scholarly journals Older people's experiences of dignity and support with eating during hospital stays: analytical framework, policies and outcomes

2021 ◽  
pp. 1-35
Author(s):  
Polly Vizard ◽  
Tania Burchardt
Keyword(s):  
Analytical Framework ◽  
Acute Hospital ◽  
Hospital Services ◽  
Older Person ◽  
High Quality ◽  
Population Average ◽  
Disabled Women ◽  
Adult Inpatient ◽  
Hospital Stays ◽  
Over Time

Abstract There is growing recognition of the importance of dignity and support with eating as markers of high-quality and older-person-centred hospital services. We use data on these markers from the national Adult Inpatient Survey for England to build up statistical evidence on older people's experiences. We find that poor and inconsistent experiences of being treated with dignity and respect, and of receiving support with eating, affect a substantial proportion of inpatients across the vast majority of acute hospital trusts. There has been remarkably little change over time, although small improvements provide some grounds for optimism relating to policy developments in the period following the Francis Inquiry. Amongst people over 65, the prevalence of inconsistent and poor experiences of dignity and support with eating was higher amongst the ‘oldest of the old’ (inpatients aged over 80), individuals who experience a long-standing limiting illness or disability, and women. The highest rates of prevalence were observed amongst disabled women over 80. Perceptions of inadequate nursing quantity and quality, and lack of choice of food, stand out from logistic regression analysis as having consistent, large associations with lack of support with eating. These factors provide potential policy levers since they are within the control of hospitals to a certain extent. In drawing lessons from our analysis for inspection, regulation and monitoring, we highlight the importance of inequalities analysis – including systematic disaggregation and separate identification of at risk sub-groups (e.g. older disabled women) – rather than relying on a ‘population average approach’.

scholarly journals Response to Fuson, Clements, and Sarama Commentary on Litkowski, Duncan, Logan, and Purpura (2020)

AERA Open ◽  
2021 ◽  
Vol 7 ◽  
pp. 233285842110271
Author(s):  
David J. Purpura ◽  
Ellen C. Litkowski ◽  
Robert J. Duncan ◽  
Jessica A. R. Logan
Keyword(s):  
Young Children ◽  
Grade Level ◽  
High Quality ◽  
Equity Issues ◽  
Quality Instruction ◽  
New Evidence ◽  
Over Time

In response to Fuson et al.’s commentary on Litkowski et al. (2020), we clarify and expand on three areas: (1) the need for prekindergarten standards, (2) the value in developmental survey work, and (3) the importance of understanding curriculum translation and uptake. Specifically, we note that standards need to be appropriate for grade-level and it is time for more aligned prekindergarten standards. Developmental survey work is critical for ensuring that standards and expectations are accurate and adjusted to meet current needs and can be used address equity issues in instruction. Furthermore, we agree that intervention and curriculum work are needed, but there should be explicit emphasis on enhancing uptake and use of high-quality instruction. Ultimately, we need a system of assessment and instruction that is continually updated and improved, that integrates and modifies new evidence over time to ensure that we are striving for—and attaining—the best results for young children.

scholarly journals The fossil record of whip spiders: the past of Amblypygi

PalZ ◽  
2021 ◽  
Author(s):  
Carolin Haug ◽  
Joachim T. Haug
Keyword(s):  
Fossil Record ◽  
3D Imaging ◽  
Three Dimensional ◽  
Dorsal Shield ◽  
Stereo Images ◽  
Geological Time ◽  
High Quality ◽  
The Past ◽  
Over Time

AbstractWhip spiders (Amblypygi), as their name suggests, resemble spiders (Araneae) in some aspects, but differ from them by their heart-shaped (prosomal) dorsal shield, their prominent grasping pedipalps, and their subsequent elongate pair of feeler appendages. The oldest possible occurrences of whip spiders, represented by cuticle fragments, date back to the Devonian (c. 385 mya), but (almost) complete fossils are known from the Carboniferous (c. 300 mya) onwards. The fossils include specimens preserved on slabs or in nodules (Carboniferous, Cretaceous) as well as specimens preserved in amber (Cretaceous, Eocene, Miocene). We review here all fossil whip spider specimens, figure most of them as interpretative drawings or with high-quality photographs including 3D imaging (stereo images) to make the three-dimensional relief of the specimens visible. Furthermore, we amend the list by two new specimens (resulting in 37 in total). The fossil specimens as well as modern whip spiders were measured to analyse possible changes in morphology over time. In general, the shield appears to have become relatively broader and the pedipalps and walking appendages have become more elongate over geological time. The morphological details are discussed in an evolutionary framework and in comparison with results from earlier studies.

scholarly journals Dynamic Signaling with Dropout Risk

2016 ◽  
Vol 8 (1) ◽  
pp. 57-82 ◽  
Author(s):  
Francesc Dilmé ◽  
Fei Li
Keyword(s):  
Time Varying ◽  
High Quality ◽  
Indivisible Good ◽  
Initial Belief ◽  
Costly Delay ◽  
Over Time

We study the role of dropout risk in dynamic signaling. A seller privately knows the quality of an indivisible good and decides when to trade. In each period, he may draw a dropout shock that forces him to trade immediately. To avoid costly delay, the seller with a low-quality good voluntarily pools with early dropouts, implying that the expected quality of the good increases over time. We characterize the time-varying equilibrium trading dynamics. It is demonstrated that the maximum equilibrium delay of trade is decreasing in the initial belief that the good is of high quality. (JEL C73, D82, D83)

Changes in care in the fourth trimester in Ireland: 2010–2020

2021 ◽  
Vol 29 (12) ◽  
pp. 683-691
Author(s):  
Jean Doherty ◽  
Mary Brosnan ◽  
Lucille Sheehy
Keyword(s):  
Negative Impact ◽  
Maternity Hospital ◽  
Care Needs ◽  
High Quality ◽  
Midwifery Care ◽  
Hospital Stays ◽  
Current Context ◽  
Discharge From Hospital ◽  
The Impact

Background There has been a shift in maternity care over the past decade. The changes encountered by postnatal ward staff and the impact of these changes on women postnatally requires exploration. This study aimed to ascertain midwives' and healthcare assistants' perspectives of the changes in postnatal care and challenges to providing care in the current context. Methods This was a qualitative study involving two focus groups of 15 midwives and healthcare assistants from an Irish urban maternity hospital. The participants' responses were analysed thematically. Results Changes in women's clinical characteristics, including increased comorbidities and caesarean section rates, were highlighted as creating additional care needs. Furthermore, additional midwifery tasks and clinical protocols as well as shorter hospital stays leave little time for high-quality, woman-centred care. Participants highlighted a negative impact on maternal health from limited follow-up midwifery care in the community. Conclusions With additional midwifery duties and a reduction in time to complete them, additional community midwifery care is key to providing high-quality follow-on care after postnatal discharge from hospital.

THE WAY AHEAD FOR ACUTE HOSPITAL SERVICES

The Lancet ◽  
1976 ◽  
Vol 308 (7997) ◽  
pp. 1235-1237 ◽  
Author(s):  
Bryan Jennett
Keyword(s):  
Acute Hospital ◽  
Hospital Services ◽  
The Way

scholarly journals Up with ecology, down with economy? The consolidation of the idea of climate change mitigation in the global public sphere

2018 ◽  
Vol 33 (6) ◽  
pp. 587-603 ◽  
Author(s):  
Tuomas Ylä-Anttila ◽  
Juho Vesa ◽  
Veikko Eranti ◽  
Anna Kukkonen ◽  
Tomi Lehtimäki ◽  
...  
Keyword(s):  
Climate Change ◽  
Public Sphere ◽  
Climate Change Mitigation ◽  
Analytical Framework ◽  
Economic Evaluations ◽  
Business Elites ◽  
The Public ◽  
The Public Sphere ◽  
Change Mitigation ◽  
Over Time

Building on theories of valuation and evaluation, we develop an analytical framework that outlines six elements of the process of consolidation of an idea in the public sphere. We then use the framework to analyse the process of consolidation of the idea of climate change mitigation between 1997 and 2013, focusing on the interplay between ecological and economic evaluations. Our content analysis of 1274 articles in leading newspapers in five countries around the globe shows that (1) ecological arguments increase over time, (2) economic arguments decrease over time, (3) the visibility of environmental nongovernmental organizations as carriers of ecological ideas increases over time, (4) the visibility of business actors correspondingly decreases, (5) ecological ideas are increasingly adopted by political and business elites and (6) a compromise emerges between ecological and economic evaluations, in the form of the argument that climate change mitigation boosts, rather than hinders economic growth.

scholarly journals The genomic variation landscape of globally-circulating clades of SARS-CoV-2 defines a genetic barcoding scheme

2020 ◽  
Author(s):  
Qingtian Guan ◽  
Mukhtar Sadykov ◽  
Raushan Nugmanova ◽  
Michael J. Carr ◽  
Stefan T. Arold ◽  
...  
Keyword(s):  
Viral Proteins ◽  
Genomic Variation ◽  
Genome Replication ◽  
High Quality ◽  
Dynamic Changes ◽  
Health Measures ◽  
Complete Genomes ◽  
Major Mutation ◽  
Genetic Barcoding ◽  
Over Time

ABSTRACTWe describe fifteen major mutation events from 2,058 high-quality SARS-CoV-2 genomes deposited up to March 31st, 2020. These events define five major clades (G, I, S, D and V) of globally-circulating viral populations, representing 85.7% of all sequenced cases, which we can identify using a 10 nucleotide genetic classifier or barcode. We applied this barcode to 4,000 additional genomes deposited between March 31st and April 15th and classified successfully 95.6% of the clades demonstrating the utility of this approach. An analysis of amino acid variation in SARS-CoV-2 ORFs provided evidence of substitution events in the viral proteins involved in both host-entry and genome replication. The systematic monitoring of dynamic changes in the SARS-CoV-2 genomes of circulating virus populations over time can guide therapeutic and prophylactic strategies to manage and contain the virus and, also, with available efficacious antivirals and vaccines, aid in the monitoring of circulating genetic diversity as we proceed towards elimination of the agent. The barcode will add the necessary genetic resolution to facilitate tracking and monitoring of infection clusters to distinguish imported and indigenous cases and thereby aid public health measures seeking to interrupt transmission chains without the requirement for real-time complete genomes sequencing.

Acute hospital services in London

BMJ ◽  
1981 ◽  
Vol 282 (6268) ◽  
pp. 996-997
Author(s):  
K A M Grant
Keyword(s):  
Acute Hospital ◽  
Hospital Services

Welfare States in the Middle East and North Africa: Puzzles and Answers

2020 ◽  
pp. 1-51
Author(s):  
Ferdinand Eibl
Keyword(s):  
Political Economy ◽  
Analytical Framework ◽  
Welfare States ◽  
Theoretical Argument ◽  
Regime Formation ◽  
General Terms ◽  
To Come ◽  
The Moment ◽  
Over Time

Chapter 1 sets out the main empirical puzzles of the book, which are (i) the early divergence of welfare trajectories in the region and (ii) their long persistence over time. Drawing on literature from authoritarianism studies and political economy, it lays out the theoretical argument explaining this empirical pattern by developing a novel analytical framework focused on elite incentives at the moment of regime formation and geostrategic constraints limiting their abilities to provide welfare. It also outlines the author’s explanation for the persistence of social policies over time and broadly describes the three types of welfare regime in the region. It sbows the limitations of existing theories in explaining this divergence and bigbligbts the book’s contribution to the literature. The theoretical argument is stated in general terms and sbould thus be of relevance to political economy and authoritarianism scholars more broadly. The chapter ends with an outline of the chapters to come.

scholarly journals 1337. Development, Maintenance, and Application of Opsonophagocytic Assays to Measure Functional Antibody Responses to Support a 20 Valent Pneumococcal Conjugate Vaccine

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S484-S484
Author(s):  
Ingrid L Scully ◽  
Mark W Cutler ◽  
Seema Gangolli ◽  
Todd Belanger ◽  
David Cooper ◽  
...  
Keyword(s):  
Quality Control ◽  
Antibody Responses ◽  
Antibody Activity ◽  
Pneumococcal Vaccines ◽  
Next Generation ◽  
High Quality ◽  
Assay Performance ◽  
Control Serum ◽  
Serological Data ◽  
Over Time

Abstract Background Opsonophagocytic assays (OPAs) are an important tool for assessing vaccine-induced functional antibody responses. OPAs are complex assays composed of many biological components (eg serum, complement sources, bacteria, and human phagocytes) which contribute to assay variability and may result in titer drift if not carefully controlled. Rigorous development and validation coupled with routine monitoring of assay performance are required to ensure that high-quality OPA serological data are consistently generated throughout the lifetime of existing and next-generation pneumococcal vaccines. Methods OPA specificity was demonstrated by competing functional antibody activity with pneumococcal polysaccharides. Assay qualification/validation assessed accuracy, precision, and sample linearity. Assay performance over time was assessed through the implementation of quality control serum data tracking systems and longterm serum proficiency panels that are routinely tested during assay performance. Human quality control sera are included on each assay plate to ensure that each plate meets pre-specified acceptance criteria. Proficiency serum panels are comprised of individual human serum samples derived from subjects immunized with pneumococcal vaccines and are used to monitor performance across a range of serological titers and over time. Results The OPAs were shown to be specific and reproducible. Monitoring of assay performance over time demonstrated that the assays are stable. For the 13 serotypes contained in 13vPnC reliable titers have been generated in over a decade of testing which is an essential prerequisite in the evaluation of next-generation pneumococcal conjugate vaccines such as 20vPnC, whose licensure depends on demonstration of non-inferiority to 13vPnC. Conclusion Maintenance and careful monitoring of high-quality assays to measure functional antibody responses, such as OPAs, is critical for the delivery of reliable serological data to support the advancement of pneumococcal vaccine programs. Pneumococcal OPAs must be rigorously maintained to ensure continuity of serological data over time and inform licensure decisions of next-generation vaccines as well as postmarketing and seroepidemiology studies. Disclosures All authors: No reported disclosures.

Sign in / Sign up

Export Citation Format

Share Document