Using intervention mapping to develop a culturally appropriate intervention to prevent childhood obesity: the HAPPY (Healthy and Active Parenting Programme for Early Years) study.

INTRODUCTION: Interventions that make extensive use of theory tend to have larger effects on behaviour. The Intervention Mapping (IM) framework incorporates theory into intervention design, implementation and evaluation, and was applied to the development of a community-based childhood obesity prevention intervention for a multi-ethnic population. METHODS: IM was applied as follows: 1) Needs assessment of the community and culture; consideration of evidence-base, policy and practice; 2) Identification of desired outcomes and change objectives following identification of barriers to behaviour change mapped alongside psychological determinants (e.g. knowledge, self-efficacy, intention); 3) Selection of theory-based methods and practical applications to address barriers to behaviour change (e.g., strategies for responsive feeding); 4) Design of the intervention by developing evidence-based interactive activities and resources (e.g., visual aids to show babies stomach size). The activities were integrated into an existing parenting programme; 5) Adoption and implementation: parenting practitioners were trained by healthcare professionals to deliver the programme within Children Centres. RESULTS: HAPPY (Healthy and Active Parenting Programme for Early Years) is aimed at overweight and obese pregnant women (BMI > 25); consists of 12 × 2.5 hr. sessions (6 ante-natal from 24 weeks; 6 postnatal up to 9 months); it addresses mother's diet and physical activity, breast or bottle feeding, infant diet and parental feeding practices, and infant physical activity. CONCLUSION: We have demonstrated that IM is a feasible and helpful method for providing an evidence based and theoretical structure to a complex health behaviour change intervention. The next stage will be to assess the impact of the intervention on behaviour change and clinical factors associated with childhood obesity. The HAPPY programme is currently being tested as part of a randomised controlled feasibility trial

Tracking EEG changes to alpha and beta binaural beats

A binaural beat can be produced by presenting two tones of differing frequency, one to each ear. Such auditory stimulation has been suggested to influence behaviour and cognition via the process of cortical entrainment. However, research so far has only shown frequency following responses in the traditional EEG frequency ranges of delta, theta and gamma. Hence a primary aim of this research was to ascertain whether it would be possible to produce clear changes in the EEG in either the alpha or beta frequency ranges. Such changes, if possible, would have a number of important implications as well as potential applications. A secondary goal was to track any observable changes in EEG throughout the entrainment epoch to gain some insight into the nature of the entrainment effects any changes in an effort to identify more effective entrainment regimes. Twenty two healthy participants were recruited and randomly allocated to one of two groups, each of which was exposed to a distinct binaural beat frequency for ten 1-minute epochs. The first group listened to an alpha binaural beat of 10Hz and the second to a beta binaural beat of 20Hz. EEG was recorded from the left and right temporal regions during pre-exposure baselines, stimulus exposure epochs and post-exposure baselines. Analysis of changes in broad-band and narrow-band amplitude, and frequency showed no effect of either binaural beat frequency eliciting a frequency following effect in the EEG. Possible mediating factors are discussed and a number of recommendations are made regarding future studies, exploring entrainment effects from binaural beat presentation

Exploring nurses’ experiences of value congruence and the perceived relationship with wellbeing and patient care and safety: a qualitative study

Background Values are of high importance to the nursing profession. Value congruence is the extent to which an individual’s values align with the values of their organisation. Value congruence has important implications for job satisfaction. Aim This study explored nurse values, value congruence and potential implications for individual nurses and organisations in terms of wellbeing and patient care and safety. Method Fifteen nurses who worked in acute hospital settings within the UK participated in semi-structured telephone interviews. Thematic analysis was utilised to analyse the data. Results Four themes were identified: organisational values incongruent with the work environment; personal and professional value alignment; nurse and supervisor values in conflict; nurses’ values at odds with the work environment. Perceived value incongruence was related to poorer wellbeing, increased burnout and poorer perceived patient care and safety. The barriers identified for nurses being able to work in line with their values are described. Conclusions Value congruence is important for nurse wellbeing and patient care and safety. Improving the alignment between the values that organisations state they hold, and the values implied by the work environment may help improve patient care and safety and support nurses in practice

Exploring patient safety outcomes for people with learning disabilities in acute hospital settings: a scoping review

Objectives To produce a narrative synthesis of published academic and grey literature focusing on patient safety outcomes for people with learning disabilities in an acute hospital setting. Design Scoping review with narrative synthesis. Methods The review followed the six stages of the Arksey and O’Malley framework. We searched four research databases from January 2000 to March 2021, in addition to handsearching and backwards searching using terms relating to our eligibility criteria—patient safety and adverse events, learning disability and hospital setting. Following stakeholder input, we searched grey literature databases and specific websites of known organisations until March 2020. Potentially relevant articles and grey literature materials were screened against the eligibility criteria. Findings were extracted and collated in data charting forms. Results 45 academic articles and 33 grey literature materials were included, and we organised the findings around six concepts: (1) adverse events, patient safety and quality of care; (2) maternal and infant outcomes; (3) postoperative outcomes; (4) role of family and carers; (5) understanding needs in hospital and (6) supporting initiatives, recommendations and good practice examples. The findings suggest inequalities and inequities for a range of specific patient safety outcomes including adverse events, quality of care, maternal and infant outcomes and postoperative outcomes, in addition to potential protective factors, such as the roles of family and carers and the extent to which health professionals are able to understand the needs of people with learning disabilities. Conclusion People with learning disabilities appear to experience poorer patient safety outcomes in hospital. The involvement of family and carers, and understanding and effectively meeting the needs of people with learning disabilities may play a protective role. Promising interventions and examples of good practice exist, however many of these have not been implemented consistently and warrant further robust evaluation

Implementing and evaluating patient‐focused safety technology on adult acute mental health wards

Accessible Summary What is known on the subject - Mental health wards can feel unsafe. We know that patients and staff have different ideas about what makes a hospital ward safe or unsafe. - Patients are often the first to know when the atmosphere on a ward becomes tense, but often, no one asks them for their views. - Patients and staff are experts and should be included in discussions about how to make wards safer. What this paper adds to existing knowledge - We got together with some service users and staff, and made an app that helps patients to tell staff when they are not feeling safe on a mental health ward. We tried it out on six wards and we asked patients and staff what they thought. - The app was easy to use and most people liked the look of it. - Patients said staff did not talk with them enough and so they liked using the app. However, some staff said they could tell how patients were feeling without an app and so they did not need it. Ward managers told us that staff were often very busy and did not always have time to use the app. What are the implications for practice - This app could help staff know straightaway when patients do not feel safe on the ward, so that they can act quickly to calm things down. - To make the most of the app, staff need to get used to it and bring it into ward routines. Introduction Safety improvement on mental health wards is of international concern. It should incorporate patient perspectives. Aim Implementation and evaluation of ‘WardSonar’, a digital safety-monitoring tool for adult acute mental health wards, developed with stakeholders to communicate patients' real-time safety perceptions to staff. Method Six acute adult mental health wards in England implemented the tool in 2022. Evaluation over 10 weeks involved qualitative interviews (34 patients, 33 staff), 39 focused ethnographic observations, and analysis of pen portraits. Results Implementation and evaluation of the WardSonar tool was feasible despite challenging conditions. Most patients valued the opportunity to communicate their immediate safety concerns, stating that staff had a poor understanding of them. Some staff said the WardSonar tool could help enhanced ward safety but recognised a need to incorporate its use into daily routines. Others said they did not need the tool to understand patients' safety concerns. Discussion Foreseeable challenges, including staff ambivalence and practical issues, appeared intensified by the post-COVID-19 context. Implications for Practice The WardSonar tool could improve ward safety, especially from patients' perspectives. Future implementation could support staff to use the real-time data to inform proactive safety interventions

How to analyse longitudinal data from multiple sources in qualitative health research : the pen portrait analytic technique

BACKGROUND: Longitudinal qualitative research is starting to be used in applied health research, having been popular in social research for several decades. There is potential for a large volume of complex data to be captured, over a span of months or years across several different methods. How to analyse this volume of data - with its inherent complexity - represents a problem for health researchers. There is a previous dearth of methodological literature which describes an appropriate analytic process which can be readily employed. METHODS: We document a worked example of the Pen Portrait analytic process, using the qualitative dataset for which the process was originally developed. RESULTS: Pen Portraits are recommended as a way in which longitudinal health research data can be concentrated into a focused account. The four stages of undertaking a pen portrait are: 1) understand and define what to focus on 2) design a basic structure 3) populate the content 4) interpretation. Instructive commentary and guidance is given throughout with consistent reference to the original study for which Pen Portraits were devised. The Pen Portrait analytic process was developed by the authors, borne out of a need to effectively integrate multiple qualitative methods collected over time. Pen Portraits are intended to be adaptable and flexible, in order to meet the differing analytic needs of qualitative longitudinal health studies. CONCLUSIONS: The Pen Portrait analytic process provides a useful framework to enable researchers to conduct a robust analysis of multiple sources of qualitative data collected over time

Subcellular heterogeneity of ryanodine receptor properties in ventricular myocytes with low T-tubule density

Rationale: In ventricular myocytes of large mammals, not all ryanodine receptor (RyR) clusters are associated with T-tubules (TTs); this fraction increases with cellular remodeling after myocardial infarction (MI). Objective: To characterize RyR functional properties in relation to TT proximity, at baseline and after MI. Methods: Myocytes were isolated from left ventricle of healthy pigs (CTRL) or from the area adjacent to a myocardial infarction (MI). Ca2+ transients were measured under whole-cell voltage clamp during confocal linescan imaging (fluo-3) and segmented according to proximity of TTs (sites of early Ca2+ release, F>F50 within 20 ms) or their absence (delayed areas). Spontaneous Ca2+ release events during diastole, Ca2+ sparks, reflecting RyR activity and properties, were subsequently assigned to either category. Results: In CTRL, spark frequency was higher in proximity of TTs, but spark duration was significantly shorter. Block of Na+/Ca2+ exchanger (NCX) prolonged spark duration selectively near TTs, while block of Ca2+ influx via Ca2+ channels did not affect sparks properties. In MI, total spark mass was increased in line with higher SR Ca2+ content. Extremely long sparks (>47.6 ms) occurred more frequently. The fraction of near-TT sparks was reduced; frequency increased mainly in delayed sites. Increased duration was seen in near-TT sparks only; Ca2+ removal by NCX at the membrane was significantly lower in MI. Conclusion: TT proximity modulates RyR cluster properties resulting in intracellular heterogeneity of diastolic spark activity. Remodeling in the area adjacent to MI differentially affects these RyR subpopulations. Reduction of the number of sparks near TTs and reduced local NCX removal limit cellular Ca2+ loss and raise SR Ca2+ content, but may promote Ca2+ waves

Assessing Public Engagement with Science in a University Primate Research Centre in a National Zoo

Recent years have seen increasing encouragement by research institutions and funding bodies for scientists to actively engage with the public, who ultimately finance their work. Animal behaviour as a discipline possesses several features, including its inherent accessibility and appeal to the public, that may help it occupy a particularly successful niche within these developments. It has also established a repertoire of quantitative behavioural methodologies that can be used to document the public's responses to engagement initiatives. This kind of assessment is becoming increasingly important considering the enormous effort now being put into public engagement projects, whose effects are more often assumed than demonstrated. Here we report our first attempts to quantify relevant aspects of the behaviour of a sample of the hundreds of thousands of visitors who pass through the ‘Living Links to Human Evolution Research Centre’ in Edinburgh Zoo. This University research centre actively encourages the public to view ongoing primate research and associated science engagement activities. Focal follows of visitors and scan sampling showed substantial ‘dwell times’ in the Centre by common zoo standards and the addition of new engagement elements in a second year was accompanied by significantly increased overall dwell times, tripling for the most committed two thirds of visitors. Larger groups of visitors were found to spend more time in the Centre than smaller ones. Viewing live, active science was the most effective activity, shown to be enhanced by novel presentations of carefully constructed explanatory materials. The findings emphasise the importance and potential of zoos as public engagement centres for the biological sciences