Global digital image correlation up to very high temperatures with grey level corrections

International audienceThe characterisation of high temperature materials for extreme environment implies experimental challenges. Displacement measurements using Digital Image Correlation (DIC) have proven to be an efficient non-contact method even at high temperatures. This paper uses global DIC and grey level corrections to analyse very high temperature tests in which inversion of the grey level distribution may occur. The benefits of grey level corrections are shown on a coated ceramic matrix composite heated up to 1400°C. The inversion of the grey level distribution is then accounted for to study various ceramics subjected to temperatures up to 1860°C

Damage Mechanism of an Environmental Barrier Coated Ceramic Matrix Composite Under Thermal and Mechanical Loadings

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A systematic review of patient safety in mental health: a protocol based on the inpatient setting

BACKGROUND: Despite the growing international interest in patient safety as a discipline, there has been a lack of exploration of its application to mental health. It cannot be assumed that findings based upon physical health in acute care hospitals can be applied to mental health patients, disorders and settings. To the authors' knowledge, there has only been one review of the literature that focuses on patient safety research in mental health settings, conducted in Canada in 2008. We have identified a need to update this review and develop the methodology in order to strengthen the findings and disseminate internationally for advancement in the field. This systematic review will explore the existing research base on patient safety in mental health within the inpatient setting. METHODS: To conduct this systematic review, a thorough search across multiple databases will be undertaken, based upon four search facets ("mental health", "patient safety", "research" and "inpatient setting"). The search strategy has been developed based upon the Canadian review accompanied with input from the National Reporting and Learning System (NRLS) taxonomy of patient safety incidents and the Diagnostic and Statistical Manual of Mental Disorders (fifth edition). The screening process will involve perspectives from at least two researchers at all stages with a third researcher invited to review when discrepancies require resolution. Initial inclusion and exclusion criteria have been developed and will be refined iteratively throughout the process. Quality assessment and data extraction of included articles will be conducted by at least two researchers. A data extraction form will be developed, piloted and iterated as necessary in accordance with the research question. Extracted information will be analysed thematically. DISCUSSION: We believe that this systematic review will make a significant contribution to the advancement of patient safety in mental health inpatient settings. The findings will enable the development and implementation of interventions to improve the quality of care experienced by patients and support the identification of future research priorities. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42016034057

A systematic review of Patient Safety in Mental Health: a protocol based on the Inpatient Setting

Background Despite the growing international interest in patient safety as a discipline, there has been a lack of exploration of its application to mental health. It cannot be assumed that findings based upon physical health in acute care hospitals can be applied to mental health patients, disorders and settings. To the authors’ knowledge, there has only been one review of the literature that focuses on patient safety research in mental health settings, conducted in Canada in 2008. We have identified a need to update this review and develop the methodology in order to strengthen the findings and disseminate internationally for advancement in the field. This systematic review will explore the existing research base on patient safety in mental health within the inpatient setting. Methods To conduct this systematic review, a thorough search across multiple databases will be undertaken, based upon four search facets (“mental health”, “patient safety”, “research” and “inpatient setting”). The search strategy has been developed based upon the Canadian review accompanied with input from the National Reporting and Learning System (NRLS) taxonomy of patient safety incidents and the Diagnostic and Statistical Manual of Mental Disorders (5th edition). The screening process will involve perspectives from at least two researchers at all stages with a third researcher invited to review when discrepancies require resolution. Initial inclusion and exclusion criteria have been developed and will be refined iteratively throughout the process. Quality assessment and data extraction of included articles will be conducted by at least two researchers. A data extraction form will be developed, piloted and iterated as necessary in accordance with the research question. Extracted information will be analysed thematically. Discussion We believe that this systematic review will make a significant contribution to the advancement of patient safety in mental health inpatient settings. The findings will enable the development and implementation of interventions to improve the quality of care experienced by patients and support the identification of future research priorities. Registration This systematic review was registered to the PROSPERO database on the 15th February 2016 (registration number CRD42016034057) and updated on 26th April 2016

Barriers and facilitators to incident reporting in mental healthcare settings: a qualitative study

Introduction: Barriers and facilitators to incident reporting have been widely researched in general healthcare. However, it is unclear if the findings are applicable to mental healthcare where care is increasingly complex. // Aim: To investigate if barriers and facilitators affecting incident reporting in mental healthcare are consistent with factors identified in other healthcare settings. // Method: Data were collected from focus groups (n=8) with 52 members of staff from across West London Trust and analysed with thematic analysis. Results: Five themes were identified during the analysis. Three themes (i)learning and improvement, (ii)time, and (iii)fear were consistent with the existing wider literature on barriers and facilitators to incident reporting. Two further themes (iv)interaction between patient diagnosis and incidents and (v)aftermath of an incident – prosecution specifically linked to the provision of mental healthcare. // Conclusions: Whilst some barriers and facilitators to incident reporting identified in other settings are also prevalent in the mental healthcare setting, the increased incidence of violent and aggressive behaviour within mental healthcare presents a unique challenge for incident reporting. // Clinical Implications: Although Interventions to improve incident reporting may be adapted/adopted from other settings, there is a need to develop specific interventions to improve reporting of violent and aggressive incidents

Patient safety in inpatient mental health settings: a systematic review.

OBJECTIVES: Patients in inpatient mental health settings face similar risks (eg, medication errors) to those in other areas of healthcare. In addition, some unsafe behaviours associated with serious mental health problems (eg, self-harm), and the measures taken to address these (eg, restraint), may result in further risks to patient safety. The objective of this review is to identify and synthesise the literature on patient safety within inpatient mental health settings using robust systematic methodology. DESIGN: Systematic review and meta-synthesis. Embase, Cumulative Index to Nursing and Allied Health Literature, Health Management Information Consortium, MEDLINE, PsycINFO and Web of Science were systematically searched from 1999 to 2019. Search terms were related to 'mental health', 'patient safety', 'inpatient setting' and 'research'. Study quality was assessed using the Hawker checklist. Data were extracted and grouped based on study focus and outcome. Safety incidents were meta-analysed where possible using a random-effects model. RESULTS: Of the 57 637 article titles and abstracts, 364 met inclusion criteria. Included publications came from 31 countries and included data from over 150 000 participants. Study quality varied and statistical heterogeneity was high. Ten research categories were identified: interpersonal violence, coercive interventions, safety culture, harm to self, safety of the physical environment, medication safety, unauthorised leave, clinical decision making, falls and infection prevention and control. CONCLUSIONS: Patient safety in inpatient mental health settings is under-researched in comparison to other non-mental health inpatient settings. Findings demonstrate that inpatient mental health settings pose unique challenges for patient safety, which require investment in research, policy development, and translation into clinical practice. PROSPERO REGISTRATION NUMBER: CRD42016034057

Barriers and facilitators to incident reporting in mental healthcare settings: a qualitative study

INTRODUCTION: Barriers and facilitators to incident reporting have been widely researched in general healthcare. However, it is unclear if the findings are applicable to mental healthcare where care is increasingly complex. AIM: To investigate if barriers and facilitators affecting incident reporting in mental healthcare are consistent with factors identified in other healthcare settings. METHOD: Data were collected from focus groups (n=8) with 52 members of staff from across [a large Mental Health] Trust and analysed with thematic analysis. RESULTS: Five themes were identified during the analysis. Three themes (i)learning and improvement, (ii)time, and (iii)fear were consistent with the existing wider literature on barriers and facilitators to incident reporting. Two further themes (iv)interaction between patient diagnosis and incidents and (v)aftermath of an incident - prosecution specifically linked to the provision of mental healthcare. CONCLUSIONS: Whilst some barriers and facilitators to incident reporting identified in other settings are also prevalent in the mental healthcare setting, the increased incidence of violent and aggressive behaviour within mental healthcare presents a unique challenge for incident reporting. CLINICAL IMPLICATIONS: Although Interventions to improve incident reporting may be adapted/adopted from other settings, there is a need to develop specific interventions to improve reporting of violent and aggressive incidents

Increased transmissibility and global spread of SARS-CoV-2 variants of concern as at June 2021.

We present a global analysis of the spread of recently emerged SARS-CoV-2 variants and estimate changes in effective reproduction numbers at country-specific level using sequence data from GISAID. Nearly all investigated countries demonstrated rapid replacement of previously circulating lineages by the World Health Organization-designated variants of concern, with estimated transmissibility increases of 29% (95% CI: 24-33), 25% (95% CI: 20-30), 38% (95% CI: 29-48) and 97% (95% CI: 76-117), respectively, for B.1.1.7, B.1.351, P.1 and B.1.617.2

Thermomechanical behavior of an environmental barrier coated ceramic matrix composite under thermal gradients

L’introduction des composites à matrice céramique (CMC) dans les turbines haute pression est un des enjeux de la prochaine génération des moteurs d’avion civil. L’environnement thermomécanique et physico-chimique extrême dans lequel évoluent ces pièces nécessite l’ajout d’un revêtement jouant le rôle de barrière thermique et environnementale, en particulier pour éviter les phénomènes de récession de surface du SiC. Dans ce contexte, cette étude a consisté à caractériser et modéliser le comportement thermomécanique du système CMC-revêtement dans un environnement thermique représentatif des conditions d’utilisation afin d’identifier les mécanismes d’endommagement pouvant impacter la durée de vie du système. La première partie du travail propose la mise en place d’un essai avec un laser permettant l’utilisation de différentes instrumentations, à très hautes températures (>1300°C), basées sur des mesures de champs par thermographie infrarouge et corrélation d’images numériques et/ou la détection d’endommagement. La seconde partie du travail présente l’étude du faïençage thermique d’un revêtement grâce aux observations expérimentales et à un modèle par éléments finis du système, alimentée par l’identification du comportement thermomécanique non linéaire du revêtement.The introduction of ceramic matrix composites (CMCs) in high pressure turbines is one of the challenges of the next generation of civil aircraft engines. The extreme thermomechanical and physicochemical environment in which these parts evolve requires the addition of a coating acting as a thermal and environmental barrier, in particular to avoid surface recession phenomena of SiC. In this context, this study consisted in characterizing and modeling the thermomechanical behavior of the CMC-coating system in a thermal environment representative of the conditions of use in order to identify the mechanisms of damage that could impact the life of the system. The first part of the work proposes the implementation of a test with a laser allowing for the use of different diagnostics, at very high temperatures (> 1300°C), based on full-field measurements by infrared thermography and digital image correlation, and / or the detection of damage. The second part of the work presents the study of thermal cracking of a coating using experimental observations and a finite element model of the system, using the calibration of the nonlinear thermomechanical behavior of the coating

Identifying research priorities for patient safety in mental health: an international expert Delphi study

Objective Physical healthcare has dominated the patient safety field; research in mental healthcare is not as extensive but findings from physical healthcare cannot be applied to mental healthcare because it delivers specialised care that faces unique challenges. Therefore, a clearer focus and recognition of patient safety in mental health as a distinct research area is still needed. The study aim is to identify future research priorities in the field of patient safety in mental health. Design Semistructured interviews were conducted with the experts to ascertain their views on research priorities in patient safety in mental health. A three-round online Delphi study was used to ascertain consensus on 117 research priority statements. Setting and participants Academic and service user experts from the USA, UK, Switzerland, Netherlands, Ireland, Denmark, Finland, Germany, Sweden, Australia, New Zealand and Singapore were included. Main outcome measures Agreement in research priorities on a five-point scale. Results Seventy-nine statements achieved consensus (>70%). Three out of the top six research priorities were patient driven; experts agreed that understanding the patient perspective on safety planning, on self-harm and on medication was important. Conclusions This is the first international Delphi study to identify research priorities in safety in the mental field as determined by expert academic and service user perspectives. A reasonable consensus was obtained from international perspectives on future research priorities in patient safety in mental health; however, the patient perspective on their mental healthcare is a priority. The research agenda for patient safety in mental health identified here should be informed by patient safety science more broadly and used to further establish this area as a priority in its own right. The safety of mental health patients must have parity with that of physical health patients to achieve this