2,624 research outputs found
A. Kanafani-Zahar, Mune. La conservation alimentaire au Liban
No full textDigard Jean-Pierre. A. Kanafani-Zahar, Mune. La conservation alimentaire au Liban. In: L'Homme, 1996, tome 36 n°139. pp. 170-171
Contact Precautions for Preventing Nosocomial Transmission of Extended-Spectrum β Lactamase-Producing Escherichia coli: A Point/Counterpoint Review
No full textContact precautions have been recommended for hospitalized patients colonized or infected with extended-spectrum β-lactamase-producing Escherichia coli (ESBL-EC). Despite such recommendations, a steady, worldwide increase of ESBL-EC has been reported. We discuss arguments in favor of and against contact precautions for ESBL-EC carriers. Healthcare settings with high ESBL-EC colonization pressure, extended hospital stay, and close contact between patients may serve as amplification platforms, further accelerating transmission. However, the evidence base for justifying the implementation of contact precautions for all ESBL-EC carriers remains weak. Until more high-level evidence is available, we support the attitude that hospitals and countries should carefully evaluate their decision on whether to implement contact precautions for ESBL-EC carriers. It is likely that a majority of patients and wards do not need to rely on contact precautions for preventing nosocomial ESBL-EC transmission in nonepidemic settings, without harming patient safety, providing sufficient compliance with standard precautions and ongoing surveillance
"Vieillir" en basque et "zahar": Les mots du vieillir
No full textIn this article, the author proposes some lexico-semantic considerations on the concept of "vieillir" in Basque language. To tell the truth, the term "vieillir" which says "zahartu" out of Basque is not exactly the object of the study but rather the term "zahar", "vieux", which can be adjective or substantive and from which the verb "zahartu" is only derived. This short note will present the various meanings of the word "zahar", and its antonyms, the shifts in meaning of "zahar" towards "mauvais" and the use of the word in phraseology. Some remarks will be made on the other terms designating somebody or something who is old.Dans cet article, l'auteur propose quelques considérations lexico-sémantiques sur la notion de "vieillir" en langue basque. A vrai dire, le terme "vieillir" qui se dit "zahartu" en basque n'est pas exactement l'objet de l'étude mais plutôt le terme "zahar", "vieux", qui peut être adjectif ou substantif et dont le verbe "zahartu" n'est qu'un dérivé. Cette brève note présentera les divers sens du mot "zahar", et ses antonymes, les glissements de sens de "zahar "vers "mauvais" et l'emploi du mot en phraséologie. Quelques remarques seront faites sur les autres termes désignant quelqu'un ou quelque chose qui est vieux
Da ideia de infância em Jean-Jacques Rousseau ou do "sono da razão"
No full textDissertação (mestrado) - Universidade Federal de Santa Catarina. Centro de Ciencias da Educação. Programa de Pós-Graduação em EducaçãoOs pensamentos expostos no século XVIII pelo genebrino Jean-Jacques Rousseau influenciaram de maneira decisiva a forma como o Ocidente passou a perceber a infância. Este autor provocou uma verdadeira divisão de águas ao publicar Emílio ou Da Educação (1762). Com este feito, mais que balançar os alicerces educacionais da época, ele delega à criança um lugar no mundo. A infância passa a ter um valor em si mesma, e a ser vista como etapa fundamental na constituição humana. Ao destacar este período da vida, além de romper definitivamente com o que vigorava em seu tempo, no qual a criança era tida como um erro passageiro - um infante (aquele que não fala); um "adulto em miniatura"; ou mero objeto de paparicação e prazer - Jean-Jacques cria uma ótica inovadora de conceber a criança. Dizia que: "A natureza quer que as crianças sejam crianças antes de serem homens." Ao elaborar um conceito de infância, Rousseau afirma que "a infância é o sono da razão". O que nos surpreende devido este autor ter vivido em pleno "Século das Luzes", justamente quando a razão era evocada como o guia seguro para o pensamento e para ação em todas as idades. Ao contrário do que possa parecer, Rousseau não desmerece o período infantil, associando-o à escuridão ou a inferioridade primeira da humanidade. Ele é considerado o "inventor da infância". Retomar pensamentos que versam sobre essas ideias rousseaunianas, inaugurais da concepção moderna de Infância, por meio de pesquisa teórica, é o objetivo traçado aqui, com intuito de avançar nas compreensões estabelecidas em torno das contribuições de Jean-Jacques Rousseau para temática em exame.The thoughts exposed in the eighteenth century by the genevan, Jean-Jacques Rousseau, influenced in a decisive way the West has to realize his childhood. This author has caused a real division of the waters or publish Emile, or On Education (1762). With this done more than shake the foundations of educational time, it leaves the child a place in the world. The child is given a value in itself, and be seen as key step in the human constitution. By highlighting this period of life, and the final break with that which prevailed in his time, in which the child was seen as a mistake passenger - an infant (who does not speak), a "miniature adult" or mere object of pampering and pleasure - Jean-Jacques creates a new perspective to conceive a child. He said: "Nature wants children to be children before being men." In developing a concept of childhood, Rousseau says that "childhood is the sleep of reason". What surprises us because this author has lived in the middle of "Age of Enlightenment", just when the reason was mentioned as the sure guide for thought and action in all ages. Contrary to what may seem, Rousseau does not diminish the infantile period, associating him to the darkness or the inferiority of humanity first. He is considered the "inventor of childhood." Resume thoughts that talk about these ideas Rousseau, the inaugural modern conception of childhood, through theoretical research, stroke is the goal here, with the aim to advance the understandings established around the contributions of Jean-Jacques Rousseau to thematic examination
Modelagem computacional da equilibração das estruturas cognitivas como proposto por Jean Piaget
No full textTese (doutorado) - Universidade Federal de Santa Catarina, Centro TecnologicoO presente trabalho consiste em uma tese de doutoramento na área de Engenharia do Conhecimento onde, a partir da conjectura de Turing sobre a possibilidade de construir máquinas inteligentes e dos trabalhos de Jean Piaget sobre como as crianças constróem seus conhecimentos, propõe-se um simulador capaz de emular as Estruturas Cognitivas e o Mecanismo pelos quais essas estruturas atingem um estado de equilíbrio majorante após desequilíbrios provocados por estímulos externos e internos
Impact and consequences of bacterial resistance in intensive care
No full textLes infections nosocomiales à bactéries multi-résistantes sont en constante augmentation en réanimation. Elles ont des conséquences individuelles et collectives majeures. La mortalité en réanimation et les prolongations des durées de séjour sont les deux principales conséquences individuelles connues à ce jour. Plusieurs facteurs confondants rendent l'interprétation des études difficiles, dont l'état sous jacent du patient, la virulence de la bactérie et l'adéquation thérapeutique. Mesurer la part de chacun de ces facteurs et préciser leur responsabilité respective est indispensable pour mobiliser les différents acteurs et améliorer le pronostic des patients en réanimation. Dans cette thèse nous avons souhaité approcher la réponse quant aux conséquences individuelles. A partir d'une base de données incluant des patients de réanimation, nous avons utilisé les méthodes statistiques les plus récentes et avons tenté de prendre en compte les différents facteurs confondants , pour répondre à trois questions précises que sont : la mortalité liée à une espèce bactérienne donnée, les facteurs associés à la mortalité des patients présentant un sepsis sévère ou choc septique en réanimation et les conséquences liées à l'isolement des patients infectés ou colonisés avec une bactérie multi-résistante. Nous montrons que (1) par l'intermédiaire d'une prolongation de la durée de séjour en réanimation, l'infection à Clostridium difficile augmente la pression de colonisation, sans pour autant avoir d'impact direct sur le décès. (2) que le pronostic des sepsis sévères et des chocs septiques dépend de l'adéquation de l'antibiothérapie et que les bactéries résistantes sont plus souvent traitées de manière inadéquate. (3) que l'isolement contact est associé non seulement à une augmentation attendue du risque de pneumonie nosocomiale a germe multi-résistants mais aussi à une augmentation du risque d'erreurs thérapeutiques et d'événements indésirables non infectieux. Cet impact délétère suggéré par des études en dehors de la réanimation doit être pris en compte lors de la mise en place des précautions contact en réanimation.Nosocomial infections with multidrug-resistant bacteria are increasing in ICU. They have major individual and collective consequences. Mortality in the ICU and prolongation of length of stay are the two main individual consequences known to date. Several confounding factors make it difficult to interpret studies, including the patient's underlying condition, the virulence of bacteria and the adequacy of therapy. It is essential to measure the share of each of these factors and to clarify their respective responsibilities to mobilize the different actors and improve the prognosis of patients in intensive care. In this thesis, and drawing upon a database including ICU patients, we used the latest statistical methods and tried to take into account the various confounding factors to evaluate the individual consequences of multidrug-resistant bacteria in ICU. We sought to address three specific questions: mortality linked to specific bacterial species, factors associated with mortality in patients with severe sepsis or septic shock in intensive care unit, and the consequences of the isolation of patients infected or colonized with multidrug-resistant bacteria. We demonstrated that (1) because they are associated with a longer stay in intensive care unit, Clostridium difficile infections increase the pressure of colonization although they have no direct consequence on mortality; (2) the prognosis of sever sepsis or septic shock depends on the adequacy of the antibiotic therapy and that resistant bacteria are often inadequately treated; and (3) that isolation is not only associated with an expected increase in the risk of nosocomial pneumonia with multi-drug resistant pathogens strains but also with an increase in non-infectious adverse events
Task force on management and prevention of Acinetobacter baumannii infections in the ICU
No full textAcinetobacter baumannii constitutes a dreadful problem in many ICUs worldwide. The very limited therapeutic options available for these organisms are a matter of great concern. No specific guidelines exist addressing the prevention and management of A. baumannii infections in the critical care setting.
Clinical microbiologists, infectious disease specialists and intensive care physicians were invited by the Chair of the Infection Section of the ESICM to participate in a multidisciplinary expert panel. After the selection of clinically relevant questions, this document provides recommendations about the use of microbiological techniques for identification of A. baumannii in clinical laboratories, antibiotic therapy for severe infections and recommendations to control this pathogen in outbreaks and endemic situations. Evidence supporting each statement was graded according to the European Society of Clinical Microbiology and Infection Diseases (ESCMID) grading system.
Empirical coverage of A. baumannii is recommended in severe infections (severe sepsis or septic shock) occurring during an A. baumannii outbreak, in an endemic setting, or in a previously colonized patient. For these cases, a polymyxin is suggested as part of the empirical treatment in cases of a high suspicion of a carbapenem-resistant (CR) A. baumannii strain. An institutional program including staff education, promotion of hand hygiene, strict contact and isolation precautions, environmental cleaning, targeted active surveillance, and antimicrobial stewardship should be instituted and maintained to combat outbreaks and endemic situations.
Specific recommendations about prevention and management of A. baumannii infections in the ICU were elaborated by this multidisciplinary panel. The paucity of randomized controlled trials is noteworthy, so these recommendations are mainly based on observational studies and pharmacodynamics modeling
Carbapenemase producing enterobacterales : from intestinal colonization ta the impact on the health of hospitalized patients
No full textLes entérobactéries productrices de carbapénémases (EPC) représentent un enjeu majeur de santé publique à l'échelle mondiale. Depuis leur identification en France, leur diffusion dans les établissements de santé n’a cessé d’augmenter, malgré la mise en place de recommandations de prévention de leur diffusion dès leur émergence. Les établissements, notamment ceux à forte prévalence d’EPC, mobilisent d’importants moyens humains et matériels pour limiter leur diffusion. Dans les services cliniques, la récurrence des épisodes à EPC entraîne des contraintes supplémentaires pour les équipes de soins et peut parfois conduire à une banalisation des situations à EPC, entraînant une habituation. Face à cette situation, il est légitime de se demander s'il est nécessaire de maintenir les recommandations actuelles de prévention des EPC (en 2024) ou de les aligner avec celles des bactéries multirésistantes. L’objectif de travail était de contribuer à répondre à cette question en évaluant deux conséquences directes de la colonisation intestinale des patients hospitalisés sur leur état de santé. Après avoir établi que le délai de décolonisation intestinale spontanée des EPC pouvait durer plusieurs années, nous avons évalué les conséquences de cette colonisation sur la survenue de bactériémies à entérobactéries, indépendamment de leur profil de résistance, ainsi que sur le délai de récupération fonctionnelle des patients hospitalisés dans des services de Médecine Physique et Réadaptation. Dans les deux cas, la colonisation intestinale par les EPC s’est révélée associée à un risque accru de bactériémies et à un allongement du délai de récupération fonctionnelle.Carbapenemase-producing Enterobacteriaceae (CPE) represent a major global public health concern. Since their identification in France, their spread in healthcare facilities has continually increased, despite the introduction of prevention guidelines at their onset. Hospitals with high CPE prevalence allocate significant human and material resources ta contain their spread. ln clinical settings, recurring CPE episodes impose additional burdens on healthcare teams, sometimes leading ta habituation. Given this situation, it's important ta question whether current (2024) CPE prevention guidelines should remain or align with those for other multidrug-resistant bacteria. This study evaluates two direct health impacts of CPE intestinal colonization on hospitalized patients: the risk of Enterobacterale bloodstream infection, regardless ta resistant phenotypes and the delay ta functional recovery. ln bath cases, CPE intestinal colonization was associated with an increased risk of bloodstream infection and prolonged the functional recovery tim
A paixão segundo Jean Genet: labirintos e barroquismos
No full textDissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Comunicação e Expressão. Programa de Pós-Gaduação em Literatura.Esta dissertação tem como título: A Paixão segundo Jean Genet: Labirintos e Barroquismos e se estende em dois intentos principais: o primeiro, consiste no estudo da arte e da estética de Genet pelo qual se procura dar fundamentação ou sustentação ao pressuposto de que sua arte revela certa tendência barroquizante. Esse intento contém também duas compreensões a saber: a do processo de escrita denominado - O labirinto de Genet e a análise dessa arte cotejando diferentes conceitos relativos ao Barroco, sobretudo aqueles fundamentados em Walter Benjamin, Heinrich Wölfflin e Eugenio D'Ors e, ainda, contemplando a poética e a estética de Genet sob o pensar filosófico de Hegel, Gaston Bachelard e Herbert Marcuse. Essas duas compreensões correspondem respectivamente aos três primeiros capítulos. O segundo intento, a leitura da paixão, se faz alicerçada em Foucault e em Bataille. Trata-se então do erotismo, da transgressão e da paixão presentes na Arte de Genet, em que os jogos de sedução, desejo e poder se realizam nas relações eróticas, ou simplesmente na intimidade e na cumplicidade entre homens. Considera-se que esse segundo intento atravessa toda a dissertação. E, ainda, no desdobre desse propósito se compõe e se atinge o quarto capítulo, nele se reflete de modo particular o homoerotismo em Genet. Segue-se a conclusão, que se apresenta antes como um descortino da arte, da paixão e do erotismo em Genet do que como concluimento ou mero desfecho
Epidémiologie et conséquences des infections nosocomiales en réanimation : Impact et conséquences de la résistance bactérienne en réanimation
No full textNosocomial infections with multidrug-resistant bacteria are increasing in ICU. They have major individual and collective consequences. Mortality in the ICU and prolongation of length of stay are the two main individual consequences known to date. Several confounding factors make it difficult to interpret studies, including the patient's underlying condition, the virulence of bacteria and the adequacy of therapy. It is essential to measure the share of each of these factors and to clarify their respective responsibilities to mobilize the different actors and improve the prognosis of patients in intensive care. In this thesis, and drawing upon a database including ICU patients, we used the latest statistical methods and tried to take into account the various confounding factors to evaluate the individual consequences of multidrug-resistant bacteria in ICU. We sought to address three specific questions: mortality linked to specific bacterial species, factors associated with mortality in patients with severe sepsis or septic shock in intensive care unit, and the consequences of the isolation of patients infected or colonized with multidrug-resistant bacteria. We demonstrated that (1) because they are associated with a longer stay in intensive care unit, Clostridium difficile infections increase the pressure of colonization although they have no direct consequence on mortality; (2) the prognosis of sever sepsis or septic shock depends on the adequacy of the antibiotic therapy and that resistant bacteria are often inadequately treated; and (3) that isolation is not only associated with an expected increase in the risk of nosocomial pneumonia with multi-drug resistant pathogens strains but also with an increase in non-infectious adverse events.Les infections nosocomiales à bactéries multi-résistantes sont en constante augmentation en réanimation. Elles ont des conséquences individuelles et collectives majeures. La mortalité en réanimation et les prolongations des durées de séjour sont les deux principales conséquences individuelles connues à ce jour. Plusieurs facteurs confondants rendent l'interprétation des études difficiles, dont l'état sous jacent du patient, la virulence de la bactérie et l'adéquation thérapeutique. Mesurer la part de chacun de ces facteurs et préciser leur responsabilité respective est indispensable pour mobiliser les différents acteurs et améliorer le pronostic des patients en réanimation. Dans cette thèse nous avons souhaité approcher la réponse quant aux conséquences individuelles. A partir d'une base de données incluant des patients de réanimation, nous avons utilisé les méthodes statistiques les plus récentes et avons tenté de prendre en compte les différents facteurs confondants , pour répondre à trois questions précises que sont : la mortalité liée à une espèce bactérienne donnée, les facteurs associés à la mortalité des patients présentant un sepsis sévère ou choc septique en réanimation et les conséquences liées à l'isolement des patients infectés ou colonisés avec une bactérie multi-résistante. Nous montrons que (1) par l'intermédiaire d'une prolongation de la durée de séjour en réanimation, l'infection à Clostridium difficile augmente la pression de colonisation, sans pour autant avoir d'impact direct sur le décès. (2) que le pronostic des sepsis sévères et des chocs septiques dépend de l'adéquation de l'antibiothérapie et que les bactéries résistantes sont plus souvent traitées de manière inadéquate. (3) que l'isolement contact est associé non seulement à une augmentation attendue du risque de pneumonie nosocomiale a germe multi-résistants mais aussi à une augmentation du risque d'erreurs thérapeutiques et d'événements indésirables non infectieux. Cet impact délétère suggéré par des études en dehors de la réanimation doit être pris en compte lors de la mise en place des précautions contact en réanimation
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