Automated Check-in Data Collection (AC DC): an investigation of utility, acceptability and effectiveness in general practice

Background: There are a range of data collection methodologies employed for collecting patient health related research data. Within primary care settings, and particularly within general practice, time and resources are limited. The utility of an automated check-in screen to collect brief research data from patients is a new option, that requires investigation. Methods: A systematic literature search was conducted to identify articles describing the use of data collection methodologies that patients currently use and interact with independently, within primary care settings. A pilot feasibility descriptive cross-sectional study was then undertaken to investigate the utility of check-in screens and to collect brief research data from patients, whilst they self-completed an automated check-in screen, prior to their appointment. Results: Limited evidence exists in health literature relating to the collection of research data using automated devices, within primary care settings. 9,274 participants were recruited to the Automated Check-in Data Collection (AC DC) Study from 9 general practices over a 3-week recruitment period. Almost 90% of all patients presented with the opportunity, participated in the study. 96.2% of participants answered the ‘clinical’ research question, reporting a degree of bodily pain experienced during the past 4 weeks. The severities of pain reported were comparable with results identified elsewhere. 89.3% of participants answered the ‘non-clinical’ research question, on happiness to be contacted about future research studies. Conclusion: Choosing which data collection method to use when conducting research, remains a predicament for researchers. Using automated check-in facilities, to integrate research into routine general practice is an efficient and effective way to collect brief research data from patients, with no variation by age of patient. With the COVID-19 pandemic initiating an extensive digital transformation in society, now is an ideal time to investigate other ways in which electronic research data can be captured quickly and efficiently

Not all suffering is pain: sources of patients' suffering in the emergency department call for improvements in communication from practitioners

Background Provision of prompt, effective analgesia is rightly considered as a standard of care in the emergency department (ED). However, much suffering is not ‘painful’ and may be under-recognised. We sought to describe the burden of suffering in the ED and explore how this may be best addressed from a patient centred perspective. Methods In a prospective cohort study, we included undifferentiated patients presenting to the ED. We undertook two face to face questionnaires with the first immediately following triage. We asked patients: (a) if they were ‘suffering’; (b) how they were suffering; and (c) what they hoped would be done to ease this. Prior to leaving the ED, we asked patients what had been done to ease their suffering. Data were analysed thematically. Results Of 125 patients included, 77 (61.6%) reported suffering on direct questioning and 92 (73.6%) listed at least one way in which they were suffering. 90 (72.0%) patients had a pain score >0/10 but only 37 (29.6%) reported that pain was causing suffering. Patients reported suffering from both physical symptoms (especially pain, nausea, vomiting and dizziness) and emotional distress (notably anxiety). Treatment (to ease physical and emotional symptoms), information (particularly diagnosis, reassurance and explanation), care (notably friendly staff) and closure (being seen, resolving the problem and going home) were the key themes identified as important for relief of suffering. Conclusions In seeking to ease suffering in the ED, clinicians must focus not only on providing analgesia but on treating Emotional distress, Physical symptoms, providing Information, Care and Closure (EPICC)

I C: Slavery and Human Trafficking

We will be discussing the issue of human trafficking from the 4 different disciplines of 1) Communication Technologies, 2) Business and the Economy, 3) Nursing and Healthcare, and 4) Psychology

Vascular disease and vascular risk factors in relation to motor features and cognition in early Parkinson's disease

Funded by Parkinson's UK National Institute for Health Research (NIHR) DeNDRoN network NIHR Newcastle Biomedical Research Unit Newcastle University NIHR funded Biomedical Research Centre in CambridgePeer reviewedPublisher PD

Comparison of Controller and Flight Deck Algorithm Performance During Interval Management with Dynamic Arrival Trees (STARS)

Managing the interval between arrival aircraft is a major part of the en route and TRACON controller s job. In an effort to reduce controller workload and low altitude vectoring, algorithms have been developed to allow pilots to take responsibility for, achieve and maintain proper spacing. Additionally, algorithms have been developed to create dynamic weather-free arrival routes in the presence of convective weather. In a recent study we examined an algorithm to handle dynamic re-routing in the presence of convective weather and two distinct spacing algorithms. The spacing algorithms originated from different core algorithms; both were enhanced with trajectory intent data for the study. These two algorithms were used simultaneously in a human-in-the-loop (HITL) simulation where pilots performed weather-impacted arrival operations into Louisville International Airport while also performing interval management (IM) on some trials. The controllers retained responsibility for separation and for managing the en route airspace and some trials managing IM. The goal was a stress test of dynamic arrival algorithms with ground and airborne spacing concepts. The flight deck spacing algorithms or controller managed spacing not only had to be robust to the dynamic nature of aircraft re-routing around weather but also had to be compatible with two alternative algorithms for achieving the spacing goal. Flight deck interval management spacing in this simulation provided a clear reduction in controller workload relative to when controllers were responsible for spacing the aircraft. At the same time, spacing was much less variable with the flight deck automated spacing. Even though the approaches taken by the two spacing algorithms to achieve the interval management goals were slightly different they seem to be simpatico in achieving the interval management goal of 130 sec by the TRACON boundary

H+/K+ ATPase activity is required for biomineralization in sea urchin embryos

AbstractThe bioelectrical signatures associated with regeneration, wound healing, development, and cancer are changes in the polarization state of the cell that persist over long durations, and are mediated by ion channel activity. To identify physiologically relevant bioelectrical changes that occur during normal development of the sea urchin Lytechinus variegatus, we tested a range of ion channel inhibitors, and thereby identified SCH28080, a chemical inhibitor of the H+/K+ ATPase (HKA), as an inhibitor of skeletogenesis. In sea urchin embryos, the primary mesodermal lineage, the PMCs, produce biomineral in response to signals from the ectoderm. However, in SCH28080-treated embryos, aside from randomization of the left-right axis, the ectoderm is normally specified and differentiated, indicating that the block to skeletogenesis observed in SCH28080-treated embryos is PMC-specific. HKA inhibition did not interfere with PMC specification, and was sufficient to block continuing biomineralization when embryos were treated with SCH28080 after the initiation of skeletogenesis, indicating that HKA activity is continuously required during biomineralization. Ion concentrations and voltage potential were abnormal in the PMCs in SCH28080-treated embryos, suggesting that these bioelectrical abnormalities prevent biomineralization. Our results indicate that this effect is due to the inhibition of amorphous calcium carbonate precipitation within PMC vesicles

Investigating the usefulness of Automated Check-in Data Collection in general practice (AC DC Study): a multicentre, cross-sectional study in England.

Objectives: To investigate the usefulness of using automated appointment check-in screens to collect brief research data from patients, prior to their general practice consultation.Design: A descriptive, cross-sectional study.Setting: Nine general practices in the West Midlands, UK. Recruitment commenced in Autumn 2018 and was concluded by 31 March 2019.Participants: All patients aged 18 years and above, self-completing an automated check-in screen prior to their general practice consultation, were invited to participate during a 3-week recruitment period.Primary and secondary outcome measures:The response rate to the use of the automated check-in screen as a research data collection tool was the primary outcome measure. Secondary outcomes included responses to the two research questions and an assessment of impact of check-in completion on general practice operationalisationResults: Over 85% (n=9274) of patients self-completing an automated check-in screen participated in the Automated Check-in Data Collection Study (61.0% (n=5653) women, mean age 55.1 years (range 18–98 years, SD=18.5)). 96.2% (n=8922) of participants answered a ‘clinical’ research question, reporting the degree of bodily pain experienced during the past 4 weeks: 32.9% (n=2937) experienced no pain, 28.1% (n=2507) very mild or mild pain and 39.0% (n=3478) moderate, severe or very severe pain. 89.3% (n=8285) of participants answered a ‘non-clinical’ research question on contact regarding future research studies: 46.9% (n=3889) of participants responded ‘Yes, I’d be happy for you to contact me about research of relevance to me’.Conclusions: Using automated check-in facilities to integrate research into routine general practice is a potentially useful way to collect brief research data from patients. With the COVID-19 pandemic initiating an extensive digital transformation in society, now is an ideal time to build on these opportunities and investigate alternative, innovative ways to collect research data.Trial registration number ISRCTN82531292

A qualitative study of sedentary behaviours in stroke survivors:non-participant observations and interviews with stroke service staff in stroke units and community services

Purpose Sedentary behaviour (SB) is associated with negative health outcomes and is prevalent post-stroke. This study explored SB after stroke from the perspective of stroke service staff. Methods Qualitative mixed-methods study. Non-participant observations in two stroke services (England/Scotland) and semi-structured interviews with staff underpinned by the COM-B model of behaviour change. Observations were analysed thematically; interviews were analysed using the Framework approach. Results One hundred and thirty-two observation hours (October - December 2017), and 31 staff interviewed (January –June 2018). Four themes were identified: (1) Opportunities for staff to support stroke survivors to reduce SB; (2) Physical and psychological capability of staff to support stroke survivors to reduce SB; (3) Motivating factors influencing staff behaviour to support stroke survivors to reduce SB; (4) Staff suggestions for a future intervention to support stroke survivors to reduce SB. Conclusions Staff are aware of the consequences of prolonged sitting but did not relate to SB. Explicit knowledge of SB was limited. Staff need training to support stroke survivors to reduce SB. Sedentary behaviour in the community was not reported to change markedly, highlighting the need to engage stroke survivors in movement from when capable in hospital, following through to home. Implications for rehabilitation Stroke survivor sedentary behaviour is influenced, directly and indirectly, by the actions and instructions of stroke service staff in the inpatient and community setting. The built and social environment, both in the inpatient and community settings, may limit opportunities for safe movement and can result in stroke survivors spending more time sedentary. Stroke service staff appreciate the benefit of encouraging stroke survivors to stand and move more, if it is safe for them to do so. Staff would be amenable to encourage stroke survivors to reduce sedentary behaviour, provided they have the knowledge and resources to equip them to support this

A co-production approach guided by the behaviour change wheel to develop an intervention for reducing sedentary behaviour after stroke

Background Stroke survivors are highly sedentary; thus, breaking up long uninterrupted bouts of sedentary behaviour could have substantial health benefit. However, there are no intervention strategies specifically aimed at reducing sedentary behaviour tailored for stroke survivors. The purpose of this study was to use co-production approaches to develop an intervention to reduce sedentary behaviour after stroke. Methods A series of five co-production workshops with stroke survivors, their caregivers, stroke service staff, exercise professionals, and researchers were conducted in parallel in two-stroke services (England and Scotland). Workshop format was informed by the behaviour change wheel (BCW) framework for developing interventions and incorporated systematic review and empirical evidence. Taking an iterative approach, data from activities and audio recordings were analysed following each workshop and findings used to inform subsequent workshops, to inform both the activities of the next workshop and ongoing intervention development. Findings Co-production workshop participants (n = 43) included 17 staff, 14 stroke survivors, six caregivers and six researchers. The target behaviour for stroke survivors is to increase standing and moving, and the target behaviour for caregivers and staff is to support and encourage stroke survivors to increase standing and moving. The developed intervention is primarily based on co-produced solutions to barriers to achieving the target behaviour. The developed intervention includes 34 behaviour change techniques. The intervention is to be delivered through stroke services, commencing in the inpatient setting and following through discharge into the community. Participants reported that taking part in intervention development was a positive experience. Conclusions To our knowledge, this is the first study that has combined the use of co-production and the BCW to develop an intervention for use in stroke care. In-depth reporting of how a co-production approach was combined with the BCW framework, including the design of bespoke materials for workshop activities, should prove useful to other researchers and practitioners involved in intervention development in stroke

Range expansion in an invasive small mammal: influence of life-history and habitat quality

Invasive species pose a major threat to biodiversity but provide an opportunity to describe the processes that lead to changes in a species' range. The bank vole (Myodes glareolus) is an invasive rodent that was introduced to Ireland in the early twentieth century. Given its continuing range expansion, the substantial empirical data on its spread thus far, and the absence of any eradication program, the bank vole in Ireland represents a unique model system for studying the mechanisms influencing the rate of range expansion in invasive small mammals. We described the invasion using a reaction-diffusion model informed by empirical data on life history traits and demographic parameters. We subsequently modelled the processes involved in its range expansion using a rule-based spatially explicit simulation. Habitat suitability interacted with density-dependent parameters to influence dispersal, most notably the density at which local populations started to donate emigrating individuals, the number of dispersing individuals and the direction of dispersal. Whilst local habitat variability influenced the rate of spread, on a larger scale the invasion resembled a simple reaction-diffusion process. Our results suggest a Type 1 range expansion where the rate of expansion is generally constant over time, but with some evidence for a lag period following introduction. We demonstrate that a two-parameter empirical model and a rule-based spatially explicit simulation are sufficient to accurately describe the invasion history of a species that exhibits a complex, density-dependent pattern of dispersa