Patients as Reviewers of Quality and Safety.

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The development of a new measure of quality of life for children with congenital cardiac disease

The purpose of the study was to develop a questionnaire measuring health-related R1 quality of life for children and adolescents with congenital heart disease, the ConQol, that would have both clinical and research applications. We describe here the process of construction of a questionnaire, the piloting and the development of a weighted scoring system, and data on the psychometric performance of the measure in a sample of 640 children and young people recruited via 6 regional centres for paediatric cardiology from across the United Kingdom. The ConQol has two versions, one designed for children aged from 8 to 11 years, and the other for young people aged from 12 to 16 years. Initial findings suggest that it is a valid and reliable instrument, is acceptable to respondents, and is simple to administer in both a research and clinical context

Surface nanoscale axial photonics: Robust fabrication of high quality factor microresonators

Recently introduced Surface Nanoscale Axial Photonics (SNAP) makes it possible to fabricate high Q-factor microresonators and other photonic microdevices by dramatically small deformation of the optical fiber surface. To become a practical and robust technology, the SNAP platform requires methods enabling reproducible modification of the optical fiber radius at nanoscale. In this Letter, we demonstrate super-accurate fabrication of high Q-factor microresonators by nanoscale modification of the optical fiber radius and refractive index using the CO2 laser and the UV excimer laser beam exposures. The achieved fabrication accuracy is better than 2 angstroms in variation of the effective fiber radius

Partners At Care Transitions (PACT). Exploring older peoples’ experiences of transitioning from hospital to home in the UK: protocol for an observation and interview study of older people and their families to understand patient experience and involvement in care at transitions

Introduction: Lengths of hospital inpatient stays have reduced. This benefits patients, who prefer to be at home, and hospitals, which can treat more people when stays are shorter. Patients may, however, leave hospital sicker, with ongoing care needs. The transition period from hospital to home, can be risky, particularly for older patients with complex health and social needs. Improving patient experience, especially through greater patient involvement, may improve outcomes for patients and is a key indicator of care quality and safety. In this research we aim to: capture the experiences of older patients and their families during the transition from hospital to home; and identify opportunities for greater patient involvement in care, particularly where this contributes to greater individual- and organisational-level resilience. Methods and Analysis: A ‘focused ethnography’ comprising observations, ‘Go-Along’ and semi-structured interviews will be used to capture patient and carer experiences during different points in the care transition from admission to 90 days after discharge. We will recruit 30 patients and their carers from six hospital departments across two NHS Trusts. Analysis of observations and interviews will use a Framework approach to identify themes to understand the experience of transitions and generate ideas about how patients could be more actively involved in their care. This will include exploring what ‘good’ care at transitions look like and seeking out examples of success, as well as recommendations for improvement. Ethics and dissemination: Ethical approval was received from the NHS Research Ethics Committee in Wales. The research findings will add to a growing body of knowledge about patient experience of transitions, in particular providing insight into the experiences of patients and carers throughout the transitions process, in ‘real time’. Importantly, the data will be used to inform the development of a patient-centred intervention to improve the quality and safety of transitions

Grounded theory research: A design framework for novice researchers

Background: Grounded theory is a well-known methodology employed in many research studies. Qualitative andquantitative data generation techniques can be used in a grounded theory study. Grounded theory sets out to discoveror construct theory from data, systematically obtained and analysed using comparative analysis. While grounded theoryis inherently flexible, it is a complex methodology. Thus, novice researchers strive to understand the discourse and thepractical application of grounded theory concepts and processes.Objective: The aim of this article is to provide a contemporary research framework suitable to inform a grounded theorystudy.Result: This article provides an overview of grounded theory illustrated through a graphic representation of the processesand methods employed in conducting research using this methodology. The framework is presented as a diagrammaticrepresentation of a research design and acts as a visual guide for the novice grounded theory researcher.Discussion: As grounded theory is not a linear process, the framework illustrates the interplay between the essentialgrounded theory methods and iterative and comparative actions involved. Each of the essential methods and processes thatunderpin grounded theory are defined in this article.Conclusion: Rather than an engagement in philosophical discussion or a debate of the different genres that can be used ingrounded theory, this article illustrates how a framework for a research study design can be used to guide and inform thenovice nurse researcher undertaking a study using grounded theory. Research findings and recommendations can contributeto policy or knowledge development, service provision and can reform thinking to initiate change in the substantive area ofinquiry

Fluorescence Efficiency and Visible Re-emission Spectrum of Tetraphenyl Butadiene Films at Extreme Ultraviolet Wavelengths

A large number of current and future experiments in neutrino and dark matter detection use the scintillation light from noble elements as a mechanism for measuring energy deposition. The scintillation light from these elements is produced in the extreme ultraviolet (EUV) range, from 60 - 200 nm. Currently, the most practical technique for observing light at these wavelengths is to surround the scintillation volume with a thin film of Tetraphenyl Butadiene (TPB) to act as a fluor. The TPB film absorbs EUV photons and reemits visible photons, detectable with a variety of commercial photosensors. Here we present a measurement of the re-emission spectrum of TPB films when illuminated with 128, 160, 175, and 250 nm light. We also measure the fluorescence efficiency as a function of incident wavelength from 120 to 250 nm.Comment: 15 pages, 9 figures, Submitted to Nuclear Instruments and Methods in Physics Research Section A: Accelerators, Spectrometers, Detectors and Associated Equipmen

An early Little Ice Age brackish water invasion along the south coast of the Caspian Sea (sediment of Langarud wetland) and its wider impacts on environment and people

Caspian Sea level has undergone significant changes through time with major impacts not only on the surrounding coasts, but also offshore. This study reports a brackish water invasion on the southern coast of the Caspian Sea constructed from a multi-proxy analysis of sediment retrieved from the Langarud wetland. The ground surface level of wetland is >6 m higher than the current Caspian Sea level (at -27.41 m in 2014) and located >11 km far from the coast. A sequence covering the last millennium was dated by three radiocarbon dates. The results from this new study suggest that Caspian Sea level rose up to at least -21.44 m (i.e. >6 m above the present water level) during the early Little Ice Age. Although previous studies in the southern coast of the Caspian Sea have detected a high-stand during the Little Ice Age period, this study presents the first evidence that this high-stand reached so far inland and at such a high altitude. Moreover, it confirms one of the very few earlier estimates of a high-stand at -21 m for the second half of the 14th century. The effects of this large-scale brackish water invasion on soil properties would have caused severe disruption to regional agriculture, thereby destabilizing local dynasties and facilitating a rapid Turko-Mongol expansion of Tamerlane’s armies from the east.N Ghasemi (INIOAS), V Jahani (Gilan Province Cultural Heritage and Tourism Organisation) and A Naqinezhad (University of Mazandaran), INQUA QuickLakeH project (no. 1227) and to the European project Marie Curie, CLIMSEAS-PIRSES-GA-2009-24751