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Article ; Online: End-of-shift surgical handover: mixed-methods, multicentre evaluation and recommendations for improvement.

Ryan, Jessica M / Simiceva, Anastasija / Eppich, Walter / Kavanagh, Dara O / McNamara, Deborah A

BJS open

2024 Volume 8, Issue 2

MeSH term(s)	Humans ; Patient Safety
Language	English
Publishing date	2024-04-03
Publishing country	England
Document type	Multicenter Study ; Journal Article
ISSN	2474-9842
ISSN (online)	2474-9842
DOI	10.1093/bjsopen/zrae023
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Article ; Online: Care experiences of older people with mental health needs and their families in emergency medical services settings.

Goode, Deborah / Ryan, Assumpta / Melby, Vidar / Slater, Paul

International journal of older people nursing

2022 Volume 18, Issue 1, Page(s) e12500

Abstract: Background: There are challenges to person-centred care provision in Emergency Medical Services (EMS) settings. The environment is often busy and noisy which can influence the experience of older people and their carer/partners when they attend ... ...

Abstract	Background: There are challenges to person-centred care provision in Emergency Medical Services (EMS) settings. The environment is often busy and noisy which can influence the experience of older people and their carer/partners when they attend emergency departments. Older people with mental health needs are a vulnerable group of people who are at risk of not having their needs met in acute care settings. This is due to complex presentations and increased pressures on the EMS system. Aim: The aim of the paper was to explore the care experience of older people with mental health needs and their carer/partners in pre-hospital and in-hospital Emergency Medical Services settings. Method: This study used an interpretive qualitative approach incorporating in-depth, individual interviews to gather information on the experience of the older person with mental health needs and carers/partners. Data were analysed using Braun and Clarke's (2006) thematic analysis. Results: Fifteen individual interviews were carried out with older people with mental health needs (n = 10) and with carers/partners (n = 5). Six themes on 'Getting there, getting in and getting out', 'Seeing the person', 'Perceptions and experiences of the pre-hospital and Emergency Department (ED)', 'The effects of the experience on personal well-being', 'Older person/carer/partner perceptions and experiences of the EMS staff' and 'Making it better' emerged from the data. Conclusions: The results suggest that previous experiences with the emergency care system influence the way older people with mental health needs and their carers make decisions on current and future care needs. Negative experiences can be influenced by the layout and organisation of the ED. Participants remain reluctant to discuss or disclose their diagnosis in the Emergency Medical Services setting due to a perceived stigma. Health and social care systems and services need to undergo transformations to ensure that all people who access services are treated fairly and effectively.
MeSH term(s)	Humans ; Aged ; Mental Health ; Caregivers/psychology ; Emergency Service, Hospital
Language	English
Publishing date	2022-08-26
Publishing country	England
Document type	Journal Article
ZDB-ID	2250661-5
ISSN	1748-3743 ; 1748-3735
ISSN (online)	1748-3743
ISSN	1748-3735
DOI	10.1111/opn.12500
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Zs.A 6376: Show issues

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Article ; Online: Daily handover in surgery: systematic review and a novel taxonomy of interventions and outcomes.

Ryan, Jessica M / McHugh, Fiachra / Simiceva, Anastasija / Eppich, Walter / Kavanagh, Dara O / McNamara, Deborah A

BJS open

2024 Volume 8, Issue 2

Abstract: Background: Poor-quality handovers lead to adverse outcomes for patients; however, there is a lack of evidence to support safe surgical handovers. This systematic review aims to summarize the interventions available to improve end-of-shift surgical ... ...

Abstract	Background: Poor-quality handovers lead to adverse outcomes for patients; however, there is a lack of evidence to support safe surgical handovers. This systematic review aims to summarize the interventions available to improve end-of-shift surgical handover. A novel taxonomy of interventions and outcomes and a modified quality assessment tool are also described. Methods: Ovid MEDLINE®, PubMed, Embase, and Cochrane databases were searched for articles up to April 2023. Comparative studies describing interventions for daily in-hospital surgical handovers between doctors were included. Studies were grouped according to their interventions and outcomes. Results: In total, 6139 citations were retrieved, and 41 studies met the inclusion criteria. The total patient sample sizes in the control and intervention groups were 11 946 and 11 563 patients, respectively. Most studies were pre-/post-intervention cohort studies (92.7%), and most (73.2%) represented level V evidence. The mean quality assessment score was 53.4% (17.1). A taxonomy of handover interventions and outcomes was developed, with interventions including handover tools, process standardization measures, staff education, and the use of mnemonics. More than 25% of studies used a document as the only intervention. Overall, 55 discrete outcomes were assessed in four categories including process (n = 27), staff (n = 14), patient (n = 12) and system-level (n = 2) outcomes. Significant improvements were seen in 51.8%, 78.5%, 58.3% (n = 9761 versus 9312 patients) and 100% of these outcomes, respectively. Conclusions: Most publications demonstrate that good-quality surgical handover improves outcomes and many interventions appear to be effective; however, studies are methodologically heterogeneous. These novel taxonomies and quality assessment tool will help standardize future studies.
MeSH term(s)	Humans ; Patient Handoff ; Hospitals
Language	English
Publishing date	2024-02-29
Publishing country	England
Document type	Systematic Review ; Journal Article
ISSN	2474-9842
ISSN (online)	2474-9842
DOI	10.1093/bjsopen/zrae011
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Article: A review of the factors influencing adoption of digital health applications for people living with dementia.

Conway, Aoife / Ryan, Assumpta / Harkin, Deirdre / Mc Cauley, Claire / Goode, Deborah

Digital health

2023 Volume 9, Page(s) 20552076231162985

Abstract: Objective: Researchers have used various theories and models to understand technology adoption, however, with the growing interest and availability of mobile applications (apps) for people living with dementia, it is desirable to have a broader insight ... ...

Abstract	Objective: Researchers have used various theories and models to understand technology adoption, however, with the growing interest and availability of mobile applications (apps) for people living with dementia, it is desirable to have a broader insight into how technology adoption may be further improved. This paper aims to explore the factors influencing the adoption of digital health applications for people living with dementia and add to the current literature on this topic. Methods: Searches were conducted in CINHAL, Web of Science, Psych Info, ProQuest Health and Medical, IEEE Xplore and Scopus. Citation searching and handsearching were used in the identification of other studies. Results: Following an assessment of relevancy, nine studies remained and are included within this review. Methodological quality was assessed using The Mixed Methods Appraisal Tool (MMAT). A thematic analysis was used for the data synthesis of included studies. Each study reported on different types of apps. Conclusion: From the synthesis of included studies, four analytic themes were identified; Theme 1: Personal and contextual factors; Theme 2: Perceived value and benefit; Theme 3: Design and content of app; and Theme 4: Digital Literacy and Confidence. People are diverse and so are their reasons for the adoption of apps. These findings provide an insight into the range of factors that impact the adoption of apps for people living with dementia. Understanding the factors that impact the adoption of mobile applications is critical to their success. These findings can be beneficial for app developers and for people living with dementia and their carers.
Language	English
Publishing date	2023-03-15
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2819396-9
ISSN	2055-2076
ISSN	2055-2076
DOI	10.1177/20552076231162985
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Article ; Online: Social Determinants of Health are Associated with Coping of Informal Caregivers of Adults with Heart Failure.

Matus, Austin / Quinn, Ryan / Stawnychy, Michael A / Thomas, Gladys / Goba, Miatta / Garo, Jenna / Gordon, Deborah / Riegel, Barbara

Clinical nursing research

2024 , Page(s) 10547738231223790

Abstract: We explored the influence of social determinants of health (SDH) risk on stress and coping style in heart failure (HF) caregivers. In this cross-sectional study, data from 250 caregivers were analyzed. Multivariable linear regression analyses were ... ...

Abstract	We explored the influence of social determinants of health (SDH) risk on stress and coping style in heart failure (HF) caregivers. In this cross-sectional study, data from 250 caregivers were analyzed. Multivariable linear regression analyses were performed to determine the extent to which SDH risk (measured using a modified PRAPARE tool (National Association of Community Health Centers), range 0-22) predicted stress (Perceived Stress Scale, 0-56) and coping style (active (0-45), avoidance (0-30), and minimization (0-30)) while accounting for caregiver burden (HF Caregiver Questionnaire (HF-CQ) 0-100). Multivariable regression analysis with backwards elimination variable selection approach was used to identify which SDH risk factors best predicted coping styles. SDH risk was significantly associated with avoidance and minimization coping styles. Each unit increase in SDH risk was associated with an increase of 0.6 ± 0.2 units (
Language	English
Publishing date	2024-01-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	1146553-0
ISSN	1552-3799 ; 1054-7738
ISSN (online)	1552-3799
ISSN	1054-7738
DOI	10.1177/10547738231223790
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Article ; Online: A Comparison of the Time Spent in Emergency Departments by Older Adults With and Without Mental Health Needs.

Goode, Deborah / Slater, Paul / Ryan, Assumpta / Melby, Vidar

Advanced emergency nursing journal

2021 Volume 43, Issue 2, Page(s) 145–161

Abstract: Older adults present to emergency medical services with a multitude of clinical and functional needs due to polypharmacy and multipathology. Older adults with mental health needs require additional time for the more comprehensive assessment required as a ...

Abstract	Older adults present to emergency medical services with a multitude of clinical and functional needs due to polypharmacy and multipathology. Older adults with mental health needs require additional time for the more comprehensive assessment required as a result of their underlying mental health condition. This article compares the time spent in emergency departments by older adults who have a mental health need with those who do not. Information on how they access prehospital and inhospital care is examined alongside key factors that impact on time spent in emergency departments. Data were collected from hospital records of older adults presenting at emergency departments in 3 large Health and Social Care Trusts in the United Kingdom using a retrospective, secondary, official personal information database source over 1 year. A total sample of 74,766 attendance records of older adults older than 65 years were examined. adults who presented with or had a mental health condition in their diagnosis or history, which made up a subsample of 1,818 people, were found to have significant differences in the time spent in emergency departments and some notable differences in trends and admission patterns. They wait longer than the older person without mental health needs, are more likely to breach the 4-hr waiting time target, are admitted in higher numbers, and rely heavily on the ambulance service. Health and social care systems and services need to undergo transformations to ensure that all people who access services are treated fairly and effectively.
MeSH term(s)	Aged ; Emergency Medical Services/statistics & numerical data ; Emergency Service, Hospital/statistics & numerical data ; Female ; Humans ; Length of Stay/statistics & numerical data ; Male ; Mental Disorders/diagnosis ; United Kingdom
Language	English
Publishing date	2021-08-19
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	2257871-7
ISSN	1931-4493 ; 1931-4485
ISSN (online)	1931-4493
ISSN	1931-4485
DOI	10.1097/TME.0000000000000350
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Article ; Online: Supporting physiotherapy learners in practice settings: a mixed methods evaluation of experiences of physiotherapy educators.

O'Connor, Deborah A / Baird, Tamsin / Jack, Kirsten / Wilkinson, Ryan G / Chambers, Alison / Hamshire, Claire

Physiotherapy theory and practice

2023 , Page(s) 1–14

Abstract: Background: Practice-based education is an essential component of pre-registration physiotherapy programs, and there is a need for a contemporary review of practice-based educational experiences.: Purpose: The aim of this study was to explore ... ...

Abstract	Background: Practice-based education is an essential component of pre-registration physiotherapy programs, and there is a need for a contemporary review of practice-based educational experiences. Purpose: The aim of this study was to explore physiotherapy practice educators' experiences of supporting learners to inform considerations for future workforce development. Methods: This was a mixed methods sequential explanatory study based in the United Kingdom (UK). Phase one of the study utilized an online survey disseminated via the Chartered Society of Physiotherapy (CSP) professional networks. Phase two consisted of three semi-structured focus group interviews with participants who expressed an interest via completion of the online survey. All were registered or associate CSP members who actively support practice-based education. Results: A total of 208 participants completed the online survey and a sub-set of 15 participated in online focus groups. Quantitative survey data were analyzed using descriptive statistics. Initial thematic analysis of qualitative data from both phases was undertaken by one researcher. Subsequent analyses were carried out independently by the remaining research team, and comparisons were made to agree on codes, categories, and themes. The practice educator is vital in developing the future workforce (30%, Conclusion: Practice educators need accessible opportunities for professional development. Practice-based education should be embedded as an integral component of all staff roles. A team approach is essential to developing the future physiotherapy workforce.
Language	English
Publishing date	2023-06-01
Publishing country	England
Document type	Journal Article
ZDB-ID	1045333-7
ISSN	1532-5040 ; 0959-3985
ISSN (online)	1532-5040
ISSN	0959-3985
DOI	10.1080/09593985.2023.2219313
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Article ; Online: Sickle Cell Disease in an Older Adult Population: A Retrospective Review of Health Care Resource Utilization.

Ryan, Jessica L / Rastegar, Jeremiah S / Dobbins, Jessica M / Peikes, Deborah N / Theodorou, Anna / Garcia, Brian / Loy, Bryan / Bell, Ebony / Olayiwola, J Nwando

Population health management

2024 Volume 27, Issue 2, Page(s) 120–127

Abstract: Sickle cell disease (SCD) has a history of health inequity, as patients with SCD are primarily Black and often marginalized from the health care system. Although recent health care and treatment advancements have prolonged life expectancy, it may be ... ...

Abstract	Sickle cell disease (SCD) has a history of health inequity, as patients with SCD are primarily Black and often marginalized from the health care system. Although recent health care and treatment advancements have prolonged life expectancy, it may be insufficient to support the complex needs of the growing population of older adults with SCD. This retrospective study used a cohort (
MeSH term(s)	Humans ; Aged ; United States/epidemiology ; Middle Aged ; Retrospective Studies ; Emergency Service, Hospital ; Medicare ; Hospitalization ; Delivery of Health Care ; Pain ; Anemia, Sickle Cell/complications ; Anemia, Sickle Cell/epidemiology ; Anemia, Sickle Cell/therapy
Language	English
Publishing date	2024-02-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	2454546-6
ISSN	1942-7905 ; 1942-7891
ISSN (online)	1942-7905
ISSN	1942-7891
DOI	10.1089/pop.2023.0268
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Article ; Online: Association between serum triglycerides and stroke type, severity, and prognosis. Analysis in 6558 patients.

Akhtar, Naveed / Singh, Rajvir / Kamran, Saadat / Joseph, Sujatha / Morgan, Deborah / Uy, Ryan Ty / Treit, Sarah / Shuaib, Ashfaq

BMC neurology

2024 Volume 24, Issue 1, Page(s) 88

Abstract: Background and objectives: Hypertriglyceridemia (HT) may increase the risk of stroke. Limited studies have shown that stroke severity and infarction size are smaller in patients with HT. We explored the relationship between triglyceride levels and ... ...

Abstract	Background and objectives: Hypertriglyceridemia (HT) may increase the risk of stroke. Limited studies have shown that stroke severity and infarction size are smaller in patients with HT. We explored the relationship between triglyceride levels and stroke risk factors, severity and outcome in a large prospective database. Design: Prospective Cross-sectional study. Setting: We retrospectively interrogated the Qatar Stroke Database in all patients admitted between 2014-2022 with acute ischemic stroke and evaluated the relationship between triglyceride, diabetes, stroke severity (measured on NIHSS), stroke type (TOAST classification) and the short- (mRS at 90 days) and long-term outcomes (MACE at 1 year) in patients with HT. Participants: Six thousand five hundred fifty-eight patients ≥20 years were included in this study RESULTS: Six thousand five hundred fifty-eight patients with ischemic stroke [mean age 54.6 ± 12. 9; male 82.1%) were included. Triglyceride levels upon admission were low-normal (≤1.1 mmol/L) in 2019 patients, high-normal (1.2-1.7 mmol/L) in 2142 patients, borderline-high (1.8-2.2 mmol/L) in 1072 patients and high (≥2.3 mmol/L) in 1325 patients. Higher triglyceride levels were associated with stroke and increased likelihood of having diabetes, obesity, active smoking, and small vessel/lacunar stroke type. An inverse relationship was noted whereby higher triglyceride levels were associated with lower stroke severity and reduced likelihood of poorer outcome (mRS 3-6) at discharge and 90 days. Long-term MACE events were less frequent in patients with higher triglyceride levels. After adjusting age, gender, diabetes, prior stroke, CAD, and obesity, multivariate analysis showed that hypertension and triglyceride levels were higher in mild ischemic strokes patients. Conclusions: Increasing triglycerides are associated with higher risk of small vessel disease and requires further prospective cohort studies for confirmation.
MeSH term(s)	Humans ; Male ; Adult ; Middle Aged ; Aged ; Ischemic Stroke ; Cross-Sectional Studies ; Prospective Studies ; Retrospective Studies ; Prognosis ; Stroke/epidemiology ; Diabetes Mellitus ; Obesity ; Triglycerides
Chemical Substances	Triglycerides
Language	English
Publishing date	2024-03-05
Publishing country	England
Document type	Journal Article
ZDB-ID	2041347-6
ISSN	1471-2377 ; 1471-2377
ISSN (online)	1471-2377
ISSN	1471-2377
DOI	10.1186/s12883-024-03572-9
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Article ; Online: Anthropogenic particle concentrations and fluxes in an urban river are temporally variable and impacted by storm events.

Berg, Elizabeth M / Dila, Deborah K / Schaul, Olivia / Eros, Audrey / McLellan, Sandra L / Newton, Ryan J / Hoellein, Timothy J / Kelly, John J

Water environment research : a research publication of the Water Environment Federation

2024 Volume 96, Issue 4, Page(s) e11021

Abstract: Anthropogenic particles (AP), which include microplastics and other synthetic, semisynthetic, and anthropogenically modified materials, are pollutants of concern in aquatic ecosystems worldwide. Rivers are important conduits and retention sites for AP, ... ...

Abstract	Anthropogenic particles (AP), which include microplastics and other synthetic, semisynthetic, and anthropogenically modified materials, are pollutants of concern in aquatic ecosystems worldwide. Rivers are important conduits and retention sites for AP, and time series data on the movement of these particles in lotic ecosystems are needed to assess the role of rivers in the global AP cycle. Much research assessing AP pollution extrapolates stream loads based on single time point measurements, but lotic ecosystems are highly variable over time (e.g., seasonality and storm events). The accuracy of models describing AP dynamics in rivers is constrained by the limited studies that examine how frequent changes in discharge drive particle retention and transport. This study addressed this knowledge gap by using automated, high-resolution sampling to track AP concentrations and fluxes during multiple storm events in an urban river (Milwaukee River) and comparing these measurements to commonly monitored water quality metrics. AP concentrations and fluxes varied significantly across four storm events, highlighting the temporal variability of AP dynamics. When data from the sampling periods were pooled, there were increases in particle concentration and flux during the early phases of the storms, suggesting that floods may flush AP into the river and/or resuspend particles from the benthic zone. AP flux was closely linked to river discharge, suggesting large loads of AP are delivered downstream during storms. Unexpectedly, AP concentrations were not correlated with other simultaneously measured water quality metrics, including total suspended solids, fecal coliforms, chloride, nitrate, and sulfate, indicating that these metrics cannot be used to estimate AP. These data will contribute to more accurate models of particle dynamics in rivers and global plastic export to oceans. PRACTITIONER POINTS: Anthropogenic particle (AP) concentrations and fluxes in an urban river varied across four storm events. AP concentrations and fluxes were the highest during the early phases of the storms. Storms increased AP transport downstream compared with baseflow. AP concentrations did not correlate with other water quality metrics during storms.
MeSH term(s)	Ecosystem ; Plastics ; Water Quality ; Rivers ; Feces ; Environmental Monitoring ; Water Pollutants, Chemical/analysis
Chemical Substances	Plastics ; Water Pollutants, Chemical
Language	English
Publishing date	2024-03-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	1098976-6
ISSN	1554-7531 ; 1047-7624 ; 1061-4303
ISSN (online)	1554-7531
ISSN	1047-7624 ; 1061-4303
DOI	10.1002/wer.11021
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