12 research outputs found
Evaluation of appendicitis risk prediction models in adults with suspected appendicitis
Background
Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis.
Methods
A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis).
Results
Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent).
Conclusion
Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified
What Are They Talking About? Listserv Discussion as a Window on the Concerns of Orthodox Jewish Educators
DIVERSIFYING OUR PERSPECTIVES ON MATHEMATICS ABOUT SPACE AND GEOMETRY: AN ECOCULTURAL APPROACH
Challenging Social Injustice in Superdiverse Contexts Through Activist Languages Education
In a current world of rapid change and immense global mobility, communities are experiencing unprecedented increases in population diversity that have dramatically heightened the challenge of ensuring social justice for linguistic minorities, including migrants, refugees, and people on the move, with implications for society as a whole. This chapter explores the rhetoric of related policies and practices and the ways in which they respond to the needs of superdiverse communities. The cases of the UK, Europe, and Australia, which all claim their multicultural status and multiculturalism as an important community resource, are discussed. Through an exploration of current research, the effectiveness of languages education policy and planning (LPP) is critiqued to provide a new paradigm that has the capacity to bring attention to and eliminate social injustice in linguistically diverse communities. The chapter argues for the nurturing of new spaces of language use that challenge the monolingual habitus and which can engage the collective autonomy of communities themselves. It conceptualizes how activist languages education can build community capacity and achieve socially just outcomes, thus simultaneously providing a better space for multilingualism and a foundation for peace