Phosphorylcholine [KLH]

Background Patients and carers should be actively involved in patient safety and empowered to use person-centred approaches where they are asked to both identify safety concerns and partner in preventing them. Objectives The aim of this study was to co-design a patient safety guide for primary care (PSG-PC) to support patients and carers to address key patient safety questions and identify key points where they can make their care safer. The objectives were to i) identify when and how patients and carers can be involved in primary care patient safety, and ii) identify the relevant information to include in the PSG-PC. Design An experience-based co-design approach. Setting and Participants We conducted three workshops with patients, carers, community pharmacists and general practitioners to develop and refine the PSG-PC. Results Participants identified both explicit and implicit issues of primary care patient safety especially relating to technical and relational components of involving patients and carers. The importance of communication, understanding roles and responsibilities, and developing partnerships between patients and health-care providers were considered essential for actively involving patients in patient safety. Co-developing the PSG-PC provided insight to improve care to develop the PSG-PC. Discussion The PSG-PC is the first guide to be developed for primary care, co-designed with patients, carers, general practitioners and pharmacists. The PSG-PC will support patients and carers to partner with health-care professionals to improve patient safety addressing international and national priorities to continuously improve patient safety.

Objective Ehlers-Danlos syndrome (EDS) is a group of genetic disorders affecting connective tissue. Symptoms include joint and ligament laxity. The objectives of this study were to compare muscle activation, joint angles, and spatiotemporal parameters during gait, and to compare isometric strength between participants with EDS (hypermobility and classical subtypes) and healthy adults. Methods Participants with EDS (n = 14) and healthy adults (n = 14) were recruited for this cross-sectional study. Lower extremity muscle activation, sagittal joint angles, and spatiotemporal parameters during gait were measured using surface electromyography (EMG), motion capture, and force plates. Isometric strength of the lower extremity joints was measured with an isokinetic dynamometer. Important characteristics (principal components [PCs]) were determined from EMG and angle waveforms using PC analysis; relationships between PC scores and groups were examined using multilevel linear models after accounting for gait speed. Spatiotemporal parameters and strength were compared using independent t-tests and effect sizes (Cohen's d coefficient). Results The EDS group was associated with delayed vastus lateralis (b = 16.69) and medialis activation (b = 11.33), higher rectus femoris (b = 28.34) and tensor fascia latae activation (b = -11.06), prolonged gluteus medius activation (b = -32.78), and lower medial gastrocnemius activation (b = -27.18). Joint angles were similar between the EDS and healthy groups. The EDS group had slower gait speeds, shorter stride lengths, and a greater percentage of time in stance (d = -1.05 to 0.96). The EDS group had weaker hip and ankle muscles (d = -0.83 to -0.97). Conclusion Alterations in muscle activation and spatiotemporal parameters during gait in patients with EDS may be a result of impaired proprioception and balance and muscle weakness. Interventions should target these deficits.