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The study aimed to determine the predictors of procedural failure (coronary cannulation) in patients undergoing coronary angiography ± percutaneous coronary intervention (PCI) from the transradial (TR) approach.We conducted an observational study of 20,315 consecutive patients undergoing TR angiography between 2016 and 2020. TR failure was described as inability to cannulate the coronary arteries. Univariate and multivariate analyses were performed to determine independent predictors of TR failure.Out of the study population, TR failure was observed in 365 (1.8%) patients, out of which 281 (77%) crossed over successfully to the transfemoral (TF) route and 84 (23%) to left radial access (LRA). Unsuccessful procedures were most likely seen in patients who were elderly, female, BAME background, short stature or with a history of hypertension, diabetes, and renal disease. On regression analysis, age (OR: 1.024; 95% Cl: 1.014-1.035), female gender (OR: 0.729; 95% Cl: 0.555-0.957), BAME (OR: 0.786; 95% Cl: 0.612-0.959), height (OR: 0.988; 95% Cl: 0.977-0.999), hypertension (OR: 1.510; 95% Cl: 1.147-1.987) and RRA (OR: 1.977; 95% Cl: 1.105-3.538) were independent predictors of TR failure. On further analysis, these predictors of failure were not seen from the LRA approach.This study identifies that rates of TR failure are low and that predictors of failure differ between the RRA and LRA. The difference in predictors between the 2 routes suggests that in patients when coronary cannulation is unsuccessful via the RRA then the LRA could be considered as a second access site. Further study is needed to see if in selected patient groups the LRA could be used as the first-choice access route.

Nature-based solutions are seen to benefit both society and biodiversity. However, research into their future resilience is required. Soft capping is a nature-based conservation strategy that mimics the natural colonisation of plants on top of ruined walls and reduces rates of material deterioration. To remain effective, soft capping species must be tolerant of future climatic conditions. We use the Maxent species distribution model to assess the resilience of soft capping species to low and high emission scenarios across Britain and Ireland. We assess the mid- and end-century presence probability of four native and archaeophyte species used in soft capping (Sedum album,S. acre,S. anglicumandSaxifraga granulata). Future presence probabilities were calculated using the climate models HadGEM3-GC31-LL, IPSL-CM6A-LR and MIROC6. Results suggest that current sedum-based soft caps will remain viable until mid-century with additional maintenance (e.g. watering) during droughts, although soft caps predominantly formed ofSedum albummay be prone to failure in south-eastern England. In the future, species more resilient to arid conditions may need to be preferentially selected for soft capping to ensure resilience under a warming climate. Species distribution modelling provides a useful way of predicting the future resilience of nature-based solutions.

The transradial access approach is a well-established route for coronary angiography and percutaneous intervention, given its lower complication rate over the transfemoral route. However, complications are still apparent, some of which can lead to serious injury. We report a case of delayed diagnosis of localized compartment syndrome , caused by haematoma and pseudoaneurysm formation following a radial procedure which resulted in long term disability. We emphasize the importance of early recognition and diagnosis of compartment syndrome to avoid long term sequalae.

Sexual violence (SV) is a pernicious issue that disproportionally impacts girls and women. Although few initiatives have demonstrated effectiveness in leading to reductions in SV, global health organizations have identified empowerment-based programs as a promising approach to SV prevention. The purpose of this article is to discuss the Girls Leadership Academy (GLA), a program of the Nebraska's Women's Center for Advancement, which is a “homegrown,” theoretically grounded, practice-based SV prevention program for adolescent girls. More specifically, we discuss previous research relevant to the GLA; the theoretical underpinnings of the GLA; and the history, context, and content of the GLA.

This paper examines movements in educational policy to address the inequitable schooling experiences of American Indian youth. We look specifically at recent policy revisions to teacher education standards in the state of Idaho which intend to address preservice teachers’ knowledge and dispositions to build understanding and respect for Indigenous ways of knowing and tribal sovereignty in classrooms and schools. We argue that critical, culturally based teacher training programs can prepare competent, equity conscious teachers to address the unique challenges of schools, especially those serving Indigenous youth. Such frameworks are vital acts of social justice education which benefit all students.

Most museum educators strive for their programs to have positive effects on students, but what impact do they really have? What factors, including museum-school programs, contribute to positive academic performance and critical thinking in particular? This article examines the Guggenheim Museum's artist-in-residence program, Learning Through Art (LTA), as a case study. Over three years, LTA worked with Randi Korn & Associates, Inc. to conduct a quasi-experimental research study examining the impact of the program on critical-thinking skills. Findings showed that LTA positively impacted five of the six identified skills for both looking at art and interpreting text. Drawing on the research findings and a critique of LTA, this article will identify characteristics of a museum-school program that contribute to increased critical-thinking skills specifically and student learning in general.

Electronic and print resources about evolution abound. However, navigating the choices can be daunting. This selection of resources is intended to provide background information about evolution science, strategies for teaching evolution, and greater insight to dealing with the evolution/ creationism debate. The Practical Resources section includes fundamental resources intended for staff who develop and implement exhibitions and programs as well as administrators who set museum priorities and policies. These practice-oriented resources provide current updates about the evolution/creationism issue, strategies for dealing with visitors’ questions about evolution, as well as content and activities suitable for use in floor staff and volunteer training. The Contemplative Resources section includes resources that delve deeper into evolution science and are more suitable for contemplation and discussion rather than immediate, practical application. A few of these books are written in a popular science genre and are intended for a general audience—very much like exhibitions— and, as such, are germane to museum work for both the information itself as well as how the information is conveyed. While evolution curricula and museum Web sites are not included in the selection, links to these items are provided by the Web sites that are listed.

Purpose – Meetings are ubiquitous in organizational life and are a great source of frustration and annoyance to many employees in the workplace, in part due to counterproductive meeting behaviors (CMBs). CMBs include engaging in irrelevant discussion, complaining about other attendees, arriving to the meeting late, and other similar, disruptive behaviors. Consistent with conservation of resources theory, the purpose of this paper is to examine the potential resource draining effect of CMBs on two key workplace attitudes/behaviors, employee voice, and coworker trust. Design/methodology/approach – The authors used Amazon’s MTurk service to recruit a sample of full-time working adults from a variety of industries who regularly attend meetings. Participants completed a survey with items relating to CMBs, trust, voice, and meeting load. Findings – The authors found that CMBs were indeed negatively related to both employee voice and coworker trust. Further, both of these relationships were even more negative for those who had fewer meetings (i.e. meeting load as a moderator). Research limitations/implications – The results of this study suggest that behavior in meetings may spill over and impact employees in other areas of their work life, perhaps harming other important work-related outcomes (e.g. performance). The cross-sectional nature of the sampling strategy is a limitation that provides opportunities for future research as discussed. Practical implications – The practical implications are rather straightforward and poignant. Managers and meetings leaders should seek ways to reduce CMBs and promote good meeting processes generally. Originality/value – The current study is the first to overtly investigate CMBs in workplace meetings and connect them to meaningful, non-meeting-related, outcomes. Further, the study shows the usefulness of conservation resources theory for explaining the dynamic processes that occur for meeting attendees.

This article presents a few salient findings from Phase I of an evaluation conducted at The Tech Museum of Innovation. Phase I focused on articulating visitors' behaviors and experiences in each of the four permanent galleries. Observations showed that visitors are spending about the same amount of time in the galleries as they spend in other museums' nondiorama exhibits, but they visit fewer components. Because some galleries performed better than others, this manuscript provides a rationale for the range of behavioral data by examining behaviors at various component types. In-depth interviews provide another perspective on the visitor experience. They showed that in some cases visitors are not grasping the individual messages of the galleries. Observation data suggest why visitors failed to obtain the galleries' big ideas. The challenge for The Tech is to consider the unique behaviors that the exhibits promote and to rework their exhibits so they more strongly reflect and convey each gallery's big idea.

When used effectively, workplace meetings serve as an invaluable opportunity for co-workers to achieve organisational objectives. However, meetings are often regarded as inefficient, unproductive, and a waste of time. Owing to meeting attendee frustration, there can be detrimental impact on employee wellbeing. In this paper, we examine the impact of a specific type of meeting behaviour, counterproductive meeting behaviours (CMBs), which include non-constructive criticism and complaints on perceptions of meeting effectiveness. Additionally, we explore the potential moderating influence of personality characteristics on this relationship. While meeting leaders may take great efforts in designing meetings based on good meeting practices supported by research, meeting outcomes could be largely influenced by the individual personality characteristics of meeting attendees. This research is aimed at developing a greater understanding of how individual differences, namely personality traits, play a role in meeting interactions and outcomes. Respondents completed a survey that measured CMBs, personality characteristics, and meeting effectiveness. Our findings indicate CMBs are negatively related to perceived meeting effectiveness. Additionally, the negative relationship was stronger for individuals who possess higher levels of agreeableness and stronger for individuals possessing lower levels of extraversion. We discuss implications for managers and meeting attendees.

The National Board of Medical Examiners (NBME) provides examinations that are used to assess physicians in training. Parts I, II, and III and the FLEX (Federation Licensing Examination) examinations results are used by state licensing boards in licensing individuals on a uniform and reciprocal basis. Most of the medical schools in the United States also use NBME examinations to assess student achievement. The NBME has included questions on law and ethics in its examinations since 1923, but the present effort to enhance this area began in 1981. Recognizing the importance of the legal and ethical aspects of medical practice, the NBME's test committees in such disciplines as pediatrics, obstetrics and gynecology, and psychiatry have specified within their exam content outlines that eth

• A clinical rating scale was developed to assess clinical skills of third-year medical students completing a two-week required clerkship in otolaryngology. Thirty-seven students in six consecutive small groups were rated with the instrument by themselves, their student peers, and the departmental staff, and the ratings compared. The instrument was usable and acceptance was good. Agreement among the different rating bodies was poor, but single observations by staff or peers were suitably reliable when multiple raters were used. The "halo effect" was particularly evident in staff ratings. ( Arch Otolaryngol 103:19-21, 1977)

Most estimates or indices of small-mammal abundance are based on trapping data or sign surveys. Trapping, either with live traps or kill traps, has many desirable features, but is expensive in time and effort and inevitably disturbing to the population. Sign surveys as used by Elton, Davis, and Findlay (1935) or Hayne (1950) avoid these difficulties but are less precise and more dependent on personal variables of skill and interpretation. A modification of the sign-survey technique which largely avoids these difficulties was suggested by Eadie (1948) in connection with a study of the food habits of shrews. To collect droppings of these animals, he distributed 4-inch squares of paper on the ground. Incidental to this collection of shrew material he noted a high incidence of field mouse droppings on the squares and suggested that "this technique might readily be developed to obtain relative census figures on certain small mammals under uniform conditions with a minimum disturbance to the animals and habitats." The present paper is a report on a series of studies evaluating the usefulness of dropping stations as a technique for population measurement and analysis of small mammals. The technique to be described involves the distribution of small squares of wood or other weather-resistant material