Evaluating the quality of care within residential services for older people

The quality of care within residential services for older people has been a source of concern within health and social care for some time. Several attempts have been made to develop a means of assessing the quality of care; however, the nature and quality of these varies enormously. The Quest process of evaluation, which was designed as a means of assessing service quality according to the structure and process of care, is presented as a possible means of improving upon current practice. The Quest system incorporates four measures: the Service Profile, the Support Questionnaire, the Observation Profile and the Occupational Stress Indicator. The Service Profile is essentially descriptive in nature, and the Occupational Stress Indicator is a published, standardised measure. The remaining Quest measures, however, were only recently developed and therefore lack evidence in support of their psychometric properties.The present study was designed to assess the validity and reliability of the Quest system within residential services for older people. The exploration of validity and reliability took several forms, incorporating both qualitative and quantitative methodologies. The overall findings of the discussion group and assessment of face validity advocated the credibility of the dimensions of support that underpin the Quest system. With regards to reliability, the findings supported the reliability of the Observation Profile but identified that further work was needed to ascertain the reliability of the Support Questionnaire. Issues relevant to the interpretation of the results were discussed along with the reasons why a number of formal assessments of validity could not be made. Further work to explore the psychometric properties of the Quest system was recommended before it can be confidently applied to residential services for older people

New Lessons: The Power of Educating Adolescent Girls

Offers data and analysis on the impact of education on adolescent girls' lives and highlights promising approaches. Calls for evaluating girl-friendly education programs, compiling data on non-formal schools, and improving curricula, access, and supports

A foot drop compensation device based on surface multi-field functional electrical stimulation—Usability study in a clinical environment

Functional electrical stimulation applies electrical pulses to the peripheral nerves to artificially achieve a sensory/motor function. When applied for the compensation of foot drop it provides both assistive and therapeutic effects. Multi-field electrodes have shown great potential but may increase the complexity of these systems. Usability aspects should be checked to ensure their success in clinical environments. We developed the Fesia Walk device, based on a surface multi-field electrode and an automatic calibration algorithm, and carried out a usability study to check the feasibility of integrating this device in therapeutic programs in clinical environments. The study included 4 therapists and 10 acquired brain injury subjects (8 stroke and 2 traumatic brain injury).The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Part of this study was supported by the European Regional Development Funds through the Interreg Sudoe Program, project SOE1/P1/F0370

Work Journey Rescheduling - Report of Surveys.

In order to model the possible effects of rescheduling the work journey on city centre peak period traffic congestion, it was necessary to obtain information about the current employment position in the city centre, and about traffic conditions in the peak period. To this end, a series of surveys were designed and implemented to collect information from a stratified sample of centrally located employers; a sample of their employees; and about traffic conditions between the hours of 07.30 and 09.30 along selected routes leading into the city centre. Problems in running the surveys were encountered and overcome, and the resulting information covered: - Employee numbers, their permitted work hours, and the type of schedule worked per employer. - The Standard Industrial Classification (SIC) of each employer. - Car parking facilities provided by employer. - Bus facilities provided by employer. - Origin of employees' journey to work. - Mode(s) used in employees' journey to work. - Employees' actual arrival at and start work times, together with departure from work time, for the week preceeding the survey. - Personal characteristics of employees. - Structure of employees' households. - Journey times and traffic flows along selected corridors. The data thus collected was used to provide a base situation against which modelled alternative work hour strategies could be tested

JISC Final Report: IncReASe (Increasing Repository Content through Automation and Services)

The IncReASe (Increasing Repository Content through Automation and Services) was an eighteen month project (subsequently extended to twenty months) to enhance White Rose Research Online (WRRO)1. WRRO is a shared repository of research outputs (primarily publications) from the Universities of Leeds, Sheffield and York; it runs on the EPrints open source repository platform. The repository was created in 2004 and had steady growth but, in common with many other similar repositories, had difficulty in achieving a “critical mass” of content and in becoming truly embedded within researchers’ workflows. The main aim of the IncReASe project was to assess ingestion routes into WRRO with a view to lowering barriers to deposit. We reviewed the feasibility of bulk import of pre-existing metadata and/or full-text research outputs, hoping this activity would have a positive knock-on effect on repository growth and embedding. Prior to the project, we had identified researchers’ reluctance to duplicate effort in metadata creation as a significant barrier to WRRO uptake; we investigated how WRRO might share data with internal and external IT systems. This work included a review of how WRRO, as an institutional based repository, might interact with the subject repository of the Economic and Social Research Council (ESRC). The project addressed four main areas: (i) researcher behaviour: we investigated researcher awareness, motivation and workflow through a survey of archiving activity on the university web sites, a questionnaire and discussions with researchers (ii) bulk import: we imported data from local systems, including York’s submission data for the 2008 Research Assessment Exercise (RAE), and developed an import plug-in for use with the arXiv2 repository (iii) interoperability: we looked at how WRRO might interact with university and departmental publication databases and ESRC’s repository. (iv) metadata: we assessed metadata issues raised by importing publication data from a variety of sources. A number of outputs from the project have been made available from the IncReASe project web site http://eprints.whiterose.ac.uk/increase/. The project highlighted the low levels of researcher awareness of WRRO - and of broader open access issues, including research funders’ deposit requirements. We designed some new publicity materials to start to address this. Departmental publication databases provided a useful jumping off point for advocacy and liaison; this activity was helpful in promoting awareness of WRRO. Bulk import proved time consuming – both in terms of adjusting EPrints plug-ins to incorporate different datasets and in the staff time required to improve publication metadata. A number of deposit scenarios were developed in the context of our work with ESRC; we concentrated on investigating how a local deposit of a research paper and attendant metadata in WRRO might be used to populate ESRC’s repository. This work improved our understanding of researcher workflows and of the SWORD protocol as a potential (if partial) solution to the single deposit, multiple destination model we wish to develop; we think the prospect of institutional repository / ESRC data sharing is now a step closer. IncReASe experienced some staff recruitment difficulties. It was also necessary to adapt the project to the changing IT landscape at the three partner institutions – in particular, the introduction of a centralised publication management system at the University of Leeds. Although these factors had some impact on deliverables, the aims and objectives of the project were largely achieved

Diaries or questionnaires for collecting self-reported healthcare utilisation and patient cost data? CHERE Project Report No 20

The literature comparing diaries and questionnaires was reviewed in order to identify the most appropriate method of collecting patient self-reported data, on health service utilisation and out-ofpocket costs, for a longitudinal study. Nine published studies met the review inclusion criteria; four compared the diary method with a self-completed questionnaire and five with an interviewer administered questionnaire. None of the eligible studies measured patient costs, and only two measured some aspects of health service utilisation. Most of the studies reported higher response rates for questionnaires than for diaries, and there was some evidence of selection bias. There was a tendency to report more symptoms, symptom intensity or health care utilisation by questionnaires compared to diaries, and compared to physician reports (included in only two studies). The review provides some information about the two approaches for collecting self-reported data, but does not provide sufficient evidence to favour either approach.diaries, health care utilisation

Telehealth: acceptability, clinical interventions and quality of life in peritoneal dialysis

Introduction: Telehealth technologies are being widely adopted across the globe for management of long-term conditions. There are limited data on its use, effectiveness and patient experience in end-stage renal disease. The aim of this pilot project was to explore patient acceptability of technology and evaluate its effect on clinical interventions and quality of life in patients undergoing peritoneal dialysis. Methods: Peritoneal dialysis patients were provided with computer tablets (PODs). PODs contained a knowledge database with treatment- and symptom-based questionnaires that generated alerts for the clinical team. Alerts were reviewed daily and followed up by a telephone call or clinic visit. Interventions were at the discretion of clinicians. Data were recorded prospectively and quality of life and Quebec User Evaluation of Satisfaction with assistive Technology questionnaires evaluated at the start and end of the programme. Results: In all, 22 patients have participated over 15 months. The mean age was 61.6 years and PODs were utilised for an average of 341.9 days with 59.1% choosing to continue beyond the study period. We received a total of 1195 alerts with an average of 2.6 alerts per day. A total of 36 admissions were avoided and patients supported to self-manage on 154 occasions. Quebec User Evaluation of Satisfaction with assistive Technology scores remained high throughout the programme although no improvement in quality of life was seen. Discussion: Telehealth is useful to monitor patients with renal failure on peritoneal dialysis. It is acceptable across age groups and provides an additional resource for patients to self-manage. Satisfaction scores and retention rates suggest a high level of acceptability

The epidemiology of injuries across the weight-training sports

Background: Weight-training sports, including weightlifting, powerlifting, bodybuilding, strongman, Highland Games, and CrossFit, are weight-training sports that have separate divisions for males and females of a variety of ages, competitive standards, and bodyweight classes. These sports may be considered dangerous because of the heavy loads commonly used in training and competition. Objectives: Our objective was to systematically review the injury epidemiology of these weight-training sports, and, where possible, gain some insight into whether this may be affected by age, sex, competitive standard, and bodyweight class. Methods: We performed an electronic search using PubMed, SPORTDiscus, CINAHL, and Embase for injury epidemiology studies involving competitive athletes in these weight-training sports. Eligible studies included peer-reviewed journal articles only, with no limit placed on date or language of publication. We assessed the risk of bias in all studies using an adaption of the musculoskeletal injury review method. Results: Only five of the 20 eligible studies had a risk of bias score ≥75 %, meaning the risk of bias in these five studies was considered low. While 14 of the studies had sample sizes >100 participants, only four studies utilized a prospective design. Bodybuilding had the lowest injury rates (0.12–0.7 injuries per lifter per year; 0.24–1 injury per 1000 h), with strongman (4.5–6.1 injuries per 1000 h) and Highland Games (7.5 injuries per 1000 h) reporting the highest rates. The shoulder, lower back, knee, elbow, and wrist/hand were generally the most commonly injured anatomical locations; strains, tendinitis, and sprains were the most common injury type. Very few significant differences in any of the injury outcomes were observed as a function of age, sex, competitive standard, or bodyweight class. Conclusion: While the majority of the research we reviewed utilized retrospective designs, the weight-training sports appear to have relatively low rates of injury compared with common team sports. Future weight-training sport injury epidemiology research needs to be improved, particularly in terms of the use of prospective designs, diagnosis of injury, and changes in risk exposure