Barriers and Facilitators of Safe Communication in Obstetrics: Results from Qualitative Interviews with Physicians, Midwives and Nurses.

Patient safety is an important objective in health care. Preventable adverse events (pAEs) as the counterpart to patient safety are harmful incidents that fell behind health care standards and have led to temporary or permanent harm or death. As safe communication and mutual understanding are of crucial importance for providing a high quality of care under everyday conditions, we aimed to identify barriers and facilitators that impact safe communication in obstetrics from the subjective perspective of health care workers. A qualitative study with 20 semi-structured interviews at two university hospitals in Germany was conducted to explore everyday perceptions from a subjective perspective (subjective theories). Physicians, midwives, and nurses in a wide span of professional experience and positions were enrolled. We identified a structural area of conflict at the professional interface between midwives and physicians. Mandatory interprofessional meetings, acceptance of subjective mistakes, mutual understanding, and debriefings of conflict situations are reported to improve collaboration. Additionally, emergency trainings, trainings in precise communication, and handovers are proposed to reduce risks for pAEs. Furthermore, the participants reported time-constraints and understaffing as a huge burden that hinders safe communication. Concluding, safety culture and organizational management are closely entwined and strategies should address various levels of which communication trainings are promising

Hybrid administrative interfaces : authority delegation and reversion in strategic alliances

Steering committees are pivotal for governing complex collaborations by consensus to facilitate coordination and knowledge sharing. Although consensus-based governance promotes mutuality, it can also cause deadlocks, stalling expeditious decision making. We examine the conditions under which alliance partners delegate decision-making authority to steering committees as well as the conditions under which authority over discordant matters can be relocated to one of the alliance partners. We argue that joint coordination concerns increase the likelihood of authority delegation, whereas the higher costs and stakes associated with decision stalemates provide grounds for authority reversion. Empirical analyses of strategic alliances in the biopharmaceutical industry support our arguments. Our paper demonstrates the versatility of contractually defined administrative interfaces in alliance governance, allowing partners to coordinate bilaterally and adapt hierarchically as and when required

Nonequilibrium coupled Brownian phase oscillators

A model of globally coupled phase oscillators under equilibrium (driven by Gaussian white noise) and nonequilibrium (driven by symmetric dichotomic fluctuations) is studied. For the equilibrium system, the mean-field state equation takes a simple form and the stability of its solution is examined in the full space of order parameters. For the nonequilbrium system, various asymptotic regimes are obtained in a closed analytical form. In a general case, the corresponding master equations are solved numerically. Moreover, the Monte-Carlo simulations of the coupled set of Langevin equations of motion is performed. The phase diagram of the nonequilibrium system is presented. For the long time limit, we have found four regimes. Three of them can be obtained from the mean-field theory. One of them, the oscillating regime, cannot be predicted by the mean-field method and has been detected in the Monte-Carlo numerical experiments.Comment: 9 pages 8 figure

Mesoscopic Aharonov-Bohm oscillations in metallic rings

We study the amplitude of mesoscopic Aharonov-Bohm oscillations in quasi-one-dimensional (Q1D) diffusive rings. We consider first the low-temperature limit of a fully coherent sample. The variance of oscillation harmonics is calculated as a function of the length of the leads attaching the ring to reservoirs. We further analyze the regime of relatively high temperatures, when the dephasing due to electron-electron interaction suppresses substantially the oscillations. We show that the dephasing length L_phi^AB governing the damping factor exp(-2pi R /L_phi^AB) of the oscillations is parametrically different from the common dephasing length for the Q1D geometry. This is due to the fact that the dephasing is governed by energy transfers determined by the ring circumference 2pi R, making L_phi^AB R-dependent.Comment: 16 pages, 4 figures, to appear in proceedings of NATO/Euresco Conference "Fundamental Problems of Mesoscopic Physics: Interactions and Decoherence", Granada (Spain), September 200

Non-equilibrium electronic transport and interaction in short metallic nanobridges

We have observed interaction effects in the differential conductance $G$ of short, disordered metal bridges in a well-controlled non-equilibrium situation, where the distribution function has a double Fermi step. A logarithmic scaling law is found both for the temperature and for the voltage dependence of $G$ in all samples. The absence of magnetic field dependence and the low dimensionality of our samples allow us to distinguish between several possible interaction effects, proposed recently in nanoscopic samples. The universal scaling curve is explained quantitatively by the theory of electron-electron interaction in diffusive metals, adapted to the present case, where the sample size is smaller than the thermal diffusion length.Comment: Published version, 6 Pages, 6 postscript figures, 1 tabl

Classification of one-dimensional quasilattices into mutual local-derivability classes

One-dimensional quasilattices are classified into mutual local-derivability (MLD) classes on the basis of geometrical and number-theoretical considerations. Most quasilattices are ternary, and there exist an infinite number of MLD classes. Every MLD class has a finite number of quasilattices with inflation symmetries. We can choose one of them as the representative of the MLD class, and other members are given as decorations of the representative. Several MLD classes of particular importance are listed. The symmetry-preserving decorations rules are investigated extensively.Comment: 42 pages, latex, 5 eps figures, Published in JPS

Antiferromagnetic interlayer exchange coupling across an amorphous metallic spacer layer

By means of magneto-optical Kerr effect we observe for the first time antiferromagnetic coupling between ferromagnetic layers across an amorphous metallic spacer layer. Biquadratic coupling occurs at the transition from a ferromagnetically to an antiferromagnetically coupled region. Scanning tunneling microscopy images of all involved layers are used to extract thickness fluctuations and to verify the amorphous state of the spacer. The observed antiferromagnetic coupling behavior is explained by RKKY interaction taking into account the amorphous structure of the spacer material.Comment: Typset using RevTex, 4 pages with 4 figures (.eps

The Effects of an AGN on Host Galaxy Colour and Morphology Measurements

We assess the effects of simulated active galactic nuclei (AGNs) on the colour and morphology measurements of their host galaxies. To test the morphology measurements, we select a sample of galaxies not known to host AGNs and add a series of point sources scaled to represent specified fractions of the observed V band light detected from the resulting systems; we then compare morphology measurements of the simulated systems to measurements of the original galaxies. AGN contributions >20 per cent bias most of the morphology measurements tested, though the extent of the apparent bias depends on the morphological characteristics of the original galaxies. We test colour measurements by adding to non-AGN galaxy spectra a quasar spectrum scaled to contribute specified fractions of the rest-frame B band light detected from the resulting systems. A quasar fraction of 5 per cent can move the NUV-r colour of an elliptical galaxy from the UV-optical red sequence to the green valley, and 20 per cent can move it into the blue cloud. Combining the colour and morphology results, we find that a galaxy/AGN system with an AGN contribution >20 per cent may appear bluer and more bulge-dominated than the underlying galaxy. We conclude that (1) bulge-dominated, E/S0/Sa, and early-type morphology classifications are accurate for red AGN host galaxies and may be accurate for blue host galaxies, unless the AGN manifests itself as a well-defined point source; and (2) although highly unobscured AGNs, such as the quasar used for our experiments, can significantly bias the measured colours of AGN host galaxies, it is possible to identify such systems by examining optical images of the hosts for the presence of a point source and/or measuring the level of nuclear obscuration.Comment: 18 pages, 19 figures, 1 table. Accepted for publication in MNRA

CANDELS Observations of the Structural Properties and Evolution of Galaxies in a Cluster at z=1.62

We discuss the structural and morphological properties of galaxies in a z=1.62 proto-cluster using near-IR imaging data from Hubble Space Telescope Wide Field Camera 3 data of the Cosmic Assembly Near-IR Deep Extragalactic Legacy Survey (CANDELS). The cluster galaxies exhibit a clear color-morphology relation: galaxies with colors of quiescent stellar populations generally have morphologies consistent with spheroids, and galaxies with colors consistent with ongoing star formation have disk-like and irregular morphologies. The size distribution of the quiescent cluster galaxies shows a deficit of compact (< 1kpc), massive galaxies compared to CANDELS field galaxies at z=1.6. As a result the cluster quiescent galaxies have larger average effective sizes compared to field galaxies at fixed mass at greater than 90% significance. Combined with data from the literature, the size evolution of quiescent cluster galaxies is relatively slow from z~1.6 to the present, growing as (1+z)^(-0.6+/-0.1). If this result is generalizable, then it implies that physical processes associated with the denser cluster region seems to have caused accelerated size growth in quiescent galaxies prior to z=1.6 and slower subsequent growth at z<1.6 compared to galaxies in the lower density field. The quiescent cluster galaxies at z=1.6 have higher ellipticities compared to lower redshift samples at fixed mass, and their surface-brightness profiles suggest that they contain extended stellar disks. We argue the cluster galaxies require dissipationless (i.e., gas-poor or "dry") mergers to reorganize the disk material and to match the relations for ellipticity, stellar mass, size, and color of early-type galaxies in z<1 clusters.Comment: Accepted for publication in ApJ. 14 pages in emulateapj format. Replacement includes improvements from referee report, and updates and additions to reference