National initiatives to improve outcomes from out-of-hospital cardiac arrest in England

NHS England report that the ambulance services attempt to resuscitate approximately 28 000 people from out-of-hospital cardiac arrest each year (approximately 1 per 2000 inhabitants per year).1 The rate of initial success (return of spontaneous circulation) was 25%, with less than half of those who are successfully resuscitated initially surviving to go home from hospital (survival to discharge 7%–8%, 2011–2014).1 (see figure 1). The survival rates contrast sharply with those observed in the best-performing emergency medical services systems, which have survival rates of 20%–25%.2–4 In 2013, the government's Cardiovascular Disease Outcomes Strategy for England set the ambitious, but achievable target of increasing survival from out-of-hospital cardiac arrest by 50%, leading to an additional 1000 lives saved each year

Identifying Contact Risks for SARS-CoV-2 Transmission to Healthcare Workers during Outbreak on COVID-19 Ward

We assessed the risk for different exposures to SARS-CoV-2 during a COVID-19 outbreak among healthcare workers on a hospital ward in late 2020. We found working with isolated COVID-19 patients did not increase the risk of COVID-19 among workers, but working shifts with presymptomatic healthcare coworkers did

Cutaneous Papilloma and Squamous Cell Carcinoma Therapy Utilizing Nanosecond Pulsed Electric Fields (nsPEF)

10.1371/journal.pone.0043891PLoS ONE78

Posterior lung herniation after a coughing spell: a case report

Lung hernias are rare, occurring most commonly after trauma or surgery. Spontaneous lung hernias are even rarer and have only been reported as occurring anteriorly. We present a 72-year-old male who developed a spontaneous posterior lung hernia after a severe coughing episode. We describe the evaluation and surgical management of this unusual condition and provide a brief review of the literature

Transport properties of heterogeneous materials derived from Gaussian random fields: Bounds and Simulation

We investigate the effective conductivity ($\sigma_e$) of a class of amorphous media defined by the level-cut of a Gaussian random field. The three point solid-solid correlation function is derived and utilised in the evaluation of the Beran-Milton bounds. Simulations are used to calculate $\sigma_e$ for a variety of fields and volume fractions at several different conductivity contrasts. Relatively large differences in $\sigma_e$ are observed between the Gaussian media and the identical overlapping sphere model used previously as a `model' amorphous medium. In contrast $\sigma_e$ shows little variability between different Gaussian media.Comment: 15 pages, 14 figure

Assessing patient-reported outcomes for automated insulin delivery systems: the psychometric properties of the INSPIRE measures.

AIM: Participants in clinical trials assessing automated insulin delivery systems report perceived benefits and burdens that reflect their experiences and may predict their likelihood of uptake and continued use of this novel technology. Despite the importance of understanding their perspectives, there are no available validated and reliable measures assessing the psychosocial aspects of automated insulin delivery systems. The present study assesses the initial psychometric properties of the INSPIRE measures, which were developed for youth and adults with Type 1 diabetes, as well as parents and partners. METHODS: Data from 292 youth, 159 adults, 150 parents of youth and 149 partners of individuals recruited from the Type 1 Diabetes Exchange Registry were analysed. Participants completed INSPIRE questionnaires and measures of quality of life, fear of hypoglycaemia, diabetes distress, glucose monitoring satisfaction. Exploratory factor analysis assessed factor structures. Associations between INSPIRE scores and other measures, HbA1c , and technology use assessed concurrent and discriminant validity. RESULTS: Youth, adult, parent and partner measures assess positive expectancies of automated insulin delivery systems. Measures range from 17 to 22 items and are reliable (α = 0.95-0.97). Youth, adult and parent measures are unidimensional; the partner measure has a two-factor structure (perceptions of impact on partners versus the person with diabetes). Measures showed concurrent and discriminant validity. CONCLUSIONS: INSPIRE measures assessing the positive expectancies of automated insulin delivery systems for youth, adults, parents and partners have meaningful factor structures and are internally consistent. The developmentally sensitive INSPIRE measures offer added value as clinical trials test newer systems, systems become commercially available and clinicians initiate using these systems

Exercising with an automated insulin delivery system: qualitative insight into the hopes and expectations of people with type 1 diabetes

For people with type 1 diabetes (T1DM), regular exercise can be highly beneficial. Although exercise has been shown to improve quality of life and health for people living with T1DM, there are common barriers. To examine such issues, we explored the perceived impact that automated insulin delivery systems could have on people with T1DM and their families. One common theme found was hopes, expectations and impact on sports and exercise. Four sites (United States: three; UK: one) were involved in this study. Two hundred and eighty-four participants were recruited across all sites; participants comprised: children (9–11 years); adolescents (12–18 years); parents/caretakers of children and adolescents with T1DM; adults with T1DM (18–77 years); and their significant others/partners. Between May and December 2015, focus groups and semi-structured interviews were conducted and analysed using content analysis. Three themes found related to the benefits of automated insulin delivery systems: (a) more freedom and spontaneity in the individual’s ability to exercise; (b) relief from worry of hypoglycaemia as a result of exercise; (c) removing the ‘guesswork’ of adjusting insulin for exercise. Two further themes emerged relating to potential concerns with regard to safely exercising while wearing an automated insulin delivery system. Further research is encouraged with a view to providing accurate algorithms and increasing confidence for those using automated insulin delivery systems and, in turn, for their exercise colleagues and loved ones

Positive youth development in swimming: clarification and consensus of key psychosocial assets

The purpose of this study was to gain a more cohesive understanding of the assets considered necessary to develop in young swimmers to ensure both individual and sport specific development. This two stage study involved (a) a content analysis of key papers to develop a list of both psychosocial skills for performance enhancement and assets associated with positive youth development, and (b) in-depth interviews involving ten expert swim coaches, practitioners and youth sport scholars. Five higher order categories containing seventeen individual assets emerged. These results are discussed in relation to both existing models of positive youth development and implications for coaches, practitioners and parents when considering the psychosocial development of young British swimmers