scholarly journals Increasing oxygen prescribing during the COVID-19 pandemic

2021 ◽  
Vol 10 (4) ◽  
pp. e001544
Author(s):  
Ramandeep Sahota ◽  
Lukasz Kamieniarz
Keyword(s):  
Outcome Measure ◽  
British Thoracic Society ◽  
Email Communication ◽  
Main Outcome Measure ◽  
The Past ◽  
Improve Compliance ◽  
Hospital Systems ◽  
The Subject ◽  
Hospital Inpatients ◽  
Standing Problem

Valid oxygen prescriptions for hospital inpatients have been a long-standing problem and have been described extensively in BMJ Open Quality with numerous quality improvement projects (QIPs) with the aim of improving compliance with oxygen prescribing.The British Thoracic Society recommends that all inpatients should have oxygen target saturation set on admission: this is motivated by risks of both undertreatment and overtreatment with oxygen. The discrepancy between the recommendation and the reality produced a number of interventions studied in QIPs over the past years, all aiming at bringing the local ward teams closer to the target. This has become even more important during the COVID-19 pandemic, where non-standard oxygen saturation targets and oxygen scarcity led hospital systems to rethink their internal guidelines on the subject.We propose three novel interventions to improve compliance: a remote, personally directed email communication to a ward pharmacist, a similar communication to ward nurses, and a remote, personally directed WhatsApp communication to junior ward doctors. We undertake a QIP which compares novel interventions developed in-house with the most successful interventions from oxygen prescribing initiatives that have previously been published by BMJ Open Quality. The main outcome measure was the proportion of patients with valid oxygen prescription on a ward.The series of novel interventions in three plan, do study, act cycles led to improvement in the outcome measure from 0% at baseline to 70% at the end of the QIP. The successful interventions from previous QIPs were ran in parallel on a similar ward and achieved improvement from 17.9% at baseline to 55.6% at the end of the QIP.This QIP demonstrates adapted interventions performed in context of social distancing aimed at members of multidisciplinary team which achieve superiority in increasing proportion of patients with a valid oxygen prescription, when compared with previously described methods from BMJ Open Quality.

Pakistan’s Development: Successes, Failures, and Future Tasks (Presidential Remarks)

1997 ◽  
Vol 36 (4I) ◽  
pp. 321-331
Author(s):  
Sarfraz Khan Qureshi
Keyword(s):  
Indian Subcontinent ◽  
General Meeting ◽  
The Past ◽  
Past Half Century ◽  
The Social ◽  
The Subject ◽  
Golden Jubilee ◽  
Freedom Movement ◽  
Past Half ◽  
Do So

It is an honour for me as President of the Pakistan Society of Development Economists to welcome you to the 13th Annual General Meeting and Conference of the Society. I consider it a great privilege to do so as this Meeting coincides with the Golden Jubilee celebrations of the state of Pakistan, a state which emerged on the map of the postwar world as a result of the Muslim freedom movement in the Indian Subcontinent. Fifty years to the date, we have been jubilant about it, and both as citizens of Pakistan and professionals in the social sciences we have also been thoughtful about it. We are trying to see what development has meant in Pakistan in the past half century. As there are so many dimensions that the subject has now come to have since its rather simplistic beginnings, we thought the Golden Jubilee of Pakistan to be an appropriate occasion for such stock-taking.

TARP DVIEJŲ KOLONŲ: XVIII A. PABAIGOS – XIX A. PRADŽIOS VILNIAUS MASONŲ KASDIENYBĖ SIMBOLIKOJE

2018 ◽  
pp. 144-163
Author(s):  
Daiva Milinkevičiūtė
Keyword(s):  
Daily Life ◽  
The Other ◽  
Daily Routine ◽  
The Past ◽  
Secular World ◽  
National Characteristics ◽  
Conservative Christian ◽  
The Subject ◽  
The One ◽  
Craft Guilds

The Age of Enlightenment is defined as the period when the universal ideas of progress, deism, humanism, naturalism and others were materialized and became a golden age for freemasons. It is wrong to assume that old and conservative Christian ideas were rejected. Conversely, freemasons put them into new general shapes and expressed them with the help of symbols in their daily routine. Symbols of freemasons had close ties with the past and gave them, on the one hand, a visible instrument, such as rituals and ideas to sense the transcendental, and on the other, intense gnostic aspirations. Freemasons put in a great amount of effort to improve themselves and to create their identity with the help of myths and symbols. It traces its origins to the biblical builders of King Solomon’s Temple, the posterity of the Templar Knights, and associations of the medieval craft guilds, which were also symbolical and became their link not only to each other but also to the secular world. In this work we analysed codified masonic symbols used in their rituals. The subject of our research is the universal Masonic idea and its aspects through the symbols in the daily life of the freemasons in Vilnius. Thanks to freemasons’ signets, we could find continuity, reception, and transformation of universal masonic ideas in the Lithuanian freemasonry and national characteristics of lodges. Taking everything into account, our article shows how the universal idea of freemasonry spread among Lithuanian freemasonry, and which forms and meanings it incorporated in its symbols. The objective of this research is to find a universal Masonic idea throughout their visual and oral symbols and see its impact on the daily life of the masons in Vilnius. Keywords: Freemasonry, Bible, lodge, symbols, rituals, freemasons’ signets.

Bronchopulmonary dysplasia and postnatal growth following extremely preterm birth

2020 ◽  
pp. fetalneonatal-2020-320816
Author(s):  
Theodore Dassios ◽  
Emma E Williams ◽  
Ann Hickey ◽  
Catey Bunce ◽  
Anne Greenough
Keyword(s):  
Bronchopulmonary Dysplasia ◽  
Head Circumference ◽  
Outcome Measure ◽  
Postnatal Growth ◽  
Z Score ◽  
Main Outcome Measure ◽  
Extremely Preterm ◽  
Postmenstrual Age ◽  
Extremely Preterm Birth ◽  
Current Incidence

ObjectivesTo report the current incidence of bronchopulmonary dysplasia (BPD) and to compare changes in weight and head circumference between infants who developed BPD and infants who did not.DesignRetrospective, whole-population study.SettingAll neonatal units in England between 2014 and 2018.PatientsAll liveborn infants born <28 completed weeks of gestation.InterventionsThe change in weight z-score (ΔWz) was calculated by subtracting the birthweight z-score from the weight z-score at 36 weeks postmenstrual age (PMA) and at discharge. The change in head circumference z-score (ΔHz) was calculated by subtracting the birth head circumference z-score from the head circumference z-score at discharge.Main outcome measureBPD was defined as the need for any respiratory support at 36 weeks PMA.Results11 806 infants were included in the analysis. The incidence of BPD was 57.5%, and 18.9% of the infants died before 36 weeks PMA. The median (IQR) ΔWz from birth to 36 weeks PMA was significantly smaller in infants who developed BPD (−0.69 (−1.28 to −0.14), n=6105) than in those who did not develop BPD (−0.89 (−1.40 to −0.33), n=2390; adjusted p<0.001). The median (IQR) ΔHz from birth to discharge was significantly smaller in infants who developed BPD (−0.33 (−1.69 to 0.71)) than in those who did not develop BPD (−0.61 (−1.85 to 0.35); adjusted p<0.001).ConclusionsPostnatal growth was better in infants diagnosed with BPD compared with infants without BPD possibly due to more aggressive nutrition strategies.

Performance Management Transformation

2020 ◽  
Keyword(s):  
Organizational Performance ◽  
Performance Management ◽  
High Performance ◽  
Best Practice ◽  
Call To Action ◽  
Daily Work ◽  
The Past ◽  
Great Debate ◽  
The Subject ◽  
New Research

No other talent process has been the subject of such great debate and emotion as performance management (PM). For decades, different strategies have been tried to improve PM processes, yielding an endless cycle of reform to capture the next “flavor-of-the-day” PM trend. The past 5 years, however, have brought novel thinking that is different from past trends. Companies are reducing their formal processes, driving performance-based cultures, and embedding effective PM behavior into daily work rather than relying on annual reviews to drive these. Through case studies provided from leading organizations, this book illustrates the range of PM processes that companies are using today. These show a shift away from adopting someone else’s best practice; instead, companies are designing bespoke PM processes that fit their specific strategy, climate, and needs. Leading PM thought leaders offer their views about the state of PM today, what we have learned and where we need to focus future efforts, including provocative new research that shows what matters most in driving high performance. This book is a call to action for talent management professionals to go beyond traditional best practice and provide thought leadership in designing PM processes and systems that will enhance both individual and organizational performance.

scholarly journals Shopping Centres, Cycling Accessibility and Planning—The Case of Nova Lund in Sweden

Urban Science ◽  
2020 ◽  
Vol 4 (4) ◽  
pp. 70
Author(s):  
Till Koglin ◽  
Lucas Glasare
Keyword(s):  
Conflicts Of Interest ◽  
Current Situation ◽  
Decision Makers ◽  
Power Structures ◽  
Literature Study ◽  
Shopping Centre ◽  
The Past ◽  
Whole Process ◽  
The Subject

This paper evaluates the history and cycling accessibility of Nova, a shopping centre established in Lund, Sweden, in 2002. The current situation was also analysed through observation and a literature review. Moreover, the study conducted a closer analysis of the history and role of the municipality based on further literature study and interviews with officials. The conclusion of the analysis indicates poor and unsafe bikeways caused by conflicts of interest between politicians, officials, landowners and the general public. It also depicts a situation in which the municipality’s master plan has been ignored, and, in contrast to the local goals, cycling accessibility at Nova has seen no significant improvement since the shopping centre was first established. The reasons for this, arguably, are a relatively low budget for bikeway improvements in the municipality, as well as a situation in which decision-makers have stopped approaching the subject, as a result of the long and often boisterous conflicts it has created in the past. Lastly, it must be noted that it is easy to regard the whole process of Nova, from its establishment to the current situation, as being symptomatic of the power structures between drivers and cyclists that still affect decision-makers at all levels.

S153 – Radiological Balloon Dilatation of Neo-Pharyngeal Strictures

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P127-P128
Author(s):  
Robert L Harris ◽  
Grundy Alan ◽  
Tunde A Odutoye
Keyword(s):  
Total Laryngectomy ◽  
Balloon Dilatation ◽  
Malignant Disease ◽  
Outcome Measure ◽  
Tertiary Care ◽  
Case Series ◽  
Stent Insertion ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Main Outcome Measure

Objectives Radiological balloon dilatation of lower oesophageal strictures is common practice. Other than some early reports from our own centre, there is little published regarding radiological dilatation of pharyngeal and upper oesophageal strictures and less still on radiological balloon dilatation of post-total laryngectomy and pharyngolaryngectomy neo-pharyngeal strictures. Standard practise is bouginage under general anaesthaesia. The objective of this study is to assess the efficacy of radiological balloon dilatation for the treatment of dysphagia secondary to neopharyngeal strictures in patients who have undergone laryngectomy. Methods A tertiary care centre case series of 20 consecutive patients (17 males and 3 females aged 40 to 84) with pharyngeal stricture and dysphagia post-total laryngectomy or pharyngolaryngectomy who underwent balloon dilatation of the stricture under radiological guidance. Maintenance of swallowing was the main outcome measure. Results 5 patients gained relief of their dysphagia with 1 balloon dilatation only. 9 patients required more than 1 dilatation to maintain swallowing. 2 patients had balloon dilatation procedures and stent insertion for palliative relief of dysphagia from known recurrent malignant disease. 3 patients failed to maintain swallowing with repeat dilatations. No patients suffered any significant complications such as perforation. Conclusions Balloon dilatation is minimally invasive and less traumatic than rigid pharyngoscopy with bouginage dilatation. It is well tolerated. It may be repeated frequently and can successfully relieve strictures of the pharynx in patients who have undergone total laryngectomy or pharyngolaryngectomy.

Skeletal and Dental Correction and Stability Following LeFort I Advancement in Patients With Cleft Lip and Palate With Mild, Moderate, and Severe Maxillary Hypoplasia

2021 ◽  
pp. 105566562199610
Author(s):  
Buddhathida Wangsrimongkol ◽  
Roberto L. Flores ◽  
David A. Staffenberg ◽  
Eduardo D. Rodriguez ◽  
Pradip. R. Shetye
Keyword(s):  
Retrospective Study ◽  
Outcome Measures ◽  
Cleft Lip ◽  
Outcome Measure ◽  
Cleft Lip And Palate ◽  
Inclusion Criteria ◽  
Maxillary Hypoplasia ◽  
Main Outcome Measure ◽  
Lateral Cephalograms

Objective: This study evaluates skeletal and dental outcomes of LeFort I advancement surgery in patients with cleft lip and palate (CLP) with varying degrees of maxillary skeletal hypoplasia. Design: Retrospective study. Method: Lateral cephalograms were digitized at preoperative (T1), immediately postoperative (T2), and 1-year follow-up (T3) and compared to untreated unaffected controls. Based on the severity of cleft maxillary hypoplasia, the sample was divided into 3 groups using Wits analysis: mild: ≤0 to ≥−5 mm; moderate: <−5 to >−10 mm; and severe: ≤−10 mm. Participants: Fifty-one patients with nonsyndromic CLP with hypoplastic maxilla who met inclusion criteria. Intervention: LeFort I advancement. Main Outcome Measure: Skeletal and dental stability post-LeFort I surgery at a 1-year follow-up. Results: At T2, LeFort I surgery produced an average correction of maxillary hypoplasia by 6.4 ± 0.6, 8.1 ± 0.4, and 10.7 ± 0.8 mm in the mild, moderate, and severe groups, respectively. There was a mean relapse of 1 to 1.5 mm observed in all groups. At T3, no statistically significant differences were observed between the surgical groups and controls at angle Sella, Nasion, A point (SNA), A point, Nasion, B point (ANB), and overjet outcome measures. Conclusions: LeFort I advancement produces a stable correction in mild, moderate, and severe skeletal maxillary hypoplasia. Overcorrection is recommended in all patients with CLP to compensate for the expected postsurgical skeletal relapse.

scholarly journals Teaching Science in Today’s Society: The Case of Particle Physics for Primary Schools

Universe ◽  
2021 ◽  
Vol 7 (6) ◽  
pp. 169
Author(s):  
Cristina Lazzeroni ◽  
Sandra Malvezzi ◽  
Andrea Quadri
Keyword(s):  
Particle Physics ◽  
Primary Schools ◽  
Scientific Information ◽  
Decision Makers ◽  
Educational Institutions ◽  
The Public ◽  
The Past ◽  
Rapid Changes ◽  
The Subject ◽  
Ongoing Project

The rapid changes in science and technology witnessed in recent decades have significantly contributed to the arousal of the awareness by decision-makers and the public as a whole of the need to strengthen the connection between outreach activities of universities and research institutes and the activities of educational institutions, with a central role played by schools. While the relevance of the problem is nowadays unquestioned, no unique and fully satisfactory solution has been identified. In the present paper we would like to contribute to the discussion on the subject by reporting on an ongoing project aimed to teach Particle Physics in primary schools. We will start from the past and currently planned activities in this project in order to establish a broader framework to describe the conditions for the fruitful interplay between researchers and teachers. We will also emphasize some aspects related to the dissemination of outreach materials by research institutions, in order to promote the access and distribution of scientific information in a way suited to the different age of the target students.

Does the Injunction Gap Violate Implementers’ Fair Trial Rights Under the ECHR?

2020 ◽  
Author(s):  
Léon E Dijkman
Keyword(s):  
Human Rights ◽  
Case Law ◽  
Fair Trial ◽  
European Convention ◽  
The Past ◽  
European Court ◽  
The Subject ◽  
The Right ◽  
Federal Supreme ◽  
Validity Of A Patent

Abstract Germany is one of few jurisdictions with a bifurcated patent system, under which infringement and validity of a patent are established in separate proceedings. Because validity proceedings normally take longer to conclude, it can occur that remedies for infringement are imposed before a decision on the patent’s validity is available. This phenomenon is colloquially known as the ‘injunction gap’ and has been the subject of increasing criticism over the past years. In this article, I examine the injunction gap from the perspective of the right to a fair trial enshrined in Art. 6 of the European Convention on Human Rights. I find that the case law of the European Court of Human Rights interpreting this provision supports criticism of the injunction gap, because imposing infringement remedies with potentially far-reaching consequences before the validity of a patent has been established by a court of law arguably violates defendants’ right to be heard. Such reliance on the patent office’s grant decision is no longer warranted in the light of contemporary invalidation rates. I conclude that the proliferation of the injunction gap should be curbed by an approach to a stay of proceedings which is in line with the test for stays as formulated by Germany’s Federal Supreme Court. Under this test, courts should stay infringement proceedings until the Federal Patent Court or the EPO’s Board of Appeal have ruled on the validity of a patent whenever it is more likely than not that it will be invalidated.

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