Victims’ Voices:Understanding the Emotional Impact of Cyberstalking and Individuals’ Coping Responses

Recent quantitative research has identified similar detrimental effects on victims of cyberstalking as those that arise from traditional stalking. The current study thematically analyzed one hundred victim narratives gathered by means of an online survey with a view to assessing the mental health and well-being implications of the experience of cyberstalking. Coping strategies employed by victims and the perceived effectiveness of each strategy were also explored. The findings suggest that the emotional impact of cyberstalking predominantly includes comorbid anxiety and depression. Common coping strategies adopted by victims in our sample include avoidant coping, ignoring the perpetrator, confrontational coping, support seeking, and cognitive reframing. Taken together, the findings demonstrate that the ramifications of cyberstalking are widespread, affecting psychological, social, interpersonal, and economic aspects of life. To adapt, some victims made major changes to both their work and social life, with some ceasing employment and others modifying their usual daily activities. The widespread negative effects of cyberstalking identified in this study highlight that this phenomenon should be a concern to both legal and mental health professionals, particularly as the comments made by our sample illustrate the current inadequacy of response and provision. Recommendations are discussed and provided for law enforcement and mental health professionals

Macmillan Rural Palliative Care Pharmacist Practitioner Project : Baseline Report 2013

The University of Strathclyde is funded to provide academic input into the NHS Highland project for 2 years (starting February 2013). The project is to be a demonstration project to inform national policy and will have direct relevance to the new proposal on the delivery of pharmacy services within NHS Scotland, ‘Prescription for Excellence’ (8). This opportunity gives NHS Highland access to the expertise developed through the previous Glasgow program and allows the University team to develop the evidence base for clinical practice within this area, and focus on developing rural pharmaceutical care capacity through the use of a community pharmacy - based practitioner

Employer choice and job quality : workplace innovation, work redesign and employee perceptions of job quality in a complex healthcare setting

This article examines employer choice in relation to job quality (JQ). Acknowledging the important role of market, institutional and technological constraints, we highlight the role of employer agency in shaping JQ by reporting on an employer-led service redesign initiative in hospital pharmacy services in Scotland. This redesign initiative aimed at upskilling employees and redirecting their work effort towards high value added, patient-facing work using robotics implementation. The article provides a critical assessment of the success of the initiative in enhancing JQ and explores a range of factors constraining and shaping employers' job quality choices

Development of the NES online palliative care medicines training series for health and social care support staff

Previous Macmillan Cancer Support and Health Board funded palliative care pharmacy service evaluations in NHS Greater Glasgow & Clyde (urban) and NHS Highland (rural) (1-4) observed a steady integration of the community pharmacy team into local palliative care services. Frontline staff in General Practice, Community Pharmacies and Care Homes in these areas were found to lack knowledge about palliative care medicines amongst their patient group. Both evaluations resulted in the development and testing of training materials in a variety of face-to-face and online formats and for different support staff

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Is there scope for rapid implementation of pharmacoepidemiology findings using quality improvement methods?

Background The Scottish Patient Safety Programme – Pharmacy in Primary Care collaborative has developed High Risk Medicine (HRM) Care Bundles (CB). These CBs, which are interventions that improve care processes and outcomes, focus on clinical assessment and patient education. Using quality improvement methods, these have been implemented in 28 community pharmacies in four health service regions – two focus on Warfarin and two on non-steroidal anti-inflammatories. The intent is for national roll out of a HRM CB, where a standardised process may act as a platform to accelerate uptake of pharmacoepidemiology findings into routine practice. Objective To develop a generic HRM CB process map to facilitate implementation. Methods Regional process maps were developed through data collection in four pharmacies, involving simulation of the CB process, staff interviews and documentation of resources. Following validation by the onsite pharmacist, commonalities among the process maps were collated to create a process map for each HRM. To develop a generic HRM process map, these were validated by 93% (n=26) of participating pharmacies. Consent was gained throughout. Ethical approval was not sought as this was service evaluation. Results Although some regional variation existed, the validation identified six core stages required for successful CB delivery: patient identification, clinical assessment, patients’ eligibility flagged, CB delivery, enrolling non-attending patients and documentation. The commonalities were sufficient to develop a generic process map encompassing staff and patients' journey, its integration into usual practice and resources utilised. Conclusion To maximise implementation success, the process map allows for targeted development of resources to facilitate each core stage. The feasibility of developing a generic process map suggests adaptability of the CB to varying clinical contexts, strengthening the CBs potential to facilitate national implementation of health informatics research. Safety concerns highlighted by pharmacoepidemiology studies could be addressed by adapting the CBs' content, allowing seamless translation of evidence into practice