Do office workers adjust their chairs? End-user knowledge, use and barriers to chair adjustment.

A quantitative field study measured end-user availability, knowledge and use levels of adjustable office chair functions in Korea-based office workers, together with their perceived barriers towards making adjustments. Fifty-one English-speaking workers were interviewed and surveyed in a related design. Results showed that of the number of adjustable functions available on their office chair (M = 5.39, SD = 2.3), participants knew fewer than half of them (M = 2.51, SD = 1.52) and used even less (M = 1.86, SD = 1.21). Fifty-three percent of participants knew two or less and 73% had used only two or less. Ten percent had used none. Results suggested physical needs (such as increased comfort or postural change) were a strong driver for previous chair adjustment behavior. Perceived cognitive barriers played a more significant role in limiting chair adjustment knowledge and use than physical or organizational barriers. Highly adjustable office chairs have the possibility of satisfying the adjustment needs of most end-users. However, adjustable chair functions need to be both available and known in order to be used.N/

Older people's experiences of their kitchens: 2000 to 2010

Purpose – This paper aims to present the quantitative results based on a comparison and evaluation of older people's experiences, needs and wants from their current kitchens, combining and comparing the results obtained from two studies conducted in 2000 and 2010 to see what progress has been made. Design/methodology/approach – A study in 2010 investigated the life-long and contemporary experiences of kitchens of 48 people aged over 60 years of age. The research included detailed questionnaire interviews asking people about their experiences of living in their current kitchen. A previous study, conducted in 2000, asked many of the same questions of 22 people in the same age group. Findings – By combining and comparing the two sets of data it seems that only limited progress has been made in terms of kitchen design meeting the needs of older people between 2000 and 2010. Research limitations/implications – Owing to the small sizes of the samples it is not possible to compare the figures statistically or present them as fully representative of the British older population but while the two samples are limited both had similar characteristics of age and gender, so differences do show potential trends over time. Practical implications – The research refers to guidance and a computer based design tool and identifies a number of practical implications for design. Social implications – As people age their abilities and needs can change and their kitchen may no longer be as accessible or appropriate to their needs. Originality/value – This paper adds to the relevant guidance for designers, developers and managers of buildings where the continued personal use of a kitchen is important for continuing independence of older people

A Transformative Learning Experience: An Undergraduate Research Conference as Authentic Assessment

This article explores an example of authentic assessment practised on the English and History undergraduate programmes at the University of Derby, involving modules which lead to a public conference. Drawing on notions of authenticity in assessment both as connected to professional scenarios and as potentially transformative for the student in a wider sense, we outline the nature of the modules and their place within broader programme-level assessment strategy. We then detail their impact in terms of public engagement and raising the profile of the disciplines as well as, crucially, student feedback. Overall, we offer this practice as an example of successful authentic assessment in the Humanities which can lead students to engage more critically with their discipline and to discover new and highly transferable skills

What makes a local accreditation programme successful and how?:A rapid realist review and in-depth consultation with senior nursing leaders

Background: Locally driven ward and unit accreditation programmes provide a comprehensive tool to assess the quality of care delivered to patients, bringing together several measures in a single overarching framework. Reported outcomes of locally driven ward accreditation include reduced variation in care delivery, increased assurance of care quality and improved staff motivation. However, there is little empirical research that clarifies the underlying assumptions about what causes outcomes or the theoretical basis to explain how ward accreditation programmes work. Design: A rapid realist review methodology with in-depth stakeholder consultation was adopted to explore the question “What are the key principles and processes of successfully implemented local ward accreditation programmes?” Setting(s): Six study sites (NHS Trusts) across England participated in this review. Participants: Sixteen senior nurse leaders at six study sites participated in focus groups lasting 90–120 min to elicit detailed reflections on how their accreditation programmes had been designed and implemented, to test out initial programme theories identified in the literature. These theories were then further scrutinised through a consultation group of key stakeholders. Methods: Ten databases were searched, after screening 186 papers for relevance, 43 remained. An additional 11 papers were identified via a Google Scholar search. The 54 papers were then appraised for ‘fitness for purpose’, and thematically analysed for context, mechanisms and outcomes. A rapid realist review approach was adopted to develop and iteratively refine programme theories of locally driven ward accreditation programmes through evidence review, expert focus groups, and in-depth stakeholder consultation. Results: Seven initial programme theories were identified from the literature: 1) Performance assessment; 2) Public disclosure and/as incentivisation; 3) Strengthening the Nursing voice; 4) Standardisation, consistency, accountability and shared governance; 5) Cultures of improvement; 6) Leadership development and 7) Teamwork and communication. These were discussed in focus groups with senior nursing teams and through a consultation group of key stakeholders. There was evidence for all seven initial programme theories, although some had more resonance with the senior nursing teams and stakeholders than others. No new theories were identified, demonstrating that the review comprehensively captured the reasons why locally driven ward accreditation programmes are thought to generate actions that lead to the outcomes the programmes are designed to produce. Conclusions: This review provides an important and newly developed conceptual framework to underpin future empirical work and evaluate the effectiveness of locally driven ward and unit accreditation programmes to improve the quality and outcome of patient care.</p

Diversification of importin-α isoforms in cellular trafficking and disease states.

The human genome encodes seven isoforms of importin α which are grouped into three subfamilies known as α1, α2 and α3. All isoforms share a fundamentally conserved architecture that consists of an N-terminal, autoinhibitory, importin-β-binding (IBB) domain and a C-terminal Arm (Armadillo)-core that associates with nuclear localization signal (NLS) cargoes. Despite striking similarity in amino acid sequence and 3D structure, importin-α isoforms display remarkable substrate specificity in vivo. In the present review, we look at key differences among importin-α isoforms and provide a comprehensive inventory of known viral and cellular cargoes that have been shown to associate preferentially with specific isoforms. We illustrate how the diversification of the adaptor importin α into seven isoforms expands the dynamic range and regulatory control of nucleocytoplasmic transport, offering unexpected opportunities for pharmacological intervention. The emerging view of importin α is that of a key signalling molecule, with isoforms that confer preferential nuclear entry and spatiotemporal specificity on viral and cellular cargoes directly linked to human diseases

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Evidence-Based Approach to Early Outpatient Treatment of SARS-CoV-2 (COVID-19) Infection

Misinformation and promotion of well-intended but disproved therapies for COVID-19 have plagued evidence-based shared decision-making throughout the COVID-19 pandemic. In times of crisis, clinicians may feel that their strong inclination to prescribe potentially harmful, unproven therapies on behalf of their patients is supported by beneficence. Clinicians should mindfully identify and avoid commission bias during this pandemic, especially as more data have accumulated to assist with clinically sound decision-making. We describe a more evidence-based approach to treatment of early outpatient COVID-19, stressing the availability of Food and Drug Administration emergency use authorization therapies and considering plausibly beneficial, nonprescription supplements that are generally regarded as safe

Understanding key mechanisms of successfully leading integrated team-based services in health and social care : protocol for a realist synthesis

Introduction As systems of health and social care in England move towards more integrated and collaborative models, leaders will need different skills than their predecessors to enable system leadership, building partnerships and working across organisations and sectors. There is little understanding of what the mechanisms for effective leadership across integrated health and social care systems might be, the contexts that influence good leadership, or the nature of the resulting outcomes. This review aims to identify, refine and test programme theories of leadership of integrated team-based services in health and social care, exploring what works, for whom and in what circumstances. Methods and analysis This study uses a realist synthesis approach, following RAMESES guidelines, supported by stakeholder consultation. Stage 1 will develop initial programme theories about leadership of integrated health and social care based on a review of the scientific and grey literature and a stakeholder consultation workshop. Stage 2 will involve focused searching of empirical literature, data extraction and synthesis to refine the initial programme theories and identify relationships between identified contexts, mechanisms and outcomes. A second stakeholder event will guide the focus of the review. Stage 3 will further refine and interrogate the theories testing them against substantive theory on leadership of complex systems and through the experiences and expertise of the stakeholder group. Ethics and dissemination Our study does not require ethics committee approval. This research will contribute to building an in-depth understanding of what aspects of leadership of integrated team-based services work, for whom and in what circumstances. It will identify the professional development needs of leaders and provide recommendations about optimal organisational and interorganisational structures and processes that support effective leadership in integrated health and social care systems. Findings will be disseminated through peer-reviewed journal publications, conference presentations and formal and informal reports. PROSPERO registration number CRD4201811929

Emotional Tone Coding Using an Abbreviated Rating Scale

Paper submitted to the University of Kansas School of Nursing in partial fulfillment of the requirements for the Nursing Honors Program.Introduction: The Emotional Tone Rating Scale (ETRS) is used to evaluate nursing communication with older adults in dimensions of care, respect, and control. Psychometric analysis of the original scale indicates that several of the 12 items overlap and that two, instead of three factors are indicated (control and person-centered). A scale was reduced to 8 items to diminish redundancy and reduce burden for raters. Background: This Pilot Study is part of a larger research study entitled Changing Talk to Reduce Resistiveness to Dementia Care. The specific aim of the larger study is to improve staff communication with nursing home residents who have dementia to reduce resistiveness to care (RTC). The intervention is a three-session staff training program on communication skills associated with avoiding RTC. The ETRS is used to evaluate the communication skills. Purpose: This study was conducted to evaluate whether the 8 and 12 item scales measure the same factors. Theoretical Framework: The ETRS is designed to measure nursing communication based on concepts and theories of person-centered care for older adults. Methodology: Twenty raters each listened to 20, 1 minute audio recordings of nursing home care, presented in a powerpoint presentation. These clips were previously rated using the 12-item scale. They rated the nurse's communication on the ETRS. Factor analysis was used to compare similarities of the original and abbreviated scales. Findings: Factor analysis revealed that the 12-item scale data and the 8-item scale data resulted in highly comparable negative correlations between person-centered and controlling scales. Factor analyses of the original 12-item scale and the 8-item scale produce similar solutions. Discussion: The two factors person-centered communication and controlling communication are similar with the shortened 8-item tool as with the previous 12-item scale the shortened version and will be used for future use. This shortened scale will help to reduce redundancies and rater burden.The University of Kansas School of Nursing Bachelor of Science Nursing Honors Progra