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From simulation to bedside: enhancing clinicians’ preparedness for recognising and responding to acute deterioration
No full textBackground
Failure to recognise and respond to patient deterioration is a global patient safety issue. Simulation-based learning may enhance clinicians’ preparedness, decision-making, and teamwork during clinical emergencies.
Aims
To evaluate clinicians’ experience of a simulation-based workshop preparing for recognition and response to acute patient deterioration in hospital settings.
Design
A single-group, post-test, repeated cross-sectional exploratory study was conducted across three metropolitan hospitals in Sydney, Australia.
Methods
Nurses and medical officers attending mandatory workshops completed the Simulation Effectiveness Tool-Modified (SET-M) and provided qualitative feedback. Additional questions sought contextual information about participants’ training backgrounds in patient deterioration, as well as open-ended feedback on the workshop's strengths and areas for improvement. Descriptive statistics and content analysis were performed.
Results
Among 153 participants, most were nurses attending orientation training. Over 90% agreed that simulation improved confidence and preparedness. Pre-briefing, scenario learning, and debriefing were rated highly. Participants valued hands-on experience and interdisciplinary collaboration.
Conclusions
The ‘’program effectively enhanced clinical preparedness and confidence. Ensuring completion prerequisites and addressing logistical challenges may further improve outcomes
Multi-planar intersegmental angular velocity in the assessment of topline movement in horses
No full textObjective
A recent survey of a large group of equine clinicians found a need for more objective assessment techniques for quality of movement, especially related to horses with clinical topline dysfunction. This study measured intersegmental movement in the sagittal, dorsal and transverse planes of the cranial thoracic to caudal thoracic (CRT-CDT), caudal thoracic to lumbar (CDT-LUM), and lumbar to sacral (LUM-SAC) segments using range of motion and angular velocity as measures of quality of movement
Methods
Six degrees of freedom spinal motion was measured at the walk and trot in 3 sound Thoroughbred and Thoroughbred cross horses, and the data were pooled giving a total of 54 gait cycles at walk and 33 at trot. These were compared against 8 cycles at walk and 13 at trot from one Thoroughbred horse that was confirmed as having moderate/severe impact and push off lameness in the right hindlimb.
Results
Both joint angles and angular velocities detected differences between the sound horses and the lame horse with angular velocity showing notably greater differences in absolute values and percentages compared with joint angles.
Conclusions
The between-group differences indicated decreased quality of movement/control in the lame horse and this was most apparent when trotting.
Clinical Relevance
Intersegmental angular velocity is measured non-invasively and may be used to assess quality of intersegmental movement in horses as it does in humans. Further investigation to assess angular velocity throughout treatment of topline dysfunction of the horse and its association with different lameness patterns is warranted
Scaffolding a Design Process for Applying Calm Technology Design to Smart Toys
Get PDFThe notion of Calm Technology, which can move between our focal and peripheral attention, is a potentially valuable but underexplored concept in relation to smart connected toys. In this paper, we explored two interconnected research questions: (a) How can scaffolding support children in understanding Calm and designing for Calm connected toys? (b) To what extent can children contribute towards the design of novel connected toys that apply Calm Technology Principles? Building on UX practice and research we developed a participatory approach to working with children we call Design School, which gave children knowledge and experience of a design process. Additionally, we created design cards to use within the Design School, which scaffolded the inclusion of Calm technology design principles within children’s designs. The Design School workshops ran over four days in a U.K. school with 30 children aged 10–11 years, design outputs were analyzed to answer the research questions. From our experiences and analysis, we make four contributions: (a) the success of design cards as a tool to scaffold children in operationalizing unfamiliar design principles, (b) an understanding of how different design activities afforded expression of Calm in design ideas, and (c) the Design School workshop format, which proved effective in enabling children to engage in design activities
Revisiting the core principles of physical rehabilitation after stroke: It’s not only what you do but how you do it that matters
Get PDFValidation of forensic cleaning processes undertaken within Sexual Assault Referral Centres
No full textThis paper describes the retrospective validation of long-established cleaning processes used within Sexual Assault Referral Centres (SARCs), for which there are variations between facilities in the detail of the cleaning approach that is applied, including whether bleach/hypochlorite cleaning reagents are permitted depending on local health and safety requirements. Six cleaning reagents commonly used within UK SARCs and Forensic Science Providers were assessed in this validation study: Chemgene HLD4H, Virkon, Microsol, Selgiene, Virusolve were tested along with Presept which was the only reagent containing bleach. Additional comparison testing was also conducted on Chemgene Medlab. These were evaluated for their DNA decontamination capability by cleaning dried-on body fluid stains deposited on typical examination room surfaces and then assessing the level of DNA remaining (percentage yield). Impact of changing different cleaning parameters were assessed against an environmental indicator guide that provides insight into SARC facility cleanliness. Differences in effectiveness of decontamination varied according to body fluid type with DNA in blood being most readily removed followed by saliva, and semen was the hardest to decontaminate. Likewise, different surfaces varied in their resilience to decontamination with Formica being the easiest to clean and vinyl the hardest. Bleach-based reagent Presept gave the best decontamination test results overall, whilst non-bleach cleaners Virkon and Selgiene were also very effective. However, as a general rule, provided double spray/wipe cycles are performed using manufacturers’ recommended concentrations and a 30 second contact time, the cleaning effectiveness of all reagents were assessed to be generally acceptable in most circumstances. The exception to this rule was cleaning dried semen on vinyl, which was the most challenging body fluid / surface combination to decontaminate. It is recommended that extra care is taken in cleaning vinyl surfaces such as the examination couch and consider additional measures if necessary
Navigating Medicine and Justice: A Life History and Phenomenological Study of Forensic Doctors’ Experiences
No full textForensic doctors play a crucial role at the intersection of medicine and law, offering expertise legal matters. However, their work exposes them to significant emotional and psychological stress, increasing the risk of burnout. Despite the critical nature of their profession, little research has explored how forensic doctors construct their professional identities, cope with work-related challenges, and make sense of their professional experiences.To address this gap, we adopted a Life History Approach combined with Interpretative Phenomenological Analysis (IPA) to examine the subjective career trajectories and meaning-making processes of forensic doctors in Italy. Semi-structured interviews were conducted with 12 participants, capturing their personal and professional histories. An in-depth analysis identified five key themes: The Nature of Forensic Medicine – Participants used metaphors to describe the complexity, artistry, and investigative nature of their work; The Professional Identity of Forensic Doctors – How they develop a sense of duty, ethical commitment, and professional resilience throughout their careers; Core Resources Needed to be a Forensic Doctor – The role of mentorship, specialized skills, and coping strategies in sustaining their careers; What Does Death Have to Teach? – The personal impact of continuous exposure to death, shaping their perspectives on life and mortality; Esse Cum – The challenges, stigma, and stereotypes forensic doctors face in their interactions with colleagues, legal professionals, and society.
This study explores the professional identities and coping mechanisms of forensic doctors, revealing that despite facing stigma, emotional strain, and burnout, they find meaning in their work, emphasizing justice and resilience
Estimating Mixed & Boundary Friction from the Lambda Ratio: Incorporating the Effect of Surface Character
No full textThe authors have previously reported a method to estimate boundary and mixed friction coefficients using lambda ratio values and friction data from Mini Traction Machines (MTM). This paper reports a more general approach which accounts for the surface height distribution of the topographies at the interface by employing the overlap functions of idealised probability height distributions of the interface components.
The overlap coefficients of probability density functions relevant to engineering rough surfaces have been calculated, and simple analytical expressions have been obtained for exponential, Gaussian and Rayleigh distribution functions. This is believed to be the first time overlap coefficients of probability density functions have been calculated and applied in a tribological context.
It has been found that the derived expressions can be used to predict mixed/boundary friction for rough surface lubricated contacts and are in good agreement with published experimental data.
It has also been noted that rough surfaces with identical Gaussian distribution functions take an especially simple form and that surfaces that are described by the Rayleigh probability density function, provide a good model for “run-in” surfaces. This feature allows tribologists to make quick and simple comparisons of the friction of new and worn, or run-in, machine components
What are the Factors Influencing Service Provider Response to Working with Families Affected by Intimate Partner Violence and Abuse? A Qualitative Systematic Review of the Literature
Get PDFPurpose
Intimate partner violence and abuse (IPVA) is a major public health issue with long-term negative impacts on abused adults and affected children. Addressing this complex problem requires a multi-agency response, but barriers to effective joint working remain. This review aimed to understand the factors that influence multi-agency response to families who experience IPVA and to their children.
Method
We undertook a qualitative systematic review of international literature via five electronic databases and supplemented the review by citation searches, online searches of grey literature, and hand searches of relevant journals. We analyzed data thematically.
Results
The 31 identified papers reported findings from 29 unique studies undertaken in six countries and drew on data from 1049 professionals across health care, social care, the police, courts, schools and voluntary organisations. The main factors influencing service provider response to IPVA were siloed approaches to IPVA, particularly the separation between adult and childrens services. This influenced assessment and response to risk. Risk was also a consideration when child-protection staff were expected to work with perpetrators in ‘family settings’, even in lower-risk cases. Multi-agency working facilitated information sharing between agencies, an understanding of each other’s remit, and building trust.
Conclusion
Multi-agency collaboration needs to be supported by clear policies of interaction between agencies. Providers of child protection services, health, mental health, housing police and probation need to be supported by specialist training in IPVA, not only in high-risk cases, but also to relieve pressure on an already overstretched workforce
Evaluation of Smoking Behaviors and Attitudes of Visually Impaired Weightlifters and Coaches
No full textThis study was designed to descriptively evaluate the smoking behaviors and attitudes toward smoking among blind powerlifting athletes and their coaches. The research employed a cross-sectional and descriptive survey design and was conducted with visually impaired athletes actively competing at the national level in Türkiye, as well as the coaches working with these athletes within the framework of International Blind Sports Federation (IBSA)-governed powerlifting. Following the approval of the ethics committee, a total of 67 participants were included in the study. Data were collected through face-to-face interviews. As the data collection instrument, a questionnaire was used, aiming to assess sociodemographic characteristics and attitudes and behaviors related to smoking. The collected data were analyzed statistically and were reported using descriptive statistics only (frequency and percentage). The findings revealed that more than half of the participants were current smokers, while the vast majority believed that smoking negatively affects athletic performance. A substantial proportion of smokers reported initiating smoking prior to starting sports, with smoking duration generally extending over many years and daily consumption levels clustering at moderate to high ranges. In addition, a widespread desire to quit smoking and confidence in the ability to quit were observed; however, participation rates in smoking cessation education and support programs were found to be low. This study provides descriptive data on smoking prevalence, smoking-related behaviors, and self-reported attitudes toward smoking and performance among blind powerlifting athletes and coaches. No objective performance indicators were measured, and no analytical comparisons between smoking behavior and performance outcomes were conducted