Intravascular device administration sets: Replacement after standard versus prolonged use in hospitalised patients--a study protocol for a randomised controlled trial (The RSVP Trial)

Introduction Vascular access devices (VADs), such as peripheral or central venous catheters, are vital across all medical and surgical specialties. To allow therapy or haemodynamic monitoring, VADs frequently require administration sets (AS) composed of infusion tubing, fluid containers, pressure-monitoring transducers and/or burettes. While VADs are replaced only when necessary, AS are routinely replaced every 3–4 days in the belief that this reduces infectious complications. Strong evidence supports AS use up to 4 days, but there is less evidence for AS use beyond 4 days. AS replacement twice weekly increases hospital costs and workload. Methods and analysis This is a pragmatic, multicentre, randomised controlled trial (RCT) of equivalence design comparing AS replacement at 4 (control) versus 7 (experimental) days. Randomisation is stratified by site and device, centrally allocated and concealed until enrolment. 6554 adult/paediatric patients with a central venous catheter, peripherally inserted central catheter or peripheral arterial catheter will be enrolled over 4 years. The primary outcome is VAD-related bloodstream infection (BSI) and secondary outcomes are VAD colonisation, AS colonisation, all-cause BSI, all-cause mortality, number of AS per patient, VAD time in situ and costs. Relative incidence rates of VAD-BSI per 100 devices and hazard rates per 1000 device days (95% CIs) will summarise the impact of 7-day relative to 4-day AS use and test equivalence. Kaplan-Meier survival curves (with log rank Mantel-Cox test) will compare VAD-BSI over time. Appropriate parametric or non-parametric techniques will be used to compare secondary end points. p Values of <0.05 will be considered significant.

Authentically ambiguous, credibly anonymous: Perceptually reframing the personal narrative towards effective persuasion in aggressive human rights contexts

Testing the strategies of discourse and materiality, this practice-based and practice-led research experiments with how anonymous storytelling by vulnerable communities, like that of the sexual minorities and their allies in Malaysia, can better speak to their human rights issues without further subjecting them to personal attacks and targetted persecution. The research identifies the critical role of the voice in lending authenticity and credibility to first person narratives; and contextual credibility as a form of credibility which personal stories naturally aspire to achieve with audiences. Adopting a discursive view of persuasion and recognising too that the power of persuasion may in effect lie with those who receive these stories rather than with those who tell them, the insights and knowledge gained from the research informed the development of the field output, Persuasive Storytelling by Vulnerable Communities in Aggressive Contexts: A Human Rights Communication Framework.

Aging-in-place: Perspectives from the construction industry

Older adults report a desire to remain within the preferred environment for as long as possible. This desire is referred to as aging-in-place. Aging-in-place integrates housing and care options. Factors affecting the ability to remain within the preferred environment include current home designs, access to housing choices, social support networks, and community services, to name a few. Research supports physical and psychosocial benefits of aging-in-place for the individual. Home modifications have the potential to influence the quality of life in a number of positive directions that range from personal mobility to community engagement. Modifications range from minor to significant. Financial resources, contractor interest and expertise, consumer awareness and consumer opportunity affect the degree of change. Increasingly, construction professionals express an interest in learning more about aging-in place. Queries ranged from obtaining a greater understanding of the meaning of the concept, impact of demographic change on housing stock, and increased awareness of universal design features. This paper presents findings from a survey administered to current members of the Canadian Home Builders’ Association – Calgary Regional Office. Within this presentation, we report findings on members understanding of demographic change and the effect of this change on the current and future housing stock. We discuss perceived barriers and benefits of the development of business models to support aging-in-place. Finally, we conclude with discussion of educational support to enhance the understanding of aging-in-place.

Intercultural Learning and Hybridity in the Culture Laboratory

The number of immigrant students in vocational education and training is steadily increasing in Finland. This poses challenges for teachers and schools. This research focuses on emerging questions of intercultural learning in the context of immigrant training, and on a method the Culture Laboratory that was developed in an attempt to respond to the challenges. The main methodological and theoretical framework lies in cultural-historical activity theory, developmental work research, and in the concepts of the intercultural and hybridity. The empirical material consists of videotaped recordings of discussions in the Culture Laboratory. The five main research questions focused on the strengths and limitations of the Culture Laboratory as a tool for intercultural learning, the significance of disturbances in it, the potential of suggestions for intercultural learning, paper as a mediating artifact , and the concept of intercultural space. The findings showed that the Culture Laboratory offered a solid background for developing intercultural learning. The disturbances manifested revealed a multitude of scripts and activities. It was also suggested that the structure of expansive learning could start from externalization instead of internalization. The suggestions the participants made opened up a hybrid learning space for intercultural development, and offered a good springboard for new ideas. Learning in Paperland posed both challenges and opportunities for immigrant students, and different paper trails emerged. Intercultural space in the Culture Laboratory was a developmental zone in which a hybrid process of observing, comparing, and creating took place. Key words: intercultural learning, immigrant training, cultural-historical activity theory, developmental work research,

Liederkranz trip to Hundseck Portraits Groups

Liederkranzausflug nach Hundseck; Standing l-r; Sidi Ullmann, Ehepaar, Alfred und Toni Hirschland, Willi Ullmann, Lisel Suess, Lene Hesse-Sinzheimer, Julius Suess, ?, Hermann Boehm, Eugen Hirsch, Dr. Carl Kahn, Frau von Michael Rothschild (Ella?), Max Sinzheimer, Grete Hirschland and Alfred Liebmann ; Seated l-r: Adele Boehm, Michael Rothschild, rosel Suess, Louis Kahn (Junior), Ehepaar Dr. Gustav Hecht, Paula Hirsch and Marianne Kahn

Wedding portrait of Adolf Wolff and Eva Nathan with guests; Berlin, Germany.

Back row against wall, left to right: Josef Molling, Margaret Molling nee Benjamin, Werner Wolff, Miss Hermann (called "Ferna", Peter Molling's governess), " Selma" (partially hidden, Anna Marianne/Berthold Nathan's cook), "Lisbeth" (Anna Marianne/Berthold's maid), Ilse Joachim, Ernst Joachim, Annemarie Nathan (3rd wife of Julius Nathan), Julius Nathan (brother of Berthold Nathan), Ernst Kallmes (son of Ceilchen nee Wolff, Helene's sister). Very tall against the wall: Max Benjamin (son of Helene). Third row, left to right: Mathilde Kaufmann nee Benjamin, Adolf Molling, Paul Nathan (son of Anna Marianne/Berthold), Marianne Rasmussen (daughter of Waldemar), Hildegard Weinberger (friend of bride), Herta Albrecht (friend of bride), Dr. Franz Gruenberg (friend of groom), Leonie Wolff nee Simon (wife of Werner Wolff), Lina Molling nee Marx (wife of Richard), Waldemar Benjamin-Rasmussen (son of Helene/David), Luzi's Husband, Minka Bernard nee Nathan (sister of Berthold Nathan), Richard Molling (brother of Claerchen), Albert Wolff (brothter of Moritz Wolff). Second row, seated, left to right: Helene Benjamin nee Wolff, Berthold Nathan, Anna Marianne Nathan nee Benjamin, bride Eva Wolff nee Nathan, groom Adolf Wolff, Claerchen Wolff nee Molling, Moritz Wolff, standing Luzi Rasmussen nee Gruen (wife of Waldemar). Front row, children on floor, left to right: Peter Molling, Elizabeth Benjamin-Rasmussen mar. Engel, Louis Peter Wolff, Helmut Benjamin Rasmussen (became Henry)

Portrait of Golde Ginsburg.

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Portrait of Simon Ginsburg.

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Studio portrait of Trude Ginsburg.

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Emilie Waldbaum Collection 1873-1876

Three certificates for Emilie Waldbaum's work as governess (1873-1876).

Ed Sullivan being presented with a fancy layer cake from the Viennese Café Eclair in New York City for the 7th anniversary of the Ed Sullivan Show Entertainment

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School group class portrait including Susan (Susi) Ehrlich; Ulm Portraits; Groups

(l-r): Ruth Altman, Irene Hirsch, Hilde Dannhauser, Suse Barth, Anneliese Hirsch, Suse Saenger, Esther Nathan, Hannelore Baer, Heinz Koerner, Ruth Bauland, Marianne Leiter, Heinz Krippel, Hanna Ullmann, Edith Weil, Otto Eckstein, Susi Ehrlich, Hans Klein, Julie Klappholz, Hanna Chose, Minna Hirsch and Rudolf Loewy

Hans Friedrich Kayser Collection 1877-1893

Photocopies of birth certificate (1877) and release from citizenship certificate (1893), Berlin.

Memoirs.

The material forms only one part of Marianne Lieberman's memoirs. It covers her time in Vienna and Maribor, Slovenia, between the years of 1939 and 1942, with individual chapter headings. Marianne Lieberman remembers her rigid father who would not see her creative talent. She describes early recollections from school, right after the Anschluss in 1938. Her father, being Jewish, had to flee Austria immediately, Marianne Lieberman and her mother went to Slovenia where they stayed with an aunt in 1939. She describes her problems of being baptized. She believed her mother went back to Vienna in 1941, that is why she headed in the same direction. Her first stop was in Graz at a relative's house. Back in Vienna, she was considered a "Mischling" and therefore in danger.