1,591 research outputs found
A Prospective Cohort Analysis of the Prevalence and Predictive Factors of Delayed Discharge After Laparoscopic Cholecystectomy in Italy: The DeDiLaCo Study
No full textBackground: the concept of early discharge ≤24 hours after laparoscopic cholecystectomy (LC) is still doubted in italy. this prospective multicentre study aims to analyze the prevalence of patients undergoing elective LC who experienced a delayed discharge >24 hours in an extensive Italian national database and identify potential limiting factors of early discharge after LC. methods: this is a prospective observational multicentre study performed from january 1, 2021 to december 31, 2021 by 90 Italian surgical units. results: a total of 4664 patients were included in the study. clinical reasons were found only for 850 patients (37.7%) discharged >24 hours after LC. after excluding patients with nonclinical reasons for delayed discharge >24 hours, 2 groups based on the length of hospitalization were created: the early group (≤24 h; 2414 patients, 73.9%) and the delayed group (>24 h; 850 patients, 26.1%). at the multivariate analysis, ASA III class (P<0.0001), charlson's comorbidity index (P=0.001), history of choledocholithiasis (P=0.03), presence of peritoneal adhesions (P<0.0001), operative time >60 min (P<0.0001), drain placement (P<0.0001), pain (P=0.001), postoperative vomiting (P=0.001) and complications (P<0.0001) were independent predictors of delayed discharge >24 hours. conclusions: the majority of delayed discharges >24 hours after LC in our study were unrelated to the surgery itself. ASA class >II, advanced comorbidity, the presence of peritoneal adhesions, prolonged operative time, and placement of abdominal drainage were intraoperative variables independently associated with failure of early discharge
A Prospective Cohort Analysis of the Prevalence and Predictive Factors of Delayed Discharge After Laparoscopic Cholecystectomy in Italy: The DeDiLaCo Study
No full textBackground: The concept of early discharge ≤24 hours after Laparoscopic Cholecystectomy (LC) is still doubted in Italy. This prospective multicentre study aims to analyze the prevalence of patients undergoing elective LC who experienced a delayed discharge >24 hours in an extensive Italian national database and identify potential limiting factors of early discharge after LC. Methods: This is a prospective observational multicentre study performed from January 1, 2021 to December 31, 2021 by 90 Italian surgical units. Results: A total of 4664 patients were included in the study. Clinical reasons were found only for 850 patients (37.7%) discharged >24 hours after LC. After excluding patients with nonclinical reasons for delayed discharge >24 hours, 2 groups based on the length of hospitalization were created: the Early group (≤24 h; 2414 patients, 73.9%) and the Delayed group (>24 h; 850 patients, 26.1%). At the multivariate analysis, ASA III class ( P <0.0001), Charlson's Comorbidity Index (P=0.001), history of choledocholithiasis (P=0.03), presence of peritoneal adhesions (P<0.0001), operative time >60 min (P<0.0001), drain placement (P<0.0001), pain ( P =0.001), postoperative vomiting (P=0.001) and complications (P<0.0001) were independent predictors of delayed discharge >24 hours. Conclusions: The majority of delayed discharges >24 hours after LC in our study were unrelated to the surgery itself. ASA class >II, advanced comorbidity, the presence of peritoneal adhesions, prolonged operative time, and placement of abdominal drainage were intraoperative variables independently associated with failure of early discharge
Factors influencing delayed discharge after day-surgery laparoscopic cholecystectomy: the DeDiLaCo study protocol
No full textObjective: Laparoscopic cholecystectomy (LC) is the gold standard for most benign gallbladder diseases. Early discharge (<24 hours) has the same outcomes as longer (>24 hours) hospital stay. Nevertheless, the rate of delayed discharge >24 hours range from 4.6% to 37%. The primary endpoint of this Italian nationwide study is to analyze the prevalence of patients undergoing elective LC who experienced a delayed discharge >24 hours and identify potential limiting factors of early discharge. Results from these analyses will be used to select patients who can be safely discharged on the same day after surgery. Secondary endpoints will be to evaluate the patient's quality of life (QoL), assess the direct health costs associated with late discharge, and quantify the patient's involvement in the treatment process. Patients and methods: This prospective, observational study was conducted following a resident-led model and the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) guidelines. All patients were treated according to the local hospital protocol and received routine care as standard therapy. Results: We expected to obtain the enrollment of at least 500 patients based on an assumed difference in discharge delay between the reference and the recruitable population of 6% and the identification of factors related to discharge failure within 24 h. Early discharge after LC leads to advantages both in terms of clinical outcomes and quality of life of the patient, and it is highly effective in terms of health costs and shortening the waiting list. However, clinical reality differs from the results of randomized studies by a complex series of non-objectionable real-world data influencing treatment plans. Therefore, we expected to identify independent predictors and factors of failure of early discharge. Conclusions: Clinical reality often differs from randomized trial results. In Italy, the vast majority of delayed discharges after LC may not be related to surgery and can be prevented both with logistical reorganization and with a readjustment of the trust reimbursement policies
Factors influencing delayed discharge after day-surgery laparoscopic cholecystectomy: the DeDiLaCo study protocol
No full textOBJECTIVE: Laparoscopic cholecystectomy (LC) is the gold standard for most benign gallbladder diseases. Early discharge (<24 hours) has the same outcomes as longer (>24 hours) hospital stay. Nevertheless, the rate of delayed discharge >24 hours range from 4.6% to 37%. The primary endpoint of this Italian nationwide study is to analyze the prevalence of patients undergoing elective LC who experienced a delayed discharge >24 hours and identify potential limiting factors of early discharge. Results from these analyses will be used to select patients who can be safely discharged on the same day after surgery. Secondary endpoints will be to evaluate the patient’s quality of life (QoL), assess the direct health costs associated with late discharge, and quantify the patient’s involvement in the treatment process. PATIENTS AND METHODS: This prospective, observational study was conducted following a resident-led model and the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) guidelines. All patients were treated according to the local hospital protocol and received routine care as standard therapy. RESULTS: We expected to obtain the enrollment of at least 500 patients based on an assumed difference in discharge delay between the reference and the recruitable population of 6% and the identification of factors related to discharge failure within 24 h. Early discharge after LC leads to advantages both in terms of clinical outcomes and quality of life of the patient, and it is highly effective in terms of health costs and shortening the waiting list. However, clinical reality differs from the results of randomized studies by a complex series of non-objectionable real-world data influencing treatment plans. Therefore, we expected to identify independent predictors and factors of failure of early discharge. CONCLUSIONS: Clinical reality often differs from randomized trial results. In Italy, the vast majority of delayed discharges after LC may not be related to surgery and can be prevented both with logistical reorganization and with a readjustment of the trust reimbursement policies
Exploratory talk within collaborative small groups in mathematics
No full textThis report describes one aspect of a wider research study on exploratory talk within collaborative small groups in secondary mathematics lessons. It outlines students’ views of using collaborative activity to learn mathematics. The fuller research study explores the extent to which exploratory talk occurs in collaborative peer groups in secondary mathematics classrooms
Assessment of (computer-supported) collaborative learning
No full textWithin the Computer-Supported Collaborative Learning (CS)CL research community there has been an extensive dialogue on theories and perspectives on learning from collaboration, approaches to scaffold (script) the collaborative process, and most recently research methodology. In contrast, the issue of assessment of collaborative learning has received much less attention. This article discusses how assessment of collaborative learning has been addressed, provides a perspective on what could be assessed, and highlights limitations of current approaches. Since assessment of collaborative learning is a demanding experience for teachers and students alike, they require adequate computer-supported and intelligent tools for monitoring and assessment. A roadmap for the role and application of intelligent tools for assessment of (CS)CL is presented
SemCW: Semantic Collaborative Writing using RST
No full textDuring collaborative writing each author works on a copy of the shared document. These copies are then merged to produce the final document. This asynchronous work is supported by several collaborative writing tools. While these tools are excellent at merging and detecting syntactic conflicts, they are not able to easily recognise semantic inconsistencies. This hinders the coherence of the document because while each individual copy might be well constructed, they may not be after the merge. To address this, we investigate the combination of the Rhetorical Structure Theory with Operational Transformation approach. In this paper, we define a data model, a set of operations to manipulate the RST structures and a set of transformation functions. A validity checker alerts the authors to areas in the text with possible semantic lapses in the merged documents
A narrative-based collaborative writing tool for coherent technical documents
No full textOne important feature of an effective document that makes it easy to read and understand is known as coherence. Technical documents produced collaboratively are often incoherent due to a lack of group consensus and misaligned contributions by the individual authors. However, current document planning techniques and writing tools do not provide explicit support for improving coherence. The goal of this research, therefore, is to develop and evaluate a new technique and tool that helps teams of authors to structure coherent technical documents. The coherence of a document can be attributed to the story (or narrative) it conveys to the reader. If this story is consistent and coherent, the same can be said about the document. A discourse theory such as Rhetorical Structure Theory (RST) that has been developed by linguists helps further to analyse and improve a narrative. RST explains the coherence of a text by virtue of relationships (such as “paragraph A justifies paragraph B”) between parts of the text. This research has combined the ideas from these parallel strands of research to develop a new document planning technique called narrative-based writing. The method involves writing down an explicit précis of the story (called a document narrative or DN) and then analysing it using RST. The DN and RST analysis are then used to structure the eventual document. To extend the usability of narrative-based writing to geographically-dispersed authors, I have designed and implemented a collaborative tool that allows co-authors to edit, analyse and review DNs. The thorough design for the tool uses a combination of three models (conceptual, business process and functional) culminating in a set of functions that enable collaborative narrative-based writing. This dissertation discusses how, in the future, these functions could be incorporated in existing collaborative writing tools. Implementing this tool, albeit in its current prototypic state, has been invaluable in understanding the complexities of modelling and manipulating DNs and RST structures. Initial investigations using the new technique and tool have been positive, encouraging me to continue the research and evaluation in this field
Bullies and victims in a primary classroom: Scaffolding a collaborative community of practice
No full textThis paper is based on a year long research project that examined changes in participation of 31 students in a Year 4/5 classroom, where bullying was occurring. The teacher (first author and researcher) facilitated authentic learning opportunities to make the social practices explicit during weekly class meetings. A socio cultural perspective and an action research process framed this qualitative study. Data sources included school behaviour records, sociograms, semi-structured interviews, teacher observations and students' reflection logs. Rogoff's planes provided the analytical framework to examine how to scaffold a collaborative community of practice. The case studies of two students, Denis and Nathan, provide exemplars of how the teacher scaffolded students' social understandings within small social groups through collaborative leadership opportunities and values education. Results spanning the school year indicated that Nathan, like many of his peers, developed confidence to make new friends and become more assertive. Although Denis took longer to adopt pro-social goals, by the end of the school year, he refrained from bullying Nathan. The significance of this research supports recent findings that a focus on the social dynamics of the classroom can bring about positive change in student behaviour
Experiences of learning through collaborative evaluation from a masters programme in professional education
No full textThis paper presents findings from a collaborative evaluation project within a masters programme in professional education. The project aimed to increase knowledge of research methodologies and methods through authentic learning where participants worked in partnership with the tutor to evaluate the module which they were studying. The project processes, areas of the course evaluated and the data collection methods are outlined. The findings focus on key themes from evaluating the effectiveness of using a collaborative evaluation approach, including: enhanced student engagement; creativity of the collaborative evaluation approach; equality between the tutor and students; and enhanced research skills. Discussion focuses on the outcomes and effectiveness of the project and tutor reflections on adopting a collaborative approach. This paper highlights lessons from the project relevant to those interested in staff-student partnership approaches and those facilitating postgraduate learning and teaching programmes and educational research courses
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