A Critical Review of Private Tuition in the Uk: A Case Study of the Northeast of England.

Private tuition and its individualized ethos have often been at the center of global educational debates. Consistent changes in the UK national education policy and practice have over the years increased the phenomenon of private tuition creating an unregulated market amongst practitioners. This has had a significant impact on quality assurance. British neo-liberalism and cultural socio-economic disadvantage across the teaching and learning arena saw parental agency and stakeholder divisions driving the marketisation of private tuition to become a profession where the driving priority was of personal profit. Research in this field of study has long recognized the need for a critical review of the monetary driven educational support systems and the diversified culture of private tuition. This research presents a critical review of the phenomenon of private tuition in the UK with a close insight into the situation in the Northeast of England. Establishing the historically political narrative of British education which encourages competitiveness between schools, this research identifies educational factors that have increased volume of this phenomenon in practice, determining variables of parental agency in the investment of private tuition. The thesis presents and concludes with a pioneering framework which offers potential to regulate the private tuition market. The research involves a population sample of 195 parents and 494 teachers from across the UK. It employs mixed methods study which includes to use of quantitative and qualitative methods, to canvas participant experiences and perceptions regarding influential factors that necessitate the use of private tuition. An open-ended questionnaire was digitally disseminated to both sample sets, in addition to semi-structured interviews conducted with 30 parents and 30 teachers, alike. The research further utilized three sets of set and mixed focus groups to validate the data. The use of SPSS software platform was used to provide the analysis of the quantified responses, while NVivo thematically analysed qualitative data. Findings demonstrate that school conversions into academies have created a culture of unnecessary pressures for both parental and teacher populations, namely administrative pressures, securing exam grades in lieu of a place on league tables, jeopardizing pupil individual focus and quality assurance. Data regarding parental agency demonstrate that variables that instigated the increase in the use of private tuition, despite their financial burdens, are the attainment of exam grades that were exacerbated with Covid-19 gaps, and failure to focus on individual needs. Despite the need for further research to capture responses that represent the whole of the national cohort, this research provides an empirical model demonstrating a regulatory framework that could be used to secure the ethical practice and improve quality assurance of private tuition provision, as well as raising standards of educational practice in this field of study

Analysis of Pharmacotherapy by patients with diagnosis of arterial hypertension

Title: Analysis of Pharmacotherapy by patients with diagnosis of arterial hypertension Student: Vasiliki Kontou Tutor: Prof. RNDr. Jiri Vlcek, CSs Department of Social and Clinical Pharmacy, Charles University of Prague, Faculty of Pharmacy in Hradec Kralove Introduction: Arterial Hypertension (AH) is characterized by elevated blood pressure, which often leads to increased morbidity and mortality. AH divided into primary and secondary. Aim: In the theoretical part the aim is to analyse the etiopathogenesis, methods of diagnosis and the treatment strategies of arterial hypertension in the recent literature. In the experimental part the aim is to analyse the provisions of the above diagnosis of arterial hypertension. Method: During a six month period were collected 58 prescriptions with the diagnosis of arterial hypertension from a pharmacy that provided pharmaceutical care in the Greek village, Mytikas. Only one prescription for one patient was analysed. In the prescriptions were collected data on drugs, patients and physicians. Results: The pilot study included 58 prescriptions. Most patients were elderly, over 65 years old and 30% were in age 71 - 80 years. General practitioners prescribed 65% of the medical prescriptions. Most frequently prescribed ARBs with hydrochlorothiazide drugs (27%) and..

Quality of life of patients with decompensated cirrhosis who undergoing serial large volume paracentesis

Introduction: Serial large volume paracentesis is the most common treatment option forrefractory ascites in patients with decompensated cirrhosis. This treatment aims to relievesymptoms and maximize the functionality of the individual’s everyday life, and to generallyimprove patient’s QoL to any extent, considering the limits imposed by the course of thediseases and patients’ health status.Purpose: The basis of this study is to assess the QoL of patients with decompensatedcirrhosis undergoing serial large volume paracentesis.Material and Method: A cohort of 60 patients attending the 2nd Department of Medicine,Medical School of Athens, Hippokration Hospital was recruited. The data were collected withthe help of a two-part anonymous self-reported questionnaire consisting of a sheet containingclinical and demographic information and the SF-36 scale. Mean and standard deviation forcontinuous data and frequencies, and percentages for categorical data were calculated. Nonparametrictests such were applied. For the analysis of the data, the statistical packageSPPS20 was employed.Results: Out of the total number of participants in the study, 64.41% were men and 35.59%were women. The average age of the respondents was 70.8, with a standard deviation of10.9 years. More than half (56.14%) were past smokers, 31.58% were current smokers andthe remaining 12.28% were non-smokers. The statistical analysis revealed that patients withhigher education (p >.Τα στοιχεία συλλέχθηκαν με την συμπλήρωση της κλίμακας ShortForm36.Για την ανάλυση των στοιχείων χρησιμοποιήθηκε το στατιστικό πακέτο SPPS 13 και η στατιστική δοκιμασία t-test και Anova.Αποτελέσματα: Από τους ασθενείς που συμμετέχουν στην μελέτη το 64,41% είναι άνδρες και το 35,59% γυναίκες. Η μέση ηλικία των ερωτηθέντων είναι 70,8 ετών με τυπική απόκλιση 10,91 έτη. Το 89,66% έχει επανεισαχθεί στο Νοσοκομείο και το 56,14% ήταν παλαιοί καπνιστές, το 31,58% ήταν τωρινοί καπνιστές και το υπόλοιπο 12,28% ήταν μη καπνιστές.Από την στατιστική ανάλυση βρέθηκε ότι σε όλες τις διαστάσεις της κλίμακας της ποιότητας ζωής (SF -36) οι ασθενείς της μελέτης μας σε σχέση με το γενικό πληθυσμό είχαν στατιστικά μειούμενους δείκτες ποιότητας ζωής.Επιπλέον βρέθηκε ότι καλύτερη ποιότητα ζωής στις κλίμακες ψυχική υγεία, σωματική λειτουργικότητα και ζωτικότητα έχουν οι ασθενείς με τριτοβάθμια εκπαίδευση (p> από τους άνδρες (p<0,05). Επίσης όσοι δεν πάσχουν από κάποιο άλλο νόσημα και δεν είναι καπνιστές έχουν καλύτερη ποιότητα ζωής.Συμπεράσματα: Με βάση τα ευρήματα της παρούσας μελέτης φαίνεται ότι παράγοντες όπως το μορφωτικό επίπεδο , η οικογενειακή κατάσταση, η ηλικία, το φύλο ,η επανεισαγωγή στο Νοσοκομείο μπορούν να επηρεάσουν την ποιότητα ζωής των ασθενών που υποβάλλονται σε εκκενωτική παρακέντηση. Επιτακτική κρίνουμε την ανάγκη Σχεδιασμού,Εφαρμογής και Αξιολόγησης Προγραμμάτων αγωγής υγείας που στόχο θα έχουν την βελτίωση της ποιότητας ζωής των ασθενών αυτών και των οικογενειών τους.Λέξεις κλειδιά: ποιότητα ζωής- μη αντιρροπούμενη κίρρωση- εκκενωτική παρακέντησ

Ποιότητα ζωής ασθενών με μη αντιρροπούμενη κίρρωση που υποβάλλονται σε εκκενωτική παρακέντηση

Εισαγωγή: Ο σκοπός στην αντιμετώπιση των ασθενών με μη αντιροπούμενη κίρρωση που υποβάλλονται σε εκκενωτική παρακέντηση είναι η ανακούφιση από τα συμπτώματα, η βελτίωση της πρόγνωσης, η μεγιστοποίηση της λειτουργικής ικανότητας του ατόμου στην καθημερινή του ζωή και γενικά η επίτευξη καλής ποιότητας ζωής εντός των περιορισμών που επιβάλει η κατάσταση υγείας της πορείας της νόσου. Σκοπός: Σκοπός της παρούσης μελέτης είναι η αξιολόγηση της ποιότητας ζωής των ασθενών με μη αντιρροπούμενη κίρρωση που υποβάλλονται σε εκκενωτική παρακέντηση. Μεθοδολογία: Στην παρούσα μελέτη συγκεντρώθηκαν δεδομένα από 60 ασθενείς της Β΄ Πανεπιστημιακής Παθολογικής Κλινικής του Γενικού Νοσοκομείου της Αθήνας &lt;&lt;Ιπποκράτειο&gt;&gt;.Τα στοιχεία συλλέχθηκαν με την συμπλήρωση της κλίμακας ShortForm 36.Για την ανάλυση των στοιχείων χρησιμοποιήθηκε το στατιστικό πακέτο SPPS 13 και η στατιστική δοκιμασία t-test και Anova. Αποτελέσματα: Από τους ασθενείς που συμμετέχουν στην μελέτη το 64,41% είναι άνδρες και το 35,59% γυναίκες. Η μέση ηλικία των ερωτηθέντων είναι 70,8 ετών με τυπική απόκλιση 10,91 έτη. Το 89,66% έχει επανεισαχθεί στο Νοσοκομείο και το 56,14% ήταν παλαιοί καπνιστές, το 31,58% ήταν τωρινοί καπνιστές και το υπόλοιπο 12,28% ήταν μη καπνιστές. Από την στατιστική ανάλυση βρέθηκε ότι σε όλες τις διαστάσεις της κλίμακας της ποιότητας ζωής (SF -36) οι ασθενείς της μελέτης μας σε σχέση με το γενικό πληθυσμό είχαν στατιστικά μειούμενους δείκτες ποιότητας ζωής. Επιπλέον βρέθηκε ότι καλύτερη ποιότητα ζωής στις κλίμακες ψυχική υγεία, σωματική λειτουργικότητα και ζωτικότητα έχουν οι ασθενείς με τριτοβάθμια εκπαίδευση (p&lt;0,05).Οι γυναίκες σύμφωνα με τα αποτελέσματα της έρευνάς μας έχουν καλύτερη ποιότητα ζωής στην κλίμακα &lt;&lt;σωματικής λειτουργικότητας&gt;&gt; από τους άνδρες (p&lt;0,05). Επίσης όσοι δεν πάσχουν από κάποιο άλλο νόσημα και δεν είναι καπνιστές έχουν καλύτερη ποιότητα ζωής. Συμπεράσματα: Με βάση τα ευρήματα της παρούσας μελέτης φαίνεται ότι παράγοντες όπως το μορφωτικό επίπεδο , η οικογενειακή κατάσταση, η ηλικία, το φύλο ,η επανεισαγωγή στο Νοσοκομείο μπορούν να επηρεάσουν την ποιότητα ζωής των ασθενών που υποβάλλονται σε εκκενωτική παρακέντηση. Επιτακτική κρίνουμε την ανάγκη Σχεδιασμού, Εφαρμογής και Αξιολόγησης Προγραμμάτων αγωγής υγείας που στόχο θα έχουν την βελτίωση της ποιότητας ζωής των ασθενών αυτών και των οικογενειών τους.Introduction: Serial large volume paracentesis is the most common treatment option for refractory ascites in patients with decompensated cirrhosis. This treatment aims to relieve symptoms and maximize the functionality of the individual’s everyday life, and to generally improve patient’s QoL to any extent, considering the limits imposed by the course of the diseases and patients’ health status. Purpose: The basis of this study is to assess the QoL of patients with decompensated cirrhosis undergoing serial large volume paracentesis. Material and Method: A cohort of 60 patients attending the 2nd Department of Medicine, Medical School of Athens, Hippokration Hospital was recruited. The data were collected with the help of a two-part anonymous self-reported questionnaire consisting of a sheet containing clinical and demographic information and the SF-36 scale. Mean and standard deviation for continuous data and frequencies, and percentages for categorical data were calculated. Non- parametric tests such were applied. For the analysis of the data, the statistical package SPPS20 was employed. Results: Out of the total number of participants in the study, 64.41% were men and 35.59% were women. The average age of the respondents was 70.8, with a standard deviation of 10.9 years. More than half (56.14%) were past smokers, 31.58% were current smokers and the remaining 12.28% were non-smokers. The statistical analysis revealed that patients with higher education (p &lt;0.05) reported better scores in QoL on the scales mental health, functionality, and vitality. Women, according to the results of our research, experienced a better QoL on the scale of physical activity than men (p &lt;0.05). Also, those who were not suffering from another disease and were not smokers had a better QoL. Conclusions: Based on the findings of the present study, it appears that factors such as educational level, marital status, age, gender, hospital readmissions can affect the QoL of patients subject to large volume paracentesis. Implementation and evaluation of health education programs aimed at improving the QoL of these patients and their families is of vital importance

Extracts from <i>Chlorella vulgaris</i> Protect Mesenchymal Stromal Cells from Oxidative Stress Induced by Hydrogen Peroxide

Microalgae as unicellular eukaryotic organisms demonstrate several advantages for biotechnological and biological applications. Natural derived microalgae products demand has increased in food, cosmetic and nutraceutical applications lately. The natural antioxidants have been used for attenuation of mitochondrial cell damage caused by oxidative stress. This study evaluates the in vitro protective effect of Chlorella vulgaris bioactive extracts against oxidative stress in human mesenchymal stromal/stem cells (MSCs). The classical solid-liquid and the supercritical extraction, using biomass of commercially available and laboratory cultivated C. vulgaris, are employed. Oxidative stress induced by 300 μM H2O2 reduces cell viability of MSCs. The addition of C. vulgaris extracts, with increased protein content compared to carbohydrates, to H2O2 treated MSCs counteracted the oxidative stress, reducing reactive oxygen species levels without affecting MSC proliferation. The supercritical extraction was the most efficient extraction method for carotenoids resulting in enhanced antioxidant activity. Pre-treatment of MSCs with C. vulgaris extracts mitigates the oxidative damage ensued by H2O2. Initial proteomic analysis of secretome from licensed (TNFα-activated) MSCs treated with algal extracts reveals a signature of differentially regulated proteins that fall into clinically relevant pathways such as inflammatory signaling. The enhanced antioxidative and possibly anti-inflammatory capacity could be explored in the context of future cell therapies

Poor timing and failure of source control are risk factors for mortality in critically ill patients with secondary peritonitis

Purpose: To describe data on epidemiology, microbiology, clinical characteristics and outcome of adult patients admitted in the intensive care unit (ICU) with secondary peritonitis, with special emphasis on antimicrobial therapy and source control. Methods: Post hoc analysis of a multicenter observational study (Abdominal Sepsis Study, AbSeS) including 2621 adult ICU patients with intra-abdominal infection in 306 ICUs from 42 countries. Time-till-source control intervention was calculated as from time of diagnosis and classified into 'emergency' (&lt; 2 h), 'urgent' (2-6 h), and 'delayed' (&gt; 6 h). Relationships were assessed by logistic regression analysis and reported as odds ratios (OR) and 95% confidence interval (CI). Results: The cohort included 1077 cases of microbiologically confirmed secondary peritonitis. Mortality was 29.7%. The rate of appropriate empiric therapy showed no difference between survivors and non-survivors (66.4% vs. 61.3%, p = 0.1). A stepwise increase in mortality was observed with increasing Sequential Organ Failure Assessment (SOFA) scores (19.6% for a value ≤ 4-55.4% for a value &gt; 12, p &lt; 0.001). The highest odds of death were associated with septic shock (OR 3.08 [1.42-7.00]), late-onset hospital-acquired peritonitis (OR 1.71 [1.16-2.52]) and failed source control evidenced by persistent inflammation at day 7 (OR 5.71 [3.99-8.18]). Compared with 'emergency' source control intervention (&lt; 2 h of diagnosis), 'urgent' source control was the only modifiable covariate associated with lower odds of mortality (OR 0.50 [0.34-0.73]). Conclusion: 'Urgent' and successful source control was associated with improved odds of survival. Appropriateness of empirical antimicrobial treatment did not significantly affect survival suggesting that source control is more determinative for outcome

Epidemiology of intra-abdominal infection and sepsis in critically ill patients: "AbSeS", a multinational observational cohort study and ESICM Trials Group Project

PURPOSE: To describe the epidemiology of intra-abdominal infection in an international cohort of ICU patients according to a new system that classifies cases according to setting of infection acquisition (community-acquired, early onset hospital-acquired, and late-onset hospital-acquired), anatomical disruption (absent or present with localized or diffuse peritonitis), and severity of disease expression (infection, sepsis, and septic shock). METHODS: We performed a multicenter (n = 309), observational, epidemiological study including adult ICU patients diagnosed with intra-abdominal infection. Risk factors for mortality were assessed by logistic regression analysis. RESULTS: The cohort included 2621 patients. Setting of infection acquisition was community-acquired in 31.6%, early onset hospital-acquired in 25%, and late-onset hospital-acquired in 43.4% of patients. Overall prevalence of antimicrobial resistance was 26.3% and difficult-to-treat resistant Gram-negative bacteria 4.3%, with great variation according to geographic region. No difference in prevalence of antimicrobial resistance was observed according to setting of infection acquisition. Overall mortality was 29.1%. Independent risk factors for mortality included late-onset hospital-acquired infection, diffuse peritonitis, sepsis, septic shock, older age, malnutrition, liver failure, congestive heart failure, antimicrobial resistance (either methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, extended-spectrum beta-lactamase-producing Gram-negative bacteria, or carbapenem-resistant Gram-negative bacteria) and source control failure evidenced by either the need for surgical revision or persistent inflammation. CONCLUSION: This multinational, heterogeneous cohort of ICU patients with intra-abdominal infection revealed that setting of infection acquisition, anatomical disruption, and severity of disease expression are disease-specific phenotypic characteristics associated with outcome, irrespective of the type of infection. Antimicrobial resistance is equally common in community-acquired as in hospital-acquired infection.status: publishe