The move to quality assurance in Chinese higher education: Tensions between policy and practices

This paper investigates quality assurance in Chinese higher education by looking at the Evaluation of the University Baccalaureate Programmes Project (EUBPP) conducted in China. It analyses factors that bring about tensions between policy and practice in this area through a study of two contrasting tertiary institutions. The results show that the aims of the EUBPP have been partly achieved through the interaction of policy-making and implementation. In the process, contextual factors connected to institutional status and stages of development have led to varying degrees of tension between policy and practices.published_or_final_versio

A quantitative high resolution computed tomography assessment of patients with stable bronchiectasis

published_or_final_versio

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Mendelian randomisation analyses find pulmonary factors mediate the effect of height on coronary artery disease

British Heart Foundation (BHF) grant RG/14/5/30893Netherlands Organisation for Health Research and Development (ZonMw VIDI 016.136.367)NIDDK grant K12DK094721Intramural Research Program of the Division of Cancer Epidemiology and Genetics, NC

Emotional intelligence training intervention among trainee teachers: a quasi-experimental study

Background: Emotional intelligence (EI) has often been linked to improvements in professional performance. Indeed, generic competencies related to EI have been included in university curricula. However, learning EI involves significant time and effort on the part of students, and this may hinder the acquisition of specific content for each degree. In this study, an intervention to develop EI in higher education students is described and evaluated. Methods: The intervention consisted of eight group sessions performed in a regular course aiming to increase EI. The sessions included strategies and training on perceiving and understanding one’s own emotions and others’ emotions, identifying and understanding the impact one’s own feelings in adopting decisions, expressing one’s own emotions and the stress experienced, and managing both one’s own emotions and emotions of others. Participants were 192 students studying for a Master of Primary Education degree. A quasi-experimental nonequivalent control group pretest-posttest design was adopted. The effectiveness of the intervention was evaluated using multi-level analyses. Results: The results showed a significant improvement in the EI of students in the experimental group compared with the control group. Conclusions: This research demonstrates that it is possible to develop EI in higher education students, without hindering the acquisition of specific content competencies and, therefore, without interfering with their academic performance and without overburdening students with work outside the classroom. Trial registration: The experiment has been registered in the Initial Deposit of the Spanish Center for Sociological Research (CIS). 7/6/2015. http://www.cis.es/cis/opencms/ES/index.html.This research was supported by the Spanish Ministry of Economy and Competitiveness under Grant number EDU2015-64562-R