Multi-dimensional, multi-national, multi-faceted hydrographic training: the Nippon Foundation GEBCO training program at the University of New Hampshire

Hydrographic training entered a new era when students arrived at the University of New Hampshire in August of 2004 to form the first class of the Nippon Foundation GEBCO (General Bathymetric Chart of the Oceans) training program. Born out of the need to replenish GEBCO’s aging human material, and of the desire to spread deep ocean mapping capabilities more widely throughout the world, the program attracted applications from 57 students in over thirty countries. The seven selected each had post graduate training and several years experience, but differed in that three were hydrographers, two geologists and two oceanographers. Classes planned for the next two years will bring in a further fourteen students. The UNH program had been selected as the closest match to the general course requirements GEBCO considered that ocean bathymetrists should have. Subjects include all types of depth measurements, oceanography, acoustics, tides, plate tectonics, sea floor morphology, ocean basins, sedimentary processes, hydrothermal-thermal processes, gravity-magnetic relationships to seafloor fabrics, positioning and geodesy, maps and charts, IHO standards, GIS, data bases, gridding, contouring, spatial statistics, and the history of GEBCO and ocean mapping. These are taught at the graduate level as part of the graduate degree program at UNH. In this paper, the experiences that participants from the different backgrounds underwent are recounted with the overall goal of improving the general education required to map the floors of the deep ocean. Recommendations are made regarding the prior preparation of students entering the program, the content and intensity of courses comprising the program, and follow-up actions to solidify the learning experience. Intangibles such as the networking of professional contacts are also evaluated. Extrapolations to training in other areas of hydrography are made

Capacity building in Ocean Bathymetry: The Nippon Foundation GEBCO Training Programme at the University of New Hampshire

A successful Capacity Building project in hydrography is underway at the University of New Hampshire. Organised by the General Bathymetric Chart of the Oceans and sponsored by the Nippon Foundation, the programme trains hydrographers and other marine scientists in bathymetric mapping. Participants are formally prepared to produce bathymetric maps when they return to their home countries through a combination of graduate level courses and workshops, practical field training, participation in deep ocean research cruises, working visits to other laboratories and institutions, focused lectures from visiting experts, and the preparation of a bathymetry map of their area from public domain data. Intangible but necessary preparation includes the networking with professionals in bathymetry and related fields within Ocean Mapping, and the building of a cadre of graduates who will form the basis of international bathymetric mapping in the future

Investigating the characteristics and needs of frequently admitting hospital patients : a cross-sectional study in the United Kingdom

Objectives: This study forms the user requirements phase of the OPTIMAL project, which, through a predictive model and supportive intervention, aims to decrease early hospital readmissions. This phase aims to investigate the needs and characteristics of patients who had been admitted to hospital ≥2 times in the past 12 months. Setting This was a cross-sectional study involving patients from Croydon University Hospital (CUH), London, UK. Participants: A total of 347 patients responded to a postal questionnaire, a response rate of 12.7%. To meet the inclusion criteria, participants needed to be aged ≥18 and have been admitted ≥2 times in the previous 12 months (August 2014–July 2015) to CUH. Primary and secondary outcomes: To profile patients identified as frequent admitters to assess gaps in care at discharge or post-discharge. Additionally, to understand the patients’ experience of admission, discharge and post-discharge care. Results: The range of admissions in the past 12 months was 2–30, with a mean of 2.8. At discharge 72.4% (n=231/347) were not given a contact for out-of-hours help. Regression analysis identified patient factors that were significantly associated with frequent admissions (>2 in 12 months), which included age (p=0.008), being in receipt of care (p=0.005) and admission due to a fall (p=0.01), but not receiving polypharmacy. Post-discharge, 41.8% (n=145/347) were concerned about being readmitted to the hospital. In the first 30 days after discharge, over half of patients (54.5% n=189/347) had no contact from a healthcare professional. Conclusion: Considering that social care needs were more of a determinant of admission risk than medical needs, rectifying the lack of integration, communication and the under-utilisation of existing patient services could prevent avoidable problems during the transition of care and help decrease the likelihood of hospital readmission

Capacity Building in Ocean Bathymetry: The Nippon Foundation GEBCO Training Programme at the University of New Hampshire

A successful Capacity Building project in hydrography is underway at the University of New Hampshire. Organised by the General Bathymetric Chart of the Oceans and sponsored by the Nippon Foundation, the programme trains hydrographers and other marine scientists in bathymetric mapping. Participants are formally prepared to produce bathymetric maps when they return to their home countries through a combination of graduate level courses and workshops, practical field training, participation in deep ocean research cruises, working visits to other laboratories and institutions, focused lectures from visiting experts, and the preparation of a bathymetry map of their area from public domain data. Intangible but necessary preparation includes the networking with professionals in bathymetry and related fields within Ocean Mapping, and the building of a cadre of graduates who will form the basis of international bathymetric mapping in the future

Role of schools in community mobilisation to improve IYCF practices in 6-24-month-old tribal children in the Banswara district, India: findings from the qualitative PANChSHEEEL study

OBJECTIVE: India has been struggling with infant malnutrition for decades. There is a need to identify suitable platforms for community engagement to promote locally feasible, resource efficient Infant and Young Child Feeding (IYCF) interventions. This study aims to explore if and how schools could represent a site for community engagement in rural India, acting as innovation hubs to foster positive change in partnership with the Angawadi centres. DESIGN: Five-phase formative study; A parallel mixed methods approach structured by a socioecological framework was used for data collection at individual, household and community levels. This paper focuses on the qualitative findings. SETTING: This study was undertaken in nine villages within two blocks, 'Ghatol' and 'Kushalgarh', in the Banswara district of Rajasthan, India. PARTICIPANTS: 17 schools were identified. Interviews were conducted with local opinion leaders and representatives in the education sector, including principals, schoolteachers, block and district education officers. Across the nine study villages, information was gathered from 67 mothers, 58 paternal grandmothers using Focus Discussion Groups (FDGs) and 49 key respondents in Key Informant Interviews. RESULTS: Schools were considered an important community resource. Challenges included limited parental participation and student absenteeism; however, several drivers and opportunities were identified, which may render schools a suitable intervention delivery site. Enrolment rates were high, with schools and associated staff encouraging parental involvement and student attendance. Existing initiatives, including the mid-day meal, play opportunities and education on health and hygiene, further highlight the potential reliability of schools as a platform for community mobilisation. CONCLUSIONS: Schools have been shown to be functional platforms frequently visited and trusted by community members. With teachers and children as change agents, schools could represent a suitable setting for community mobilisation in future wider scale intervention studies. Expanding the supportive environment around schools will be essential to reinforce healthy IYCF practices in the long term

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Shared decision making and experiences of patients with long-term conditions : has anything changed?

Background Medication problems among patients with long-term conditions (LTCs) are well documented. Measures to support LTC management include: medicine optimisation services by community pharmacists such as the Medicine Use Review (MUR) service in England, implementation of shared decision making (SDM), and the availability of rapid access clinics in primary care. This study aimed to investigate the experience of patients with LTCs about SDM including medication counselling and their awareness of community pharmacy medication review services. Methods A mixed research method with a purposive sampling strategy to recruit patients was used. The quantitative phase involved two surveys, each requiring a sample size of 319. The first was related to SDM experience and the second to medication counselling at discharge. Patients were recruited from medical wards at St. George’s and Croydon University Hospitals.The qualitative phase involved semi-structured interviews with 18 respiratory patients attending a community rapid access clinic. Interviews were audio-recorded and transcribed verbatim. Thematic analysis using inductive/deductive approaches was employed. Survey results were analysed using descriptive statistics. Results The response rate for surveys 1 and 2 survey was 79% (n = 357/450) and 68.5% (240/350) respectively. Survey 1 showed that although 70% of patients had changes made to their medications, only 40% were consulted about them and two-thirds (62.2%) wanted to be involved in SDM. In survey 2, 37.5% of patients thought that medication counselling could be improved. Most patients (88.8%) were interested in receiving the MUR service; however 83% were not aware of it. The majority (57.9%) were interested in receiving their discharge medications from community pharmacies. The interviews generated three themes; lack of patient-centered care and SDM, minimal medication counselling provided and lack of awareness about the MUR service. Conclusion Although patients wanted to take part in SDM, yet SDM and medication counselling are not optimally provided. Patients were interested in the MUR service; however there was lack of awareness and referral for this service. The results propose community pharmacy as a new care pathway for medication supply and counselling post discharge. This promotes a change of health policy whereby community-based services are used to enhance the performance of acute hospitals