Implementing person-centred outcome measures (PCOMs) into routine palliative care: A protocol for a mixed-methods process evaluation of the RESOLVE PCOM Implementation Strategy

Introduction Person-centred outcome measures improve quality of care and patient outcomes but are used inconsistently in palliative care practice. To address this implementation gap, we developed the 'RESOLVE Implementation Strategy'. This protocol describes a process evaluation to explore mechanisms through which this strategy does, or does not, support the implementation of outcome measures in routine palliative care practice. Methods and analysis Multistrand, mixed-methods process evaluation. Strand one will collect routine outcomes data (palliative Phase of Illness, Integrated Palliative care Outcomes Scale, Australia-modified Karnofsky Performance Status) to map the changes in use of outcome measures over 12 months (July 2021-July 2022). Strand two will collect survey data over the same 12-month period to explore how professionals' understandings of, skills in using and ability to build organisational practices around, outcome measures change over time. Strand three will collect interview data to understand the mechanisms underpinning/affecting our implementation strategy. Thematic framework analysis and descriptive statistics will be used to analyse qualitative and quantitative data, respectively. Ethics and dissemination For strand one, ethical approval has been obtained (Cambridge REC, REF: 20/EE/0188). For strands two and three, ethical approval has been obtained from Hull York Medical School ethics committee (2105). Tailored feedback of study findings will be provided to participating sites. Abstracts and papers will be submitted to national/international conferences and peer-reviewed journals. Lay and policy briefings and newsletters will be shared through patient and public involvement and project networks, plus via the project website

Implementing person-centred outcome measures in palliative care: An exploratory qualitative study using Normalisation Process Theory to understand processes and context

© The Author(s) 2020. Background: Despite evidence demonstrating the utility of using Person-Centred Outcome Measures within palliative care settings, implementing them into routine practice is challenging. Most research has described barriers to, without explaining the causal mechanisms underpinning, implementation. Implementation theories explain how, why, and in which contexts specific relationships between barriers/enablers might improve implementation effectiveness but have rarely been used in palliative care outcomes research. Aim: To use Normalisation Process Theory to understand and explain the causal mechanisms that underpin successful implementation of Person-Centred Outcome Measures within palliative care. Design: Exploratory qualitative study. Data collected through semi-structured interviews and analysed using a Framework approach. Setting/participants: 63 healthcare professionals, across 11 specialist palliative care services, were purposefully sampled by role, experience, seniority, and settings (inpatient, outpatient/day therapy, home-based/community). Results: Seven main themes were developed, representing the causal mechanisms and relationships underpinning successful implementation of outcome measures into routine practice. Themes were: Subjectivity of measures; Frequency and version of Integrated Palliative care Outcome Scale; Training, education, and peer support; Building and sustaining community engagement; Electronic system readiness; The art of communication; Reinforcing use through demonstrating value. Conclusions: Relationships influencing implementation resided at individual and organisational levels. Addressing these factors is key to driving the implementation of outcome measures into routine practice so that those using palliative care services can benefit from the systematic identification, management, and measurement of their symptoms and concerns. We provide key questions that are essential for those implementing and using outcome measures to consider in order to facilitate the integration of outcome measures into routine palliative care practice

Lithuania

This report is part of the project The Factbook on the Illicit Trade in Tobacco Products(henceforth ITTP)

Ensayo comparativo de rendimiento de maíz - Campaña 2023

La elección de un cultivar considera un conjunto de características como el ciclo, la velocidad de secado de grano, el comportamiento sanitario, la resistencia al quebrado y al vuelco de la caña, los rendimientos y relación precio/rentabilidad. Cada uno de estos aspectos puede tener una importancia relativa distinta según las características de producción de la empresa agropecuaria. El objetivo de este trabajo es la identificación de híbridos comerciales de maíz de genética moderna, estables y con alto potencial de rendimiento que ayude a asesores y productores en la elección de los materiales, en el área de influencia de la localidad de San Antonio de Areco, en el norte de la provincia de Buenos Aires.EEA PergaminoFil: Mousegne, Fernando. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Pergamino. Agencia de Extensión Rural San Antonio de Areco; ArgentinaFil: Jecke, Fernando Ariel. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Pergamino. Agencia de Extensión Rural San Antonio de Areco; ArgentinaFil: Dunne, Camila. Universidad Nacional de San Antonio de Areco (UNSAdA). Estudiante; ArgentinaFil: Santarelli, Alex. Universidad Nacional de San Antonio de Areco (UNSAdA); ArgentinaFil: Cabrera, Nazareno. Universidad Nacional de San Antonio de Areco (UNSAdA); ArgentinaFil: Monti, Macarena. Universidad Nacional de San Antonio de Areco (UNSAdA); ArgentinaFil: Olaeta, Martina. Universidad Nacional de San Antonio de Areco (UNSAdA); ArgentinaFil: Laco Tkaczuk, Belén. Universidad Nacional de San Antonio de Areco (UNSAdA); Argentin

Endo-Epicardial Homogenization of the Scar Versus Limited Substrate Ablation for the Treatment of Electrical Storms in Patients With Ischemic Cardiomyopathy

ObjectivesThis study investigated the impact on recurrences of 2 different substrate approaches for the treatment of these arrhythmias.BackgroundCatheter ablation of electrical storms (ES) for ventricular arrhythmias (VAs) has shown moderate long-term efficacy in patients with ischemic cardiomyopathy.MethodsNinety-two consecutive patients (81% male, age 62 ± 13 years) with ischemic cardiomyopathy and ES underwent catheter ablation. Patients were treated either by confining the radiofrequency lesions to the endocardial surface with limited substrate ablation (Group 1, n = 49) or underwent endocardial and epicardial ablation of abnormal potentials within the scar (homogenization of the scar, Group 2, n = 43). Epicardial access was obtained in all Group 2 patients, whereas epicardial ablation was performed in 33% (14) of these patients.ResultsMean ejection fraction was 27 ± 5. During a mean follow-up of 25 ± 10 months, the VAs recurrence rate of any ventricular tachycardia (VTs) was 47% (23 of 49 patients) in Group 1 and 19% (8 of 43 patients) in Group 2 (log-rank p = 0.006). One patient in Group 1 and 1 patient in Group 2 died at follow-up for noncardiac reasons.ConclusionsOur study demonstrates that ablation using endo-epicardial homogenization of the scar significantly increases freedom from VAs in ischemic cardiomyopathy patients

Predicting needlestick and sharps injuries in nursing students: Development of the SNNIP scale

© 2020 The Authors. Nursing Open published by John Wiley & Sons Ltd. Aim: To develop an instrument to investigate knowledge and predictive factors of needlestick and sharps injuries (NSIs) in nursing students during clinical placements. Design: Instrument development and cross-sectional study for psychometric testing. Methods: A self-administered instrument including demographic data, injury epidemiology and predictive factors of NSIs was developed between October 2018–January 2019. Content validity was assessed by a panel of experts. The instrument's factor structure and discriminant validity were explored using principal components analysis. The STROBE guidelines were followed. Results: Evidence of content validity was found (S-CVI 0.75; I-CVI 0.50–1.00). A three-factor structure was shown by exploratory factor analysis. Of the 238 participants, 39% had been injured at least once, of which 67.3% in the second year. Higher perceptions of “personal exposure” (4.06, SD 3.78) were reported by third-year students. Higher scores for “perceived benefits” of preventive behaviours (13.6, SD 1.46) were reported by second-year students

A Qualitative Exploration of the Use of Contraband Cell Phones in Secured Facilities

Offenders accepting contraband cell phones in secured facilities violate state corrections law, and the possession of these cell phones is a form of risk taking behavior. When offenders continue this risky behavior, it affects their decision making in other domains where they are challenging authorities; and may impact the length of their incarceration. This qualitative phenomenological study examined the lived experience of ex-offenders who had contraband cell phones in secured correctional facilities in order to better understand their reasons for taking risks with contraband cell phones. The theoretical foundation for this study was Trimpop\u27s risk-homeostasis and risk-motivation theories that suggest an individual\u27s behaviors adapt to negotiate between perceived risk and desired risk in order to achieve satisfaction. The research question explored beliefs and perceptions of ex-offenders who chose to accept the risk of using contraband cell phones during their time in secured facilities. Data were collected anonymously through recorded telephone interviews with 8 male adult ex-offenders and analyzed using thematic content analysis. Findings indicated participants felt empowered by possession of cell phones in prison, and it was an acceptable risk to stay connected to family out of concern for loved ones. The study contributes to social change by providing those justice system administrators, and prison managers responsible for prison cell phone policies with more detailed information about the motivations and perspectives of offenders in respect to using contraband cell phones while imprisoned in secured facilities

Una questione agra: l'io traduttore in "Una questione privata" e "La vita agra"

La lingua di Una questione privata e de La vita agra, vista come costruzione culturale condizionata dal contesto, sarà l’oggetto di questo lavoro. L’accento sarà messo sulla sua capacità di andare oltre la mera definizione del dizionario e condizionare il lettore, avvicinandolo ai personaggi. In particolare, si studierà la presenza di termini nella loro lingua originale, come mezzo per permettere al lettore di trovarsi sulla stessa lunghezza d’onda dei personaggi e di avere la loro stessa percezione della realtà. Effettivamente, nei due romanzi scelti, le lingue straniere hanno un forte rilievo, che se nell’opera di Fenoglio si nota soprattutto a livello di riferimenti più o meno impliciti alla letteratura inglese, in quella di Bianciardi si coglie come vera e propria presenza di interferenze. In entrambi i casi, questa tendenza è principalmente dovuta all’esistenza di un “io traduttore”, in cui si incontrano l’io dell’autore e l’io del protagonista. Si può affermare, dunque, che l’uso di termini stranieri sia una scelta stilistica consapevole e volontaria dei due scrittori, che tra l’altro erano anche traduttori, proprio come i loro protagonisti