Decision making in interhospital transport of critically ill patients: national questionnaire survey among critical care physicians

Objective: This study assessed the relative importance of clinical and transport-related factors in physicians' decision-making regarding the interhospital transport of critically ill patients. Methods: The medical heads of all 95 ICUs in The Netherlands were surveyed with a questionnaire using 16 case vignettes to evaluate preferences for transportability; 78 physicians (82%) participated. The vignettes varied in eight factors with regard to severity of illness and transport conditions. Their relative weights were calculated for each level of the factors by conjoint analysis and expressed in beta. The reference value (beta = 0) was defined as the optimal conditions for critical care transport; a negative beta indicated preference against transportability. Results: The type of escorting personnel (paramedic only: beta = 3.1) and transport facilities (standard ambulance beta = 1.21) had the greatest negative effect on preference for transportability. Determinants reflecting severity of illness were of relative minor importance (dose of noradrenaline beta = 0.6, arterial oxygenation beta = 0.8, level of peep beta = 0.6). Age, cardiac arrhythmia, and the indication for transport had no significant effect. Conclusions: Escorting personnel and transport facilities in interhospital transport were considered as most important by intensive care physicians in determining transportability. When these factors are optimal, even severely critically ill patients are considered able to undergo transport. Further clinical research should tailor transport conditions to optimize the use of expensive resources in those inevitable road trip

Evaluating the performance of phenological models for a range of cultivars in a cool climate context for New Zealand : A Dissertation submitted in partial fulfilment of the requirements for the Degree of Master of Wine and Viticulture at Lincoln University

Abstract withheld due to embargo restriction

Are We Closing the School Discipline Gap?

During the 2011-12 school year, nearly 3.5 million public school students were suspended out-of-school at least once. This report examines data on out-of-school suspension rates in every school district in the country and also examines on data on out-of-school suspension rates at the state and national levels. It documents disparities in the use of out-of-school suspension experienced by students with disabilities, and those from historically disadvantaged racial, ethnic, and gender subgroups. At the district level, on average more than one in every ten elementary students and at least one out of every four secondary students enrolled were suspended in 2011-12. Nationally, suspension rates are three to four times higher at the secondary level than at the elementary level. An examination of the racial and gender disparities among secondary students with disabilities shows that males, and most often Black males (33.8%), have the highest risk for suspension, followed by Latino males (23.2%). Also important to note is that Black females with disabilities are suspended at higher rates than White males with disabilities—22.5% and 16.2%, respectively. These disparities extend beyond the vast loss of instruction time experienced by students who are suspended. A school or school district’s excessive use of exclusionary discipline raises alarms because of the negative impact high suspension rates have on graduation rates, the learning environment, and rates of juvenile crime and delinquency in the larger community. Suggestions for remedies are also detailed

Closing the School Discipline Gap in California: Signs of Progress

This report describes the most current state and district suspension rates, and covers both trends and racial disparities in the use of suspension in California. A spreadsheet accompanying this report enables any reader to find their own district’s most recent disaggregated data, as well as three- year trends for out-of-school suspensions, all of which can be compared to other districts in California. We hope that policymakers in the state and across the nation will take note of the state- and district-level progress, and of the large disparities indicating that a great deal more effort is warranted

Are We Closing the School Discipline Gap?

During the 2011-12 school year, nearly 3.5 million public school students were suspended out-of-school at least once. This report examines data on out-of-school suspension rates in every school district in the country and also examines on data on out-of-school suspension rates at the state and national levels. It documents disparities in the use of out-of-school suspension experienced by students with disabilities, and those from historically disadvantaged racial, ethnic, and gender subgroups. At the district level, on average more than one in every ten elementary students and at least one out of every four secondary students enrolled were suspended in 2011-12. Nationally, suspension rates are three to four times higher at the secondary level than at the elementary level. An examination of the racial and gender disparities among secondary students with disabilities shows that males, and most often Black males (33.8%), have the highest risk for suspension, followed by Latino males (23.2%). Also important to note is that Black females with disabilities are suspended at higher rates than White males with disabilities—22.5% and 16.2%, respectively. These disparities extend beyond the vast loss of instruction time experienced by students who are suspended. A school or school district’s excessive use of exclusionary discipline raises alarms because of the negative impact high suspension rates have on graduation rates, the learning environment, and rates of juvenile crime and delinquency in the larger community. Suggestions for remedies are also detailed

Closing the School Discipline Gap in California: Signs of Progress

This report describes the most current state and district suspension rates, and covers both trends and racial disparities in the use of suspension in California. A spreadsheet accompanying this report enables any reader to find their own district’s most recent disaggregated data, as well as three- year trends for out-of-school suspensions, all of which can be compared to other districts in California. We hope that policymakers in the state and across the nation will take note of the state- and district-level progress, and of the large disparities indicating that a great deal more effort is warranted

Inhibitory zona incerta neurons produce exploratory behavior via inhibition of glutamatergic cuneiform neurons

The cuneiform nucleus (CnF) regulates locomotor activity, which is canonically viewed as being primarily involved in initiating locomotion and regulating speed. Recent research shows greater context dependency in the locomotor functions of this nucleus. Glutamatergic neurons, which contain vesicular glutamate transporter 2 (vGLUT2), regulate context-dependent locomotor speed in the CnF and play a role in defensive behavior. Here, we identify projections from the medial zona incerta (mZI) to CnF vGLUT2 neurons that promote exploratory behavior. Using fiber photometry recordings in male mice, we find that mZI gamma-aminobutyric acid (GABA) neurons increase activity during periods of exploration. Activation of mZI GABAergic neurons is associated with reduced spiking of CnF neurons. Additionally, activating both retrogradely labeled mZI-CnF GABAergic projection neurons and their terminals in the CnF increase exploratory behavior. Inhibiting CnF vGLUT2 neuronal activity also increases exploratory behavior. These findings provide evidence for the context-dependent dynamic regulation of CnF vGLUT2 neurons, with the mZI-CnF circuit shaping exploratory behavior