Coronary artery bypass surgery in the elderly : is it worthwhile?

Objectives: To evaluate the early outcomes after coronary surgery in the elderly. Methods: A retrospective analysis (April 1995- January 2012) of mortality, morbidity and hospital stay, derived from a single surgeon’s practice. Outcomes of patients over 70 (group A, n=785) were compared with those of controls under 70 (group B, n=2772). Results: Intervention rate was significantly higher (1502/106 vs 467/106, p<0.0001). There were significantly fewer single and quintuple grafts, and significantly more double grafts in group A. The use of an internal thoracic artery (ITA) was lower in group A (748/785, 95.3% vs 2695/2772, 97.2%, p=0.006). Mortality for the entire coronary surgical practice was 1.2%. The overall mortality was 2.7% in group A and 0.8% in group B (p<0.0001). Freedom from any post- operative complication occurred in 57.7% in group A and in 75.6% in group B (p<0.0001). Cardiac complications (except for perioperative MI and atrial flutter) were significantly higher in group A, as were major neurological, renal and respiratory complications, as well as minor wound complications. All complications resulted in patient morbidity but cerebrovascular accident had the worst impact, contributing to perioperative death in 8 of the 18 cases ingroupAandin4ofthe24casesingroupB (p=0.049). Average length of stay on intensive care was similar (1.19±1.84 days for group A and 1.13±1.48 days for group B, p=0.38). The average HDU stay was longer in group A (1.43±2.70 vs 0.95±3.68 days, p=0.006) as was the average ward stay (4.00±3.33 vs 3.25±2.23 days, p<0.0001). Conclusions: Although mortality and morbidity remain significantly higher, taken in the context of the overall clinical problem, cardiac surgery has much to offer in this select group of patients.peer-reviewe

Review of the occupational health and safety of Britain’s ethnic minorities

This report sets out an evidence-based review on work-related health and safety issues relating to black and minority ethnic groups. Data included available statistical materials and a systematic review of published research and practice-based reports. UK South Asians are generally under-represented within the most hazardous occupational groups. They have lower accident rates overall, while Black Caribbean workers rates are similar to the general population; Bangladeshi and Chinese workers report lowest workplace injury rates UK South Asian people exhibit higher levels of limiting long-term illness (LLI) and self reported poor health than the general population while Black Africans and Chinese report lower levels. Ethnic minority workers with LLI are more likely than whites to withdraw from the workforce, or to experience lower wage rates. Some of these findings conflict with evidence of differentials from USA, Europe and Australasia, but there is a dearth of effective primary research or reliable monitoring data from UK sources. There remains a need to improve monitoring and data collection relating to black and ethnic minority populations and migrant workers. Suggestions are made relating to workshops on occupational health promotion programmes for ethnic minorities, and ethnic minority health and safety 'Beacon' sites

Individual learner differences and distance language learning: an overview

No abstract available

"Obstacles to School Progression in Rural Pakistan: An Analysis of Gender and Sibling Rivalry Using Field Survey Data"

This paper aims to identify the obstacles to school progression by integrating field surveys conducted in twenty-five Pakistani villages, using economic theory and econometric analysis. The full-information maximum likelihood (FIML) estimation of the sequential schooling decision model reveals important dynamics of the gender difference in educational attainment, intrahousehold resource-allocation patterns, and transitory income and wealth effects. We find a high educational retention rate and observe that school progression rates between male and female students after secondary school are comparable. In particular, we find gender-specific and schooling-stage-specific birth-order effects on education. Our overall findings are consistent with the theoretical implications of optimal schooling behavior under binding credit constraints and the self-selection in education-friendly households. Finally, we find serious supply-side constraints on primary education for females.

#BlackGirlMathMagic: A Mixed Methods Study Examining African American Girls in Standardized MathematicsTesting

Black women have been making successful strides in mathematics for decades; however, they continue to be underrepresented in mathematics and other STEM fields. According to Young et al. (2017), Black girls and women perform lower in mathematics than all other racial gender groups except for Black males. Considering the stakes for Black girls and women in mathematics, this study sought to address this group\u27s challenges early in their secondary education experiences, focusing on standardized testing. The purpose of this explanatory-sequential mixed-methods study was to determine how different mathematics item types impacted the performance of African American girls, especially multiple-select multiple-choice (MSMC) items. The participants were 18-sixth grade African American girls and two mathematics teachers from an urban charter school in the Southeastern United States. Procedures included administering a 15-item Expressions and Equations mathematics assessment with three types of test items, including single-select multiple-choice (MC), MSMC, and short-answer constructed-response (CR) items. The assessment was followed by retrospective think-aloud student interviews of the MSMC items and supplemental teacher interviews for additional context. Five of the original students from the mathematics assessment completed the interview. Given the extenuating circumstances related to the coronavirus pandemic, their teachers were able to highlight factors that may have contributed to their students’ performance. The results and findings were multifaceted. Using Friedman’s nonparametric test, a statistically significant difference was detected for the Black girls’ performance on MSMC items compared to MC and CR items; MSMC items had the lowest performance overall. From the girls’ retrospective think-aloud interviews, four themes were uncovered: the use of Standards for Mathematical Practices (SMPs), inaccurate mathematics language, mathematical misunderstandings, and lack of testwiseness strategies. Next, regarding the pandemic school year, teachers revealed an overall lack of student participation, high student absences, technical difficulties with online learning, and the limited capacity to meet student needs either in-person or virtually. The cumulative findings supported the quantitative assessment results. Overall, the findings suggest that Black girls are currently disadvantaged, even more so during the pandemic, due to lack of instructional support, minimal to late testwiseness training, and misaligned assessment experiences

Investing in People

Foundations have long created programs to provide grants to individuals—most often in the form of fellowships, scholarships, and prizes. Several of these programs have become so prominent that they are now institutions in and of themselves. Consider just a few examples: the Pulitzer Prize, Fulbright Program, and MacArthur "genius" awards. Governments, as well as foundations large and small, fund individual support programs.The Robert Wood Johnson Foundation has generously allowed the authors of this report to examine its portfolio of individual support programs to explore what the authors believe are some of the strategic fundamentals underlying this type of programming that could be applied to future individual support grantmaking. The purpose of this study is to inform those interested in individual support programs about not only some of the strategy considerations underlying this type of grantmaking but what these programs can be expected to achieve—and under what circumstances.

Measuring the Impact of Youth Voluntary Service Programs

Summary and Conclusions of a meeting of international experts hosted by the World Bank and Innovations in Civic Participation to discuss evaluation of the impact of youth civic engagement on development