I know what I like, and I like what I know: Patient preferences and expectations when choosing an arts therapies group.

Patient preferences deserve consideration as they play a role in engagement with psychosocial interventions. This study sought to understand more about preferences and expectations of the arts therapies, in order to support informed decision-making. Semi-structured interviews were conducted with 17 participants in a trial of group music therapy, art therapy and dance-movement therapy. Audio recordings were transcribed. Data relating to the process of choosing their preferred arts therapies groups, expectations and experiences of the groups were analysed using framework analysis. Three overarching themes were found relating to the experience of choosing an arts therapies group and subsequently attending it: past experiences of the art forms, social interactions in the groups and expectations of helpfulness. Familiarity and perceived capability were important factors for the therapy experiences. Although each participant had a unique decision-making process, the themes offer understanding of common considerations when making a choice about engagement with the arts therapies. Clinicians should guide discussions around past experiences of the art forms, group dynamics and therapy aims during shared decision making for the arts therapies.

Transforming community nursing services in the UK; lessons from a participatory evaluation of the implementation of a new community nursing model in East London based on the principles of the Dutch Buurtzorg model.

BACKGROUND: Buurtzorg, a model of community nursing conceived in the Netherlands, is widely cited as a promising and evidence-based approach to improving the delivery of integrated nursing and social care in community settings. The model is characterised by high levels of patient and staff satisfaction, professional autonomy exercised through self-managing nursing teams, client empowerment and holistic, patient centred care. This study aimed to examine the extent to which some of the principles of the Buurtzorg model could be adapted for community nursing in the United Kingdom. METHODS: A community nursing model based on the Buurtzorg approach was piloted from June 2017-August 2018 with a team of nurses co-located in a single general practice in the Borough of Tower Hamlets, East London, UK. The initiative was evaluated using a participatory methodology known as the Researcher-in-Residence model. Qualitative data were collected using participant observation of meetings and semi-structured interviews with nurse team members, senior managers, patients/carers and other local stakeholders such as General Practitioners (GP) and social workers. A thematic framework analysis of the data was carried out. RESULTS: Implementation of a community nursing model based on the Buurtzorg approach in East London had mixed success when assessed against its key principles. Patient experience of the service was positive because of the better access, improved continuity of care and longer appointment times in comparison with traditional community nursing provision. The model also provided important learning for developing service integration in community care, in particular, how to form effective collaborations across the care system with other health and social care professionals. However, some of the core features of the Buurtzorg model were difficult to put into practice in the National Health Service (NHS) because of significant cultural and regulatory differences between The Netherlands and the UK, especially the nurses' ability to exercise professional autonomy. CONCLUSIONS: Whilst many of the principles of the Buurtzorg model are applicable and transferable to the UK, in particular promoting independence among patients, improving patient experience and empowering frontline staff, the successful embedding of these aims as normalised ways of working will require a significant cultural shift at all levels of the NHS.

Rastreabilidade em medicina laboratorial: um estímulo global para resultados exatos no cuidado com o paciente

RESUMO Os resultados da medicina laboratorial influenciam uma alta porcentagem das decisões tomadas pelos médicos. A globalização requer que os resultados obtidos por métodos diferentes sejam concordantes, garantindo a segurança do paciente. É necessário haver colaboração internacional para difundir essa exigência. Essa colaboração deve basear-se na rastreabilidade da medicina laboratorial, bem como na adoção de procedimentos de medição e materiais de referência de alta hierarquia metrológica e que sejam comutáveis internacionalmente. A aplicação da cadeia de rastreabilidade metrológica facilita essa abordagem universal. A quantificação de colesterol no soro e Hemoglobina sanguínea A1c (HbA1c) no sangue serve como exemplo do processo de padronização de métodos com impacto demonstrado nos resultados clínicos. Por outro lado, a quantificação de paratormônio (PTH) e hemoglobina A2 (HbA2) no sangue revela a variabilidade entre os métodos atualmente em uso, que compromete o tratamento do paciente e demanda, portanto, a harmonização e/ou padronização dos métodos. Os desafios à difusão da rastreabilidade em medicina laboratorial incluem fatores como disponibilidade de materiais e métodos de referência, diferenças geográficas, uso de unidades de medida variadas, ensaios de analitos complexos e coordenação mundial limitada. Uma colaboração abrangente requer o envolvimento das partes interessadas no âmbito mundial, desde especialistas gerais a aqueles com particular experiência em medicina laboratorial, com vivência em laboratórios clínicos de rotina. Um plano de coordenação é apresentado neste artigo com ações atribuídas a cada um dos envolvidos.

ABSTRACT Laboratory medicine results influence a high percentage of all clinical decisions. Globalization requires that laboratory medicine results should be transferable between methods in the interests of patient safety. International collaboration is necessary to deliver this requirement. That collaboration should be based on traceability in laboratory medicine and the adoption of higher order international commutable reference materials and measurement procedures. Application of the metrological traceability chain facilitates a universal approach. The measurement of serum cholesterol and blood HbA1c serve as examples of the process of method standardization where an impact on clinical outcomes is demonstrable. The measurement of plasma parathyroid hormone and blood HbA2 serve as examples where the current between method variability is compromising patient management and method standardization and/or harmonization is required. Challenges to the widespread adoption of traceability in laboratory medicine include the availability of reference materials and methods; geographical differences; the use of variable units; complex analytes and limited global coordination. The global collaboration requires the involvement of several different stakeholder groups ranging from international experts to laboratory medicine specialists in routine clinical laboratories. A coordinated action plan is presented with actions attributable to each of these stakeholder groups.

Correction to: Exploring experiences of people participation activities in a British national health service trust: a service user-led research project.

[This corrects the article DOI: 10.1186/s40900-019-0140-8.].

Exploring experiences of people participation activities in a British national health service trust: a service user-led research project.

BACKGROUND: People participation teams are being established in many British NHS Trusts. They support active service user involvement in staff recruitment interviews, in evaluations of care and in programmes to improve services. No studies exploring experience of people involved in these activities are available in published mental health literature. In this project we explored benefits experienced and suggestions for improvement provided by service users. METHODS: The design, materials and methods of the project were developed in workshops including N = 15 service users. Three service user researchers were trained to carry out research interviews and qualitative analysis of the data. They were responsible for the management of the project on a day-to-day basis with weekly supervision by academic researchers and authored this paper. The service user researchers interviewed people with at least 1 year of experience of being involved in a People Participation team activities. Interviews were based on a topic guide, which was developed in workshops with a larger number of service users (N = 15) and explored reasons for joining the group, how participation helped recovery and suggestions for service improvement. RESULTS: Fifteen service users were recruited and interviewed. Reasons for joining the group were identified: to "give back" to the service, to influence service change, curiosity, desire to meet like-minded people and to structure the day. Benefits reported included: sharing experiences, improving self-confidence, feeling valued, having a better understanding of services, overcoming personal fears, and developing better coping mechanisms for psychological difficulties. Being involved in People Participation activities helped to gain or refresh listening and interpersonal skills, communication skills, public speaking and creative skills and to develop better ways to cope with conflict. Suggestions for improvement were focused on changing staff attitudes, further promoting participation (e.g. through websites), simplifying payment procedures and establishing a moving-on support system to help people to access regular employment and gain full social inclusion. CONCLUSIONS: Our findings showed that People Participation initiatives can have benefits at least for some patients and help their recovery through a positive effect on self-confidence, providing room for feeling valued and for obtaining or refreshing personal skills. This provides support for the development and refinement of People Participation Teams and for larger scale research to test their effects.

13C NMR quantification of mono and diacylglycerols obtained through the solvent-free lipase-catalyzed esterification of saturated fatty acids.

In the present investigation, we studied the enzymatic synthesis of monoacylglycerols (MAG) and diacylglycerols (DAG) via the esterification of saturated fatty acids (stearic, palmitic and an industrial residue containing 87% palmitic acid) and glycerol in a solvent-free system. Three immobilized lipases (Lipozyme RM IM, Lipozyme TL IM and Novozym 435) and different reaction conditions were evaluated. Under the optimal reaction conditions, esterifications catalyzed by Lipozyme RM IM resulted in a mixture of MAG and DAG at high conversion rates for all of the substrates. In addition, except for the reaction of industrial residue at atmospheric pressure, all of these products met the World Health Organization and European Union directives for acylglycerol mixtures for use in food applications. The products were quantified by (13)C NMR, with the aid of an external reference signal which was generated from a sealed coaxial tube filled with acetonitrile-d3. After calibrating the area of this signal using the classical external reference method, the same coaxial tube was used repeatedly to quantify the reaction products.

Inclusive deaf studies: barriers and pathways.

Joining scholars signaling the need for new directions in Deaf Studies, the authors recommend a more expansive, nuanced, and interdisciplinary approach that encompasses the many ways deaf people live today. Rather than destroy Deaf culture, this approach is the only realistic way to allow it and Deaf Studies to survive. Deaf Studies today continues the focus of founding scholarship on native White American Sign Language users, now head of a powerful hierarchy through which they receive privileged status at the expense of deaf people with different language backgrounds and races or ethnicities. This marginalization is unsustainable and impedes knowledge. A companion article (this issue), "Deaf Studies: A Critique of the Predominant U.S. Theoretical Direction," analyzes this reactive stance that is oriented by a focus on audism built on the concepts of phonocentrism and colonialism.

Deaf studies: a critique of the predominant U.S. theoretical direction.

The focus and concerns establishing Deaf Studies in the 1970s have rigidified into a reactive stance toward changing historical conditions and the variety of deaf lives today. This critique analyzes the theoretical foundation of this stance: a tendency to downplay established research in the field of Deaf Studies and linguistics, the employment of outdated examples of discrimination, an uncritical acceptance of Derrida's phonocentrism, flawed uses of Saussure's linguistic theory, and reliance on the limiting metaphor of colonialism. The purpose of the critique ultimately is to point Deaf Studies in a new direction. Issues with conceptualizing an expanded Deaf Studies are the focus of a companion article (this issue), "Inclusive Deaf Studies: Barriers and Pathways."