... Tel: 0171-919-7206; Fax: 0171-919-7223; Email: cea0lmg@gold.ac.uk; or Dr. Mark McDermott, Dep... more ... Tel: 0171-919-7206; Fax: 0171-919-7223; Email: cea0lmg@gold.ac.uk; or Dr. Mark McDermott, Department of Psychology, University of East London, Romford Road, Stratford, London, E15 4LZ, UK, Tel: (0) 181-590-7000 ext 4474; Fax (0) 181-849-3697; Email: mrmcdermott ...
The English National Health Service Institute for Innovation and Improvement designed a series of... more The English National Health Service Institute for Innovation and Improvement designed a series of programmes called The Productive Series. These are innovations designed to help healthcare staff reduce inefficiency and improve quality, and have been implemented in healthcare organisations in at least 14 different countries. This paper examines an implementation of the first module of the Productive Community Services programme called 'The Well Organised Working Environment'. The quantitative component aims to identify the quantitative outcomes and impact of the implementation of the Well Organised Working Environment module. The qualitative component aims to describe the contexts, mechanisms and outcomes evident during the implementation, and to consider the implication of these findings for healthcare staff, commissioners and implementation teams. Mixed methods explanatory sequential design. Community Healthcare Organisation in East Anglia, England. For the quantitative data, participants were 73 staff members that completed End of Module Assessments. Data from 25 services that carried out an inventory of stock items stored were also analysed. For the qualitative element, participants were 45 staff members working in the organisation during the implementation, and four members of the Productive Community Services Implementation Team. Staff completed assessments at the end of the module implementation, and the value of items stored by clinical services was recorded. After the programme concluded, semi-structured interviews with staff and a focus group with members of the Productive Community Services implementation team were analysed using Framework Analysis employing the principles of Realist Evaluation. 62.5% respondents (n=45) to the module assessment reported an improvement in their working environment, 37.5% (n=27) reported that their working environment stayed the same or deteriorated. The reduction of the value of items stored by services ranged from £4 to £5039 across different services. Results of the qualitative analysis suggests explanations for why the programme worked in some contexts and not others, for instance due to varying levels of management support, and varying levels of resources allocated to carrying out or sustaining the improvement work. Quantitative analysis of data generated during healthcare improvement initiatives can give an impression of the benefits realised, but additional qualitative analysis also provides opportunity for learning to improve future implementations. Targets set by commissioners for innovation should focus on sustaining improvement rather demonstrating one-off benefits, and implementation teams should not let their preconceptions of what will and what will not work prevent them from trying interventions that may benefit staff.
Social Behavior and Personality an International Journal, 1998
... Tel: 0171-919-7206; Fax: 0171-919-7223; Email: cea0lmg@gold.ac.uk; or Dr. Mark McDermott, Dep... more ... Tel: 0171-919-7206; Fax: 0171-919-7223; Email: cea0lmg@gold.ac.uk; or Dr. Mark McDermott, Department of Psychology, University of East London, Romford Road, Stratford, London, E15 4LZ, UK, Tel: (0) 181-590-7000 ext 4474; Fax (0) 181-849-3697; Email: mrmcdermott ...
Gaming technology - exergaming - is a novel tool to facilitate exercise, improve balance, and enc... more Gaming technology - exergaming - is a novel tool to facilitate exercise, improve balance, and encourage rehabilitation training. This review will describe some of the key exergame research to promote physical activity and its use in rehabilitation in other diseases or clinical populations. We will then describe the current state of research in exergaming in people with multiple sclerosis and describe the theories for the mechanism behind some of the improvements in outcomes seen after using exergaming. Lastly, we will identify gaps in the literature and provide directions for future work in this growing area. The current work is contradictory and there is no consensus with regards to training duration/intensity and the outcomes used to assess the clinical effectiveness. This in part is due to the off-the-shelf nature of the games used. A more satisfactory approach would be the development of bespoke games which match a clinical need. Exergames are seen as enjoyable and could be effe...
Advances in experimental medicine and biology, 2006
Mental rehearsal of a physical task (or motor ideation) has been studied since the 1930&a... more Mental rehearsal of a physical task (or motor ideation) has been studied since the 1930's 1. Initial studies looking at the electrical activity in the muscle (EMG) date back to Jacobson 2 who demonstrated that the muscles used in mentally rehearsing a task are the same as those used to perform the task. Since this initial report a range of studies has provided evidence for 3-5 or against 6-8 muscle activation during mental imagery. The nature of the mental rehearsal EMG patterns do not always mirror those produced during physical ...
Advances in experimental medicine and biology, 2006
Using imagery to perform a conscious mental rehearsal of a physical task, designed to aid perform... more Using imagery to perform a conscious mental rehearsal of a physical task, designed to aid performance 1, has proved beneficial in a variety of tasks, ranging from physical therapy to flight training to sporting performance 2. Yet the physical/psychological basis underpinning the success of mental rehearsal is still unclear 3. A number of theories have been proposed. One, psychoneuromuscular theory, suggests that imagery results in a neuromuscular pattern that is identical to the patterns used in actual movements 4. Mental rehearsal is therefore ...
Tibial eminence avulsion fracture at the ACL footprint may be caused by high-energy forces such a... more Tibial eminence avulsion fracture at the ACL footprint may be caused by high-energy forces such as a fall, in which the ACL ligament proves stronger than the forces that hold the bone together. For reasons of bone maturity however, tibial spine avulsion fractures where the ACL remains intact, typically occur in children but are rare in adults. This case demonstrates a rare type of adult tibial avulsion fracture with intact ACL and subsequent fragment fixation failure in which vitamin D deficiency may have been contributory. Because there is a high rate of inadequate vitamin D levels in patients undergoing orthopaedic surgery and a known impact on bone healing complications, post-operative bone fixation failure may also occur. This case report may therefore prompt further awareness for considering pre-surgical vitamin D deficiency screening in adults presenting with rare avulsion fractures, and may further demonstrate its impact on surgical outcomes.
The Productive Series is a collection of change programmes designed by the English National Healt... more The Productive Series is a collection of change programmes designed by the English National Health Service (NHS) Institute for Innovation and Improvement to help frontline healthcare staff improve quality and reduce wasted time, so that this time can be reinvested into time spent with patients. The programmes have been implemented in at least 14 countries around the world. This study examines an implementation of the Productive Community Services programme that took place in a Community healthcare organisation in England from July 2010 to March 2012. To explore staff members' perceptions of a Productive Community Services implementation. Cross-sectional interview. Community Healthcare Organisation in East Anglia, England. 45 participants were recruited using purposive, snowballing and opportunistic sampling methods to represent five main types of staff group in the organisation; clinical team members, administrative team members, service managers/team leaders, senior managers and software support staff. Team members were recruited on the basis that they had submitted data for at least one Productive Community Services module. Semi-structured individual and group interviews were carried out after the programme concluded and analysed using thematic analysis. This report focuses on six of the themes identified. The analysis found that communication was not always effective, and there was a lack of awareness, knowledge and understanding of the programme. Many staff did not find the Productive Community Services work relevant, and although certain improvements were sustained, suboptimal practices crept back. Although negative outcomes were reported, such as the programme taking time away from patients initially, many benefits were described including improved stock control and work environments, and better use of the Electronic Patient Record system. One of the themes identified highlighted the positive perceptions of the programme, however a focus on five other themes indicate that important aspects of the implementation could have been improved. The innovation and implementation literature already addresses the issues identified, which suggests a gap between theory and practice for implementation teams. A lack of perceived relevance also suggests that similar programmes need to be made more easily adaptable for the varied specialisms found in Community Services. Further research on Productive Community Services implementations and knowledge transfer is required, and publication of studies focusing on the less positive aspects of implementations may accelerate this process.
Pediatrics international : official journal of the Japan Pediatric Society, 2012
Many physical activity intervention programs are unable to sustain long-term improvements in acti... more Many physical activity intervention programs are unable to sustain long-term improvements in activity levels and are often not cost-effective. The aim of this study was to determine if a low-cost school- and community-centered sports coaching program was able to improve health-related fitness in children. Children from three schools in socially deprived areas took part in weekly coaching sessions over two 10 week periods during the school year. Coaching was provided by local community-based sports clubs. Body mass index (BMI), jump height, handgrip strength, and 20 m shuttle run test (20mSRT) performance were assessed before and after each of the two intervention periods, to determine short- and long-term changes in health-related fitness. Age- and sex-normalized z-scores were calculated using normative UK reference data for each measure. BMI z-score did not change in the short term, as expected, but importantly was significantly lower at the end of the study. Both handgrip and 20mS...
Social Behavior and Personality: an international journal, 1998
... Tel: 0171-919-7206; Fax: 0171-919-7223; Email: cea0lmg@gold.ac.uk; or Dr. Mark McDermott, Dep... more ... Tel: 0171-919-7206; Fax: 0171-919-7223; Email: cea0lmg@gold.ac.uk; or Dr. Mark McDermott, Department of Psychology, University of East London, Romford Road, Stratford, London, E15 4LZ, UK, Tel: (0) 181-590-7000 ext 4474; Fax (0) 181-849-3697; Email: mrmcdermott ...
... Tel: 0171-919-7206; Fax: 0171-919-7223; Email: cea0lmg@gold.ac.uk; or Dr. Mark McDermott, Dep... more ... Tel: 0171-919-7206; Fax: 0171-919-7223; Email: cea0lmg@gold.ac.uk; or Dr. Mark McDermott, Department of Psychology, University of East London, Romford Road, Stratford, London, E15 4LZ, UK, Tel: (0) 181-590-7000 ext 4474; Fax (0) 181-849-3697; Email: mrmcdermott ...
The English National Health Service Institute for Innovation and Improvement designed a series of... more The English National Health Service Institute for Innovation and Improvement designed a series of programmes called The Productive Series. These are innovations designed to help healthcare staff reduce inefficiency and improve quality, and have been implemented in healthcare organisations in at least 14 different countries. This paper examines an implementation of the first module of the Productive Community Services programme called 'The Well Organised Working Environment'. The quantitative component aims to identify the quantitative outcomes and impact of the implementation of the Well Organised Working Environment module. The qualitative component aims to describe the contexts, mechanisms and outcomes evident during the implementation, and to consider the implication of these findings for healthcare staff, commissioners and implementation teams. Mixed methods explanatory sequential design. Community Healthcare Organisation in East Anglia, England. For the quantitative data, participants were 73 staff members that completed End of Module Assessments. Data from 25 services that carried out an inventory of stock items stored were also analysed. For the qualitative element, participants were 45 staff members working in the organisation during the implementation, and four members of the Productive Community Services Implementation Team. Staff completed assessments at the end of the module implementation, and the value of items stored by clinical services was recorded. After the programme concluded, semi-structured interviews with staff and a focus group with members of the Productive Community Services implementation team were analysed using Framework Analysis employing the principles of Realist Evaluation. 62.5% respondents (n=45) to the module assessment reported an improvement in their working environment, 37.5% (n=27) reported that their working environment stayed the same or deteriorated. The reduction of the value of items stored by services ranged from £4 to £5039 across different services. Results of the qualitative analysis suggests explanations for why the programme worked in some contexts and not others, for instance due to varying levels of management support, and varying levels of resources allocated to carrying out or sustaining the improvement work. Quantitative analysis of data generated during healthcare improvement initiatives can give an impression of the benefits realised, but additional qualitative analysis also provides opportunity for learning to improve future implementations. Targets set by commissioners for innovation should focus on sustaining improvement rather demonstrating one-off benefits, and implementation teams should not let their preconceptions of what will and what will not work prevent them from trying interventions that may benefit staff.
Social Behavior and Personality an International Journal, 1998
... Tel: 0171-919-7206; Fax: 0171-919-7223; Email: cea0lmg@gold.ac.uk; or Dr. Mark McDermott, Dep... more ... Tel: 0171-919-7206; Fax: 0171-919-7223; Email: cea0lmg@gold.ac.uk; or Dr. Mark McDermott, Department of Psychology, University of East London, Romford Road, Stratford, London, E15 4LZ, UK, Tel: (0) 181-590-7000 ext 4474; Fax (0) 181-849-3697; Email: mrmcdermott ...
Gaming technology - exergaming - is a novel tool to facilitate exercise, improve balance, and enc... more Gaming technology - exergaming - is a novel tool to facilitate exercise, improve balance, and encourage rehabilitation training. This review will describe some of the key exergame research to promote physical activity and its use in rehabilitation in other diseases or clinical populations. We will then describe the current state of research in exergaming in people with multiple sclerosis and describe the theories for the mechanism behind some of the improvements in outcomes seen after using exergaming. Lastly, we will identify gaps in the literature and provide directions for future work in this growing area. The current work is contradictory and there is no consensus with regards to training duration/intensity and the outcomes used to assess the clinical effectiveness. This in part is due to the off-the-shelf nature of the games used. A more satisfactory approach would be the development of bespoke games which match a clinical need. Exergames are seen as enjoyable and could be effe...
Advances in experimental medicine and biology, 2006
Mental rehearsal of a physical task (or motor ideation) has been studied since the 1930&a... more Mental rehearsal of a physical task (or motor ideation) has been studied since the 1930's 1. Initial studies looking at the electrical activity in the muscle (EMG) date back to Jacobson 2 who demonstrated that the muscles used in mentally rehearsing a task are the same as those used to perform the task. Since this initial report a range of studies has provided evidence for 3-5 or against 6-8 muscle activation during mental imagery. The nature of the mental rehearsal EMG patterns do not always mirror those produced during physical ...
Advances in experimental medicine and biology, 2006
Using imagery to perform a conscious mental rehearsal of a physical task, designed to aid perform... more Using imagery to perform a conscious mental rehearsal of a physical task, designed to aid performance 1, has proved beneficial in a variety of tasks, ranging from physical therapy to flight training to sporting performance 2. Yet the physical/psychological basis underpinning the success of mental rehearsal is still unclear 3. A number of theories have been proposed. One, psychoneuromuscular theory, suggests that imagery results in a neuromuscular pattern that is identical to the patterns used in actual movements 4. Mental rehearsal is therefore ...
Tibial eminence avulsion fracture at the ACL footprint may be caused by high-energy forces such a... more Tibial eminence avulsion fracture at the ACL footprint may be caused by high-energy forces such as a fall, in which the ACL ligament proves stronger than the forces that hold the bone together. For reasons of bone maturity however, tibial spine avulsion fractures where the ACL remains intact, typically occur in children but are rare in adults. This case demonstrates a rare type of adult tibial avulsion fracture with intact ACL and subsequent fragment fixation failure in which vitamin D deficiency may have been contributory. Because there is a high rate of inadequate vitamin D levels in patients undergoing orthopaedic surgery and a known impact on bone healing complications, post-operative bone fixation failure may also occur. This case report may therefore prompt further awareness for considering pre-surgical vitamin D deficiency screening in adults presenting with rare avulsion fractures, and may further demonstrate its impact on surgical outcomes.
The Productive Series is a collection of change programmes designed by the English National Healt... more The Productive Series is a collection of change programmes designed by the English National Health Service (NHS) Institute for Innovation and Improvement to help frontline healthcare staff improve quality and reduce wasted time, so that this time can be reinvested into time spent with patients. The programmes have been implemented in at least 14 countries around the world. This study examines an implementation of the Productive Community Services programme that took place in a Community healthcare organisation in England from July 2010 to March 2012. To explore staff members' perceptions of a Productive Community Services implementation. Cross-sectional interview. Community Healthcare Organisation in East Anglia, England. 45 participants were recruited using purposive, snowballing and opportunistic sampling methods to represent five main types of staff group in the organisation; clinical team members, administrative team members, service managers/team leaders, senior managers and software support staff. Team members were recruited on the basis that they had submitted data for at least one Productive Community Services module. Semi-structured individual and group interviews were carried out after the programme concluded and analysed using thematic analysis. This report focuses on six of the themes identified. The analysis found that communication was not always effective, and there was a lack of awareness, knowledge and understanding of the programme. Many staff did not find the Productive Community Services work relevant, and although certain improvements were sustained, suboptimal practices crept back. Although negative outcomes were reported, such as the programme taking time away from patients initially, many benefits were described including improved stock control and work environments, and better use of the Electronic Patient Record system. One of the themes identified highlighted the positive perceptions of the programme, however a focus on five other themes indicate that important aspects of the implementation could have been improved. The innovation and implementation literature already addresses the issues identified, which suggests a gap between theory and practice for implementation teams. A lack of perceived relevance also suggests that similar programmes need to be made more easily adaptable for the varied specialisms found in Community Services. Further research on Productive Community Services implementations and knowledge transfer is required, and publication of studies focusing on the less positive aspects of implementations may accelerate this process.
Pediatrics international : official journal of the Japan Pediatric Society, 2012
Many physical activity intervention programs are unable to sustain long-term improvements in acti... more Many physical activity intervention programs are unable to sustain long-term improvements in activity levels and are often not cost-effective. The aim of this study was to determine if a low-cost school- and community-centered sports coaching program was able to improve health-related fitness in children. Children from three schools in socially deprived areas took part in weekly coaching sessions over two 10 week periods during the school year. Coaching was provided by local community-based sports clubs. Body mass index (BMI), jump height, handgrip strength, and 20 m shuttle run test (20mSRT) performance were assessed before and after each of the two intervention periods, to determine short- and long-term changes in health-related fitness. Age- and sex-normalized z-scores were calculated using normative UK reference data for each measure. BMI z-score did not change in the short term, as expected, but importantly was significantly lower at the end of the study. Both handgrip and 20mS...
Social Behavior and Personality: an international journal, 1998
... Tel: 0171-919-7206; Fax: 0171-919-7223; Email: cea0lmg@gold.ac.uk; or Dr. Mark McDermott, Dep... more ... Tel: 0171-919-7206; Fax: 0171-919-7223; Email: cea0lmg@gold.ac.uk; or Dr. Mark McDermott, Department of Psychology, University of East London, Romford Road, Stratford, London, E15 4LZ, UK, Tel: (0) 181-590-7000 ext 4474; Fax (0) 181-849-3697; Email: mrmcdermott ...
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