Understanding the role of Foundation doctors through a self-reported time-mapping pilot study

2020 ◽  
Vol 96 (1136) ◽  
pp. 316-320
Author(s):  
James Schuster-Bruce ◽  
Gita Lingam ◽  
Ryan Laurence Love ◽  
Ryan Kerstein

IntroductionThere is a reduction in Foundation trainee applications to speciality training and this is attributed to an administrative job role, with subsequent fears of burnout. This pilot study presents the findings of a real-time self-reporting tool to map a group of Foundation doctors’ elective activities. Self-reporting is efficient, low cost to run and allows for repeated measures and scalability. It aimed to example how a time-map could be used by departments to address any work imbalances and improve both well-being and future workforce planning.MethodFoundation doctors’, at a busy District General Hospital, were asked to contemporaneously report their work activities over an ‘elective’ day. Outcomes measures included the mean duration per task and the time of day these were performed.ResultsNine Foundation doctors’ returned 26 timesheet days. Foundation doctors’ time was split between direct patient tasks (18.2%, 106.8 min per day), indirect patient tasks (72.9%, 428.6 min per day) and personal or non-patient activities. Indirect tasks were the most frequent reason for Foundation doctors leaving late. No clinical experience was recorded at all and only an average of 4% (23.4 min per day) of a Foundation doctors’ time was spent in theatre.ConclusionsThis particular cohort performed a high proportion of indirect tasks. These have been associated with burnout. Time-mapping is a low-cost, acceptable and seemingly scalable way to elucidate a clearer understanding of the type of activities Foundation doctors may perform. This methodology could be used to modernise the traditional Foundation doctor job description.

2019 ◽  
Author(s):  
Nikki Theofanopoulou ◽  
Katherine Isbister ◽  
Julian Edbrooke-Childs ◽  
Petr Slovák

BACKGROUND A common challenge within psychiatry and prevention science more broadly is the lack of effective, engaging, and scale-able mechanisms to deliver psycho-social interventions for children, especially beyond in-person therapeutic or school-based contexts. Although digital technology has the potential to address these issues, existing research on technology-enabled interventions for families remains limited. OBJECTIVE The aim of this pilot study was to examine the feasibility of in-situ deployments of a low-cost, bespoke prototype, which has been designed to support children’s in-the-moment emotion regulation efforts. This prototype instantiates a novel intervention model that aims to address the existing limitations by delivering the intervention through an interactive object (a ‘smart toy’) sent home with the child, without any prior training necessary for either the child or their carer. This pilot study examined (i) engagement and acceptability of the device in the homes during 1 week deployments; and (ii) qualitative indicators of emotion regulation effects, as reported by parents and children. METHODS In this qualitative study, ten families (altogether 11 children aged 6-10 years) were recruited from three under-privileged communities in the UK. The RA visited participants in their homes to give children the ‘smart toy’ and conduct a semi-structured interview with at least one parent from each family. Children were given the prototype, a discovery book, and a simple digital camera to keep at home for 7-8 days, after which we interviewed each child and their parent about their experience. Thematic analysis guided the identification and organisation of common themes and patterns across the dataset. In addition, the prototypes automatically logged every interaction with the toy throughout the week-long deployments. RESULTS Across all 10 families, parents and children reported that the ‘smart toy’ was incorporated into children’s emotion regulation practices and engaged with naturally in moments children wanted to relax or calm down. Data suggests that children interacted with the toy throughout the duration of the deployment, found the experience enjoyable, and all requested to keep the toy longer. Child emotional connection to the toy—caring for its ‘well-being’—appears to have driven this strong engagement. Parents reported satisfaction with and acceptability of the toy. CONCLUSIONS This is the first known study investigation of the use of object-enabled intervention delivery to support emotion regulation in-situ. The strong engagement and qualitative indications of effects are promising – children were able to use the prototype without any training and incorporated it into their emotion regulation practices during daily challenges. Future work is needed to extend this indicative data with efficacy studies examining the psychological efficacy of the proposed intervention. More broadly, our findings suggest the potential of a technology-enabled shift in how prevention interventions are designed and delivered: empowering children and parents through ‘child-led, situated interventions’, where participants learn through actionable support directly within family life, as opposed to didactic in-person workshops and a subsequent skills application.


2019 ◽  
Vol 69 (7) ◽  
pp. 471-474 ◽  
Author(s):  
K Hamilton ◽  
E Fraser ◽  
T Hannan

Abstract Background Increasing workplace physical activity has important implications for workers’ health and well-being. However, few interventions targeting physical activity in the workplace are grounded in behavioural theory. Aims The aim of this study was to develop and pilot a 6-week habit-based intervention designed to promote the development of workplace physical activity habits and increase average weekly step counts. Changes in the strength of workplace physical activity habit and weekly step counts were assessed at 1 and 6 weeks following the intervention. Methods The study was a prospective three-wave within-subjects single-arm intervention study that ran for 12 weeks (baseline, 7 weeks, 12 weeks). During the 6-week intervention, participants received information regarding 10 top tips (10TT) to increase and promote habit formation and wore a pedometer during work hours. Differences in workplace physical activity habit and weekly step counts were compared across baseline (T1), 1 (T2) and 6 weeks (T3) post-intervention using repeated measures analyses of variance. Results Data from 20 sedentary office workers at a large Australian University were included. The average strength of workplace physical activity habits significantly increased from baseline (M = 3.90) to 1 week post-intervention (M = 4.45), and these effects were maintained 6 weeks later (M = 4.72). No significant increase in step counts were observed across any of the time points (all P > 0.05). Conclusions The results of this pilot study reveal that workplace physical activity habits can be strengthened via a habit-based intervention. Further research is needed to replicate these findings in larger cohorts of office workers.


Author(s):  
Weiyun Chen ◽  
Zhanjia Zhang ◽  
Bruno Giordani ◽  
Janet Larson

Background: To increase psychological well-being and physical activity (PA) behaviors, our pilot study used the social ecological model as the framework to design the 4Active intervention, focusing on multicomponent exercise group lessons at the interpersonal level and self exercise enhanced by activity trackers at the individual level. The purpose of this pilot study was to examine the effectiveness of the two-level 4Active intervention in improving psychological well-being and PA participation in older adults living in retirement communities. Methods: Participants were 27 older adults with a mean age of 85.9 ± 9.3 years. Based on the two-arm, quasi-experimental study design, fourteen older adults (2 men, 12 women) living in one retirement community (RC) were assigned into the intervention group receiving the two-level 4Active intervention, whereas 13 older adults (1 man, 12 women) living in another RC were allocated to the active control group receiving group exercise intervention alone for eight weeks. One week before and after the interventions, the participants were pre-tested and post-tested in psychological well-being (i.e., life satisfaction, subjective happiness, positive affect, and negative affect) and weekly PA minutes (i.e., weekly walking, vigorous, moderate, and total PA minutes). The data were analyzed be means of descriptive statistics, independent sample t-tests, and ANCOVA repeated measures. Results: The results of ANCOVA repeated measures indicated that both groups maintained their slightly high or very high levels of life satisfaction, happiness, and positive affect over times. However, the two-level 4Active intervention group showed significant decreases in negative affect (F = 4.78, p = 0.04, η2 = 0.23) and significance increases in weekly moderate PA (F = 10.355, p = 0.004, η2 = 0.310) compared with the active control group over time. Conclusion: It is concluded that engaging in the two-level 4Active intervention including group-based multicomponent exercises and technology-enhanced self-exercises is more effective in decreasing negative affect and increasing weekly moderate PA METS-min in physically and cognitively frail older adults over time, compared with attending the group exercises alone.


2021 ◽  
Vol 11 ◽  
pp. 204512532098663
Author(s):  
David M. O’Shaughnessy ◽  
Ilana Berlowitz ◽  
Robin Rodd ◽  
Zoltán Sarnyai ◽  
Frances Quirk

Aims: The therapeutic use of psychedelics is regaining scientific momentum, but similarly psychoactive ethnobotanical substances have a long history of medical (and other) uses in indigenous contexts. Here we aimed to evaluate patient outcomes in a residential addiction treatment center that employs a novel combination of Western and traditional Amazonian methods. Methods: The study was observational, with repeated measures applied throughout treatment. All tests were administered in the center, which is located in Tarapoto, Peru. Data were collected between 2014 and 2015, and the study sample consisted of 36 male inpatients who were motivated to seek treatment and who entered into treatment voluntarily. Around 58% of the sample was from South America, 28% from Europe, and the remaining 14% from North America. We primarily employed repeated measures on a psychological test battery administered throughout treatment, measuring perceived stress, craving frequency, mental illness symptoms, spiritual well-being, and physical and emotional health. Addiction severity was measured on intake, and neuropsychological performance was assessed in a subsample from intake to at least 2 months into treatment. Results: Statistically significant and clinically positive changes were found across all repeated measures. These changes appeared early in the treatment and were maintained over time. Significant improvements were also found for neuropsychological functioning. Conclusion: These results provide evidence for treatment safety in a highly novel addiction treatment setting, while also suggesting positive therapeutic effects.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Arthur Holtzclaw ◽  
Jack Ellis ◽  
Christopher Colombo

Abstract Background Almost half of trainees experience burnout during their career. Despite the Accreditation Council on Graduate Medical Education (ACGME) recommendation that training programs enact well-being curricula, there is no proven method of addressing this difficult topic. Methods We created a curriculum addressing physician resiliency and well-being, designed for an Internal Medicine Residency Program. This curriculum utilized episodes from a medical television series, Scrubs, to facilitate a monthly, 1-h faculty guided discussion group. We collected informal feedback and abbreviated Maslach Burnout Inventories (aMBI) monthly and conducted a formal focus group after 6 months to gauge its effectiveness. Results The curriculum was successfully conducted for 12 months with each session averaging 18–20 residents. Residents reported high satisfaction, stating it was more enjoyable and helpful than traditional resiliency training. 19 of 24 residents (79 %) completed a baseline aMBI, and 17 of 20 residents (85 %) who attended the most recent session completed the 6-month follow-up, showing a non-significant 1-point improvement in all subsets of the aMBI. Conclusions This novel, low-cost, easily implemented curriculum addressed resiliency and burn-out in an Internal Medicine Residency. It was extremely well received and can easily be expanded to other training programs or to providers outside of training.


Author(s):  
Thais Pousada García ◽  
Jessica Garabal-Barbeira ◽  
Patricia Porto Trillo ◽  
Olalla Vilar Figueira ◽  
Cristina Novo Díaz ◽  
...  

Background: Assistive Technology (AT) refers to “assistive products and related systems and services developed for people to maintain or improve functioning and thereby to promote well-being”. Improving the process of design and creation of assistive products is an important step towards strengthening AT provision. Purpose: (1) to present a framework for designing and creating Low-Cost AT; (2) to display the preliminary results and evidence derived from applying the framework. Methodology: First, an evidence-based process was applied to develop and conceptualize the framework. Then, a pilot project to validate the framework was carried out. The sample was formed by 11 people with disabilities. The measure instruments were specific questionnaire, several forms of the Matching Person-Technology model, the Psychosocial Impact of Assistive Device Scale, and a tool to assess the usability and universal design of AT. Results: The framework integrates three phases: Identification (Design), Creation (Making the prototype), and Implementation (Outcome Measures), based on the principles of Design Thinking, and with a user-centered perspective. The preliminary results showed the coherence of the entire process and its applicability. The matching between person and device was high, representing the importance of involving the user in the design and selection of AT. Conclusions: The framework is a guide for professionals and users to apply a Low-Cost and Do-It-Yourself perspective to the provision of AT. It highlights the importance of monitoring the entire procedure and measuring the effects, by applying the outcome measures.


2020 ◽  
pp. 1-13
Author(s):  
Raed A. Alharbi ◽  
Saleh A. Aloyuni ◽  
Faizan Kashoo ◽  
Mohamed I. Waly ◽  
Harpreet Singh ◽  
...  

Abstract Objective: Infantile hemiplegia due to brain injury is associated with poor attention span, which critically affects the learning and acquisition of new skills, especially among children with left-sided infantile hemiplegia (LSIH). This study aimed to improve the selective visual attention (SVA) of children with LSIH through transcranial direct current stimulation (tDCS). Methods: A total of 15 children participated in this randomized, double-blinded, pilot study; of them, 10 experienced LSIH, and the remaining 5 were healthy age-matched controls. All the children performed the Computerized Stroop Color-Word Test (CSCWT) at baseline, during the 5th and 10th treatment sessions, and at follow-up. The experimental (n = 5) and control groups (n = 5) received tDCS, while the sham group (n = 5) received placebo tDCS. All three groups received cognitive training on alternate days, for 3 weeks, with the aim to improve SVA. Results: Two-way repeated measures analysis of variance (ANOVA) showed a statistically significant change in the mean scores of CSCWT between time points (baseline, 5th and 10th sessions, and follow-up) within-subject factor, group (experimental, sham) between-subject factor and interaction (time points X group) (p < 0.005). Furthermore, a one-way repeated measures ANOVA showed significant differences between time point (p < 0.005) for the experimental and control group but not the sham group. Conclusion: These pilot results suggest that future research should be conducted with adequate samples to enable conclusions to be drawn.


2021 ◽  
pp. 089826432110209
Author(s):  
Guilherme M. Balbim ◽  
Susan Aguiñaga ◽  
Olusola A. Ajilore ◽  
Eduardo E. Bustamante ◽  
Kirk I. Erickson ◽  
...  

Objective: To investigate the effects of the BAILAMOSTM dance program on physical activity (PA), cardiorespiratory, and cognitive health. Methods: A parallel, two-armed pilot study was conducted with 57 older Latinos randomized to the BAILAMOSTM dance program ( n = 28) or health education (HE) ( n = 29). We conducted two- and three-way repeated-measures ANOVAs. Results: BAILAMOSTM participants increased participation in leisure moderate-to-vigorous PA (LMVPA) ( F[1,53] = 3.17, p = .048, η2 G = .01) and performance in global cognition relative to HE participants ( F[1,52] = 4.19, p = .045, η2 G = .01). Attendance moderated increases in moderate PA, MVPA, LMVPA, and total PA ( p < .05). Participants of both groups with ≥75% attendance increased participation in PA. Among participants with <75% attendance, BAILAMOSTM participants increased PA relative to HE. Discussion: BAILAMOSTM positively impacted self-reported PA and global cognition in older Latinos. Even smaller doses of dance appear to impact self-reported PA levels.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Christian Keicher ◽  
Lena Pyrkosch ◽  
Bernd Wolfarth ◽  
Andreas Ströhle

Abstract Background Whole-body electromyostimulation (WB-EMS) training is used in popular and health sports to improve muscular performance. Little is known about the possible psychological effects of WB-EMS training. The aim of the study is therefore to investigate the possible psychological effects of WB-EMS training on subjective well-being, relaxation, mood, and perceived stress. Materials and Methods Twenty-five healthy subjects underwent conventional WB-EMS training and Sham training (without the application of electrical stimulation) as part of a randomized, controlled pilot study in a crossover design. Subjective well-being and subjective relaxation were assessed using visual analog scales, the current state of mood was assessed with Multidimensional Mood State Questionnaires (MDBF), and the current level of stress was assessed with Recovery–Stress Questionnaires/Erholungs-Belastungs-Fragebögen (RESTQEBF) before and after training. Results WB-EMS training has a statistically significant positive effect on subjective well-being and subjective relaxation, as well as on the awake subscale of the MDBF. No significant main effect of sequence and no interaction effects were found. Also, compared to a Sham training session, a single WB-EMS training session had no significant effect on mood, nervousness, or the current level of stress. Conclusion Besides physiological effects, WB-EMS might also have a strong psychological impact. WB-EMS could be beneficial for people who, due to their limitations, have problems training on a regular basis and with adequate training intensity. Trial Registration German Clinical Trials Register, DRKS00012583, 22 June 2017.


2020 ◽  
pp. 1420326X2097546
Author(s):  
Richard A Sharpe ◽  
Andrew J Williams ◽  
Ben Simpson ◽  
Gemma Finnegan ◽  
Tim Jones

Fuel poverty affects around 34% of European homes, representing a considerable burden to society and healthcare systems. This pilot study assesses the impact of an intervention to install a new first time central heating system in order to reduce fuel poverty on household satisfaction with indoor temperatures/environment, ability to pay bills and mental well-being. In Cornwall, 183 households received the intervention and a further 374 went onto a waiting list control. A post-intervention postal questionnaires and follow-up phone calls were undertaken ( n = 557) to collect data on household demographics, resident satisfaction with indoor environment, finances and mental well-being (using the Short Warwick-Edinburgh Mental Wellbeing scale). We compared responses between the waiting list control and intervention group to assess the effectiveness of the intervention. A total of 31% of participants responded, 83 from the waiting list control and 71 from the intervention group. The intervention group reported improvements in the indoor environment, finances and mental well-being. However, these benefits were not expressed by all participants, which may result from diverse resident behaviours, lifestyles and housing characteristics. Future policies need to consider whole house approaches alongside resident training and other behaviour change techniques that can account for complex interactions between behaviours and the built environment.


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