The mental health safety improvement programme: a national quality improvement collaborative to reduce restrictive practice in England

In 2018, 38 mental health inpatient wards belonging to NHS trusts across England took part in the national reducing restrictive practice collaborative project, which aimed to reduce the use of rapid tranquillisation, restraint and seclusion of patients by 33%. Teams were supported to use quality improvement tools by skilled coaches as part of a national collaborative learning system. At the end of the programme, the overall use of restrictive practice had reduced by 15%. Of the teams that achieved improvements, the average reduction in restrictive practice was 61%. Across the collaborative there were improvements in the mean monthly use of restraints and rapid tranquillisation, and in the total use of all three measures of restrictive practice combined. Support from quality improvement coaches allowed ideas to be tested across the collaborative, enabling the creation of a theory of change for reducing restrictive practice based on areas with a high degree of belief to inform future improvement work in this area

Social ecological factors associated with physical activity and screen time amongst mothers from disadvantaged neighbourhoods over three years

Background: Mothers from socioeconomically disadvantaged neighbourhoods are at elevated risk of physical inactivity and high levels of screen time. Yet, little is known regarding the social ecological factors that are longitudinally associated with physical activity and screen time in this target group, and whether the age of their children impacts these relationships. This study aimed to longitudinally examine the social ecological factors associated with physical activity and screen time amongst mothers living in socioeconomically disadvantaged neighbourhoods, and whether these differed according to their child's age. Methods: Data were from 895 mothers living in socioeconomically disadvantaged neighbourhoods (mean age 36.7 years) at baseline and three-year follow-up. Mothers self-reported weekly discretionary physical activity (leisure-time, LTPA; transport-related, TRPA) and screen time durations. Linear regression models assessed associations between five intrapersonal, three social and five physical environmental factors and LTPA, TRPA and screen time, adjusting for confounding factors, clustering by neighbourhood and baseline variables. Interaction analysis was conducted for age of children (younger and older children (n = 442) and mothers with older children (aged 5-12 years) only (n = 453). Results: In adjusted models, all intrapersonal factors (self-efficacy, enjoyment, outcome expectations, behavioural intentions and behavioural skill), social support from friends, neighbourhood cohesion and number of televisions were longitudinally associated with LTPA amongst all mothers. Interaction models showed that findings were generally consistent across groups (i.e., those with both younger and older children compared to those with older children only), with three exceptions. Physical activity enjoyment and social support from family were associated with LTPA only among mothers with older children. Neighbourhood cohesion was associated with screen time only amongst mothers with both younger and older children. No associations were detected for TRPA. Conclusion: Intrapersonal, social and physical environmental factors were longitudinally associated with mother's LTPA, whilst neighbourhood cohesion was longitudinally associated with screen time behaviours amongst mothers. Interventions aimed at increasing LTPA amongst mothers (particularly those from socioeconomically disadvantaged neighbourhoods) may need to target all domains of the social ecological model and may require some tailoring according to the age of children. Further work is needed to identify longitudinal associations with screen time and TRPA in this population group

Parents’ engagement in an Australian school- and home-based group RCT to reduce children’s sitting time and promote physical activity: Transform-Us!

Session - S34 Involvement of parents in multicomponent school-based interventions targeting energy balance related behaviours among children and adolescents: Lessons learned from process evaluation: abstract S34.2Conference Theme: Promoting Healthy Eating and Activity WorldwidePURPOSE: Transform-Us! was a 3-year group RCT aiming to determine the effectiveness of strategies to reduce 8-year old Australian children’s sedentary behaviour (SB) or promote their physical activity (PA), or both (PA+SB) compared with usual practice (C) at school and home. METHOD: Process evaluation data were collected at post--‐intervention (T3) Nov/Dec 2011. Nine newsletters per year were …postprin

Strategies to promote children\u27s school based physical activity : Transform-Us! Mid-intervention findings

Session 202 - School based interventions: paper 276This journal suppl. entitled: Be Avtive 2012Many children engage in suboptimal levels of PA despite the associated health risks. Schools (n=20) in the Transform-Us! program were randomized to one of four intervention arms that target increases in children’s PA (PA), reductions in sedentary behavior (SB), both behaviors (SB+PA) or control current practice (C). This examination focuses on the PA promotion strategies employed in the PA and SB+PA arms compared with the C arm. To promote children’s PA each PA and SB+PA class was provided with sporting and circus equipment; asphalt line markings were installed at the school; and teachers were asked to encourage PA. Grade 3 children at participating schools were invited to take part in evaluation assessments including the completion of a self-report survey. Findings from the PA promotion strategy questions at baseline (Feb–June 2010), and T2 (Nov/Dec) are reported here. Children (n=425, 55% female) were asked to respond (yes/no) to five items asking about social support for PA from their class teacher, which were then summed to create a ‘teacher social support’ scale. Children were also asked to indicate if ‘there are markings on the walls or on the school playground to help us play games’ (perceived availability of line markings); if they are ‘allowed to use school sports equipment during recess and lunch breaks’ (perceived accessibility of sports equipment); and how much they like ‘the areas to play in at school’ using a 5-point Likert scale (perceived school environment). Between baseline and T2, teacher social support increased in both PA (1.7[1.4] vs 2.1[1.4]) and SB arms (1.9[1.4] vs 2.4[1.4) but declined in C (2.0[1.4] vs 1.7[1.5]). For all three arms, increases were seen in perceived availability of line markings (PA: 53.2% vs 69.4%; SB+PA: 59.3% vs 71.4%; C: 60.0% vs 69.8%); perceived accessibility of sport equipment (PA: 87.7% vs 97.2%: SB+PA: 80.7 vs 94%; C: 85.4% vs 97.6%); and perceived school environment (PA: 1.44[0.9] vs 1.42[0.8]; SB+PA: 1.5[0.8] vs 1.6[0.7]; C: 1.4[0.9] vs 1.5[0.7]) between baseline and T2. All findings were significant at a 1% probability level. At the mid-intervention time point, findings suggest that PA strategies have increased perceived availability of line markings, accessibility of sport equipment, and perceived school environment in children allocated to the PA and SB+PA arms. However, there were also unexpected increases in the C arm for three out of four items. Post-intervention findings will add to these preliminary findings

Virtual Compton scattering and the generalized polarizabilities of the proton at Q(2)=0.92 and 1.76 GeV2

Virtual Compton scattering (VCS) on the proton has been studied at the Jefferson Laboratory using the exclusive photon electroproduction reaction ep -\u3e ep gamma. This paper gives a detailed account of the analysis which has led to the determination of the structure functions P-LL - P-TT/epsilon and P-LT and the electric and magnetic generalized polarizabilities (GPs) alpha(E) (Q(2)) and beta(M) (Q(2)) at values of the four-momentum transfer squared Q(2) = 0.92 and 1.76 GeV2. These data, together with the results of VCS experiments at lower momenta, help building a coherent picture of the electric and magnetic GPs of the proton over the full measured Q(2) range and point to their nontrivial behavior

Virtual Compton scattering and neutral pion electroproduction in the resonance region up to the deep inelastic region at backward angles

We have made the first measurements of the virtual Compton scattering (VCS) process via the H(e, e\u27p). exclusive reaction in the nucleon resonance region, at backward angles. Results are presented for the W-dependence at fixed Q(2) = 1 GeV(2) and for the Q(2) dependence at fixed W near 1.5 GeV. The VCS data show resonant structures in the first and second resonance regions. The observed Q(2) dependence is smooth. The measured ratio of H(e, e\u27p). to H(e, e\u27p) pi(0) cross sections emphasizes the different sensitivity of these two reactions to the various nucleon resonances. Finally, when compared to real Compton scattering (RCS) at high energy and large angles, our VCS data at the highest W (1.8-1.9 GeV) show a striking Q(2) independence, which may suggest a transition to a perturbative scattering mechanism at the quark level

Quantification of a subsea CO2 release with lab-on-chip sensors measuring benthic gradients

We present a novel approach to detecting and quantifying a subsea release of CO2 from within North Sea sed�iments, which mimicked a leak from a subsea CO2 reservoir. Autonomous lab-on-chip sensors performed in situ measurements of pH at two heights above the seafloor. During the 11 day experiment the rate of CO2 release was gradually increased. Whenever the currents carried the CO2-enriched water towards the sensors, the sensors measured a decrease in pH, with a strong vertical gradient within a metre of the seafloor. At the highest release rate, a decrease of over 0.6 pH units was observed 17 cm above the seafloor compared to background mea�surements. The sensor data was combined with hydrodynamic measurements to quantify the amount of CO2 escaping the sediments using an advective mass transport model. On average, we directly detected 43 ± 8% of the released CO2 in the water column. Accounting for the incomplete carbonate equilibration process increases this estimate to up to 61 ± 10%. This technique can provide long-term in situ monitoring of offshore CO2 res�ervoirs and hence provides a tool to support climate change mitigation activities. It could also be applied to characterising plumes and quantifying other natural or anthropogenic fluxes of dissolved solutes

Is level of implementation linked with intervention outcomes? Process evaluation of the TransformUs intervention to increase children's physical activity and reduce sedentary behaviour

Background TransformUs was a four-arm school-based intervention to increase physical activity and reduce sedentary behaviour among primary school children. Pedagogical and environmental strategies targeted the classroom, school grounds and family setting. The aims of this study were to evaluate program fidelity, dose, appropriateness, satisfaction and sustainability, and associations between implementation level and outcomes among the three intervention arms. Methods At baseline, 18-months (mid-intervention) and 30-months (post-intervention), teachers, parents and children completed surveys, and children wore GT3X ActiGraph accelerometers for 8 days at each time point to determine physical activity and sedentary time. Implementation data were pooled across the three intervention groups and teachers were categorised by level of implementation: (i) ‘Low’ ( 67% delivered). Linear and logistic mixed models examined between group differences in implementation, and the association with children’s physical activity and sedentary time outcomes. Qualitative survey data were analysed thematically. Results Among intervention recipients, 52% (n = 85) of teachers, 29% (n = 331) of parents and 92% (n = 407) of children completed baseline evaluation surveys. At 18-months, teachers delivered on average 70% of the key messages, 65% set active/standing homework, 30% reported delivering > 1 standing lesson/day, and 56% delivered active breaks per day. The majority of teachers (96%) made activity/sports equipment available during recess and lunch, and also used this equipment in class (81%). Fidelity and dose of key messages and active homework reduced over time, whilst fidelity of standing lessons, active breaks and equipment use increased. TransformUs was deemed appropriate for the school setting and positively received. Implementation level and child behavioural outcomes were not associated. Integration of TransformUs into existing practices, children’s enjoyment, and teachers’ awareness of program benefits all facilitated delivery and sustainability. Conclusions This study demonstrated that intervention dose and fidelity increased over time, and that children’s enjoyment, senior school leadership and effective integration of interventions into school practices facilitated improved intervention delivery and sustainability. Teacher implementation level and child behavioural outcomes were unrelated, suggesting intervention efficacy was achieved irrespective of implementation variability. The potential translatability of TransformUs into practice contexts may therefore be increased. Findings have informed scale-up of TransformUs across Victoria, Australia. Trial registration International Standard Randomized Controlled Trial Number ISRCTN83725066; Australian New Zealand Clinical Trials Registry Number ACTRN12609000715279. Registered 19 August 2009. Available at: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=308387&isReview=tru

Examination of mid-intervention mediating effects on objectively assessed sedentary time among children in the Transform-Us! Cluster-randomized controlled trial

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Buzz off! An evaluation of ultrasonic acoustic vibration for the disruption of marine micro-organisms on sensor-housing materials

Biofouling is a process of ecological succession which begins with the attachment and colonization of micro-organisms to a submerged surface. For marine sensors and their housings, biofouling can be one of the principle limitations to long-term deployment and reliability. Conventional antibiofouling strategies using biocides can be hazardous to the environment, and therefore alternative chemical-free methods are preferred. In this study, custom-made testing assemblies were used to evaluate ultrasonic vibration as an antibiofouling process for marine sensor-housing materials over a 28-day time course. Microbial biofouling was measured based on (i) surface coverage, using fluorescence microscopy and (ii) bacterial 16S rDNA gene copies, using Quantitative polymerase chain reaction (PCR). Ultrasonic vibrations (20 KHz, 200 ms pulses at 2-s intervals; total power 16·08 W) significantly reduced the surface coverage on two plastics, poly(methyl methacrylate) and polyvinyl chloride (PVC) for up to 28 days. Bacterial gene copy number was similarly reduced, but the results were only statistically significant for PVC, which displayed the greatest overall resistance to biofouling, regardless of whether ultrasonic vibration was applied. Copper sheet, which has intrinsic biocidal properties was resistant to biofouling during the early stages of the experiment, but inhibited measurements made by PCR and generated inconsistent results later on