35 research outputs found

    International Negotiation Simulations: An Examination Of Learning Processes And Outcomes

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    Negotiation skills are valuable tools especially in the international business context. However, the extent to which negotiation simulations build new skills rather than augment existing skills is unclear. This empirical study focuses on the extent to which Mexican students and U.S. students learned from a negotiation simulation. The results indicate that all students learned something but that the Mexican students learned more

    Increasing Skin Infections and Staphylococcus aureus Complications in Children, England, 1997-2006

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    During 1997-2006, general practitioner consultations for skin conditions for children <18 years of age in England increased 19%, from 128.5 to 152.9/1,000 child-years, and antistaphylococcal drug prescription rates increased 64%, from 17.8 to 29.1/1,000 child-years. During the same time period, hospital admissions for Staphylococcus aureus infections rose 49% from 53.4 to 79.3/100,000 child-years.link_to_subscribed_fulltex

    Increasing Short-Stay Unplanned Hospital Admissions among Children in England; Time Trends Analysis '97-'06

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    BACKGROUND: Timely care by general practitioners in the community keeps children out of hospital and provides better continuity of care. Yet in the UK, access to primary care has diminished since 2004 when changes in general practitioners' contracts enabled them to 'opt out' of providing out-of-hours care and since then unplanned pediatric hospital admission rates have escalated, particularly through emergency departments. We hypothesised that any increase in isolated short stay admissions for childhood illness might reflect failure to manage these cases in the community over a 10 year period spanning these changes. METHODS AND FINDINGS: We conducted a population based time trends study of major causes of hospital admission in children 2 days. By 2006, 67.3% of all unplanned admissions were isolated short stays <2 days. The increases in admission rates were greater for common non-infectious than infectious causes of admissions. CONCLUSIONS: Short stay unplanned hospital admission rates in young children in England have increased substantially in recent years and are not accounted for by reductions in length of in-hospital stay. The majority are isolated short stay admissions for minor illness episodes that could be better managed by primary care in the community and may be evidence of a failure of primary care services

    Risk factors for hospital admission with RSV bronchiolitis in England: a population-based birth cohort study.

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    OBJECTIVE: To examine the timing and duration of RSV bronchiolitis hospital admission among term and preterm infants in England and to identify risk factors for bronchiolitis admission. DESIGN: A population-based birth cohort with follow-up to age 1 year, using the Hospital Episode Statistics database. SETTING: 71 hospitals across England. PARTICIPANTS: We identified 296618 individual birth records from 2007/08 and linked to subsequent hospital admission records during the first year of life. RESULTS: In our cohort there were 7189 hospital admissions with a diagnosis of bronchiolitis, 24.2 admissions per 1000 infants under 1 year (95%CI 23.7-24.8), of which 15% (1050/7189) were born preterm (47.3 bronchiolitis admissions per 1000 preterm infants (95% CI 44.4-50.2)). The peak age group for bronchiolitis admissions was infants aged 1 month and the median was age 120 days (IQR = 61-209 days). The median length of stay was 1 day (IQR = 0-3). The relative risk (RR) of a bronchiolitis admission was higher among infants with known risk factors for severe RSV infection, including those born preterm (RR = 1.9, 95% CI 1.8-2.0) compared with infants born at term. Other conditions also significantly increased risk of bronchiolitis admission, including Down's syndrome (RR = 2.5, 95% CI 1.7-3.7) and cerebral palsy (RR = 2.4, 95% CI 1.5-4.0). CONCLUSIONS: Most (85%) of the infants who are admitted to hospital with bronchiolitis in England are born at term, with no known predisposing risk factors for severe RSV infection, although risk of admission is higher in known risk groups. The early age of bronchiolitis admissions has important implications for the potential impact and timing of future active and passive immunisations. More research is needed to explain why babies born with Down's syndrome and cerebral palsy are also at higher risk of hospital admission with RSV bronchiolitis

    Changing indications and socio-demographic determinants of (adeno)tonsillectomy among children in England--are they linked? A retrospective analysis of hospital data.

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    OBJECTIVE: To assess whether increased awareness and diagnosis of obstructive sleep apnoea syndrome (OSAS) and national guidance on tonsillectomy for recurrent tonsillitis have influenced the socio-demographic profile of children who underwent tonsillectomy over the last decade. METHOD: Retrospective time-trends study of Hospital Episodes Statistics data. We examined the age, sex and deprivation level, alongside OSAS diagnoses, among children aged <16 years who underwent (adeno)tonsillectomy in England between 2001/2 and 2011/12. RESULTS: Among children aged <16 years, there were 29,697 and 27,732 (adeno)tonsillectomies performed in 2001/2 and 2011/12, respectively. The median age at (adeno)tonsillectomy decreased from 7 (IQR: 5-11) to 5 (IQR: 4-9) years over the decade. (Adeno)tonsillectomy rates among children aged 4-15 years decreased by 14% from 350 (95%CI: 346-354) in 2001/2 to 300 (95%CI: 296-303) per 100,000 children in 2011/12. However, (adeno)tonsillectomy rates among children aged <4 years increased by 58% from 135 (95%CI: 131-140) to 213 (95%CI 208-219) per 100,000 children in 2001/2 and 2011/2, respectively. OSAS diagnoses among children aged <4 years who underwent surgery increased from 18% to 39% between these study years and the proportion of children aged <4 years with OSAS from the most deprived areas increased from 5% to 12%, respectively. CONCLUSIONS: (Adeno)tonsillectomy rates declined among children aged 4-15 years, which reflects national guidelines recommending the restriction of the operation to children with more severe recurrent throat infections. However, (adeno)tonsillectomy rates among pre-school children substantially increased over the past decade and one in five children undergoing the operation was aged <4 years in 2011/12.The increase in surgery rates in younger children is likely to have been driven by increased awareness and detection of OSAS, particularly among children from the most deprived areas

    Sovereign Wealth Funds and Caribbean Economic Development: Measures Matter

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    This short paper presents a brief survey of the literature on Sovereign Wealth Funds (SWF) as a potential trigger of economic growth in developing countries. Some authors argue that a stable institutional environment that eases public and private investments could be the primary determinant of growth. Given the limited data availability, we compare the economic statistics of Trinidad and Tobago and Botswana, countries with a SWF, versus Jamaica and Namibia as control counterparts. The paper discusses the possibility that returns on a SWF could lead to sustainable growth if they are invested in human capital formation

    Just-in-Time versus Just-in-Case: Inventory systems and their potential impact on Caribbean Companies

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    The transition from Just-In-Time to Just-In-Case inventory systems has been discussed for over twenty years. The implications for such a change are possibly more problematic for Caribbean companies and economies than for others. The paper examines the root of the problem, the implications if such a change were to occur, and the possible strategies that could be used to adapt to a new supply chain system. Data from primary industry and fresh produce companies is used to evaluate the extent to which the change has already occurred. Based on US Company data, the results indicate that to this point there has been no shift from Just-in-Time to Just-in-Case. However, planning for such an eventuality would probably be good practice

    Just-in-Time versus Just-in-Case: Inventory systems and their potential impact on Caribbean Companies

    No full text
    The transition from Just-In-Time to Just-In-Case inventory systems has been discussed for over twenty years. The implications for such a change are possibly more problematic for Caribbean companies and economies than for others. The paper examines the root of the problem, the implications if such a change were to occur, and the possible strategies that could be used to adapt to a new supply chain system. Data from primary industry and fresh produce companies is used to evaluate the extent to which the change has already occurred. Based on US Company data, the results indicate that to this point there has been no shift from Just-in-Time to Just-in-Case. However, planning for such an eventuality would probably be good practice

    Liver Transplant Tolerance and Its Application to the Clinic: Can We Exploit the High Dose Effect?

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    The tolerogenic properties of the liver have long been recognised, especially in regard to transplantation. Spontaneous acceptance of liver grafts occurs in a number of experimental models and also in a proportion of clinical transplant recipients. Liver graft acceptance results from donor antigen-specific tolerance, demonstrated by the extension of tolerance to other grafts of donor origin. A number of factors have been proposed to be involved in liver transplant tolerance induction, including the release of soluble major histocompatibility (MHC) molecules from the liver, its complement of immunosuppressive donor leucocytes, and the ability of hepatocytes to directly interact with and destroy antigen-specific T cells. The large tissue mass of the liver has also been suggested to act as a cytokine sink, with the potential to exhaust the immune response. In this review, we outline the growing body of evidence, from experimental models and clinical transplantation, which supports a role for large tissue mass and high antigen dose in the induction of tolerance. We also discuss a novel gene therapy approach to exploit this dose effect and induce antigen-specific tolerance robust enough to overcome a primed T cell memory response
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