Walking Football During Ramadan Fasting for Cardiometabolic and Psychological Health Benefits to the Physically Challenged and Aged Populations

Concurrent exercise and intermittent fasting regimens for long periods have been shown to enhance cardiometabolic health in healthy individuals. As exercise and fasting confer health benefits independently, we propose that Muslims who are fasting, especially those experiencing health and clinical challenges, continually engage in physical activity during the Ramadan month. In this opinion piece, we recommend walking football (WF) as the exercise of choice among Muslims who are fasting. WF can be played by any individual regardless of the level of fitness, skills, and age. WF has been shown to elicit cardiovascular and metabolic stress responses, which are suitable for populations with low fitness levels. Most importantly, WF has the inherent characteristics of being a fun team activity requiring social interactions among participants and, hence, likely to encourage long-term consistent and sustainable participation.

Using Team-Based Learning in an Online Synchronous Gerontology Course

Team-based learning (TBL) was chosen for its learner-centered approach to intentional engagement and purposeful application of course material in a cross-listed, upper-level gerontology class (i.e., Social Forces in Aging). Intedashboard, an online TBL platform, was utilized to support the online synchronous course, which is especially useful for its integration of class material, module assessments, peer/course evaluations, and dashboard display of live team activity. From the perspective of an emerging scholar, this symposia session will explore the application of TBL as a tool for developing teams, helping students personally connect with course material, and support inclusive teaching initiatives. More specifically, this presentation examines how a scaffolded TBL exercise on cumulative advantage/disadvantage, intersectionality, and social identities led to increased identification and awareness of students’ social location, and the perceived impacts on their later lives.

Follow the Fossils

The ability for people to connect, learn, and communicate about science has been enhanced through the Internet, specifically through social media platforms. Facebook and Twitter are well-studied, while Instagram is understudied. This Element provides insight into using Instagram as a science education platform by pioneering a set of calculated metrics, using a paleontology-focused account as a case study. Framed by the theory of affinity spaces, the authors conducted year-long analyses of 455 posts and 139 stories that were created as part of an informal science learning project. They found that team activity updates and posts outside of their other categories perform better than their defined categories. For Instagram stories, the data show that fewer slides per story hold viewers' attention longer, and stories using the poll tool garnered the most interaction. This Element provides a baseline to assess the success of Instagram content for science communicators and natural science institutions.

Stiffen the sinews, summon up the blood, and strain upon the start: enfranchising the medical profession for clinically proximate advocacy of improved healthcare

Objective: To discuss and reflect upon the role of medical practitioners, including psychiatrists, as health advocates on behalf of patients, carers and staff. Conclusions: Health advocacy is a key professional competency of medical practitioners, and is part of the RANZCP framework for training and continuing professional development. Since advocacy is often a team activity, there is much that is gained experientially from volunteering and working with other more experienced health advocates within structurally and financially independent (of health systems and governments) representative groups (RANZCP, AMA, unions). Doctors may begin with clinically proximate advocacy for improved healthcare in health systems, across the public and private sectors. Health advocacy requires skill and courage, but can ultimately influence systemic outcomes, sway policy decisions, and improve resource allocation.

Communication Objectives Model (COM): A Taxonomy of Face-to-Face Communication Objectives to Inform Tele-Presence Technology Adoption

Computer-mediated communication (CMC) has become the new normal in the era of pandemic-induced physical distancing. CMC has dramatically reduced business travel and daily commuting for knowledge workers able to work from home, which in turn reduces carbon emissions and energy expenditure. CMC offers a different communication experience compared to in-person interactions, and its impact on the success of communication is complex. Here, we report the Communication Objectives Model (COM), a framework developed to: a) understand differences in the performance of communication objectives between CMC and face-to-face interactions, and b) guide future research on measurement of such communication objectives. Given that effective communication is essentially the result of a team activity, the psychosocial constructs that comprise our framework are derived from team research across multiple domains (e.g., social psychology, human-computer interaction, and computer supported cooperative work). Constructs of interest include trust, rapport, engagement, conflict management, collective efficacy, mental models, and shared situation awareness. For each construct, we provide a definition, empirical evidence, and theoretical bases for its observable behavioral markers, as well as potential measurement methods and analytical techniques. The contributions of this research include a framework for characterizing differences between different communication media, a hypothetical implementation demonstrating how the framework can inform the decision to travel in-person versus to deploy CMC (i.e., a travel replacement threshold), and an inventory of tools and techniques that can be used to measure and assess the psychosocial constructs involved in CMC.

A Comparison of Neonatal Outreach Service Activity Before and During The First UK Wave of SARS-COV-2 in Leicestershire, UK

Neonatal outreach services provide post discharge support to babies with additional needs and their families. This includes support for nasogastric feeding and supplemental home oxygen use for babies with bronchopulmonary dysplasia (BPD). People potentially at higher risk of serious COVID-19 infection have been encouraged to shield and vulnerable babies requiring supplemental oxygen were in this category. This study reviews the impact of COVID-19 on a tertiary Neonatal service outreach team during the first UK COVID wave and lockdown in March-May 2020 compared to March-May 2019. Outreach service activity was captured on a team activity database including home visits, phone contacts, babies on home oxygen and overnight saturation monitoring. Outreach home visits increased by 33%, telephone contacts increased by 24% and additional support was required by families with 20 virtual clinics instead of 7 face to face clinics. However, emergency department attendances by babies receiving supplemental home oxygen dropped significantly. Emergency department attendances for these babies were over 700% higher pre-Covid than during this Covid lockdown period (1.8 vs 0.25 attendances / baby in home oxygen). It was possible to maintain neonatal outreach support with adapted working including risk assessments and appropriate PPE. Feedback on the neonatal outreach service provision during Covid lockdown was received from 75% families with babies in supplemental home oxygen; 83% of them strongly agreed and 17% agreed that a high quality of care was provided during COVID-19. All respondents were extremely likely to recommend the service to friends and families.

The impact of the SARS-CoV-2 epidemic outbreak on the vascular access team operations after conversion to COVID-19 dedicated hospital

Background: On February 21 2020, in Schiavonia Hospital occurred the first death by COVID-19 in Italy and since this date SARS-CoV-2 caused more than 100,000 deaths in our country. Our hospital was immediately closed and re-opened after 15 days as a reference Covid Hospital. Among services involved in a process of destruction and rebirth there was also the Vascular Access Team. Methods: We analyzed our Vascular Access Team activity comparing data from the first month (March) in which basically it did not work and data from the following month (April) in which we began to re-build the Team adapting it to the new reality. Results: In all patients admitted to Intensive Care Unit a Centrally Inserted Central Catheter multilumen was placed, but in March only 5.5% of patients admitted to Medicine-Sub-intensive Unit had a catheter different from the short peripheral cannula while in April it was possible to guarantee a more suitable catheter 31.7% of patients admitted to Medicine-Sub-intensive Unit ( p < 0.000). In April, compared to March, a significant higher number of Midline were implanted in Medicine-Sub-intensive Unit (36/139 vs 12/238 p < 0.000) where also a higher number of Centrally Inserted Central Catheter and Femoral Inserted Central Catheter were implanted (8/139 vs 1/238 p = 0.003). This change allowed us to implant more vascular accesses in Medicine-Sub-intensive Unit favoring Midline with a longer average duration. Only one patient with Midline developed a catheter vein thrombosis, and in only one patient the device was removed for suspected infection. Conclusions: The experience we gained will allow us to be more prepared in the future and our experience has highlighted that a structured Vascular Access Team is necessary to respond adequately to COVID-19 patients’ needs, to ensure the effectiveness of the maneuver, to reduce complications and to avoid the waste of resources, always working in safe condition.

Crossing Academic Boundaries for Diagnostic Safety: 10 Complex Challenges and Potential Solutions From Clinical Perspectives and High-Reliability Organizing Principles

Objective We apply the high-reliability organization (HRO) paradigm to the diagnostic process, outlining challenges to enacting HRO principles in diagnosis and offering solutions for how diagnostic process stakeholders can overcome these barriers. Background Evidence shows that healthcare is starting to organize for higher reliability by employing various principles and practices of HRO. These hold promise for enhancing safer care, but there has been little consideration of the challenges that clinicians and healthcare systems face while enacting HRO principles in the diagnostic process. To effectively deploy the HRO perspective, these barriers must be seriously considered. Method We review key principles of the HRO paradigm, the diagnostic errors and harms that potentially can be prevented by its enactment, the challenges that clinicians and healthcare systems face in executing various principles and practices, and possible solutions that clinicians and organizational leaders can take to overcome these challenges and barriers. Results Our analyses reveal multiple challenges including the inherent diagnostic uncertainty; the lack of diagnosis-focused performance feedback; the fact that diagnosis is often a solo, rather than team, activity; the tendency to simplify the diagnostic process; and professional and institutional status hierarchies. But these challenges are not insurmountable—there are strategies and solutions available to overcome them. Conclusion The HRO lens offers some important ideas for how the safety of the diagnostic process can be improved. Application The ideas proposed here can be enacted by both individual clinicians and healthcare leaders; both are necessary for making systematic progress in enhancing diagnostic performance.