1,009 research outputs found

    Sterile neutrinos in the Milky Way: Observational constraints

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    We consider the possibility of constraining decaying dark matter by looking out through the Milky Way halo. Specifically we use Chandra blank sky observations to constrain the parameter space of sterile neutrinos. We find that a broad band in parameter space is still open, leaving the sterile neutrino as an excellent dark matter candidate.Comment: Submitted to ApJL, 4 pages, 4 figure

    Impact of public release of performance data on the behaviour of healthcare consumers and providers.

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    BACKGROUND: It is becoming increasingly common to publish information about the quality and performance of healthcare organisations and individual professionals. However, we do not know how this information is used, or the extent to which such reporting leads to quality improvement by changing the behaviour of healthcare consumers, providers, and purchasers. OBJECTIVES: To estimate the effects of public release of performance data, from any source, on changing the healthcare utilisation behaviour of healthcare consumers, providers (professionals and organisations), and purchasers of care. In addition, we sought to estimate the effects on healthcare provider performance, patient outcomes, and staff morale. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, and two trials registers on 26 June 2017. We checked reference lists of all included studies to identify additional studies. SELECTION CRITERIA: We searched for randomised or non-randomised trials, interrupted time series, and controlled before-after studies of the effects of publicly releasing data regarding any aspect of the performance of healthcare organisations or professionals. Each study had to report at least one main outcome related to selecting or changing care. DATA COLLECTION AND ANALYSIS: Two review authors independently screened studies for eligibility and extracted data. For each study, we extracted data about the target groups (healthcare consumers, healthcare providers, and healthcare purchasers), performance data, main outcomes (choice of healthcare provider, and improvement by means of changes in care), and other outcomes (awareness, attitude, knowledge of performance data, and costs). Given the substantial degree of clinical and methodological heterogeneity between the studies, we presented the findings for each policy in a structured format, but did not undertake a meta-analysis. MAIN RESULTS: We included 12 studies that analysed data from more than 7570 providers (e.g. professionals and organisations), and a further 3,333,386 clinical encounters (e.g. patient referrals, prescriptions). We included four cluster-randomised trials, one cluster-non-randomised trial, six interrupted time series studies, and one controlled before-after study. Eight studies were undertaken in the USA, and one each in Canada, Korea, China, and The Netherlands. Four studies examined the effect of public release of performance data on consumer healthcare choices, and four on improving quality.There was low-certainty evidence that public release of performance data may make little or no difference to long-term healthcare utilisation by healthcare consumers (3 studies; 18,294 insurance plan beneficiaries), or providers (4 studies; 3,000,000 births, and 67 healthcare providers), or to provider performance (1 study; 82 providers). However, there was also low-certainty evidence to suggest that public release of performance data may slightly improve some patient outcomes (5 studies, 315,092 hospitalisations, and 7502 providers). There was low-certainty evidence from a single study to suggest that public release of performance data may have differential effects on disadvantaged populations. There was no evidence about effects on healthcare utilisation decisions by purchasers, or adverse effects. AUTHORS\u27 CONCLUSIONS: The existing evidence base is inadequate to directly inform policy and practice. Further studies should consider whether public release of performance data can improve patient outcomes, as well as healthcare processes

    Navigating collaborative open innovation projects:Staging negotiations of actors' concerns

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    Open innovation has attracted significant attention as companies respond to increasing innovative complexities by opening their organizational boundaries to interact with stakeholders along the innovation funnel. However, knowledge from customers and users is not always easily translated into solutions that can be commercialized. Micro-level challenges of open innovation projects that might be impeding commercialization remain under-explored in the literature. To address this research gap, we use a collaborative staging approach inspired by actor-network theory to focus on micro-level negotiations of actors' concerns at the project level. Analysing data collected via ethnographic research and participant observation in a longitudinal qualitative case study, we investigate how managers and designers navigated value creation and capture when conceptualizing an app for hospitalized stroke patients. Our findings reveal an action-oriented staging approach to collaborative open innovation efforts and selective enactment of business models depending on whether the focus is value capture or value creation. Furthermore, we point to a repertoire of staging moves that managers and designers can use to facilitate productive negotiations and network alignment as value creation opportunities co-evolve and to conceptualize value offers in collaborative open innovation processes

    Drawing a river:Utilizing the Power of Metaphors in Interviews With Children and Young People

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    In the field of qualitative health research on children, scholars have called for the inclusion of children’s perspectives. Still, health care research on children appears to be characterized by an exclusionary approach that stems from a conception of disability and sickness as equivalent to a lack of agency. This article responds to the call to include children’s perspectives. It presents the Double-view (Dovi)-river interview, which is a drawing- and metaphor-based interview method that enables ambiguous and multi-layered life course narratives. Based on two steps – (1) a life course interview conducted while drawing a river of the child’s life and (2) revisiting and unfolding the child’s stories – the method allows for an arts-based, joint exploration of life experiences. Inspired by childhood studies as well as a poststructuralist epistemology, the article discusses and proposes ways to challenge power relations between the adult interviewer and the child interviewee. It is argued that the method can also challenge the predominant deficit view and the dichotomous understanding of children’s experiences of their life and capabilities that characterize much health care practice and health research, by focusing both on challenges and opportunities. Doing so enables a more nuanced and appreciative approach to children. We draw on empirical examples from a study with children with disabilities. However, we suggest that the method’s potential for enabling articulation of the complex and ambiguous can inspire qualitative research and health care practice more broadly
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