Show don’t tell: assessing the impact of co-developed patient information videos in paediatric uveitis

Background/Objectives: There is a paucity of online educational content targeting children and young people with uveitis. We evaluated the impact of a co-designed patient education video on subjective and objective understanding of childhood uveitis. Subjects/Methods: Co-designed patient education media were produced in collaboration with the Childhood Uveitis Studies steering group and the Great Ormond Street Hospital Generation R Young People’s Advisory Group and narrated by children. Patients managed within the Uveitis service at GOSH were invited to take part in a pre–post survey, undertaken immediately prior to and following viewing of a patient education video. Results: Forty-three patients participated. These were stratified according to age, duration of disease, and treatment type for analysis. Self-rated knowledge improved across all groups (p = 0.001), particularly in those with a new diagnosis of uveitis (Z = −8.124, p < 0.001). Objective knowledge scores improved across all questions, especially in younger children, those with new disease, and those on steroid only treatment (Z = −3.847, p < 0.001, Z = −3.975, p < 0.001, Z = −3.448, p < 0.001; respectively). Most participants reported the videos to be easy to understand and with the right amount of information. All stated that they learned something new. Conclusions: Patient understanding of disease and treatment is crucial to achieving the best possible outcomes for this chronic, relapsing remitting and potentially blinding disorder. Our findings data shows the potential value of co-designed patient information videos, specifically in our study benefitting younger patients and those recently diagnosed. We suggest that other clinical teams could collaborate fruitfully with patient groups to develop similar videos to target possible misinformation and potentially improve patient outcomes

An assessment of aerosol‐cloud interactions in marine stratus clouds based on surface remote sensing

An assessment of aerosol-cloud interactions (ACI) from ground-based remote sensing under coastal stratiform clouds is presented. The assessment utilizes a long-term, high temporal resolution data set from the Atmospheric Radiation Measurement (ARM) Program deployment at Pt. Reyes, California, United States, in 2005 to provide statistically robust measures of ACI and to characterize the variability of the measures based on variability in environmental conditions and observational approaches. The average ACIN (= dlnNd/dlna, the change in cloud drop number concentration with aerosol concentration) is 0.48, within a physically plausible range of 0–1.0. Values vary between 0.18 and 0.69 with dependence on (1) the assumption of constant cloud liquid water path (LWP), (2) the relative value of cloud LWP, (3) methods for retrieving Nd, (4) aerosol size distribution, (5) updraft velocity, and (6) the scale and resolution of observations. The sensitivity of the local, diurnally averaged radiative forcing to this variability in ACIN values, assuming an aerosol perturbation of 500 c-3 relative to a background concentration of 100 cm-3, ranges betwee-4 and -9 W -2. Further characterization of ACI and its variability is required to reduce uncertainties in global radiative forcing estimates

Measuring the effect of affordances on a crash cart medicine packaging

Abstract: In the United States, most drugs stored in crash carts of emergency rooms are packaged in folding cartons with opening mechanisms that involve pressing and tearing the bottom of the package. Anecdotal evidence and a previous study conducted by the research team suggest that these packages are counterintuitive for lay users. The concept of affordances, how design features communicate actionable possibilities, can be applied to improve the usability of packaging. In order to measure the effect of individual design features and previous experience on opening time and error frequency during first opening attempt, a commercially available package for epinephrine was redesigned and tested with two panels of participants; 33 lay users and 17 healthcare providers. Each experiment was conducted as a randomized complete block design with three factors: location of opening mechanism (top or bottom), type of opening mechanism (press-in or tab), and colour contrast in opening area (with and without). By crossing all possible conditions (2x2x2), eight different folding carton designs resulted. Each participant was treated as a block and presented all eight designs in a random order. Participants stood behind a counter of a fixed height and completed eight opening tasks in a lab facility (lay users) and an emergency room (healthcare providers). They were instructed to imagine an emergency scenario where they needed to remove all contents from each package as quickly as possible. Results show that colour contrast had no significant effect on opening time, having a tab significantly reduces time to open. More specifically, tabs cued the user as to the correct end containing the opening feature regardless of it was positioned on the top or bottom of the package. When there was no tab, then having the opening at the top resulted in a significant reduction in time to open, compared to having the opening at the bottom. In an analysis comparing the eight designs, the actual commercial packages ranked as the worst designs in terms of opening time and error frequency. Findings have critical implications for designing packages that are more usable and for eliminating errors during product use

Maria Edgeworth : The double disguise

The Double Disguise heralds the regional novel that Maria Edgeworth was to pioneer in Castle Rackrent (1800). Written at eighteen and now published for the first time, this dramatic comedy includes Edgeworth's first Irish character sketch and her first attempt at Hiberno-English. We encounter her budding interest in the realistic characterisation, language and setting that were to become trademarks of her adult writing.112 page(s

Introduction

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Changing the system by changing the workforce: employing consumers to increase access, cultural diversity, and engagement

Services to families have traditionally been delivered in a medical model. This presents challenges including workforce shortages, lack of cultural diversity, lack of training in strength-based work, and difficulty in successfully engaging and retaining families in the therapy process. The system of care (SOC) effort has worked to establish formal roles for caregivers in SOC to improve services. This paper provides an example of one community\u27s efforts to change the SOC by expanding the roles available to caregivers in creating systems change. It describes the model developed by Communities of Care (CoC), a SOC in Central Massachusetts, and its evolution over a 10 year period. First person accounts by system partners, caregivers hired into professional roles as well as a family receiving services, demonstrate how hiring caregivers at all levels can change systems and change lives, not only for those being served but for the caregiver/professionals doing the work. It also demonstrates, however, that change at the system level is incremental, takes time, and can be fleeting unless an ongoing effort is made to support and sustain those changes

Bombesin-like Peptides Modulate Alveolarization and Angiogenesis in Bronchopulmonary Dysplasia

Rationale: The incidence of bronchopulmonary dysplasia (BPD), a chronic lung disease of newborns, is paradoxically rising despite medical advances. We demonstrated elevated bombesin-like peptide levels in infants that later developed BPD. In the 140-day hyperoxic baboon model of BPD, anti-bombesin antibody 2A11 abrogated lung injury