Explore the vast range of titles available.

Background Patient experience is a complex phenomenon that presents challenges for appropriate and effective measurement. With the lack of a standardized measurement approach, efforts have been made to simplify the evaluation and reporting of patient experience by using single‐item measures, such as the Net Promoter Score (NPS). Although NPS is widely used in many countries, there has been little research to validate its effectiveness and value in the healthcare setting. The aim of this study was to systematically evaluate the evidence that is available about the application of NPS in healthcare settings. Methods Studies were identified using words and synonyms that relate to NPS, which was applied to five electronic databases: Medline, CINAHL, Proquest, Business Journal Premium, and Scopus. Titles and s between January 2005 and September 2020 were screened for relevance, with the inclusion of quantitative and qualitative studies in the healthcare setting that evaluated the use of NPS to measure patient experience. Results Twelve studies met the inclusion criteria. Four studies identified benefits associated with using NPS, such as ease of use, high completion rates and being well‐understood by a range of patients. Three studies questioned the usefulness of the NPS recommendation question in healthcare settings, particularly when respondents are unable to select their service provider. The free‐text comments section, which provides additional detail and contextual cues, was viewed positively by patients and staff in 4 of 12 studies. According to these studies, NPS can be influenced by a wide range of variables, such as age, condition/disease, intervention and cultural variation; therefore, caution should be taken when using NPS for comparisons. Four studies concluded that NPS adds minimal value to healthcare improvement. Conclusion The literature suggests that many of the proposed benefits of using NPS are not supported by research. NPS may not be sufficient as a stand‐alone metric and may be better used in conjunction with a larger survey. NPS may be more suited for use in certain healthcare settings, for example, where patients have a choice of provider. Staff attitudes towards the use of NPS for patient surveying are mixed. More research is needed to validate the use of NPS as a primary metric of patient experience. Patient or Public Contribution Consumer representatives were provided with the research findings and their feedback was sought about the study. Consumers commented that they found the results to be useful and felt that this study highlighted important considerations when NPS data is used to evaluate patient experience.

Background Poor quality sleep in hospitals may be problematic for patients, negatively impacting their recovery and wellbeing. This project aimed to investigate the effectiveness of codesign in addressing key issues affecting sleep disruption in the healthcare setting. Methods Codesign with patients, staff and consumer representatives was conducted in an acute metropolitan tertiary public hospital in Sydney, Australia. Through a four‐stage process, a multimodal intervention to address and reduce the impact of sleep disruptions among hospital inpatients was created. Pre‐ and post‐intervention evaluation was used to determine changes in patient‐reported sleep disruption. Results ‘The HUSH Project’ (Help Us Support Healing) intervention resulted from the codesign process, which included the provision of HUSH Sleep Packs (with earplugs, eye masks and herbal tea), patient information resources, and ward‐based Sleep Champions. Survey data from 210 patients revealed a statistically significant decrease in patient‐reported noise disturbances for patients in shared rooms following the 4‐week intervention period of the HUSH program. Conclusion The HUSH Project demonstrated that a novel multimodal intervention may be valuable in reducing sleep disruption in hospitals. These findings also indicate the benefits of using codesign methodology to support improvement projects that seek to enhance patient experiences of care. Patient or Public Contribution This project utilised codesign methodology, which involved significant contributions from patients and consumer representatives, from research conceptualisation into intervention design, implementation and project evaluation.

Barber et al discuss the case study of a 22-year-old man with intense pain in, dusky discoloration of and reduced sensation to his right foot. He had a history of migraines and 2 years of mild intermittent calf discomfort with exercise, for which he had not sought medical attention. He had a family history of premature coronary artery disease. Peripheral artery duplex ultrasonography showed reduced blood flow in both tibial arteries and a deep vein thrombosis in his right leg. Given the abnormal arterial flow, computed tomography (CT) angiography was ordered, which showed a chronic occlusion in the patient's right superficial femoral artery and an occluded infrarenal abdominal aorta with collateralization. Splenomegaly and axillary adenopathy were noted. He was treated with apixaban and referred to the vascular surgery team.

Background Patient-reported experience measures (PREMs) are used to drive and evaluate unit and organisational-level healthcare improvement, but also at a population level, these measures can be key indicators of healthcare quality. Current evidence indicates that ethnically diverse communities frequently experience poorer care quality and outcomes, with PREMs data required from this population to direct service improvement efforts. This review synthesises evidence of the methods and approaches used to promote participation in PREMs among ethnically diverse populations. Methods A rapid evidence appraisal (REA) methodology was utilised to identify the disparate literature on this topic. A search strategy was developed and applied to three major electronic databases in July 2022 (Medline; PsycINFO and CINAHL), in addition to websites of health agencies in Organisation for Economic Co-operation and Development countries via grey literature searches. A narrative evidence synthesis was undertaken to address the review question. Results The review resulted in 97 included studies, comprised 86 articles from electronic database searches and 11 articles from the grey literature. Data extraction and synthesis identified five strategies used in PREM instruments and processes to enhance participation among ethnically diverse communities. Strategies applied sought to better inform communities about PREMs, to create accessible PREMs instruments, to support PREMs completion and to include culturally relevant topics. Several methods were used, predominantly drawing upon bicultural workers, translation, and community outreach to access and support communities at one or more stages of design or administration of PREMs. Limited evidence was available of the effectiveness of the identified methods and strategies. PREMs topics of trust, cultural responsiveness, care navigation and coordination were identified as pertinent to and frequently explored with this population. Conclusions The findings provide a basis for a maturity model that may guide change to increase participation of ethnically diverse communities in PREMs. In the short-medium term, health systems and services must be able to recognise and respond to cultural and linguistic diversity in the population when applying existing PREMs. In the longer-term, by working in collaboration with ethnically diverse communities, systems and services may co-create adapted or novel PREMs that tackle the factors that currently inhibit uptake and completion among ethnically diverse communities.

Mitral regurgitation (MR) is the systolic retrograde flow from the left ventricle (LV) to the left atrium. Despite the recognized importance of hemodynamic force (HDF) in cardiology, its exploration in MR has been limited. Therefore, we aimed to explore non-invasively assessed HDF as a novel biomarker for evaluating MR utilizing 4D-flow MRI. The study cohort comprised 15 healthy controls (19–61 years, 53% men) and 26 MR patients with preserved ejection fraction (EF) (33–75 years, trivial–severe, 54% men). The HDF analysis involved the semi-automatic calculation of systolic–diastolic root mean square (RMS), average, and transverse/longitudinal ratio across three directions (S-L: septal–lateral, I-A: inferior–anterior, and B-A: basal–apical) using Segment, v2.2 R6410 (Lund, Sweden, Medviso). A noticeable trend shift emerged in HDF as the MR severity increased (p-value < 0.05). The MR severity demonstrated a noteworthy correlation with systolic RMS B-A, average B-A, diastolic average B-A, systolic average S-L, B-A, and systolic–diastolic ratio (rho = 0.621, 0.457, 0.317, 0.318, 0.555, −0.543, −0.35, respectively; p-value < 0.05). HDF significantly correlated with LV function (end-diastolic volume, end-systolic volume, EF, and mass; p-value < 0.05). Systolic RMS B-A and diastolic RMS S-L emerged as significant predictors of MR (Beta, 95% CI [3.253, 1.204–5.301], [5.413, 0.227–10.6], p-value < 0.05). This study emphasizes HDF as a potential hemodynamic biomarker for evaluating MR.

The amount and complexity of data recorded by high energy physics experiments are rapidly growing, and with these grow the difficulties in visualizing such data. To study the physics of neutrinos, a type of elementary particle, scientists use liquid argon time projection chamber (LArTPC) detectors, among other technologies. LArTPCs have a very high spatial resolution and resolve many of the elementary particles that come out of a neutrino interacting within the argon in the detector. Visualizing these neutrino interactions is of fundamental importance to understanding the properties of neutrinos, but also monitoring and checking on the detector conditions and operations. From these ideas, we have developed TITUS, an event display that shows images recorded by these neutrino detectors. TITUS is a piece of software that reads data coming from LArTPC detectors (as well as the corresponding simulation) and allows users to explore such data in multiple ways. TITUS is flexible to enable fast prototyping and customization.

Background A statutory duty of candour (SDC) was introduced in 2022 in the Australian state of Victoria to increase openness and honesty with patients and families about healthcare adverse events. SDC requires each healthcare service entity by law to provide the patient or their family or carer who experiences an adverse event with; a written account of the facts, an apology, a description of the health service's response to the event, and the steps being taken to prevent reoccurrence. This research aims to evaluate the impacts of SDC in the 2 years since its implementation. Design A mixed‐methods sequential design will be employed, comprising a document literature review, document analysis, survey and interview data from patients, families and health service staff between 2024 and 2026. Discussion By conducting an evaluation of the impacts of SDC within 2 years of its implementation in Victorian health settings, this research will provide the first independent evidence of how the SDC is being used and affecting healthcare experiences. This research will use evaluation criteria from the UK's Duty of Candour review to gather data that can be compared with UK findings and the disclosure experiences of patients in New South Wales, Australia. Our findings will provide a vital contribution to the sparse evidence base about the SDC and its application in healthcare settings internationally. Patient or Public Contribution Three members of the public (JM, LW and KS) were involved in the design of the research proposal, reviewing and contributing to the ethics protocol, the protocol paper as authors and the protocol for the systematic review that has been developed as a basis for this research. These collaborators will contribute to be involved in all aspects of the research as part of the project team.

Introduction Intellectual disability, defined by significant limitations in both intellectual functioning and adaptive behaviour with onset during the developmental period, affects an estimated 2% (108 million) of people worldwide. People with intellectual disability experience major health inequity, poor health outcomes and premature deaths, with mortality rates that are 7–12 times higher than the general population. Patient‐reported experience measures (PREMs) are used worldwide to target improvements in healthcare delivery. Yet, systematic review evidence confirms that people with intellectual disability are excluded from PREMs due to a lack of suitable measurement instruments and supports. To improve healthcare quality and outcomes, people with intellectual disability and their supporters, and academic and clinician researchers will together Coproduce PREMs for, and with, this population apply the PREM in hospitals and use the data to inform local quality improvement projects. Methods and Analysis Our 3‐year project employs a multi‐method design using coproduction, underpinned by an implementation science framework. We will coproduce PREMs that will be applied to improve healthcare quality and outcomes for people with intellectual disability whilst engaging in co‐research with people with lived experience of having an intellectual disability and their carers, clinicians and academic researchers. Study 1 will coproduce PREMs for use by people with intellectual disability to report their experiences of inpatient hospital care. Study 2 will use the co‐produced PREMs to capture the experiences of people with intellectual disability as inpatients in Australian hospitals; determine PREMs reliability and validity; and costs associated with use. Study 3 will develop the required capability to translate our PREMs into hospitals across Australia. Study 4 will apply PREMs data via continuous quality improvement in partnering hospitals to reduce preventable healthcare associated harm, hospitalisation, and prolonged length of stay experienced by people with intellectual disability. Study 5 will provide a process evaluation of our co‐research approach. Quantitative and qualitative analysis will be undertaken, and results will be examined against the project aims. Ethics and Dissemination Ethical approval has been obtained (520241735259588; X24‐0366; 115771). This study is being conducted with partner health agencies and services nationally in Australia to support achievement of the research aims and translation of findings into practice. Targeted outputs with research dissemination will be guided by, and in collaboration with, the project Consumer Leadership Group, consumer and health system stakeholders, with governance from the Project Steering Group. Patient or Public Contribution The Listen to Me project has been designed and planned to ensure the involvement of people with a broad range of abilities, including those with profound intellectual disability who will be able to contribute along with their support person/s. The governance structure of Listen to Me is innovative and inclusive, with consumers providing leadership across all elements of the project. This is co‐research conceptualised and conducted with a Consumer Leadership Group (CLG) comprising eight people with lived experiences of intellectual disability; two of whom have an intellectual disability and six of whom are parents or siblings who support family members with intellectual disability. The CLG were involved in the design of the research proposal, reviewing and contributing to the ethics protocols, and the writing of this protocol as authors. The CLG will direct and contribute to all aspects of the research as part of the research team. An easy read summary of this protocol is provided in Supplementary file 1.

Background Three-dimensional (3D) models have the unique ability to replicate individualized cardiac anatomy and may therefore provide clinical benefit. Transcatheter aortic valve implantation (TAVI) currently relies on preoperative imaging for accurate valve sizing, type of valve used, and avoidance of complications. Three-dimensional (3D) modelling may provide benefit for optimal preoperative TAVI planning. The goal of this study is to assess the utility of 3D modelling in the prediction of paravalvular leak (PVL) post TAVI. Methods Retrospective analysis of five patients who underwent TAVI at our center. Pre-operative cardiac gated CT images were utilized to create a 3D printed model with true size aortic root dimensions, including the coronary artery ostium location and left ventricular outflow tract. Deployment of the corresponding model and size TAVI valve into the created 3D model at a similar depth of implantation via fluoroscopy was performed for each patient. Degree of PVL was assessed using a closed system with water infusion under pressure over a duration of 5 s. Correlation was made between the volume obtained in the closed loop model during the pressurized period and the degree of PVL reported on the patients post TAVI placement on transthoracic echocardiogram. Results One female, and four males (age in years ranged from 68 to 87) underwent successful TAVI (0% 30-day mortality). PVL on post procedure TTE ranged from none to trivial. Successful deployment of TAVI valves inside the 3D model occurred in all cases. The average volume of water collected on three trials over 5 s ranged between 19.1–24.1 ml A multivariate linear regression showed significant association between the degree of PVL reported on post-operative transthoracic echocardiogram and the amount of volume detected in the 3D model (difference: -3.9657, 95% CI: (− 4.6761,-3.2554), p  < 0.001). Conclusions Our experiments show that replicated 3D models have potential clinical utilization in predicting PVL in the TAVI population. Future research into the role of 3D modelling in the field of TAVI should continue to be explored.