ObjectivesThis paper offers new insight into the link between success in high stakes exams and subsequent education and labour market outcomes. It is the first study to look holistically at the ...impact of crossing an important high stakes threshold on both academic and vocational education choices and ultimately labour market outcomes.
MethodIt does so by comparing those either side of a formerly important threshold in the English education system at the end of compulsory schooling (achieving five general certificate of secondary education A* to C passes) which was commonly regarded as the minimum benchmark for continuing into post-compulsory education.
ResultsI find that crossing this threshold led to an 6.3-6.7 percentage point increase in the proportion of men and women (respectively) going on to take academic qualifications, with little change in the proportion taking vocational qualifications, leading to a net increase in those staying on after compulsory schooling. Women's daily earnings in 2017-18 (11-13 years after leaving compulsory schooling) were 3.1 percentage points higher for those just crossing the threshold, but men's early labour market outcomes were unchanged.
ConclusionThe results for men can be explained by low returns to academic qualifications for marginal learners. The findings for women do not disappear after accounting for subsequent education choices, suggesting that crossing the threshold may play a signalling role for employers as well as education institutions.
ObjectivesThis is descriptive analysis of post-16 education and labour market activities, pathways and outcomes based on different socioeconomic, demographic and education factors. This research uses ...powerful administrative data from England to carry out analysis of over 3.6 million individuals doing their General Certificate of Secondary Education exams (GCSEs) between 2002 and 2007.
MethodEducation records and combined with tax and social security records (from the National Pupil Database). Longitudinal Education Outcomes (LEO) data allowing these individuals to be tracked in their post compulsory education over a 10-15 year period. The analysis makes comparisons using of a range of background characteristics including socioeconomic status, special educational needs (SEN) status, gender, ethnicity, first language and location (region). It also observes how these differ for different education levels, doing comparisons of: 1) graduates and non-graduates and 2) non-graduates achieving level 3 or above and level 2 or below.
ResultsIt finds that Post 16 (i.e. compulsory in England) Education and labour market pathways are incredibly diverse and they differ significantly based on individual characteristics. Higher levels of education lead to better labour market outcomes and most sub-groups achieving a higher education level leads to better labour market outcomes than their comparators (with different characteristics). For example, there are higher proportions of graduates that were Free School Meals eligible (a proxy for lower socioeconomic status) in employment and lower proportions claiming benefits than non-Free School Meals (FSM) eligible non-graduates, 15 years after their GCSEs (63 percent versus 58 percent and five versus nine percent respectively). Of those in employment, the FSM eligible graduates earn around £5,000 more per year than non-FSM eligible non-graduates and their earnings potential seem to have different trajectories.
ConclusionThere are some interesting and insightful findings, but it should be noted that findings are descriptive. It is recommended that in depth, technical analysis is undertaken to explored further.
Surgical adverse events: a systematic review Anderson, Oliver, B.Sc., M.Sc., M.R.C.S; Davis, Rachel, B.Sc., M.Sc., Ph.D; Hanna, George B., Ph.D ...
The American journal of surgery,
08/2013, Letnik:
206, Številka:
2
Journal Article
Recenzirano
Abstract Background The aim of this systematic review is to quantify potentially preventable patient harm from the frequency, severity, and preventability of the consequences and causes of surgical ...adverse events to help target patient safety improvement efforts. Data Sources Two authors independently reviewed articles retrieved from systematic searches of the Cochrane library, MEDLINE, Embase, PsycINFO, and Cumulative Index to Nursing & Allied Health Literature databases for inclusion and exclusion criteria, methodology, and end points. All retrospective record review studies of adverse events were included. The primary end point was the frequency of general surgery adverse events. The secondary end points were the severity and preventability of consequences and causes. Conclusions Fourteen record review studies incorporating 16,424 surgical patients were included. Adverse events occurred in 14.4% of patients (interquartile range IQR, 12.5% to 20.1%), and potentially preventable adverse events occurred in 5.2% (IQR, 4.2% to 7.0%). The consequences of 3.6% of adverse events (IQR, 3.1% to 4.4%) were fatal, those of 10.4% (IQR, 8.5% to 12.3%) were severe, those of 34.2% (IQR, 29.2% to 39.2%) were moderate, and those of 52.5% (IQR, 49.8% to 55.3%) were minor. Errors in nonoperative management caused more frequent adverse events than errors in surgical technique.
Objective
To report the configuration, risk factors, fixation methods and complication rates after repair of humeral condylar fractures (HCF) in French bulldogs, and report the presence of humeral ...intracondylar fissures (HIF) in this population as a possible predisposing factor.
Study design
Retrospective clinical cohort study.
Sample population
Forty‐four elbows.
Methods
The medical records of dogs referred between January 2012 and December 2021 were searched for French bulldogs presenting with HCF. Signalment, fracture configuration, stabilization method and complication occurrence were obtained. Postoperative radiographs were assessed for implant positioning, and computed tomography (CT) scans were assessed for the presence and size of HIF in the contralateral elbow.
Results
Lateral humeral condylar fractures represented 28/44 (63.6%) of HCF in French bulldogs. Repair with a transcondylar screw (TCS) and Kirschner‐wire(s) (K‐wire) were 7.62 times more likely to result in a major complication (95% CI: 1.43, 21.89; p = .01) compared to other methods. All incidences (7/7) of TCS migration were within the TCS + K‐wire group. A HIF was identified in 18/31 (58.1%) dogs. Older animals were not significantly less likely to have a HIF than younger animals (p = .129).
Conclusions
Fracture stabilization with a TCS and K‐wire(s) was associated with an increased risk of major complications and migration of the TCS. A HIF was present in the contralateral elbow of over half of the French bulldogs where CT was available.
Clinical significance
A HIF may be a predisposing factor of HCF in French bulldogs. Alternative methods of stabilization to a TCS and K‐wire(s) should be used to reduce complication risk.
The global utilization of single-use, non-biodegradable plastics, such as bottles made of polyethylene terephthalate (PET), has contributed to catastrophic levels of plastic pollution. Fortunately, ...microbial communities are adapting to assimilate plastic waste. Previously, our work showed a full consortium of five bacteria capable of synergistically degrading PET. Using omics approaches, we identified the key genes implicated in PET degradation within the consortium's pangenome and transcriptome. This analysis led to the discovery of a novel PETase, EstB, which has been observed to hydrolyze the oligomer BHET and the polymer PET. Besides the genes implicated in PET degradation, many other biodegradation genes were discovered. Over 200 plastic and plasticizer degradation-related genes were discovered through the Plastic Microbial Biodegradation Database (PMBD). Diverse carbon source utilization was observed by a microbial community-based assay, which, paired with an abundant number of plastic- and plasticizer-degrading enzymes, indicates a promising possibility for mixed plastic degradation. Using RNAseq differential analysis, several genes were predicted to be involved in PET degradation, including aldehyde dehydrogenases and several classes of hydrolases. Active transcription of PET monomer metabolism was also observed, including the generation of polyhydroxyalkanoate (PHA)/polyhydroxybutyrate (PHB) biopolymers. These results present an exciting opportunity for the bio-recycling of mixed plastic waste with upcycling potential.
Promyelocytic leukemia (PML) protein forms the basis of PML nuclear bodies (PML NBs), which control many important processes. We have screened an shRNA library targeting ubiquitin pathway proteins ...for effects on PML NBs, and identified RNF8 and RNF168 DNA-damage response proteins as negative regulators of PML NBs. Additional studies confirmed that depletion of either RNF8 or RNF168 increased the levels of PML NBs and proteins, whereas overexpression induced loss of PML NBs. RNF168 partially localized to PML NBs through its UMI/MIU1 ubiquitin-interacting region and associated with NBs formed by any PML isoform. The association of RNF168 with PML NBs resulted in increased ubiquitylation and SUMO2 modification of PML. In addition, RNF168 was found to associate with proteins modified by SUMO2 and/or SUMO3 in a manner dependent on its ubiquitin-binding sequences, suggesting that hybrid SUMO-ubiquitin chains can be bound. In vitro assays confirmed that RNF168, preferentially, binds hybrid SUMO2-K63 ubiquitin chains compared with K63-ubiquitin chains or individual SUMO2. Our study identified previously unrecognized roles for RNF8 and RNF168 in the regulation of PML, and a so far unknown preference of RNF168 for hybrid SUMO-ubiquitin chains.
American Indian/Alaska Native (AI/AN) communities are disproportionally impacted by the opioid overdose epidemic. There remains a dearth of research evaluating methods for effectively implementing ...treatments for opioid use disorder (OUD) within these communities. We describe proceedings from a 2‐day Collaborative Board (CB) meeting tasked with developing an implementation intervention for AI/AN clinical programs to improve the delivery of medications to treat OUD (MOUD). The CB was comprised of Elders, cultural leaders, providers, individuals with lived experience with OUD, and researchers from over 25 communities, organizations, and academic institutions. Conversations were audio‐recorded, transcribed, and coded by two academic researchers with interpretation oversight provided by the CB. These proceedings provided a foundation for ongoing CB work and a frame for developing the program‐level implementation intervention using a strength‐based and holistic model of OUD recovery and wellbeing. Topics of discussion posed to the CB included engagement and recovery strategies, integration of extended family traditions, and addressing stigma and building trust with providers and clients. Integration of traditional healing practices, ceremonies, and other cultural practices was recommended. The importance of centering AI/AN culture and involving family were highlighted as priorities for the intervention.
Highlights
Findings inform the future integration of a holistic approach to opioid treatment for Indigenous people.
Integration of traditional healing practices, ceremonies, and other practices was recommended.
Guidance was provided for implementation studies conducted in partnership with Indigenous communities.
Acetylcholine modulates the virulence of
and regulates an appropriate immune response to infection in a
infection model. Indeed, the evidence suggests that
possesses a functional cholinergic receptor ...that can regulate filamentous growth and biofilm formation. Furthermore,
immune cell subsets possess repertories of cholinergic receptors which regulate an effective and appropriate cellular immune response to
infection. This study aimed to investigate the cholinergic receptor subtype involved in regulation of filamentous growth and biofilm formation by
and determine the roles of cholinergic receptors in modulation of
immune cell subsets. The general muscarinic receptor agonist, pilocarpine hydrochloride, inhibited
biofilm formation and pathogenicity, a phenomenon that could be reversed using the general muscarinic receptor antagonist, scopolamine. Pilocarpine hydrochloride protected
larvae from
infection via inhibition of
filamentation and appropriate regulation of cellular immunity. However, scopolamine abrogated the capacity of pilocarpine hydrochloride to protect
larvae from
infection. Furthermore, acetylcholine and pilocarpine hydrochloride exhibited differential modulatory capabilities on
hemocyte responses to
The data in this article demonstrate that a muscarinic receptor modulates
filamentation and biofilm formation. Furthermore, the results suggest that
hemocyte subsets possess unique repertoires of cholinergic receptors that regulate their differentiation, activation, and function in contrasting manners. Therefore, targeting cholinergic receptors by repurposing currently licensed cholinergic drugs may offer novel therapeutic solutions for the prevention or treatment of fungal infections.
is the most common human fungal pathogen with an estimated crude mortality rate of 40%. The ability of the organism to switch from the yeast to hyphal form and produce biofilms are important virulence factors.
infections are combatted by the host immune system. However,
triggers a strong inflammatory response that, if not appropriately regulated, can damage host tissues. Therefore, it is important that the host immune response eliminates the fungus but limits tissue damage. This study provides evidence that targeting cholinergic receptors cannot only curb the virulence of
by inhibiting filamentous growth and biofilm formation but can also appropriately regulate the host immune response to induce rapid clearance with limited damage to vital tissues. This article provides evidence that repurposing licensed drugs that target cholinergic receptors may offer novel therapeutic solutions for the prevention or treatment of fungal infections.
Background Multimodal interventions aim to improve health care workers’ adherence to hand hygiene guidelines. Visitors are not primarily targeted, but may spread epidemic infections. Effective ...interventions that improve the adherence of visitors to hand hygiene guidelines are needed to prevent the transmission of epidemic infections to or from health care environments. Methods An electronic motion sensor–triggered audible hand hygiene reminder was installed at hospital ward entrances. An 8-month preinterventional and postinterventional study was carried out to measure the adherence of hospital visitors and staff to hand hygiene guidelines. Results Overall hand hygiene adherence increased from 7.6% to 49.9% ( P < .001). The adherence of visitors and nonclinical staff increased immediately from 10.6% to 63.7% and from 5.3% to 34.8%, respectively ( P < .001). Adherence of doctors, nurses, and physiotherapists increased gradually from 4.5% to 38.3%, from 5.4% to 43.4%, and from 8.7% to 49.5%, respectively ( P < .001). Improved adherence was sustained among visitors and clinical staff ( P < .001), but not among nonclinical staff ( P = .341). Conclusions The electronic motion sensor–triggered audible reminder immediately and significantly improved and sustained greater adherence of hospital visitors and clinical staff to hand hygiene guidelines. This is an effective addition to multimodal hand hygiene interventions and may help control epidemic infections.
Abstract Background Ward round skills are essential for the best management of surgical inpatients, but assessment of their quality has received inadequate attention. This study aims to design and ...validate the surgical ward round assessment tool (SWAT). Methods We used modified Healthcare Failure Mode and Effects Analysis to develop the SWAT by identifying ward round steps. We assessed the validity of the SWAT using simulated and real surgical ward rounds. Results The Healthcare Failure Mode and Effects Analysis identified 30 ward round steps that were developed into the SWAT. Nineteen surgeons completed simulated surgical ward rounds. Eight fully trained surgeons scored significantly higher than 11 trainee surgeons when assessed with the SWAT ( P = .001). On average, the participants thought the realism of the simulation was good. Forty-four surgeons completed real surgical ward rounds. Fifteen experts scored significantly higher than 29 trainee surgeons when assessed with SWAT ( P = .001). Inter-rater reliability was .85 to .89, respectively. Conclusions The SWAT can be used to assess the quality of task-based and nontechnical surgical ward round skills.
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