Search

Tracheomegaly is defined as an abnormally dilated trachea and is seen in patients requiring long-standing mechanical ventilation and/or significant hyperinflation of their endotracheal or tracheostomy tube cuffs can occur in adults with severe COVID-19. Tracheomegaly is linked with inadequate nutrition, pneumonia, diabetes, hypotension, steroids, and protracted mechanical ventilation, which are common in COVID-19 patients. Findings include cuff leaks that necessitate cuff overinflation to maintain adequate tidal volumes. Tracheomegaly can be diagnosed with chest radiographs, chest computed tomography, bronchoscopy, or diagnostic laryngoscopy or tracheoscopy. This condition leads to a concern for obstruction, airway collapse, aspiration pneumonia, and iatrogenic tracheal injuries.

This chapter discusses various challenges authors face in navigating the international academic publishing ecosystem from a scholarly communication perspective. The chapter is intended to give readers a better understanding of common topics and issues in publishing so that, as authors, they can make more informed decisions about where and how to publish.

Background There is an increasing prevalence of physical inactivity during childhood, which is associated with a variety of health problems. However, the mechanisms by which acute exercise benefits cognition in childhood remains unknown. Here we describe the protocol for a randomized crossover trial called SNEACY (Sympathetic Nervous System & Exercise Affects Cognition in Youth), a study designed to better understand mechanisms linking acute exercise and cognition in 9–10-year-old healthy, cognitively normal children. Methods Children from the Greater Boston, MA region will be recruited to participate in this single center study. A randomized crossover design will be utilized, such that participants will act as their own controls, through initial randomization to condition assignment and condition counterbalancing across participants. One hundred three children will participate in three randomized acute interventions: moderate intensity treadmill exercise (20 min, 70–75% of their maximal heart rate), seated rest (20 min), and a Trier Social Stress Test for Children (14 min). These visits will occur on 3 three separate days, approximately 5–8 days apart. Before and after each intervention, children complete a variety of cognitive tasks measuring attentional inhibition while their neuroelectric activity is recorded. Variables of interest include EEG data, accuracy and reaction time, academic achievement, and salivary alpha amylase. Academic achievement is also assessed following interventions. In addition, children provide passive drool samples throughout the interventions to measure various biomarkers that may explain the acute exercise benefit on cognition. Discussion The results from this study could influence educational and public health recommendations to enhance cognition and learning in pre-adolescent children. Trial registration ClinicalTrials.gov NCT03592238. Registered on 19 July 2018

Purpose Although the tracheostomy is one of the most frequently performed procedures in the intensive care unit, there is little consensus in the postoperative management. Lack of standardization i...

This article presents the results of a global study on resettlement practice in the mining industry. We examine how international policy commitments are operationalised by the mining sector and how practitioners from across the institutional spectrum engage with planning and implementation efforts by the industry. Interviews were conducted with 52 senior practitioners from mining companies, consultancies, international finance institutions and international non-government organisations. Results confirm knowledge, resourcing, capacity and coordination gaps among each of the institutions. These findings give additional substance to emerging reports about the urgent need to improve performance in this area of practice. The article concludes with a call for further sector-specific research into mining and resettlement.

This article reports on a study of an agricultural region in southeast Queensland, Australia that is undergoing rapid change with development of an extensive coal seam gas industry and some large open cut coal mines. The region has become a locus of land use conflict between various industries: farming, grazing, mining and gas extraction. The effects of these multiple industries on each other, on environmental assets, infrastructure and economic and social systems entail many risks. Infrastructure shortfalls, a two-speed economy, widening social divisions, threatened livelihoods and stress in the face of rapid and far-reaching change associated with a new industry are evident in the words of those experiencing the impacts that provide the data reported in the paper. These problems are shown to be characterised by connectedness, complexity, uncertainty, disputed science, conflict, multiple stakeholders and an associated multiplicity of perspectives and values. The problem-solving and management strategies being adopted are unlikely to satisfactorily resolve the 'wicked' problems associated with this resources boom because they tackle aspects of the problem in a fragmented way, rely on inconclusive 'science', cannot readily incorporate hard to quantify aspects, values and subjective considerations, involve a restricted group of key decision-makers, and are dependent on formal rules and planning. The article proposes characteristics of alternative mechanisms involving adaptive risk management and multi-stakeholder participation. However the authors also caution that most of the barriers identified are not easily overcome.

Artisanal and small-scale mining (ASM) is a critical poverty reduction strategy for millions of people around the world; however, it is notoriously dangerous. While there is an awareness of the dangers associated with ASM activities, with the exception of mercury contamination from artisanal gold mining activities, health and safety risks among artisanal miners, their families, and their communities have not been fully addressed in the scholarly literature or by regulatory institutions in countries where ASM is prevalent. This article applies a participatory action framework and draws from three different but complementary data sources, including a survey administered to ASM scholars and practitioners, data gathered from participants in Australian Government-sponsored short courses at the University of Queensland (UQ), and interactions between scholars from UQ and Mongolian mine inspectors, to demonstrate the growing significance of an integrated research approach to understand the full scope of health and safety risks facing the ASM sector. It also reveals some of the practical challenges to mitigating health and safety risks, specifically capacity building among regulatory agencies who work with limited resources to meet the inspection requirements of both the large- and small-scale mining sectors. This article concludes that research on health and safety issues in the ASM sector must incorporate a more holistic and regional approach with both qualitative and quantitative data collection methodologies.

The Social Water Assessment Protocol (SWAP) is a tool consisting of a series of questions on 14 themes designed to capture the social context of water around a mine site. A pilot study of the SWAP, conducted in Prestea-Huni Valley, Ghana, showed that some communities were concerned about whether the groundwater was potable. The mining company’s concern was that there was a cycle of dependency amongst communities that received treated water from the mining company. The pilot identified potential data sources and stakeholder groups for each theme, and gaps in themes, and suggested refinements to questions to improve the SWAP.

Despite its importance as an economic activity and livelihood strategy in sub-Saharan Africa, artisanal and small-scale mining (ASM) is associated with many negative social, environmental and health impacts, and presents particular sustainable development challenges. Numerous universities, NGOs, associations, companies, and governments are working to resolve the many challenges created by ASM. These challenges include lack of formalization and regulation, poor environmental practices, health and safety risks, child and forced labor, inequitable distribution of benefits, security issues, and conflicts with large-scale mining, among many others. This chapter documents approaches to working with the ASM sector in sub-Saharan Africa to promote economic development, effective governance, protection and rehabilitation of the environment, and health and safety. The study draws primarily on an analysis of work plans focused on ASM developed by officials from developing countries who undertook capacity-building courses sponsored by the Australian Government through its Australia Awards program and the former International Mining for Development Centre. It also draws on interviews with key stakeholders in the ASM sector and is supplemented by a literature review.

A resources boom and the incursion of large scale coal mining and coal seam gas projects has precipitated environmental conflicts and other social struggles in traditionally agricultural communities of the Darling Downs. These relate to control of economic resources, cultural practices and, more generally, regional identity. This paper examines the social space where these struggles are taking place using sociologist Pierre Bourdieu's analytical concepts. Data was collected through interviews and photographs in two local government areas of the region – Toowoomba and Western Downs – using changes to physical landscape as an indicator of changing relationships in social space.With the advent of the new industry, agricultural communities are experiencing the pervasive presence of the resources industry and a systematic loss of control of resources. This prompts a struggle as they try to maintain their traditionally dominant power position.

The trauma service experienced preventable delays caused by an Accreditation Council for Graduate Medical Education work restrictions and a 16% increase in patient census. Furthermore, nurses needed a consistently accessible provider for the coordination of care. We hypothesized that using experienced acute care nurse practitioners (ACNPs) on the stepdown unit would improve throughput and decrease length of stay (LOS) and hospital charges. Moreover, we hypothesized that adding ACNPs would improve staff satisfaction. On December 1, 2011, the Vanderbilt University Medical Center Division of Trauma reassigned ACNPs to the stepdown area 5 days a week for a pilot program.LOS data from December 1, 2011 through December 1, 2012 was compared with data from the same months from the previous two years and estimated hospital charges and patient days were extrapolated. Physician and nursing surveys were performed. Data from 2010 (n = 2,559) and 2011 (n= 2,671) were averaged and the mean LOS for the entire trauma service was 7.2 days. After adding an experienced ACNP, the average LOS decreased to 6.4 days, a 0.8 day reduction. Per patient, there was a $ 9,111.50 savings in hospital charges, for a reduction of $27.8 million dollars in hospital charges over the 12 month pilot program.A confidential survey administered to attending physicians showed that 100% agreed that a nurse practitioner in the stepdown area was beneficial and helped throughput. Dayshift nurses were surveyed, and 100% agreed or strongly agreed that the ACNPs were knowledgeable about the patient's plan of care, experienced in the care of trauma patients, and improved patient care overall.The addition of experienced ACNPs resulted in the decrease of overall trauma service LOS, saving almost $9 million in hospital charges.Economic/decision study, level III.

The human right to water has recently been recognized by both the United Nations General Assembly and the Human Rights Council. As the mining industry interacts with water on multiple levels, it is important that these interactions respect the human right to water. Currently, a disconnect exists between mine site water management practices and the recognition of water from a human rights perspective. It has been argued that the Minerals Council of Australia Water Accounting Framework can be used to strengthen the connection between water management and human rights. This article extends this connection through the use of a Social Water Assessment Protocol (SWAP). The SWAP is a scoping tool consisting of a set of questions classified into taxonomic themes under leading topics with suggested sources of data that enable mine sites to better understand the local water context in which they operate. Three of the themes contained in the SWAP – gender, Indigenous peoples and health – are discussed to demonstrate...

The purpose of this study was to assess the value of research from the perspective of alumni who completed an undergraduate research (UGR) project in family and consumer sciences. The sample included 16 participants from three institutions with similar missions but different structures. The interviewees’ responses were coded by the authors to develop an initial set of descriptors. The text was also coded using Ethnograph version 6.0. The findings revealed many more positive than negative responses in regard to attitudes, research skills, professionalism, value of the project to their current job, relationship with their undergraduate mentor, presentation of the research project, and suggestions for improvement. The most positive responses were in the categories of research skills attributed to the UGR (89%), value of the project to their job (87%), and faculty mentorship (81%). Overall, these findings support the benefits of UGR and the investment of university resources for research projects with faculty members for undergraduate students.

The Health Information Portability and Accountability Act (HIPAA) regulations require that agencies provide authorizations that can be read and understood. Agencies are responsible to comply with this regulation. It is estimated that half of Americans read at an eighth-grade reading level. All institutional review boards (IRBs) listed on the website of the U.S. Department of Health and Human Services were contacted by investigators in this study. Fifty-one IRBs returned HIPAA templates on which readability tests could be completed. Three readability tests were used on all templates, including the Flesch Reading Ease formula, the Dale-Chall formula, and the Fry formula. For the returned templates, the mean of the Dale-Chall readability formula gave a ninth-grade level; the mean scores for the Flesch Reading Ease and Fry formulas were at a high-school reading level or above. The readability scores ranged from sixth-grade to college graduate. This study demonstrates that HIPAA authorization forms are written at too high a level for most of the population. Based on the results of this study and other similar studies, it can be concluded that consumers/patients are currently being asked to read important health-related documents that may be beyond their reading level.

Rapid expansion of the coal seam gas (CSG) sector in Queensland has fuelled debate on the sector's contributions to community sustainability in a rural economy dominated by farming of food and cotton, cattle grazing, coal mining, and a modest level of tourism. For example, will the impacts of CSG extraction on surface and groundwater have sustained negative impacts on the growing of grain, and if so, what should be expected of the CSG industry today? The intensity of debate has been accompanied by an array of operating conditions placed on CSG projects by the state government, extensive media coverage, and a focus on what it takes to maintain a ‘social license to operate’. Such a context is a challenge for resource companies committed to sustainability principles and to contributing to the social, economic and institutional development of the communities in which they operate as well as to the conservation of biodiversity and integrated approaches to land use planning. In this context, our research has explored perceptions of the social and environmental impacts in two local government areas of rural Queensland. We surveyed and interviewed stakeholders affected by – and/or influential in – decision making and management of mining, CSG extraction, and agriculture in these areas. We asked their views on the state of the environment, the economy, social fabric, human capital, and local infrastructure, comparing today to five years ago. Their responses reveal how this contested arena harbours ‘wicked’ problems: issues that are hard to formulate in simple terms and where every potential solution has irreversible consequences. Our findings suggest further that successful co-existence of multiple industries and a social license to operate for CSG companies depend on effective management by resource companies, and by regulators, of operating practices, off-site impacts, and the distribution of benefits.