Evaluation of the Family Liaison Officer role during the COVID-19 pandemic.

Communication within healthcare settings is often a subject of contention for patients' families at the best of times; however, contention was greatly magnified in the United Kingdom by restrictions on hospital visitations during the early stage of the COVID-19 pandemic. To support communication between families and patients, a central London hospital introduced the role of the family liaison officer (FLO). This study was designed to evaluate the rapid implementation of the FLO and to explore potential for it to become a standard role. Semi-structured interviews were conducted with five FLOs and seven colleagues who had worked alongside them between April and June, 2020. Two versions of the role emerged based on FLOs' previous background: clinical (primarily nurses) and pastoral (primarily play specialists). The FLO became a key role during the pandemic in facilitating communication between patients, clinical teams, and families. Challenges associated with the role reflect the speed in which it was implemented. It was evident to those in the role, and clinicians who the role was supporting, that it had potential to help improve hospital communication and the work of healthcare staff beyond the pandemic.

The assessment of intersegmental motion and pelvic tilt in elite oarsmen.

UNLABELLED: Low back pain (LBP) is a common problem in elite oarsmen. The relevance of spinal and pelvic flexibility to good rowing technique and the incidence of LBP is unclear. PURPOSE: The aim of this study was to investigate patterns of spinal and pelvic mobility in a group of elite oarsmen with and without a history of LBP. METHODS: Twenty elite oarsmen were recruited into this study, including nine with no history of spinal problems, four with a current spinal problem, and the remainder with a history of LBP. Subjects were scanned using an interventional magnetic resonance imaging (MRI) scanner. Four key stages of the rowing stroke were simulated within the scanner, and sagittal images of the lumbar spine and sacrum were obtained. From these images intersegmental motion was determined along with the angle of lordosis and position of the lumbar spine and sacrum. RESULTS: Different mobility trends were seen; oarsmen with no history of LBP demonstrated the greatest mobility in their lower lumbar regions (at the L5/S1 level in the catch position 7.5 degrees +/-1.3 in normals; 4.8 degrees +/-1.2 in previous LBP groups; and 2.8 degrees +/-5.5 in current LBP group) and the lowest rotation of their pelvis (level in the catch position 13.9 degrees +/-11.2 in normals; 16.1 degrees +/-6.8 in previous back pain groups; and 15.2 degrees +/-11.2 in current back pain group). In contrast, those with either current or previous LBP presented with a hypomobility of their spine which appeared to be compensated for by increased pelvic rotation. CONCLUSIONS: Marked differences were observed in the motion characteristics of these 3 groups of oarsmen. At present it is not known if these changes are causative or effect.

The use of interventional open MRI to assess the kinematics of the lumbar spine in patients with spondylolisthesis.

STUDY DESIGN: Open interventional MRI techniques were used to investigate the intervertebral mobility of the lumbar spine in subjects with isthmic and degenerative spondylolisthesis. The findings were compared with those in a published database of subjects with no history of low back pain. OBJECTIVE: To investigate patterns of intervertebral mobility in subjects with spondylolisthesis to determine the level of spinal instability in this population. SUMMARY OF BACKGROUND DATA: Subjects with spondylolisthesis have been considered to present with a special form of spinal instability. Consequently, this condition is frequently managed by spinal fusion. However, confusion exists regarding whether there is excessive motion at the level of the defect. METHODS: For this study, 29 subjects presenting to spinal clinics with spondylolisthesis (15 isthmic and 14 degenerative) were recruited and compared with an existing database of control subjects. The motion characteristics of these subjects in flexed and extended positions were investigated using interventional open MRI of known precision. In all the subjects, the level of resting pain, the grade of slip, and the level of the defect were noted. RESULTS: No mobility differences, in terms of both angular and translational motion, were found between the subjects with spondylolisthesis and those with no history of low back pain, suggesting that subjects with spondylolisthesis do not present with either instability or hypermobility. CONCLUSION: A spondylolytic defect does not lead to detectable instability or hypermobility in the lumbar spine.