural brasileiro: novas institucionalidades e protagonismo dos atores / Territorial development policies in the brazilian countryside: new institutional arrangements and key protagonists / Politiques de développement du territoire en milieu rural au Brésil: les nouvelles pratiques institutionnelles et le rôle des acteurs

This article analyzes the implementation of two policies for territorial development of the Brazilian countryside in the first decade of the 21st century: the Program for the SustainableDevelopment of Rural Territories (Pronat) and the Program for Territories of Citizenship (PTC). Examining the new institutional arrangements, the programs' socialmanagement and governance structures, and the protagonist role of the various stakeholders, the article concludes that to a certain extent the programs represent a unique strategy for political action and development in the respective geographic areas.However, they still face enormous challenges for effective consolidation of their results.

Dans cet article, on examine lamise en place de deux politiques orientées vers le développement du territoire en milieu rural au Brésil dans les années 2000: le Programme de Développement Durable des Territoires Ruraux (Pronat) et le Programme Territoires de la Citoyenneté (PTC). D'après l'examen des nouvelles pratiques institutionnelles en cours, de la gestion sociale des programmes et de leurs structures de gouvernance, ainsi que du rôle des acteurs engagés, on conclut que ces derniers ont suivi, d'une certaine façon, une stratégie singulière d'action politique pour le développement des régions concernées, malgré les immenses enjeux à venir, afin d'aboutir à des résultats vraiment solides.

Advance in Acupuncture Associated with Milieu Therapy for Neonatal Rats with Hypoxic-ischemic Brain Damage (review) / 中国康复理论与实践

@#This paper would review the experimental research over acupuncture associated with milieu therapy towards neonatal rats with hypoxic-ischemic brain damage during the past decade, while focus on exploring the therapeutical mechanism of acupuncture and rehabilitation for cerebral palsy.

Experimental study the cardiomyogenic differentiation of bone marrow mesenchymal stem cell induced by 5-azacytidine in a "Cardiac-like" milieu / 中国综合临床

Objective To determine the effectivity of 5-azacytidine(5-Aza) inducing the cardiomyogenic SCs were isolated and purified from Sprague-Dawley (SD) rats. Some BMSCs were induced with 5-Aza,group Ⅰ was not induced with 5-Aza and the third generation of cells were used for the next experiment; group Ⅱ were cultured and induced with 5-Aza( 10 μmol/L) at the third day of the culture for 24 h; group Ⅲ were induced with 5-Aza( 10 μmol/L) for 24 h when the third generation of cell were fused; group Ⅳ were induced with 5-Aza( 10 μmol/L) for 24h at the third day of primary cuhure,which were induced with 5-Aza( 10 μmol/L) for 24 h before the third gener-phosis was found in the BMSCs among groups. CD34 was negatively expressed and CD29 and CD44 were positively gle 5-Aza inducing group(group Ⅲ ) was much higher than that in no 5-Aza inducing group( group Ⅰ ) [ MHC : (6. 82±2.05 ) % vs (3.61±1.14) % ], cTnI: (5.63±1.86) % vs (2.76±0.82) %, P < 0.05 ], but was significantly lower than the percentage in the double 5-Aza inducing group ( group Ⅳ ) [ MHC : ( 12.18±3.16) % vs ( 6.82±2. 05)% ] ,cTni:(9.93±2.79)% vs(5.63±1.86)% ,P<0.05]. Conclusions 5-Aza could promote the cardio-myogenic differentiation of BMSCs in a "Cardiac-like" Milieu. 5-Aza double induing is better than the single indu-cing.

Coorperative study on the mental health issues of Japanese orphans and their Chinese family (Ⅳ):early childhood experience and later personality and behavioral characteristics / 中国心理卫生杂志

The Japanese orphans who remained in Northeastern District of China atthe end of world War Ⅱ were raised by their Chinese foster parents and grew up in Chinesesociety,but more than forty years later,they displayed even many characteristics closely relat-ed to Japanese culture.The findings of the 54 Japanese orphans investigated indicate signifi-cant relationship between early childhood experience and the development of personality andpattern of behavior in adulthood.