105 research outputs found

    Promoting Scholarship and Faculty Development through Faculty Learning Communities

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    Faculty learning communities (FLCs), whether they are topic or cohort-based, are a form of professional development that promote scholarship and collegiality among faculty members. This article describes how a number of FLCs were initiated in a Faculty of Nursing (FoN). Members who participated described the FLCs as scholarly, creative and morale enhancing. One of the most significant impacts in the topic-based FLCs was having members create a scholarly product such as articles, letters, theatrical performances, books, faculty modules, briefs and paintings. For the cohort-based FLC the product was preparing pre tenure faculty for tenure. It is recommended FLCs be voluntary, include meals, ask members to commit to attending each session and have expert facilitation. This article describes several examples of FLC’s and best practices around development and facilitation for effective FLC’s. Résumé : Les communautés apprenantes, qu’elles soient thématiques ou fondées sur une cohorte, sont une forme de développement professionnel qui encourage l’avancement des connaissances et la collégialité entre des membres du corps professoral. Cet article présente comment des communautés apprenantes ont été mises en place au sein d’une faculté de sciences infirmières. Les membres impliqués ont décrit l’expérience comme étant scholarly, créative et renforçant le moral. L’un des impacts les plus importants des communautés apprenantes thématiques est la création par les membres de « produits » scientifiques tels qu’articles, lettres, spectacles de théâtre, livres, modules de formation, résumés ou peintures. Quant à la communauté apprenante fondée sur une cohorte, elle visait la préparation de membres du corps professoral à l’obtention de leur permanence. Il est recommandé que l’inscription à une communauté apprenante se fasse sur une base volontaire, que les repas soient fournis, que les participants s’engagent à participer à toutes les séances et que les séances soient animées par un expert. Cet article décrit plusieurs exemples de communautés apprenantes et souligne les pratiques exemplaires en matière de mise sur pied et d’animation afin d’obtenir des communautés apprenantes efficaces

    Staying Ahead of the Digital Technological Curve Using Survey Methods

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    In the early twentieth century, surveys were an innovative and neoteric methodology. Collected in-person or by mail, researchers could ascertain the thoughts and opinions of a small sample, which could then be applied to the general population. Almost one hundred years later, the use of surveys has become pervasive in society due to digital technological advancement. However, while the digital evolution has not only altered the possibilities of how, when, and where surveys may be administered, the threats to this methodology has also evolved. While issues related to previously known errors (i.e. sampling error, non-response error, etc.) remain and have also evolved, new threats regarding confidentiality and privacy, design issues, and others, have emerged in response to this digital advancement. Novice and experienced researchers alike should be cognizant of the impact digital technologies have had on survey data collection to ensure high quality research findings. This paper explores the threats to survey methodology due to digital technological changes and discusses how novice researchers and students can mitigate these challenges. Au début du vingtième siècle, les sondages constituaient une méthodologie novatrice et moderne. Les chercheurs pouvaient, à partir d’un petit échantillon, cerner des idées et opinions recueillies en personne ou par courrier, pour ensuite les appliquer à la population générale. Près de 100 ans plus tard, grâce aux avancées de la technologie numérique, les sondages sont omniprésents dans la société. Or, l’évolution numérique a non seulement modifié les paramètres spatiotemporels et les techniques d’administration des sondages, mais aussi les risques liés à cette méthodologie. Alors que les problèmes liés aux erreurs déjà connues (erreurs d’échantillonnage, erreurs de non-réponse, etc.) demeurent et évoluent tout autant, de nouvelles menaces associées à la confidentialité et à la protection des renseignements personnels, aux questions de conception et à d’autres enjeux ont surgi en réaction à cette évolution technologique. Afin d’optimiser la qualité des résultats de recherche, les chercheuses débutantes et chevronnées devraient être au fait des retombées possibles des technologies numériques sur la collecte de données par sondage. Cet article porte sur les menaces à la méthodologie des sondages en raison des changements liés aux technologies numériques, et traite de stratégies permettant aux étudiantes et aux chercheuses débutantes d’éviter ces écueils

    The effects of maintenance schedules following pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a randomised controlled trial.

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    OBJECTIVES: Pulmonary rehabilitation (PR) provides benefit for patients with chronic obstructive pulmonary disease (COPD) in terms of quality of life (QoL) and exercise capacity; however, the effects diminish over time. Our aim was to evaluate a maintenance programme for patients who had completed PR. SETTING: Primary and secondary care PR programmes in Norfolk. PARTICIPANTS: 148 patients with COPD who had completed at least 60% of a standard PR programme were randomised and data are available for 110 patients. Patients had greater than 20 pack year smoking history and less than 80% predicted forced expiratory volume in 1 s but no other significant disease or recent respiratory tract infection. INTERVENTIONS: Patients were randomised to receive a maintenance programme or standard care. The maintenance programme consisted of 2 h (1 h individually tailored exercise training and 1 h education programme) every 3 months for 1 year. PRIMARY AND SECONDARY OUTCOME MEASURES: The Chronic Respiratory Questionnaire (CRQ) (primary outcome), endurance shuttle walk test (ESWT), EuroQol (EQ5D), hospital anxiety and depression score (HADS), body mass index (BMI), body fat, activity levels (overall score and activity diary) and exacerbations were assessed before and after 12 months. RESULTS: There was no statistically significant difference between the groups for the change in CRQ dyspnoea score (primary end point) at 12 months which amounted to 0.19 (-0.26 to 0.64) units or other domains of the CRQ. There was no difference in the ESWT duration (-10.06 (-191.16 to 171.03) seconds), BMI, body fat, EQ5D, MET-minutes, activity rating, HADS, exacerbations or admissions. CONCLUSIONS: A maintenance programme of three monthly 2 h sessions does not improve outcomes in patients with COPD after 12 months. We do not recommend that our maintenance programme is adopted. Other methods of sustaining the benefits of PR are required. TRIAL REGISTRATION NUMBER: NCT00925171.This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-0408-16225). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.This is the final published version. It first appeared at http://bmjopen.bmj.com/content/5/3/e005921.full?g=w_thorax_open_tab

    Geographical distribution and relative risk of Anjozorobe virus (Thailand orthohantavirus) infection in black rats (Rattus rattus) in Madagascar

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    Acknowledgements We thank those who facilitated the survey: householders, heads of fokontany, local administration and health authorities from Ministry of Health. We would like to express our gratitude to the staff of the Plague Central Laboratory Unit, Institut Pasteur de Madagascar: Dr. Minoarisoa Rajerison who facilitated this study; Corinne Rahaingosoamamitiana and Soanandrasana Rahelinirina for helping to conduct and organize the field work. We would also like to thank Dr. Fanjasoa Rakotomanana and Dr. Lalaina Arivony Nomenjanahary assistance in the field trips and technical and field support. Funding This work was supported by the Institut Pasteur de Madagascar (Internal Project through ZORA: Zoonoses, Rodent and Arboviruses) and Wellcome Trust Fellowships to ST (#081705, #095171). VR was also supported though Girard’s fellowship undergraduate program from the Institut Pasteur de Madagascar. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Peer reviewedPublisher PD

    Interstitial lung disease and specialist palliative care access: a healthcare professionals survey

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    Background Fibrotic interstitial lung disease is an incurable disease with poor prognosis. We aimed to understand factors affecting decisions regarding referrals to specialist palliative care services and to address barriers and facilitators to referrals from healthcare professionals’ perspectives. Methods A survey study of healthcare professionals, including respiratory physicians, interstitial lung disease nurse specialists, respiratory nurse specialists and palliative care physicians, was conducted using a questionnaire, entailing 17 questions. Results Thirty-six respondents, including 15 interstitial lung disease nurse specialists completed the questionnaire. Symptom control, psychological/spiritual support, general deterioration and end-of-life care were the most common reasons for referrals to specialist palliative care services. Most respondents felt confident in addressing palliative care needs and discussing palliative care with patients. A few participants emphasised that experienced respiratory nurse specialists are well placed to provide symptom management and to ensure continuity of patient care. Participants reported that access to palliative care could be improved by increasing collaborative work between respiratory and palliative care teams. Conclusions Most respondents felt that enhancing access to specialist palliative care services would benefit patients. However, palliative care and respiratory care should not be considered as mutually exclusive and multidisciplinary approach is recommended

    Combined technique as first approach in mechanical thrombectomy: Efficacy and safety of REACT catheter combined with stent retriever

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    Acute stroke; Endovascular treatment; Mechanical thrombectomyAccidente cerebrovascular agudo; Tratamiento endovascular; Trombectomía mecánicaAccident cerebrovascular agut; Tractament endovascular; Trombectomia mecànicaIntroduction Mechanical thrombectomy (MT) with combined treatment including both a stent retriever and distal aspiration catheter may improve recanalization rates in patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO). Here, we evaluated the effectiveness and safety of the REACT aspiration catheter used with a stent retriever. Methods This prospective study included consecutive adult patients who underwent MT with a combined technique using REACT 68 and/or 71 between June 2020 and July 2021. The primary endpoints were final and first pass mTICI 2b-3 and mTICI 2c-3 recanalization. Analysis was performed after first pass and after each attempt. Secondary safety outcomes included procedural complications, symptomatic intracranial hemorrhage (sICH) at 24 h, in-hospital mortality, and 90-day functional independence (modified Rankin Scale [mRS] 0–2). Results A total of 102 patients were included (median age 78; IQR: 73–87; 50.0% female). At baseline, median NIHSS score was 19 (IQR: 11–21), and ASPECTS was 9 (IQR: 8–10). Final mTICI 2b-3 recanalization was achieved in 91 (89.2%) patients and mTICI 2c-3 was achieved in 66 (64.7%). At first pass, mTICI 2b-3 was achieved in 55 (53.9%) patients, and mTICI 2c-3 in 37 (36.3%). The rate of procedural complications was 3.9% (4/102), sICH was 6.8% (7/102), in-hospital mortality was 12.7% (13/102), and 90-day functional independence was 35.6% (36/102). Conclusion A combined MT technique using a stent retriever and REACT catheter resulted in a high rate of successful recanalization and first pass recanalization in a sample of consecutive patients with AIS due to LVO in clinical use

    Uganda's experience in Ebola virus disease outbreak preparedness, 2018-2019.

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    BACKGROUND: Since the declaration of the 10th Ebola Virus Disease (EVD) outbreak in DRC on 1st Aug 2018, several neighboring countries have been developing and implementing preparedness efforts to prevent EVD cross-border transmission to enable timely detection, investigation, and response in the event of a confirmed EVD outbreak in the country. We describe Uganda's experience in EVD preparedness. RESULTS: On 4 August 2018, the Uganda Ministry of Health (MoH) activated the Public Health Emergency Operations Centre (PHEOC) and the National Task Force (NTF) for public health emergencies to plan, guide, and coordinate EVD preparedness in the country. The NTF selected an Incident Management Team (IMT), constituting a National Rapid Response Team (NRRT) that supported activation of the District Task Forces (DTFs) and District Rapid Response Teams (DRRTs) that jointly assessed levels of preparedness in 30 designated high-risk districts representing category 1 (20 districts) and category 2 (10 districts). The MoH, with technical guidance from the World Health Organisation (WHO), led EVD preparedness activities and worked together with other ministries and partner organisations to enhance community-based surveillance systems, develop and disseminate risk communication messages, engage communities, reinforce EVD screening and infection prevention measures at Points of Entry (PoEs) and in high-risk health facilities, construct and equip EVD isolation and treatment units, and establish coordination and procurement mechanisms. CONCLUSION: As of 31 May 2019, there was no confirmed case of EVD as Uganda has continued to make significant and verifiable progress in EVD preparedness. There is a need to sustain these efforts, not only in EVD preparedness but also across the entire spectrum of a multi-hazard framework. These efforts strengthen country capacity and compel the country to avail resources for preparedness and management of incidents at the source while effectively cutting costs of using a "fire-fighting" approach during public health emergencies

    The origins and spread of domestic horses from the Western Eurasian steppes

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    This is the final version. Available on open access from Nature Research via the DOI in this recordData availability: All collapsed and paired-end sequence data for samples sequenced in this study are available in compressed fastq format through the European Nucleotide Archive under accession number PRJEB44430, together with rescaled and trimmed bam sequence alignments against both the nuclear and mitochondrial horse reference genomes. Previously published ancient data used in this study are available under accession numbers PRJEB7537, PRJEB10098, PRJEB10854, PRJEB22390 and PRJEB31613, and detailed in Supplementary Table 1. The genomes of ten modern horses, publicly available, were also accessed as indicated in their corresponding original publications57,61,85-87.NOTE: see the published version available via the DOI in this record for the full list of authorsDomestication of horses fundamentally transformed long-range mobility and warfare. However, modern domesticated breeds do not descend from the earliest domestic horse lineage associated with archaeological evidence of bridling, milking and corralling at Botai, Central Asia around 3500 BC. Other longstanding candidate regions for horse domestication, such as Iberia and Anatolia, have also recently been challenged. Thus, the genetic, geographic and temporal origins of modern domestic horses have remained unknown. Here we pinpoint the Western Eurasian steppes, especially the lower Volga-Don region, as the homeland of modern domestic horses. Furthermore, we map the population changes accompanying domestication from 273 ancient horse genomes. This reveals that modern domestic horses ultimately replaced almost all other local populations as they expanded rapidly across Eurasia from about 2000 BC, synchronously with equestrian material culture, including Sintashta spoke-wheeled chariots. We find that equestrianism involved strong selection for critical locomotor and behavioural adaptations at the GSDMC and ZFPM1 genes. Our results reject the commonly held association between horseback riding and the massive expansion of Yamnaya steppe pastoralists into Europe around 3000 BC driving the spread of Indo-European languages. This contrasts with the scenario in Asia where Indo-Iranian languages, chariots and horses spread together, following the early second millennium BC Sintashta culture
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