The longitudinal variability of equatorial electrojet and vertical drift velocity in the African and American sectors

While the formation of equatorial electrojet (EEJ) and its temporal variation is believed to be fairly well understood, the longitudinal variability at all local times is still unknown. This paper presents a case and statistical study of the longitudinal variability of dayside EEJ for all local times using ground-based observations. We found EEJ is stronger in the west American sector and decreases from west to east longitudinal sectors. We also confirm the presence of significant longitudinal difference in the dusk sector pre-reversal drift, using the ion velocity meter (IVM) instrument onboard the C/NOFS satellite, with stronger pre-reversal drift in the west American sector compared to the African sector. Previous satellite observations have shown that the African sector is home to stronger and year-round ionospheric bubbles/irregularities compared to the American and Asian sectors. This study's results raises the question if the vertical drift, which is believed to be the main cause for the enhancement of Rayleigh–Taylor (RT) instability growth rate, is stronger in the American sector and weaker in the African sector – why are the occurrence and amplitude of equatorial irregularities stronger in the African sector

Quantum switches and quantum memories for matter-wave lattice solitons

We study the possibility of implementing a quantum switch and a quantum memory for matter wave lattice solitons by making them interact with "effective" potentials (barrier/well) corresponding to defects of the optical lattice. In the case of interaction with an "effective" potential barrier, the bright lattice soliton experiences an abrupt transition from complete transmission to complete reflection (quantum switch) for a critical height of the barrier. The trapping of the soliton in an "effective" potential well and its release on demand, without loses, shows the feasibility of using the system as a quantum memory. The inclusion of defects as a way of controlling the interactions between two solitons is also reported

Measuring the impact of COVID-19 on hospital care pathways

Care pathways in hospitals around the world reported significant disruption during the recent COVID-19 pandemic but measuring the actual impact is more problematic. Process mining can be useful for hospital management to measure the conformance of real-life care to what might be considered normal operations. In this study, we aim to demonstrate that process mining can be used to investigate process changes associated with complex disruptive events. We studied perturbations to accident and emergency (A &E) and maternity pathways in a UK public hospital during the COVID-19 pandemic. Co-incidentally the hospital had implemented a Command Centre approach for patient-flow management affording an opportunity to study both the planned improvement and the disruption due to the pandemic. Our study proposes and demonstrates a method for measuring and investigating the impact of such planned and unplanned disruptions affecting hospital care pathways. We found that during the pandemic, both A &E and maternity pathways had measurable reductions in the mean length of stay and a measurable drop in the percentage of pathways conforming to normative models. There were no distinctive patterns of monthly mean values of length of stay nor conformance throughout the phases of the installation of the hospital’s new Command Centre approach. Due to a deficit in the available A &E data, the findings for A &E pathways could not be interpreted

Cost analysis of an integrated disease surveillance and response system: case of Burkina Faso, Eritrea, and Mali

<p>Abstract</p> <p>Background</p> <p>Communicable diseases are the leading causes of illness, deaths, and disability in sub-Saharan Africa. To address these threats, countries within the World Health Organization (WHO) African region adopted a regional strategy called Integrated Disease Surveillance and Response (IDSR). This strategy calls for streamlining resources, tools, and approaches to better detect and respond to the region's priority communicable disease. The purpose of this study was to analyze the incremental costs of establishing and subsequently operating activities for detection and response to the priority diseases under the IDSR.</p> <p>Methods</p> <p>We collected cost data for IDSR activities at central, regional, district, and primary health care center levels from Burkina Faso, Eritrea, and Mali, countries where IDSR is being fully implemented. These cost data included personnel, transportation items, office consumable goods, media campaigns, laboratory and response materials and supplies, and annual depreciation of buildings, equipment, and vehicles.</p> <p>Results</p> <p>Over the period studied (2002–2005), the average cost to implement the IDSR program in Eritrea was $0.16 per capita,$0.04 in Burkina Faso and $0.02 in Mali. In each country, the mean annual cost of IDSR was dependent on the health structure level, ranging from$35,899 to $69,920 at the region level,$10,790 to $13,941 at the district level, and$1,181 to $1,240 at the primary health care center level. The proportions spent on each IDSR activity varied due to demand for special items (e.g., equipment, supplies, drugs and vaccines), service availability, distance, and the epidemiological profile of the country.</p> <p>Conclusion</p> <p>This study demonstrates that the IDSR strategy can be considered a low cost public health system although the benefits have yet to be quantified. These data can also be used in future studies of the cost-effectiveness of IDSR.</p

Implementing an artificial intelligence command centre in the NHS: a mixed-methods study

Background Hospital ‘command centres’ use digital technologies to collect, analyse and present real-time information that may improve patient flow and patient safety. Bradford Royal Infirmary has trialled this approach and presents an opportunity to evaluate effectiveness to inform future adoption in the United Kingdom. Objective To evaluate the impact of the Bradford Command Centre on patient care and organisational processes. Design A comparative mixed-methods study. Operational data from a study and control site were collected and analysed. The intervention was observed, and staff at both sites were interviewed. Analysis was grounded in a literature review and the results were synthesised to form conclusions about the intervention. Setting The study site was Bradford Royal Infirmary, a large teaching hospital in the city of Bradford, United Kingdom. The control site was Huddersfield Royal Infirmary in the nearby city of Huddersfield. Participants Thirty-six staff members were interviewed and/or observed. Intervention The implementation of a digitally enabled hospital command centre. Main outcome measures Qualitative perspectives on hospital management. Quantitative metrics on patient flow, patient safety, data quality. Data sources Anonymised electronic health record data. Ethnographic observations including interviews with hospital staff. Cross-industry review including relevant literature and expert panel interviews. Results The Command Centre was implemented successfully and has improved staff confidence of better operational control. Unintended consequences included tensions between localised and centralised decision-making and variable confidence in the quality of data available. The Command Centre supported the hospital through the COVID-19 pandemic, but the direct impact of the Command Centre was difficult to measure as the pandemic forced all hospitals, including the study and control sites, to innovate rapidly. Late in the study we learnt that the control site had visited the study site and replicated some aspects of the command centre themselves; we were unable to explore this in detail. There was no significant difference between pre- and post-intervention periods for the quantitative outcome measures and no conclusive impact on patient flow and data quality. Staff and patients supported the command-centre approaches but patients expressed concern that individual needs might get lost to ‘the system’. Conclusions Qualitative evidence suggests the Command Centre implementation was successful, but it proved challenging to link quantitative evidence to specific technology interventions. Staff were positive about the benefits and emphasised that these came from the way they adapted to and used the new technology rather than the technology per se. Limitations The COVID-19 pandemic disrupted care patterns and forced rapid innovation which reduced our ability to compare study and control sites and data before, during and after the intervention

Temporal Change and Fishing Down Food Webs in Small-Scale Fisheries in Morondava, Madagascar

Small-scale fisheries (SSFs) are often undervalued and unmanaged as a result of a lack of data. A study of SSFs in Menabe, western Madagascar in 1991 found diverse catches and a productive fishery with some evidence of declining catches. Here we compare data collected at the same landing site in 1991 and 2011. 2011 had seven times greater total monthly landings due to more people fishing and higher individual catches. Catch composition showed a lower mean trophic level in 2011 indicating overfishing, the true extent of which may be masked due to changes in technology and fishing behaviours. Limited management action since 2011 means these trends have likely continued and an urgent need for both greater understanding, and management of these fisheries remains if they are to continue providing food and income for fishing communities

Differences in public's perception of air quality and acceptability of a clean air zone : A mixed-methods cross sectional study

Background: Air pollution is a major cause of morbidity and mortality. Clean Air Zones (CAZs) which restrict the entry of polluting vehicles in targeted areas have been identified as potentially effective in improving health and reducing air pollution; however, their implementation can be controversial. Methods: A cross-sectional survey was completed by 1949 respondents who lived or worked in Bradford, a multi-cultural deprived city in England, between April and December 2021. Of these, 1137 were recruited from the longitudinal Born in Bradford (BiB) family cohort (families with children born in the city during 2007–2011) and 812 were from the general public. Bradford is the seventh largest metropolitan district in England and Wales with a population of over half a million mainly white British and Pakistani origin. The BiB families cohort and the general public respondents were used for descriptive analysis of perception of air quality and acceptability of CAZ, then the relationship between participants responses with demographic characteristics were investigated using the BiB families cohort. Outcomes included perceptions of air quality and acceptability of the CAZ supplemented by free-text questions. Thematic analysis was used to code free-text data. Descriptive analyses were performed on the entire sample. Latent class analysis was used to characterise participants was performed in the BiB dataset for whom detailed existing socio-demographic data were available. Results: The majority of participants (67%) considered improving air quality in Bradford as extremely important; 70% supported implementation of the CAZ. Three latent classes were identified within the BiB sample: deprived white British families (25%), more affluent white British families (32%) and deprived Pakistani-origin families (43%). Deprived white British (OR = 0.54, 95% CI: 0.34 to 0.84) and more affluent white British families (OR = 0.53, 95% CI: 0.36 to 0.79) were less likely to say the air quality was good/excellent when compared with deprived Pakistani-origin families. Affluent White British families were more likely to support the CAZ compared with deprived white British families (OR = 2.24; 95% CI: 1.55. to 3.25) and deprived Pakistani-origin families (OR = 2.06, 95% CI: 1.50 to 2.85). Qualitative analysis suggested that a perceived lack of cohesion in the policy and concerns about financial impacts drove negative attitudes. Conclusion: Families in Bradford were generally supportive of the planned CAZ and efforts to reduce pollution; however, support was weaker in more deprived communities. Pakistani-origin communities living in deprived areas perceived air quality as better than other groups. Tailored approaches to communicate about the proposed benefits of policies such as CAZ prior to implementation may be an important way to increase acceptability amongst vulnerable groups

Effects of computerised clinical decision support systems (CDSS) on nursing and allied health professional performance and patient outcomes: a systematic review of experimental and observational studies

Objective Computerised clinical decision support systems (CDSS) are an increasingly important part of nurse and allied health professional (AHP) roles in delivering healthcare. The impact of these technologies on these health professionals’ performance and patient outcomes has not been systematically reviewed. We aimed to conduct a systematic review to investigate this. Materials and methods The following bibliographic databases and grey literature sources were searched by an experienced Information Professional for published and unpublished research from inception to February 2021 without language restrictions: MEDLINE (Ovid), Embase Classic+Embase (Ovid), PsycINFO (Ovid), HMIC (Ovid), AMED (Allied and Complementary Medicine) (Ovid), CINAHL (EBSCO), Cochrane Central Register of Controlled Trials (Wiley), Cochrane Database of Systematic Reviews (Wiley), Social Sciences Citation Index Expanded (Clarivate), ProQuest Dissertations & Theses Abstracts & Index, ProQuest ASSIA (Applied Social Science Index and Abstract), Clinical Trials.gov, WHO International Clinical Trials Registry (ICTRP), Health Services Research Projects in Progress (HSRProj), OpenClinical(www.OpenClinical.org), OpenGrey (www.opengrey.eu), Health.IT.gov, Agency for Healthcare Research and Quality (www.ahrq.gov). Any comparative research studies comparing CDSS with usual care were eligible for inclusion. Results A total of 36 106 non-duplicate records were identified. Of 35 included studies: 28 were randomised trials, three controlled-before-and-after studies, three interrupted-time-series and one non-randomised trial. There were ~1318 health professionals and ~67 595 patient participants in the studies. Most studies focused on nurse decision-makers (71%) or paramedics (5.7%). CDSS as a standalone Personal Computer/LAPTOP-technology was a feature of 88.7% of the studies; only 8.6% of the studies involved ‘smart’ mobile/handheld-technology. Discussion CDSS impacted 38% of the outcome measures used positively. Care processes were better in 47% of the measures adopted; examples included, nurses’ adherence to hand disinfection guidance, insulin dosing, on-time blood sampling and documenting care. Patient care outcomes in 40.7% of indicators were better; examples included, lower numbers of falls and pressure ulcers, better glycaemic control, screening of malnutrition and obesity and triaging appropriateness. Conclusion CDSS may have a positive impact on selected aspects of nurses’ and AHPs’ performance and care outcomes. However, comparative research is generally low quality, with a wide range of heterogeneous outcomes. After more than 13 years of synthesised research into CDSS in healthcare professions other than medicine, the need for better quality evaluative research remains as pressing