Hospital Variation In Performance For Acute Myocardial Infarction With The Ncdr Action Registry-Gwtg all-Or-None” Composite Measure

Background: While mortality rates for cardiovascular disease have declined, many patients still fail to receive effective and timely care. Studies report that characteristics including census region of the United States (Midwest, West, Northeast and South), neighborhood classification (urban, rural, suburban), and teaching status are all associated with the quality of care provided. It has been reported that national quality improvement campaigns have been shown improve the quality of AMI care for these patients and increase compliance to guideline recommended treatment. Use of defect-free composite measures is increasing as they promote full execution of all processes of care, encourage a focus on the whole sequence of care instead of individual components, and offer a more sensitive scale to judge improvement in situations of already high compliance. The aforementioned hospital characteristics have not been analyzed using this defect-free composite measure as the outcome. This study aims to evaluate the degree to which hospital performance varied on the “all-or-none” composite measure and to identify hospital characteristics that were predictive of higher rates of defect-free care. Methods: Using data from the National Cardiovascular Data Registry (NCDR) – Acute Coronary Treatment and Intervention Outcomes Network (ACTION) – Get With the Guidelines (AR-G) [NCDR AR-G] a total of 791,354 patients and 1,332 hospitals were analyzed. The “all-or-none” defect-free composite consisting of 11 ACC/AHA recommended guidelines was the primary outcome. The association between defect-free care and the hospital characteristics of interest was determined by multivariate logistic regression. Results: Hospitals located in the Midwest and Northeast regions of the US were more likely to provide defect-free care (OR [95% CI]: 1.79 [1.73, 1.86] and 1.13 [1.07, 1.20], respectively) than hospitals in the South; while hospitals located in rural or suburban areas were less likely (OR [95% CI]: 0.83 [0.80, 0.87] and 0.95 [0.92, 0.98]) to provide defect-free care than hospitals in urban areas. In addition, teaching hospitals are less likely to provide defect-free care (OR [95% CI]: 0.96 [0.93, 0.99]) than hospitals that are non-teaching. Hospitals in all categories demonstrated positive trends in compliance throughout the study period. Conclusions: In order to move from already high rates of compliance to full compliance, it must be recognized that hospital level variations in care still exist. This continued variation in care by hospital characteristics suggests that the institutions within each category face unique challenges. Studies are needed to identify these challenges and propose potential solutions

Providing nursing support within residential care homes

This study examines a joint NHS-Local Authority initiative providing a dedicated nursing and physiotherapy team to three residential care homes in Bath and North East Somerset. The initiative aims to meet the nursing needs of residents where they live and to train care home staff in basic nursing. * Hospital admissions and nursing home transfers were prevented. Care home staff and managers preferred residents to be able to stay in their home when they were ill, as did residents themselves. * Enhancing health-orientated education and training of care home staff was challenging at first but relationships improved, and the confidence and professionalism of care staff grew. * Residents’ nursing needs cannot simply be equated with their level of dependency. For example, a resident with dementia can be functionally independent yet have major, often un-communicated health needs. * The early detection of illness and resulting opportunity for early intervention was a major part of the team’s work. Residents were likely to benefit from improved quality of life. * Overall, estimates of costs and savings ranged from a 'worst case' scenario of £2.70 extra to a more likely scenario of £36.90 saved per resident per week. Savings were mainly in reduced use of NHS services, while the Primary Care Trust and Adult Social Services both funded the intervention, highlighting the need for partnership working to sustain funding. * The researchers conclude that any increase in cost should be measured against the benefits of promoting long-term quality of life, quality of care and providing a firm foundation for future workforce development

Critical Literacy And Engagement In Special Education

This Capstone addresses the research question, what is the effect of critical literacy practices on engagement in secondary special education classrooms? Motivated by a desire to provide secondary special educators with tools to meet diverse learner needs in innovative, engaging and challenging ways, the author chronicles the key experiences that led to the topic choice and reviews the literature related to the research question. Additionally, the document includes an overview of educator professional development methodology and an outline for the design of the final Capstone project. The project derived from this research includes a year-long professional development plan for secondary special educators include agendas, learning targets and materials for 12 PD sessions encompassing 15 hours of cohort learning. The final chapter of the Capstone paper addresses key learnings derived from the process including the value of the literature review in guiding project creation and the insights gained in overcoming difficulties with a collaborative approach, and how these learnings intersect with professional development. Lastly, the paper addresses potential limitations of the project and implications for future research into the intersection of critical literacy, engagement and special education

News Flash: Content Framing of Higher Education during the COVID-19 Campus Closures

The COVID-19 pandemic swept the world in a cascade of crises, impacting every industry and individual. This study sought to analyze the prevailing narratives of higher education news coverage during the initial crisis event of COVID-19, when colleges and universities around the world closed their doors and sent students home. Historically, higher education has not been well positioned by the media in times of crisis. A tarnished reputation can lead to direct and immediate loses in enrollment, funding, rankings, selectivity of students and the financial health of an institution. The framing of media narratives plays a direct role in how that dialogue plays out and whether or not an institution can emerge unscathed. This study is a quantitative content analysis of the 169 articles published by the New York Times, Wall Street Journal, and USA Today between March 5, 2020, and June 3, 2020; when the COVID-19 pandemic forced campus closures around the world. The articles were coded by generic and issue-specific frames, source attribution, tone, valence, frequency, and themes. The overwhelmingly deleterious results provide guidance for university leaders and stakeholders in the wake of future crisis events and give further evidence to the power, responsibility, and privilege of journalists, especially in times of crisis, and the importance of wielding that power responsibly

The Effects of an Integrated Rhythmic and Literacy Intervention on the Development of Phonological Awareness and Rhythm Skills of Preschoolers

This study explored the impact of an integrated rhythm-literacy (IRL) intervention on the development of rhythm and phonological awareness (PA) skills in preschool children ages 4-5.5 years old. The IRL intervention draws from research that examines the role rhythm may play in the development of PA and is composed of three main events. Those events include (1) integrated rhythm-literacy text interactions, (2) integrated rhythm-literacy call and response and (3) integrated rhythm-literacy movement. The study used an experimental pretest-posttest design. A total of 43 participants took part in the study (intervention group = 23 children, comparison group = 20 children). Initial results indicate that the IRL intervention significantly improved the rhythm and rhyme awareness of the intervention group over the comparison group

Compostagem doméstica em educação ambiental : potencial de uma abordagem holística

Tomando como objecto de estudo projectos de Compostagem Doméstica (CD) no contexto escolar, este artigo apresenta uma análise do processo de implementação actual de uma prática sustentável milenar. No momento em que a compostagem se expande pelas escolas do país, em especial no 1.º Ciclo do Ensino Básico, tornou-se pertinente observar em profundidade experiências pedagógicas que usam esta metodologia de aproveitamento de resíduos orgânicos como um meio didáctico. Através de uma visão da CD baseada nas vertentes técnica; ambiental; de saúde; pedagógica; social e económica, foi realizado um estudo de casos múltiplos em três contextos educativos. Comparou-se o nível de desenvolvimento daquelas vertentes em escolas com diferentes graus de experiência em compostagem. A compostagem foi igualmente assumida como um “elo” que completa o ciclo da matéria orgânica, com as componentes-chave - “resíduos” e “fertilização do solo”. Entre outros aspectos, os resultados deste trabalho reforçaram a percepção de que o cruzamento da compostagem doméstica com outros projectos (e.g. hortas pedagógicas e outras práticas tradicionais) potencializa uma prática mais abrangente da educação ambiental.CIFPEC - Unidade de Investigação 644 da Fundação para a Ciência e a Tecnologia (FCT

Fungal silver nanoparticles

Este resumo faz parte de: Book of abstracts of the Meeting of the Institute for Biotechnology and Bioengineering, 2, Braga, Portugal, 2010. A versão completa do livro de atas está disponível em: http://hdl.handle.net/1822/1096

Just the Spark You Needed: A Standards Showcase

We want this session to be a spark for you! Seeing what other people are doing is often that very spark we need to create or tweak something into what will work for our own buildings. As school media specialists, we are usually the only of our kind and don\u27t get the chance to see what awesome things others are doing. This session will share successful projects and materials from well-respected Metro area high schools that address media and information literacy skills embedded into the Common Core Standards. Lesson examples include technology such as Google Forms, LibGuides, Google Sites, Twitter, PicMonkey, Google Maps, YouTube playlists and even a foray into Flipped Education. This session will also be an opportunity for academic librarians to see what skills their future students are being taught