Fall Prevention Assessment in the Intermediate Care Patient Population

Fall Prevention Assessment in the Intermediate Care Patient Population Falls cause greater than 600,000 deaths per year and are the most common injury in people over 65 years of age. Fall prevention in the acute care setting has been identified as key goal in the most recent JCAHO review process. Falls on an intermediary care unit lead to an increased rate of morbidity, delayed discharge, and excess cost expenditure. Even with appropriate evidence-based tools in place, Hospital A’s intermediate care unit, recorded an increased rate of falls; the highest rate in its health care system. An investigation identified factors contributing to the excessive fall rate. After assessing the current protocol, performing direct observation, reviewing charts, and surveying the nursing staff, appropriate protocols had been implemented and the patients’ risk of falling was documented accurately the electronic health record (EHR). However, in an excess of caution, signage had been posted identifying virtually all patients as high risk. The presumptive, unintended consequence of this practice was decreased attention the most at-risk patients and thus contributed to the increased fall rate. An educational intervention for staff was developed and proposed to redirect attention to the protocol ensuring that posted signage and other aspects of the protocol accurately reflected each patient’s fall risk. Appropriate use of the protocol could allow nurses to be properly sensitized to high-risk patients and distribute resources more effectively. After a review of the relevant literature, a recommendation was made to add a validated tool to assess delirium as well. It is expected that including this assessment will further refine the identification of patients at high risk for falls. Reinforcement of the existing, evidence-based, fall prevention protocol should heighten awareness as to appropriate signage of patient risk. Additional assessment of delirium will increase the sensitivity of identifying patients at higher risk of falling due to their compromised mental status. Successful implementation with this combined approach should decrease the rate of falls on an intermediate care unit thereby decreasing patient morbidity and excess hospital costs

Gender and motor competence affects perceived likelihood and importance of physical activity outcomes among 14 year olds

Little is understood about the impact of level of motor competence on self-perceptions in adolescence, in particular how this may differentially affect girls and boys. A sample of 1,568 14-year-old participants (766 girls and 802 boys) were grouped into four motor competence levels (very low to high) based on the McCarron Assessment of Neuromuscular Development (MAND). Self-perceptions were assessed using the Self-Perception Profile for Adolescents. Boys had higher self-perceptions of global self-worth, athletic competence, and physical appearance, whereas girls had higher scores for close friendships and behavioral conduct. Main effects in the predicted direction were found for motor competence for self-perceptions of global self-worth, athletic competence, physical appearance, close friendships, social acceptance, and romantic appeal. These findings indicate that level of motor competence is important in many aspects of self-perceptions, affecting girls and boys differently. Higher motor competence has a protective effect on psychosocial health, particularly for girls

Gomphonema parvulum (Kutzing) Kutzing: Ecophysiological, Morphometric and Observational Studies of a Species Complex

Perturbations to environmental conditions experienced by any one species, can invoke a physiological and/or behavioural response that may be expressed morphologically and ecologically. This has important implications for diatom taxonomy and the use of diatoms as environmental indicators. The reliable recognition of a taxon with a particular life history, morphology, ecology and physiology may necessitate the adoption of narrower species concepts than those in current floras. This would have the advantage of clarifying the ecological ranges of taxa used in biological monitoring programmes. Gomphonema parvulum has long been a taxonomic problem. The species exhibit considerable is found over a wide range of environmental conditions. lt has also been used as an indicator of "pollution" in diatom indices of water quality. Clones of G. parvulum, exhibiting a range of morphologies, were isolated from different sites into unialgal culture. Experimental investigations on the clones, tested against different environmental variables to determine ecological tolerances of different isolates, occasionally produced auxospores. This rare opportunity allowed the morphology of particular clones to be studied over their full size range (initial cell through to mother cells). Additionally, aspects of diatom behaviour, including sexual reproduction could be observed and recorded. Results indicate that not only are there differences in cell shape and behaviour with size and environmental condition, but in some G. parvulum clones, heteropolarity is not determined in the auxospore or initial cell, but becomes established after a series of vegetative divisions. This increases the likelihood that specimens may have been incorrectly identified as different species or varieties (G. parvulum complex encompasses two previously described species, G. gracile and G. hebridense), underlining the need for experimental studies and culturing. These observations argue strongly against reliance on diatom valve morphology as the sole criterion on which to delimit taxa, and provide a compelling argument for the benefits of algal culturing and observation of live material. There are serious issues for the sampling of waters and the use of diatom indices of water quality. Community analyses, water quality indices and taxonomic studies will be invalid, especially if different parts of the life cycle are shown to be ecologically as well as morphological variable

How music benefits children

This article considers the notion of cognitive, behavioural and socio-emotional transfer effects of musical learning. It recaps past findings and adds a short summary of my recent PhD thesis findings supporting a beneficial effect of musical learning on these factors. However, the article also criticises the notion of transfer effects suggesting that this misunderstands how musical learning works, and suggesting the effected factors are actually integral to the process of musical learning

The OneTogether collaborative approach to reduce the risk of surgical site infection: identifying the challenges to assuring best practice

Background: Surgical site infections (SSI) account for 16% of healthcare associated infections, and are associated with considerable morbidity, mortality and increased costs of care. Ensuring evidence-based practice to prevent SSI is incorporated across the patient’s surgical journey is complex. OneTogether is a quality improvement collaborative of infection prevention and operating department specialists, formed to support the spread and adoption of best practice to prevent SSI. This paper describes the findings of an expert workshop on infection prevention in operating departments. Methods: A total of 84 delegates from 75 hospitals attended the workshop, comprising 46 (55%) theatre nurses/operating department practitioners; 16 (19%) infection control practitioners and 22 (26%) other healthcare practitioners. Discussion focused on evidence, policy implementation and barriers to best practice. Responses were synthesised into a narrative review. Results: Delegates reported significant problems in translating evidence-based guidance into everyday practice, lack of local polices and poor compliance. Major barriers were lack of leadership, poorly defined responsibilities, and lack of knowledge/training. Conclusions: This workshop has provided important insights into major challenges in assuring compliance with best practice in relation to the prevention of SSI. The OneTogether partnership aims to support healthcare practitioners to improve the outcomes of patients undergoing surgery by reducing the risk of SSI

Telling the difference between deceiving and truth telling: An experiment in a public space

The behavioral experiment presented in this paper investigated deception tasks (both concealment and lying) undertaken in a public space. The degree of risk of deception detection and the demands of self-regulation when deceiving were manipulated. The results showed a significant interaction effect between veracity and risk of deception detection, emerged for the body movement of “hand(s) in pocket(s)”. The incidence of “hand(s) in pocket(s)” was found to increase from truth telling to deceiving conditions when the risk of deception detection was higher, and to decrease from truth telling to deceiving conditions when the risk was lower. Higher risk of deception detection was also found in magnifying the “overall negative and controlled impression” displayed by both deceivers and truth tellers, compared to the lower risk of detection condition. We also discussed the possible effects of risk of deception detection and depletion of self-regulation, on deception behavior. Further studies and the connection between this study and the research community of computer vision and multimodel interaction is also discussed

Taking Time: A Mixed Methods Study of Parkinson’s Disease Caregiver Participation in Activities in Relation to Their Wellbeing

© 2020 Lia Prado et al. This is an open access article distributed under the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Objectives. Although many studies have shown that psychosocial interventions, such as dance classes, can improve quality of life for people with Parkinson’s disease (PD): few have addressed the role of, and potential benefits to, the caregivers in such activities. This mixed methods study explored the reasons for caregiver participation in a variety of activities and considered whether participation in, or abstention from these, affected the wellbeing of the caregivers. Method. Transcriptions of a focus group (two people with PD, two caregivers) and eight semistructured interviews (caregivers) were analysed using Grounded Theory (GT). To test the hypotheses derived from the GT, caregivers (n = 75) completed an online survey about activities they and the person they care for participated in, alongside the PDQ-Carer questionnaire, to establish the caregiver’s levels of wellbeing. Results. Qualitative findings suggested that caregivers tried to find a balance between caring for the person with PD and participating in activities to attend to their own needs. Reasons for participating in activities for people with PD included being able to socialise in an empathetic safe space, alongside engaging in physical activity that provided some respite distraction, such as dancing with others to music. Reasons for not participating included generating time for oneself and increasing the independence of the person with PD. Quantitative results suggested that most of the participants’ wellbeing was not compromised, although this was gendered: female caregivers reported lower wellbeing scores than male caregivers. Overall, 62% of caregivers participated in joint activities. Linear regression revealed a significant relationship between nonparticipation in daily activities and stress levels for female caregivers only, whereby the more independent the person with PD was, the lower the stress of the caregiver. Conclusion. This study suggests that caregivers of people with PD can find a healthy balance in terms of their own wellbeing by jointly participating in two-thirds of activities while ensuring the remaining third is time reserved for themselves.Peer reviewe

Music in our minds and bodies matters.

This is a pre-publication version of the following article: Rose, D., Jones Bartoli, A., & Heaton, P., ‘Music in our minds and bodies matters’, PsyPAG Quarterly, Issue 103, June 2017. © 2017 The British Psychological Society.This paper aims to convey an introduction to the psychology of music. At a very basic level, sound informs our model of the world, aiding survival. Musical sound and practice further offers a merging of exogenous and endogenous temporal states and templates, employing multiple complex neural mechanisms. Here we provide an overview of the literature exploring why music matters to our minds and bodies.Peer reviewedFinal Accepted Versio

A study of cognitive and behavioural transfer effects associated with children learning to play musical instruments for the first time over one academic year.

This is a pre-publication version of the following article: Dawn Rose, Alice Jones Bartoli, and Pamela Heaton, “A study of cognitive and behavioural transfer effects associated with children learning to play musical instruments for the first time over one academic year.”, The Psychology of Education Review, Vol. 39(2): 54-70, October 2015.Interest in studies investigating the indirect effect of music education, evaluated theoretically as ‘transfer effects’ (Barnett & Ceci, 2002) has been re-energised by the recent changes in policy that require musical provision to be justified (Branscombe, 2012). Here we take a holistic approach to musical learning, nesting neuro-psychological measures of near and far transfer within one battery of tests. The mixed design considered the multi-modal characteristics of musicality along a continuum assessing changes over time for behavioural visuo and psycho-motor skills and factors of both intelligence and memory in children in a pilot study. Participants (N=38) aged between 7-9 years were tested over a period of one UK academic year. Groups were assigned based on the amount of musical training they received. Results suggest an advantage for those participants taking music lessons over and above statutory provisions, particularly for hand/eye coordination and nonverbal reasoning.Peer reviewedFinal Accepted Versio