Providing Feedback Following Leadership Walkrounds is Associated with Better Patient Safety Culture, Higher Employee Engagement and Lower Burnout

Background There is a poorly understood relationship between Leadership WalkRounds (WR) and domains such as safety culture, employee engagement, burnout and work-life balance. Methods This cross-sectional survey study evaluated associations between receiving feedback about actions taken as a result of WR and healthcare worker assessments of patient safety culture, employee engagement, burnout and work-life balance, across 829 work settings. Results 16 797 of 23 853 administered surveys were returned (70.4%). 5497 (32.7% of total) reported that they had participated in WR, and 4074 (24.3%) reported that they participated in WR with feedback. Work settings reporting more WR with feedback had substantially higher safety culture domain scores (first vs fourth quartile Cohen’s d range: 0.34–0.84; % increase range: 15–27) and significantly higher engagement scores for four of its six domains (first vs fourth quartile Cohen’s d range: 0.02–0.76; % increase range: 0.48–0.70). Conclusion This WR study of patient safety and organisational outcomes tested relationships with a comprehensive set of safety culture and engagement metrics in the largest sample of hospitals and respondents to date. Beyond measuring simply whether WRs occur, we examine WR with feedback, as WR being done well. We suggest that when WRs are conducted, acted on, and the results are fed back to those involved, the work setting is a better place to deliver and receive care as assessed across a broad range of metrics, including teamwork, safety, leadership, growth opportunities, participation in decision-making and the emotional exhaustion component of burnout. Whether WR with feedback is a manifestation of better norms, or a cause of these norms, is unknown, but the link is demonstrably potent

Comparative Efficacy of BioUD to Other Commercially Available Arthropod Repellants Against the Ticks Amblyomma americanum and Dermacentor variabilis on Cotton Cloth

BioUD is an arthropod repellent that contains the active ingredient 2-undecanone originally derived from wild tomato plants. Repellency of BioUD was compared with five commercially available arthropod repellents against the ticks Amblyomma americanum (L.) and Dermacentor variabilis Say in two-choice bioassays on treated versus untreated cotton cheesecloth. Overall mean percentage repellency against both species was greatest for and did not differ significantly between BioUD (7.75% 2-undecanone) and products containing 98.1% DEET, 19.6% IR3535, and 30% oil of lemon eucalyptus. Products containing 5% and 15% Picaridin and 0.5% permethrin were also repellent compared with untreated controls but to a lesser degree than BioUD. The four most active repellents at the same concentrations used before were directly compared in head-to-head bioassays on cotton cheesecloth. BioUD provided significantly greater overall mean percentage repellency than IR3535 for A. americanum and D. variabilis. BioUD was significantly more repellent than oil of lemon eucalyptus for A. americanum but did not differ significantly in repellency against D. variabilis. No statistically significant difference in overall mean percentage repellency was found between BioUD and DEET for A. americanum or D. variabilis. In a 7-week time course bioassay, BioUD applied to cotton cheesecloth and held at room temperature provided 5 weeks of \u3e 90% repellency against A. americanum

Children’s play and independent mobility in 2020: results from the British Children’s Play Survey

The British Children’s Play Survey was conducted in April 2020 with a nationally representative sample of 1919 parents/caregivers with a child aged 5–11 years. Respondents completed a range of measures focused on children’s play, independent mobility and adult tolerance of and attitudes towards risk in play. The results show that, averaged across the year, children play for around 3 h per day, with around half of children’s play happening outdoors. Away from home, the most common places for children to play are playgrounds and green spaces. The most adventurous places for play were green spaces and indoor play centres. A significant difference was found between the age that children were reported to be allowed out alone (10.74 years; SD = 2.20 years) and the age that their parents/caregivers reported they had been allowed out alone (8.91 years; SD = 2.31 years). A range of socio-demographic factors were associated with children’s play. There was little evidence that geographical location predicted children’s play, but it was more important for independent mobility. Further, when parents/caregivers had more positive attitudes around children’s risk-taking in play, children spent more time playing and were allowed to be out of the house independently at a younger age

The Formation and Evolution of Planetary Systems: SIRTF Legacy Science in the VLT Era

We will utilize the sensitivity of SIRTF through the Legacy Science Program to carry out spectrophotometric observations of solar-type stars aimed at (1) defining the timescales over which terrestrial and gas giant planets are built, from measurements diagnostic of dust/gas masses and radial distributions; and (2) establishing the diversity of planetary architectures and the frequency of planetesimal collisions as a function of time through observations of circumstellar debris disks. Together, these observations will provide an astronomical context for understanding whether our solar system - and its habitable planet - is a common or a rare circumstance. Achieving our science goals requires measuring precise spectral energy distributions for a statistically robust sample capable of revealing evolutionary trends and the diversity of system outcomes. Our targets have been selected from two carefully assembled databases of solar-like stars: (1) a sample located within 50 pc of the Sun spanning an age range from 100-3000 Myr for which a rich set of ancillary measurements (e.g. metallicity, stellar activity, kinematics) are available; and (2) a selection located between 15 and 180 pc and spanning ages from 3 to 100 Myr. For stars at these distances SIRTF is capable of detecting stellar photospheres with SNR >30 at lambda < 24 microns for our entire sample, as well as achieving SNR >5 at the photospheric limit for over 50% of our sample at lambda=70 microns. Thus we will provide a complete census of stars with excess emission down to the level produced by the dust in our present-day solar system. More information concerning our program can be found at: http://gould.as.arizona.edu/fepsComment: 8 postscript pages with 1 figure. To appear in the Springer-Verlag Astrophysics Series `The Origins of Stars and Planets: The VLT View' eds. J. Alves & M. McCaughrea

Advances in genetics: widening our understanding of prostate cancer

Prostate cancer is a leading cause of cancer-related death in Western men. Our understanding of the genetic alterations associated with disease predisposition, development, progression, and therapy response is rapidly improving, at least in part, owing to the development of next-generation sequencing technologies. Large advances have been made in our understanding of the genetics of prostate cancer through the application of whole-exome sequencing, and this review summarises recent advances in this field and discusses how exome sequencing could be used clinically to promote personalised medicine for prostate cancer patients.</ns4:p

Topological Defects and CMB anisotropies : Are the predictions reliable ?

We consider a network of topological defects which can partly decay into neutrinos, photons, baryons, or Cold Dark Matter. We find that the degree-scale amplitude of the cosmic microwave background (CMB) anisotropies as well as the shape of the matter power spectrum can be considerably modified when such a decay is taken into account. We conclude that present predictions concerning structure formation by defects might be unreliable.Comment: 14 pages, accepted for publication in PR

The Formation and Evolution of Planetary Systems: First Results from a Spitzer Legacy Science Program

We present 3-160 micron photometry obtained with the IRAC and MIPS instruments for the first five targets from the Spitzer Legacy Science Program "Formation and Evolution of Planetary Systems" and 4-35 micron spectro-photometry obtained with the IRS for two sources. We discuss in detail our observations of the debris disks surrounding HD 105 (G0V, 30 +- 10 Myr) and HD 150706 (G3V, ~ 700 +- 300 Myr). For HD 105, possible interpretations include large bodies clearing the dust inside of 45 AU or a reservoir of gas capable of sculpting the dust distribution. The disk surrounding HD 150706 also exhibits evidence of a large inner hole in its dust distribution. Of the four survey targets without previously detected IR excess, spanning ages 30 Myr to 3 Gyr, the new detection of excess in just one system of intermediate age suggests a variety of initial conditions or divergent evolutionary paths for debris disk systems orbiting solar-type stars.Comment: Six postscript pages with one additional PDF file. To appear in the ApJ Supplement, Vol. 154, Spitzer Special Issue, September, 200

The Organization of Turn-Taking in Pool Skate Sessions

This is an Accepted Manuscript of an article published by Taylor & Francis in Research on Language and Social Interaction on 18th November 2015, available online: http://www.tandfonline.com/10.1080/08351813.2015.1090114.This study takes pool skating, where only one skater rides at a time, as an example of a turn-taking system, albeit one that is organized not through speech but through bodily actions. This allows us to revisit Sacks, Schegloff, and Jefferson’s (1974) famous “turn taking” paper—in particular, their initial broad conception of turn-taking systems as including activities other than the speech-exchange systems studied by conversation analysis. Despite the original declaration, non-speech turn-taking systems have evaded close scrutiny for the past four decades. By turning our attention to such a system here, this study makes two contributions: firstly, to the sociology of turn-organized activities (through a comparison of the central features of turn-taking for conversation with pool skating) and, secondly, to the study of how bodily actions can accomplish pre-beginnings (since in pool skate sessions, this is the place to settle the matter of turn allocation in order to avoid overlaps in riding)

Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Background A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets. Methods Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis. Results A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001). Conclusion We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty