29 research outputs found
Университетское образование в Нидерландах: состояние изученности проблемы в отечественной науке
No full textЗдійснено аналіз стану дослідження розвитку університетської освіти у Нідерландах у вітчизняній педагогічній науці, виокремлено невисвітлені раніше аспекти проблеми та окреслено завдання дослідницького пошуку в означеному напрямку. Охарактеризовано наукові праці українських вчених, які розглядають проблему розвитку університетської освіти Нідерландів у контексті вивчення вищої освіти країн Західної Європи.The article is devoted to the analysis of the research state of the Netherlands university education development in Ukrainian pedagogical science. The aspects of the problem that had not been studied previously are highlighted in the article. The tasks for research in this field are outlined. The author characterizes research of Ukrainian scientists who consider the problem of the Netherlands university education development in the context of Western Europe Higher Education Study.
The scientific works of such Ukrainian researchers are analyzed in the article: A. Rzhevska (“Western Europe university education development”), O. Meshchaninov (“Modern models of university education in Ukraine: theory and practice”), H. Poberezska (“The trends of higher education development in Western Europe and Ukraine”), S. Sysoieva and T. Krystopchuk (“Educational systems of European Union countries: general characteristics”).
The author concludes that there is no scientific research directly devoted to the Netherlands higher education development in Ukrainian pedagogical science. The majority of scientists covering the Netherlands in their studies research only some aspects of education in this country, but there is no thesis based on the analysis of the formation and development of the Netherlands modern university education in the Ukrainian pedagogical heritage. Considering the absence of such research relevance of Ukrainian higher education modernization based on the developed European countries experience author proves the advisability of carrying out the systematic analysis of the Netherlands university education development.Посвящено анализу состояния изученности развития университетского образования в Нидерландах в отечественной науке, выделены аспекты проблемы которые раньше не изучались, а также определены задания исследовательского поиска в обозначенном направлении. Охарактеризованы научные работы украинских ученых, которые рассматривают проблему развития университетского образования Нидерландов в контексте изучения высшего образования стран Западной Европы
Modeling of assessment of reliability transport systems
No full textThis article presents results of a study based on the analysis of the development of the theory of reliability whose indicators are formulated indicators of transport systems reliability and contributed to building a system of factors determining their reliability. It is established that the formation of the theory of reliability of transport systems today is not completed. Based on the specifics of the systems, new reliability indicators were proposed and substantiated such as emergency downtime and reliability of emergency downtime. On the basis of the performed studies, it was found that the specifics of the transport process require the introduction of emergency downtime close to the recovery time and the reliability of emergency downtime. It is necessary to introduce two close parameters such as the average recovery time and the average emergency idle time. They are associated with the need to distinguish between the idle time of a technological system, or a separate element when a failure occurs, and the idle time that is needed. For the technological links of the transport system, the main purpose of which is to ensure efficient operation transport process, the probability of emergency downtime can serve as a criterion for assessing their reliability
Epidemiology and Burden of Ventilator-Associated Pneumonia among Adult Intensive Care Unit Patients: A Portuguese, Multicenter, Retrospective Study (eVAP-PT Study)
No full textVentilator-associated pneumonia (VAP) is a prevailing nosocomial infection in critically ill patients requiring invasive mechanical ventilation (iMV). The impact of VAP is profound, adversely affecting patient outcomes and placing a significant burden on healthcare resources. This study assessed for the first time the contemporary VAP epidemiology in Portugal and its burden on the healthcare system and clinical outcomes. Additionally, resource consumption (duration of iMV, intensive care unit (ICU), hospital length of stay (LOS)) and empirical antimicrobial therapy were also evaluated. This multicenter, retrospective study included patients admitted to the hospital between July 2016 and December 2017 in a participating ICU, who underwent iMV for at least 48 h. Patients with a VAP diagnosis were segregated for further analysis (n = 197). Control patients, ventilated for >48 h but without a VAP diagnosis, were also included in a 1:1 ratio. Cumulative VAP incidence was computed. All-cause mortality was assessed at 28, 90, and 365 days after ICU admission. Cumulative VAP incidence was 9.2% (95% CI 8.0-10.5). The all-cause mortality rate in VAP patients was 24.9%, 34.0%, and 40.6%, respectively, and these values were similar to those observed in patients without VAP diagnosis. Further, patients with VAP had significantly longer ICU (27.5 vs. 11.0 days, p 48 h developing VAP, leading to increased resource consumption (longer ICU and hospital LOS). An unexpectedly high incidence of inappropriate, empirical antimicrobial therapy was also noted, being positively associated with a higher mortality risk of these patients. Knowledge of the Portuguese epidemiology characterization of VAP and its multidimensional impact is essential for efficient treatment and optimized long-term health outcomes of these patientsinfo:eu-repo/semantics/publishedVersio
a prospective cohort study
No full textFunding Information: The members of VIP1 and VIP2 study groups are listed in Additional file 1 and are listed in their individual PubMed records. Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.Background: The Clinical Frailty Scale (CFS) is frequently used to measure frailty in critically ill adults. There is wide variation in the approach to analysing the relationship between the CFS score and mortality after admission to the ICU. This study aimed to evaluate the influence of modelling approach on the association between the CFS score and short-term mortality and quantify the prognostic value of frailty in this context. Methods: We analysed data from two multicentre prospective cohort studies which enrolled intensive care unit patients ≥ 80 years old in 26 countries. The primary outcome was mortality within 30-days from admission to the ICU. Logistic regression models for both ICU and 30-day mortality included the CFS score as either a categorical, continuous or dichotomous variable and were adjusted for patient’s age, sex, reason for admission to the ICU, and admission Sequential Organ Failure Assessment score. Results: The median age in the sample of 7487 consecutive patients was 84 years (IQR 81–87). The highest fraction of new prognostic information from frailty in the context of 30-day mortality was observed when the CFS score was treated as either a categorical variable using all original levels of frailty or a nonlinear continuous variable and was equal to 9% using these modelling approaches (p < 0.001). The relationship between the CFS score and mortality was nonlinear (p < 0.01). Conclusion: Knowledge about a patient’s frailty status adds a substantial amount of new prognostic information at the moment of admission to the ICU. Arbitrary simplification of the CFS score into fewer groups than originally intended leads to a loss of information and should be avoided. Trial registration NCT03134807 (VIP1), NCT03370692 (VIP2)publishersversionpublishe
QUALITY ASSURANCE IN HIGHER EDUCATION: EUROPEAN AND DOMESTIC EXPERIENCE
No full textProblem setting. Higher education is the most important component of national capital. It helps to overcome social conflicts that exist in modern society. In this regard, the priority development of higher education is considered in the countries of the world as a driving force of social progress.
Recent research and publications analysis. The study of the problem of ensuring the quality of higher education belongs to the sphere of scientific interests of both Ukrainian and foreign scientists. Among modern domestic researchers dealing with theoretical and methodological issues of higher quality assurance, such scientists as N. Batechko, O. Zhornova, S. Karpenchuk, T. Krystopchuk, V. Moroz, T. Dobko, I. Zolotaryova, S. Kalashnikova, V. Kovtunets, S. Kurbatov, I. Linyova, V. Lugovoi, I. Prokhor, N. Sydorenko, I. Stankevich, I. Sikorska, Zh. Talanova, M. Trebin, T. Finikov, S. Sharov and others. A significant contribution to the theoretical development of higher quality assurance problems was also made by foreign scientists ‑ K. Argyris, G. Becker, J. Brennan, R. Brown, L. Brockerhoff, R. Williams, A. Helmke, G. Papadopoulos, E. Sallis, R. Harris, S. Harris-Hemmert, D. Schön, and others. Despite the fact that the understanding of various problems of ensuring higher quality has been widely reflected in the scientific literature, a number of issues that need to be constantly considered remain debatable.
Paper objective. The purpose of the article is to study the essence of the concept of “higher education quality” in the modern socio-philosophical discourse; consideration of methodological approaches to the analysis of this phenomenon; identification of the main factors that determine the effectiveness of the higher education quality assurance system.
Paper main body. Ensuring the quality of higher education is currently an extremely acute issue for many countries. This is primarily related to the transition from elite to mass higher education, the active introduction of modern distance learning information technologies into the educational process, the need to ensure the competitiveness of graduates of higher education institutions in the conditions of a globalized labor market and academic mobility, etc. In Ukraine, the problem of ensuring the quality of higher education is gaining particular importance. This is evidenced by state programs for the development of higher education, including the Law “On Higher Education”, in which for the first time a separate section dedicated to the problems of ensuring the quality of higher education appears.
Three quality models of higher education are known in the world, namely: 1. “English”, based on the internal self-assessment of the academic community. The formation of such a mechanism for assessing the quality of education is connected with the significant autonomy of educational institutions in Great Britain and the decentralization of education management. In this country, there is a multi-level system of accreditation of universities and educational programs. This model of education quality assessment also prevails in Australia, and a new approach to the accreditation of educational programs has been introduced. The accreditation procedure includes, along with internal evaluations and quality guarantees, external criteria and recommendations from industrial enterprises; 2. The “French” model provides for an external evaluation of higher education institutions to determine their responsibility to society; 3. The “American” model, which is actually being implemented in Ukraine today, is an organic combination of the two mentioned, which gives it significant advantages and wide opportunities in its application, as it provides for both public and state forms of control of the achieved results.
The implementation of European standards and recommendations for ensuring the quality of higher education is implemented in the activities of higher education institutions of Ukraine. Art. 16 Chap. V of the Law of Ukraine “On Higher Education” defines the structure of the higher education quality assurance system. It is noted that the quality assurance system of higher education in Ukraine consists of: 1) systems of ensuring the quality of educational activities and the quality of higher education by institutions of higher education (system of internal quality assurance); 2) systems of external assurance of the quality of educational activities of institutions of higher education and the quality of higher education; 3) systems of quality assurance of activities of the National Agency for Quality Assurance of Higher Education and independent institutions of assessment and quality assurance of higher education.
Conclusions of the research. The system of higher education of Ukraine must follow the path of mutual approximation of its own achievements and the latest European experience in the issue of ensuring the quality of higher education in modern conditions of social development. This will contribute to the growth of the competitiveness of graduates of Ukrainian higher education institutions, the full entry of higher education institutions of Ukraine into the European area of higher education
Epidemiology of intra-abdominal infection and sepsis in critically ill patients: "AbSeS", a multinational observational cohort study and ESICM Trials Group Project
No full textPurposeTo describe the epidemiology of intra-abdominal infection in an international cohort of ICU patients according to a new system that classifies cases according to setting of infection acquisition (community-acquired, early onset hospital-acquired, and late-onset hospital-acquired), anatomical disruption (absent or present with localized or diffuse peritonitis), and severity of disease expression (infection, sepsis, and septic shock).MethodsWe performed a multicenter (n=309), observational, epidemiological study including adult ICU patients diagnosed with intra-abdominal infection. Risk factors for mortality were assessed by logistic regression analysis.ResultsThe cohort included 2621 patients. Setting of infection acquisition was community-acquired in 31.6%, early onset hospital-acquired in 25%, and late-onset hospital-acquired in 43.4% of patients. Overall prevalence of antimicrobial resistance was 26.3% and difficult-to-treat resistant Gram-negative bacteria 4.3%, with great variation according to geographic region. No difference in prevalence of antimicrobial resistance was observed according to setting of infection acquisition. Overall mortality was 29.1%. Independent risk factors for mortality included late-onset hospital-acquired infection, diffuse peritonitis, sepsis, septic shock, older age, malnutrition, liver failure, congestive heart failure, antimicrobial resistance (either methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, extended-spectrum beta-lactamase-producing Gram-negative bacteria, or carbapenem-resistant Gram-negative bacteria) and source control failure evidenced by either the need for surgical revision or persistent inflammation.ConclusionThis multinational, heterogeneous cohort of ICU patients with intra-abdominal infection revealed that setting of infection acquisition, anatomical disruption, and severity of disease expression are disease-specific phenotypic characteristics associated with outcome, irrespective of the type of infection. Antimicrobial resistance is equally common in community-acquired as in hospital-acquired infection
Use of failure-to-rescue to identify international variation in postoperative care in low-, middle- and high-income countries: A 7-day cohort study of elective surgery
No full textThe incidence and impact of postoperative complications are poorly described. Failure-to-rescue, the rate of death following complications, is an important quality measure for perioperative care but has not been investigated across multiple health care systems. Methods. We analysed data collected during the International Surgical Outcomes Study, an international 7-day cohort study of adults undergoing elective inpatient surgery. Hospitals were ranked by quintiles according to surgical procedural volume (Q1 lowest to Q5 highest). For each quintile we assessed in-hospital complications rates, mortality, and failure-to-rescue. We repeated this analysis ranking hospitals by risk-adjusted complication rates (Q1 lowest to Q5 highest). Results. A total of 44 814 patients from 474 hospitals in 27 low-, middle-, and high-income countries were available for analysis. Of these, 7508 (17%) developed one or more postoperative complication, with 207 deaths in hospital (0.5%), giving an overall failure-to-rescue rate of 2.8%. When hospitals were ranked in quintiles by procedural volume, we identified a threefold variation in mortality (Q1: 0.6% vs Q5: 0.2%) and a two-fold variation in failure-to-rescue (Q1: 3.6% vs Q5: 1.7%). Ranking hospitals in quintiles by risk-adjusted complication rate further confirmed the presence of important variations in failureto- rescue, indicating differences between hospitals in the risk of death among patients after they develop complications. Conclusions. Comparison of failure-to-rescue rates across health care systems suggests the presence of preventable postoperative deaths. Using such metrics, developing nations could benefit from a data-driven approach to quality improvement, which has proved effective in high-income countries
Epidemiology of intra-abdominal infection and sepsis in critically ill patients: “AbSeS”, a multinational observational cohort study and ESICM Trials Group Project
No full textPurpose: To describe the epidemiology of intra-abdominal infection in an international cohort of ICU patients according to a new system that classifies cases according to setting of infection acquisition (community-acquired, early onset hospital-acquired, and late-onset hospital-acquired), anatomical disruption (absent or present with localized or diffuse peritonitis), and severity of disease expression (infection, sepsis, and septic shock). Methods: We performed a multicenter (n = 309), observational, epidemiological study including adult ICU patients diagnosed with intra-abdominal infection. Risk factors for mortality were assessed by logistic regression analysis. Results: The cohort included 2621 patients. Setting of infection acquisition was community-acquired in 31.6%, early onset hospital-acquired in 25%, and late-onset hospital-acquired in 43.4% of patients. Overall prevalence of antimicrobial resistance was 26.3% and difficult-to-treat resistant Gram-negative bacteria 4.3%, with great variation according to geographic region. No difference in prevalence of antimicrobial resistance was observed according to setting of infection acquisition. Overall mortality was 29.1%. Independent risk factors for mortality included late-onset hospital-acquired infection, diffuse peritonitis, sepsis, septic shock, older age, malnutrition, liver failure, congestive heart failure, antimicrobial resistance (either methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, extended-spectrum beta-lactamase-producing Gram-negative bacteria, or carbapenem-resistant Gram-negative bacteria) and source control failure evidenced by either the need for surgical revision or persistent inflammation. Conclusion: This multinational, heterogeneous cohort of ICU patients with intra-abdominal infection revealed that setting of infection acquisition, anatomical disruption, and severity of disease expression are disease-specific phenotypic characteristics associated with outcome, irrespective of the type of infection. Antimicrobial resistance is equally common in community-acquired as in hospital-acquired infection. © 2019, The Author(s)
Antimicrobial Lessons From a Large Observational Cohort on Intra-abdominal Infections in Intensive Care Units
No full textSevere intra-abdominal infection commonly requires intensive care. Mortality is high and is mainly determined by disease-specific characteristics, i.e. setting of infection onset, anatomical barrier disruption, and severity of disease expression. Recent observations revealed that antimicrobial resistance appears equally common in community-acquired and late-onset hospital-acquired infection. This challenges basic principles in anti-infective therapy guidelines, including the paradigm that pathogens involved in community-acquired infection are covered by standard empiric antimicrobial regimens, and second, the concept of nosocomial acquisition as the main driver for resistance involvement. In this study, we report on resistance profiles of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus faecalis and Enterococcus faecium in distinct European geographic regions based on an observational cohort study on intra-abdominal infections in intensive care unit (ICU) patients. Resistance against aminopenicillins, fluoroquinolones, and third-generation cephalosporins in E. coli, K. pneumoniae and P. aeruginosa is problematic, as is carbapenem-resistance in the latter pathogen. For E. coli and K. pneumoniae, resistance is mainly an issue in Central Europe, Eastern and South-East Europe, and Southern Europe, while resistance in P. aeruginosa is additionally problematic in Western Europe. Vancomycin-resistance in E. faecalis is of lesser concern but requires vigilance in E. faecium in Central and Eastern and South-East Europe. In the subcohort of patients with secondary peritonitis presenting with either sepsis or septic shock, the appropriateness of empiric antimicrobial therapy was not associated with mortality. In contrast, failure of source control was strongly associated with mortality. The relevance of these new insights for future recommendations regarding empiric antimicrobial therapy in intra-abdominal infections is discussed
Epidemiology of intra-abdominal infection and sepsis in critically ill patients: “AbSeS”, a multinational observational cohort study and ESICM Trials Group Project
No full textPurpose: To describe the epidemiology of intra-abdominal infection in an international cohort of ICU patients according to a new system that classifies cases according to setting of infection acquisition (community-acquired, early onset hospital-acquired, and late-onset hospital-acquired), anatomical disruption (absent or present with localized or diffuse peritonitis), and severity of disease expression (infection, sepsis, and septic shock). Methods: We performed a multicenter (n = 309), observational, epidemiological study including adult ICU patients diagnosed with intra-abdominal infection. Risk factors for mortality were assessed by logistic regression analysis. Results: The cohort included 2621 patients. Setting of infection acquisition was community-acquired in 31.6%, early onset hospital-acquired in 25%, and late-onset hospital-acquired in 43.4% of patients. Overall prevalence of antimicrobial resistance was 26.3% and difficult-to-treat resistant Gram-negative bacteria 4.3%, with great variation according to geographic region. No difference in prevalence of antimicrobial resistance was observed according to setting of infection acquisition. Overall mortality was 29.1%. Independent risk factors for mortality included late-onset hospital-acquired infection, diffuse peritonitis, sepsis, septic shock, older age, malnutrition, liver failure, congestive heart failure, antimicrobial resistance (either methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, extended-spectrum beta-lactamase-producing Gram-negative bacteria, or carbapenem-resistant Gram-negative bacteria) and source control failure evidenced by either the need for surgical revision or persistent inflammation. Conclusion: This multinational, heterogeneous cohort of ICU patients with intra-abdominal infection revealed that setting of infection acquisition, anatomical disruption, and severity of disease expression are disease-specific phenotypic characteristics associated with outcome, irrespective of the type of infection. Antimicrobial resistance is equally common in community-acquired as in hospital-acquired infection
