Beyond service education: Impacting the human experience with sustained training utilizing the Experience Model of Communication

Patients scheduling or checking in for medical appointments often share with frontline employees’ details of their stories, including their worries, prior negative experiences, and hopes. These interactions require employees to not only complete their task, but also to be mindfully present, picking up on important social cues and showing appropriate emotional congruence and empathic understanding. Based on a review of recorded patient calls, a gap was identified in the communication skills of desk and scheduling staff at this large academic medical center, and a sustained training program was created to fill this gap. The training is centered on an evolving set of theoretical principles and skills that have come to be known as the Experience Model of Communication (XMOC). We wanted to understand if training in XMOC, a set of skills essential for healthcare providers, would also be beneficial for frontline staff. The training was evaluated with pre/post surveys, listening sessions, an annual evaluation, and quarterly tracking of patient experience scores, and findings suggest that the training content has had a positive impact. We continue to build and evaluate the training program to identify and refine the elements that make up XMOC and the most effective ways to transfer that learning to the staff who benefit. Experience Framework This article is associated with the Staff & Provider Engagement lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework). Access other PXJ articles related to this lens. Access other resources related to this lens

Women Bound to Be Active: One Year Follow-Up to an Innovative Pilot Intervention to Increase Physical Activity and Self-Worth in Women

The purpose of this investigation was to assess the effectiveness of a lifestyle intervention (a women’s book club; Women Bound to be Active) in promoting long-term physical activity (PA). Thirty-five women (26-70 years; mean age 50.6 years) completed the 8-month intervention and participated in the one-year follow-up. At follow-up, PA returned to baseline levels; however, self-worth and body mass index significantly improved. Women were more knowledgeable about PA at follow-up; however, they failed to maintain PA after the intervention. Components of the intervention were effective in improving self-worth and lowering BMI at one-year follow-up. To enhance long-term PA adherence continued research and intervention modifications are needed

Total Knee Arthroplasty Assessments Should Include Strength and Performance-Based Functional Tests to Complement Range-of-Motion and Patient-Reported Outcome Measures

Range of motion (ROM) and pain often define successful recovery after total knee arthroplasty (TKA), but these routine clinical outcomes correlate poorly or not at all to functional capacity after TKA. The purpose of this Perspective is to underscore the importance of muscle strength and performance-based functional tests in addition to knee ROM and patient-reported outcome (PRO) measures to evaluate outcomes after TKA. Specifically: (1) muscle strength is the rate-limiting step for recovery of function after TKA; (2) progressive rehabilitation targeting early quadriceps muscle strengthening improves outcomes and does not compromise ROM after TKA; (3) ROM and PROs fail to fully capture functional limitations after TKA; and (4) performance-based functional tests are critical to evaluate function objectively after TKA. This Perspective also addresses studies that question the need for or benefit of physical therapy after TKA because their conclusions focus only on ROM and PRO measures. Future research is needed to determine the optimal timing, delivery, intensity, and content of physical therapy

Improving the estimation of deep-sea megabenthos biomass: dimension to wet weight conversions for abyssal invertebrates

Deep-sea megafaunal biomass has typically been assessed by sampling with benthic sledges and trawls, but non-destructive methods, particularly photography, are becoming increasingly common. Estimation of individual wet weight in seabed photographs has been achieved using equations obtained from measured trawl-caught specimens for a limited number of taxa. However, a lack of appropriate conversion factors has limited estimation across taxa encompassing whole communities. Here we compile relationships between measured body dimensions and preserved wet weights for a comprehensive catalogue of abyssal epibenthic megafauna, using ~47,000 specimens from the Porcupine Abyssal Plain (NE Atlantic) housed in the Discovery Collections. The practical application of the method is demonstrated using an extremely large dataset of specimen measurements from seabed photographs taken in the same location. We also collate corresponding field data on fresh wet weight, to estimate the impact of fixation in formalin and preservation in industrial denatured alcohol on the apparent biomass. Taxa with substantial proportions of soft tissues lose 35 to 60% of their wet weight during preservation, while those with greater proportions of hard tissues lose 10 to 20%. Our total estimated fresh wet weight biomass of holothurians and cnidarians in the photographic survey was ~20 times the previous estimates of total invertebrate biomass based on trawl catches. This dramatic uplift in megabenthic biomass has significant implications for studies of standing stocks, community metabolism, and numerical modelling of benthic carbon flows

Using Wearable Technology to Quantify Physical Activity Recovery: Secondary Report From the AFTER (App-Facilitated Tele-Rehabilitation) Program for COVID-19 Survivors Randomized Study

Background: Knowledge on physical activity recovery after COVID-19 survival is limited. The AFTER (App-Facilitated Tele-Rehabilitation) program for COVID-19 survivors randomized participants, following hospital discharge, to either education and unstructured physical activity or a telerehabilitation program. Step count data were collected as a secondary outcome, and we found no significant differences in total step count trajectories between groups at 6 weeks. Further step count data were not analyzed. Objective: The purpose of this analysis was to examine step count trajectories and correlates among all participants (combined into a single group) across the 12-week study period. Methods: Linear mixed models with random effects were used to model daily steps over the number of study days. Models with 0, 1, and 2 inflection points were considered, and the final model was selected based on the highest log-likelihood value. Results: Participants included 44 adults (41 with available Fitbit [Fitbit LLC] data). Initially, step counts increased by an average of 930 (95% CI 547-1312; PPPP Conclusions: Participants showed a marked improvement in daily step counts during the first 3 weeks of the study, followed by more gradual improvement in the remaining 9 weeks. Physical activity data and step count recovery trajectories may be considered surrogates for physiological recovery, although further research is needed to examine this relationship

Core competencies for pain management: results of an interprofessional consensus summit.

ObjectiveThe objective of this project was to develop core competencies in pain assessment and management for prelicensure health professional education. Such core pain competencies common to all prelicensure health professionals have not been previously reported.MethodsAn interprofessional executive committee led a consensus-building process to develop the core competencies. An in-depth literature review was conducted followed by engagement of an interprofessional Competency Advisory Committee to critique competencies through an iterative process. A 2-day summit was held so that consensus could be reached.ResultsThe consensus-derived competencies were categorized within four domains: multidimensional nature of pain, pain assessment and measurement, management of pain, and context of pain management. These domains address the fundamental concepts and complexity of pain; how pain is observed and assessed; collaborative approaches to treatment options; and application of competencies across the life span in the context of various settings, populations, and care team models. A set of values and guiding principles are embedded within each domain.ConclusionsThese competencies can serve as a foundation for developing, defining, and revising curricula and as a resource for the creation of learning activities across health professions designed to advance care that effectively responds to pain

Resilience of a tropical sport fish population to a severe cold event varies across five estuaries in southern Florida

For species that are closely managed, understanding population resilience to environmental and anthropogenic disturbances (i.e., recovery trajectories across broad spatial areas) can guide which suite of management actions are available to mitigate any impacts. During January 2010, an extreme cold event in south Florida caused widespread mortality of common snook, Centropomus undecimalis, a popular sport fish. Interpretation of trends using fishery-independent monitoring data in five south Florida estuaries showed that changes in catch rates of adult snook (\u3e500 mm standard length) varied between no effects postevent to large effects and 4-yr recoveries. The reasons for the variation across estuaries are unknown, but are likely related to differences in estuary geomorphology and habitat availability (e.g., extent of deep rivers and canals) and differences in the proportions of behavior contingents (i.e., segments of the population that use divergent movement tactics) that place snook in different areas of the estuary during winter. Emerging awareness of the presence of behavior contingents, identification of overwintering sites, and improvements of abundance indices in remote nursery habitats should provide a better understanding of population resilience to disturbance events for snook. Given that changes in the frequency of short-lived, severe cold events are currently unknown, the findings and management actions described here for a tropical species living at the edge of its distribution should be useful to scientists forecasting the effects of climate change

Glycosylated superparamagnetic nanoparticle gradients for osteochondral tissue engineering

In developmental biology, gradients of bioactive signals direct the formation of structural transitions in tissue that are key to physiological function. Failure to reproduce these native features in an in vitro setting can severely limit the success of bioengineered tissue constructs. In this report, we introduce a facile and rapid platform that uses magnetic field alignment of glycosylated superparamagnetic iron oxide nanoparticles, pre-loaded with growth factors, to pattern biochemical gradients into a range of biomaterial systems. Gradients of bone morphogenetic protein 2 in agarose hydrogels were used to spatially direct the osteogenesis of human mesenchymal stem cells and generate robust osteochondral tissue constructs exhibiting a clear mineral transition from bone to cartilage. Interestingly, the smooth gradients in growth factor concentration gave rise to biologically-relevant, emergent structural features, including a tidemark transition demarcating mineralized and non-mineralized tissue and an osteochondral interface rich in hypertrophic chondrocytes. This platform technology offers great versatility and provides an exciting new opportunity for overcoming a range of interfacial tissue engineering challenges