91 research outputs found

    Oxygen saturation as a predictor of adverse maternal outcomes in women with preeclampsia.

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    OBJECTIVE: We sought to determine the role of respiratory assessment by cardiorespiratory symptoms and/or oxygen saturation by pulse oximetry (SpO2) in predicting adverse maternal outcomes in women admitted to hospital with preeclampsia. METHODS: These data derive from an international, prospective multicentre cohort study, PIERS (Pre-eclampsia Integrated Estimate of RiSk), which assesses predictors of adverse outcomes in women admitted to tertiary perinatal units with preeclampsia. Univariate and multivariate analyses of cardiorespiratory symptoms and pulse oximetry were performed to assess their ability to predict a combined adverse maternal outcome developed through international Delphi consensus. RESULTS: SpO2 successfully predicted adverse maternal outcomes; the area under the receiver-operator characteristic curve (AUC ROC) was 0.71 (95% CI 0.65 to 0.77). Combining the symptoms of chest pain and/or dyspnea with pulse oximetry improved this predictive ability (AUC ROC 0.73; 95% CI 0.67 to 0.78). When SpO2 was stratified into risk groups using inflection points on the ROC curve, the highest risk group (SpO2 90% to 93%) had an odds ratio of 18.1 (95% CI 8.2 to 40.2) for all outcomes within 48 hours when compared with the baseline group (SpO2 98% to 100%). CONCLUSION: Assessing SpO2 aids in the assessment of maternal risk in women admitted to hospital with preeclampsia. An SpO2 value of ≀ 93% confers particular risk. The symptom complex of chest pain and/or dyspnea adds to the association

    Legal Empowerment and Horizontal Inequalities after Conflict

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    This article explores whether legal empowerment can address horizontal inequalities in post-conflict settings, and, if so, how. It argues that legal empowerment has modest potential to reduce these inequalities. Nevertheless, there are risks that legal empowerment might contribute to a strengthening of group identities, reduction of social cohesion, and, in the worst case, triggering of conflict. It looks at how two legal empowerment programmes in Liberia navigated the tensions between equity and peace

    Academic research into marketing: many publications, but little impact?

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    This article reviews some issues associated with the way in which academic research into marketing is evaluated by UK education authorities using their Research Excellence Framework (REF), in particular the impact component of the assessment. It discusses the extent to which research by marketing academics published in leading academic journals is relevant to the concerns of marketing management and how this relevance or lack of it may be reflected in the relative paucity of impact submissions in marketing. It considers the model of impact assessment used in the REF and how this differs from how marketing academics work in practice, giving three examples of significant impact that would not be acceptable under current rules. It concludes by suggesting that alternative models for impact should be investigated and suggests that using more practical models might result in better engagement of marketing academics with business, leading to greater relevance in teaching and employability of marketing graduates

    Systematically reviewing and synthesizing evidence from conversation analytic and related discursive research to inform healthcare communication practice and policy: an illustrated guide

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    Background Healthcare delivery is largely accomplished in and through conversations between people, and healthcare quality and effectiveness depend enormously upon the communication practices employed within these conversations. An important body of evidence about these practices has been generated by conversation analysis and related discourse analytic approaches, but there has been very little systematic reviewing of this evidence. Methods We developed an approach to reviewing evidence from conversation analytic and related discursive research through the following procedures: ‱ reviewing existing systematic review methods and our own prior experience of applying these ‱ clarifying distinctive features of conversation analytic and related discursive work which must be taken into account when reviewing ‱ holding discussions within a review advisory team that included members with expertise in healthcare research, conversation analytic research, and systematic reviewing ‱ attempting and then refining procedures through conducting an actual review which examined evidence about how people talk about difficult future issues including illness progression and dying Results We produced a step-by-step guide which we describe here in terms of eight stages, and which we illustrate from our ‘Review of Future Talk’. The guide incorporates both established procedures for systematic reviewing, and new techniques designed for working with conversation analytic evidence. Conclusions The guide is designed to inform systematic reviews of conversation analytic and related discursive evidence on specific domains and topics. Whilst we designed it for reviews that aim at informing healthcare practice and policy, it is flexible and could be used for reviews with other aims, for instance those aiming to underpin research programmes and projects. We advocate systematically reviewing conversation analytic and related discursive findings using this approach in order to translate them into a form that is credible and useful to healthcare practitioners, educators and policy-makers

    Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

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    This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

    Variations in training of surgical oncologists: Proposal for a global curriculum

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    Gamelan Music of Java: An Introduction

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