Parent satisfaction with the Minimal Motor Dysfunction Unit: a survey

This study investigated parent satisfaction with the Minimal Motor Dysfunction Unit (MMDU), a service for clumsy children based in Adelaide. A questionnaire was developed and mailed to 102 parents whose children had attended the MMDU between 1991 and 1993. The response rate was 76 per cent.The level of parent satisfaction with the overall MMDU service was 86 per cent. Parents rated the processes of service delivery and the resulting outcomes as more important to them than structural aspects of the service. Based on parent comments, recommendations were made to assist in further improving the quality of the MMDU service. Parent satisfaction should be investigated as an outcome measure for other paediatric physiotherapy services

Mixing research methods in health professional degrees: thoughts for undergraduate students and supervisors

This commentary considers some of the challenges of applying mixed methods research in undergraduate research degrees, especially in professions with a clinical health focus. Our experience in physiotherapy academia is used as an example. Mixed methods research is increasingly appreciated in its own right as a third paradigm, however the success of educating novice researchers in mixing methods requires reflection on a range of theoretical and practical issues. We explore some of the under-reported features of mixed methods on a theoretical level, including the use of terminology, and the challenge of research labels, and on a practical level, the benefits of including mixing methods in clinical research and the issue of appropriate examination. Key Words: Mixed Methods, Student Research, and Qualitative and Quantitative

Extended Scope Physiotherapists are Effective and Safe in the Emergency Department: A Systematic Review and Meta-Analysis

Purpose: Extended scope physiotherapists (ESPs) are an innovative approach to service delivery that have emerged in response to increasing pressures on emergency departments (EDs). While previous systematic reviews have suggested that ESPs have a positive impact on ED outcomes, clinical practice recommendations based on limited evidence highlight a pressing need for evaluation studies to truly determine their effectiveness and safety in this setting. Therefore, the objective of this systematic review and meta-analysis was to evaluate the clinical effectiveness and safety of ESPs when delivering services in EDs. Method: Systematic literature searches were conducted using the online databases: Medline (Ovid), CINAHL (EBSCOhost), Scopus, PEDro, Cochrane Library and Informit in October, 2019. Randomised controlled trials (RCTs) or cohort studies investigating the clinical effectiveness and safety of ESPs in EDs in comparison with usual ED medical care providers were eligible for inclusion. Data extraction was completed using a form specifically developed for the study. The quality of each study was assessed using the Crowe Critical Appraisal Tool (CCAT) as well as a subjective assessment of bias, and the level of evidence was graded using the National Health and Medical Research Council (NHMRC) evidence hierarchy. Random-effects model meta-analyses were conducted using Stata (version 16.1). Results: Eleven studies met the inclusion criteria for the systematic review. These studies provided III-1 to III-3 evidence, with quality scores ranging from 50% to 93%. Consistent positive results were found regarding ESP clinical effectiveness and safety with meta-analyses demonstrating significant reductions in wait time (Cohen’s d effect size: -0.54; 95% confidence interval [CI]: -0.64 to -0.45) and length of stay (Cohen’s d effect size: -0.79; 95% CI: -0.86 to -0.72) for patients managed by ESPs. Although, confounding of results by treatment urgency made it difficult to establish a clear causal link between ESP services and outcomes. Conclusion: Although it was not able to be suggested that ESPs are an appropriate substitute for usual ED medical care due to the presence of bias and confounding, the results highlighted that ESPs, as an additional staff member in EDs, improve throughput and access to care for patients in lower urgency triage categories

Life at the edge: exploring male athlete criminality

Involvement in sport is not a barrier to negative behaviours, and athletes, like others in society, become involved in criminality. There is a relative paucity of research into the experiences of athletes who commit crimes. Whilst previous links exist between involvement in sport and violent and sexual crimes, a more significant body of empirical evidence is lacking. This paper utilises the concept of elite interviewing to explore the stories of ten male athletes who committed criminal offences either during or immediately after their athletic careers. Key emerging themes include the restrictive nature of sport, the need for excitement, risk appetite, and the impact of social influence. Male athlete behaviour is considered within the model of edgework, and themes are analysed as potential paths to edgework activities. The findings suggest the nature of both sport and male athletes can result in them seeking edgework experiences, and committing crimes as a consequence

The role of teamwork and communication in the emergency department: A systematic review

Abstract The aim of this study was to develop a systematic review using international research to describe the role of teamwork and communication in the emergency department, and its relevance to physiotherapy practice in the emergency department. Searches were conducted of CINAHL, Academic Search Premier, Scopus, Cochrane, PEDro, Medline, Embase, Amed and PubMed. Selection criteria included full-text English language research papers related to teamwork and/or communication based directly in the emergency department, involvement of any profession in the emergency department, publication in peer-reviewed journals, and related to adult emergency services. Studies were appraised using a validated critical appraisal tool. Fourteen eligible studies, all of mid-range quality, were identified. They demonstrated high levels of staff satisfaction with teamwork training interventions and positive staff attitudes towards the importance of teamwork and communication. There is moderate evidence that the introduction of multidisciplinary teams to the ED may be successful in reducing access block, and physiotherapists may play a role in this. The need for teamwork and communication in the ED is paramount, and their roles are closely linked, with the common significant purposes of improving patient safety, reducing clinical errors, and reducing waiting times

Participatory arts and affective engagement with climate change: the missing link in achieving climate compatible behaviour change?

Despite a growing number of arts based climate change interventions and the importance emphasised in the social psychology literature of achieving affective (emotional) engagement with climate change before climate compatible behaviour change is likely (exactly the kind of engagement the arts and humanities are arguably best at), to date there has been no systematic application of interpretive social science techniques to understand the ways in which these arts based interventions do, or do not, achieve affective public engagement with climate change and hence might hold the key to unlocking broader climate compatible behaviour change. This article makes three key contributions. First, it analyses the literature across social psychology and participatory arts to demonstrate why participatory, climate change based arts interventions could hold the key to more effective approaches to engaging multiple publics in climate compatible behaviour change. Second, using a small sample of participants in an arts based climate change intervention in the Inner Hebrides, Scotland, it demonstrates the potential value of combining social science techniques (in this case Q Methodology) with participatory arts interventions to better understand and learn from the ways in which climate based arts interventions achieve affective public engagement with climate change. Thirdly, it extends its analysis to engage explicitly with the under-researched issue of the role of place attachment and local, situated knowledge in mediating the influence of climate change communication. These contributions provide the basis for a significant new research and policy agenda looking forward

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Community prevalence of SARS-CoV-2 in England from April to November, 2020: results from the ONS Coronavirus Infection Survey

Background: Decisions about the continued need for control measures to contain the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rely on accurate and up-to-date information about the number of people testing positive for SARS-CoV-2 and risk factors for testing positive. Existing surveillance systems are generally not based on population samples and are not longitudinal in design. Methods: Samples were collected from individuals aged 2 years and older living in private households in England that were randomly selected from address lists and previous Office for National Statistics surveys in repeated crosssectional household surveys with additional serial sampling and longitudinal follow-up. Participants completed a questionnaire and did nose and throat self-swabs. The percentage of individuals testing positive for SARS-CoV-2 RNA was estimated over time by use of dynamic multilevel regression and poststratification, to account for potential residual non-representativeness. Potential changes in risk factors for testing positive over time were also assessed. The study is registered with the ISRCTN Registry, ISRCTN21086382. Findings: Between April 26 and Nov 1, 2020, results were available from 1 191 170 samples from 280327 individuals; 5231 samples were positive overall, from 3923 individuals. The percentage of people testing positive for SARS-CoV-2 changed substantially over time, with an initial decrease between April 26 and June 28, 2020, from 0·40% (95% credible interval 0·29–0·54) to 0·06% (0·04–0·07), followed by low levels during July and August, 2020, before substantial increases at the end of August, 2020, with percentages testing positive above 1% from the end of October, 2020. Having a patient facing role and working outside your home were important risk factors for testing positive for SARS-CoV-2 at the end of the first wave (April 26 to June 28, 2020), but not in the second wave (from the end of August to Nov 1, 2020). Age (young adults, particularly those aged 17–24 years) was an important initial driver of increased positivity rates in the second wave. For example, the estimated percentage of individuals testing positive was more than six times higher in those aged 17–24 years than in those aged 70 years or older at the end of September, 2020. A substantial proportion of infections were in individuals not reporting symptoms around their positive test (45–68%, dependent on calendar time. Interpretation: Important risk factors for testing positive for SARS-CoV-2 varied substantially between the part of the first wave that was captured by the study (April to June, 2020) and the first part of the second wave of increased positivity rates (end of August to Nov 1, 2020), and a substantial proportion of infections were in individuals not reporting symptoms, indicating that continued monitoring for SARS-CoV-2 in the community will be important for managing the COVID-19 pandemic moving forwards