RESUMO
The COVID-19 pandemic was declared by the World Health Organization on 11 March 2020. The rapid spread of SARS-CoV-2 required an equally rapid response from health-care organizations to find innovative ways to utilize the existing workforce to care for people with COVID-19. Using an evaluative case study, a unique insight into the collaborative allied health and nursing professions' response to COVID-19 at a specialist cardiothoracic hospital in the United Kingdom is presented. The aim of the case study was to evaluate how an interprofessional workforce from the wider organization could be supported to work in critical care as part of a crisis response. In identifying the key enablers to setting up an interprofessional Essential Care Team and learning from the lived experiences of those involved, this case study has demonstrated that, in supported, interprofessional teams the wider organizational workforce can be facilitated to effectively and safely provide critical care services. The lessons learned from this study will support future pandemic responses and aid the identification of further opportunities for interprofessional learning and practice. Ultimately, the study highlights that by identifying and investing in the key enablers, health-care organizations can be better prepared to respond to a global crisis.
Assuntos
Pessoal Técnico de Saúde , Comportamento Cooperativo , Infecções por Coronavirus/enfermagem , Cuidados de Enfermagem , Assistência Centrada no Paciente/organização & administração , Pneumonia Viral/enfermagem , Betacoronavirus , COVID-19 , Humanos , Observação , Estudos de Casos Organizacionais , Pandemias , Equipe de Assistência ao Paciente , SARS-CoV-2 , Reino UnidoRESUMO
BACKGROUND: Plans to phase out fossil fuel-powered internal combustion engine (ICE) vehicles and to replace these with electric and hybrid-electric (E-HE) vehicles represent a historic step to reduce air pollution and address the climate emergency. However, there are concerns that E-HE cars are more hazardous to pedestrians, due to being quieter. We investigated and compared injury risks to pedestrians from E-HE and ICE cars in urban and rural environments. METHODS: We conducted a cross-sectional study of pedestrians injured by cars or taxis in Great Britain. We estimated casualty rates per 100 million miles of travel by E-HE and ICE vehicles. Numerators (pedestrians) were extracted from STATS19 datasets. Denominators (car travel) were estimated by multiplying average annual mileage (using National Travel Survey datasets) by numbers of vehicles. We used Poisson regression to investigate modifying effects of environments where collisions occurred. RESULTS: During 2013-2017, casualty rates per 100 million miles were 5.16 (95% CI 4.92 to 5.42) for E-HE vehicles and 2.40 (95%CI 2.38 to 2.41) for ICE vehicles, indicating that collisions were twice as likely (RR 2.15; 95% CI 2.05 to 2.26) with E-HE vehicles. Poisson regression found no evidence that E-HE vehicles were more dangerous in rural environments (RR 0.91; 95% CI 0.74 to 1.11); but strong evidence that E-HE vehicles were three times more dangerous than ICE vehicles in urban environments (RR 2.97; 95% CI 2.41 to 3.7). Sensitivity analyses of missing data support main findings. CONCLUSION: E-HE cars pose greater risk to pedestrians than ICE cars in urban environments. This risk must be mitigated as governments phase out petrol and diesel cars.
Assuntos
Acidentes de Trânsito , Automóveis , Pedestres , Humanos , Estudos Transversais , Pedestres/estatística & dados numéricos , Reino Unido , Acidentes de Trânsito/prevenção & controle , Acidentes de Trânsito/estatística & dados numéricos , Segurança , Masculino , Feminino , Adulto , População Rural , Ferimentos e Lesões/prevenção & controle , Ferimentos e Lesões/epidemiologiaRESUMO
Heterosis is an important phenomenon in agriculture. However, heterosis often greatly varies among hybrids and among traits. To investigate heterosis across a large number of traits and numerous genotypes, we evaluated 12 life history traits on parents and hybrids derived from five Arabidopsis thaliana ecotypes (Col, Ler-0, Cvi, Ws, and C24) by using a complete diallel analysis containing 20 hybrids. Parental contributions to heterosis were hybrid and trait specific with a few reciprocal differences. Most notably, C24 generated hybrids with flowering time, biomass, and reproductive traits that often exceeded high-parent values. However, reproductive traits of C24 and Col hybrids and flowering time traits of C24 and Ler hybrids had no heterosis. We investigated whether allelic variation at flowering time genes FRIGIDA (FRI) and FLOWERING LOCUS C (FLC) could explain the genotype- and trait-specific contribution of C24 to hybrid traits. We evaluated both Col and Ler lines introgressed with various FRI and FLC alleles and hybrids between these lines and C24. Hybrids with functional FLC differed from hybrids with nonfunctional FLC for 21 of the 24 hybrid-trait combinations. In most crosses, heterosis was fully or partially explained by FRI and FLC. Our results describe the genetic diversity for heterosis within a sample of A. thaliana ecotypes and show that FRI and FLC are major factors that contribute to heterosis in a genotype and trait specific fashion.