Healthcare services managers: what information do they need and use?

Objectives: To gain insight into the information behaviour of healthcare services managers as they draw on information while engaged in decision making unrelated to individual patient care. Objectives – The purpose of this research project was to gain insight into the information behaviour of healthcare services managers as they use information while engaged in decision-making unrelated to individual patient care. Methods – This small-scale, exploratory, multiple case study used the critical incident technique in nineteen semi-structured interviews. Responses were analyzed using ‘Framework,’ a matrix-based content analysis system. Results – This paper presents findings related to the internal information that healthcare services managers need and use. Their decisions are influenced by a wide variety of factors. They must often make decisions without all of the information they would prefer to have. Internal information and practical experience set the context for new research-based information, so they are generally considered first. Conclusions – Healthcare services managers support decisions with both facts and value-based information. These results may inform both delivery of health library services delivery and strategic health information management planning. They may also support librarians who extend their skills beyond managing library collections and teaching published information retrieval skills, to managing internal and external information, teaching information literacy, and supporting information sharing

Reaching health service managers with research

Introduction. The aim of this paper is to identify and characterize the routes by which research may reach health service managers to influence their critical decisions. Method.This research used two series of qualitative interviews, documentary analysis (a calendar study) and a card-sorting exercise to explore the workplace information practices of thirty-six health service managers. Analysis. Both interview studies used the cross-case analysis. The second interview study also used within-case analysis in the form of information transaction mapping. Information transactions, calendar study and card-sorting exercise data were reported quantitatively. Results. This exploratory study found that these health service managers overcame short time lines, unclear processes and simultaneous conflicting priorities by bringing together groups accustomed to sharing information orally to inform their critical decisions. Each decision was informed by different categories and types of information. Group decisions allowed information from multiple sources, including research, to be integrated until there was just enough for a comfortable decision. Research reached these managers through one or more of at least eight different routes. Conclusions. Professional standards, conferences, structurally positioned gatekeepers (knowledgeable co-workers in positions related to the critical decision subject) and other information sources that appraise and filter research then blend it with local context are preferred over research papers that must be searched, read, appraised and then integrated with other information types. Eight routes by which research reaches health services managers are compared with seven elements in a research-to-policy conceptual framework

The influence of phosphatidylserine localisation and lipid phase on membrane remodelling by the ESCRT-II/ESCRT-III complex

The endosomal sorting complex required for transport (ESCRT) organises in supramolecular structures on the surface of lipid bilayers to drive membrane invagination and scission of intraluminal vesicles (ILVs), a process also controlled by membrane mechanics. However, ESCRT association with the membrane is also mediated by electrostatic interactions with anionic phospholipids. Phospholipid distribution within natural biomembranes is inhomogeneous due to, for example, the formation of lipid rafts and curvature-driven lipid sorting. Here, we have used phase-separated giant unilamellar vesicles (GUVs) to investigate the link between phosphatidylserine (PS)-rich lipid domains and ESCRT activity. We employ GUVs composed of phase separating lipid mixtures, where unsaturated DOPS and saturated DPPS lipids are incorporated individually or simultaneously to enhance PS localisation in liquid disordered (Ld) and/or liquid ordered (Lo) domains, respectively. PS partitioning between the coexisting phases is confirmed by a fluorescent Annexin V probe. Ultimately, we find that ILV generation promoted by ESCRTs is significantly enhanced when PS lipids localise within Ld domains. However, the ILVs that form are rich in Lo lipids. We interpret this surprising observation as preferential recruitment of the Lo phase beneath the ESCRT complex due to its increased rigidity, where the Ld phase is favoured in the neck of the resultant buds to facilitate the high membrane curvature in these regions of the membrane during the ILV formation process. Ld domains offer lower resistance to membrane bending, demonstrating a mechanism by which the composition and mechanics of membranes can be coupled to regulate the location and efficiency of ESCRT activity

Determining the economic costs and benefits of conservation actions: A decision support framework

The need for conservation action to be cost-effective is widely accepted, resulting in increased interest and effort to assess effectiveness. Assessing the financial and economic costs of conservation is equally important for assessing cost-effectiveness, yet their measurement and assessment are repeatedly identified as lacking. The healthcare sector, in contrast, has made substantial progress in identifying and including costs in decision-making. Here, we consider what conservation can learn from this experience. We present a three-step framework for identifying and recording the relevant economic costs and benefits of conservation interventions where the user (1) describes the costing context, (2) determines which types of cost and benefit to include, and (3) obtains values for these costs and benefits alongside metadata necessary for others to interpret the data. This framework is designed to help estimate economic costs but can also be used flexibly to record the direct costs of interventions (i.e., financial costs) and calculate financial and economic benefits. Although recording data on economic costs and benefits is deceptively complex, this framework facilitates improved recording, and indicates how collating this data could enhance the assessment of cost-effectiveness across conservation contexts using a range of decision-making tools. © 2022 The Authors. Conservation Science and Practice published by Wiley Periodicals LLC on behalf of Society for ConservationWe thank Alec Christie, Ashley Simkins, and Anthony Waldron for helpful discussions and Arcadia, MAVA, and the David and Claudia Harding Foundation for funding. We thank two anonymous reviewers, and Gwen Iacona for detailed comments that helped improve the manuscript. The work was completed by Thomas White as part of a PhD supported by a Balfour studentship at the Department of Zoology, University of Cambridge

The influence of phosphatidylserine localisation and lipid phase on membrane remodelling by the ESCRT-II/ESCRT-III complex

The endosomal sorting complex required for transport (ESCRT) organises in supramolecular structures on the surface of lipid bilayers to drive membrane invagination and scission of intraluminal vesicles (ILVs), a process also controlled by membrane mechanics. However, ESCRT association with the membrane is also mediated by electrostatic interactions with anionic phospholipids. Phospholipid distribution within natural biomembranes is inhomogeneous due to, for example, the formation of lipid rafts and curvature-driven lipid sorting. Here, we have used phase-separated giant unilamellar vesicles (GUVs) to investigate the link between phosphatidylserine (PS)-rich lipid domains and ESCRT activity. We employ GUVs composed of phase separating lipid mixtures, where unsaturated DOPS and saturated DPPS lipids are incorporated individually or simultaneously to enhance PS localisation in liquid disordered (Ld) and/or liquid ordered (Lo) domains, respectively. PS partitioning between the coexisting phases is confirmed by a fluorescent Annexin V probe. Ultimately, we find that ILV generation promoted by ESCRTs is significantly enhanced when PS lipids localise within Ld domains. However, the ILVs that form are rich in Lo lipids. We interpret this surprising observation as preferential recruitment of the Lo phase beneath the ESCRT complex due to its increased rigidity, where the Ld phase is favoured in the neck of the resultant buds to facilitate the high membrane curvature in these regions of the membrane during the ILV formation process. Ld domains offer lower resistance to membrane bending, demonstrating a mechanism by which the composition and mechanics of membranes can be coupled to regulate the location and efficiency of ESCRT activity

Counter-propagating entangled photons from a waveguide with periodic nonlinearity

The conditions required for spontaneous parametric down-conversion in a waveguide with periodic nonlinearity in the presence of an unguided pump field are established. Control of the periodic nonlinearity and the physical properties of the waveguide permits the quasi-phase matching equations that describe counter-propagating guided signal and idler beams to be satisfied. We compare the tuning curves and spectral properties of such counter-propagating beams to those for co-propagating beams under typical experimental conditions. We find that the counter-propagating beams exhibit narrow bandwidth permitting the generation of quantum states that possess discrete-frequency entanglement. Such states may be useful for experiments in quantum optics and technologies that benefit from frequency entanglement.Comment: submitted to Phys. Rev.

Pion photoproduction on the nucleon in the quark model

We present a detailed quark-model study of pion photoproduction within the effective Lagrangian approach. Cross sections and single-polarization observables are investigated for the four charge channels, $\gamma p\to \pi^+ n$, $\gamma n\to \pi^- p$, $\gamma p\to \pi^0 p$, and $\gamma n\to \pi^0 n$. Leaving the $\pi N\Delta$ coupling strength to be a free parameter, we obtain a reasonably consistent description of these four channels from threshold to the first resonance region. Within this effective Lagrangian approach, strongly constrainted by the quark model, we consider the issue of double-counting which may occur if additional {\it t}-channel contributions are included.Comment: Revtex, 35 pages, 16 eps figures; version to appear on PR

Large-angle production of charged pions by 3 GeV/c - 12.9 GeV/c protons on beryllium, aluminium and lead targets

Measurements of the double-differential $\pi^{\pm}$ production cross-section in the range of momentum 100 \MeVc \leq p < 800 \MeVc and angle 0.35 \rad \leq \theta < 2.15 \rad in proton--beryllium, proton--aluminium and proton--lead collisions are presented. The data were taken with the HARP detector in the T9 beam line of the CERN PS. The pions were produced by proton beams in a momentum range from 3 \GeVc to 12.9 \GeVc hitting a target with a thickness of 5% of a nuclear interaction length. The tracking and identification of the produced particles was performed using a small-radius cylindrical time projection chamber (TPC) placed inside a solenoidal magnet. Incident particles were identified by an elaborate system of beam detectors. Results are obtained for the double-differential cross-sections at six incident proton beam momenta (3 \GeVc, 5 \GeVc, 8 \GeVc, 8.9 \GeVc (Be only), 12 \GeVc and 12.9 \GeVc (Al only)) and compared to previously available data

Effective Lagrangian Approach to the Theory of Eta Photoproduction in the N∗(1535)N^{*}(1535) Region

We investigate eta photoproduction in the $N^{*}(1535)$ resonance region within the effective Lagrangian approach (ELA), wherein leading contributions to the amplitude at the tree level are taken into account. These include the nucleon Born terms and the leading $t$-channel vector meson exchanges as the non-resonant pieces. In addition, we consider five resonance contributions in the $s$- and $u$- channel; besides the dominant $N^{*}(1535)$, these are: $N^{*}(1440),N^{*}(1520),N^{*}(1650)$ and $N^{*}(1710)$. The amplitudes for the $\pi^\circ$ and the $\eta$ photoproduction near threshold have significant differences, even as they share common contributions, such as those of the nucleon Born terms. Among these differences, the contribution to the $\eta$ photoproduction of the $s$-channel excitation of the $N^{*}(1535)$ is the most significant. We find the off-shell properties of the spin-3/2 resonances to be important in determining the background contributions. Fitting our effective amplitude to the available data base allows us to extract the quantity $\sqrt{\chi \Gamma_\eta} A_{1/2}/\Gamma_T$, characteristic of the photoexcitation of the $N^{*}(1535)$ resonance and its decay into the $\eta$-nucleon channel, of interest to precise tests of hadron models. At the photon point, we determine it to be $(2.2\pm 0.2)\times 10^{-1} GeV^{-1}$ from the old data base, and $(2.2\pm 0.1) \times 10^{-1} GeV^{-1}$ from a combination of old data base and new Bates data. We obtain the helicity amplitude for $N^{*}(1535)\rightarrow \gamma p$ to be $A_{1/2}=(97\pm 7)\times 10^{-3} GeV^{-1/2}$ from the old data base, and $A_{1/2}=(97\pm 6)\times 10^{-3} GeV^{-1/2}$ from the combination of the old data base and new Bates data, compared with the results of the analysis of pion photoproduction yielding $74\pm 11$, in the same units.Comment: 43 pages, RevTeX, 9 figures available upon request, to appear in Phys. Rev.