G208(P) A new regional level 3 teaching programme: reviewing success one year on

Introduction: Special Care Home (SCH) residents require supervision for activities of daily living but not regular nursing care. Emergency Department (ED) use by seniors in SCHs is poorly studied. A recent study in Nova Scotia found seniors represented over 20% of ED visits. We studied SCH resident ED visits in a community with a population of 30,000 aged over 65 years and with 785 SCH beds, to define reasons for ED visits to a tertiary ED, and if these could be avoided. Methods: We performed a retrospective chart review of SCH residents’ visits to an ED (SCH-ED) which has 56,000 total ED (TED) visits over one year. Reasons for visit, admission data, and avoidability were collected. A geriatrician and ED physician independently reviewed visits. Initial disagreement on avoidability (27%) was adjudicated through case discussion. Results: Demographic data revealed 344 ED visits by 111 SCH residents over one year; 37% of visits resulted in admission. 13.9% of residents visited the ED on at least one occasion (average 3.1 visits); mean age 78.4 years; female 66.7%; ambulance arrival 91.0%. The three most common chief complaints were shortness of breath, weakness and abdominal pain. Most SCH-ED visits were Canadian Triage and Acuity Scale (CTAS) Level 3 (63.4%, TED 53.3%). Of CTAS Level 3 visits, 35.3% were admitted (TED 12.9%). SCH-ED visits were avoidable in 40.6% of cases. Gastrointestinal (18%), pain (16.5%), falls, functional decline or injury (14%) and respiratory (12%) were the most common avoidable diagnostic groups, accounting for 57% of total SCH visits. Conclusion: ED visits by SCH residents demonstrated increased acuity and admission rates with a high number of repeat visits. Of all SCH-ED visits, 40% were potentially avoidable. Further study may determine if improved community services reduces ED visits or hospital admission. Gastrointestinal, respiratory, falls and pain diagnoses may be important areas of focus.

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regentrans: a framework and R package for using genomics to study regional pathogen transmission

10.1101/2021.07.25.21261097 ◽

2021 ◽

Author(s):

Sophie Hoffman ◽

Zena Lapp ◽

Joyce Wang ◽

Evan Snitkin

Keyword(s):

R Package ◽

Multidrug Resistant ◽

Pathogen Transmission ◽

Regional Level ◽

Whole Genome Sequencing Data ◽

Sequencing Data ◽

Transmission Networks ◽

Carbapenem Resistant ◽

One Year

Increasing evidence of regional pathogen transmission networks highlights the importance of investigating the dissemination of multidrug-resistant organisms (MDROs) across a region to identify where transmission is happening and how pathogens move across regions. We developed a framework for investigating MDRO regional transmission dynamics using whole-genome sequencing data and created regentrans, an easy-to-use, open source R package that implements these methods (https://github.com/Snitkin-Lab-Umich/regentrans). Using a dataset of over 400 carbapenem-resistant Klebsiella pneumoniae isolates collected from patients in 21 long-term acute care hospitals (LTACHs) over a one-year period, we demonstrate how to use our framework to gain insights into differences in inter- and intra-facility transmission across different LTACHs and over time. These tools will allow investigators to better understand the origins and transmission patterns of MDROs, which is the first step in understanding how to stop transmission at the regional level.

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Radical nephrectomy with resection of vena cava thrombus using extracorporeal circulation and deep hypothermic circulatory arrest

Canadian Urological Association Journal ◽

10.5489/cuaj.6736 ◽

2020 ◽

Vol 15 (4) ◽

Author(s):

Gregory J. Nason ◽

Khaled Ajib ◽

Guan Hee Tan ◽

Dixon T.S. Woon ◽

George T. Christakis ◽

...

Keyword(s):

Extracorporeal Circulation ◽

Radical Nephrectomy ◽

Circulatory Arrest ◽

Vena Cava ◽

Deep Hypothermic Circulatory Arrest ◽

Hypothermic Circulatory Arrest ◽

Perioperative Morbidity ◽

Level 3 ◽

One Year ◽

The One

Introduction: Patients with renal cell carcinoma (RCC) with level 3 or 4 caval thrombus have a poor prognosis, with reported five-year survival rates of 30–40%. The aim of this study was to assess the perioperative morbidity and long-term oncological outcomes for radical nephrectomy with resection of vena cava thrombus using a combined surgical approach, including extracorporeal circulation and deep hypothermic circulatory arrest. Methods: A retrospective review was performed of the institutional case log to identify all radical nephrectomies with caval thrombus performed from January 2006 to May 2020. Results: Twenty-five patients were identified with level 2 thrombus in one (4%), level 3 thrombus in eight (32%), and level 4 in 16 (64%). The median followup was 20.6 months (range 0.2–133.3). The median age at surgery was 68.4 years (range 44.2–85.5). Twenty-one (84%) patients were symptomatic at presentation. Six (24%) patients had distant metastases at diagnosis. The median circulatory arrest time was 15 minutes (range 6–35). The 30-day grade ≥3 complication rate was 8%. The 30-day mortality rate was 8%. The one-year, two-year, three-year, and five-year recurrence-free survival (RFS) rates were 53%, 18%, 10%, and 10%, respectively. The median time to systemic treatment was 7.7 months (range 1.2–25.7). The one-year, two-year, three-year, five-year overall survival (OS) rates were 70%, 43%, 36%, and 31%, respectively. Conclusions: Radical nephrectomy with resection of vena cava thrombus using extracorporeal circulation and deep hypothermic circulatory arrest is associated with some morbidity and mortality but remains a safe and effective strategy for advanced RCC patients who would otherwise be managed palliatively.

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Assessment of the risk of foreign divestment in Poland during the COVID-19 pandemic

Wiadomości Statystyczne. The Polish Statistician ◽

10.5604/01.3001.0014.8757 ◽

2021 ◽

Vol 66 (5) ◽

pp. 26-42

Author(s):

Marcin Salamaga

Keyword(s):

Direct Investment ◽

Regional Level ◽

Logit Models ◽

International Crises ◽

Fdi Inflows ◽

Services Sector ◽

Foreign Divestment ◽

Polish Economy ◽

One Year ◽

Entire Economy

The importance of foreign direct investment (FDI) to the economic development of Poland cannot be overestimated, both at the regional level and in relation to the economy as a whole. Since FDIs are powered by capital sensitive to various national and international crises, it seems natural to ask whether the situation connected with the global COVID-19 pandemic is reflected in the reduction of FDI inflows to Poland. The aim of the paper is to identify the determinants of the foreign divestment process in the Polish economy as a whole and in its main sectors during the COVID-19 pandemic. The article analyses scenarios of foreign divestment in Poland in an annual perspective, starting from the outbreak of the epidemic in March 2020 up to February 2021. The study used data from a survey conducted in April and May 2020 among nearly 500 enterprises realising FDI in Poland. The benchmark for the surveyed companies was the level of their involvement in FDIs covering a one-year period prior to the announcement of the epidemic. The application of logit models allowed the identification of the most important factors of foreign divestment during COVID-19, including the location of FDIs in the services sector, industry, the IT sector, increased market openness and interactions of variables taking into account the restrictions introduced to the economy due to the pandemic. The level of risk of divestment of these variables depends, however, on the volume of FDI reductions declared by investors and on the sector of the economy. If considerable divestment is assumed, FDIs in the services sector are then burdened with a higher risk of divestment than FDIs in the processing industry. Assuming small divestments, FDIs in the IT sector constitute a factor bearing the greatest risk of FDI reduction in the entire economy.

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How student teachers’ understanding of the greenhouse effect develops during a teacher education programme

Nordic Studies in Science Education ◽

10.5617/nordina.411 ◽

2012 ◽

Vol 2 (3) ◽

pp. 17-29 ◽

Cited By ~ 10

Author(s):

Margareta Ekborg ◽

Mats Areskoug

Keyword(s):

Teacher Education ◽

Student Teachers ◽

Greenhouse Effect ◽

Education Programme ◽

Teaching Programme ◽

Teacher Education Programme ◽

Science Courses ◽

Adequate Understanding ◽

One Year ◽

Mathematics And Science

This paper reports on a longitudinal study on how student teachers’ understanding of the greenhouse effect developed through a teacher education programme in mathematics and science for pupils aged 7-13. All student teachers, who were accepted to the programme one year, were followed trough 2.5 years of the programme. The student teachers took science courses in which they were taught about the greenhouse effect.Data was collected by questionnaires three times. The results show that a majority of the student teachers developed an adequate understanding of the greenhouse effect during the teaching programme. Several of the students developed further in the second science course. However a rather big group of students with poor understanding did not develop any further in the second science course and no one demonstrated full understanding. Different ways of collecting data and categorising responses affected how the students’ understanding was interpreted.

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Microbiological Monitoring in the System of Epidemiological Surveillance of Purulent-Septic Infections in a Multidisciplinary Hospital

Acta biomedica scientifica ◽

10.29413/abs.2019-4.5.19 ◽

2019 ◽

Vol 4 (5) ◽

pp. 122-126 ◽

Cited By ~ 1

Author(s):

O. A. Noskova ◽

E. D. Agapova ◽

E. A. Baturina ◽

G. V. Gvak

Keyword(s):

Microbial Ecology ◽

Abdominal Cavity ◽

Age Groups ◽

Regional Level ◽

Etiological Factor ◽

Epidemiological Surveillance ◽

Gram Negative ◽

Microbiological Monitoring ◽

Leading Role ◽

One Year

The purpose of the research was to study epidemiological manifestations and etiological structure of sepsis in a multidisciplinary hospital for children.Materials and methods. An analysis of cases of 85 patients with a diagnosis of sepsis hospitalized in a multidisciplinary hospital at the regional level (Irkutsk) for the period 2013–2018 was carried out.Results and discussion. The most affected age groups are children under one year old (23.5 %) and from one year to two years (29.4 %). During the study period, 572 bacterial and fungal cultures, represented by 19 types of microorganisms, playing a leading role in the formation of the microbial ecology of the hospital, were isolated from patients with GPSI. In the structure of the GPSI microflora, gram-negative microorganisms are found in 49.8 % of cases, grampositive microbiota – in 30.1 %, fungi account for one fifth of all positive findings. A. baumannii and P. aeruginosa were sown more often from blood, sputum and abdominal cavity, and S. aureus and A. baumannii were the most frequent pathogens from wounds. The largest number of enterococci is isolated from urine.Conclusions. The etiological factor in the development of nosocomial GPSI in most cases is gram-negative microorganisms – A. baumanii (39.9 %), P. aeruginosa (20.7 %), K. pneumoniae (23.1 %). At the same time, in recent years, fungi have become increasingly important in the etiology of septic conditions.

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Scholarly Activity in a Vocational Context

Scholarly Communication and the Publish or Perish Pressures of Academia - Advances in Knowledge Acquisition, Transfer, and Management ◽

10.4018/978-1-5225-1697-2.ch003 ◽

2017 ◽

pp. 20-44

Author(s):

Bob Bell ◽

Jonathan Eaton ◽

Richard Hodgson ◽

Graham J. Mytton ◽

Peter Smith

Keyword(s):

Higher Education ◽

Regional Level ◽

Scholarly Activity ◽

Collaborative Approach ◽

North East ◽

The North ◽

The United Kingdom ◽

Vocational Setting ◽

One Year

This chapter explores the issues which surround the development of a culture of research and scholarly activity within the college-based higher education sector in the United Kingdom. It uses as a case study the North East College Regional Scholarship Network (NECRSN), which contains a number of providers who are collaborating on the development of scholarly activity within, and across, their institutions. This chapter uses the experience of the participants in the NECRSN to explore the challenges at institutional and departmental levels of inculcating a culture of scholarly activity within college-based higher education. The activities of the network are used as an example to demonstrate how a collaborative approach at a regional level can stimulate innovation and alleviate some of the pressures on academics pursuing research within a vocational setting. The approach has now been operating for one year, and has seen some initial success.

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PREDICTIVE VALUE OF OTHER COMPREHENSIVE INCOME: EVIDENCE FROM ASEAN

Jurnal Akuntansi dan Keuangan Indonesia ◽

10.21002/jaki.2020.09 ◽

2020 ◽

Vol 17 (2) ◽

Author(s):

Puji Rahayu ◽

◽

Indra Kusuma ◽

Keyword(s):

Predictive Value ◽

Value Relevance ◽

Relevant Information ◽

Fair Value ◽

Financial Reports ◽

Comprehensive Income ◽

Future Performance ◽

Other Comprehensive Income ◽

Level 3 ◽

One Year

This paper examines the predictive value of other comprehensive income and its disclosure in ASEAN. Unlike value relevance, the predictive value of other comprehensive income has not been extensively addressed in the literature. We conduct the first study examining the predictive value of other comprehensive income and its disclosure to prove that not only fair value as relevant information, but also other comprehensive income reflecting the changes of fair value. We use hand-collected data taken from the financial reports. This study employs a panel regression model to test the ability of other comprehensive income and its disclosure to predict firms’ future performance. The results confirm that as relevant information, other comprehensive income and its disclosure have predictive value. In addition, other comprehensive income which interacted with disclosure of other comprehensive income resulted predictive value only for one year ahead. Furthermore, other comprehensive income components which belongs to fair value level 1 and 2 have predictive value because it uses market-based input. Meanwhile, other comprehensive components which belong to fair value level 3 only have predictive value for one year ahead because it uses unobservable input that can lead to higher subjectivity.

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786 Virtual Teaching in the COVID Era: Providing Surgical Trainee Teaching Via Online Webinars and Video Conferencing

British Journal of Surgery ◽

10.1093/bjs/znab259.873 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

A Blythe

Keyword(s):

Northern Ireland ◽

Surgical Training ◽

Training Needs ◽

Surgical Trainee ◽

Teaching Programme ◽

Surgical Trainees ◽

Sustained Change ◽

Virtual Teaching ◽

One Year ◽

Future Topics

Abstract Introduction Core surgical training is dependent on a balance of lecture-based and procedure-based teaching. Due to the COVID-19 pandemic, from March 2020 teaching provided by the Northern Ireland Medical and Dental Training Agency (NIMDTA) for Core Surgical Trainees (CSTs) was cancelled. In lieu of this, a virtual teaching programme was developed to ensure this vital aspect of training was not neglected. Method Firstly, one-year free Affiliate membership to the Royal College of Surgeons of Edinburgh (RCSEd) was provided for all Northern Ireland CSTs, allowing access to RCSEd online webinars. Second, a weekly teaching schedule was developed with accompanying webinar – this was based on the MRCS curriculum. Third, consultants and senior registrars were recruited to conduct a virtual teaching session via videoconferencing. Feedback was collated and used to guide future topics covered. The teaching sessions were recorded for trainee dissemination with consent from the tutors. Results Ten teaching sessions were conducted over three months. While attendance was variable, overall feedback was very positive with requests for this virtual teaching to continue. As such, NIMDTA adopted the teaching programme as their new primary method of lecture-based teaching for all Northern Ireland CSTs. Conclusions Although prepared in a short space of time, a novel, highly successful teaching programme was developed in Northern Ireland to meet the training needs of CSTs. This has resulted in a sustained change to training in Northern Ireland and may be imperative in supporting surgical training in a foreseeably socially distanced world.

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Between ‘Savage Man’ and ‘Most Faithful Englishman’ Manteo and the Early Anglo-Indian Exchange, 1584–1590

Itinerario ◽

10.1017/s0165115300044545 ◽

2000 ◽

Vol 24 (2) ◽

pp. 146-169 ◽

Cited By ~ 1

Author(s):

Michael Leroy Oberg

Keyword(s):

North Carolina ◽

Chesapeake Bay ◽

One Year ◽

Anglo Indian

In August of 1587 Manteo, an Indian from Croatoan Island, joined a group of English settlers in an attack on the native village of Dasemunkepeuc, located on the coast of present-day North Carolina. These colonists, amongst whom Manteo lived, had landed on Roanoke Island less than a month before, dumped there by a pilot more interested in hunting Spanish prize ships than in carrying colonists to their intended place of settlement along the Chesapeake Bay. The colonists had hoped to re-establish peaceful relations with area natives, and for that reason they relied upon Manteo to act as an interpreter, broker, and intercultural diplomat. The legacy of Anglo-Indian bitterness remaining from Ralph Lane's military settlement, however, which had hastily abandoned the island one year before, was too great for Manteo to overcome. The settlers found themselves that summer in the midst of hostile Indians.

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