Live bedside music in daily clinical practice of a surgical hospital ward among older patients:A controlled study design of an innovative practice

OBJECTIVE: There is an increasing interest in the role of the arts, particularly music, in healthcare. Music seems an attractive non-pharmacological intervention for older patients to improve postoperative outcomes. Although live music elicits more meaningful responses from an audience than recorded music, the use of live music is still rare on hospital wards. In view of the positive effects of recorded music on older surgical patients, we designed, in collaboration with a conservatoire, an innovative practice named Meaningful Music in Health Care (MiMiC). The aim is to determine whether live bedside music implements into daily practice and allows improves patient outcomes. METHOD: This manuscript provides an overview of a trial evaluating if live bedside music can improve postoperative outcomes in older patients. The MiMiC initiative is a non randomized controlled trial study among older surgical patients on three hospital wards. Live bedside music is performed by professional musicians, once a day for six or seven consecutive days. The primary outcome is experienced pain; secondary outcomes are anxiety, relaxation and physical parameters (heart rate, heart rate variability, blood pressure, respiratory rate and oxygenation). Measurements of these variables are collected before the intervention, 30 min afterwards and again after three hours. Daily evaluations determine whether this innovative practice can be implemented in daily practice. CONCLUSION: This manuscript describes a new practice, live bedside music by professional musicians, on surgical hospital wards aiming to improve patient outcomes. It offers a new field of interprofessional collaboration for the benefit of patients. Further research must be conducted focussing on patient outcomes, including cost-effectiveness and the experiences of patients and healthcare professionals

Entanglement of a qubit with a single oscillator mode

We solve a model of a qubit strongly coupled to a massive environmental oscillator mode where the qubit backaction is treated exactly. Using a Ginzburg-Landau formalism, we derive an effective action for this well known localization transition. An entangled state emerges as an instanton in the collective qubit-environment degree of freedom and the resulting model is shown to be formally equivalent to a Fluctuating Gap Model (FGM) of a disordered Peierls chain. Below the transition, spectral weight is transferred to an exponentially small energy scale leaving the qubit coherent but damped. Unlike the spin-boson model, coherent and effectively localized behaviors may coexist.Comment: 4 pages, 1 figure; added calculation of entanglement entrop

Exploring the causes of adverse events in hospitals and potential prevention strategies

Objectives To examine the causes of adverse events (AEs) and potential prevention strategies to minimise the occurrence of AEs in hospitalised patients. Methods For the 744 AEs identified in the patient record review study in 21 Dutch hospitals, trained reviewers were asked to select all causal factors that contributed to the AE. The results were analysed together with data on preventability and consequences of AEs. In addition, the reviewers selected one or more prevention strategies for each preventable AE. The recommended prevention strategies were analysed together with four general causal categories: technical, human, organisational and patient-related factors. Results Human causes were predominantly involved in the causation of AEs (in 61% of the AEs), 61% of those being preventable and 13% leading to permanent disability. In 39% of the AEs, patient-related factors were involved, in 14% organisational factors and in 4% technical factors. Organisational causes contributed relatively often to preventable AEs (93%) and AEs resulting in permanent disability (20%). Recommended strategies to prevent AEs were quality assurance/peer review, evaluation of safety behaviour, training and procedures. For the AEs with human and patient-related causes, reviewers predominantly recommended quality assurance/peer review. AEs caused by organisational factors were considered preventable by improving procedures. Discussion Healthcare interventions directed at human causes are recommended because these play a large role in AE causation. In addition, it seems worthwhile to direct interventions on organisational causes because the AEs they cause are nearly always believed to be preventable. Organisational factors are thus relatively easy to tackle. Future research designs should allow researchers to interview healthcare providers that were involved in the event, as an additional source of information on contributing factors.

Live and Recorded Music Interventions to Reduce Postoperative Pain:Protocol for a Nonrandomized Controlled Trial

BACKGROUND: Postoperative patients who were previously engaged in the live musical intervention Meaningful Music in Healthcare reported significantly reduced perception of pain than patients without the intervention. This encouraging finding indicates a potential for postsurgical musical interventions to have a place in standard care as therapeutic pain relief. However, live music is logistically complex in hospital settings, and previous studies have reported the more cost-effective recorded music to serve as a similar pain-reducing function in postsurgical patients. Moreover, little is known about the potential underlying physiological mechanisms that may be responsible for the reduced pain perceived by patients after the live music intervention.OBJECTIVE: The primary objective is to see whether a live music intervention can significantly lower perceived postoperative pain compared to a recorded music intervention and do-nothing control. The secondary objective is to explore the neuroinflammatory underpinnings of postoperative pain and the potential role of a music intervention in mitigating neuroinflammation.METHODS: This intervention study will compare subjective postsurgical pain ratings among 3 groups: live music intervention, recorded music intervention, and standard care control. The design will take the form of an on-off nonrandomized controlled trial. Adult patients undergoing elective surgery will be invited to participate. The intervention is a daily music session of up to 30 minutes for a maximum of 5 days. The live music intervention group is visited by professional musicians once a day for 15 minutes and will be asked to interact. The recorded music active control intervention group receives 15 minutes of preselected music over headphones. The do-nothing group receives typical postsurgical care that does not include music.RESULTS: At study completion, we will have an empirical indication of whether live music or recorded music has a significant impact on postoperative perceived pain. We hypothesize that the live music intervention will have more impact than recorded music but that both will reduce the perceived pain more than care-as-usual. We will moreover have the preliminary evidence of the physiological underpinnings responsible for reducing the perceived pain during a music intervention, from which hypotheses for future research may be derived.CONCLUSIONS: Live music can provide relief from pain experienced by patients recovering from surgery; however, it is not known to what degree live music improves the patients' pain experience than the logistically simpler alternative of recorded music. Upon completion, this study will be able to statistically compare live versus recorded music. This study will moreover be able to provide insight into the neurophysiological mechanisms involved in reduced pain perception as a result of postoperative music listening.TRIAL REGISTRATION: The Netherlands Central Commission on Human Research NL76900.042.21; https://www.toetsingonline.nl/to/ccmo_search.nsf/fABRpop?readform&amp;unids=F2CA4A88E6040A45C1258791001AEA44.INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/40034.</p

Public exhibit for demonstrating the quantum of electrical conductance

We present a new robust setup that explains and demonstrates the quantum of electrical conductance for a general audience and which is continuously available in a public space. The setup allows users to manually thin a gold wire of several atoms in diameter while monitoring its conductance in real time. During the experiment, a characteristic step-like conductance decrease due to rearrangements of atoms in the cross-section of the wire is observed. Just before the wire breaks, a contact consisting of a single atom with a characteristic conductance close to the quantum of conductance can be maintained up to several seconds. The setup is operated full-time, needs practically no maintenance and is used on different educational levels

Application of a finite-difference modeling scheme for ultrasonic defect characterization

Modeling schemes, which compute the propagation of ultrasonic wave fields, serve as research tools in NDE. The objectives to use such schemes are diverse. Firstly, they may be used to set the requirements for the ultrasonic data acquisition method and the processing algorithm. Secondly, they may be used to improve understanding of the actual measurement, i.e. for interpretation. Thirdly, they may play a central role in the inversion of the measurement for defect characterization, i.e. model driven inversion and neural network training

Trajectory of Thirst Intensity and Distress from Admission to 4-Week Follow Up at Home in Patients with Heart Failure

Background: Patients with heart failure (HF) can suffer from increased thirst intensity and distress. Trajectories of thirst intensity and distress from hospital to home are unclear. The aim of this study was to describe thirst intensity and distress trajectories in patients from the time of hospital admission to 4 weeks after discharge, and describe trajectories of thirst intensity and distress by patients’ characteristics (gender, age, body mass index [BMI], plasma urea, anxiety, and depression). Patients and methods: In this observational study, data were collected from patients with HF (n=30) at hospital admission, discharge, and at 2 and 4 weeks after discharge. Thirst intensity (visual analog scale, 100 mm) and distress (Thirst Distress Scale-HF, score 9–45) were used. Trajectories were examined using growth modeling. Results: Trajectory of the thirst intensity was significantly different, for patients with low and high thirst intensity levels (median cut-off 39 mm), from admission to 4 weeks follow up (thirst increased and decreased, respectively). Patients with high level of thirst distress (median score \u3e 22) at admission, having fluid restriction and women continued to have higher thirst distress over time. Patients feeling depressed had higher thirst intensity over time. There were no differences in the trajectories of thirst intensity and distress by age, BMI, plasma urea, and anxiety. Conclusion: Intensity and distress of thirst, having fluid restriction, and feeling depressed at the admission were critical in predicting the trajectory of thirst intensity and distress after discharge to home in patients with HF. Effective intervention relieving thirst should be provided before their discharge to home

Entanglement between charge qubits induced by a common dissipative environment

We study entanglement generation between two charge qubits due to the strong coupling with a common bosonic environment (Ohmic bath). The coupling to the boson bath is a source of both quantum noise (leading to decoherence) and an indirect interaction between qubits. As a result, two effects compete as a function of the coupling strength with the bath: entanglement generation and charge localization induced by the bath. These two competing effects lead to a non-monotonic behavior of the concurrence as a function of the coupling strength with the bath. As an application, we present results for charge qubits based on double quantum dots.Comment: 9 pages, 7 figure

Putting Leininger’s nursing theory ‘culture care diversity and universality’ into operation in the curriculum – Part 1

The culturally diverse South African society necessitates inclusion of transcultural nursing in the curriculum. This article focuses on research regarding the putting of Leininger's nursing theory into operation in the curriculum to provide a scientific base for the inclusion of such nursing. The research process and results are discussed