4,511 research outputs found
Rates of Anastomotic Complications and Their Management Following Esophagectomy: Results of the Oesophago-Gastric Anastomosis Audit (OGAA)
No full textObjective: This study aimed to characterize rates and management of anastomotic leak (AL) and conduit necrosis (CN) after esophagectomy in an international cohort. Background: Outcomes in patients with anastomotic complications of esophagectomy are currently uncertain. Optimum strategies to manage AL/CN are unknown, and have not been assessed in an international cohort. Methods: This prospective multicenter cohort study included patients undergoing esophagectomy for esophageal cancer between April 2018 and December 2018 (with 90 days of follow-up). The primary outcomes were AL and CN, as defined by the Esophageal Complications Consensus Group. The secondary outcomes included 90-day mortality and successful AL/CN management, defined as patients being alive at 90 day postoperatively, and requiring no further AL/CN treatment. Results: This study included 2247 esophagectomies across 137 hospitals in 41 countries. The AL rate was 14.2% (n = 319) and CN rate was 2.7% (n = 60). The overall 90-day mortality rate for patients with AL was 11.3%, and increased significantly with severity of AL (Type 1: 3.2% vs. Type 2: 13.2% vs. Type 3: 24.7%, P < 0.001); a similar trend was observed for CN. Of the 329 patients with AL/CN, primary management was successful in 69.6% of cases. Subsequent rounds of management lead to an increase in the rate of successful treatment, with cumulative success rates of 85.4% and 88.1% after secondary and tertiary management, respectively. Conclusion: Patient outcomes worsen significantly with increasing AL and CN severity. Reintervention after failed primary anastomotic complication management can be successful, hence surgeons should not be deterred from trying alternative management strategies
An empirical investigation of dance addiction
No full textAlthough recreational dancing is associated with increased physical and psychological well-being, little is known about the harmful effects of excessive dancing. The aim of the present study was to explore the psychopathological factors associated with dance addiction. The sample comprised 447 salsa and ballroom dancers (68% female, mean age: 32.8 years) who danced recreationally at least once a week. The Exercise Addiction Inventory (Terry, Szabo, & Griffiths, 2004) was adapted for dance (Dance Addiction Inventory, DAI). Motivation, general mental health (BSI-GSI, and Mental Health Continuum), borderline personality disorder, eating disorder symptoms, and dance motives were also assessed. Five latent classes were explored based on addiction symptoms with 11% of participants belonging to the most problematic class. DAI was positively associated with psychiatric distress, borderline personality and eating disorder symptoms. Hierarchical linear regression model indicated that Intensity (ß=0.22), borderline (ß=0.08), eating disorder (ß=0.11) symptoms, as well as Escapism (ß=0.47) and Mood Enhancement (ß=0.15) (as motivational factors) together explained 42% of DAI scores. Dance addiction as assessed with the Dance Addiction Inventory is associated with indicators of mild psychopathology and therefore warrants further research
Analysis of causation of loss of communication with marine autonomous systems: a probability tree approach
No full textThe last decade has seen the eagerly anticipated introduction of marine autonomous systems as a pragmatic tool for ocean observation. However, outstanding reliability problems means that these vehicles are not yet fulfilling their true potential. Of the classes of problems, loss of communication with a marine autonomous system is both fundamental and difficult to diagnose. In our view, this is due to two reasons: first in many cases users are not technologists and secondly if a vehicle is lost the task of diagnosing the root cause is subject to epistemic uncertainty that users are often reluctant to quantify in a formal manner. As a result users may accept the first hypothesis considered as the main root cause for loss of communication. We show that this approach can result in an increased unreliability of marine autonomous systems through failure to ascertain and then address the true root causes. Consequently, we propose a probability tree approach to help diagnose root cause(s) for loss of communication with a marine autonomous system (MAS). The model was developed based on the results of two detailed investigations and a body of failure data collected from 205 undersea glider operations
Emotional availability (EA) teleintervention for adoptive families
No full text2012 Fall.Includes bibliographical references.This study evaluated the new online Emotional Availability (EA) Intervention for use with adoptive families in enhancing parent-child EA, parental perceptions of EA, child attachment behaviors, parent-child emotional attachment, and reducing parent-reported child behavioral problems and parenting-related stress. Participants in this study were adoptive parents and their adopted children ages 1.5 - 5 years old (N = 15 dyads). Participants were placed in an immediate intervention group (IG) or a delayed intervention group (DG) that would receive the 6-week EA Intervention after the IG. Results revealed significant differences in the IG in child behavioral problems, parent-child EA, parental perceptions of EA, and parent-child emotional attachment, improvements not seen in the DG. Analysis of effects of the DG after receiving the EA Intervention revealed significant differences over time also in child behavioral problems, parent-child EA, parental perceptions of EA, and parent-child emotional attachment. Implications, limitations, and future directions are discussed
Environmental (waste) compliance control systems for UK SMEs
No full textWhile the ‘environment’ is often perceived as a heavily regulated area of business, in reality, directly-regulated businesses represent a small proportion of the business community. This study aimed to evaluate and outline potential improvements to compliance controls for small and medium-sized enterprises (SMEs), particularly those involved in the waste sector. Forty-four SMEs from England were interviewed/audited between April-September 2008. Using a UK-based system as a case-in-point, the Environment Agency’s (EA) Operational Risk Appraisal (‘Opra’)/Compliance Assessment Report (CAR) system was analysed. Environmental compliance performance indicators and an initial assessment methodology for SMEs were developed. The study showed:• Compliance with permitting legislation was poor in many areas.• Regulatory authorities are either unable/failing to implement their enforcement policies or unable/failing to identify non-compliances due to the infrequency or limited nature of their inspections.• Improvements are needed to the EA Opra/CAR system – control measures are not fully taken into account when calculating risk.Recommendations to improve SME compliance controls include using internationally applicable general and specific compliance and non-compliance performance indicators, re-designing the Opra system and using an initial assessment methodology based on understanding the hazardousness of SME categories, compliance levels and operator competency.<br/
Comparative genomic and transcriptomic analysis revealed genetic characteristics related to solvent formation and xylose utilization in <it>Clostridium acetobutylicum </it>EA 2018
No full textAbstract Background Clostridium acetobutylicum, a gram-positive and spore-forming anaerobe, is a major strain for the fermentative production of acetone, butanol and ethanol. But a previously isolated hyper-butanol producing strain C. acetobutylicum EA 2018 does not produce spores and has greater capability of solvent production, especially for butanol, than the type strain C. acetobutylicum ATCC 824. Results Complete genome of C. acetobutylicum EA 2018 was sequenced using Roche 454 pyrosequencing. Genomic comparison with ATCC 824 identified many variations which may contribute to the hyper-butanol producing characteristics in the EA 2018 strain, including a total of 46 deletion sites and 26 insertion sites. In addition, transcriptomic profiling of gene expression in EA 2018 relative to that of ATCC824 revealed expression-level changes of several key genes related to solvent formation. For example, spo0A and adhEII have higher expression level, and most of the acid formation related genes have lower expression level in EA 2018. Interestingly, the results also showed that the variation in CEA_G2622 (CAC2613 in ATCC 824), a putative transcriptional regulator involved in xylose utilization, might accelerate utilization of substrate xylose. Conclusions Comparative analysis of C. acetobutylicum hyper-butanol producing strain EA 2018 and type strain ATCC 824 at both genomic and transcriptomic levels, for the first time, provides molecular-level understanding of non-sporulation, higher solvent production and enhanced xylose utilization in the mutant EA 2018. The information could be valuable for further genetic modification of C. acetobutylicum for more effective butanol production.</p
Navigating Enterprise Architecture (EA) Institutionalization: The Interplay of EA and Agile
No full textIn the rapidly evolving context of digital transformation, the effective adoption, management, and institutionalization of Enterprise Architecture (EA) have emerged as significant efforts for organizations looking for ways to navigate the complex requirements of modern business environments. This Ph.D. thesis embarks on a comprehensive exploration of different aspects of EA, ranging from its adoption challenges to its interaction with agile transformations. This study's main objective is to shed light on different aspects of EA adoption, management, challenges, and integration within large-scale organizations.
The research questions that form the foundation of this thesis are designed to explore the complex nuances of an EA's journey within an organization. The thesis investigates the role of stakeholders in influencing the perception and institutionalization of EA in order to respond to the first research question. It highlights the complex interactions between different stakeholders and their different interests, showing how these interactions can have a big impact on how successful EA initiatives are. The study goes deeper into the organizational factors that contributed to the failure of EA management initiatives, explaining the significance of legitimacy and showing challenges to achieving normative and cultural-cognitive legitimacy.
The third research question focuses on the topic of delegitimization of established EA practices. The thesis shows the ways through which EA practices can lose momentum and relevance within organizations by examining the complex interplay of regulatory, pragmatic, normative, and cultural-cognitive legitimacy. Building on this foundation, the thesis navigates the cycles of EA's institutionalization, de-institutionalization, and re-institutionalization within the organizational context. This dynamic approach highlights the importance of regaining legitimacy and adapting to modern organizational approaches in order to achieve successful re-institutionalization.
In light of the growing popularity of agile approaches, the thesis investigates the challenges posed by such paradigm shifts to established EA practices. The study outlines the modifications that must be made to EA practices by identifying the main functions that EA must do to support organizational agility. The outcome of this study is a collection of five papers, each of which shows a different part of EA's journey. Together, these contributions enhance the understanding of EA's adoption, management, and integration with agile paradigms, significantly advancing the body of knowledge in this domain.
This Ph.D. thesis gives a comprehensive overview of EA's strategic, operational, and innovative capacity. It shows how stakeholders, organizational dynamics, and an evolving digital environment all work together. This thesis helps organizations looking to use the advantages of EA in their goals of sustainable growth and agility by addressing the research questions and highlighting different aspects of the EA's role.Fulltext not availabl
Video game addiction: past, present and future
No full textGaming addiction has become a topic of increasing research interest. The last decade has witnessed a significant increase in the number of empirical studies examining various aspects of problematic video game play and video game addiction. This paper begins with a brief past history of how research into video game addiction has changed over the last three decades (i.e., the 1980s, 1990s and 2000s). It then examines more thoroughly the contemporary research literature by analyzing the (i) prevalence of problematic video game use and video game addiction, (ii) negative consequences of excessive video game use, (iii) factors associated with problematic video game use and video game addiction, and (iv) the treatment of problematic video game use and video game addiction. The paper concludes by looking at the trends in the field and a somewhat theoretical examination of what the future of video game addiction might be.Mark D. Griffiths, Daria J. Kuss and Daniel L. Kin
Duration of Antimicrobial Therapy in Treating Complicated Intra-Abdominal Infections: A Comprehensive Review
No full textBackground: Surgeons managing intra-abdominal infections should always respect the basic principles of antibiotic treatment. An adequate duration of antimicrobial therapy is important to optimize empiric therapy and minimize selective pressures favoring antimicrobial resistance. Methods: The optimal duration of antibiotic therapy for intra-abdominal infections (IAIs) has been debated in the last years. A literature research, based on PubMed database and limited to English language publications, was performed without restriction of time or type of manuscript. Results: In stable patients a short course of antimicrobial therapy (3-5 d) after adequate source control, depending on fever and leukocytosis, may be a reasonable option. In critically ill patients with severe sepsis and septic shock, an individualized approach is always mandatory and patient's inflammatory response should be monitored regularly. Procalcitonin may be helpful for guiding antibiotic treatment in critically ill surgical patients and in predicting treatment response. Conclusions: General surgeons managing intra-abdominal infections should always respect the basic principles of antibiotic treatment. Duration of antimicrobial treatment is an important variable to evaluate in treating complicated intra-abdominal infections
Emotional availability of adult interpersonal relationships questionnaire (EA-AIRQ): validation and implications for research and practice
No full text2017 Summer.Includes bibliographical references.Emotional Availability (EA) is commonly known as a parent-child construct used to describe the level of healthy emotional connection in the dyadic relationships (Biringen et al., 2014). Stemming from John Bowlby's (Bowlby, 1969) work on attachment, EA provides a gauge to the level of parent's receptiveness to a child's emotional feedback, both positive and negative (Biringen et al., 2014). In addition to relationships between the parent and child, EA conceptually should be applicable to a wide array of relationships. This paper will define the construct of EA and its foundations in attachment theory. It will then focus on the development and validation of a brief EA Adult Interpersonal Relationships Questionnaire (EA-AIRQ). A total of 215 Amazon Mechanical Turk workers were administered this measure (with request for participants to complete the measure for 'friends' and then for 'romantic partners'). Participants also completed the measures of attachment and mental well being. The EA-AIRQ was composited in two ways: 1-unit-weighted, with each item equally weighted (by adding all items), and 2-regression-weighted, that is, from a factor analysis for friends and romantic partners separately with the aim of obtaining a one-factor solution. Correlations between these composites and the other administered measures revealed meaningful patterns. Implications for research and clinical practice are discussed
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