In our survey, prolonged mechanical ventilation followed by difficult weaning were frequent indications for PDT. This result was in line with previous surveys and reports in the literature. Tracheostomy in the ICU was typically indicated when patients were unlikely to undergo success- ful extubation . In this case, the risk of tracheostomy outweighed the risk of prolonged translaryngeal intub- ation . The most frequent timing of PDT insertion in this international survey was reported as 7–15 days; this is in line with previous national surveys [5–12]. Recent trials did not report any improvement in mortality after 30 days comparing early (<4 days) and late (>10 days) tracheostomy  or onset of pneumonia with the cutoff between early Table 2 Procedural features of percutaneous dilatational tracheostomy performed in the intensive care unit (Continued)
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number of respondents (≤50) were recruited from each country. It should also be noted that the survey did not include respondents from Australia and New Zealand, countries where home therapies are most common. Data from a larger, more comprehensive group of ne- phrologists, along with appropriate statistical analysis, would help further elucidate worldwide practices and preferences in dialysis treatment. Finally, the process of recruiting survey respondents may have itself biased the study population in some way, perhaps recruiting only the most enthusiastic professionals. Therefore, survey re- sults may not fully portray the full spectrum of ne- phrologists’ attitudes. Of note, in another international survey comprising 544 respondents, physician atti- tudes toward the evidence for high-dose HD differed significantly between those who typically had patients on high-dose HD and conventional ICHD providers . High-dose HD providers were significantly more likely to agree with statements that such regimens im- prove quality of life, improve nutritional status, reduce erythropoietin requirements and are cost effective com- pared with ICHD providers .
U21HSG developed an extensive survey to explore how social media is being used in health science education as well as educators’ and students’ opinions on it. The survey was trialled with students and faculty members within U21HSG first. Based on the feedback, we modified the survey and then distributed it subsequently in a more widespread approach. The results from the original trial were not included in our final analysis. The survey was first distributed among the members of the group as a trial. Feedback was received from the group, and the survey was modified accordingly before distribution. Prior to the distribution of the survey, an ethical approval was sought and granted from all 8 institutions. The Web-based survey was hosted using the FluidSurveys (SurveyMonkey) platform and was distributed among health science educators and students in the following 8 universities: Fudan University (China), Tecnologico de Monterrey (Mexico), University College Dublin (Ireland), University of British Columbia (Canada), University of Nottingham (United Kingdom), University of Birmingham (United Kingdom), Hong Kong University (Hong Kong), and the University of Melbourne (Australia). Responses to the survey were anonymous and were received between April and October 2014.
Demographers are revealed by this survey to be a fairly interdisciplinary group of social scientists. Using, as before, the six broad categories of discipline (see footnote 2), the average number of subjects in which respondents have been trained is 2.3, and the average number practised is the same. Nearly three quarters of respondents (73.8%) are trained in two or more disciplines, and just over a third (34.4%) are trained in three or more. This reflects partly the fact that population science is rarely available as a major subject of study at first degree level, but is more often studied at postgraduate level, so most demographers will have studied at least one other subject before taking up demography. There is much diversity in practice also – 70.0% practise two or more disciplines, and 37.6% three or more. The question asked about subjects studied does not allow us to establish the order in which disciplines were studied. Of those with demographic training, the average number of subjects studied is 2.68 and of those without, 1.5. Just over two fifths (41.6%) of respondents say they moved to demography from another discipline. A fifth (19.5%) describe themselves as always having practised demography and slightly more (23.2%) say that they have always combined demography with another discipline.
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Abstract. Container terminals require continuous benchmarking of competitiveness factors. This paper discusses factors of competitiveness with a main focus on feeder and mixed terminals (in which both feeder and transshipment services are provided). Method statement includes an economic literature review with respect to competitiveness factors and a container port expert survey process to achieve a list of most important factors among global container port operators. Experts were selected from different countries and private container terminals. A questionnaire was developed and sent online to them. Questions required both a ranking of factors as well as assigning monetary values to critical variables. Responses were analyzed using a pre-established strategy. Overall, experts ranked first the role of market related competitiveness factors related to service quality, price level and adaptability to the changing market environment. Intermodal links and general hinterland connections factors were more often mentioned than factors relating to nautical accessibility or other factors. Both assignment of monetary values as well as ranking have produced mutually coherent results. The paper does not claim to be definitive; it aims to provide an update of competitive factors hierarchy and highlights issues for further port development.
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Abstract: Simulation is rapidly penetrating the terrain of health care education and has gained growing acceptance as an educational method and patient safety tool. Despite this, the state of simulation in health care education has not yet been evaluated on a global scale. In this project, we studied the global status of simulation in health care education by determining the degree of financial support, infrastructure, manpower, information technology capabilities, engagement of groups of learners, and research and scholarly activities, as well as the barriers, strengths, opportunities for growth, and other aspects of simulation in health care education. We utilized a two-stage process, including an online survey and a site visit that included interviews and debriefings. Forty-two simulation centers worldwide participated in this study, the results of which show that despite enormous interest and enthusiasm in the health care community, use of simulation in health care education is limited to specific areas and is not a budgeted item in many institutions. Absence of a sustainable business model, as well as sufficient financial support in terms of budget, infrastructure, manpower, research, and scholarly activities, slows down the movement of simulation. Specific recommendations are made based on current find- ings to support simulation in the next developmental stages.
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We conducted a multi-center, cross sectional, self-admi- nistered survey of adult ICUs in Denmark, Germany, Greece, Italy, Norway, Switzerland, the Netherlands and the United Kingdom (UK). These countries represent three of the four European sub-regions: Northern, Wes- tern, and Southern Europe. Our sample frame com- prised all ICUs providing mechanical ventilation to critically ill adults in Denmark, Norway, Switzerland, the UK, and the Netherlands identified through existing intensive care networks. For example, ICUs in the UK were identified using the 2008 Directory of Critical Care . Telephone contact was made to confirm that the ICU met inclusion criteria and to obtain nurse manager contact details. In Germany, Greece, and Italy we were unable to identify a reliable comprehensive list of all adult ICUs. Therefore nurse managers were recruited from existing personal e-mail lists within regions of a country (Attica in Greece and the Piedmont and Valle D’Aosta Regions in Italy) and nationally via advertise- ments in local journals and websites.
Our survey shows evidence of weak communication among anaesthetists involved in laparoscopic liver resection (LLR), varied perceptions of the intensity of postoperative pain following LLR, and variety in the postoperative analgesia techniques used, which, among other factors, contributes to differences in the length of hospital stay. It also shows a need for: 1) audits and 2) randomised controlled trials and improvements in communication and information exchange among centres regarding postoperative analgesia in LLR. Our contact database can become a platform for a website where anaesthetists can share their experiences.
Background: The teaching of the sensitive ex- aminations—i.e. that of the female breast, fe- male pelvis, female and male rectum and male genitalia—is a challenging part of the under- graduate curriculum. There are no studies to date detailing how national and international medical schools teach all of these examinations. Purposes: This research sought to document the teaching strategies used by national and in- ternational medical schools regarding the sen- sitive examinations. Methods: The sensitive exa- minations surveyed are the: 1) Female breast; 2) Female pelvis; 3) Male genitalia; 4) Female and male rectum. The term “female sensitive exa- minations” is used to refer to female breast and female pelvis examinations. This was a ques- tionnaire study, which polled national New Zea- land medical schools as well as international medical schools. Questions included: a) sensi- tive examination teaching method; b) stress re- duction strategies; c) perceived graduating stu- dent confidence. Results: A total of 104 medical schools participated in this survey in 2010. Ar- tificial manikin usage was the most common technique utilized for each sensitive examina- tion (60% of all schools, 95% CI 55% - 65%), whe- ther as the sole teaching method or in combina- tion with other methods. The next most common technique was teaching associates (49% of schools, 95% CI 44% - 54%). The female breast and pelvis sensitive examinations used the
decision to decannulate a tracheostomized patient. Second, there is significant variability in clinicians' decannulation opin- ions. Third, clinicians are able to define decannulation failure and identify what they believe are acceptable rates of failure. Clinicians are able to identify patient factors that they believe are important in the decision to decannulate a tracheos- tomized patient. However, there is significant variability in clini- cians' opinions. For example, decannulation recommendations varied between physicians and respiratory therapists as well as between clinicians who worked at acute facilities and those who worked at chronic care facilities. Our results are consist- ent with a growing body of scientific literature suggesting that factors idiosyncratic to health care providers are major deter- minants of the medical decisions and care that patients receive . Tracheostomy care, therefore, is likely to vary sig- nificantly depending on the individual clinician responsible for a patient's care. Our findings highlight the need for clinical studies in tracheostomy care to guide clinical decision-mak- ing. Clinicians indicated in our survey that, in determining whether to decannulate a tracheostomized patient, the patient's level of consciousness, ability to tolerate tracheostomy capping, cough effectiveness, secretions, and oxygenation needed to be evaluated. Although the ability to tolerate tracheostomy capping was judged to be an important determinant of tracheostomy decannulation, it did not influ- ence clinicians' recommendations in the clinical scenarios. Previous studies and guidelines have also suggested that max- imal expiratory pressure, peak cough flows, arterial blood gases, and upper airway endoscopy may be useful in the decannulation decision-making process, although these fac- tors require special equipment and expertise and are more complicated than the simple bedside criteria employed in our study [15-17]. We propose that a patient's level of conscious- ness, cough effectiveness, secretions, and oxygenation be tested in a clinical trial as four simple bedside factors to con- sider in determining whether to decannulate a tracheos- tomized patient.
A total of 12,094 women aged 15–49 years were sampled for this study, with all study analyses conducted on weighted sample data. Weighting was based on population data obtained from the World Bank, and from the 2006–2008 National Survey on Family Growth (USA), the 2006 Bayer Market Seg- mentation Study (France), the 2007 German Federal Ministry for Health Survey (Germany), and data from the Brazilian Ministry of Health (Brazil). In addition, samples from each country were designed to contain a minimum of 40% of women aged 15–34 years with the aim of gaining robust data from those with the greatest need for contraception. The lower limit was selected because women ,15 years of age are less likely to be engaged in sexual activity compared with those $15 years of age; the upper limit reflects the decline in fertility that occurs as women age. 7 In addition,
RESULTS Demographics. A total of 86 participants completed the survey, yielding a participation rate of 80%. There were 45 in residency training (median 4.6 years [interquartile range (IQR) 1–12] since graduation from medical school) and 41 board-certified neurologists (for a median of 5.5 years [IQR 1–15]). The participants originated from the European Union or the European Economic Area (EEA) (n 5 49; countries: Bulgaria, Croatia, Denmark, Estonia, Germany, Greece, Hungary, Italy, Lithuania, Macedonia, Poland, Portugal, Romania, Slovenia, Spain, Turkey, United Kingdom) and Eastern Europe (n 5 30; countries: Armenia, Azerbaijan, Belarus, Bosnia and Herzegovina, Georgia, Moldova, Russia, Serbia, Ukraine). A minor group consisted of delegates from Africa and the Middle East (n 5 7; Egypt, Iraq, Nigeria, Tunisia). From each country, there were 1 to 4 participants, except for Romania (n 5 10) and Russia (n 5 14). The analysis of country of graduation and current workplace revealed that 95.2% had remained in their home country.
bushwalking trails, river fishing, and four wheel driving whilst offering a range of accommodation options, restaurants, pubs and cafes within the township. Importantly, it is also a base for skiers at Mt Hotham and Dinner Plain and a key milestone on iconic touring routes. As reported later in the findings, according to the visitors’ survey conducted in Harrietville, it is the relaxing and beautiful environment that is attractive to many visitors. As such, visitors to Harrietville comprise a large proportion of ‘habituals’ who come and stay in Harrietville for an annual holiday as well as being a stop-over for ‘lifestyle leaders’ who take part in a wide range of leisure activities such as bush- walking, four-wheel driving, cycling amongst others. The town’s economy is highly reliant on tourism with most of the town’s population, either directly or indirectly, receiving income either through business operations or employment in the accommodation, retail or food and beverage industries. In summary, Harrietville is a special place for visitors and the broader community and while it is a small hamlet, the town occupies a niche position within the local and regional tourism economy. 2. 3 The Harrietville Visitor Survey
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The importance of students’ engagement with their learning has long been known to those working on the enhancement of learning and teaching, but it is only recently that awareness has reached more broadly and affected the public discourse around educational quality. The proposed inclusion of items on engagement in the UK’s National Student Survey will only accelerate this trend. This is a positive step and the Higher Education Academy is proud to have led the way in shifting attention towards institutions’ support and encouragement for student engagement, and away from an emphasis on more passive modes of learning. The UK is not alone in experiencing this shift, as is illustrated by the recent implementation of a national student engagement survey in Ireland. Promoting the value of students’ participation in
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In summary, this global survey of PCPs and respiratory specialists showed high awareness of COPD-management guidelines. These guidelines appear to be widely followed by both PCPs and respiratory physicians with regard to diagnostic practices, including reported use of spirometry and frequent consideration of risk factors, including smoking history, symp- tom presentation, and family history. However, there appears to be less adoption of guidelines when applied to COPD treat- ment choice, with fewer physicians of both types selecting a suggested GOLD global strategy treatment choice in patient scenarios. Further research is needed to better understand the barriers to implementing treatment recommendations and rationale for alternative treatment choices using a tailored approach for different medical specialties. These data can inform physician-education strategies and public health infra- structure relevant to country-specific/local guidelines with the aim to improve COPD disease management and outcomes.
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Richardson (1999) studies a similar model, in which governments set import tariffs (instead of export subsidies) to maximize a convex combination of aggregate surplus and producer surplus. Richardson compares the GATT and pre-GATT regimes. (He does not consider the international cooperation case.) He finds that, when both governments only care about producer surplus, trade liberalization usually induces countries to adopt a tougher merger policy, i.e., to choose a higher number of firms. The intuition is similar to the one in Horn and Levinsohn (2001): under trade liberalization, governments can no longer use import tariffs to keep foreign firms out of the domestic market. Given the Cournot assumption, they therefore have incentives to increase the number of firms so as to give Stackelberg leadership to domestic firms and steal market shares from foreign firms.
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Figure 2 shows the distribution and evolution of aggregate capital inflows over time. Foreign borrowing and financial investments in developing countries have risen from relatively low levels to unprecedented amounts within nearly 40 years, approaching to $750 billion in nominal terms. However, this escalation was not monotonic. Lending driven cross0 border financing, displaying largely similar profile across geographical regions, has increased rather gradually until 1980s. It is depressed throughout this decade because of debt problems and international credit dry0up in some LAC countries (i.e. Latin American debt crisis that started in 1982). Financial integration, capital account liberalization and privatization of the late 1980s have facilitated and accelerated the international investment process that has led net capital flows to escalate. Exceeding aggregate net debt flows from early 1990s onwards, aggregate net equity flows have acted as a lean0against0the0wind in keeping total capital inflows uninhibited from devastating impacts (visible in this figure) of the contagious East Asian financial crisis that started in 1997 and resulted in lingering debt overhangs in most of the regions. 4 Relative to GDP however, the rise is less impressive and regular, given growth of GDP and depreciation of the US dollar against some developing country currencies.
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Ethics approval to undertake a survey of worldwide RA fellowship directors was obtained from the Sunnybrook Health Sciences Center research ethics board. Directors of all RA fellowship programs known to the authors from around the world were asked to complete the survey. Potential participants were identified from the ASRA database for RA fellowships, comprehensive Google searches for international RA fellowship positions (keywords: “regional anesthesia” and “fellowship”), and word-of-mouth referral, starting from those known to the authors. Eligible respondents were required to have a RA fellowship program in place at the time of completion of the survey. Participants were aware that the information they provided would be held individually confidential but that the pooled information would be analyzed and undergo publication.
This international, anonymous, web-based study was devel- oped during the inaugural Stillbirth Summit in October 2011 . The STARS consortium was formed between sev- eral clinicians, academics, researchers, and bereaved parents from Australia, New Zealand, the United Kingdom and the United States of America. This unique partnership allowed bereaved parents to have direct discussions with the con- sortium members regarding common experiences prior to their loss in order to inform the development of the survey. The survey included questions related to established risk factors (e.g. cigarette smoking, perceived changes in fetal movements) as well as questions relating to emer- ging risk factors (e.g. gut instinct that something was wrong during the pregnancy and an increase in fetal ac- tivity in the days immediately prior to the fetal demise). Several questions included in the survey were raised by bereaved parents at the 2011 Stillbirth Summit and have not been previously addressed in large-scale studies.
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Recent research in international macroeconomics attempts to cap- ture these commonly observed features of international prices derived from microfoundations. As Betts and Devereux (2000) note pricing-to-market plays a crucial role in the exchange rate determina- tion and international business cycles. The presence of pricing-to- market limits the role of exchange rate policies to increase or decrease aggregate demand in a certain country. A successful exchange rate policy potentially requires larger shocks to fundamen- tals thereby increasing the volatility of exchange rates. Secondly, an aggregate pricing-to-market means departure from the PPP. Therefore it constrains the comovements of consumption across countries whereas increasing the comovements of output across countries. Incorporation of microfoundations for international price stickiness in the general equilibrium analysis proves to be crucial. However, general equilibrium models are beyond the scope of this survey paper 6 .
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