Assessing satisfaction with social care services among black and minority ethnic and white British carers of stroke survivors in England

Overall satisfaction levels with social care are usually high but lower levels have been reported among black and minority ethnic (BME) service users in England. Reasons for this are poorly understood. This qualitative study therefore explored satisfaction with services among informal carer participants from five different ethnic groups. Fifty-seven carers (black Caribbean, black African, Asian Indian, Asian Pakistani and white British) were recruited from voluntary sector organisations and a local hospital in England, and took part in semi-structured interviews using cognitive interviewing and the critical incident technique. Interviews took place from summer 2013 to spring 2014. Thematic analysis of the interviews showed that participants often struggled to identify specific ‘incidents’, especially satisfactory ones. When describing satisfactory services, participants talked mostly about specific individuals and relationships. Unsatisfactory experiences centred on services overall. When rating services using cognitive interviewing, explicit comparisons with expectations or experiences with other services were common. Highest satisfaction ratings tended to be justified by positive personal characteristics among practitioners, trust and relationships. Lower level ratings were mostly explained by inconsistency in services, insufficient or poor care. Lowest level ratings were rare. Overall, few differences between ethnic groups were identified, although white British participants rated services higher overall giving more top ratings. White British participants also frequently took a more overall view of services, highlighting some concerns but still giving top ratings, while South Asian carers in particular focused on negative aspects of services. Together these methods provide insight into what participants mean by satisfactory and unsatisfactory services. Cognitive interviewing was more challenging for some BME participants, possibly a reflection of the meaningfulness of the concept of service satisfaction to them. Future research should include comparisons between BME and white participants’ understanding of the most positive parts of satisfaction scales and should focus on dissatisfied participants

Improving C2 Effectiveness Based on Robust Connectivity

This chapter describes an approach to develop an improved metric for network effectiveness through the use of Cares\u27 (2005) Information Age Combat Model (IACM) as a context for combat (or competition) between networked forces. The IACM highlights the inadequacy of commonly used quantifiable metrics with regards to comparing networks that differ only by the placement of a few links. An agent-based simulation is used to investigate the potential value of the Perron-Frobenius Eigenvalue (λPFE) as an indicator of network effectiveness. The results validate this assumption. Another measurement is proven to be equally important, namely the robustness of a configuration. Potential applications from the domain of ballistic missile defense are included to show operational relevance

Mode Bifurcation and Fold Points of Complex Dispersion Curves for the Metamaterial Goubau Line

In this paper the complex dispersion curves of the four lowest-order transverse magnetic modes of a dielectric Goubau line ($\epsilon>0, \mu>0$) are compared with those of a dispersive metamaterial Goubau line. The vastly different dispersion curve structure for the metamaterial Goubau line is characterized by unusual features such as mode bifurcation, complex fold points, both proper and improper complex modes, and merging of complex and real modes

Ablation debris control by means of closed thick film filtered water immersion

The performance of laser ablation generated debris control by means of open immersion techniques have been shown to be limited by flow surface ripple effects on the beam and the action of ablation plume pressure loss by splashing of the immersion fluid. To eradicate these issues a closed technique has been developed which ensured a controlled geometry for both the optical interfaces of the flowing liquid film. This had the action of preventing splashing, ensuring repeatable machining conditions and allowed for control of liquid flow velocity. To investigate the performance benefits of this closed immersion technique bisphenol A polycarbonate samples have been machined using filtered water at a number of flow velocities. The results demonstrate the efficacy of the closed immersion technique: a 93% decrease in debris is produced when machining under closed filtered water immersion; the average debris particle size becomes larger, with an equal proportion of small and medium sized debris being produced when laser machining under closed flowing filtered water immersion; large debris is shown to be displaced further by a given flow velocity than smaller debris, showing that the action of flow turbulence in the duct has more impact on smaller debris. Low flow velocities were found to be less effective at controlling the positional trend of deposition of laser ablation generated debris than high flow velocities; but, use of excessive flow velocities resulted in turbulence motivated deposition. This work is of interest to the laser micromachining community and may aide in the manufacture of 2.5D laser etched patterns covering large area wafers and could be applied to a range of wavelengths and laser types

The Ames Vertical Gun Range

The Ames Vertical Gun Range (AVGR) is a national facility for conducting laboratory- scale investigations of high-speed impact processes. It provides a set of light-gas, powder, and compressed gas guns capable of accelerating projectiles to speeds up to 7 km s(exp -1). The AVGR has a unique capability to vary the angle between the projectile-launch and gravity vectors between 0 and 90 deg. The target resides in a large chamber (diameter approximately 2.5 m) that can be held at vacuum or filled with an experiment-specific atmosphere. The chamber provides a number of viewing ports and feed-throughs for data, power, and fluids. Impacts are observed via high-speed digital cameras along with investigation-specific instrumentation, such as spectrometers. Use of the range is available via grant proposals through any Planetary Science Research Program element of the NASA Research Opportunities in Space and Earth Sciences (ROSES) calls. Exploratory experiments (one to two days) are additionally possible in order to develop a new proposal

“Struggling to stay connected”: comparing the social relationships of healthy older people and people with stroke and aphasia

Background: Having a stroke and aphasia can profoundly affect a person’s social relationships. Further, poor social support is associated with adverse post-stroke outcomes such as psychological distress, worse quality of life, and worse recovery. To date, no study has used complex measures of social network and perceived social support to compare stroke survivors with aphasia, without aphasia, and the general older population. A better understanding of which aspects of social support are most affected by stroke and aphasia may inform stroke services. Aims: To compare the social networks and perceived functional social support of people following a stroke, with and without aphasia, and healthy older adults. Methods & Procedures: Cross-sectional interview-based study. People with a first stroke were recruited from two acute stroke units and interviewed 6 months post onset. We recruited 60 stroke participants without aphasia, average age 69.8 (SD = 14.3), and 11 stroke participants with aphasia, average age 66.5 (SD = 13.7). One hundred and six healthy older adults were recruited via the community, average age 62.8 (SD = 9.5). All participants completed the Medical Outcomes Study Social Support Survey (SSS) and the Stroke Social Network Scale (SSNS). One-way independent groups ANOVAs were used to compare stroke participants with aphasia, stroke participants without aphasia, and healthy older adults. Outcomes & Results: After adjusting for multiple comparisons (p < .004), there was a significant difference on overall social network between the three groups (p < .001), with those with aphasia scoring significantly lower than healthy older adults (p < .001). The difference between healthy older adults and people with aphasia on the friends domain of the social network scale was also significant (p = .002). There was no significant difference between the three groups on overall perceived functional social support. Conclusions: People with aphasia have less diverse social networks than healthy older adults, with friendships particularly affected. Stroke services should monitor for social isolation, and consider ways to support people following a stroke in maintaining or establishing diverse social networks