Staying Ahead of the Wave.
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ABSTRACT:
SUBMITTER: Singer AJ
PROVIDER: S-EPMC7175466 | biostudies-literature | 2020 Apr
REPOSITORIES: biostudies-literature
Publications
Staying Ahead of the Wave.
Singer Adam J AJ Morley Eric J EJ Henry Mark C MC
The New England journal of medicine 20200413 18
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Project description:ObjectivesThis study examines how the results of the Hospital Survey on Patient Safety Culture changed between 2012 and 2019 and identifies organisational factors affecting these changes.DesignThe study combined the use of quantitative surveys of staff and qualitative interviews with hospital leadership. Secondary data analysis was performed for previous surveys.SettingThis study was conducted in a tertiary care teaching multisite hospital in Riyadh, Saudi Arabia.ParticipantsOne thousand hospital staff participated in the survey. Thirty-one executive board members and directors and four focus groups of frontliners were qualitatively interviewed.Primary and secondary outcome measuresTwelve safety culture dimensions were assessed to study the patient safety culture as perceived by the healthcare professionals. An additional semi-structured interview was conducted to identify organisational factors, changes, and barriers affecting the patient safety culture. Furthermore, suggestions to improve patient safety were proposed.ResultsComparing the results revealed a general positive trend in scores from 2012 to 2019. The areas of strength included teamwork within and across units, organisational learning, managerial support, overall perception of safety and feedback and communication about error. Non-punitive response to error, staffing and communication and openness consistently remain the lowest-scoring composites. Interview results revealed that organisational changes may have influenced the answers of the participants on some survey composites.ConclusionsPatient safety is a moving target with areas for improvement that are continuously identified. Effective quality improvement initiatives can lead to visible changes in the patient safety culture in a hospital, and consistent leadership commitment and support can maintain these improvements.
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Project description:Wastewater based epidemiology is a potential early warning tool for the detection of COVID-19 outbreak. Sewage surveillance for SARS-CoV-2 RNA was introduced in Hungary after the successful containment of the first wave of the pandemic to forecast the resurge of infections. Three wastewater treatment plants servicing the entire population (1.8 million) of the capital, Budapest were sampled weekly. 24 h composite (n = 44) and grab samples (n = 21) were concentrated by an in-house flat sheet membrane ultrafiltration method. The efficiency and reproducibility of the method was comparable to those previously published. SARS-CoV-2 RNA was quantified using RT-qPCR of the N gene. The first positive signal in sewage was detected 2 weeks before the rise in case numbers. Viral concentration and volume-adjusted viral load correlated to the weekly new cases from the same week and the rolling 7-day average of active cases in the subsequent week. The correlation was more pronounced in the ascending phase of the outbreak, data was divergent once case numbers plateaued. Wastewater surveillance was found to be effective in predicting the second wave of the outbreak in Hungary. Data indicated that even relatively low frequency (weekly) sampling is useful and at the same time, cost effective tool in outbreak detection.
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Project description:ObjectiveTo identify the challenges adult community sport participants anticipate when returning to sport in Victoria, Australia, post a COVID-19 shutdown.MethodsUsing online concept mapping, participants brainstormed challenges to returning to community sport, sorted them into groups and rated them for impact and ability/capacity to overcome. Analysis included multidimensional scaling and hierarchical cluster analysis.ResultsForty-five community sport participants representing 24 sports identified 69 unique challenges to returning to sport. Eight clusters/questions participants need answered emerged from the sorting data (mean cluster impact and ability/capacity rating out of 5): Will we have enough participants? (3.32, 2.89); How do we stay safe? (3.31, 3.35); How will our sport change? (3.17, 2.85); How can we stay together? (3.15, 3.01); Will I be physically ready? (3.15, 3.05); What about the money? (2.86, 2.53); What about me? (2.65, 3.13); and What about the facilities? (2.49, 2.45).ConclusionsParticipants perceived paradoxical challenges to returning to sport after COVID-19 shutdown, which revolved around staying safe, staying connected and accessing meaningful sport activities. Implications for public health: Sport organisations and public health practitioners should address the participant-centred challenges identified in this study to maximise the public health benefits of participants returning to community sport.
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Project description:Abstract Dispersal is a critical process that shapes the structure of wild animal populations. In species that form multi‐level societies, natal dispersal might be social (associating with a different social community while remaining near the natal area), spatial (moving away from the natal area while continuing to associate with the same community) or both social and spatial (associating with a different community and moving away from the natal area). For such species, classical spatial measures of dispersal, such as distance moved, might not capture social dispersal. We examined dispersal outcomes for 67 male and 70 female giraffe calves over 7 years in a large, unfenced, ecologically heterogeneous landscape. We tested predictions about the influence of sex, food availability, low‐ and high‐impact human settlements, and local giraffe population density on social or spatial dispersal, dispersal distance, and age of dispersal. We found that dispersal is sex‐specific, with females being predominately philopatric. When dispersing, both sexes did so at a mean of 4 years of age. Most (69% of total) young males dispersed, with 84% of male dispersers associating with a different adult female social community than that of their mother, but one in four of these dispersers remained spatially near to their natal area. For adolescent males that dispersed socially but not spatially, overlapping female social communities may represent a potential pool of unrelated mating partners without the risks of travelling to unfamiliar areas. Just 26% of young females dispersed and half of these continued to associate with the adult female social community into which they were born, confirming the importance of maintaining ties among females from calf to adulthood. Furthermore, individuals born farther from high‐impact human settlements were more likely to spatially or socially‐and‐spatially disperse, move greater distances from their natal areas, and disperse at a younger age. Our study highlights the potential importance of social structure in dispersal decisions, and of tracking social structure when studying dispersal in multi‐level societies, as effective dispersal can be attained without large‐scale spatial displacements. This study is the first to investigate whether social dispersal occurs in animal societies characterised by open fission‐fusion group membership within stable multi‐group communities, where individuals can disperse with little to no spatial displacement.
| S-EPMC9291750 | biostudies-literature
Project description:This paper introduces the reader to the context for the papers in this journal supplement by describing the background and task assigned to the authors, a short history of the development of the field of literacy and health in Canada, some recent developments and opportunities, some information on the nature and magnitude of the issue, and an overview of the supplement. The publication results from the Second Canadian Conference on Literacy and Health. Authors were asked to summarize what was learned at the conference, what we need to know, and what we need to do to move the field forward in relation to the themes of the conference. The four themes were: Building Best Practices in Literacy and Health; Focusing on Language and Culture; Building Knowledge in Literacy and Health; and Building Healthy Public Policy.
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Project description:We outline the key questions about comets that must be answered in order to understand cometary formation in the context of the protoplanetary disc and the role of comets in the formation and evolution of the solar system. We then discuss the new understanding of comets from Rosetta and from other recent advances, including work presented by others at the discussion meeting. Finally, we suggest some key directions for future projects to better address the above questions.This article is part of the themed issue 'Cometary science after Rosetta'.
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Project description:BackgroundDepression is often a chronic relapsing condition, with relapse rates of 50-80% in those who have been depressed before. This is particularly problematic for those who become suicidal when depressed since habitual recurrence of suicidal thoughts increases likelihood of further acute suicidal episodes. Therefore the question how to prevent relapse is of particular urgency in this group.Methods/designThis trial compares Mindfulness-Based Cognitive Therapy (MBCT), a novel form of treatment combining mindfulness meditation and cognitive therapy for depression, with both Cognitive Psycho-Education (CPE), an equally plausible cognitive treatment but without meditation, and treatment as usual (TAU). It will test whether MBCT reduces the risk of relapse in recurrently depressed patients and the incidence of suicidal symptoms in those with a history of suicidality who do relapse. It recruits participants, screens them by telephone for main inclusion and exclusion criteria and, if they are eligible, invites them to a pre-treatment session to assess eligibility in more detail. This trial allocates eligible participants at random between MBCT and TAU, CPE and TAU, and TAU alone in a ratio of 2:2:1, stratified by presence of suicidal ideation or behaviour and current anti-depressant use. We aim to recruit sufficient participants to allow for retention of 300 following attrition. We deliver both active treatments in groups meeting for two hours every week for eight weeks. We shall estimate effects on rates of relapse and suicidal symptoms over 12 months following treatment and assess clinical status immediately after treatment, and three, six, nine and twelve months thereafter.DiscussionThis will be the first trial of MBCT to investigate whether MCBT is effective in preventing relapse to depression when compared with a control psychological treatment of equal plausibility; and to explore the use of MBCT for the most severe recurrent depression--that in people who become suicidal when depressed.
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Project description:Foragers often systematically deviate from rate-maximizing choices in two ways: accuracy and precision. That is, they use suboptimal threshold values and also show variability in their application of those thresholds. We hypothesized that these biases are related and, more specifically, that foragers' widely known accuracy bias--over-staying--could be explained, at least in part, by their imprecision. To test this hypothesis, we analysed choices made by three rhesus macaques in a computerized patch foraging task. Confirming previously observed findings, we found high levels of variability. We then showed, through simulations, that this variability changed optimal thresholds, meaning that a forager aware of its own variability should increase its leaving threshold (i.e. over-stay) to increase performance. All subjects showed thresholds that were biased in the predicted direction. These results indicate that over-staying in patches may reflect, in part, an adaptation to behavioural variability.
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Project description:The year 2020 was not easy for Emergency Medicine (EM) clinicians with the burden of tackling a pandemic. A large focus, rightfully so, was placed on the evolving diagnosis and management of patients with COVID-19 and, as such, the ability of clinicians to remain up to date on key EM pharmacotherapy literature may have been compromised. This article reviews the most important EM pharmacotherapy publications indexed in 2020. A modified Delphi approach was utilized for selected journals to identify the most impactful EM pharmacotherapy studies. A total of fifteen articles, eleven trials and four meta-analyses, were identified. This review provides a summary of each study, along with a commentary on the impact to the EM literature and EM clinician.
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Project description: Not available
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