Reporting patterns and predictors of common minor adverse events following osteopathic treatment: Lessons learned from a prospective, patient-administered questionnaire feasibility study in a UK teaching clinic

ABSTRACT Introduction Whole blood (WB) is the optimal resuscitation fluid in hemorrhagic shock. Military research focuses on mortality benefits of WB acquired through walking blood banks (WBBs). Few military-based studies on donation effects exist, almost exclusively performed on small special operation forces. No Department of Defense regulations for postdonation precautions in nonaviation crew members exist. Further study is warranted regarding safety and limitations in postdonation populations. Materials and Methods A feasibility (n = 25) prospective interventional study examined the safety of exertion (defined as a 1.6-km treadmill run at volunteers’ minimum passing pace for the Army Physical Fitness Test) following 1 unit of WB donation. Subjects served as their own controls, performing baseline testing 7 days before donation, with repeat testing 1 h following donation conducted by Armed Services Blood Program personnel. Adverse events, pre- and postexertion vital signs (VS) were evaluated. Results There were no adverse events throughout testing. Only resting heart rate (68 vs. 73 beats · min−1, p < 0.01) and postexertion heart rate were significantly different among pre- and postdonation VS. Additional significant findings were time to attain postexertion normocardia (116 vs. 147 seconds, p < 0.01). A small but statistically significant change in Borg perceived exertional scores was noted (10.3 vs. 10.8, p < 0.05). Conclusions This feasibility study demonstrates the first safety test of regular military populations performing exertion immediately following the standardized WB donation. VS changes may translate into a small but significant increase in perceived postdonation exertion. Future studies should expand duration and intensity of exertion to match combat conditions.

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Field Experiment Report for Verification of Abandoned Lignite Mines by Robotic Exploration System

Journal of Robotics and Mechatronics ◽

10.20965/jrm.2018.p1004 ◽

2018 ◽

Vol 30 (6) ◽

pp. 1004-1013 ◽

Cited By ~ 2

Author(s):

Hiroyasu Miura ◽

Ayaka Watanabe ◽

Masayuki Okugawa ◽

Susumu Kurahashi ◽

Masamitsu Kurisu ◽

...

Keyword(s):

Feasibility Study ◽

Local Governments ◽

Lessons Learned ◽

Test Field ◽

Filling Material ◽

Robotic Exploration ◽

Lignite Mine ◽

Cavity Filling ◽

Tokai Region ◽

Lignite Mines

The risk of collapse and subsidence of abandoned lignite mines has been noted in the Tokai region of Japan. The cavity-filling process by local governments has been ongoing. There is no cavity map in the abandoned lignite mines, and it is necessary to understand and explore the underground space in order to estimate the amount of filling material needed. By request from Mitake-cho in Gifu Prefecture, we received the opportunity to explore the inside of an abandoned lignite mine using our robotic system. Prior to the exploration of the actual abandoned lignite mine, as a feasibility study, an experimental test field that simulated the elements of the abandoned lignite mine was prepared outdoors. Some experiments were performed and the robotic exploration system was evaluated in this study. This paper describes the lessons learned from the feasibility study.

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Mind-body training – a single-arm feasibility study of community-delivered Baduanjin training for frail older adults

10.21203/rs.3.rs-26070/v1 ◽

2020 ◽

Author(s):

Xiao Liu ◽

Jean Wei Ting Seah ◽

Benedict Wei Jun Pang ◽

Mary Ann Tsao ◽

Falong Gu ◽

...

Keyword(s):

Older Adults ◽

Adverse Events ◽

Training Program ◽

Grip Strength ◽

Feasibility Study ◽

Fall Risk ◽

Knee Extension ◽

Frail Older Adults ◽

Hand Grip ◽

Frailty Score

Abstract Background Frailty is a common geriatric syndrome, characterized by reduced physiologic reserve and increased vulnerability to stressors, due to cumulative decline in multiple physiological systems. Our study examined the feasibility and effects of a community-delivered BDJ training program among pre-frail/frail community-dwelling older people in preparation for a randomised control implementation study.Methods Our study was a single arm feasibility study in community setting. Eleven participants (aged 77 ± 6 years; 2 frail, 9 prefrail at baseline) completed the program. Sixteen week group BDJ training co-designed and implemented by community-based providers in Singapore. Recruitment, attendance and adverse events were recorded throughout the training. A participants’ survey was also administered after the training program. Effects of the intervention on physical and functional outcomes (hand grip strength, knee extension strength, Time Up and Go (TUG), Physiological Profile Assessment (PPA), 30-second Sit-to-Stand test, 6-meter fast gait speed test), frailty outcomes (frailty score and status), and other outcomes (Maastricht Questionnaire (MQ), Fall Efficacy Scale (FES), Montreal Cognitive Assessment (MoCA), Geriatric Depression Scale (GDS), and EQ-5D-5L) were examined before and after the program.Results Of 31 older adults screened to be frail, 15 met inclusion criteria and 3 refused participation resulting in 12 older adults enrolled in the program. One participant was hospitalized (unrelated to BDJ training) and the other 11 completed the program with average overall attendance of 89%. Most (89%) of the 44 training sessions had attendance > 80%. The program received positive feedback with no training-related adverse events. Participants either reversed (n = 2) or maintained (n = 9) their frailty statuses. There were significant within-group post-training improvements in hand grip strength (p = 0.013), knee extension strength (p = 0.048), TUG (p = 0.018), MQ (p = 0.001), FES (p = 0.022), MoCA (p = 0.014), GDS (p = 0.028), EQ-5D-5L index score (p = 0.029). The reduction of frailty score and PPA fall risk score showed moderate-to-large effect size.Conclusions Community-delivered BDJ training program was safe and feasible for prefrail/frail older adults with the potential to improve physical and cognitive function, reduce fall risk, improve psychological well-being, and reverse frailty status.

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Sharing Lessons Learned to Prevent Adverse Events in Anesthesiology Nationwide

Journal of Patient Safety ◽

10.1097/pts.0000000000000616 ◽

2019 ◽

Vol Publish Ahead of Print ◽

Author(s):

Christina Soncrant ◽

Julia Neily ◽

Sam John T. Sum-Ping ◽

Arthur W. Wallace ◽

Edward R. Mariano ◽

...

Keyword(s):

Adverse Events ◽

Lessons Learned

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Continuous glucose monitoring in older people with diabetes and memory problems: a mixed-methods feasibility study in the UK

BMJ Open ◽

10.1136/bmjopen-2019-032037 ◽

2019 ◽

Vol 9 (11) ◽

pp. e032037 ◽

Cited By ~ 3

Author(s):

Katharina Mattishent ◽

Kathleen Lane ◽

Charlotte Salter ◽

Ketan Dhatariya ◽

Helen M May ◽

...

Keyword(s):

Mixed Methods ◽

Adverse Events ◽

Older People ◽

Feasibility Study ◽

Continuous Glucose Monitoring ◽

Glucose Monitoring ◽

Data Capture ◽

Secondary Outcome ◽

Memory Problems ◽

The Uk

ObjectivesOlder people with diabetes are at increased risk of harm from hypoglycaemia, particularly where there are coexisting memory problems. Continuous glucose monitoring (CGM) offers important benefits in terms of detecting hypoglycaemia, but the feasibility of use and extent of data capture has not been tested in this patient group. Our objective was to investigate the feasibility of trialling a CGM intervention in the community setting in older people with diabetes and memory problems.DesignMixed-methods feasibility study.SettingCommunity dwellings in the UK.ParticipantsPatients aged ≥65 with diabetes and abbreviated mental test score ≤8 or known dementia.InterventionFreeStyle Libre CGM.Primary and secondary outcome measuresFeasibility criteria were numbers of eligible patients, recruitment, attrition, extent of capture of glucose readings and adverse events. Qualitative interview.ResultsWe identified 49 eligible participants; 17 consented, but 5 withdrew before recording of data because they or their carers felt unable to manage study procedures. 12 participants (mean age 85 years) completed the study without adverse events. Data capture across 14 days ranged between 3% and 92% (mean 55%); 6 participants had <60% capture. Hypoglycaemic events were recorded in six out of nine insulin users. Qualitative interviews found: the device does not interfere with daily activities, usability and comfort was positive, and it was helpful for carers in monitoring participants’ glucose concentrations.ConclusionsThe device was acceptable to participants, and carers reported greater ease in monitoring the participant’s glucose concentrations. However, completeness of data capture varied considerably with this device due to the need for users to conduct ≥3 scans per day. Real-time devices with automated data transfer may be more suitable in older people with memory problems.

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Successes with and barriers to patient-reported outcome deployment at a comprehensive cancer center.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.30_suppl.292 ◽

2018 ◽

Vol 36 (30_suppl) ◽

pp. 292-292

Author(s):

Nadine Jackson McCleary ◽

Deborah Schrag ◽

Neil E. Martin ◽

Sadiqa Mahmood ◽

Elizabeth Beyer ◽

...

Keyword(s):

Adverse Events ◽

Assessment Tool ◽

Treatment Plan ◽

Patient Reported Outcome ◽

Lessons Learned ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Patient Reported ◽

Oncology Practice ◽

Plan Modification

292 Background: Routine collection of patient reported outcomes (PROs) reduces hospitalizations and improves quality of life. In the absence of clear implementation guidelines and research guiding deployment, PROs may not have the desired impact on outcomes in routine oncology practice. We share lessons learned from PRO deployment at Dana-Farber Cancer Institute. Methods: We developed a symptom/toxicity assessment tool based on the PRO-CTCAE to capture 15 symptomatic adverse events with a 1-week recall: fatigue/ decreased appetite/insomnia/ shortness of breath/numbness and tingling/concentration, general pain/anxiety/sadness, rash, nausea/vomiting/fever, constipation, and diarrhea. Responses from eligible English-literate patients scheduled for a gastrointestinal cancer center or adult palliative care visit between January 18 to March 22, 2018 were transmitted directly from clinic tablet to the EMR. To evaluate the deployment, we sought qualitative feedback from clinic staff and three multidisciplinary working groups comprised of patients, nurses, pharmacists, operations leaders, quality/safety experts, and health services researchers to identify technical and workflow gaps in PRO Content, Implementation, and Analytics. Results: We noted a 38% response rate of the N = 4440 PROs assigned to N = 4440 scheduled visits for N = 2055 unique patients (36% were completed, 2% started but not completed); 62% were not started. Workflow enhancement requests include an updated summary view, a clinical documentation tool, a scoring algorithm to highlight severe responses, and a quality metric dashboard to evaluate the deployment. Ongoing analyses are studying the proportion of moderate-severe symptomatic adverse events reported and their association with provider action (i.e., supportive care referral, chemotherapy treatment plan modification, or unplanned ED/hospitalization in the subsequent 30 days). Conclusions: Refinement of the PRO deployment strategy is needed to guide implementation efforts and demonstrate meaningful impact in routine oncology practice.

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