MEETING SSO TREATMENT REQUIREMENTS WITH A HIGH RATE PROCESS TRAIN: PILOT RESULTS LEAD THE WAY

2002 ◽  
Vol 2002 (9) ◽  
pp. 13-42
Author(s):  
Brian Matson ◽  
Paul Eckley ◽  
Francis B. Kessler ◽  
Robert B. Eimstad ◽  
Jamel Demir ◽  
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Keyword(s):  
2020 ◽  
Vol 19 (3) ◽  
pp. 116-117
Author(s):  
Christian P Subbe ◽  

What makes us human? In 2015 Jeremy Vine asked this question to a selection of leading British thinkers and writers. The answers were as diverse as the people he interviewed. While you might have your own views about the complexity of being human I would suggest that being able to articulate thoughts and communicate them to others might be one of the characteristics that distinguishes us from other life forms. And if we think more about the achievements of human culture then being able to communicate thoughts in writing and reading other people’s thoughts is one of the unique abilities that humanity has acquired during its evolution: Young humans spend extensive time to learn how to read and write. They write on paper, they read books and they do the same on computers. They become adults. They read and write most days: they e-mail their telephone company, file online forms to the tax office and or write romantic notes to their partner. Then they get older and become unwell and enter large modern building full of the most state-of-the-art technology. But here, in hospitals, none of them are allowed to read or write. They are being asked questions by someone who is often younger and in a rush. That person usually speaks a different language called jargon and try their best to translate their jargon to normal language.1 Patients are not allowed to write their own records and access to read the records is cumbersome. And if this is how we structure communication in our clinical practice then why are we surprised about the hierarchical relationship between patients and healthcare professionals and the high rate of error due to miscommunication? There might be good reasons for the way we document in healthcare: historically only the educated few like doctors were able to read and write and therefore the way to record patient histories had to be by those who were educated to do so. Additionally professions have always defined themselves by their own professional language and jargon that allows their members to describe matters precisely and at the same time create a sense of identity. Things have however changed in the last 100 years and a large proportion of our patients is able to read and write and might be perfectly capable to document their own information (and subsequently read all information that relates to them). The paper from Renggli et al in this issue of Acute Medicine explores the feasibility of documentation by patients on admission to hospital in Switzerland by using a web-based platform: at least half of the patients who were admitted with an emergency to hospital could document important parts their own medical history. The study demonstrated that documentation by patients added additional new information over and beyond of that collected by doctors and improved completeness of records, especially for the increasingly important social history. The paper has three important implications: Good information needs time: Patients can add more information if given the questions and their own time – rushing through an unprepared face-to-face consultation is unlikely to bring out the most relevant information in a reliable fashion. Sharing with patients might improve work-efficiency. Up to 25% of the time of doctors and nurses working in hospitals is taken up by documentation2,3: at a time when so many employed in healthcare are overworked and burnt out it would be reckless not to consider changes in information flow through the lens of work-load and efficiency. Quality care needs joint ownership with patients: Patients participation in the co-design and delivery of new services and shared decision of patients and clinicians in making of complex decision has been challenging to say the least. Co-ownership of clinical records is potentially a key strategic lever to achieve better decisions and services. Patient organisations and policy makers are expecting for patients to access medical records. Personal health records are now compulsory in some countries with roll-out of access for all citizens completed in countries like Estonia since 20084 and Sweden since 2018.5 It is National Health Service (NHS) policy to make a “personalized healthcare” available to everybody by 2020.6 That is now. Despite this there is virtually no evidence for the usage of personal health records in hospital.7,8 There are significant caveats to the current study: Half of the patients approached declined to take part and it is unclear why this was the case. Maybe they did not want to take part in any research. Maybe they felt too unwell to write. And maybe they were unable to read and write. While most people reaching adulthood in European countries have gone to school there is also evidence that up to 7 million adults in England are functionally illiterate and not able to read and write beyond the most basic level9 and relying on friends and family members, signs and symbols to travel through modern life. There is also an increasing body of work about digital exclusion and concerns that those who are unable to navigate the online world are at risk of being left behind by society.10 There are additional questions about ownership: do patients own all data that relates to their care or is documentation by healthcare professionals their intellectual property. There are strong arguments for both perspectives. From a patient safety point of view their would seem to be a strong imperative to come to pragmatic agreements. Research suggests that the majority of serious adverse events was flagged by patients and relatives at a time when they could have been predicted and potentially prevented by clinical teams.11 But safety critical information is often hidden from those who are most affected by it, the patients. The paper by Renggli et all does therefore provide important evidence for the development of a more co-operative and democratic way of providing acute care by using something that is a key part of being human: the ability to read and write.


1968 ◽  
Vol 21 (2) ◽  
pp. 207-220
Author(s):  
F. Ormonroyd

It is abundantly clear that improvement in regularity and safety of operations in poor visibility can only come about through increased precision during the non-visual phase of the approach and missed approach and through continuing use of the instrument guidance to the lowest possible height within the prescribed limitations during the visual phase. In common with most other airlines, B.E.A. is planning to introduce Category II operations in the near future and this paper deals with some of the problems which we have met and the way in which we plan to tackle them.By virtue of being an exclusively short-haul airline, B.E.A. flight times are! short compared with time spent on the ground. As a result, flight schedules need to be closely integrated to provide a high rate of utilization of both aircraft and crews, and so any serious disruption of services by the weather affects B.E.A. to a greater extent than other airlines.


2010 ◽  
Vol 63 (7-8) ◽  
pp. 531-534
Author(s):  
Caslav Milic

Introduction. Suicide is a conscious and deliberate extermination of one?s own life. Suicidal motives can be exogenous and endogenous. Exogenous factors are those from social and economic sphere, moral and political ones. There are numerous elements: demographic, socio-pathological, clinical-psychopathological and, in recent time, seasonal variations and meteorological characteristics are considered to be significant. Aim. On the basis of the analyzed literature the aim of this paper was to show the connection among seasonal variations, frequency and suicidal features. Methods. Numerous epidemiological analyses of suicide have found a connection between suicide and seasonal variations. The connection between seasonal variations and suicide regarding the way of committing it (violent and nonviolent one) has been checked. Seasons, particularly spring and summer, have influence on suicide, which confirms the fact that suicide rate in time corresponds with seasonal variations. Results. Suicides in younger age groups of both sexes show smaller asymmetry in seasonal distribution than in older groups. Seasonal influence on suicide rate has been proved to be bigger in men than in women. As for the connection between seasonal characteristics and suicide regarding the way of committing it (violent and nonviolent suicide) most studies show that suicide, but only the violent one, is in direct connection with seasons. Annual trend shows the peak from March to May (from early to late spring) for violent suicide. Conclusion. To have knowledge about the influence of seasonal variations on committing suicide is very important for taking adequate preventive measures, especially in those countries which have high rate of suicide.


Behaviour ◽  
1990 ◽  
Vol 112 (1-2) ◽  
pp. 23-35 ◽  
Author(s):  
Peter Nonacs

AbstractAnt foragers are known to communicate food presence in distant patches, but do they also communicate information about distant mortality risk? Recruitment to a food source in a laboratory Lasius pallitarsis colony depended upon whether the initial returning foragers had encountered mortality risk (a larger Formica subnuda) and the quality of the food they found. When food quality was high, risk appeared to not affect recruitment; when quality was low, risk inhibited foraging. In a second experiment, L. pallitarsis colonies had access to food of several qualities through a divided trail, which forced foragers to take different routes to and from the food patch. Danger was either entirely absent, present only on the way to the patch, present only on the way from the patch, or along both routes. When food quality was poor colonies recruited to food when risk was absent, but risk anywhere significantly reduced the level of foraging. This included the situation where only returning foragers could encounter danger, which strongly suggests that their behaviour was a critical factor in whether nestmates would continue foraging. When food quality was moderate, only treatments with risk on the way to the food significantly inhibited foraging. When food quality was good, colonies continued to forage at a high rate, irrespective of presence or location or risk. In total, L. pallitarsis foragers appear to communicate and use information about both food and mortality risk in deciding whether to exploit patches.


2020 ◽  
Author(s):  
Maxime Izoulet

COVID-19 (Coronavirus Disease-2019) is an international public health problem with a high rate of severe clinical cases. Several treatments are currently being tested worldwide. This paper focuses on anti-malarial drugs such as chloroquine or hydroxychloroquine, which have been currently reviewed by a systematic study as a good potential candidate and that has been reported as the most used treatment by a recent survey of physicians. We compare the dynamics of COVID-19 death rates in countries using anti-malaria drugs as a treatment from the start of the epidemic versus countries that do not, the day of the 3rd death and the following 10 days. We show that the first group have a much slower dynamic in death rates that the second group. This univariate analysis is of course only one additional piece of evidence in the debate regarding the efficiency of anti-malaria drugs, and it is also limited as the two groups certainly have other systemic differences in the way they responded to the pandemic, in the way they report death or in their population that better explain differences in dynamics (systematic differences that may also explain their choice to rely on anti-malaria drugs in the first place). Nevertheless, the difference in dynamics is so striking that we believe that the urgency context commands presenting the univariate analysis before delving into further analysis. In the end, this data might ultimately be either a piece of evidence in favor or anti-malaria drugs or a stepping stone in understanding further what other ecological aspects place a role in the dynamics of COVID-19 deaths.


2011 ◽  
Vol 2 (5) ◽  
pp. 333-341 ◽  
Author(s):  
Marie Fablet ◽  
Cristina Vieira

AbstractEvolvability can be defined as the capacity of an individual to evolve and thus to capture adaptive mutations. Transposable elements (TE) are an important source of mutations in organisms. Their capacity to transpose within a genome, sometimes at a high rate, and their copy number regulation are environment-sensitive, as are the epigenetic pathways that mediate TE regulation in a genome. In this review we revisit the way we see evolvability with regard to transposable elements and epigenetics.


2017 ◽  
Vol 14 (1-2) ◽  
pp. 56-62 ◽  
Author(s):  
Lila Bahadur Bishwakarma

This paper based on my MPhil dissertation which attempts to exemplify the way of caste-based discrimination practices around schools premises. The Dalit teachers who underwent various forms of such discrimination practices in their school life at different places of Dhading District are the narrated life hi/stories while pledging narrative inquiry. The method was developed with interpretive research paradigm as narratives had immeasurable potentialities to construct meaning of socio-cultural situatedenss of Dalits’ lives and caste-based schooling approach. I, as narrative inquirer, affirmed Freirean perspective to get insight on the nature of Dalit discrimination at school and the way they cope with it. Due to discrimination, there would be high rate of irregularity and dropout even still there is. However, at this context due to various reasons and efforts flexibility (improvement) is being taken places against caste-based discrimination at school in the name of inclusivity, encounters aged-long concept of social exclusion, in present days. It is, perhaps, because of transformative educational approach for a few decades. Transformative education is one of the best means to address Dalit issue with the advocacy of equality and equity. It is significant green signal of transforming ranked society into democratic one. Nepalese Journal of Development and Rural StudiesVol. 14 (Joint issue) (1&2), 2017, Page: 56-62


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