Extended Course Length: Influential Course Components of an Outdoor Leadership Semester

2020 ◽  
Vol 12 (2) ◽  
Author(s):  
Patrick Lewis ◽  
Abigail Speck ◽  
Noah Schaefer ◽  
Matt Vosler ◽  
Angelique Atlas
Keyword(s):  
Outdoor Leadership ◽  
Course Length ◽  
Extended Course

scholarly journals 144. Little evidence of same-day, oral antibiotic prescribing at ambulatory surgery centers

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S82-S83
Author(s):  
Laura M King ◽  
Lauri Hicks ◽  
Sarah Kabbani; Sharon Tsay ◽  
Katherine E Fleming-Dutra
Keyword(s):  
Surgical Procedures ◽  
Ambulatory Surgery ◽  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Oral Antibiotic ◽  
Chi Square ◽  
Convenience Sample ◽  
Ambulatory Surgery Centers ◽  
National Public Health ◽  
Course Length

Abstract Background The objective of our study was to describe oral antibiotic prescriptions associated with procedures in ambulatory surgery centers (ASC) to evaluate if there are major national opportunities to improve antibiotic use in this setting. Methods We identified surgical procedures in ASCs and oral antibiotic prescriptions in the IBM® MarketScan® Commercial 2018 database, a large convenience sample of privately-insured individuals aged < 65 years. We excluded visits with same-day hospitalizations and those with infectious diagnoses that may warrant antibiotic treatment. We included only antibiotic prescriptions dispensed on the same day as an ASC visit. We calculated the number of visits and oral antibiotic prescriptions and the percent of visits with oral antibiotic prescriptions overall, and by patient age group (< 18 and 18–64 years), antibiotic class, and procedure type. We also calculated median antibiotic course length. Across-group comparisons were evaluated using chi-square tests. Results In 2018, 918,127 ASC visits with surgical procedure codes were captured, of which 37,032 (4.0%) were associated with same-day oral antibiotic prescriptions. The percent of visits with antibiotic prescriptions was significantly higher among children compared to adults (9.4% vs 3.8%; p< 0.01); however, adults accounted for 89% of prescriptions. Respiratory/nasal and urinary tract system procedures were most frequently associated with antibiotic prescriptions (Figure). Median course length was 5 (interquartile range 3–7) days. The most common antibiotic class was cephalosporins (49.6% of prescriptions), followed by penicillins (12.6%) and fluoroquinolones (10.9%). Figure. Percent of ambulatory surgery center visits with same-day antibiotic prescriptions by procedure category, IBM® MarketScan® Commercial Database, 2018 Conclusion Only 4% of ASC procedures were associated with same-day oral antibiotic prescriptions, suggesting antibiotics are not commonly prescribed in ASCs on the day of surgical procedures. Additionally, the observed 5-day median duration may suggest that some of these courses are intended for treatment rather than prophylaxis. Our estimates represent lower bounds for oral antibiotic prescriptions in this setting, as we only captured same-day prescriptions. However, our findings suggest that ASC facilities may not be high-impact targets for national, public health antibiotic stewardship efforts. Disclosures All Authors: No reported disclosures

scholarly journals Insights from Learning Analytics for Hands-On Cloud Computing Labs in AWS

2020 ◽  
Vol 10 (24) ◽  
pp. 9148
Author(s):  
Germán Moltó ◽  
Diana M. Naranjo ◽  
J. Damian Segrelles
Keyword(s):  
Cloud Computing ◽  
Learning Analytics ◽  
Cloud Provider ◽  
Online Students ◽  
Computing Services ◽  
Hands On ◽  
Data Processing Tool ◽  
Amazon Web Services ◽  
Course Length ◽  
And Performance

Cloud computing instruction requires hands-on experience with a myriad of distributed computing services from a public cloud provider. Tracking the progress of the students, especially for online courses, requires one to automatically gather evidence and produce learning analytics in order to further determine the behavior and performance of students. With this aim, this paper describes the experience from an online course in cloud computing with Amazon Web Services on the creation of an open-source data processing tool to systematically obtain learning analytics related to the hands-on activities carried out throughout the course. These data, combined with the data obtained from the learning management system, have allowed the better characterization of the behavior of students in the course. Insights from a population of more than 420 online students through three academic years have been assessed, the dataset has been released for increased reproducibility. The results corroborate that course length has an impact on online students dropout. In addition, a gender analysis pointed out that there are no statistically significant differences in the final marks between genders, but women show an increased degree of commitment with the activities planned in the course.

Outdoor Leadership ‐ The Last Male Domain?

2002 ◽  
Vol 7 (2) ◽  
pp. 85-94 ◽  
Author(s):  
Nina Saunders ◽  
Bob Sharp
Keyword(s):  
Outdoor Leadership

Exploring Participant Development Through Adventure-Based Programming: A Model from the National Outdoor Leadership School

2007 ◽  
Vol 29 (1) ◽  
pp. 1-18 ◽  
Author(s):  
Jim Sibthorp ◽  
Karen Paisley ◽  
John Gookin
Keyword(s):  
Outdoor Leadership

scholarly journals Rokitansky diverticulum with esophageo-spinal fistula leading to infective spondylodisciitis – A case report and review of literature

2021 ◽  
Author(s):  
Ashish Kukreja ◽  
Balamurugan Thirugnanam ◽  
Seema Janardhan ◽  
D Sreeniv ◽  
Thomas J Kishen
Keyword(s):  
Case Report ◽  
Rare Condition ◽  
Sinus Tract ◽  
Metallic Stent ◽  
Esophageal Diverticulum ◽  
Cystic Lung ◽  
Vertebral Biopsy ◽  
Pulmonary Arterial ◽  
Vertebral Bodies ◽  
Extended Course

Abstract Background- Infective thoracic spondylodiscitis secondary to spontaneous perforation of the esophageal diverticulum is a rare condition. Case Report- A 56-year-old lady with cystic lung disease and pulmonary arterial hypertension of nine years duration and progressive dysphagia for two years was diagnosed with mid-esophageal diverticulum five months prior to presentation. The lady presented with infrascapular chest wall pain of one month’s duration and dyspnoea and wheezing of 15 days duration. Imaging showed a mid-esophageal diverticulum at T4-T5 level with a sinus tract extending to the T2-T3 disc, reduced T2-T3 disc height with endplate irregularities, and contrast enhancement of T2-T5 vertebral bodies suggestive of spondylodiscitis. Although a percutaneous vertebral biopsy was inconclusive, the blood culture grew Streptococcus Pseudoporcinus. The esophageal diverticulum was managed with an endoluminal stent and the infective spondylodisciitis was managed with an extended course of antibiotics led to the healing of both lesions. Conclusions- A Rokitansky mid-esophageal diverticulum with esophageo-spinal fistula causing infective spondylodisciitis is a rare condition. A combined management of the leaking esophageal diverticulum using an esophageal endoluminal metallic stent and an extended course of antibiotics to treat the infective spondylodisciitis led to a good outcome.

scholarly journals Clostridium septicumEmpyema in an Immunocompetent Woman

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Alexander B. Granok ◽  
Patrick A. Mahon ◽  
Genesio W. Biesek
Keyword(s):  
Internal Hernia ◽  
Medical Literature ◽  
Clostridium Septicum ◽  
First Report ◽  
Extended Course

We report a case of aClostridium septicumempyema in an immunocompetent woman following operation for an incarcerated internal hernia. The patient was successfully treated with pleural decortication and an extended course of postoperative antibiotics. This is the first report of such an infection in the medical literature.

Hospital antibiotic course length for community-acquired pneumonia

2021 ◽  
pp. dtb-2021-000057
Keyword(s):  
Critical Care ◽  
Community Acquired Pneumonia ◽  
Double Blind ◽  
Course Length

AbstractOverview of: Dinh A, Ropers J, Duran C, et al. Discontinuing β-lactam treatment after 3 days for patients with community-acquired pneumonia in non-critical care wards (PTC): a double-blind, randomised, placebo-controlled, non-inferiority trial. Lancet 2021;397:1195–203.

The Back-to-Nature Crowd

2021 ◽  
pp. 195-240
Author(s):  
Phoebe S.K. Young
Keyword(s):  
Environmental Awareness ◽  
High Tech ◽  
Popular Belief ◽  
Outdoor Leadership ◽  
Personal Freedom ◽  
Social Contracts ◽  
Self Discovery ◽  
1960S And 1970S ◽  
The 1960S ◽  
Minimum Impact

By the 1960s and 1970s, generational dynamics and modern environmentalism fostered new camping experiences that led away from amenity-rich and resource-heavy family campgrounds. Youth who came of age in this era shaped new forms of camping to support interests in self-discovery, countercultural values, and environmental awareness. Organizers and participants of the National Outdoor Leadership School, launched in 1965, began to link backcountry camping with countercultural mindsets, personal freedom, and connection with nature. In so doing they experimented with new social contracts in microcosm, and after 1970 increasingly began to align their mission with environmentalist agendas. Echoing the popular belief that the personal is political, many began to embrace specific forms of camping like backpacking as a way of expressing their identity and viewpoints. The new popularity of minimum-impact forms of camping in turn generated a growing market for high-tech outdoor gear intended to enhance experience and advance conservation.

scholarly journals 2033. A Systematic Review of Systematic Reviews: Procalcitonin in the ICU to Guide Antibiotic Therapy

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S683-S683
Author(s):  
Joshua York ◽  
Maithili Varadarajan ◽  
James Wilson ◽  
Gavin Barlow
Keyword(s):  
Antimicrobial Resistance ◽  
Systematic Reviews ◽  
A Priori ◽  
Study Groups ◽  
Health Crisis ◽  
Consistent Finding ◽  
Number Of Patients ◽  
Antibiotic Duration ◽  
Course Length ◽  
The Impact

Abstract Background Antimicrobial resistance is an emerging global health crisis with overall antimicrobial use a key contributor. Strategies to safely reduce antibiotic course length are important. Procalcitonin (PCT) is a serum biomarker produced in the presence of bacterial infection. There have been many systematic reviews (SRs) evaluating PCT in various populations but its use remains controversial. The aim of this SR of SRs was to evaluate the extent to which PCT in critical care (ICU) impacts antibiotic duration and other reported outcomes. Methods A systematic search of major databases using an “a priori” strategy and protocol was performed. SRs were included if one of the reported outcomes related to antibiotic duration or initiation in the ICU. Data were extracted by an author, checked and corrected independently by another author. The quality of SRs was assessed by 2 authors independently using AMSTAR II. Disagreements were resolved by consensus with a third author. Results are presented narratively and in tabular format (Table 1). Results Figure 1 shows the PRISMA diagram. 19 SRs were included. The number of patients included ranged from 308 to 6,037 (median = 1,316) across SRs. Overall, there was a consistent finding of a statistically significant (sf) reduction in antibiotic duration in study groups using PCT cessation protocols (all studies in Table 1). 3 SRs did not contain suitable statistics for inclusion in Table 1. SRs that presented the antibiotic duration outcome as a mean or median difference in exposure days (N = 16) showed a median reduction of 2.10 days (range −1.19 to -5) with PCT use. 1 SR found an sf decrease in mortality with PCT use. 4 SRs included antibiotic initiation as an outcome: 2 found an sf decrease in antibiotic prescription rate with PCT; 2 found no difference. Conclusion SRs have found that PCT use in ICU leads to an sf reduction in antibiotic duration without impacting mortality. There are no data presented in the SRs about the impact of this on antimicrobial resistance. Few SRs detail the infections included; thus the applicability of these findings to a single ICU remains challenging. Other outcomes, such as length of stay, are not affected by PCT use in ICU. Disclosures All authors: No reported disclosures.

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