The Efficacy of Re-Warm-Up Practices during Half-Time: A Systematic Review

Background and Objectives: The passive nature of rest breaks in sport could reduce athletes’ performance and even increase their risk of injury. Re-warm-up activities could help avoid these problems, but there is a lack of research on their efficacy. This systematic review aimed at analyzing the results of those randomized controlled trials (RCTs) that provided information on the effects of re-warm-up strategies. Materials and Methods: Four electronic databases (Web of Science, Scopus, PubMed, and SPORTDiscus) were searched from their inception to January 2021, for RCTs on the effects of re-warm-up activities on sports performance. Interventions had to be implemented just after an exercise period or sports competition. Studies that proposed activities that were difficult to replicate in the sport context or performed in a hot environment were excluded. Data were synthesized following PRISMA guidelines, while the risk of bias was assessed following the recommendations of the Cochrane Collaboration. Results: A total of 14 studies (178 participants) reporting data on acute or short-term effects were analyzed. The main outcomes were grouped into four broad areas: physiological measures, conditional abilities, perceptual skills, and sport efficiency measures. The results obtained indicated that passive rest decreases physiological function in athletes, while re-warm-up activities could help to improve athletes’ conditional abilities and sporting efficiency, despite showing higher fatigue levels in comparison with passive rest. The re-warm-up exercise showed to be more effective than passive rest to improve match activities and passing ability. Conclusions: Performing re-warm-up activities is a valuable strategy to avoid reducing sports performance during prolonged breaks. However, given that the methodological quality of the studies was not high, these relationships need to be further explored in official or simulated competitions.

Practice transformation at scale through a microsystems quality improvement (QI) approach.

e18667 Background: How oncology providers should implement practice transformation for value-based care is unclear, particularly at scale. Organizational size enables efficient “top down” approaches, but also presents challenges such as physician engagement. Dis-economies of scale can be acute in oncology due to physician autonomy and coordination costs. We hypothesized that organizational change based in sense-making models that enhance physician engagement and use a decentralized, iterative microsystems approach will enable practice transformation to scale. Methods: Florida Cancer Specialists & Research Institute (FCS) is a physician led 250-oncologist statewide practice, with regional variation in disease state/mix, patient cohort, etc., making a purely top-down approach to organizational change infeasible. FCS prototyped a transformation strategy starting in June 2017 based on sharing interpreted data with physician and executive leadership. Later implementation directly engaged physicians in a microsystems quality QI strategy focused on regional performance. Interventions targeted disease, health service utilization, location, and individual physicians. Performance was evaluated using data from Medicare’s Oncology Care Model (OCM) and assessed using the one-sided risk target (4% below benchmark). We analyzed 70,239 performance period (PP) episodes at FCS across 35,116 patients. Results: In the pre- intervention period (90% of PP1 episodes, completed by June 2017), FCS was 5.8% above target. Performance was 10.9% above target for the remainder of PP1 (10% of PP1 episodes), then improved to 0.3% above target in PP2 and PP3, and below target by 0.9%, 0.8%, and 0.75% in PP4, PP5, and PP6. Early QI efforts focused on performance in lung cancer, which was 2.5% over target in PP1; it improved to 2.1% under target in PP6. Later regional QI sessions targeted cancer, utilization and providers. Pre-intervention, all 18 regions were above target; by PP6, 11 out of 19 regions were below target. Relative to the pre-intervention period, per-episode inpatient costs increased by 12.1% for the remainder of PP1 and increased by 4.3% and 1.3% in PP2 and PP6; inpatient costs decreased in PP3, PP4, and PP5 by 3.8%, 2.4% and 4.8%. Conclusions: Practice transformation in oncology can achieve scale through models of organizational change that foster physician engagement. Data, when clinically contextualized, is a foundational tool in the sense-making process. Scale can develop through an additive microsystems approach in which QI units are de-centralized, accountability is defined, and iteration becomes part of organizational culture. [Table: see text]

Victorian healthcare experience survey 2016–2018; evaluation of interventions to improve the patient experience

Background Patient experience is recognised as a quality of care indicator and increasingly health services are working on achieving set targets and improving their performance. Interventions at the point of care targeting communication with patients, patient engagement in care processes and discharge planning are associated with better patient experience. However, their efficacy and application to different contexts are still unclear. The aims were to describe the interventions implemented by health services to improve patient experience, their impact on overall patient experiences and specific experiences in areas of communication, discharge planning, patient education on treatment/tests, the physical environment and access to care. Methods Secondary data analysis of the Victorian Healthcare Experience inpatient surveys reported in September 2016 and 2018 and content analysis of interventions published in the Victorian Quality Account for 2017 from 59 public health services in Victoria, Australia. The interventions were categorised using an adapted taxonomy of professional interventions by the Cochrane EPOC Review Group. Univariate tests and confirmatory factor analysis were conducted to test measure invariance across the 2016 and 2018 groups and examine the association between each of the intervention categories on overall patient experience measure and specific outcome measures. Results This study found that the overall patient experience was consistent (93%) between 2016 and 2018 samples. In comparing impact, a single intervention rather than none or multiple interventions in communication, respect and dignity and treatment and disease education areas were associated with a higher level of the overall patient experience. Interventions in waiting time, access to service, care continuity and emotional support categories were associated with a decrease in overall patient experience. Conclusion This study found that to improve the overall patient experience, more focus is needed on evidence-based interventions in dignity and respect and emotional support. Furthermore, the choice of interventions should be guided by evidence of their efficacy and prioritising implementing one intervention well, provides more gains.

Victorian Healthcare Experience Survey 2016 – 2018; Evaluation of Interventions to Improve the Patient Experience.

BackgroundPatient experience is recognised as a quality of care indicator and increasingly health services are working on achieving set targets and improving their performance. Interventions at the point of care targeting communication with patients, patient engagement in care processes and discharge planning are associated with better patient experience. However, their efficacy and application to different contexts are still unclear. The aims were to describe the interventions implemented by health services to improve patient experience, their impact on overall patient experiences and specific experiences in areas of communication, discharge planning, patient education on treatment/tests, the physical environment and access to care.MethodsSecondary data analysis of the Victorian Healthcare Experience inpatient surveys reported in September 2016 and 2018 and content analysis of interventions published in the Victorian Quality Account for 2017 from 59 public health services in Victoria, Australia. The interventions were categorised using an adapted taxonomy of professional interventions by the Cochrane EPOC Review Group. Univariate tests and confirmatory factor analysis were conducted to test measure invariance across the 2016 and 2018 groups and examine the association between each of the intervention categories on overall patient experience measure and specific outcome measures.ResultsThis study found that the overall patient experience was consistent (93%) between 2016 and 2018 samples. In comparing impact, a single intervention rather than none or multiple interventions in communication, respect and dignity and treatment and disease education areas were associated with a higher level of the overall patient experience. Interventions in waiting time, access to service, care continuity and emotional support categories were associated with a decrease in overall patient experience. ConclusionThis study found that to improve the overall patient experience, more focus is needed on evidence-based interventions in dignity and respect and emotional support. Furthermore, the choice of interventions should be guided by evidence of their efficacy and prioritising implementing one intervention well, provides more gains.

Kritično pisanje in uprizoritvene študije: primer slovenskega casopisa Maska

Pričujoči članek je prevod članka Bojane Kunst, ki ga je napisala ob 100. izdaji časopisa za scenske umetnosti Maska (2006) za zbornik Contesting Performance. Global Sites of Research v zbirki Performance Interventions, ki so ga uredili John McKenzie, Heike Roms in C. J. W.-L. Wee (2010) pri založbi Palgrave McMillan. Za prevod tega pomembnega članka, ki kontekstualizira specifično vlogo in regionalno samodržnost revije Maska ter njeno prepletenost z živo prakso v okviru širšega, globalnega konteksta formacije akademske discipline uprizoritvenih študij (Performance studies), smo se odločili ob jubileju, ko Maska izdaja že svojo 200. številko.

Bark and Butterflies

This chapter explores the role of site-specific projections in the digital remediation of family and personal history and their role in memorial work and remembrance. The chapter refers primarily to the mixed-media performance/installation Bark and Butterflies by the author (palkadiaries.com). Drawing on the work of Marianna Hirsch, the chapter explicates the notion of post-memory, which complicates and extends family history through the idea of inherited traumatic memory. The concept is applied to Bark and Butterflies and accordingly the chapter offers a case study, amplified with theoretical reflections, on the role of projection in the creation of mixed-media memorial works and their dissemination. Bark and Butterflies was the artistic result of a research trip to Siberia following in the footsteps of an inherited wartime diary, which narrates the exile to the Gulag of the author’s father and grandfather. The chapter outlines and demonstrates the role of site-specific projections in a series of action-research performance interventions en route and examines the potential they offer for the visual interrogation and remediation of symbolic space. The chapter argues that site-specific projections produce a ‘phantasmagoric’ counter-world in which the experience of time and space becomes collapsed and that through this temporal and spatial overlap Bark and Butterflies enacts an immersive process of ‘self-sacralization’, using projections to re-enact paradigmatic devotional forms (Turner), in a type of secular ‘aesthetic redemption’ (Kristeva). In this case, the chapter concludes, the art of projection acts as a contemporary procedure within a personal ritual of pilgrimage and remembrance.

Brief Experimental Analysis of Math Interventions: A Synthesis of Evidence

Brief experimental analysis (BEA) is a quick method used to identify the function of student learning difficulties and match effective interventions to students’ needs. Extensive work has been done to explore the use of this methodology to determine effective reading interventions; however, a smaller number of published studies have examined the use of BEAs in math. The purpose of the current review was to identify all studies that have used BEA methodology in math. Fifteen studies that included 63 participants and used BEA methodology to identify the most effective math intervention for students were located. Results of the synthesis indicate that the majority of BEAs compared skill and performance interventions on computational fluency; however, the methodology across the included studies varied. Strengths and limitations of the research, in addition to implications for research and practice, are discussed.