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Empowering the Participant Voice (EPV) is an NCATS-funded six-CTSA collaboration to develop, demonstrate, and disseminate a low-cost infrastructure for collecting timely feedback from research participants, fostering trust, and providing data for improving clinical translational research. EPV leverages the validated Research Participant Perception Survey (RPPS) and the popular REDCap electronic data-capture platform. This report describes the development of infrastructure designed to overcome identified institutional barriers to routinely collecting participant feedback using RPPS and demonstration use cases. Sites engaged local stakeholders iteratively, incorporating feedback about anticipated value and potential concerns into project design. The team defined common standards and operations, developed software, and produced a detailed planning and implementation Guide. By May 2023, 2,575 participants diverse in age, race, ethnicity, and sex had responded to approximately 13,850 survey invitations (18.6%); 29% of responses included free-text comments. EPV infrastructure enabled sites to routinely access local and multi-site research participant experience data on an interactive analytics dashboard. The EPV learning collaborative continues to test initiatives to improve survey reach and optimize infrastructure and process. Broad uptake of EPV will expand the evidence base, enable hypothesis generation, and drive research-on-research locally and nationally to enhance the clinical research enterprise.
Inside Wembley Stadium, the men’s England manager, Gareth Southgate, huddles his players together for a final team talk before the players step up to take their penalty kicks. First for England is Harry Kane, who scores with a shot that is low and to the goalkeeper’s right. Next is Harry Maguire, who smashes the ball into the top right of the goal. However, Marcus Rashford hits the post and Jadon Sancho’s and Bukayo Saka’s efforts are saved by Italian goalkeeper Gianluigi Donnarumma. It is the final of the UEFA (Union of European Football Associations) European Football Championship (Euro 2020), held in July 2021 due to the COVID-19 pandemic, and England have been defeated on penalties. Sadly, the online racist abuse which followed soured what should have been a proud moment for English football, as the national men’s team had reached their first major tournament final since 1966.
After the penalty kicks, in the ensuing moments online, the three young England players who missed theirs were rendered Black and ‘foreign’ above anything else, thereby exposing people’s deeply held views concerning race relations. Of particular interest here is the fact that a Fédération Internationale de Football Association (FIFA) report released in June 2022 highlighted that more than a third of the online abuse during the final came from online accounts based in the United Kingdom (UK). To offer further context, the abuse mirrored online reactions a decade prior towards Black English players Ashley Cole and Ashley Young, who also missed penalties against Italy during Euro 2012 (Press Association, 2012). The Euro 2020 case illustrates both the ease with which online racism is expressed and its frequency – it sadly represents yet another chapter in the history of online racism within football. What is clear is that forms of hate and forms of racism are evolving, with much of this moving online. Indeed, while racist chants and insults, and even bananas, were once hurled at players inside football stadiums, we can now observe these epithets in multiple digital forms. Many strategies (past and present) have sought to challenge online racism in football, some being more effective than others.
Reflecting on sustained calls for patient-centredness and culture change in long-term care, we evaluated the relative importance of personal and organisational predictors of palliative care, hypothesising the former as weaker predictors than the latter. Health-care employees (N = 184) from four Canadian long-term care homes completed a survey of person-centred care, self-efficacy, employee wellbeing and occupational characteristics. Using backward stepwise regression models, we examined the relative contributions of these variables to person-centred palliative care. Specifically, blocks of variables representing personal, organisational and occupational characteristics; palliative care self-efficacy; and employee wellbeing were simultaneously regressed on variables representing aspects of person-centred care. The change in R2 associated with the removal of each block was examined to determine each block's overall contribution to the model. We found that occupational characteristics (involvement in care planning), employee wellbeing (compassion satisfaction) and self-efficacy were reliably associated with person-centred palliative care (p < 0.05). Facility size was not associated, and facility profit status was less consistently associated. Demographic characteristics (gender, work experience, education level) and some aspects of employee wellbeing (burnout, secondary trauma) were also not reliably associated. Overall, these results raise the possibility that humanistic care is less related to intrinsic characteristics of employees, and more related to workplace factors, or to personal qualities that can be cultivated in the workplace, including meaningful role engagement, compassion and self-efficacy.
To assess the incidence rate of S. aureus colonization at baseline along with the mupirocin susceptibility (or resistance) rate in patients in a neonatal intensive care unit (NICU) and a pediatric intensive care unit (PICU) in conjunction with the implementation of universal decolonization as the standard of care.
Design:
Prospective cohort study.
Setting:
Children’s Hospital of Michigan (CHM) inpatient intensive care units (ICUs).
Participants:
Newly admitted pediatric patients to the CHM NICU or PICU aged between 1 day and ≤21 years.
Interventions:
Baseline and follow-up S. aureus screening cultures were obtained before patients underwent universal decolonization with mupirocin 2% antibiotic ointment (intranasal and umbilical) and chlorhexidine baths as standard of care to reduce CLABSI rates.
Results:
Baseline S. aureus colonization rates of new admissions to the CHM NICU and PICU were high at 32% and 29%, respectively. Baseline mupirocin susceptibility to any S. aureus growth was 98.4%. All baseline culture isolates whether positive for MRSA or MSSA, with one exception, had minimum inhibitory concentrations (MICs) of ≤0.19 µg/mL. All follow-up study cultures after universal decolonization at 7 days or beyond with any S. aureus growth had mupirocin MICs of ≤0.125 µg/mL.
Conclusions:
Baseline S. aureus colonization rates of new admissions to the CHM ICUs were high as was baseline mupirocin susceptibility. Follow-up cultures, albeit limited in number, did not detect increasing mupirocin MICs over 1 year, despite broad mupirocin exposure due to the implementation of universal decolonization.
How much water does the world need to support growing human populations? What are the potential effects of climate change on the world's water resources? These questions and more are discussed in this thoroughly updated and expanded new edition. Written at the undergraduate level, this accessible textbook covers the fundamentals of water resources, water law, allocation, quality and quantity, health issues, and provides examples of potential personal actions and solutions. There is a keener focus on climate change, as many of the predictions made in the first edition have now come to pass. This new edition features improved artwork, more active learning prompts, more positive examples of beneficial changes, basic introductions to scientific approaches and a discussion of emerging contaminants and LiDAR technology. It contains strong teaching features, with new 'In Depth' and 'Think About It' sections to encourage class discussion, and homework questions to test students' understanding.