Improving Outcomes for Patients With Tracheostomy Through Implementation of AARC Clinical Practice Guidelines.

Background: The COVID-19 global pandemic dramatically increased our institution's tracheostomy census. Comparing our existing protocols with American Association for Respiratory Care (AARC) January 2021 clinical practice guideline (CPG) relevant to caring for adult patients with tracheostomy in the acute care setting revealed numerous opportunities for improving our care of those patients. We assembled an interdisciplinary tracheostomy team to implement AARC CPG recommendations and manage all patients with tracheostomy in our hospital.

Middle and late Pleistocene Middle Stone Age lithic technology from Pinnacle Point 13B (Mossel Bay, Western Cape Province, South Africa).

Excavations at a complex of caves and open air sites at Pinnacle Point, Mossel Bay, Southern Africa have uncovered rich stratified assemblages of Middle Stone Age materials, including those from Pinnacle Point Cave 13B (PP13B) that comprises the first modernly excavated assemblage in southern Africa to be securely dated to the Middle Pleistocene. We report here on the complete excavated lithic artifact assemblage from PP13B. Both technological and typological analyses of the complete assemblage were performed.

Early human use of marine resources and pigment in South Africa during the Middle Pleistocene.

Genetic and anatomical evidence suggests that Homo sapiens arose in Africa between 200 and 100 thousand years (kyr) ago, and recent evidence indicates symbolic behaviour may have appeared approximately 135-75 kyr ago. From 195-130 kyr ago, the world was in a fluctuating but predominantly glacial stage (marine isotope stage MIS6); much of Africa was cooler and drier, and dated archaeological sites are rare. Here we show that by approximately 164 kyr ago (+/-12 kyr) at Pinnacle Point (on the south coast of South Africa) humans expanded their diet to include marine resources, perhaps as a response to these harsh environmental conditions.