38 research outputs found
The reference site collaborative network of the european innovation partnership on active and healthy ageing
Seventy four Reference Sites of the European Innovation
Partnership on Active and Healthy Ageing (EIP on AHA)
have been recognised by the European Commission in
2016 for their commitment to excellence in investing and
scaling up innovative solutions for active and healthy
ageing. The Reference Site Collaborative Network
(RSCN) brings together the EIP on AHA Reference Sites
awarded by the European Commission, and Candidate
Reference Sites into a single forum. The overarching goals
are to promote cooperation, share and transfer good
practice and solutions in the development and scaling up
of health and care strategies, policies and service delivery
models, while at the same time supporting the action
groups in their work. The RSCN aspires to be recognized
by the EU Commission as the principal forum and
authority representing all EIP on AHA Reference Sites.
The RSCN will contribute to achieve the goals of the EIP
on AHA by improving health and care outcomes for
citizens across Europe, and the development of sustainable
economic growth and the creation of jobs
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
Summary
Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally.
Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies
have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of
the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income
countries globally, and identified factors associated with mortality.
Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to
hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis,
exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a
minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical
status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary
intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause,
in-hospital mortality for all conditions combined and each condition individually, stratified by country income status.
We did a complete case analysis.
Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital
diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal
malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome
countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male.
Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3).
Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income
countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups).
Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome
countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries;
p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients
combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11],
p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20
[1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention
(ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety
checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed
(ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of
parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65
[0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality.
Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome,
middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will
be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger
than 5 years by 2030
Queer empathy : or, reading/writing the queer in Victorian poetry
Any study of Victorian sexuality provides a cultural mirror for our own contemporary anxieties about sexual difference, homophobia, alternative masculinities and the range of perversities that characterizes 'queer' practices. This article explores notions of queer subjectivity and empathy in writer/reader relations as they inform cross-gender or transsexual play in late Victorian poetics, as demonstrated by the controversial William Sharp/Fiona Macleod impersonation.13 page(s
"Be these his daughters?" Caroline Bowles Southey, Elizabeth Barrett Browning and disruption in a patriarchal poetics of women's autobiography
21 page(s
Victorian women poems : a new annotated anthology
The Poets -- Felicia Hemans (1793-1835) -- Elizabeth Barrett Browning (1806-1861) -- Emily Pfeiffer (1827-1890) -- Christina Rossetti (1830-1894) -- Augusta Webster (1837-1894) -- Adah Isaacs Menken (1839?-1868) -- Mathilde Blind (1841-1896) -- 'Michael Field' [Katharine Harris Bradley (1846-1914) and Edith Emma Cooper (1862-1913)] -- Constance Naden (1858-1889) -- Rosamund Marriott Watson (1860-1911) -- Mary Elizabeth Coleridge (1861-1907) -- May Kendall [Emma Goldworth] (1861-1943) -- Amy Levy (1861-1889).382 page(s)Rev. ed