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A classroom of exuberant youngsters explores art in its most varied forms, from painting, music, and writing to cooking and performing.
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Patient Satisfaction with Telehealth in Rural Settings: A Systematic Review
Telehealth provides health care services to clients through telecommunications. Rehabilitation services such as occupational therapy, physical therapy, and speech-language therapy can be delivered via telehealth. The aim of this study was to evaluate patients’ reports of their satisfaction with telehealth compared to standard in-person therapy for patients living in rural areas. Four databases were utilized for this systematic review. The following words were searched: telehealth, rural, and patient satisfaction. Abstract searches identified 251 articles, and 55 were read in full text. Four articles met inclusion criteria. There was high satisfaction for patients in all studies regarding the use of telehealth. Findings showed that overall, telehealth supported increased rates of patient satisfaction for OT, PT, and SLP services delivered to rural communities.
Journal Article
The Hunger Games
Set in a future where the Capitol selects a boy and girl from the twelve districts to fight to the death on live television. Katniss Everdeen volunteers to take her younger sister's place for the latest match.
DVD
Experiences of in-patient mental health services: systematic review
In-patients in crisis report poor experiences of mental healthcare not conducive to recovery. Concerns include coercion by staff, fear of assault from other patients, lack of therapeutic opportunities and limited support. There is little high-quality evidence on what is important to patients to inform recovery-focused care.AimsTo conduct a systematic review of published literature, identifying key themes for improving experiences of in-patient mental healthcare.
A systematic search of online databases (MEDLINE, PsycINFO and CINAHL) for primary research published between January 2000 and January 2016. All study designs from all countries were eligible. A qualitative analysis was undertaken and study quality was appraised. A patient and public reference group contributed to the review.
Studies (72) from 16 countries found four dimensions were consistently related to significantly influencing in-patients' experiences of crisis and recovery-focused care: the importance of high-quality relationships; averting negative experiences of coercion; a healthy, safe and enabling physical and social environment; and authentic experiences of patient-centred care. Critical elements for patients were trust, respect, safe wards, information and explanation about clinical decisions, therapeutic activities, and family inclusion in care.
A number of experiences hinder recovery-focused care and must be addressed with the involvement of staff to provide high-quality in-patient services. Future evaluations of service quality and development of practice guidance should embed these four dimensions.Declaration of interestK.B. is editor of British Journal of Psychiatry and leads a national programme (Synergi Collaborative Centre) on patient experiences driving change in services and inequalities.
Journal Article
Reflection of near-infrared light confers thermal protection in birds
Biologists have focused their attention on the optical functions of light reflected at ultraviolet and human-visible wavelengths. However, most radiant energy in sunlight occurs in ‘unseen’ near-infrared (NIR) wavelengths. The capacity to reflect solar radiation at NIR wavelengths may enable animals to control heat gain and remain within their critical thermal limits. Here, using a continent-wide phylogenetic analysis of Australian birds, we show that species occupying hot, arid environments reflect more radiant energy in NIR wavelengths than species in thermally benign environments, even when controlling for variation in visible colour. Biophysical models confirm that smaller species gain a greater advantage from high NIR reflectivity in hot, arid environments, reducing water loss from compensatory evaporative cooling by up to 2% body mass per hour. These results highlight the importance of NIR reflectivity for thermal protection, which may become increasingly critical as the frequency of extreme climatic events increases.
More than half of solar radiation is at near-infrared (NIR) wavelengths. Here, Medina et al. show that among Australian birds NIR reflectivity is higher in species from hot, arid environments and their biophysical modelling further shows that this can reduce water loss from evaporative cooling.
Journal Article
A Circular Economy for the Data Centre Industry: Using Design Methods to Address the Challenge of Whole System Sustainability in a Unique Industrial Sector
The data centre industry (DCI) has grown from zero in the 1980s, to enabling 60% of the global population to be connected in 2021 via 7.2 million data centres. The DCI is based on a linear economy and there is an urgent need to transform to a Circular Economy to establish a secure supply chain and ensure an economically stable and uninterrupted service, which is particularly difficult in an industry that is comprised of ten insular subsectors. This paper describes the CEDaCI project which was established to address the challenge in this unique sector; this ground-breaking project employs a whole systems approach, Design Thinking and the Double Diamond methods, which rely on people/stakeholder engagement throughout. The paper reviews and assesses the impact of these methods and project to date, using quantitative and qualitative research, via an online sectoral survey and interviews with nine data centre and IT industry experts. The results show that the project is creating positive impact and initiating change across the sector and that the innovative output (designs, business models, and a digital tool) will ensure that sectoral transformation continues; the project methods and structure will also serve as an exemplar for other sectors.
Journal Article
The microstructure of white feathers predicts their visible and near-infrared reflectance properties
Research on the optical properties of animal integuments, including fur, feather, skin and cuticle, has focussed almost exclusively on animal-visible wavelengths within the narrow range of 300-700 nm. By contrast, the near-infrared (NIR) portion of direct sunlight, spanning 700-2600 nm, has been largely ignored despite its potentially important thermal consequences. We quantified variation in visible and NIR reflectance and transmission for white body contour feathers of 50 bird species, and examined how well they are predicted by feather macro- and micro-structural morphology. Both visible and NIR reflectance of the feathers varied substantially across species. Larger, thicker, and sparser feathers that are characteristic of larger species, and feathers with rounder barbs and more closely spaced barbules, had high average reflectance, particularly within avian-visible wavelengths (300-700 nm). Feathers with rounder barbs and more closely situated barbules also had high average reflectance, particularly for NIR wavelengths. Barb roundness and barbule density were the only predictors of NIR reflectance after accounting for variation in visible reflectance and body size. Our results highlight the potential for adaptive variation in NIR reflectance mediated by feather structure, which may inform the design of functional materials to control light and heat.
Journal Article
The Roles of Rule Type and Word Term in the Deductive Reasoning of Adults with and without Dyslexia
Despite its importance to everyday functioning, reasoning is underexplored in developmental dyslexia. The current study investigated verbal deductive reasoning on the Wason selection task, not previously used in dyslexia research despite its well-established pedigree. Reasoning rule was manipulated, with the conditional rules varying in the logical values presented. The word frequency and imageability of the word terms was also manipulated. Twenty-six adults with dyslexia and 31 adults without dyslexia completed Wason selection task problems. No group difference in reasoning accuracy or completion time was found. However, the participants were most accurate when reasoning with the rule type “If p, then not q” and least accurate with the rule type “If p then q”. More trials were also answered correctly when the word terms were highly imageable but of average word frequency. These findings are in line with the general reasoning literature. Dyslexia status did not interact with either rule type or word term type. The study expands upon previous research by testing verbal deductive reasoning in dyslexia, highlighting the role of imageability in facilitating reasoning performance for all, regardless of the presence or absence of dyslexia. Implications for the design of educational materials are considered.
Journal Article
Cognitive Remediation in Bipolar (CRiB2): study protocol for a randomised controlled trial assessing efficacy and mechanisms of cognitive remediation therapy compared to treatment as usual
Background
A substantial proportion of people with bipolar disorder (BD) experience persistent cognitive difficulties associated with impairments in psychosocial functioning and a poorer disorder course. Emerging evidence suggests that cognitive remediation (CR), a psychological intervention with established efficacy in people with schizophrenia, can also benefit people with BD. Following a proof-of-concept trial showing that CR is feasible and potentially beneficial for people with BD, we are conducting an adequately powered trial in euthymic people with BD to 1) determine whether an individual, therapist-supported, computerised CR can reduce cognitive difficulties and improve functional outcomes; and 2) explore how CR exerts its effects.
Methods
CRiB2 is a two-arm, assessor-blind, multi-site, randomised controlled trial (RCT) comparing CR to treatment-as-usual (TAU). Participants are people with a diagnosis of BD, aged between 18 and 65, with no neurological or current substance use disorder, and currently euthymic. 250 participants will be recruited through primary, secondary, tertiary care, and the community. Participants will be block-randomised (1:1 ratio, stratified by site) to continue with their usual care (TAU) or receive a 12-week course of therapy and usual care (CR + TAU). The intervention comprises one-on-one CR sessions with a therapist supplemented with independent cognitive training for 30–40 h in total. Outcomes will be assessed at 13- and 25-weeks post-randomisation. Efficacy will be examined by intention-to-treat analyses estimating between-group differences in primary (i.e., psychosocial functioning at week 25 measured with the Functional Assessment Short Test) and secondary outcomes (i.e., measures of cognition, mood, patient-defined goals, and quality of life). Global cognition, metacognitive skills, affect fluctuation, and salivary cortisol levels will be evaluated as putative mechanisms of CR through mediation models.
Discussion
This study will provide a robust evaluation of efficacy of CR in people with BD and examine the putative mechanisms by which this therapy works. The findings will contribute to determining the clinical utility of CR and potential mechanisms of action.
Trial registration
Cognitive Remediation in Bipolar 2 (CRiB2): ISRCTN registry:
https://www.isrctn.com/ISRCTN10362331
. Registered 04 May 2022. Overall trial status: Ongoing; Recruitment status: Recruiting.
Journal Article
Top 10 priorities for problematic hip replacement research: a priority setting partnership led by the British Hip Society and the James Lind Alliance
ObjectivesTo identify and prioritise research uncertainties regarding the assessment, management and rehabilitation of patients with problematic hip replacements through a national Priority Setting Partnership (PSP).DesignA national PSP using the James Lind Alliance (JLA) methodology.SettingUK.ParticipantsPatients, carers and healthcare professionals (HCPs) involved in the care of patients with problematic hip replacements.MethodsA steering group was established. The James Lind Alliance methodology was followed throughout. A nationwide survey was conducted to collect unanswered questions. These were refined, prioritised through an interim survey and ranked at a final consensus workshop.ResultsThe initial survey yielded 201 questions, refined to 32. The interim survey had 191 respondents, leading to 19 questions at the final workshop. The top 10 research priorities were agreed on.ConclusionsThis PSP identified key research priorities for problematic hip replacements, focusing on diagnosis, pain management, perioperative optimisation and infection. These priorities can inform researchers and funders to improve outcomes for affected patients.
Journal Article