“The team needs to feel cared for”: staff perceptions of compassionate care, aids and barriers in adolescent mental health wards

BackgroundCompassion is vital in healthcare. Current understandings of the nature of compassionate care, its aids and barriers, are more theoretically developed than grounded in staff experience. This study explores staff perceptions of compassionate care in child and adolescent mental health wards.MethodsThree focus groups were conducted with a total of 35 staff from adolescent mental health wards (10–12 people in each group), on the nature of compassionate care, aids and barriers. Transcripts were analysed using thematic analysis. A follow-up survey with 36 workers from other UK child and adolescent mental health wards was completed and means and standard deviations of responses were analysed to confirm wider resonance of themes.ResultsElements of compassionate care fell into six themes relating to individual, team and organisational factors: emotional connection, sense of being valued, attention to the whole person, understanding, good communication, and practical help/resources. Aids and barriers mirrored each other, and showed that what staff think is key to the nature of compassionate care for patients is also what they feel they need to receive to be able to show compassionate care.ConclusionsThis study suggests that staff need the same elements of compassion as those which they seek to provide. A greater emphasis needs to be placed on providing staff with individual, team and organisational level resources which help them to feel compassionately held within the interconnected systems in which they work, in order to be able to continue to provide high level compassionate care. Staff need to be nourished, valued and compassionately cared for in order to be able to care compassionately for the patients they look after

Item development for a patient‐reported measure of compassionate healthcare in action

Background Compassionate care is a fundamental component of healthcare today; yet, many measures of compassionate care are subjective in focus and lack clarity around what compassionate care looks like in practice. Measures mostly relate to physical healthcare settings, neglecting mental healthcare. They also lack significant involvement of people with lived experience (PLE) of healthcare delivery in their development. This study aimed to begin the process of developing a new patient-reported measure, one that captures the observable actions of compassionate care delivery or ‘compassionate healthcare in action’ by any healthcare professional working in any care setting. The study involves PLE of healthcare delivery, both patients and staff, throughout. Methods A multistage mixed-methods scale development process was followed. First, items were derived inductively from reflexive thematic analysis of patient and clinician interviews about what compassionate care meant to them (n = 8), with additional items derived deductively from a literature review of existing measures. Next, a panel of patient, clinician and researcher experts in compassionate care was recruited (Round 1: n = 33, Round 2: n = 29), who refined these items in a two-round modified online Delphi process. Results Consensus was reached on 21 items of compassionate care in action relating to six facets: understanding, communication, attention, action, emotional sensitivity and connection. These items will form the basis for further scale development. Conclusions This item development work has laid the foundation of a potential new tool to systematically measure what compassionate healthcare in action looks like to patients. Further research is underway to produce a valid and reliable version of this proposed new measure. We have outlined these initial stages in detail in the hope of encouraging greater transparency and replicability in measure development, as well as emphasising the value of involving PLE throughout the process. Patient or Public Contribution This study involved PLE of both physical and mental healthcare (as staff, patients and service users) throughout the development of the new measure, including initial project conceptualisation and participation in item generation and refinement stages

Feminine Identities

The first four essays in this volume all focus on issues of gender in the works of different English authors and thinkers. Shorter versions of each of these essays were formerly presented as papers in an autonomous section of the Research and Educational Programme on Studies of Identity at the XXth Meeting of the Portuguese Association of Anglo-American Studies (Póvoa de Varzim, 1999) and published in the proceedings of the conference. The second cluster of essays in this volume — two of which (Jennie Wang’s and Teresa Cid’s) were first presented, in shorter versions, at the joint ASA/CAAS Conference (Montréal, 1999) — addresses the work of American women variously engaged in contexts of cultural diversity and grappling with the ideas of what it means to be an American and a woman, particularly in the twentieth century. These essays approach, from different angles, the definitional quandaries and semantic difficulties encountered when speaking about the self and the United States and provide, in one way or another, a sort of feminine rewriting of American myths and history.Fundação para a Ciência e a Tecnologi

Cold Atom Space Payload Atmospheric Drag Mission (CASPA-ADM)

To gain better understanding of the upper atmospheric dynamics requires more accurate determination of the mass density distribution in the thermosphere. Improved measurements of drag, by means of satellite accelerometery, can be used to more precisely determine this distribution. In addition, atmospheric drag in Low Earth Orbit (LEO) is particularly of interest for climate modelling, weather forecasting and satellite orbit prediction. RAL Space, Teledyne-e2v and the University of Birmingham are developing a Cold Atom Space Payload Atmospheric Drag Mission (CASPA-ADM). The aim of the project, supported by the UK Centre for Earth Observation Instrumentation (CEOI), is to develop a technology demonstrator based on Cold Atom Interferometry (CAI) to take sensitive measurements of atmospheric drag. The underlying CAI technology has been previously flown on the Chinese Space Station, the International Space Station, and in sounding rockets. However, it has not yet been used as the fundamental sensor technology in a free flight space mission. The team is producing a space-suitable accelerometer that can be embedded in small satellites such as 16U CubeSats and are addressing the engineering challenges associated with space qualification and miniaturisation, while keeping the performance level of systems with larger Size, Weight and Power (SWaP)

Electronic and magnetic properties of SnO2/CrO2 thin superlattices

In this article, using first-principles electronic structure calculations within the spin density functional theory, alternated magnetic and non-magnetic layers of rutile-CrO2 and rutile-SnO2 respectively, in a (CrO2)n(SnO2)n superlattice (SL) configuration, with n being the number of monolayers which are considered equal to 1, 2, ..., 10 are studied. A half-metallic behavior is observed for the (CrO2)n(SnO2)n SLs for all values of n. The ground state is found to be FM with a magnetic moment of 2 μB per chromium atom, and this result does not depend on the number of monolayers n. As the FM rutile-CrO2 is unstable at ambient temperature, and known to be stabilized when on top of SnO2, the authors suggest that (CrO2)n(SnO2)n SLs may be applied to spintronic technologies since they provide efficient spin-polarized carriers

Fludarabine, cytarabine, granulocyte colony-stimulating factor, and idarubicin with gemtuzumab ozogamicin improves event-free survival in younger patients with newly diagnosed aml and overall survival in patients with npm1 and flt3 mutations

Purpose To determine the optimal induction chemotherapy regimen for younger adults with newly diagnosed AML without known adverse risk cytogenetics. Patients and Methods One thousand thirty-three patients were randomly assigned to intensified (fludarabine, cytarabine, granulocyte colony-stimulating factor, and idarubicin [FLAG-Ida]) or standard (daunorubicin and Ara-C [DA]) induction chemotherapy, with one or two doses of gemtuzumab ozogamicin (GO). The primary end point was overall survival (OS). Results There was no difference in remission rate after two courses between FLAG-Ida + GO and DA + GO (complete remission [CR] + CR with incomplete hematologic recovery 93% v 91%) or in day 60 mortality (4.3% v 4.6%). There was no difference in OS (66% v 63%; P = .41); however, the risk of relapse was lower with FLAG-Ida + GO (24% v 41%; P < .001) and 3-year event-free survival was higher (57% v 45%; P < .001). In patients with an NPM1 mutation (30%), 3-year OS was significantly higher with FLAG-Ida + GO (82% v 64%; P = .005). NPM1 measurable residual disease (MRD) clearance was also greater, with 88% versus 77% becoming MRD-negative in peripheral blood after cycle 2 (P = .02). Three-year OS was also higher in patients with a FLT3 mutation (64% v 54%; P = .047). Fewer transplants were performed in patients receiving FLAG-Ida + GO (238 v 278; P = .02). There was no difference in outcome according to the number of GO doses, although NPM1 MRD clearance was higher with two doses in the DA arm. Patients with core binding factor AML treated with DA and one dose of GO had a 3-year OS of 96% with no survival benefit from FLAG-Ida + GO. Conclusion Overall, FLAG-Ida + GO significantly reduced relapse without improving OS. However, exploratory analyses show that patients with NPM1 and FLT3 mutations had substantial improvements in OS. By contrast, in patients with core binding factor AML, outcomes were excellent with DA + GO with no FLAG-Ida benefit