Risk of postoperative pulmonary complications in adult surgical patients with metabolic syndrome: a systematic review and meta-analysis protocol

Background: Metabolic syndrome (MetS) is defined as an accumulation of risk factors that include chronic hypertension, dyslipidaemia, insulin resistance and obesity and leads to an increased risk for diabetes, cardiovascular disease and stroke. MetS is widespread and estimated to affect up to a quarter of the global population. Patients with MetS who undergo surgery are associated with an increased risk of postoperative complications when compared with patients with a non-MetS profile. An emerging body of literature points to MetS being associated with a greater risk of postoperative pulmonary complications (PPC) in the surgical patient. PPC are associated with increased postoperative morbidity and mortality, Intensive care unit (ICU) admission, length of stay (ICU and hospital), health care costs, resource usage, unplanned re-intubation and prolonged ventilatory time. Methods/design: We will search for relevant studies in the following electronic bibliographic databases: EMBASE, MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Scopus as well as scan the reference lists of included studies for potential additional literature. Two authors will independently screen titles and abstracts to identify potentially relevant studies for inclusion based on predefined inclusion and exclusion criteria. The Cochrane Collaboration Review Manager (Review Manager 5) statistical software will be used to conduct this systematic review and meta-analysis and generate forest plots to demonstrate comparison of findings across studies included for meta analysis. Subgroup and sensitivity analysis will be performed to assess the heterogeneity of included studies. A descriptive synthesis of the statistical data will be provided to summarise the results and findings of the systematic review and meta-analysis. Discussion: This review will be the first to report and summarise the risk for and incidence of PPC in adult patients with MetS undergoing surgery across a range of surgical specialities. The results have the potential to inform the development of evidenced-based interventions to improve the management of PPC in the surgical patient with MetS. Findings from this systematic review and meta-analysis will inform a subsequent Delphi study on priorities and responses to PPC in patients with MetS. We will also disseminate our results through publication in scientific peerreviewed journals, conference presentations and promotion throughout our network of surgical safety champions in clinical settings

An elusive balance: the small community in mass society, 1940-1960

In the 1920s and 1930s, leading commentators on American culture began to express deep concern over the rate and direction of social change. As the urban-industrial order came to dominate the cultural landscape, many schools of thought arose in opposition. Some groups constituting this cultural minority position focused on what they referred to as the small community, as an alternative to the dominant cultural paradigm. The small community, usually in the form of the small town, had traditionally been the leading type of settlement in America. During the first third of the twentieth century, small communitarians tried to resist the movement of American society away from a predominantly rural culture to one increasingly driven and shaped by urban-led culture. Southern Agrarians, decentralists, regionalists, proponents of the TVA and greenbelt towns, subsistence homestead advocates, Henry Ford, Catholic ruralists, and assorted people intent on going back-to-the-land all opposed the transformation of the small community milieu from a majority position in American culture to a substantial, but nevertheless, minority position;While much of the opposition to the developing urban-industrial order lost its focus during the period of 1940 to 1960, a remaining tiny minority of cultural critics continued to resist further marginalization of the small community. New groups of regionalists, social scientists, agrarian and utopian communitarians studied, wrote, and talked about how the small community could be revitalized, and in the process, how a new balance could be established between the locale and the larger territory. Some of their themes echoed the previous period, such as decentralization, regional authorities, help to small farmers, planning at all societal levels, and cooperative enterprises, while newer concepts involved community study groups, greater use of adult education, and area development centers, increasingly funded by states;The actions of the small communitarians in the forties and fifties linked them to the cultural reformers of the twenties and thirties, and the anti-establishment protesters and radicals of the sixties and seventies whose message about community has turned into eager and renewed efforts toward the maintenance of quality of life in locales, still threatened by a highly centralized mass society

Workplace Democracy in the Lab

While intuition suggests that empowering workers to have some say in the control of the firm is likely to have beneficial incentive effects, empirical evidence of such an effect is hard to come by because of numerous confounding factors in the naturally occurring data. We report evidence from a real-effort experiment confirming that worker performance is sensitive to the process used to select the compensation contract. Groups of workers that voted to determine their compensation scheme provided significantly more effort than groups that had no say in how they would be compensated. This effect is robust to controls for the compensation scheme implemented and worker characteristics (i.e., ability and gender).real-effort experiment, workplace democracy, decision control rights

Developing Translation Skills

https://scholarworks.moreheadstate.edu/student_scholarship_posters/1140/thumbnail.jp