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The scientific method : a guide to finding useful knowledge
\"I found this book to be a particularly engaging and useful treatment of scientific method and practice whereby the authors' target is to improve practice. There is a lot of subversion out there that they want to avoid with a content-positive approach. The book's themes for improving scientific practice are generated from earthy checklists, all concerned to improve compliance with the substantive content of science. It results in checklists for eleven user categories, from researchers to courts. The checklists all derive from key elements of the scientific method, summarized by eight criteria. I want to apply seven of these elements to my early work in experimental economics that will help me to see how this book can help you, which is its purpose\"-- Provided by publisher.
Book
A Systematic Literature Review of Predictive Maintenance for Defence Fixed-Wing Aircraft Sustainment and Operations
In recent decades, the increased use of sensor technologies, as well as the increase in digitalisation of aircraft sustainment and operations, have enabled capabilities to detect, diagnose, and predict the health of aircraft structures, systems, and components. Predictive maintenance and closely related concepts, such as prognostics and health management (PHM) have attracted increasing attention from a research perspective, encompassing a growing range of original research papers as well as review papers. When considering the latter, several limitations remain, including a lack of research methodology definition, and a lack of review papers on predictive maintenance which focus on military applications within a defence context. This review paper aims to address these gaps by providing a systematic two-stage review of predictive maintenance focused on a defence domain context, with particular focus on the operations and sustainment of fixed-wing defence aircraft. While defence aircraft share similarities with civil aviation platforms, defence aircraft exhibit significant variation in operations and environment and have different performance objectives and constraints. The review utilises a systematic methodology incorporating bibliometric analysis of the considered domain, as well as text processing and clustering of a set of aligned review papers to position the core topics for subsequent discussion. This discussion highlights state-of-the-art applications and associated success factors in predictive maintenance and decision support, followed by an identification of practical and research challenges. The scope is primarily confined to fixed-wing defence aircraft, including legacy and emerging aircraft platforms. It highlights that challenges in predictive maintenance and PHM for researchers and practitioners alike do not necessarily revolve solely on what can be monitored, but also covers how robust decisions can be made with the quality of data available.
Journal Article
ما وراء تربية الموهوبين : تصميم برامج أكاديمية متقدمة للموهوبين وتنفيذها
يحتوي الكتاب الذي ألفه أربعة من أبرز الخبراء في هذا المجال يحتوي على مراجعات للمارسات والسياسات التقليدية الحالية في ميدان تربية الموهوبين ولا يكتفي بذلك بل يقدم لمنسقي برامج الموهوبين ومديري المدارس المعنيين أسلوبا موسعا لتدريس الطلاب الموهوبين وقد أورد المؤلفون أمثلة تفصيلية تعرف القارئ على الحالات والبرامج الواقعية المألوفة لمنسق الموهبة لمراحل من الروضة إلى الصف الثاني عشر في موضوعات مثل التجميع العنقودي والتسريع وزيادة التنوع وربطوا طوال هذا الكتاب الحالات بالمعايير الرسمية الأساسية العامة والإستجابة للتدخل وبثروة من البحوث الخارجية لدعم الأفكار المقترحة.
BOOK
Guidelines for Perioperative Care for Pancreatoduodenectomy: Enhanced Recovery After Surgery (ERAS) Recommendations 2019
Background
Enhanced recovery after surgery (ERAS) pathways are now implemented worldwide with strong evidence that adhesion to such protocol reduces medical complications, costs and hospital stay. This concept has been applied for pancreatic surgery since the first published guidelines in 2012. This study presents the updated ERAS recommendations for pancreatoduodenectomy (PD) based on the best available evidence and on expert consensus.
Methods
A systematic literature search was conducted in three databases (Embase, Medline Ovid and Cochrane Library Wiley) for the 27 developed ERAS items. Quality of randomized trials was assessed using the Consolidated Standards of Reporting Trials statement checklist. The level of evidence for each item was determined using the Grading of Recommendations Assessment Development and Evaluation system. The Delphi method was used to validate the final recommendations.
Results
A total of 314 articles were included in the systematic review. Consensus among experts was reached after three rounds. A well-implemented ERAS protocol with good compliance is associated with a reduction in medical complications and length of hospital stay. The highest level of evidence was available for five items: avoiding hypothermia, use of wound catheters as an alternative to epidural analgesia, antimicrobial and thromboprophylaxis protocols and preoperative nutritional interventions for patients with severe weight loss (> 15%).
Conclusions
The current updated ERAS recommendations for PD are based on the best available evidence and processed by the Delphi method. Prospective studies of high quality are encouraged to confirm the benefit of current updated recommendations.
Journal Article
Representation of Ecological Systems within the Protected Areas Network of the Continental United States
If conservation of biodiversity is the goal, then the protected areas network of the continental US may be one of our best conservation tools for safeguarding ecological systems (i.e., vegetation communities). We evaluated representation of ecological systems in the current protected areas network and found insufficient representation at three vegetation community levels within lower elevations and moderate to high productivity soils. We used national-level data for ecological systems and a protected areas database to explore alternative ways we might be able to increase representation of ecological systems within the continental US. By following one or more of these alternatives it may be possible to increase the representation of ecological systems in the protected areas network both quantitatively (from 10% up to 39%) and geographically and come closer to meeting the suggested Convention on Biological Diversity target of 17% for terrestrial areas. We used the Landscape Conservation Cooperative framework for regional analysis and found that increased conservation on some private and public lands may be important to the conservation of ecological systems in Western US, while increased public-private partnerships may be important in the conservation of ecological systems in Eastern US. We have not assessed the pros and cons of following the national or regional alternatives, but rather present them as possibilities that may be considered and evaluated as decisions are made to increase the representation of ecological systems in the protected areas network across their range of ecological, geographical, and geophysical occurrence in the continental US into the future.
Journal Article
Mortality and costs associated with acute kidney injury following major elective, non-cardiac surgery
This study evaluated postoperative AKI severity and its relation to short- and long-term patient outcomes.
A retrospective, single-center cohort study of patients undergoing surgery from January 2015 to May 2020.
An urban, academic medical center.
Adult patients undergoing elective, non-cardiac surgery at our institution with a postoperative length of stay (LOS) of at least 24 h were included. Patients were included in 1-year mortality analysis if their procedure occurred prior to June 2019.
None.
Postoperative AKI was identified and staged using the Kidney Disease Improving Global Outcomes definitions. The outcomes analyzed were in-hospital mortality, LOS, total cost of the surgical hospitalization, and 1-year mortality.
Of the 8887 patients studied, 648 (7.3%) had postoperative AKI. AKI was associated with severity-dependent increases in all outcomes studied. Patients with AKI had rates of in-hospital mortality of 2.0%, 3.8%, and 12.5% for stage 1, 2, and 3 AKI compared to 0.3% for patients without AKI. Mean total costs of the surgical hospitalization were $23,896 (SD $23,736) for patients without AKI compared to $33,042 (SD $27,115), $39,133 (SD $34,006), and $73,216 ($82,290) for patients with stage 1, 2, and 3 AKI, respectively. In the 6729 patients who met inclusion for 1-year mortality analysis, AKI was also associated with 1-year mortality rates of 13.9%, 19.4%, and 22.7% compared to 5.2% for patients without AKI. In multivariate models, stage 1 AKI patients still had a higher probability of 1-year mortality (OR 1.9, 95% CI 1.3–2.6, p < 0.001) in addition to $4391 of additional costs when compared to patients without AKI (95% CI $2498–$6285, p < 0.001).
All stages of postoperative AKI were associated with increased LOS, surgical hospitalization costs, in-hospital mortality, and 1-year mortality. These findings suggest that patients with even a low-grade or stage 1 AKI are at higher risk for short- and long-term complications.
•Any stage of postoperative Acute Kidney Injury (AKI) is associated with increased length of stay and costs.•Minor, low-stage postoperative AKI is associated with higher risk of 1-year mortality after surgery.•Any severity of insult to the function of the renal system may play a significant role in patient outcomes.
Journal Article
By the Numbers: How is Recovery Defined by the US Endangered Species Act?
Nearly 40 years after passage of the US Endangered Species Act, the prospects for listed species remain dim because they are too severely imperiled by the time they receive the act's protection. Even if threats are abated, the low abundances required for recovery often preclude a high probability of persistence. The lack of sufficient data for setting recovery objectives also remains a barrier. Delisting is considered possible for only 74% of the 1173 species with recovery plans—92% of threatened and 69% of endangered species. The median number of populations required for delisting (8) was at or below the historical numbers for 64% and at or below the numbers at listing for 37% of the species. The median number of individuals required for recovery (2400) exceeded the abundances at listing for 93% of the species, but most were below the levels considered necessary for long-term persistence, especially in changing environments.
Journal Article
Counselling for post-traumatic stress disorder
This book addresses the specifics of counselling clients who have suffered major trauma, whether recently or in the past, and includes 18 detailed case examples together with transcripts of sessions. It is unique in covering the diagnosis and treatment of the full spectrum of post-traumatic states. This fully updated Third Edition includes the needs of special populations: children/adolescents, refugees and those in pain are also addressed. Additional material includes a new PTSD screening inventory and a counselling competence scale.
eBook
Pilot of rapid implementation of the advanced practice provider in the workflow of an existing tele-critical care program
Incorporating the advanced practice provider (APP) in the delivery of tele critical care medicine (teleCCM) addresses the critical care provider shortage. However, the current literature lacks details of potential workflows, deployment difficulties and implementation outcomes while suggesting that expanding teleCCM service may be difficult. Here, we demonstrate the implementation of a telemedicine APP (eAPP) pilot service within an existing teleCCM program with the objective of determining the feasibility and ease of deployment. The goal is to augment an existing tele-ICU system with a balanced APP service to assess the feasibility and potential impact on the ICU performance in several hospitals affiliated within a large academic center. A REDCap survey was used to assess eAPP workflows, expediency of interventions, duration of tasks, and types of assignments within different service locations. Between 02/01/2021 and 08/31/2021, 204 interventions (across 133 12-h shift) were recorded by eAPP (n
routine
= 109 (53.4%); n
urgent
= 82 (40.2%); n
emergent
= 13 (6.4%). The average task duration was 10.9 ± 6.22 min, but there was a significant difference based on the expediency of the task (F [2; 202] = 3.89;
p
< 0.022) and type of tasks (F [7; 220] = 6.69;
p
< 0.001). Furthermore, the eAPP task type and expediency varied depending upon the unit engaged and timeframe since implementation. The eAPP interventions were effectively communicated with bedside staff with only 0.5% of suggestions rejected. Only in 2% cases did the eAPP report distress. In summary, the eAPP can be rapidly deployed in existing teleCCM settings, providing adaptable and valuable care that addresses the specific needs of different ICUs while simultaneously enhancing the delivery of ICU care. Further studies are needed to quantify the input more robustly.
Journal Article
Treating medically unexplained symptoms via improving access to psychological therapy (IAPT): major limitations identified
Background
Improving Access to Psychological Therapies is a UK Government funded initiative to widen access to psychological treatment for a range of common mental health complaints, such as depression and anxiety. More recently, the service has begun to treat patients with medically unexplained symptoms. This paper reports on a review of treatment protocols and early treatment data for medically unexplained symptoms, specifically the illness myalgic encephalomyelitis/chronic fatigue syndrome.
Main text
A series of seven core problems and failings are identified, including an unproven treatment rationale, a weak and contested evidence-base, biases in treatment promotion, exaggeration of recovery claims, under-reporting of drop-out rates, and a significant risk of misdiagnosis and inappropriate treatment.
Conclusions
There is a pressing need for independent oversight of this service, specifically evaluation of service performance and methods used to collect and report treatment outcomes. This service offers uniform psycho-behavioural therapy that may not meet the needs of many patients with medically unexplained health complaints. Psychotherapy should not become a default when patients’ physical symptoms remain unexplained, and patients should be fully informed of the rationale behind psychotherapy, before agreeing to take part. Patients who reject psychotherapy or do not meet selection criteria should be offered appropriate medical and psychological support.
Journal Article