Union Institutions Research Articles

Survey of clinical microbiology and infectious disease testing capabilities among institutions in Africa.

Inadequate laboratory infrastructure and testing capabilities are a major impediment to addressing the infectious disease burden in Africa. Therefore, the aims of this study were to characterize the clinical microbiology/infectious disease laboratory capabilities among countries in Africa. A survey to assess the microbiological testing capabilities at hospitals, government laboratories, and free-standing public and private laboratories in African countries was developed by subject matter experts. Questions included institutional demographics and microbiology services in the broad categories of bacteriology, virology, mycology, parasitology, and rapid diagnostics/point-of-care testing. The survey was distributed using the American Society of Clinical Pathology email listserv between June and August 2022. In total, 131 unique institutions in 28 countries endorsed at least 1 type of microbiology service, with parasitology (80.9%, 106/131) and bacteriology (77.9%, 102/131) being most common, while mycology (45.0%, 59/131) and virology (45.8%, 60/131) laboratories were less prevalent. The most frequently performed bacteriology test was bacterial identification (90.2%, 92/102), followed by aerobic bacterial cultures and antimicrobial susceptibility testing (both 89.2%, 91/102). Among all clinical microbiology/infectious disease laboratories, the most commonly tested agents were HIV (90.8%, 119/131), Treponema pallidum (78.6%, 103/131), Plasmodium falciparum (76.3%, 100/131), Mycobacterium tuberculosis (76.3%, 100/131), and hepatitis C virus (74.8%, 98/131). These findings provide contemporary data regarding the availability of critical infectious disease testing capabilities among institutions in Africa. These results and future additional studies will be crucial for understanding where strategic investment in the laboratory and public health infrastructure is warranted.

Money laundering and compliance in professional football: the case of Belgium in light of the new EU AML single rulebook

In recent decades, football has evolved from a purely sporting activity into a global economic phenomenon. Along with this metamorphosis, questions of corporate governance and compliance have come to the fore when it comes to the governance of (professional) football clubs. A good example is the consequences of, and efforts to prevent, criminal activities in the form of money laundering. In recent years, the risks of money laundering activities through the professional football sector have often been highlighted by, for example, European Union institutions. In Belgium, an alleged money laundering scandal in professional football led to legislative measures. This contribution considers the application of Belgium’s preventive anti-money laundering framework to professional football in comparison to the novel EU AML Single Rulebook legal framework as applicable to professional football. It concludes that this legal framework is not a miracle solution to the problems facing the sector, and furthermore, the application of this framework raises several questions.

Current state of quality improvement research across cardiac ICUs: a Pediatric Cardiac Intensive Care Society (PCICS) survey.

Outcomes for children with heart disease improved over the past decades. Quality improvement (QI) research in paediatric cardiac critical care is a key driver of improvement. The availability and variability of QI research across the field is unknown. This project represents a step in understanding the role. The Pediatric Cardiac Intensive Care Society (PCICS) can serve to support institutions' needs, drive collaborations, and utilise available infrastructure at member institutions for improvement work. The PCICS Quality Improvement and Safety Committee developed a survey to assess the state of QI research. The survey was disseminated over several months and available via QR code at the World Congress of Pediatric Cardiology and Cardiac Surgery in 2023. Fifty-eight respondents completed the survey representing at least 38 unique institutions. Most respondents participated in QI research (52/58, 90%). Most QI projects were single centre (41% of respondents), and of those, the majority were from a minority of institutions (13 institutions [34% of total institutions]). QI support is available at slightly more than half of units, and 55% (32/58) have access to a QI specialist. QI support and rate of publications is significantly lower for small/medium units as compared to large units. Respondents suggested most interest from PCICS in networking with other members with similar project ideas (50/58, 86%). PCICS member institutions are committed to QI research, with limitations in support, local specialists, and networking. Increasing connectivity and accessibility to QI resources may reduce burden to individual members and institutions to achieve QI research.

Cooperation between national courts and EU institutions in competition law cases

The article explores the interplay between national courts and European Union institutions in the context of competition law enforcement of rules enshrined in Articles 101 and 102 TFEU. Cooperation between national competition authorities and national courts on one hand and EU institutions on the other hand is crucial for ensuring the effective and consistent application of competition rules. The article deals with the mechanisms of this cooperation. It examines the role of the European Commission and the Court of Justice of the European Union (CJEU) in providing guidance to national competition authorities and national courts. The article underscores the importance of a cohesive approach to competition law enforcement that is applied by national institutions of the EU member states. The concept and meaning of legal security in criminal law is well defined by Professor Jadwiga Potrzeszcz who states that "legal security is a state achieved by law established in general, and in particular by means of criminal law, in which human life’s goods and interests are protected in the most comprehensive and effective possible manner (and) harmonizes properly with the most important functions of criminal law, namely with a protective function and a guarantee function." (Potrzeszcz, 2018, p. 301) In accordance with the aforementioned definition, the author aims to introduce Criminal Codes that were in effect in the territory of present-day Slovakia, shedding light on whether they were guarantees of legal security in the state or not, i.e., whether they protected "human life’s goods and interests in the most comprehensive and effective possible manner."

Formation of a Unified Educational Space of the Union State from the Perspective of the Policy of Patriotic Education

Introduction. Awareness of the commonality of geopolitical and civilizational challenges of the Russian Federation and the Republic of Belarus pushes for deepening integration cooperation in different directions. Close attention is paid to the problem of security, interpreted in an expanded way. Its provision correlates with the strengthening of the humanitarian dimension of the Union State, including the formation of a unified educational space. In modern conditions, its correlation with the consolidation of the policy of patriotic education in the integration field is being actualized. The purpose of the article is to identify the specifics of their coupling, taking into account the dynamics of union construction. Materials and Methods. The research is based on the methods of binary comparison, traditional and discourse analysis of official texts. An additional method is a formalized correspondence expert survey. The key materials are normative legal acts of the Russian Federation and the Republic of Belarus, interstate, intergovernmental and integration agreements, information content of the web resources of the Union State. The theoretical and methodological foundations of the research are a new political institutionalism, a multidimensional model of social action, and the paradigm of “political unification”. Results. The article describes the normative foundations of state policy in the field of education and integration guidelines in the cultural and humanitarian plane within the framework of the movement towards the Union educational space. The demanded categories of the axiological plan are revealed, referring to the relationship between education and upbringing. The key lines of discursive practices at the sites of the union institutions are shown. The understanding of the need to adapt education systems to the requirements of the time and the linking of patriotic education with the protection and preservation of common historical memory are emphasized. Discussion and Conclusion. The results of the study and expert assessments suggest the articulation of not only positive changes, but also urgent vectors for improving national approaches and integration solutions. They correspond to the elimination of conflicts, the development and adoption of new documents at the level of the Union State, the implementation of value categories and new areas of unified policy. The results obtained may be of interest to public authorities and union institutions, participants in patriotic education in the territory of the Union State.

Better data for budgetary surveillance: EU law on statistics as key to unlocking the potential of public sector accounting

The quality of the data available for monitoring budgetary discipline of the Member States has been a hot topic within the European Union (EU) institutions and in the literature ever since the beginning of the economic crisis in 2008. The COVID-19 pandemic has shown the inadequacy, not only of the data, but also of the policy instruments available for coordinating efforts and decision-making. In this paper, we attempt to unlock the potential of public sector accounting (PSA) for contributing to the improvement of EU surveillance mechanisms. We look beyond the idea of standardised accounting rules for the entire EU public sector (European Public Sector Accounting Standards) into a less controversial area of EU competence, and we explore the conditions for introducing reporting obligations based on PSA data as part of EU law on statistics. Points for practitioners The current succession of crises might create momentum for a change in EU fiscal policy-making. New instruments for the monitoring of the budgetary situation in the Member States could become necessary. The EU institutions cannot impose the European Public Sector Accounting Standards. However, a new standardised reporting instrument could become binding EU law if it would come in the shape of a statistical methodology. Basic principles of EU law guarantee that any new statistical reporting obligations are limited to what is necessary, proportionate and cost-effective.

Pediatric oncology nutritional practices in high-income countries: A survey from the International Society of Paediatric Oncology (SIOP).

Optimal nutrition in pediatric oncology can influence cancer-related outcomes. To establish an understanding of nutrition practice and perceptions of best practice, we queried nutrition providers practicing in pediatric oncology care centers in high-income countries. An electronic, multidisciplinary, cross-sectional survey of nutrition practices was conducted among pediatric oncology nutrition practitioners. Final analysis included 110 surveys from 71 unique institutions and included practitioners from Europe, the United States, Canada, Australia/New Zealand, South America, and the Middle East/Asia. The majority of institutions (97%) reported having dietitians; 72% had designated oncology dietitians. Approximately half of the practitioners (47%) reported feeling their institutions were inadequately staffed. The majority (78%) of institutions completed nutrition risk screening, but there was no consensus on specific screening practices. Half (50%) of the institutions that screened for nutrition risk did so in both inpatient and outpatient settings. The majority (80%) of institutions completed a nutrition assessment close to the time of diagnosis. Those that did not cite lack of staff and/or lack of time, lack of standardized approach, and consult only level of nutritional care as primary barriers. The most common topic of nutrition education provided to patients/families was nutrition-related symptom management (68%). While most institutions reported having pediatric oncology dietitians, we found a lack of standardized practice and perceived inadequate staffing. In addition, what providers perceived to be best practice did not always align with day-to-day clinical practice. Ongoing efforts are needed to develop evidence-based guidelines, including staffing recommendations, to support specialized care in this population.

Building an Effective International Medical Evacuation Program for Ukrainian Patients With Cancer Amid Prolonged Military Conflict.

During military conflicts, the immediate response to a severely disrupted health care system often overlooks the needs of patients with cancer who require continuous specialized care. The full-scale Russian invasion of Ukraine in February 2022 was no exception, leaving many Ukrainian patients without access to essential care. We conducted a retrospective cohort study to assess the impact of the MedEvac program, facilitating the transfer of Ukrainian patients with cancer to European Union (EU) institutions for treatment, and to describe its components. Patient data from the Ministry of Health of Ukraine (MOH) database (April 2022-April 2023) were analyzed. Of 639 applications in the MOH database, 339 (53.1%) had sufficient data for analysis and, of those, 281 (82.9%) were evacuated to EU hospitals. Median age of evacuated patients was 47 (IQR, 38-58) years and most were newly diagnosed (94.0%, n = 264). Predominantly, patients were evacuated for systemic cancer therapy (81.9%, n = 230). Multivariate logistic regression analysis revealed that a good performance status (Eastern Cooperative Oncology Group 0-2) was the most significant factor associated with evacuation (odds ratio [OR], 9.64 [95% CI, 3.08 to 30.23]). Patients with melanoma were more likely to be evacuated, even after adjustment for performance status (OR, 2.56 [95% CI, 1.14 to 5.72]), while patients with head and neck cancer were significantly less so (OR, 0.20 [95% CI, 0.06 to 0.72]). MedEvac program provides a viable model for medical evacuation and management of patients with cancer amid prolonged military conflict, highlighting the importance of international cooperation and setting a precedent for other crisis responses. Continuous evaluation and adaptation are essential to ensure the program's effectiveness and sustainability.

The Role of Integration Associations in the Fight against Pandemics on the Example of the European Union and Eurasian Economic Union

INTRODUCTION. The academic value of this article lies in augmenting the scientific understanding of the role of integration unions in healthcare and the methods and means of combating pandemics and epidemics at an integration level. This is achieved by addressing the research objective: to identify the legal and institutional structures and mechanisms existing at the level of integration unions for combating pandemics and their consequences, and to assess their effectiveness. The research objectives are defined as follows: to examine the actions of integration unions in combating the pandemic from legal and material- economic perspectives; to determine the actual role of integration unions in combating pandemics and similar threats to public health for the further improvement of international cooperation and Eurasian integration; to evaluate the compliance of the actions of integration union institutions with their founding documents; and to develop ways to improve integrations in the field of health protection based on the experience gained.MATERIALS AND METHODS. The methodological basis of the research is grounded in the general philosophical method of dialectics. Special and specific scientific methods applied include: the comparative legal method (comparing the legal systems and regulations of different integration unions, and the various measures taken in response to the pandemic), the sociological method (examining the impact of pandemic conditions on society in different integration environments), and the axiological method (studying values as the foundation of integration unions, their reflection, and influence on making internationally significant decisions).RESEARCH RESULTS. In determining the effectiveness of the institutions, structures, and mechanisms of integration unions in ensuring epidemiological wellbeing, a significant role of integrations in counteracting pandemic and epidemiological threats to health has been identified. This is evidenced by the actions and measures taken by the EU and the EAEU during the recent COVID-19 pandemic. Aspects of cooperation between member countries (transport communication, coordination of sanitary measures, support of the economy and social sphere, information and experience exchange) and the institutions of these integration unions (European Commission, European Parliament, Eurasian Economic Commission) were dictated by their founding acts (TEU, TFEU, Treaty on the EAEU) and other documents.DISCUSSION AND CONCLUSIONS. During the crisis, not only challenges requiring solutions in ensuring well-being (balance of freedoms and restrictions, rational allocation of resources, balance of national and integration interests) emerged, but also prospects for the future development of integrations (NextGenerationEU Plan, the emergence of a Global Digital Health Certification Network). Judicial practice was formed (lawsuits by the European Commission, work of the EAEU Court). Conclusions highlight the need to increase the resilience and centralization of EU healthcare systems, prepare the budget for potential future threats, which serves as a useful experience for Eurasian integration, and the importance of deepening integration, reforming existing institutions, and establishing interstate dialogue for the EAEU. The crisis became a catalyst for the development of integrations, the cause of the emergence of new conflicts and contradictions, the solutions of which determined the direction of evolution in the future.

Nowe instytucje dla biznesu wykorzystującego sztuczną inteligencję – elementy etyczne

The aim of the article is an attempt to present the ethical elements in the newly shaped by the European Union institutions for business and, more broadly, for an economy based on advanced digital solutions, especially artificial intelligence (AI) systems. The presented research is conducted within the institutional approach in economic theory, which takes into account social and axiological elements in economic analyses. The first part presents selected negative social consequences of the business use of artificial intelligence systems. The second part contained a brief analysis of the significance of institutions in the concept of institutional economics. Then, key documents of the European Union related to the ethical aspects of AI use by businesses were introduced, especially the upcoming AI Act regulation.

Drafting a Cybersecurity Standard for Outer Space Missions: On Critical Infrastructure, China, and the Indispensability of a Global Inclusive Approach

Despite limited progress within international institutions, the need for articulating a regulatory framework for cyber operations in outer space is becoming a pressing concern. One precondition for regulation is to share cybersecurity and outer-space common terminology that can inform the negotiation of standards, policies and laws. While the UN Institute for Disarmament Research has recently issued a baseline policy glossary, binding technical definitions are missing, and the lack of a binding international cybersecurity regime adds to the obsolescence of a binding outer-space regime tracing back to half a century ago. As the IEEE SA embarks on the drafting of the first-ever technical standard for cybersecure-by- design outer-space missions, scoping and conceptual challenges abound. Technical standards are US-centred, non-binding, engineering-intensive exercises, where lawyers and Asian jurisdictions are only marginally involved; nevertheless, as China’s framework for cybersecurity is refined and its involvement in outer-space policing deepens, its disengagement from Western-driven standard-setting bodies appears unsustainable. Drawing on the specific challenge of defining what makes a cyber system ‘mission-critical’, I expose the necessity to examine how domestic cybersecurity laws from a diverse range of States identify ‘critical’ information infrastructure. Generalising therefrom, I advocate a jurisdictionally inclusive process that combines American supremacy in technical standard-setting for outer-space missions with Chinese normative contributions to cybersecurity regulation, including on data localisation and mandatory multilevel cyber-hygiene requirements. I further argue that involving legal experts from a diverse range of jurisdictions and sociolegal cultures may enhance the global reception of standardisation outputs, thus securing higher degrees of voluntary compliance therewith. This could foster cooperation and promote regional and global satellite cybersecurity.

COVID-19 crisis management in Greek airlines

This study provides a comprehensive analysis of Greeceʼs aviation management during the COVID-19 pandemic. Greece was selected as a focal point due to its significant role in European tourism and its burgeoning air transport industry, both of which suffered greatly from the pandemic. The research is exploratory in nature and incorporates an analysis of secondary sources including airline archives, public services, national regulatory authorities, European Union institutions, and public media, along with a series of detailed, semi-structured interviews with six executives from leading Greek airlines. The study illuminates the primary effects of the COVID-19 crisis on Greek air transport, scrutinizes the crisis management strategies employed by the airlines and assesses their perceived effectiveness. It also delves into the guidance and support provided by the Greek government and both national and international civil aviation organizations. Moreover, the study explores the impact of the crisis on emerging opportunities and innovations. Finally, it reflects on the lessons learned and offers recommendations for future improvements.

Heterogeneity in Pre-operative Staphylococcus aureus Screening and Decolonization Strategies among Healthcare Institutions

Background: Staphylococcus aureus (SA) is the most common pathogen causing surgical site infections (SSIs). In the past decade, strategies incorporating new SA decolonization products have been implemented to prevent SSIs in surgical patients. The objective of this cross-sectional study was to determine which pre-operative screening and decolonization strategies are currently utilized in healthcare institutions. Methods: A survey was programmed in REDCap and emailed to members of the Society for Healthcare Epidemiology of America Research Network, the Minnesota chapter of the Association of Practitioners in Infection Control and Epidemiology, and the Minnesota Hospital Association between May-August 2023. We report the prevalence of institutional screening and decolonization strategies and decolonization products used for the prevention of SA SSIs. Results: A total of 153 unique institutions initiated the survey and 111 provided complete data on their institutional screening and decolonization strategies. The most commonly reported strategies included universal decolonization (decolonization of pre-operative patients without screening for carrier status) (n=31, 27.9%), no screening or decolonization (n=24, 21.6%), targeted screening for methicillin-sensitive Staphylococcus aureus (MSSA) or methicillin-resistant Staphylococcus aureus (MRSA) and decolonization based on carrier status (n=24, 21.6%), or MRSA only screening and decolonization (n=11, 9.9%) (Figure 1). Institutions that utilized targeted screening and decolonization strategies frequently reported using nasal mupirocin (n=18, 66.7%MSSA, n=29, 60.4%MRSA), chlorhexidine gluconate (CHG) bathing (n=16, 59.3%MSSA, n=28, 58.3%MRSA), and CHG cloths (n=7, 25.9%MSSA, n=14, 29.2%MRSA) (Figure 2). Among the 31 institutions that reported implementing the universal decolonization strategy, CHG bathing (n=18, 58.1%), CHG cloths (n=15, 48.4%), and nasal povidone iodine (n=14, 45.2%) were the most prevalent decolonization products. Additionally, a smaller percentage of institutions used nasal alcohol gel (n=5, 16.1%) for universal decolonization. Conclusion: Compared to the survey we conducted in 2012, we report a new shift towards universal decolonization and a small increase in targeted SA screening and decolonization.1 In the 2012 survey we reported 37% of respondents’ institutions screened pre-operative patients for SA carriage and the majority of those institutions decolonized carriers.1 Universal decolonization was not reported in the 2012 survey.1 We highlight the continued heterogeneity in practice at this time, which may reflect the ongoing uncertainty in optimal decolonization practices and emphasizes the need for future research.

Perspectives and Awareness of Environmental Sustainability in the Infection Prevention and Control Community Nationally

Background: Healthcare contributes significantly to waste production and greenhouse gas emissions. This became especially apparent during the COVID-19 pandemic. Yet there is modest recognition of this issue, particularly within decision-making in Infection Prevention and Control (IPC). The aim of our study was to gauge general knowledge and attitudes of hospital epidemiologists (HEs) and infection preventionists (IPs) around the intersection of environmental sustainability and IPC, and to identify related institutional practices. Methods: An online survey, composed of ten questions related to environmental sustainability in IPC, was created and emailed to members of the SHEA Research Network (SRN), a national consortium of healthcare facilities collaborating on IPC research, from August - October 2023. Survey answers were collated via Redcap© and descriptive results were obtained. Results: Forty-two individuals (33 HEs, 7 directors of IPC, and 2 IPs) from unique institutions completed the survey. Thirty (71.4%) were from academic medical centers, 5 (11.9%) were from VA medical centers and 7 (16.7%) were from community hospitals. Over half of participants correctly estimated the amount of waste and carbon emissions produced annually by the US healthcare system (6 million tons and 8.5% of national emissions, respectively). However, only 42.9% considered environmental sustainability concerns important or very important when making IPC decisions. Fifteen (34.9%) had an environmental sustainability committee at their institution and of these, 8 had an established relationship with the IPC department. The most common techniques to promote sustainability amongst institutions were water/energy conservation (59.5%), reusable personal protective equipment (52.4%) and Leadership in Energy and Environmental Design (LEED) certification (47.6%). When asked which efforts they would support at their institution, 28.6% would eliminate the use of single-use endoscopes and one third would avoid use of ethylene oxide for sterilization. In deciding whether to support environmental sustainability measures, key considerations participants articulated were patient safety concerns, knowledge about effectiveness and costs, and administrative support. Conclusion: Although there is growing awareness around the contribution of the healthcare industry to carbon emissions and waste production, IPC professionals have not yet universally adopted measures to promote environmental sustainability. In our survey, many participants acknowledged the importance of balancing patient safety and sustainability concerns. Our study demonstrates the need for more research and education to inform decisions around environmentally sustainable efforts in IPC that also preserve patient safety. Additionally, professional and regulatory bodies must acknowledge and promote the importance of environmental sustainability in IPC decision-making.

Teatr „Łejery” – edukacja przez sztukę na przykładzie działalności Szkoły Podstawowej nr 83 im. Emilii Waśniowskiej w Poznaniu (wybrane problemy)

Primary School No. 83 Emilia Waśniowska in Poznań is known in Poland as “Łejery”. It is a unique institution in the country because, although it is a “systemic” school, it implements its educational programme through art, is based on selected assumptions of non-directive pedagogy, and the main educational means at the school is broadly understood theatre. The subject of the author’s study is to present the theatre operating at Primary School No. 83. “Łejery” in Poznań as a means of comprehensive education for children and young adolescents. The author, based on sources (websites, sources evoked – interviews with Jerzy Hamerski) and observations made from September 1 to December 22, 2023, as well as the literature on the subject, considers education at Primary School No. 83 in Poznań, presents the figure the founder of the Poznań “Łejery”, and analyses the ways of using theatre in the education process of children and youth attending the described school.

A national census for the off-label treatment of complex aortic aneurysms

ObjectiveDespite regulatory challenges, device availability, and rapidly expanding techniques, off-label endovascular repair of complex aortic aneurysms (cAAs) has expanded in the past decade. Given the lack of United States Food and Drug Administration-approved endovascular technology to treat cAAs, we performed a national census to better understand volume and current practice patterns in the United States. MethodsTargeted sampling identified vascular surgeons with experience in off-label endovascular repair of cAAs. An electronic survey was distributed with institutional review board approval from the University of Rochester to 261 individuals with a response rate of 38% (n = 98). ResultsA total of 93 respondents (95%) reported off-label endovascular repair of cAAs. Mean age was 45.7 ± 8.3 years, and 84% were male. Most respondents (59%) were within the first 10 years of practice, and 69% trained at institutions with a high-volume of off-label endovascular procedures for complex aortic aneurysms with or without a physician-sponsored investigational device exemption (PS-IDE). Twelve respondents from 11 institutions reported institutional PS-IDEs for physician-modified endografts (PMEGs), in-situ laser fenestration (ISLF), or parallel grafting technique (PGT), including sites with PS-IDEs for custom-manufactured devices. Eighty-nine unique institutions reported elective off-label endovascular repair with a mean of 20.2 ± 16.5 cases/year and ∼1757 total cases/year nationally. Eighty reported urgent/emergent off-label endovascular repair with a mean of 5.7 ± 5.4 cases/year and ∼499 total cases/year nationally. There was no correlation between high-volume endovascular institutions (>15 cases/year) and institutions with high volumes of open surgical repair for cAAs (>15 cases/year; odds ratio, 0.7; 95% confidence interval, 0.3-1.5; P = .34). Elective techniques included PMEG (70%), ISLF (30%), hybrid PMEG/ISLF (18%), and PGT (14%), with PMEG being the preferred technique for 63% of respondents. Techniques for emergent endovascular treatment of complex aortic disease included PMEG (52%), ISLF (40%), PGT (20%), and hybrid-PMEG/ISLF (14%), with PMEG being the preferred technique for 41% of respondents. Thirty-nine percent of respondents always or frequently offer referrals to institutions with PS-IDEs for custom-manufactured devices. The most common barrier for referral to PS-IDE centers included geographic distance (48%), longitudinal relationship with patient (45%), and costs associated with travel (33%). Only 61% of respondents participate in the Vascular Quality Initiative for complex endovascular aneurysm repair, and only 57% maintain a prospective institutional database. Eighty-six percent reported interest in a national collaborative database for off-label endovascular repair of cAA. ConclusionsEstimates of off-label endovascular repair of cAAs are likely underrepresented in the literature based on this national census. PMEG was the most common technique for elective and emergent procedures. Under-reported off-label endovascular repair of cAA outcomes data appears to be limited by non-standardized PS-IDE reporting to the United States Food and Drug Administration, and the lack of Vascular Quality Initiative participation and prospective institutional data collection. Most participants are interested in a national collaborative database for endovascular repair of cAAs.

Organization of PhD studies at the Faculty of Public Health of the Slovak Medical University in the context of practice.

The Slovak Medical University (SMU) holds a unique position in the health education system in Slovakia. It has a direct connection to the health sector, allowing health education to reflect the actual needs in this field. Because of increasing importance of public health in the last decades, more attention must be given to disease prevention and the promotion of healthy lifestyles. We aim to highlight the main characteristics of health higher education at one of the specialized health universities in Slovakia, with a particular focus on public health and its practical impacts. We analysed the available legal regulations for postgraduate studies in Slovakia and the officially valid documents of the Faculty of Public Health (FPH) and the Slovak Medical University in accordance with the accredited study programme in Public Health. Archived data from the Department of Science, Research, and Doctoral Studies of the Faculty over the past 10 years were used for the analysis of postgraduate studies (2013-2023). PhD studies in Slovakia are conducted in accordance with Act No. 131/2002 Coll. on Higher Education Institutions and on amendments to certain acts. There are two forms of PhD study in Slovakia: full-time and external. The evaluation of study results is based on the credit system. The doctoral study programme proceeds according to an individual study plan under the guidance of the advisor. The PhD study concludes with the defence of the dissertation, which serves as the final thesis. A total of 97 students have graduated at FPH SMU in Public Health in the last 10 years. The majority of graduates were females (68% vs. 32% males) and studied in the external form of study (80.4% vs. 19.6% in the full-time programme). The most frequent research topics at FPH SMU in the last 10 years included Epidemiology and Prevention of Non-communicable (21.7%) and Infectious Diseases (11.3%), Health Management and Policy (17.5%), Environmental Health (15.5%), as well as Occupational Health (13.4%). High-quality and innovative postgraduate education in public health plays a crucial role in this field, preparing experts for the public health services. From a quality perspective, it is substantial to share experiences with various study programmes across the European region, as well as with other universities. Graduates of the Faculty of Public Health are highly sought-after professionals with diverse career opportunities not only in Slovakia but also within the European Union, other countries, and various important international institutions.

Linguistic authority in the context of European mobility: addressing the empty promise of élite multilingualism

ABSTRACT This qualitative study examines linguistic authority in an international department of a European Union institution in Luxembourg. Using socio-pragmatic discourse analysis, it investigates language workers’ stances towards language use at work. The findings reveal manipulative effects of language ideologies – (élite) multilingualism and native speakerism – that promote a business-like understanding of the value of language(s) in a public institution. While the institution benefits from this setup, its negative effects seem more pronounced for (“routed”) workers in unstable situations of international mobility compared to those who are settled (“rooted”). The paper advocates for increased critical language awareness and seeks to sensitise stakeholders to the effects of language ideologies in professional settings. This discussion is particularly relevant for public institutions that promote multilingualism while using English as the common language of communication. However, it may also inspire other multilingual organisations in which management aims to enhance their employees’ work experience.

Breaking barriers, building faculty: A qualitative analysis to exploring faculty development in academic hospital medicine.

Hospital medicine (HM) continues to be primarily composed of junior hospitalists and research has highlighted a paucity of mentors and academic output. Faculty advancement programs have been identified as a means to support junior hospitalists in their career trajectories and to advance the field. The optimal approach to supporting faculty development (FD) efforts is not known. To understand hospitalist groups' approaches to FD, including efforts that were perceived to be effective, and to identify barriers as well as potential future directions for FD. Rapid qualitative methods were utilized including templated summaries and matrix analysis to identify major themes. Virtual focus groups with hospitalists in the Hospital Medicine Reengineering Network (HOMERuN). Qualitative themes. Nineteen individuals from 17 unique institutions from across the United States in May 2022 participated in seven focus groups. Four key themes emerged from the study and included (1) academic hospitalist programs face multifaceted challenges and barriers to FD in HM, (2) groups have embraced a diversity of structures and frameworks, (3) due to clinical volumes, FD programs have had to adapt and evolve to meet FD needs, and (4) participants identified multiple areas for improvement, including defining tangible outcomes of FD programs and creating a repository of FD material which can be shared widely.

The Impact of Acute Peri-operative Particulate Matter Exposure on Endoscopic Sinus Surgery Outcomes: A Preliminary Multi-site Investigation.

Environmental exposures have been postulated to play an important role in the pathophysiology of chronic rhinosinusitis (CRS). Particulate matter (PM) is one of the most widely studied ambient air pollutants, but its peri-operative impact on CRS is unknown. To determine the effect of acute, peri-operative PM exposure on outcomes after endoscopic sinus surgery (ESS). Participants with CRS who self-selected ESS were prospectively enrolled. The 22-item SinoNasal Outcome Test (SNOT-22) and Medical Outcomes Study Questionnaire Short-Form 6-D (SF-6D) health utility values scores were recorded. Using residence zip codes, a secondary analysis of patient exposure to PM <2.5 μm and <10 μm (PM2.5 and PM10, respectively) was performed for the month of surgery utilizing data from Environmental Protection Agency air quality monitors. Spearman's correlation coefficients (ρ), 95% confidence intervals (CIs), and effect estimates (β) were used to determine the magnitudes of association. Simple, multivariate regression analysis was also completed. One hundred and seven patients from four geographically unique institutions across the US were enrolled with a follow-up of 6 months. Patients with higher peri-operative PM2.5 exposure had less improvement in their SNOT-22 scores after ESS compared to those with less exposure using both univariate analysis (ρ = 0.26, 95% CI: 0.08, 0.43; P = .01) and after covariate adjustment with multivariate analysis (B = 1.06, 95% CI: 0.001, 2.14, P = .05). Similar associations were not found with SF-6D outcomes or with PM10 as an exposure of interest. No significant correlations were found between peri-operative PM levels and Lund-Kennedy endoscopy scores post-operatively. Preliminary data from this pilot study reveal that PM exposure at the time of ESS may negatively associate with post-operative improvement in sinonasal quality-of-life. Larger, population-based studies with more standardized PM exposure windows are needed to confirm the clinical significance of the present findings.