The influence of human behaviour on the sustenance of the forest resource base

The aim of the study was to determine the knowledge, attitude and needs that influence human behaviour towards the exploitation of the forest and its regeneration. Oyibi and Amranhia in the Greater Accra Region were the study areas. Thirty inhabitants were interviewed using questionnaires. Questions centered on the knowledge individuals have concerning tree regeneration, attitudes of individuals towards tree felling, bush burning and tree planting and the existing individual and social needs that motivate people to fell trees, plant trees and burn bush. Results from the study indicated that inhabitants acknowledged that tree planting can replace the trees cut by man but only a few see the need to plant trees. They believe that trees regenerate on their own and that birds are the main agents that help in tree regeneration. The inhabitants also had negative attitude towards bush burning, they all agreed that bush burning destroys the vegetation. They also agreed that tree felling destroys the quality of the vegetation. The main reason why people fell trees despite their negative attitude towards tree felling is the need for money which is satisfied by the sale of fuelwood and charcoal. Individuals also burn bush to satisfy their needs for game and to reduce the volume of weeded plant debris to ease cultural practices in agriculture. In order to curb the rapid rate of tree felling and its consequences, it is suggested that alternate forest resources should be provided to satisfy the needs of the people. These could be achieved through fruit tree, fuelwood and pole cultivation. JOURNAL OF THE GHANA SCIENCE ASSOCIATION Volume 1 Number 2, January (1999) pp. 125-13

A Coronavirus Disease 2019 Pandemic Pivot: Development of the American Board of Anesthesiology\u27s Virtual APPLIED Examination

In 2020, the coronavirus disease 2019 (COVID-19) pandemic interrupted the administration of the APPLIED Examination, the final part of the American Board of Anesthesiology (ABA) staged examination system for initial certification. In response, the ABA developed, piloted, and implemented an Internet-based virtual form of the examination to allow administration of both components of the APPLIED Exam (Standardized Oral Examination and Objective Structured Clinical Examination) when it was impractical and unsafe for candidates and examiners to travel and have in-person interactions. This article describes the development of the ABA virtual APPLIED Examination, including its rationale, examination format, technology infrastructure, candidate communication, and examiner training. Although the logistics are formidable, we report a methodology for successfully introducing a large-scale, high-stakes, 2-element, remote examination that replicates previously validated assessments

First-attempt success rate of video laryngoscopy in small infants (VISI): a multicentre, randomised controlled trial

Background: Orotracheal intubation of infants using direct laryngoscopy can be challenging. We aimed to investigate whether video laryngoscopy with a standard blade done by anaesthesia clinicians improves the first-attempt success rate of orotracheal intubation and reduces the risk of complications when compared with direct laryngoscopy. We hypothesised that the first-attempt success rate would be higher with video laryngoscopy than with direct laryngoscopy. Methods: In this multicentre, parallel group, randomised controlled trial, we recruited infants without difficult airways abnormalities requiring orotracheal intubation in operating theatres at four quaternary children's hospitals in the USA and one in Australia. We randomly assigned patients (1:1) to video laryngoscopy or direct laryngoscopy using random permuted blocks of size 2, 4, and 6, and stratified by site and clinician role. Guardians were masked to group assignment. The primary outcome was the proportion of infants with a successful first attempt at orotracheal intubation. Analysis (modified intention-to-treat [mITT] and per-protocol) used a generalised estimating equation model to account for clustering of patients treated by the same clinician and institution, and adjusted for gestational age, American Society of Anesthesiologists physical status, weight, clinician role, and institution. The trial is registered at ClinicalTrials.gov, NCT03396432. Findings: Between June 4, 2018, and Aug 19, 2019, 564 infants were randomly assigned: 282 (50%) to video laryngoscopy and 282 (50%) to direct laryngoscopy. The mean age of infants was 5·5 months (SD 3·3). 274 infants in the video laryngoscopy group and 278 infants in the direct laryngoscopy group were included in the mITT analysis. In the video laryngoscopy group, 254 (93%) infants were successfully intubated on the first attempt compared with 244 (88%) in the direct laryngoscopy group (adjusted absolute risk difference 5·5% [95% CI 0·7 to 10·3]; p=0·024). Severe complications occurred in four (2%) infants in the video laryngoscopy group compared with 15 (5%) in the direct laryngoscopy group (–3·7% [–6·5 to –0·9]; p=0·0087). Fewer oesophageal intubations occurred in the video laryngoscopy group (n=1 [<1%]) compared with in the direct laryngoscopy group (n=7 [3%]; –2·3 [–4·3 to –0·3]; p=0·028). Interpretation: Among anaesthetised infants, using video laryngoscopy with a standard blade improves the first-attempt success rate and reduces complications. Funding: Anaesthesia Patient Safety Foundation, Society for Airway Management, and Karl Storz Endoscopy