«Белая дача» А.П. Чехова – как часть культурного ландшафта Крыма

Данная работа написана в рамках научного проекта кафедры культурологии «Культурные ландшафты Крыма» и посвящена рассмотрению «Белой дачи» А.П. Чехова (ныне Дом-музей А.П. Чехова в Ялте) как культурному ландшафту – результату сотворчества человека и природы

Online focus groups as a tool to collect data in hard-to-include populations: examples from paediatric oncology

Contains fulltext : 81501.pdf (publisher's version ) (Open Access)BACKGROUND: The purpose of this article is to describe and evaluate the methodology of online focus group discussions within the setting of paediatric oncology. METHODS: Qualitative study consisting of separate moderated asynchronous online discussion groups with 7 paediatric cancer patients (aged 8-17), 11 parents, and 18 survivors of childhood cancer (aged 8-17 at diagnosis). RESULTS: All three participant groups could be actively engaged over a one-week period. Respondents highly valued the flexibility and convenience of logging in at their own time and place to join the discussion. Adolescent patients and survivors emphasized that the anonymity experienced made them feel comfortable to express their views in detail. The findings indicate a strong preference for online group discussions across all participant groups. CONCLUSION: The findings show that online focus group methodology is a feasible tool for collecting qualitative data within the setting of paediatric oncology, and may offer new opportunities to collect data in other hard-to-include populations. The evaluations seem to indicate that the online group discussions have given participants an opportunity to articulate their experiences and views in a way they might not have done in a traditional group discussion.9 p

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Uitspraakgids Marokkaans bij het Woordenboek Marokkaans-Arabisch

Deze uitspraakgids met bijbehorende geluidsfragmenten helpt gebruikers van het Woordenboek Marokkaans-Arabisch.</p

Descriptive peer norms, self-control and dietary behaviour in young adults Descriptive peer norms, self-control and dietary behaviour in young adults

There is evidence that perceived peer eating norms can influence dietary behaviour. This cross-sectional study examined whether certain personality traits increase the likelihood that personal eating habits are similar to perceived peer eating habits. We assessed frequency of consumption of sugarsweetened soda (SSS) and sweet pastries (SP), as well as perceived peer descriptive eating norms for SSS and SP in a group of 1056 young adults. We examined whether individual differences in the need for social acceptance and self-control moderated whether participants were likely to display similar dietary habits to their peers. Perceived peer eating norms for SSS and SP predicted frequency of consumption; believing that one&apos;s peers frequently consumed SSS and SP was associated with increased personal consumption for both. Individuals with low self-control, as opposed to high self-control, were more likely to adhere to peer norms for SP, but not for SSS. Trait social acceptance needs did not significantly moderate similarity between peer norms and personal consumption for either SSS or SP. The extent to which young adults adhere to descriptive peer dietary norms may depend upon self-control, whereby individuals with low self-control are less able to inhibit social influence of descriptive peer norms on dietary behaviour

Feed the Alien!: The Effects of a Nutrition Instruction Game on Children's Nutritional Knowledge and Food Intake

Item does not contain fulltextObjective: Serious games are a promising venue to increase children's nutritional knowledge in an entertaining format. The aim of this study was to test the short-term effectiveness of the Alien Health Game, a videogame designed to teach elementary school children about nutrition and healthy food choices. Materials and Methods: To examine the effects of the Alien Health Game, an experimental design with a single between-subjects factor (experimental condition vs. active control condition) was used. A total of 108 Dutch children (10-13 years; 58 boys) were randomly assigned to either play Alien Health using the Kinect sensor for two consecutive days, for 1 hour of gameplay (experimental condition; n = 50), or a web-based nutrition game for the same period (active control condition; n = 58). Participants' nutritional knowledge was assessed at pretest, immediate, and at 2-week follow-up. Food intake was assessed at immediate and 2-week follow-up. Results: Participants who played Alien Health had better knowledge of the five most important macronutrients of foods at immediate posttest, but not at follow-up. Participants were better able to distinguish the healthier food item out of two options over time, but this effect did not differ for those in the experimental versus the active control condition. No differences in food intake, neither in the consumption of nutrient-dense or energy-dense foods, were found between children playing both games. Conclusion: A brief game-based intervention like the Alien Health Game has the potential to improve children's nutritional knowledge in the short term, but may not be strong enough to increase nutritional knowledge and actual eating behavior in the long term. Further investigation is warranted before this game is applied in future nutrition education programs.11 p