Cronobacter spp. as emerging causes of healthcare-associated infection

Background: Until recently, members of the Cronobacter genus (formerly known as Enterobacter sakazakii) were a relatively unknown cause of nosocomial infections. However, their association with infant infections, particularly through the consumption of contaminated reconstituted infant formula in neonatal intensive care units, has resulted in international efforts to improve neonatal health care. Aim: To investigate current understanding of this emergent group of bacterial pathogens and the steps taken to reduce neonatal infection. Methods: A literature review was undertaken to determine current knowledge of the Cronobacter genus with respect to recent taxonomic revisions, sources and clinical relevance. Findings: The majority of severe neonatal meningitis infections are associated with one of the 10 Cronobacter spp., the clonal complex known as C. sakazakii sequence type 4. International efforts by the Food and Agriculture Organization–World Health Organization (WHO) to reduce the risk of neonatal infection by this organism have resulted in improved microbiological safety of powdered infant formula (PIF), but revised guidelines for feeding practices have been problematic. In addition, the majority of infections occur in the adult population and the sources are unknown. Conclusion: International improvements in the microbiological safety of PIF and advice on feeding practices have focused on improving neonatal health care following the heightened awareness of Cronobacter infections in this particular age group. These measures are also likely to reduce neonatal exposure to other opportunistic bacterial pathogens, but a number of unresolved issues remain with respect to the practicalities of feeding premature neonates safely while following WHO advice

Conducting experiments and pupils\u27 attitudes towards physics

Fizika je za večino učencev in odraslih eden najtežjih in zato najmanj priljubljenih predmetov v šoli. Predsodki glede fizike se prenašajo skozi generacije in tako ustvarjajo začaran krog nerazumevanja naravoslovja v splošnem. Zgodi se tudi, da je otrok do predmeta negativno nastrojen še preden se z njim sreča. Vzroke za izjemno nepriljubljenost je iskalo že mnogo raziskovalcev, najti pa je moč tudi veliko raziskav, ki poskušajo odnos učencev, dijakov ali študentov do fizike na različne načine izboljšati. Možnost za izboljšavo trenutnega stanja bi lahko iskali v novih poučevalnih smernicah. Kot predlog se ponuja raziskovalni pouk, ki je neke vrste približek pravega znanstvenega raziskovanja. Takšen pouk temelji na učenčevi aktivnosti, poleg specifičnih pa poudarja tudi splošne učne cilje. V diplomskem delu je opisan učni poseg v obliki raziskovalnega pouka, s katerim sem hotela izboljšati odnos osnovnošolcev do fizike. Zasnovala sem zanimive eksperimente, ki jih lahko uporabimo med ali po pouku in so povezani z učno snovjo. Raziskava je potekala v dveh delih. V prvem delu so učenci eksperimente izvajali v obliki treh domačih nalog, vodeni pa so bili z delovnimi listi. Prva naloga se imenuje »Izstreljevanje vatiranih paličic«, temelji pa na razumevanju dela, energije in energijskih pretvorb. Pri poskusu iz slamic na različne načine izstreljujemo vatirane paličice. Drugo nalogo, »Konfeti«, lahko uporabimo za poglabljanje razumevanja prožnostne energije, obravnava pa tudi druge oblike energije ter prenos energije med telesi. Pri tej nalogi s preprostim pripomočkom, sestavljenim iz balona in kartonastega tulca, izstreljujemo papirnate kroglice različnih mas. Zadnja naloga, »Kotaljenje plastenk«, pa poleg elementov iz prvih dveh nalog preverja še razumevanje pojma notranja energija. Pri tej nalogi po klančini spuščamo prazno oziroma s sipko snovjo do polovice napolnjeno plastenko. V drugem delu raziskave sem izvedla tri učne ure. Prva je bila uvodna obravnava tlaka. Izvedla sem demonstracijsko raziskavo, s katero sem učencem želela približati, kako raziskovanje sploh poteka in jim pokazati, kaj bom od njih v naslednjih urah pričakovala. S pomočjo gobe za brisanje table in klad sem raziskala, od česa je tlak odvisen. Druga ura je bila bolj podobna tradicionalnemu pouku, saj smo ponavljali snov prejšnje ure in opravili nekaj izračunov. Pri tretji uri sem učence razdelila v skupine, vsaka skupina pa je dobila svoje raziskovalno vprašanje. Vprašanja so temeljila na razumevanju prostornine in mase, navezovala pa so se tudi že na gostoto, ki je bila obravnavana naslednjo šolsko uro. Naloge sem se lotila z zasnovo zanimivih eksperimentov, ki so povezani z učno snovjo in namenjeni obravnavi med ali po pouku. Izdelala sem tudi učne liste, ki so učence natančno vodili pri izdelavi pripomočka, izvedbi eksperimenta in razmisleku o fizikalnem ozadju. Pred posegi so učenci izpolnjevali vprašalnike, s katerimi sem ugotavljala njihov odnos do fizike. Podoben vprašalnik so izpolnjevali tudi po aktivnostih, njihove odgovore pa sem nato primerjala. Analiza rezultatov je pokazala, da so bile aktivnosti uspešne. Učenci so po poskusih namreč povedali, da se jim fizika z eksperimenti zdi bolj zanimiva kot tradicionalen pouk fizike. Upoštevati pa je treba, da tovrsten pristop ni primeren za vsako uro in vsak učni cilj.Physics has for most pupils and adults been one of the least favourite subjects at school. Prejudice against physics has been passed down through generations and has consequently created a vicious circle of incomprehension of natural sciences in general. Children can also show negative predispositions towards the subject before they even encounter it. Reasons for the exceptional unpopularity of the subject has been researched by manyone can also find numerous studies trying to differently improve attitudes of elementary and secondary school pupils, as well as university students towards physics. We could look for possibilities for improvement of the current state within new lecturing guidelines. Inquiry-based science education has been proposed as an option. Such lectures are based on pupils’ engagement and they accentuate general educational objectives next to the specific ones. The thesis describes a lecturing activity in a form of inquiry based science education, with which I wanted to improve the pupils’ attitude towards physics. I have designed interesting experiments that may be used during or after lectures, with regard to the subject matter. The research was carried out in two phases. In the first phase, the pupils conducted the experiments as three work sheet-guided homework assignments. The first assignment, “Cotton Sticks Shooting”, is based on the understanding of work, energy and energy conversions. In this experiment we were shooting cotton sticks out of straws. The second assignment, “Confetti”, can be used for a more in-depth understanding of the elastic energy, but addresses other forms of energy and energy transmission between bodies, as well. Here we used a simple tool made out of a balloon and cardboard tube to shoot out paper balls with different masses. The final assignment, “Rolling Plastic Bottles”, assesses the understanding of the concept of the internal energy, in addition to the elements from the first assignment. This time we were dropping downhill empty or half-full plastic bottles containing a fine material. In the second phase of the research I conducted three lectures. The first one was an introductory lesson on pressure. I presented a demonstration research, with which I wanted to familiarise the pupils with the actual process of the inquiry, as well as to acquaint them with what I would be expecting from them in the future lectures. I used a blackboard erasing sponge and weights to assess the factors that would lead to pressure changes. The second lecture resembled a traditional lecture, where we revised what we had learned in the previous lecture and carried out several calculations. For the third lecture I divided the pupils into groups, where each group received a specific research question. The questions were based on the understanding of volume and mass, but were also related to density, which they touched upon later in the following lecture. The pupils took questionnaires prior to my lectures, which I used to determine their attitude towards physics. They took similar questionnaires after the activities, which I later used to compare their answers. An analysis of the results showed that the performed activities were successful. The pupils afterwards stated that physics was more interesting when performing experiments than listening to a traditional physics lesson. It should be noted however that this type of approach is not suitable for every lecture and every learning objective

Conducting experiments and pupils' attitudes towards physics

Physics has for most pupils and adults been one of the least favourite subjects at school. Prejudice against physics has been passed down through generations and has consequently created a vicious circle of incomprehension of natural sciences in general. Children can also show negative predispositions towards the subject before they even encounter it. Reasons for the exceptional unpopularity of the subject has been researched by many; one can also find numerous studies trying to differently improve attitudes of elementary and secondary school pupils, as well as university students towards physics. We could look for possibilities for improvement of the current state within new lecturing guidelines. Inquiry-based science education has been proposed as an option. Such lectures are based on pupils’ engagement and they accentuate general educational objectives next to the specific ones. The thesis describes a lecturing activity in a form of inquiry based science education, with which I wanted to improve the pupils’ attitude towards physics. I have designed interesting experiments that may be used during or after lectures, with regard to the subject matter. The research was carried out in two phases. In the first phase, the pupils conducted the experiments as three work sheet-guided homework assignments. The first assignment, “Cotton Sticks Shooting”, is based on the understanding of work, energy and energy conversions. In this experiment we were shooting cotton sticks out of straws. The second assignment, “Confetti”, can be used for a more in-depth understanding of the elastic energy, but addresses other forms of energy and energy transmission between bodies, as well. Here we used a simple tool made out of a balloon and cardboard tube to shoot out paper balls with different masses. The final assignment, “Rolling Plastic Bottles”, assesses the understanding of the concept of the internal energy, in addition to the elements from the first assignment. This time we were dropping downhill empty or half-full plastic bottles containing a fine material. In the second phase of the research I conducted three lectures. The first one was an introductory lesson on pressure. I presented a demonstration research, with which I wanted to familiarise the pupils with the actual process of the inquiry, as well as to acquaint them with what I would be expecting from them in the future lectures. I used a blackboard erasing sponge and weights to assess the factors that would lead to pressure changes. The second lecture resembled a traditional lecture, where we revised what we had learned in the previous lecture and carried out several calculations. For the third lecture I divided the pupils into groups, where each group received a specific research question. The questions were based on the understanding of volume and mass, but were also related to density, which they touched upon later in the following lecture. The pupils took questionnaires prior to my lectures, which I used to determine their attitude towards physics. They took similar questionnaires after the activities, which I later used to compare their answers. An analysis of the results showed that the performed activities were successful. The pupils afterwards stated that physics was more interesting when performing experiments than listening to a traditional physics lesson. It should be noted however that this type of approach is not suitable for every lecture and every learning objective

Occurrence of Enterobacter sakazakii in the nursery environment of maternity hospitals in Greater São Paulo

Enterobacter sakazakii é um bacilo Gram-negativo, pertencente à família Enterobacterieceae. Este microrganismo vem ganhando a atenção das autoridades de saúde pública ao redor do mundo, não tanto pela morbidade, que é baixa, mas pela elevada taxa de mortalidade que varia de 40-80%. O patógeno afeta principalmente recém-nascidos de baixo peso e bebês com até seis meses de idade. Em comum, estas crianças têm o fato de serem alimentadas com fórmula infantil desidratada, a base de leite. Em nosso país ainda não existem muitos estudos sobre a ocorrência deste patógeno em fórmulas infantis, nem no ambiente de preparo das mesmas. O objetivo deste trabalho foi avaliar as condições de produção de mamadeiras para recém-nascidos em maternidades da Grande São Paulo, além de determinar a população de E. sakazakii em fórmulas infantis desidratadas e reidratadas. A população de Enterobacteriaceae e a presença de E. sakazakii também foram avaliadas em amostras ambientais, de utensílios e mão de manipuladores. Avaliou se ainda o comportamento do patógeno em fórmula infantil reidratada simulando as condições de oferecimento aos bebês. Coletou-se amostras de três hospitais maternidades diferentes (A-escola/B-público/C-particular) e analisou-se a presença de E. sakazakii usando método ISO. Para fórmulas desidratadas e reidratadas usou-se a mesma metodologia e a técnica de número mais provável (NMP). A população de Enterobacteriaceae foi determinada usando-se PetrifilmTM 3M. E. sakazakii foi detectada em duas amostras do Hospital A (na sobra da mamadeira que voltou do berçário e de uma amostra da lata lacrada da fórmula infantil desidratada. A população nesta amostra foi de 0,03 NMP/100g.) No Hospital B, foi detectada em apenas uma amostra (na esponja de lavagem das mamadeiras contaminadas). No Hospital C, E. sakazakii não foi detectada nas amostras analisadas. Quanto à população de Enterobacteriaceae nos lactários, observou-se uma variação, sendo que as amostras colhidas no hospital C foram as que apresentaram populações mais elevadas. As cepas de E. sakazakii isoladas apresentaram comportamento similar àquele da cepa padrão, ocorrendo um aumento de 2 log na população do patógeno quando simulou-se as condições de serviço das fórmulas, via naso-gástrica, aos bebês nos berçários.Enterobacter sakazakii is a bacillus belonging to the Enterobacteriaceae family. It is considered an opportunistic pathogen that has been gaining attention from health authorities all over the world. While morbidity associated with this bacterium is low, mortality rates can range from 40-80%. The pathogen affects mainly low-birth-weight neonates (first 28 days), but babies less than 6 month old are also at risk. Powdered infant formula has been incriminated as the possible source of the microorganism to the infected babies. ln Brazil, as in several other countries, there is scarce information regarding the incidence of E. sakazakii in powdered infant formula, in reconstituted formula, and in milk kitchens areas in hospitals. The objective of this study was to evaluated the presence of E. sakazakii in the environment, utensils, handlers, powdered and rehydrated infant formula from milk kitchens from different maternity wards in Sao Paulo, Brazil. Moreover, it was evaluated the behavior of the pathogen in rehydrated infant formula. Samples were collected from 3 hospitals maternities (A-school/B-public/C-particular) and analyzed for E. sakazakii using the ISO method. For formula (powdered or rehydrated) the MPN technique was used. Enterobacteriaceae population was determined using PetrifilmTM 3M. E. sakazakii was found in one unopened formula can collected from Hospital A (0,03 MPN/100g), although the pathogen could not be detected in other cans from the same lot. E. sakazakii was also found in leftovers from one nursing bottle from the same hospital and from one cleaning sponge from Hospital B. E. sakazakii was not detected in none of the samples from Hospital C. A variation in Enterobacteriaceae population in milk kitchens was observed. Samples collected in Hospital C presented the highest population. Isolated strains of E. sakazakii presented similar behavior to standard strains, When spiked in rehidrated infant formula. A 2 log increase in the population of the pathogen was observed when simulating the conditions of formula administration to the babies by naso-gastric tubing

Identification of gifted students with inquiry-based learning

Odkrivanje nadarjenih, talentiranih in nadpovprečno sposobnih oseb je vedno bilo pomembno za razvoj in napredek družbe. V vzgoji in izobraževanju lahko v tej smeri veliko naredimo z zgodnjim odkrivanjem nadarjenosti – tako omogočimo, da z nadarjenimi učenci delamo ustrezno, da gojimo in spodbujamo njihove prednosti, da jim pomagamo premostiti njihove morebitne šibkosti. Le skupek naštetega omogoča razvoj njihovega celotnega potenciala. Poudariti velja, da se nadarjenost lahko kaže na mnogih različnih področjih. Velikokrat so kriteriji za nadarjenost jasni – nadarjeni glasbeniki imajo na primer izreden posluh, smisel za ritem ter razvito ustrezno motoriko za igranje izbranega inštrumentanadarjeni športniki dosegajo najboljše rezultate v svoji generacijinadarjeni umetniki se znajo izražati skozi različne oblike umetnosti, in še bi lahko naštevali. Že dolgo pa vemo, da so nekateri ljudje izjemno uspešni v iskanju vzorcev in vzročno-posledičnih povezav v naši okolici. Ti ljudje so pogosto uspešni kot znanstveniki na različnih področjih in, kadar se usmerijo v naravoslovje, za njih lahko trdimo, da so nadarjeni na naravoslovnem področju. Prav znanstveniki so tisti, ki družbi prinašajo napredek, žal pa je kljub temu fenomen naravoslovno nadarjenih otrok, torej otrok, ki bi lahko postali znanstveniki, še vedno relativno slabo raziskan. Mnogi raziskovalci so že opazili, da standardizirani testi za odkrivanje nadarjenosti ne odkrijejo vseh nadarjenih. Tako so pogosto iz različnih vzrokov spregledani otroci, ki so del manjšin, otroci priseljencev, otroci, ki prihajajo iz za šolo manj spodbudnega okolja ter dvojno izjemni otroci (otroci s primanjkljaji, ki so hkrati nadarjeni). Ti otroci običajno za šolo in kakršnokoli šolsko delo niso motivirani, zato se na testih odrežejo slabše kot njihovi vrstniki, ali pa zaradi drugih primanjkljajev, kot so na primer pomanjkljiv besedni zaklad, težave z branjem, pisanjem, računanjem, novim jezikom, ravni dosežkov vrstnikov enostavno ne dosegajo. Omenili smo že, da naravoslovno nadarjeni otroci pogosto odrastejo v znanstvenike. Prav zato se zdi samoumevno, da je način učenja, ki takšnim otrokom ustreza, izpeljan iz prave znanstvene metode. Takšnemu pouku rečemo raziskovalni pouk oziroma učenje z raziskovanjem. Temeljna značilnost raziskovalnega učenja je učenčeva aktivnost, kot cilj pa sta pri tem načinu pouka navedeni tako odgovor na zastavljeno raziskovalno vprašanje, kot tudi sama pot, po kateri smo do tega odgovora prišli. V magistrskem delu predstavimo učno enoto, ki smo jo oblikovali po pravilih raziskovalnega učenja in ki bi lahko predstavljala osnutek inštrumenta za odkrivanje naravoslovno nadarjenih učencev. V učni enoti obravnavamo nekatera sodobna znanstvena spoznanja, ki še niso vključena v učni načrt in o katerih se v vsakdanjem življenju običajno ne pogovarjamo – kljub temu, da se z njimi srečujemo vsakodnevno. Prav zaradi tega naj bi vsi učenci pri raziskovalnem učenju ob tej enoti začeli z iste točke, brez kakršnegakoli predznanja. Poleg tega je učna enota zastavljena tako, da od učenca ne zahteva zapletenega računanja ali gostobesednega strokovnega izražanja. S tem smo se ognili oviram standardiziranih testov za odkrivanje nadarjenih, o katerih smo pisali nekaj vrstic višje. Učna enota je sestavljena iz petih nalog. S prvo nalogo preverimo otrokovo predznanje. V drugi nalogi se otroci prvič srečajo z digitalnim mikroskopom ter z njim opazujejo pisano fotografijo na računalniškem zaslonu. Tukaj želimo, da otrok sam navede čim več svojih opažanj. V tretji nalogi učenec z digitalnim mikroskopom sistematično opazuje, kako nastanejo različne barve na računalniškem zaslonu. Svoje znanje nato učenec uporabi v četrti in peti nalogi, ki jima rečemo tudi »identifikacijski nalogi«. Te dve nalogi namreč preverjata, v kolikšni meri je učenec razumel pravila aditivnega mešanja barv, ki jih je pravkar spoznal v tretji nalogi. V raziskavi je sodelovalo 44 učencev iz dveh slovenskih osnovnih šol. V deležu pravilnih odgovorov je izstopalo 5 učencev, še posebno pa je izstopal en učenec, ki je na prav vsa vprašanja odgovoril pravilno. Odgovore teh učencev smo podrobno analizirali ter v njih poiskali značilnosti, ki jih običajno pripisujemo nadarjenim učencem. Uspešnost učencev pri spopadanju z našo učno enoto smo primerjali tudi z njihovimi ocenami. Samo eden izmed izpostavljenih je bil med najuspešnejšimi tudi učno. Ostali sicer so učno uspešni, vendar imajo v povprečju nekoliko nižje zaključne ocene kot nekateri drugi vrstniki, ki so se pri naši učni enoti slabše izkazali. Kljub temu, da so nekateri učenci čisti odličnjaki, so se na naših preizkusih odrezali slabše kot njihovi učno nekoliko manj uspešni kolegi. Učni uspeh torej ni povezan z uspešnostjo reševanja naše učne enote.Identifying gifted, talented and persons with an above-average competence has always been of great importance for the development and progress of the society. When it comes to education and childcare, we can do a lot in this direction by an early identification of gifted children – that enables us to handle gifted students appropriately, to cultivate and encourage their advantages, as well as help them overcome their potential weaknesses. Only a combination of the above-mentioned enables development of their full potential. It needs to be emphasized that giftedness may be manifested in many different areas. Criteria for giftedness are often clear – talented musicians, for example, have an exceptional ear for music, sense of rhythm and developed suitable motoric functions for playing an instrumentgifted athletes achieve the best results in their generationsgifted artists are capable of expressing themselves through different forms of art, and so forth. However, we have known for a long time that some people are remarkably successful in finding patterns and cause-and-effect relationships in our surroundings. These people are frequently successful as scientists in different areas and, when they focus on natural sciences, we may say that they are gifted in the field of natural sciences. Scientists are the ones who bring progress to the societynevertheless, the phenomenon of children gifted in natural sciences, i.e. children that may become scientists, is unfortunately still relatively poorly researched. Many researchers have already noticed that standardised giftedness identification tests do not detect all gifted persons. Consequently, children who belong to minorities, children of immigrants, children who come from disadvantaged backgrounds education-wise, as well as twice-exceptional students (children with learning weaknesses who are simultaneously gifted) are often for various reasons overlooked. These children usually lack motivation for school or any school-related work, which is why their test results are poorer compared to their peers, or due to other weaknesses such as lack of vocabulary, reading, writing or calculating weaknesses, language barrier, or they simply do not reach the achievement levels of their peers. We have already mentioned that children gifted in natural sciences often grow up to become scientists. Therefore, it seems self-evident that the learning method suitable for these children is derived from an actual scientific method. This type of schooling is called inquiry-based learning. The fundamental feature of inquiry-based learning is the student’s activity, where the goals of this method include finding an answer to the research question, as well as the means of finding the answer. The thesis presents a learning unit that we have developed according to the rules of inquiry-based learning and which may represent an outline for an instrument for identifying students gifted in natural sciences. The learning unit addresses certain contemporary scientific discoveries that have not yet been included in the curriculum and are usually not talked about in the everyday life – nevertheless, we encounter them every day. This is why all students should start from the same point in this unit of inquiry-based learning, without any prior knowledge. Besides, the learning unit has been formed in such a way that it does not require complicated calculations or verbose technical expressions from the student. That way we have avoided the obstacles of the above-mentioned standardised giftedness identification tests. The learning unit is composed of five tasks. The first task evaluates the child’s prior knowledge. In the second tasks children encounter for the first time a digital microscope and observe a photograph in colour on a computer screen. Here we ask the students to provide as many observations as possible. In task three they use the digital microscope to observe systematically how different colours are produced on the computer screen. Students then use their knowledge in tasks four and five, which we call “identification tasks”. These two tasks examine the extent to which the students understand the rules of additive colour mixing that they have just observed in task three. A sample of 44 students from two Slovenian elementary schools participated in the study. In the fraction of correct responses five students stood out, one student especially, who provided correct answers to all questions. We analysed the answers of these students in detail and looked for features that are usually attributed to gifted students. The students’ performance in tackling our learning unit was compared to their grades. Only one of the exposed students was among the most successful at school. The rest were also successful at school, but had slightly lower final grades on average than some other peers who had a poorer performance at our learning unit. Even though some were straight-A students, they performed poorer at our tests than their slightly less successful peers at school. School achievement is therefore not related to the achievement at our learning unit tests

Integratori alimentari per la pratica sportiva: composizione, indicazioni ed opportunità di utilizzo

Inizialmente viene data una definizione generale di integratori alimentari, evidenziando le categorie e le normative europee applicate in tale campo. Successivamente vengono affrontati una serie di integratori adatti a differenti discipline sportive come sport di squadra, di endurance, ecc...Infine vengono valutati i vantaggi e gli svantaggi derivanti dall'assunzione di integratori a livello di alte performanc

The role of citizen public interest groups in the decision-making process of a science-intensive culture.

In our science-intensive culture and society, citizens find it increasingly difficult to participate in the decision-making process on issues that have an impact on their health and safety, their environment, and their future generations. This dissertation explores how concerns about the environment have escalated in the past three decades from being peripheral to that of a mainstream social movement. Most environmental concerns stem from the deployment of technologies where technical expertise is essential to effective participation in the decision-making process. The nuclear fission technology is an example of a technology that can have a profound impact on health and safety, and the environment. Its highly toxic, long-lived wastes will impact future generations. The manner in which the current policy for the disposal of low-level radioactive waste was devised and passed by Congress provides the information base through which the role of citizen groups in the decision-making process in a science-intensive culture is explored, as they seek to overcome the adverse environmental impacts and economic inequities of this Act. The information gathering technique was that of the focused interview. Twenty- one people were interviewed, including citizen leaders, generators, politicians, government officials, and a media representative, to examine the role of citizen groups in trying to participate in decision-making on this and other technology based policies. The actual process by which citizens have confronted the current flawed policy on disposal of low-level radioactive waste is described which includes how technical expertise from various sources made the citizens' case credible and effective. Several existing and theoretical models of citizen participation are described. Recommendations and conclusions include (1) establishing a National Task Force on Economy and Environment linked to a Citizens' Adversary Council which would review new technologies, for which the public is expected to pay, to determine whether they reflect citizens' values, goals and intergenerational responsibilities; and (2) providing for financial resources for expert assistance for citizen participation as part of every law or permitting process that impacts the environment at the state and federal level. A recommended model is proposed based on the concept of sustainable development.Ph.D.Environmental scienceHealth and Environmental SciencesLawPolitical scienceSocial SciencesUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/128839/2/9208657.pd

Enterobacter sakazakii in Dried Infant Formulas and Milk Kitchens of Maternity Wards in Sao Paulo, Brazil

This study was the first conducted in Brazil to evaluate the presence of Enterobacter sakazakii in milk-based powdered infant formula manufactured for infants 0 to 6 months of age and to examine the conditions of formula preparation and service in three hospitals in Sao Paulo State, Brazil. Samples of dried and rehydrated infant formula, environments of milk kitchens, water, bottles and nipples, utensils, and hands of personnel were analyzed, and E. sakazakii and Enterobacteriaceae populations were determined. All samples of powdered infant formula purchased at retail contained E. sakazakii at <0.03 most probable number (MPN)/100 g. In hospital samples, E. sakazakii was found in one unopened formula can (0.3 MPN/100 g) and in the residue from one nursing bottle from hospital A. All other cans of formula from the same lot bought at a retail store contained E. sakazakii at <0.03 MPN/100 g. The pathogen also was found in one cleaning sponge from hospital B. Enterobacteriaceae populations ranged from 10(1) to 10(5) CFU/g in cleaning aids and <5 CFU/g in all formula types (dry or rehydrated), except for the sample that contained E. sakazakii, which also was contaminated with Enterobacteriaceae at 5 CFU/g. E. sakazakii isolates were not genetically related. In an experiment in which rehydrated formula was used as the growth medium, the temperature was that of the neonatal intensive care unit (25 C), and the incubation time was the average time that formula is left at room temperature while feeding the babies (up to 4 h), a 2-log increase in levels of E. sakazakii was found in the formula. Visual inspection of the facilities revealed that the hygienic conditions in the milk kitchens needed improvement. The length of time that formula is left at room temperature in the different hospitals while the babies in the neonatal intensive care unit are being fed (up to 4 h) may allow for the multiplication of E. sakazakii and thus may lead to an increased health risk for infants.CAPES Coordenacao de Aperfeicoamento de Pessoal de Ensino SuperiorCNPq Conselho Nacional de Desenvolvimeno Cientffico e TecnologicoR&F Laboratories, OxoidSFDK LaboratoriosBiotrace InternationalNestle[CDC 7006