Protein-nucleic acids interactions: new ways of connecting structure, dynamics and function

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Does Telemedical Support of First Responders Improve Guideline Adherence in an Offshore Emergency Scenario? A Simulator-Based Prospective Study

OBJECTIVE: To investigate, in a simulator-based prospective study, whether telemedical support improves quality of emergency first response (performance) by medical non-professionals to being non-inferior to medical professionals. SETTING: In a simulated offshore wind power plant, duos (teams) of offshore engineers and teams of paramedics conducted the primary survey of a simulated patient. PARTICIPANTS: 38 offshore engineers and 34 paramedics were recruited by the general email invitation. INTERVENTION: Teams (randomised by lot) were supported by transmission technology and a remote emergency physician in Berlin. OUTCOME MEASURES: From video recordings, performance (17 item checklist) and required time (up to 15 min) were quantified by expert rating for analysis. Differences were analysed using two-sided exact Mann-Whitney U tests for independent measures, non-inferiority was analysed using Schuirmann one-sided test. The significance level of 5 % was Holm-Bonferroni adjusted in each family of pairwise comparisons. RESULTS: Nine teams of engineers with, nine without, nine teams of paramedics with and eight without support completed the task. Two experts quantified endpoints, insights into rater dependence were gained. Supported engineers outperformed unsupported engineers (p<0.01), insufficient evidence was found for paramedics (p=0.11). Without support, paramedics outperformed engineers (p<0.01). Supported engineers' performance was non-inferior (at one item margin) to that by unsupported paramedics (p=0.03). Supported groups were slower than unsupported groups (p<0.01). CONCLUSIONS: First response to medical emergencies in offshore wind farms with substantially delayed professional care may be improved by telemedical support. Future work should test our result during additional scenarios and explore interdisciplinary and ecosystem aspects of this support. TRIAL REGISTRATION NUMBER: DRKS0001437

Behandeling van die volwasse persoon wat as kind seksueel gemolesteer is

Afrikaans textHierdie studie bied vanuit 'n ekosistemiese benadering 'n verduideliking van die lewenswereld van die volwasse persoon wat as kind gemolesteer is. Enkele uitgangspunte van die ekosistemiese benadering word bespreek wat dien as vertrekpunt waarvolgens die navorser konstruksies oor die as kind gemolesteerde volwassene konstrueer. Daar word gefokus op die langtermyneffekte van die kindermolestering met spesifieke verwysing na die effek op die • fisiese gedrag van die volwassene; • die aard van die seksuele verhoudings van die volwassene; en • die aard van die interpersoonlike verhoudings van die volwassene. Tydens hierdie bespreking word die oorlewingstrategiee, wat die volwassene aanwend om met die l angtermyneffekte te oorl eef, duidel i k belig. Die he l i ngsproses waardeur 'n vol wassene vol gens sy of haar ei e pas beweeg ten einde die effek van die molestering te verwerk, word volledig bespreek. Die teorie is toegepas in die navorsing om die uitwerking van die kindermolestering op volwassenes te beskryf asook enkele gebeure (events) van die helingsproses waardeur 'n volwassene beweeg het. Gevolgtrekkings en aanbevelings word geformuleer ten einde die bruikbaarheid van hierdie studie in die praktyk aan te dui.In this study the world of the adult survivor of sexua 1 abuse is described in terms of the eco-systemic approach, as well as certain constructions within the approach. These constructions served as a base on which the researcher construed further constructions of the adult survivor of sexual abuse. The study focuses on the 1 ong term effects of the child abuse with specific reference to the effect on • the physical behaviour of the adult; • the nature of the sexual relationships of the adult; and • the nature of the interpersonal relationships of the adult. The strategies of the adult in surviving with these long term effects are also highlighted in the discussion. The healing process through which the adult survivor passes in healing the sexual trauma according to his or her own pace, is fully discussed. In the empirical research the theory is applied to describe the effect of sexual abuse on the lives of adults as well as on certain events of the healing process. Conclusions and recommendations are formulated to indicate the usefulness of this study for the field.Social WorkD.Phil. (Maatskaplike Werk

Managing Partnerships for Online Learning: An Institutional Work Perspective

Online education is increasingly important to universities with continued pressure for new forms of revenue, ambitions to service more diverse learners and meet the expectations of students. Accelerated by the COVID-19 pandemic, many institutions have implemented online programs, with a growing number doing so in partnership with an Online Program Management (OPM) provider. However, little is known about how these partnerships operate on the ground, the impact on universities, or how these arrangements might evolve over time. This exploratory qualitative study examines the day-to-day work of academic leaders with responsibility for university-OPM partnerships. The research sought to develop a clearer understanding of how academic leaders influence the provision of online learning at their institution, and how partnerships might evolve over time. Data was collected through semi- structured interviews with 15 academic leaders. Institutional work forms the theoretical basis for this study, offering scope for explanations of the flows of influence between daily practices of academic leaders, organizational change, and field level influences, with consideration for organizational boundaries and new institutional arrangements for online learning. The study found that academic leaders engage extensively in varied forms of institutional work related to online learning and OPM partnerships, focused on ‘creating’ and ‘maintaining’ institutions and identified new forms of institutional work related to monitoring the external environment, enacting new ways of operating and corralling stakeholders toward endorsed models. The research outlines online capabilities being built at universities and offers insights into how university-OPM partnerships are evolving over time. Findings suggest that academic leaders exercise practical and projective agency regarding their institutions’ immediate and long- term arrangements for online learning and are central to the development of university partnering capability. The knowledge gained from this study is expected to further stakeholders’ understanding of how organizational change related to online learning and university-OPM partnerships happens over time, using institutional theory to highlight the mechanisms by which new practices and norms may become embedded and institutionalized, a topic that remains relatively unexplored, but is of increasing importance for universities

Moving from medical to health systems classifications of deaths : extending verbal autopsy to collect information on the circumstances of mortality

Acknowledgements The authors would also like to acknowledge the field staff at the MRC, SA/Wits Agincourt Unit, particularly Sizzy Ngobeni. The authors also acknowledge Drs Malin Eriksson and Edward Fottrell at Umeå Centre for Global Health Research *UCGHR) who contributed to the development of the SF-VA indicators, Dr Nawi Ng at UCGHR who advised on the cause of death categories, and Dr Kerstin Edin at UCGHR who provided comments on the manuscript categories, and Dr Kerstin Edin who provided comments on the manuscript. Funding A Health Systems Research Initiative Development Grant from the UK Department for International Development (DFID), Economic and Social Research Council (ESRC), Medical Research Council (MRC (and the Wellcome Trust (MR/N005597/1) funds the research presented in this paper. Support for the Agincourt HDSS including verbal autopsies was provided by The Wellcome Trust, UK (grants 058893/Z/99/A; 069683/Z/02/Z; 085477/Z/08/Z; 085477/B/08/Z), and the University of the Witwatersrand and Medical Research Council, South Africa.Peer reviewedPublisher PD

Initiating a participatory action research process in the Agincourt health and socio–demographic surveillance site

Financial disclosure Funding: The research presented in this paper is funded by a Development Grant as part of the Health Systems Research Initiative from Department for International Development (DFID)/Medical Research Council (MRC)/Wellcome Trust/Economic and Social Research Council (ESRC) (MR/N005597/1). The fieldwork was completed with the Umeå Centre for Global Health Research, with support from FORTE: Swedish Council for Health, Working Life and Welfare (grant No. 2006–1512). The School of Public Health at the University of the Witwatersrand, the South African Medical Research Council, and the Wellcome Trust, UK support the MRC/Wits Rural Public Health and Health Transitions Research Unit and Agincourt HDSS (Grants 058893/Z/99/A; 069683/Z/02/Z; 085477/Z/08/Z; 085477/B/08/Z). OW is a recipient of an MSc Chevening Scholarship, the UK government's global scholarship programme, funded by the Foreign and Commonwealth Office (FCO) and partner organizations (Chevening Ref.: NGCV–2015–1194).Peer reviewedPublisher PD