Backstage Staff Communication: The Effects of Different Levels of Visual Exposure to Patients

Objective: This article examines how visual exposure to patients predicts patient-related communication among staff members. Background: Communication among healthcare professionals private from patients, or backstage communication, is critical for staff teamwork and patient care. While patients and visitors are a core group of users in healthcare settings, not much attention has been given to how patients' presence impacts staff communication. Furthermore, many healthcare facilities provide team spaces for improved staff teamwork, but the privacy levels of team areas significantly vary. Method: This article presents an empirical study of four team-based primary care clinics where staff communication and teamwork are important. Visual exposure levels of the clinics were analyzed, and their relationships to staff members' concerns for having backstage communication, including preferred and nonpreferred locations for backstage communication, were investigated. Results: Staff members in clinics with less visual exposure to patients reported lower concerns about having backstage communication. Staff members preferred talking in team areas that were visually less exposed to patients in the clinic, but, within team areas, the level of visual exposure did not matter. On the other hand, staff members did not prefer talking in visually exposed areas such as corridors in the clinic and visually exposed areas within team spaces. Conclusions: Staff members preferred talking in team areas, and they did not prefer talking in visually exposed areas. These findings identified visually exposed team areas as a potentially uncomfortable environment, with a lack of agreement between staff members' preferences toward where they had patient-related communication

The Representational Function of Clinic Design: Staff and Patient Perceptions of Teamwork

This study empirically investigates the relationships between visibility attributes and both patients’ and staff members’ teamwork experiences. Teamwork among healthcare professionals is critical for the safety and quality of patient care. While a patient-centered, team-based care approach is promoted in primary care clinics, little is known about how clinic layouts can support the teamwork experiences of staff and patients in team-based primary clinics

Two-dimensional solitons on the surface of magnetic fluids

We report an observation of a stable soliton-like structure on the surface of a ferrofluid, generated by a local perturbation in the hysteretic regime of the Rosensweig instability. Unlike other pattern-forming systems with localized 2D structures, magnetic fluids are characterized by energy conservation; hence their mechanism of soliton stabilization is different from the previously discussed gain/loss balance mechanism. The radioscopic measurements of the soliton's surface profile suggest that locking on the underlying periodic structure is instrumental in its stabilization.Comment: accepted for publication by Physical Review Letter

Designing for Effective and Safe Multidisciplinary Primary Care Teamwork: Using the Time of COVID-19 as a Case Study

Effective medical teamwork can improve the effectiveness and experience of care for staff and patients, including safety. Healthcare organizations, and especially primary care clinics, have sought to improve medical teamwork through improved layout and design, moving staff into shared multidisciplinary team rooms. While co-locating staff has been shown to increase communi-cation, successful designs balance four teamwork needs: face-to-face communications; situational awareness; heads-down work; perception of teamness. However, precautions for COVID-19 make it more difficult to conduct face-to-face communications. In this paper we describe a model for un-derstanding how layout affects these four teamwork needs and describe how the perception of teamwork by staff changed after COVID-19 precautions were put in place. Observations, interviews and two standard surveys were conducted in two primary care clinics before COVID-19 and again in 2021 after a year of precautions. In general, staff felt more isolated and found it more difficult to conduct brief consults, though these perceptions varied by role. RNs, who spent more time on the phone, found it convenient to work part time-from home, while medical assistants found it more difficult to find providers in the distanced clinics. These cases suggest some important considera-tions for future clinic designs, including greater physical transparency that also allow for physical separation and more spaces for informal communication that are distanced from workstations

Spatially resolved stress measurements in materials with polarization-sensitive optical coherence tomography: image acquisition and processing aspects

We demonstrate that polarization-sensitive optical coherence tomography (PS-OCT) is suitable to map the stress distribution within materials in a contactless and non-destructive way. In contrast to transmission photoelasticity measurements the samples do not have to be transparent but can be of scattering nature. Denoising and analysis of fringe patterns in single PS-OCT retardation images are demonstrated to deliver the basis for a quantitative whole-field evaluation of the internal stress state of samples under investigation.Comment: 10 pages, 6 figures; Copyright: Blackwell Publishing Ltd 2008; The definitive version is available at: www.blackwell-synergy.co

Effect of vitamin D supplementation on blood pressure:a systematic review and meta-analysis incorporating individual patient data

D-PRESSURE Collaboration: et al.[Importance]: Low levels of vitamin D are associated with elevated blood pressure (BP) and future cardiovascular events. Whether vitamin D supplementation reduces BP and which patient characteristics predict a response remain unclear.[Objective]: To systematically review whether supplementation with vitamin D or its analogues reduce BP.[Data Sources]: We searched MEDLINE, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials, and http://www.ClinicalTrials.com augmented by a hand search of references from the included articles and previous reviews. Google was searched for gray literature (ie, material not published in recognized scientific journals). No language restrictions were applied. The search period spanned January 1, 1966, through March 31, 2014.[Study Selection]: We included randomized placebo-controlled clinical trials that used vitamin D supplementation for a minimum of 4 weeks for any indication and reported BP data. Studies were included if they used active or inactive forms of vitamin D or vitamin D analogues. Cointerventions were permitted if identical in all treatment arms.[Data Extraction and Synthesis]: We extracted data on baseline demographics, 25-hydroxyvitamin D levels, systolic and diastolic BP (SBP and DBP), and change in BP from baseline to the final follow-up. Individual patient data on age, sex, medication use, diabetes mellitus, baseline and follow-up BP, and 25-hydroxyvitamin D levels were requested from the authors of the included studies. For trial-level data, between-group differences in BP change were combined in a random-effects model. For individual patient data, between-group differences in BP at the final follow up, adjusted for baseline BP, were calculated before combining in a random-effects model.[Main Outcomes and Measures]: Difference in SBP and DBP measured in an office setting.[Results]: We included 46 trials (4541 participants) in the trial-level meta-analysis. Individual patient data were obtained for 27 trials (3092 participants). At the trial level, no effect of vitamin D supplementation was seen on SBP (effect size, 0.0 [95% CI, −0.8 to 0.8] mm Hg; P = .97; I2 = 21%) or DBP (effect size, −0.1 [95% CI, −0.6 to 0.5] mm Hg; P = .84; I2 = 20%). Similar results were found analyzing individual patient data for SBP (effect size, −0.5 [95% CI, −1.3 to 0.4] mm Hg; P = .27; I2 = 0%) and DBP (effect size, 0.2 [95% CI, −0.3 to 0.7] mm Hg; P = .38; I2 = 0%). Subgroup analysis did not reveal any baseline factor predictive of a better response to therapy.[Conclusions and Relevance]: Vitamin D supplementation is ineffective as an agent for lowering BP and thus should not be used as an antihypertensive agent.Peer reviewe

Systematic Heterogeneity of Fractional Vesicle Pool Sizes and Release Rates of Hippocampal Synapses

AbstractHippocampal neurons in tissue culture develop functional synapses that exhibit considerable variation in synaptic vesicle content (20–350 vesicles). We examined absolute and fractional parameters of synaptic vesicle exocytosis of individual synapses. Their correlation to vesicle content was determined by activity-dependent discharge of FM-styryl dyes. At high frequency stimulation (30 Hz), synapses with large recycling pools released higher amounts of dye, but showed a lower fractional release compared to synapses that contained fewer vesicles. This effect gradually vanished at lower frequencies when stimulation was triggered at 20 Hz and 10 Hz, respectively. Live-cell antibody staining with anti-synaptotagmin-1-cypHer 5, and overexpression of synaptopHluorin as well as photoconversion of FM 1-43 followed by electron microscopy, consolidated the findings obtained with FM-styryl dyes. We found that the readily releasable pool grew with a power function with a coefficient of 2/3, possibly indicating a synaptic volume/surface dependency. This observation could be explained by assigning the rate-limiting factor for vesicle exocytosis at high frequency stimulation to the available active zone surface that is proportionally smaller in synapses with larger volumes