7 research outputs found
Promoting Entrepreneurship amid Youth in Windhoekâs Informal Settlements: A Namibian Case
Considering the high unemployment rate among Namibian youth and a lack of job opportunities, the promotion of entrepreneurship has gained wider attention in the country. A number of initiatives have been started such as entrepreneurship trainings and workshops, business idea competitions, etc. All these aim to inspire young people to think of alternative income sources. As part of a two-year funded community outreach research and development (R&D) project, we have investigated participatory approaches to engage marginalized youth into conceptualizing their own context, imparting skills, and deriving new career paths. This article reports and reflects on one of the interventions we have recently concluded with a group of youth in Havana, an informal settlement in the outskirts of Windhoek. We conducted what we entitled âThe Havana Entrepreneurâ, a series of interactions inspired upon the model of the American reality game show âThe Apprenticeâ. Over a number of weeks two youth groups were given challenges to tackle by means of competing against one another. After completion of each challenge, groups were rated by a number of judges on skills demonstrated such as marketing, presentation, reflection and creativity among others. We observed an increase in, and improvement of skills revealed along tasksâ completion, besides an openly expressed self-realization and discovery of abilities by participants. Moreover, the youth are currently engaged in the continuation of activities beyond the initial entrepreneurial interactions. Thus we suggest replicating âThe Havana Entrepreneurâ, including the recording on camera of it by the youth themselves as a new mode to instigating a wider entrepreneurial spirit in informal settlements
Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study
Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk
The German Konzentrationslager and the Debates about the Annihilation of the Herero, 1905â1908
Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study
Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice
Safety and efficacy of intraperitoneal drain placement after emergency colorectal surgery. An international, prospective cohort study
Intraperitoneal drains are often placed during emergency colorectal surgery. However, there is a lack of evidence supporting their use. This study aimed to describe the efficacy and safety of intraperitoneal drain placement after emergency colorectal surgery. Method: COMPlicAted intra-abdominal collectionS after colorectal Surgery (COMPASS) is a prospective, international, cohort study into which consecutive adult patients undergoing emergency colorectal surgery were enrolled (from 3 February 2020 to 8 March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included rate and time-to-diagnosis of postoperative intraperitoneal collections, rate of surgical site infections (SSIs), time to discharge and 30-day major postoperative complications (Clavien-Dindo III-V). Multivariable logistic and Cox proportional hazards regressions were used to estimate the independent association of the outcomes with drain placement. Results: Some 725 patients (median age 68.0âyears; 349 [48.1%] women) from 22 countries were included. The drain insertion rate was 53.7% (389 patients). Following multivariable adjustment, drains were not significantly associated with reduced rates (odds ratio [OR] =â1.56, 95% CI: 0.48-5.02, pâ=â0.457) or earlier detection (hazard ratio [HR] =â1.07, 95% CI: 0.61-1.90, pâ=â0.805) of collections. Drains were not significantly associated with worse major postoperative complications (ORâ=â1.26, 95% CI: 0.67-2.36, pâ=â0.478), delayed hospital discharge (HRâ=â1.11, 95% CI: 0.91-1.36, pâ=â0.303) or increased risk of SSIs (ORâ=â1.61, 95% CI: 0.87-2.99, pâ=â0.128). Conclusion: This is the first study investigating placement of intraperitoneal drains following emergency colorectal surgery. The safety and clinical benefit of drains remain uncertain. Equipoise exists for randomized trials to define the safety and efficacy of drains in emergency colorectal surgery