Factors influencing the implementation of advanced midwife practitioners in healthcare settings: a qualitative study

Objective: To explore factors influencing the implementation of advanced midwife practitioner roles. Design: Semi-structured individual face-to-face and focus group interviews were conducted. Data analysis was performed using the Framework Method. Setting and participants: A purposive sample (n = 32) included chief nursing officers, middle managers, head midwives/nurses, primary care team leaders, midwives with and without advanced midwife practitioner roles, heads of midwifery educations, and obstetricians. Findings: Budgetary constraints on a governmental and healthcare organizational level were mentioned as main barriers for role implementation. The current fee-for-service financing model of healthcare professionals was also seen as an impediment. Obstetricians considered the implementation of advanced midwife practitioner roles as a possible financial and professional threat. Documenting the added value of advanced midwife practitioner roles was regarded a prerequisite for gaining support to implement such roles. Healthcare managers' and midwives' attitudes towards these roles were considered essential. Participants warned against automatically transferring the concept of advanced practice nursing to midwifery. Although participants seldom discussed population healthcare needs as a driver for implementation, healthcare organizations' heightened focus on quality improvement and client safety was seen as an opportunity for implementation. University hospitals were perceived as pioneers regarding advanced midwife practitioner roles. Key conclusions and implications for practice: Multiple factors influencing role implementation on a governmental, healthcare organizational, and workforce level illustrate the complexity of the implementation process, and highlight the need for a well-thought-out implementation plan involving all relevant stakeholders. Pilot projects for the implementation of advanced midwife practitioners in university hospitals might be useful

A mathematical model for unsteady mixed flows in closed water pipes

We present the formal derivation of a new unidirectional model for unsteady mixed flows in non uniform closed water pipe. In the case of free surface incompressible flows, the \FS-model is formally obtained, using formal asymptotic analysis, which is an extension to more classical shallow water models. In the same way, when the pipe is full, we propose the \Pres-model, which describes the evolution of a compressible inviscid flow, close to gas dynamics equations in a nozzle. In order to cope the transition between a free surface state and a pressured (i.e. compressible) state, we propose a mixed model, the \PFS-model, taking into account changes of section and slope variation

Tau Neutrinos in the Next Decade: from GeV to EeV

Tau neutrinos are the least studied particle in the Standard Model. Thiswhitepaper discusses the current and expected upcoming status of tau neutrinophysics with attention to the broad experimental and theoretical landscapespanning long-baseline, beam-dump, collider, and astrophysical experiments.This whitepaper was prepared as a part of the NuTau2021 Workshop.<br

The multiplicity of performance management systems:Heterogeneity in multinational corporations and management sense-making

This field study examines the workings of multiple performance measurement systems (PMSs) used within and between a division and Headquarters (HQ) of a large European corporation. We explore how multiple PMSs arose within the multinational corporation. We first provide a first‐order analysis which explains how managers make sense of the multiplicity and show how an organization's PMSs may be subject to competing processes for control that result in varied systems, all seemingly functioning, but with different rationales and effects. We then provide a second‐order analysis based on a sense‐making perspective that highlights the importance of retrospective understandings of the organization's history and the importance of various legitimacy expectations to different parts of the multinational. Finally, we emphasize the role of social skill in sense‐making that enables the persistence of multiple systems and the absence of overt tensions and conflict within organizations

The Power Board of the KM3NeT Digital Optical Module: design, upgrade, and production

The KM3NeT Collaboration is building an underwater neutrino observatory at the bottom of the Mediterranean Sea consisting of two neutrino telescopes, both composed of a three-dimensional array of light detectors, known as digital optical modules. Each digital optical module contains a set of 31 three inch photomultiplier tubes distributed over the surface of a 0.44 m diameter pressure-resistant glass sphere. The module includes also calibration instruments and electronics for power, readout and data acquisition. The power board was developed to supply power to all the elements of the digital optical module. The design of the power board began in 2013, and several prototypes were produced and tested. After an exhaustive validation process in various laboratories within the KM3NeT Collaboration, a mass production batch began, resulting in the construction of over 1200 power boards so far. These boards were integrated in the digital optical modules that have already been produced and deployed, 828 until October 2023. In 2017, an upgrade of the power board, to increase reliability and efficiency, was initiated. After the validation of a pre-production series, a production batch of 800 upgraded boards is currently underway. This paper describes the design, architecture, upgrade, validation, and production of the power board, including the reliability studies and tests conducted to ensure the safe operation at the bottom of the Mediterranean Sea throughout the observatory's lifespa

Prospects for combined analyses of hadronic emission from γ\gamma-ray sources in the Milky Way with CTA and KM3NeT

The Cherenkov Telescope Array and the KM3NeT neutrino telescopes are major upcoming facilities in the fields of $\gamma$-ray and neutrino astronomy, respectively. Possible simultaneous production of $\gamma$ rays and neutrinos in astrophysical accelerators of cosmic-ray nuclei motivates a combination of their data. We assess the potential of a combined analysis of CTA and KM3NeT data to determine the contribution of hadronic emission processes in known Galactic $\gamma$-ray emitters, comparing this result to the cases of two separate analyses. In doing so, we demonstrate the capability of Gammapy, an open-source software package for the analysis of $\gamma$-ray data, to also process data from neutrino telescopes. For a selection of prototypical $\gamma$-ray sources within our Galaxy, we obtain models for primary proton and electron spectra in the hadronic and leptonic emission scenario, respectively, by fitting published $\gamma$-ray spectra. Using these models and instrument response functions for both detectors, we employ the Gammapy package to generate pseudo data sets, where we assume 200 hours of CTA observations and 10 years of KM3NeT detector operation. We then apply a three-dimensional binned likelihood analysis to these data sets, separately for each instrument and jointly for both. We find that the largest benefit of the combined analysis lies in the possibility of a consistent modelling of the $\gamma$-ray and neutrino emission. Assuming a purely leptonic scenario as input, we obtain, for the most favourable source, an average expected 68% credible interval that constrains the contribution of hadronic processes to the observed $\gamma$-ray emission to below 15%.Comment: 18 pages, 15 figures. Submitted to journa

Untersuchung eines Einlaufmodells im Hyperschallkanal H2K des DLR

Die RWTH Aachen kooperiert im Rahmen eines Teilprojekts des DFG Sonderforschungsbereichs 253 mit dem DLR-Institut AS, Abteilung Windkanäle Köln-Porz. Inhalt der Aktivitäten sind Windkanaluntersuchungen an einem im Rahmen des Projekts vorgegebenen Einlaufsystem für das zukünftige Hyperschall-Raumflugzeug ELAC. Ziel ist es, unter Berücksichtigung viskoser Effekte wie Stoß/Grenzschicht-Wechselwirkungen, Grenzschichtablösung und Grenzschichttransition geeignete Maßnahmen zur Verbesserung der Einlaufgeometrie zu erarbeiten. Inhalt der Arbeit ist eine experimentelle Untersuchung der Einlaufströmung im Hyperschallwindkanal H2K an einem Einlaufmodell bei den Anströmmachzahlen 5,3 und 6,0. Das Windkanal-Modell wurde im Hinblick auf den Einsatz von Druck- und Infrarotmesstechnik ausgelegt. Die Seitenwände des Modells verfügen über Fenster zur schlierenoptischen Sichtbarmachung der Stoßlagen. Innerhalb des Windkanals wird das Einlaufmodell an eine Drossel angeschlossen, die den Gegendruck der Brennkammer simuliert und dabei den durchgesetzten Massenstrom misst. Im Rahmen der Arbeit wurden die Transitionslagen auf den Rampen sowie auftretende Wärmelasten mittels IR-Thermographie bestimmt. In Abhängigkeit des durch die Messdrossel erzeugten Gegendrucks wurde der durchgesetzte Massenstrom ermittelt, um damit die Güte des Einlaufs zu beurteilen. Die gewonnenen Messdaten sind zusammengestellt sowie vor dem Hintergrund aktueller Literatur interpretiert. Abschließend sind Emphelungen für eine verbesserte geometrische Einlaufgestaltung gegeben