The emoji current mood and experience scale: the development and initial validation of an ultra-brief, literacy independent measure of psychological health.

BACKGROUND: There is increasing interest in measuring wellbeing and mental health in a range of settings and services outside conventional mental health care settings. However, ensuring that measurement does not intrude on the primary service activity whilst promoting inclusion through minimizing literacy demands, requires ultra-brief and easy to use tools. AIMS: To develop and test a brief emoji-based tool to assess mental health, wellbeing, resilience and community connection. METHOD: In study 1, 672 adults completed an online questionnaire study comprising a new emoji measure and established questionnaires assessing mental health, resilience, community connection and wellbeing. In study 2, 415 participants completed a paper-and-pencil version of the emoji measure, mental health and community connection, with 212 individuals providing data at a second time point. RESULTS: Multidimensional scaling revealed a meaningful structure to the emoji measure with validity demonstrated through relationships to existing scales. Stability over time and sensitivity to change were also demonstrated. CONCLUSIONS: The emoji-based measure presented here provides an ultra-brief measure of mood and current experience, with minimal literacy demands on participants. Further research is now needed to test the properties and utility of the scale with other participant groups.

Therapeutic opportunities for targeting cellular senescence in progressive multiple sclerosis.

Recent studies have implicated cellular senescence as a disease-related process linked to progressive forms of multiple sclerosis (MS). Herein, we present an overview of the current pharmacopeia of cellular senescence affecting compounds and evidence for their effects, if known, in murine and cellular models of MS. Consideration is also given to the utility of these compounds for the treatment of progressive MS, with an examination of past and current clinical trials that have tested these agents, often for other purposes, in the MS patient population. Lastly, we discuss the implications and potential utility for targeting cellular senescence as a strategy to fulfil the unmet need of treatment options for the progressive MS population.

What do people hospitalised with COVID-19 think about their care? Results of a satisfaction survey during the first wave of COVID-19 in Liverpool.

Despite huge advances in vaccines, testing and treatments for COVID-19, there is negligible evidence on the perceptions of people hospitalised with COVID-19 about the care they received. To address this, we developed a satisfaction survey for people with COVID-19 admitted to our hospital during the first COVID-19 wave in Liverpool. Of those invited, 98/160 (61%) responded, of whom 94/98 (96%) completed the survey. Respondents rated overall care highly (mean 4.7/5) and 89/94 (95%) reported that they would recommend the hospital to friends and/or family. Most respondents felt safe on the ward (94%), with privacy maintained (93%) and pain well managed (90%). Fewer than two-thirds (63%) of respondents considered themselves adequately consulted regarding medications and side effects. Sleep and food/drink quality were also highlighted as areas for improvement. To overcome the issues raised, we generated a 'COVID-19 practice pointers' poster within an integrated educational bundle on COVID-19 wards. The impact of the bundle on perceptions of people hospitalised with COVID-19 will be evaluated in people hospitalised with COVID-19 in Liverpool in 2021. Whether hospitalised for COVID-19 or other conditions, our survey results are a timely reminder of the importance of involving patients in shaping the care that they receive.

A patient satisfaction survey and educational package to improve the care of people hospitalised with COVID-19: a quality improvement project, Liverpool, UK.

Background: The perspectives and experiences of people hospitalised with COVID-19 have been under-reported during the coronavirus pandemic. We developed and conducted a COVID-19 patient satisfaction survey in a large university-affiliated secondary healthcare centre in Liverpool, UK, during Europe's first coronavirus wave (April-June 2020). The survey found that care was rated highly, including among people of Black Asian and Minority Ethnic (BAME) background. However, sleep-quality and communication about medications and discharge-planning were identified as areas for improvement.   Methods: To improve care for people with COVID-19 admitted to our centre, we designed an educational package for healthcare professionals working on COVID-19 wards. The package, implemented in August 2020, included healthcare worker training sessions on providing holistic care and placement of "Practice Pointers" posters. Patient satisfaction was re-evaluated during the second/third COVID-19 waves in Liverpool (September 2020 - February 2021). Results: Across waves, most (95%) respondents reported that they would recommend our hospital to friends and/or family and rated overall care highly. Comparison of the responses of second/third-wave respondents (n=101) with first-wave respondents (n=94) suggested improved patient satisfaction across most care domains but especially those related to having worries and fears addressed and being consulted about medications and their side-effects. Conclusions: People admitted with COVID-19 to our centre in Liverpool, including those from BAME background, rated the care they received highly. A simple education package improved the feedback on care received by respondents between the first and second/third waves. These UK-first findings are informing regional strategies to improve person-centred care of hospitalised people with COVID-19.

Using engagement in sustainable construction to improve mental health and social connection in disadvantaged and hard to reach groups: a new green care approach.

Background: The positive impact of the outdoors on physical and mental health is increasingly being evidenced. However, the impact on vulnerable and disadvantaged individuals engaging in group based sustainable building construction has not been examined.Aim: To provide the first pragmatic examination of the impact of engaging in a brief (8 days over 8 weeks) outdoor sustainable construction project on the mental health and social connectedness of hard to reach and disadvantaged groups.Methods: In study 1, 93 young people not in education, employment or training took part whilst study 2 comprised 55 adults who were asylum seekers, long-term unemployed or men with longstanding depression. Self-report data were collected at baseline and towards the end of the programme.Results: Those with poor mental health and social connection at baseline showed statistically and clinically significant improvements in depression, anxiety, resilience and social connection by the end of the brief intervention.Conclusion: Engagement in a group based sustainable construction project can provide significant mental health and social benefits to a range of vulnerable and hard to reach groups with difficulties in these areas. Building on these findings could be important for health and social care policy for marginalised groups.

Neophyte experiences of football (soccer) match analysis: a multiple case study approach.

Performance analysis is extensively used in sport, but its pedagogical application is little understood. Given its expanding role across football, this study explored the experiences of neophyte performance analysts. Experiences of six analysis interns, across three professional football clubs, were investigated as multiple cases of new match analysis. Each intern was interviewed after their first season, with archival data providing background information. Four themes emerged from qualitative analysis: (1) "building of relationships" was important, along with trust and role clarity; (2) "establishing an analysis system" was difficult due to tacit coach knowledge, but analysis was established; (3) the quality of the "feedback process" hinged on coaching styles, with balance of feedback and athlete engagement considered essential; (4) "establishing effect" was complex with no statistical effects reported; yet enhanced relationships, role clarity, and improved performances were reported. Other emic accounts are required to further understand occupational culture within performance analysis.

Intramedullary fibular and impaction allografting in revision total elbow arthroplasty with endosteal deficiency.

One of the many reasons for failed revision elbow replacement is loss of the normally irregular shape of the endosteal surface leading to reduced ability to provide rotational control of the humeral or ulnar component within the intramedullary canal. The endosteal bone loss of the distal humerus or proximal ulna compromises the rotational stability of the stem in the intramedullary canal. In these cases, impaction cancellous allografting techniques, similar to the ones used in revision total hip arthroplasties, are commonly used to address the osseous deficiency, but these methods are not optimal for providing rotational control of the prosthetic stem. We describe a technique of restoring the irregular shape of the endosteal bone using intramedullary fibular allografting to enhance the rotational control of the prosthetic stem within the intramedullary bone canal.

Published evidence relevant to the diagnosis of impingement syndrome of the shoulder.

BACKGROUND: Acromioplasty for impingement syndrome of the shoulder is one of the most common orthopaedic surgical procedures. The rate with which this procedure is performed has increased dramatically. This investigation sought high levels of evidence in the published literature related to five hypotheses pertinent to the concept of the impingement syndrome and the rationale supporting acromioplasty in its treatment. METHODS: We conducted a systematic review of articles relevant to the following hypotheses: (1) clinical signs and tests can reliably differentiate the so-called impingement syndrome from other conditions, (2) clinically common forms of rotator cuff abnormality are caused by contact with the coracoacromial arch, (3) contact between the coracoacromial arch and the rotator cuff does not occur in normal shoulders, (4) spurs seen on the anterior aspect of the acromion extend beyond the coracoacromial ligament and encroach on the underlying rotator cuff, and (5) successful treatment of the impingement syndrome requires surgical alteration of the acromion and/or coracoacromial arch. Three of the authors independently reviewed each article and determined the type of study, the level of evidence, and whether it supported the concept of the impingement syndrome. Articles with level-III or IV evidence were excluded from the final analysis. RESULTS: These hypotheses were not supported by high levels of evidence. CONCLUSIONS: The concept of impingement syndrome was originally introduced to cover the full range of rotator cuff disorders, as it was recognized that rotator cuff tendinosis, partial tears, and complete tears could not be reliably differentiated by clinical signs alone. The current availability of sonography, magnetic resonance imaging, and arthroscopy now enable these conditions to be accurately differentiated. Nonoperative and operative treatments are currently being used for the different rotator cuff abnormalities. Future clinical investigations can now focus on the indications for and the outcome of treatments for the specific rotator cuff diagnoses. It may be time to replace the nonspecific diagnosis of so-called impingement syndrome by using modern methods to differentiate tendinosis, partial tears, and complete tears of the rotator cuff.

Plating of a periarticular medial clavicle fracture.

This article describes a case of a 23-year-old man who sustained a far medial fracture dislocation of the medial clavicle. We performed an open reduction and internal fixation of the fragment back to the remaining medial fragment using a small locking plate. This fracture can be problematic and usually requires reduction due to the potential vascular or airway compromise. Because the fracture often occurs at the medial physis, it is difficult to secure in place to prevent displacement. Historically, fixation of this fracture has been problematic with sutures and K-wires. Failure of fixation and migration of K-wires have been reported. In the past, plates have been inadequate or too large for this area to provide fixation. With the development of locking plates, a fixed-angle construct can be created to secure a small periarticular portion of bone as in the distal radius. In our case, the small distal radius locking plate was able to secure the lateral shaft to the medial piece with good stability in the medial clavicle. We were able to get multiple screws in the medial fragment in a low-profile plate. Postoperatively, the patient was permitted to use his arm for most activities but was restricted from pushing, pulling, or lifting heavy objects for 4 weeks. He recovered well and returned to normal activities of daily living with no restriction. Therefore, these plates may have a role in fixation of periarticular fractures.

Discotic liquid crystalline poly(propylene imine) dendrimers based on triphenylene.

The design, synthesis, and mesomorphic properties of a new series of homodendrimers consisting of the commercially available poly(propylene imine) (PPI) dendrimers (G = 1-5), PPI-(NH(2))(n)() (n = 4, 8, 16, 32, 64), functionalized with a discotic triphenylene moiety are reported. The liquid crystalline behavior was investigated by means of differential scanning calorimetry (DSC), polarizing-light optical microscopy (POM), and X-ray diffractometry (XRD). All of the homodendrimers showed mesomorphic properties, with the second to fifth generations giving a hexagonal columnar mesophase (Col(h)) and the first generation a rectangular columnar mesophase (Col(r)). The X-ray study reveals that these mesophases show a highly ordered structure with segregation of triphenylenes and dendrimers into separate columns and a regular stacking distance inside the triphenylene columns. GPC analysis showed that the dendrimers had good monodispersity and MALDI-TOF studies of the first three generations gave good evidence that all of the terminal amino groups of the dendrimers were functionalized with a discotic unit.