Patient experience and satisfaction with admission to an acute geriatric community hospital in the Netherlands: a mixed method study

PurposeThe acute geriatric community hospital (AGCH) in an intermediate care facility is an alternative to conventional hospitalization. A comprehensive geriatric assessment and rehabilitation are integrated into acute medical care for older patients. This study aims to evaluate patient experience and satisfaction with the AGCH.Design/methodology/approachThis is a mixed method observational study including a satisfaction questionnaire and qualitative interviews with AGCH patients or informal caregivers.FindingsA total of 152 participants filled in the questionnaire, and thirteen semi-structured interviews were conducted. Twelve categories and four overarching themes emerged in the analysis. In general, study participants experience the admission to the AGCH as positive and are satisfied with the care they received; there were also suggestions for improvement.Research limitations/implicationsLimitations of this study include possible participation bias. The results show that patients value this type of care indicating that it should be implemented elsewhere. Further research will focus on health outcomes, readmission rates and cost effectiveness of the AGCH.Originality/valueThis is the first study to evaluate care satisfaction with the AGCH. It shows that hospitalized older adults positively value the AGCH as an alternative to hospitalization.

Predictive symptoms for COVID-19 in the community: REACT-1 study of over 1 million people

Background Rapid detection, isolation, and contact tracing of community COVID-19 cases are essential measures to limit the community spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to identify a parsimonious set of symptoms that jointly predict COVID-19 and investigated whether predictive symptoms differ between the B.1.1.7 (Alpha) lineage (predominating as of April 2021 in the US, UK, and elsewhere) and wild type. Methods and findings We obtained throat and nose swabs with valid SARS-CoV-2 PCR test results from 1,147,370 volunteers aged 5 years and above (6,450 positive cases) in the REal-time Assessment of Community Transmission-1 (REACT-1) study. This study involved repeated community-based random surveys of prevalence in England (study rounds 2 to 8, June 2020 to January 2021, response rates 22%–27%). Participants were asked about symptoms occurring in the week prior to testing. Viral genome sequencing was carried out for PCR-positive samples with N-gene cycle threshold value < 34 (N = 1,079) in round 8 (January 2021). In univariate analysis, all 26 surveyed symptoms were associated with PCR positivity compared with non-symptomatic people. Stability selection (1,000 penalized logistic regression models with 50% subsampling) among people reporting at least 1 symptom identified 7 symptoms as jointly and positively predictive of PCR positivity in rounds 2–7 (June to December 2020): loss or change of sense of smell, loss or change of sense of taste, fever, new persistent cough, chills, appetite loss, and muscle aches. The resulting model (rounds 2–7) predicted PCR positivity in round 8 with area under the curve (AUC) of 0.77. The same 7 symptoms were selected as jointly predictive of B.1.1.7 infection in round 8, although when comparing B.1.1.7 with wild type, new persistent cough and sore throat were more predictive of B.1.1.7 infection while loss or change of sense of smell was more predictive of the wild type. The main limitations of our study are (i) potential participation bias despite random sampling of named individuals from the National Health Service register and weighting designed to achieve a representative sample of the population of England and (ii) the necessary reliance on self-reported symptoms, which may be prone to recall bias and may therefore lead to biased estimates of symptom prevalence in England. Conclusions Where testing capacity is limited, it is important to use tests in the most efficient way possible. We identified a set of 7 symptoms that, when considered together, maximize detection of COVID-19 in the community, including infection with the B.1.1.7 lineage.

Adjustment for survey non-participation using record linkage and multiple imputation: A validity assessment exercise using the Health 2000 survey

Aims: It is becoming increasingly possible to obtain additional information about health survey participants, though not usually non-participants, via record linkage. We aimed to assess the validity of an assumption underpinning a method developed to mitigate non-participation bias. We use a survey in Finland where it is possible to link both participants and non-participants to administrative registers. Survey-derived alcohol consumption is used as the exemplar outcome. Methods: Data on participants (85.5%) and true non-participants of the Finnish Health 2000 survey (invited survey sample N=7167 aged 30-79 years) and a contemporaneous register-based population sample ( N=496,079) were individually linked to alcohol-related hospitalisation and death records. Applying the methodology to create synthetic observations on non-participants, we created ‘inferred samples’ (participants and inferred non-participants). Relative differences (RDs) between the inferred sample and the invited survey sample were estimated overall and by education. Five per cent limits were used to define acceptable RDs. Results: Average weekly consumption estimates for men were 129 g and 131 g of alcohol in inferred and invited survey samples, respectively (RD –1.6%; 95% confidence interval (CI) –2.2 to –0.04%) and 35 g for women in both samples (RD –1.1%; 95% CI –2.4 to –0.8%). Estimates for men with secondary levels of education had the greatest RD (–2.4%; 95% CI –3.7 to –1.1%). Conclusions: The sufficiently small RDs between inferred and invited survey samples support the assumption validity and use of our methodology for adjusting for non-participation. However, the presence of some significant differences means caution is required.

On the quality of professional development in the United States: Examining music educators’ experiences, sentiments, and emotions

The purpose of this study was to develop a valid and reliable assessment tool to measure music educators’ participation in and perceptions of their high-quality professional development (PD) experiences. A sample of 450 in-service music educators across the United States completed a 78-item rating scale embedded within 10 domains reflecting high-quality PD criteria: (a) content, (b) evidence/research, (c) coherence, (d) relevance, (e) active learning, (f) application, (g) collaboration, (h) reflection, (i) feedback, and (j) duration. Participants also answered the open-ended question, “What are some adjectives you would use to describe your overall professional development experiences?” Data were analyzed using Rasch measurement analyses and sentiment analyses. Results indicated an overall acceptable data-to-model fit, with the content domain reflecting most participation and the duration domain reflecting least participation. Bias analyses suggested that music educators received systematically different quality PD experiences based upon their teaching area and/or grade-level emphases. Participants had an overall positive sentiment of their PD experiences, which positively correlates with the level of quality PD they experienced ( r = 0.42, p < .05). The most frequent emotions of the participants were trust and joy. Implications for the development and programming of PD in the field of music education are discussed.

Deep immunity and the progress towards the endemic equilibrium of the Sars-CoV2.

The path to endemicity is characterised by the progression of deep immunity, that is, the decrease in the severity of the virus. Deep immunity cannot be reliably derived from measures of cases, whether these come PCR or serological surveys, notably because the first are subject to participation bias and the second are not continuously collected.We rely on immunological theory to devise a novel indicator of the progression of deep immunity in the active population. This indicator, based on the changing age structure of COVID-related hospitalisations, is more robust than any measures base on serological surveys or PCR tests. We find that at least two-thirds of the path to endemicity has been covered, with a reduction of the severity of the virus of at least two-thirds of the 30-60 years-old population. Measuring the progression of the deep immunity in other age groups is less robust and relevant:-Virtually the whole under-30 population had acquired deep cross-immunity by exposure to endemic coronaviruses prior to the first wave, so that neither their exposure not the progression of their immunity can be robustly measured-The immunity of the elderly is not robust, and must be complemented by vaccines, so measuring their exposure is not as relevant).