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Patients with CHD can be exposed to high levels of cumulative ionising radiation. Utilisation of electroanatomic mapping during catheter ablation leads to reduced radiation exposure in the general population but has not been well studied in patients with CHD. This study evaluated the radiation sparing benefit of using three-dimensional mapping in patients with CHD.
Data were retrospectively collected from the Catheter Ablation with Reduction or Elimination of Fluoroscopy multi-institutional registry. Patients with CHD were selected. Those with previous ablations, concurrent diagnostic or interventional catheterisation and unknown arrhythmogenic foci were excluded. The control cohort was matched for operating physician, arrhythmia mechanism, arrhythmia location, weight and age. The procedure time, rate of fluoroscopy use, fluoroscopy time, procedural success, complications, and distribution of procedures per year were compared between the two groups.
Fifty-six patients with congenital heart disease and 56 matched patients without CHD were included. The mean total procedure time was significantly higher in patients with CHD (212.6 versus 169.5 minutes, p = 0.003). Their median total fluoroscopy time was 4.4 minutes (compared to 1.8 minutes), and their rate of fluoroscopy use was 23% (compared to 13%). The acute success and minor complication rates were similar and no major complications occurred.
With the use of electroanatomic mapping during catheter ablation, fluoroscopy use can be reduced in patients with CHD. The majority of patients with CHD received zero fluoroscopy.
Knotweed (Fallopia spp.) is an herbaceous perennial from East Asia that was brought to Europe and North America and, despite control efforts, subsequently spread aggressively on both continents. Data are available on knotweed’s modes of sexual and asexual spread, historical spread, preferred habitat, and ploidy levels. Incomplete information is available on knotweed’s current global geographic distribution and genetic diversity. The chemical composition of knotweed leaves and rhizomes has been partially discovered as related to its ability to inhibit growth and germination of neighboring plant communities via phytochemicals. There is still critical information missing. There are currently no studies detailing knotweed male and female fertility. Specifically, information on pollen viability would be important for further understanding sexual reproduction as a vector of spread in knotweed. This information would help managers determine the potential magnitude of knotweed sexual reproduction and the continued spread of diverse hybrid swarms. The potential range of knotweed and its ability to spread into diverse habitats makes studies on knotweed seed and rhizome cold tolerance of utmost importance, yet to date no such studies have been conducted. There is also a lack of genetic information available on knotweed in the upper Midwest. Detailed genetic information, such as ploidy levels and levels of genetic diversity, would answer many questions about knotweed in Minnesota, including understanding its means of spread, what species are present in what densities, and current levels of hybridization. This literature review summarizes current literature on knotweed to better understand its invasiveness and to highlight necessary future research that would benefit and inform knotweed management in the upper Midwest.
Catheter ablation is a safe and effective therapy for the treatment of supraventricular tachycardia in children. Current improvements in technology have allowed progressive reduction in radiation exposure associated with the procedure. To assess the impact of three-dimensional mapping, we compared acute procedural results collected from the Catheter Ablation with Reduction or Elimination of Fluoroscopy registry to published results from the Prospective Assessment after Pediatric Cardiac Ablation study.
Inclusion and exclusion criteria from the Prospective Assessment after Pediatric Cardiac Ablation study were used as guidelines to select patient data from the Catheter Ablation with Reduction or Elimination of Fluoroscopy registry to compare acute procedural outcomes between cohorts. Outcomes assessed include procedural and fluoroscopy exposure times, success rates of procedure, and complications.
In 786 ablation procedures, targeting 498 accessory pathways and 288 atrioventricular nodal reentrant tachycardia substrates, average procedural time (156.5 versus 206.7 minutes, p < 0.01), and fluoroscopy time (1.2 versus 38.3 minutes, p < 0.01) were significantly shorter in the study group. Success rates for the various substrates were similar except for manifest accessory pathways which had a significantly higher success rate in the study group (96.4% versus 93.0%, p < 0.01). Major complication rates were significantly lower in the study group (0.3% versus 1.6%, p < 0.01).
In a large, multicentre study, three-dimensional systems show favourable improvements in clinical outcomes in children undergoing catheter ablation of supraventricular tachycardia compared to the traditional fluoroscopic approach. Further improvements are anticipated as technology advances.
The role of personality in work and organizational (W&O) psychology at both a theoretical and an applied level is crucial for predicting and explaining important individual and organizational performance criteria (Anderson, 2005; Woods & Anderson, 2016). For example, personality variables play a prominent role in predicting job performance and other relevant organizational performance outcomes. The relevance of personality at work can be gauged by the number of (a) scientific articles describing the relationship between personality and work behavior and processes, and (b) applied W&O psychologists drawing extensively upon personality measurement and theory to inform their practice.
This chapter examines three important equity themes that impact on the educational use of digital technologies – gender, digital divide and rurality. The chapter begins with the issue of gender, since the under-representation of female students in digital technologies subjects in upper secondary school education and the resultant under-representation in university education and the ICT industry has been an enduring problem. This is despite numerous research studies and different types of affirmative action strategies being undertaken. These include programs such as school-based ICT clubs for girls and special events targeting the recruitment of girls or industry-based programs and initiatives to address the ongoing difficulties with adequate female recruitment. Following this is a section on the digital divide, and the concluding section examines issues associated with rurality and digital technologies in education.
Why is gender under-representation in ICT/digital technology subjects important?
What are the key factors leading to gender disparity and how can it be redressed?
What is the ‘digital divide’ and is it an issue we need to worry about in Australia?
How does rurality impact on equity, and how can we plan for it in digital technology access and outcomes?
Gender and digital technologies
The gender divide
Unfortunately the gender disparity reported in digital technology-related school subjects over a decade ago continues unabated (Anderson et al., 2005; Lyons et al., 2012).
Non-invasive survey in the Stonehenge ‘Triangle’, Amesbury, Wiltshire, has highlighted a number of features that have a significant bearing on the interpretation of the site. Geophysical anomalies may signal the position of buried stones adding to the possibility of former stone arrangements, while laser scanning has provided detail on the manner in which the stones have been dressed; some subsequently carved with axe and dagger symbols. The probability that a lintelled bluestone trilithon formed an entrance in the north-east is signposted. This work has added detail that allows discussion on the question of whether the sarsen circle was a completed structure, although it is by no means conclusive in this respect. Instead, it is suggested that it was built as a façade, with other parts of the circuit added and with an entrance in the south.
Since the publication of “A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals” in 2008, prevention of healthcare-associated infections (HAIs) has become a national priority. Despite improvements, preventable HAIs continue to occur. The 2014 updates to the Compendium were created to provide acute care hospitals with up-to-date, practical, expert guidance to assist in prioritizing and implementing their HAI prevention efforts. They are the product of a highly collaborative effort led by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise, including the Centers for Disease Control and Prevention(CDC), the Institute for Healthcare Improvement (IHI), the Pediatric Infectious Diseases Society (PIDS), the Society for Critical Care Medicine (SCCM), the Society for Hospital Medicine (SHM), and the Surgical Infection Society (SIS).
Integrated non-invasive survey in the Stonehenge ‘triangle’, Amesbury, Wiltshire, has highlighted a number of features that have a significant bearing on the interpretation of the site. Among them are periglacial and natural topographical structures, including a chalk mound that may have influenced site development. Some geophysical anomalies are similar to the post-holes in the car park of known Mesolithic date, while others beneath the barrows to the west may point to activity contemporary with Stonehenge itself. Evidence that the ‘North Barrow’ may be earlier in the accepted sequence is presented and the difference between the eastern and western parts of the enclosure ditch highlighted, while new data relating to the Y and Z Holes and to the presence of internal banks that mirror their respective circuits is also outlined.
Since the publication of “A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals” in 2008, prevention of healthcare-associated infections (HAIs) has become a national priority. Despite improvements, preventable HAIs continue to occur. The 2014 updates to the Compendium were created to provide acute care hospitals with up-to-date, practical, expert guidance to assist in prioritizing and implementing their HAI prevention efforts. They are the product of a highly collaborative effort led by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise, including the Centers for Disease Control and Prevention (CDC), the Institute for Healthcare Improvement (IHI), the Pediatric Infectious Diseases Society (PIDS), the Society for Critical Care Medicine (SCCM), the Society for Hospital Medicine (SHM), and the Surgical Infection Society (SIS).
Establishment potential is one of the primary components of invasive species risk assessment. Models that predict establishment of potentially invasive ornamental crops often ignore differences among cultivars and the variability in plant response to site-specific factors. The objective of this study was to determine the extent to which differences among cultivars and habitat characteristics affect establishment of 5 cultivars of ornamental cleome. Experiments were conducted to compare germination, survival, and growth of cultivars in cultivated (gardens) and noncultivated (roadsides and prairies) environments and, in prairies, the effects of competition (low, intermediate, and high). In the first experiment, germination, survival, and growth were recorded in gardens, prairies, and roadsides in four locations in Minnesota. In the second experiment, the effects of competition with resident species were studied in five seed lots from three cultivars in three prairie sites. Additionally, a quantitative description of germination and transplantable seedling quality, when grown under greenhouse production standards, was obtained and compared with results from the cultivated and noncultivated outdoor environments. Germination in greenhouse conditions was significantly greater (78%) than in garden, prairies, or roadsides (< 46%). Mortality was greater in noncultivated than in cultivated environments (3% wk−1 and 1.4% wk−1, respectively). Survival was affected by competition, which reduced population establishment. Cultivar differences were most pronounced at seedling emergence, whereas habitat characteristics were more influential at later stages of the life cycle. Germination and plant height were similar among noncultivated environments. Variability in seedling emergence, survival, and growth in response to cultivar, habitat, and competition are important determinants of establishment potential. Among the cultivars studied, the native cleome, roughseed clammyweed, has a greater establishment potential than the nonnative cleome, spiderflower.
Efforts to institute a system for the control and prohibition of khat in Kenya are examined in this article. Prohibition was introduced in the 1940s after an advocacy campaign led by prominent colonial officials. The legislation imposed a racialized view of the effect of khat, seeking to protect an allegedly ‘vulnerable’ community in the north of the country while allowing khat to be consumed and traded in other areas, including Meru where ‘traditional’ production and consumption was permitted. Colonial policy took little account of African opinion, although African agency was evident in the failure and ultimate collapse of the prohibition in the face of widespread smuggling and general infringement. Trade in khat became ever more lucrative, and in the final years of colonial rule economic arguments overcame the prohibition lobby. The imposition of prohibition and control indicates the extent to which colonial attitudes towards and beliefs about cultural behaviour among Africans shaped policies, but the story also illustrates the fundamental weakness of the colonial state in its failure to uphold the legislation.
We have proposed that a dialectic perspective on innovation may serve well as a first step of an integrative framework for research on innovation and for effective practice. We would like to thank all commentators for their stimulating and challenging ideas and SIOP for enabling this dialog. In keeping with the process view inherent to dialectic thinking, we would like to use this reply to refine and extend the core ideas presented in the focal article by means of integrating explanatory concepts, by critically examining the add-on value of a dialectic perspective, and by pointing out future research needs and ideas for management.
Innovation, the development and intentional introduction of new and useful ideas by individuals, teams, and organizations, lies at the heart of human adaptation. Decades of research in different disciplines and at different organizational levels have produced a wealth of knowledge about how innovation emerges and the factors that facilitate and inhibit innovation. We propose that this knowledge needs integration. In an initial step toward this goal, we apply a dialectic perspective on innovation to overcome limitations of dichotomous reasoning and to gain a more valid account of innovation. We point out that individuals, teams, and organizations need to self-regulate and manage conflicting demands of innovation and that multiple pathways can lead to idea generation and innovation. By scrutinizing the current use of the concept of organizational ambidexterity and extending it to individuals and teams, we develop a framework to help guide and facilitate future research and practice. Readers expecting specific and universal prescriptions of how to innovate will be disappointed as current research does not allow such inferences. Rather, we think innovation research should focus on developing and testing principles of innovation management in addition to developing decision aids for organizational practice. To this end, we put forward key propositions and action principles of innovation management.