No abstract available.
Anesthesia* ; Great Britain*

PURPOSE: The importance of human dignity in care is well-recognized. Care recipients' experiences with undignified care have been reported in many countries. However, few studies have measured these situations quantitatively, especially as there are no tools applicable to inpatients receiving ordinary daily care. This study aimed to develop a valid and reliable Inpatient Dignity Scale (IPDS) that can measure inpatients' expectations of and satisfaction with dignity in daily care. METHODS: We conducted a three-phase research project: item generation and a preliminary survey with 47 items related to patients' dignity in Japan, a main survey with 36 items with deliberate translation into English in Singapore, and a confirmatory survey with 35 items in England, with 442, 430, and 500 inpatients as participants in questionnaire surveys, respectively. Data from each survey were processed using factor analysis. RESULTS: Authors obtained a scale with a four-factor structure with acceptable reliability: (F1) respect as a human being, (F2) respect for personal feelings and time, (F3) respect for privacy, and (F4) respect for autonomy. CONCLUSION: The Inpatient Dignity Scale can be periodically used by hospital administrators or nurses to preserve inpatients' dignity in daily care by monitoring inpatients' views regarding their expectations of and satisfaction with dignity.
England ; Great Britain ; Hospital Administrators ; Humans ; Inpatients ; Japan ; Nursing ; Personhood ; Privacy ; Psychometrics ; Singapore

BACKGROUND: Improved knee prosthesis designs have led to an increase in the use of patellofemoral arthroplasty as a primary treatment option in recent times. We report the early results and outcomes of the Zimmer Gender Solutions Patello-Femoral Joint (PFJ) system used to treat isolated patellofemoral osteoarthritis (PFA). METHODS: We retrospectively reviewed and analysed data of patients who underwent PFJ replacement (PFJR) at our institution with a minimum follow-up of 2 years. RESULTS: Median Oxford Knee score (OKS) was 38 (interquartile range, 28 to 42) at the latest follow-up with a significant improvement from preoperative scores (p < 0.0005). Median OKS was 40 for unilateral PFJRs and 39 for nonobese patients (body mass index [BMI] < 30 kg/m²). There was no significant difference in OKS between unilateral and bilateral procedures (p = 0.462). Likewise, there was no significant difference in OKS between obese and nonobese patients (p = 0.272). Two knees (4%) were revised for progression of osteoarthritis. No complications were reported related to infectious or thromboembolic causes. CONCLUSIONS: Our study showed good early results of the PFJ system, at least equal to those of other leading brands in the National Joint Registry for England, Wales and Northern Ireland (NJR). There have been no complications related to either the implantation technique or prosthetic design for this new implant. Progression of tibiofemoral arthritis remains a major concern. Our study also suggests that PFJR in obese patients and bilateral procedures can have good results.
Arthritis ; Arthroplasty* ; England ; Follow-Up Studies ; Humans ; Joints* ; Knee ; Knee Joint ; Knee Prosthesis ; Northern Ireland ; Osteoarthritis ; Patellofemoral Joint* ; Prostheses and Implants ; Retrospective Studies ; Wales

BACKGROUND: Few studies have examined the effects of a forward rotating shift pattern on police employee performance and well-being. This study sought to compare sleep duration, cognitive performance, and vigilance at the start and end of each shift within a three-shift, forward rotating shift pattern, common in United Kingdom police forces. METHODS: Twenty-three police employee participants were recruited from North Yorkshire Police (mean age, 43 years). The participants were all working the same, 10-day, forward rotating shift pattern. No other exclusion criteria were stipulated. Sleep data were gathered using both actigraphy and self-reported methods; cognitive performance and vigilance were assessed using a customized test battery, comprising five tests: motor praxis task, visual object learning task, NBACK, digital symbol substitution task, and psychomotor vigilance test. Statistical comparisons were conducted, taking into account the shift type, shift number, and the start and end of each shift worked. RESULTS: Sleep duration was found to be significantly reduced after night shifts. Results showed a significant main effect of shift type in the visual object learning task and NBACK task and also a significant main effect of start/end in the digital symbol substitution task, along with a number of significant interactions. CONCLUSION: The results of the tests indicated that learning and practice effects may have an effect on results of some of the tests. However, it is also possible that due to the fast rotating nature of the shift pattern, participants did not adjust to any particular shift; hence, their performance in the cognitive and vigilance tests did not suffer significantly as a result of this particular shift pattern.
Actigraphy ; Fatigue ; Great Britain ; Humans ; Learning ; Police

PURPOSE: There has been limited research on physicians’ perceptions of the specialty characteristics that are needed to sustain a successful career in medical specialties in Korea. Medical Specialty Preference Inventory in the United States or SCI59 (specialty choice inventory) in the United Kingdom are implemented to help medical students plan their careers. The purpose of this study was to explore the characteristics of the major specialties in Korea. METHODS: Twelve physicians from different specialties participated in an exploratory study consisting of qualitative interviews about the personal ability and emotional characteristics and job attributes of each specialty. The collected data were analysed with content analysis methods. RESULTS: Twelve codes were extracted for ability & skill attributes, 23 codes for emotion & attitude attributes, and 12 codes for job attributes. Each specialty shows a different profile in terms of its characteristic attributes. CONCLUSION: The findings have implications for the design of career planning programs for medical students.
Great Britain ; Humans ; Korea ; Students, Medical ; United States

Following several medical scandals, the issue of medical regulation has come under the spotlight in the Republic of Korea. In this article, the authors examine the administrative measures newly required of doctors in the past five years in order to illustrate the current state of medical regulation and demonstrate the urgent need for self-regulation. The history of the General Medical Council in the United Kingdom and its newly launched system of "revalidation" can provide an instructive example of a self-regulation system, and it suggests several principles for self-regulation in Korea. The recent disarray can be viewed as an opportunity to introduce a new system of self-regulation. The authors present three principles-professionalism, transparency, and fairness-for a successful system of medical regulation.
Great Britain ; Korea* ; Licensure ; Professionalism ; Republic of Korea ; Self-Control*

A career in surgery in the United Kingdom demands a commitment to a long journey of assessment. The assessment methods used must ensure that the appropriate candidates are selected into a programme of study or a job and must guarantee public safety by regulating the progression of surgical trainees and the certification of trained surgeons. This review attempts to analyse the psychometric properties of various assessment methods used in the selection of candidates to medical school, job selection, progression in training, and certification. Validity is an indicator of how well an assessment measures what it is designed to measure. Reliability informs us whether a test is consistent in its outcome by measuring the reproducibility and discriminating ability of the test. In the long journey of assessment in surgical training, the same assessment formats are frequently being used for selection into a programme of study, job selection, progression, and certification. Although similar assessment methods are being used for different purposes in surgical training, the psychometric properties of these assessment methods have not been examined separately for each purpose. Because of the significance of these assessments for trainees and patients, their reliability and validity should be examined thoroughly in every context where the assessment method is being used.
Certification ; Great Britain* ; Humans ; Methods* ; Psychometrics ; Reproducibility of Results ; Schools, Medical

PURPOSE: Esoteric jargon and technical language are potential barriers to the teaching of science and medicine. Effective teaching strategies which address these barriers are desirable. Here, we created and evaluated the effectiveness of standalone learning 'equivalence-based instruction' (EBI) resources wherein the teaching of a small number of direct relationships between stimuli (e.g., anatomical regions, their function, and pathology) results in the learning of higher numbers of untaught relationships. METHODS: We used a pre and post test design to assess students' learning of the relations. Resources were evaluated by students for perceived usefulness and confidence in the topic. Three versions of the resources were designed, to explore learning parameters such as the number of stimulus classes and the number of relationships within these classes. RESULTS: We show that use of EBI resulted in demonstrable learning of material that had not been directly taught. The resources were well received by students, even when the quantity of material to be learned was high. There was a strong desire for more EBI-based teaching. The findings are discussed in the context of an ongoing debate surrounding 'rote' vs. 'deep' learning, and the need to balance this debate with considerations of cognitive load and esoteric jargon routinely encountered during the study of medicine. CONCLUSION: These standalone EBI resources were an effective, efficient and well-received method for teaching neuroanatomy to medical students. The approach may be of benefit to other subjects with abundant technical jargon, such as science and medicine.
Cognition ; Great Britain ; Humans ; Learning ; Methods ; Neuroanatomy* ; Students, Medical

PURPOSE: It aimed at testing the validity and reliability of a validated team-based learning student assessment instrument (TBL-SAI) to assess United Kingdom pharmacy students' attitude toward TBL. METHODS: TBL-SAI, consisting of 33 items, was administered to undergraduate pharmacy students from two schools of pharmacy each at University of Wolverhampton and University of Bradford were conducted on the data, along with comparison between the two schools. RESULTS: Students' response rate was 80.0% (138/173) in completion of the instrument. Overall, the instrument demonstrated validity and reliability when used with pharmacy students. Sub-analysis between schools of pharmacy did, however, show that four items from Wolverhampton data, had factor loadings of less than 0.40. No item in the Bradford data had factor loadings less than 0.40. Cronbach's alpha score was reliable at 0.897 for the total instrument: Wolverhampton, 0.793 and Bradford, 0.902. Students showed preference to TBL, with Bradford's scores being statistically higher (P<0.005). CONCLUSION: This validated instrument has demonstrated reliability and validity when used with pharmacy students. Furthermore students at both schools preferred TBL compared to traditional teaching.
Great Britain* ; Humans ; Learning* ; Pharmacies ; Pharmacy* ; Reproducibility of Results ; Students, Pharmacy

BACKGROUND: The study analyzes penalties imposed on organizations for breaching safety and health regulations. The research questions are as follows: what are the commonly breached safety and health regulations? How proportional are penalties imposed on organizations for breaching health and safety regulations in the United Kingdom? METHODS: The study employed sequential explanatory mixed research strategies for better understanding of health and safety penalties imposed on organizations. Actual health and safety convictions and penalties data for 10 years (2006 to 2016) were obtained through the United Kingdom Health and Safety Executive (HSE) public register for convictions. Overall, 2,217 health and safety cases were analyzed amounting to total fines of £37,179,916, in addition to other wide-ranging penalties. For thorough understanding, eight interviews were conducted with industry practitioners, lawyers, and HSE officials as part of the study qualitative data. RESULTS: Findings show that the Health and Safety at Work (HSW) Act accounted for 46% of all HSE prosecution cases in the last decade. This is nearly half of the total safety and health at work prosecutions. Moreover, there is widespread desire for organizations to comply with the HSW Act, but route fines are seen as burdensome and inimical to business growth. CONCLUSION: A key deduction from the study reveal significant disproportionality concerning penalties imposed on organizations for breaching safety and health regulations. On aggregate, small companies tend to pay more for health and safety offenses in a ratio of 1:2 compared to large companies. The study also reveals that the HSW Act accounted for nearly half of the total safety and health at work prosecutions in the last decade.
Commerce ; Great Britain* ; Humans ; Lawyers ; Social Control, Formal*