Warwickshire College

Airway-related complications are common in ICUs and cause serious patient harm. We determined the prevalence of known and predicted difficult airways in ICU patients in the UK, assessed whether these patients are identifiable as at risk, and evaluated the presence of airway management plans through local investigator-led bedside assessment. We conducted a prospective, multicentre, observational study in 106 UK ICUs. Adult patients without treatment escalation plans precluding artificial airway insertion were included. Patients with known difficult airways (defined as difficulty in face-mask ventilation, laryngoscopy, or intubation) or predicted difficult airways (defined as BMI ≥30 kg m-2, tracheostomy in situ, pathology or recent surgery affecting airway management, or modified MACOCHA score ≥3) were evaluated. Presence of clear identification and airway management planning for at-risk patients was assessed by local investigators. Amongst 1965 patients, 872 (44.4%) had an artificial airway in situ (tracheal tube n=639 [73.3%], tracheostomy tube n=233 [26.7%]). Among 1519 patients with intubation details, 244 (16.1%) had a known difficult airway (difficult face-mask ventilation n=32 [2.1%], laryngoscopy n=37 [2.4%], intubation n=182 [12.0%]). In this population, 70 (28.7%) were clearly identifiable to investigators, and 75 (30.7%) had airway management plans. Excluding patients with a known difficult airway, 922 patients had predicted difficult airway management, of whom 125 (13.6%) were clearly identifiable and 181 (19.6%) had airway management plans. Known and predicted difficult airways are common in UK ICU patients, but these at-risk patients are often not clearly identifiable to healthcare professionals.

Abstract Prior research has suggested the need for complementary efforts by multiple stakeholders (government, NGOs, employers) to support workplace integration for refugees, but has paid less attention to how such programs are developed and enacted in specific settings, and how they then influence refugees' workplace integration trajectories. In this article, we develop a process perspective on refugee workplace integration, drawing on a qualitative longitudinal study of the deployment of an internship and mentoring program for skilled refugees in a Swedish manufacturing firm with a history of engagement with diversity and inclusion issues. The data include documents, observations, and 32 interviews with managers, mentors and refugee‐newcomers, the latter interviewed at three points in time during, shortly after, and three or more years after the internship. We derive a process model showing that although practices at the company level may be developed and enacted in a way that reflect goal complementarity between stakeholders, refugee experiences are nevertheless permeated by a shifting pattern of dialectic tensions as refugees progress through four phases of interaction with the firm (pre‐internship, internship, transition to employment, post‐transition). We highlight the central mediating role of the inclusionary practices of front‐line managers and mentors' in interaction with refugee‐newcomers' agency, learning and adaptation in facilitating transitions to first employment and even beyond.

In agriculture, the early and accurate identification of plant diseases is an important step in increasing crop yield. Leaf disease detection is one of the most widely used methods for identifying plant diseases. In recent years, automatic and accurate classification of plant leaf diseases has attracted increasing research attention. With the emergence of deep neural networks (DNN), the identification and classification of plant leaf diseases have achieved competitive results. This study proposes a method based on data augmentation techniques and advanced deep neural network models to improve the accuracy of the identification and classification of plant leaf diseases. First, augmentation techniques using image processing have been applied to efficiently train DNN models. Then, the advanced DNN models were fine-tuned to improve the classification accuracy and execution time. The method was evaluated on two public datasets (apple and potato leaf diseases) with accuracies of 98.08% and 99.07%, respectively.

The National Identification Number (NIN) is a unique number assigned to every Nigerian and legal resident of the country. A robust identity management system is crucial for delivering social and economic services effectively. This study evaluated the operational effectiveness of the National Identity Management Commission (NIMC) and provided recommendations for improvement. Data was collected using a self-administered survey and open-ended interviews. Seventy-two participants responded to the survey, while ten individuals, including both NIMC staff and clients, were interviewed. The survey responses were analyzed using statistical tools. Results indicated widespread dissatisfaction with the current operational state and effectiveness of the NIMC. Key challenges identified included bribery, corruption, and inefficient bureaucracy. To address these issues, the study recommends reorienting NIMC staff in client management, enhancing collaboration with the National Population Commission (NPC) and the National Electoral Commission (NIEC) for data synergy, and adopting up-to-date digital technology for identity enrollment and management amongst others. However, it was also recommended that further studies in this area can explore digital technologies NIMC can adopt for identity management to reduce inefficiencies in its operations.

When using food and green waste composts as peat-free plant growing media, there is a challenge that nutrient immobilisation and high pH and salts content limit plant growth. The present study explored the use of spent mushroom compost (SMC) of Agaricus subrufescens in a sustainable plant growing system where only vermicompost from digested food waste and composted green wastes were used, even for the seedling stage. However, negative effects of high compost inclusion were offset by adding SMC. Significantly higher plant yield was obtained in several of the SMC amended treatments in four out of five lettuce experiments and in one tomato experiment. In addition, an experiment with cucumbers showed that nutrients were not available to the plant when the mushroom mycelium was actively growing, but became available if the mushroom mycelium had been inactivated first by pasteurisation. A significant effect from SMC was not observed under full fertigation. This study demonstrated that the addition of pasteurised Agaricus mycelium colonised compost can successfully offset negative effects from high pH and EC as well as limited nutrient supply (and nitrogen immobilisation) in peat-free, compost-based growing media.

There is a range of risk factors that can lead to peripheral intravenous (IV) cannula failure, and several failed cannulation attempts can result in the patient experiencing increased pain, discomfort and delays in receiving IV therapy. The Vessel Health and Preservation (VHP) framework is a tool that can be used to improve clinical decision-making and the patient experience in relation to vascular access and IV therapy. Use of the VHP framework can ensure the right vein and right vascular access device (VAD) is selected at the right time for each patient. This article describes how healthcare practitioners can use the VHP framework to support and enhance vein assessment and VAD selection. It outlines the various types of VAD available, focusing on short-term peripheral IV cannulae, which are the most commonly used devices. It also explores the potential benefits of implementing the VHP framework in clinical areas.

Emergency situations are relatively commonplace in the veterinary practice, and as such are linked in with the RCVS Day One competencies. Student veterinary nurses have always had an element of emergency nursing included in their training. Good teamwork, communication and preparation are key factors in the successful resolution of the emergent case. An appropriate framework should be followed during the triage process, which identifies the main issues and considerations in the critical patient. The use of monitoring equipment is vital during this period, and veterinary staff should endeavour to be familiar with its use to gain most value from the information it provides.

This article describes a study which investigated the motivations behind why teachers dedicate non-directed time to school-related tasks and the extent to which managers understand and harness these motivations. Data were collected through three case studies within one secondary school. Three heads of department (HoDs) and three teachers were interviewed, and questionnaires were given to all the teachers in the three departments. A questionnaire was developed using ideas from the voluntary sector with the premise that teachers give their time out of their ‘own free will’. This was used to assess what motivates teachers to dedicate their non-directed time to school-focused tasks and the attitudes of their managers towards this. A common finding from all case studies was that teachers are motivated by the idea that they are ‘doing it for the students’. At the same time, it was reported that ‘motivators’ such as performance-related pay had little effect on teachers’ motivation to dedicate their non-directed time to school-focused activities but could increase teachers’ work pressure and stress. The implications for educational managers from this research is that an understanding of teachers’ motivation is imperative if they are to be managed well, especially in terms of the monitoring of non-directed time, and that a reduction of pressure from extrinsic motivators may be of benefit to teachers’ well-being and job satisfaction. One way in which this could be achieved is through a more collaborative style of management and shared departmental goals.