The Effects of Foam Rolling vs Dynamic Stretching on Anaerobic Performance

Please refer to the pdf version of the abstract located adjacent to the title

Improving patient experience and safety at transitions of care through the Your Care Needs You (YCNY) intervention: a study protocol for a cluster randomised controlled feasibility trial

Background: Patients, particularly older people, often experience safety issues when transitioning from hospital to home. Although the evidence is currently equivocal as to how we can improve this transition of care, interventions that support patient involvement may be more effective. The ‘Your Care Needs You’ (YCNY) intervention supports patients to ‘know more’ and ‘do more’ whilst in hospital in order that they better understand their health condition and medications, maintain their daily activities, and can seek help at home if required. The intervention aims to reduce emergency hospital readmissions and improve safety and experience during the transition to home. Methods: As part of the Partners At Care Transitions (PACT) programme of research, a multi-centred cluster randomised controlled trial (cRCT) will be conducted to explore the feasibility of the YCNY intervention and trial methodology. Data will be used to refine the intervention and develop a protocol for a definitive cRCT. Ten acute hospital wards (the clusters) from varying medical specialties including older peoples’ medicine, trauma and orthopaedics, cardiology, intermediate care, and stroke will be randomised to deliver YCNY or usual care on a 3:2 basis. Up to 200 patients aged 75 years and over and discharged to their own homes will be recruited to the study. Patients will complete follow-up questionnaires at 5-, 30-, and 90-days post-discharge and readmission data up to 90-days post-discharge will be extracted from their medical records. Study outcomes will include measures of feasibility (e.g. screening, recruitment, and retention data) and processes required to collect routine data at a patient and ward level. In addition, interviews and observations involving up to 24 patients/carers and 28 staff will be conducted to qualitatively assess the acceptability, usefulness, and feasibility of the intervention and implementation package to patients and staff. A separate sub-study will be conducted to explore how accurately primary outcome data (30-day emergency hospital readmissions) can be gathered for the definitive cRCT. Discussion: This study will establish the feasibility of the YCNY intervention which aims to improve safety and experience during transitions of care. It will identify key methodological and implementation issues that need to be addressed prior to assessing the effectiveness of the YCNY intervention in a definitive cluster randomised controlled trial

The MAVEN Magnetic Field Investigation

The MAVEN magnetic field investigation is part of a comprehensive particles and fields subsystem that will measure the magnetic and electric fields and plasma environment of Mars and its interaction with the solar wind. The magnetic field instrumentation consists of two independent tri-axial fluxgate magnetometer sensors, remotely mounted at the outer extremity of the two solar arrays on small extensions ("boomlets"). The sensors are controlled by independent and functionally identical electronics assemblies that are integrated within the particles and fields subsystem and draw their power from redundant power supplies within that system. Each magnetometer measures the ambient vector magnetic field over a wide dynamic range (to 65,536 nT per axis) with a quantization uncertainty of 0.008 nT in the most sensitive dynamic range and an accuracy of better than 0.05%. Both magnetometers sample the ambient magnetic field at an intrinsic sample rate of 32 vector samples per second. Telemetry is transferred from each magnetometer to the particles and fields package once per second and subsequently passed to the spacecraft after some reformatting. The magnetic field data volume may be reduced by averaging and decimation, when necessary to meet telemetry allocations, and application of data compression, utilizing a lossless 8-bit differencing scheme. The MAVEN magnetic field experiment may be reconfigured in flight to meet unanticipated needs and is fully hardware redundant. A spacecraft magnetic control program was implemented to provide a magnetically clean environment for the magnetic sensors and the MAVEN mission plan provides for occasional spacecraft maneuvers - multiple rotations about the spacecraft x and z axes - to characterize spacecraft fields and/or instrument offsets in flight

Improving the safety and experience of transitions from hospital to home: a cluster randomised controlled feasibility trial of the ’Your Care Needs You’ intervention versus usual care

Background: The ‘Your Care Needs You’ (YCNY) intervention aims to increase the safety and experience of transitions for older people through greater patient involvement during the hospital stay. Methods: A cluster randomised controlled feasibility trial was conducted on NHS inpatient wards (clusters) where ≥ 40% of patients were routinely ≥ 75 years. Wards were randomised to YCNY or usual care using an unequal allocation ratio (3:2). We aimed to recruit up to 20 patients per ward. Follow-up included routine data collection and questionnaires at 5-, 30-, and 90-days post-discharge. Eligible patients were ≥ 75 years, discharged home, stayed overnight on participating wards, and could read and understand English. The trial assessed the feasibility of delivering YCNY and the trial methodology through recruitment rates, outcome completion rates, and a qualitative evaluation. The accuracy of using routinely coded data for the primary outcome in the defnitive trial was assessed by extracting discharge information for up to ten nonindividual consenting patients per ward. Results: Ten wards were randomised (6 intervention, 4 control). One ward withdrew, and two wards were unable to deliver the intervention. Seven-hundred twenty-one patients were successfully screened, and 161 were recruited (95 intervention, 66 control). The patient post-discharge attrition rate was 17.4% (n = 28). Primary outcome data were gathered for 91.9% of participants with 75.2% and 59.0% providing secondary outcome data at 5 and 30 days post-discharge respectively. Item completion within questionnaires was generally high. Post-discharge follow-up was terminated early due to the COVID-19 pandemic afecting 90-day response rates (16.8%). Data from 88 nonindividual consenting patients identifed an error rate of 15% when using routinely coded data for the primary outcome. No unexpected serious adverse events were identifed

Correction: The feasibility and acceptability of implementing video reflexive ethnography (VRE) as an improvement tool in acute maternity services

Following publication of the original article [1], the authors reported missing information in the ‘Acknowledgements’ section. The statement in the ‘Acknowledgements’ section originally read: None. The statement in the ‘Acknowledgements’ section should read: The authors would like to thank Mr Dileep Wijeratne for his extensive support in both the set up and delivery of this research project. We would also like to thank all of the staff from Leeds Teaching Hospitals maternity services, in particular the clinical leads for anaesthetics, obstetrics and the head of midwifery for their time and support. The original article [1] has been updated

Feeding back surveillance data to prevent hospital-acquired infections.

We describe the Centers for Disease Control and Prevention's National Nosocomial Infections Surveillance system. Elements of the system critical for successful reduction of nosocomial infection rates include voluntary participation and confidentiality; standard definitions and protocols; identification of populations at high risk; site-specific, risk- adjusted infection rates comparable across institutions; adequate numbers of trained infection control professionals; dissemination of data to health-care providers; and a link between monitored rates and prevention efforts

The feasibility and acceptability of implementing video reflexive ethnography (VRE) as an improvement tool in acute maternity services

Background Video-reflexive ethnography (VRE) has been argued to be an alternative approach to collaborative learning in healthcare teams, more able to capture the complexities of the healthcare environment than simulation. This study aims to explore the feasibility and acceptability of employing VRE as an improvement tool in acute maternity services. Method Focused ethnography and semi-structured interviews (n = 17) explored the feasibility of employing VRE from the perspective of the researcher-facilitator, and that of the healthcare staff participants. Reflexive thematic analysis was used to generate key themes. Results We identified four themes related to feasibility of employing VRE as an improvement approach: laying the groundwork; challenges of capturing in-situ video footage; effective facilitation of reflexive feedback; and, power to change. Of note was the central role of the facilitator in building and maintaining staff trust in the process, particularly in being able to guide collaborative, non-punitive discussion during reflexive feedback sessions. Interestingly, when considering implementation of change, structural hierarchies were evident with more senior staff better able to develop and effect ideas. Two themes related to acceptability of VRE among healthcare staff were identified: staff response to the role of VRE in improvement; and the power of a different perspective. Staff were overwhelmingly positive about their experience of VRE, particularly appreciating the time, space and autonomy it afforded them to navigate and articulate ideas for change and improvement. Conclusion VRE is both feasible and acceptable as an improvement tool with acute, multi-disciplinary maternity staff teams. It is an important healthcare improvement tool that could prompt the development and maintenance of team resilience factors in the face of increasing stress and burn-out of healthcare staff in maternity services

Development of an evidence-based framework of factors contributing to patient safety incidents in hospital settings: a systematic review

Objective The aim of this systematic review was to develop a ‘contributory factors framework’ from a synthesis of empirical work which summarises factors contributing to patient safety incidents in hospital settings. Design A mixed-methods systematic review of the literature was conducted. Data sources Electronic databases (Medline, PsycInfo, ISI Web of knowledge, CINAHL and EMBASE), article reference lists, patient safety websites, registered study databases and author contacts. Eligibility criteria Studies were included that reported data from primary research in secondary care aiming to identify the contributory factors to error or threats to patient safety. Results 1502 potential articles were identified. 95 papers (representing 83 studies) which met the inclusion criteria were included, and 1676 contributory factors extracted. Initial coding of contributory factors by two independent reviewers resulted in 20 domains (eg, team factors, supervision and leadership). Each contributory factor was then coded by two reviewers to one of these 20 domains. The majority of studies identified active failures (errors and violations) as factors contributing to patient safety incidents. Individual factors, communication, and equipment and supplies were the other most frequently reported factors within the existing evidence base. Conclusions This review has culminated in an empirically based framework of the factors contributing to patient safety incidents. This framework has the potential to be applied across hospital settings to improve the identification and prevention of factors that cause harm to patients