Evaluation of the Succession Planning Development Pathway for Consultant Nurses, Midwives and Allied Health Professionals.

sch_nurpub954pu

The Foundation Supernova Survey: Measuring Cosmological Parameters with Supernovae from a Single Telescope

Measurements of the dark energy equation-of-state parameter, $w$, have been limited by uncertainty in the selection effects and photometric calibration of $z<0.1$ Type Ia supernovae (SNe Ia). The Foundation Supernova Survey is designed to lower these uncertainties by creating a new sample of $z<0.1$ SNe Ia observed on the Pan-STARRS system. Here, we combine the Foundation sample with SNe from the Pan-STARRS Medium Deep Survey and measure cosmological parameters with 1,338 SNe from a single telescope and a single, well-calibrated photometric system. For the first time, both the low-$z$ and high-$z$ data are predominantly discovered by surveys that do not target pre-selected galaxies, reducing selection bias uncertainties. The $z>0.1$ data include 875 SNe without spectroscopic classifications and we show that we can robustly marginalize over CC SN contamination. We measure Foundation Hubble residuals to be fainter than the pre-existing low-$z$ Hubble residuals by $0.046 \pm 0.027$ mag (stat+sys). By combining the SN Ia data with cosmic microwave background constraints, we find $w=-0.938 \pm 0.053$, consistent with $\Lambda$CDM. With 463 spectroscopically classified SNe Ia alone, we measure $w=-0.933\pm0.061$. Using the more homogeneous and better-characterized Foundation sample gives a 55% reduction in the systematic uncertainty attributed to SN Ia sample selection biases. Although use of just a single photometric system at low and high redshift increases the impact of photometric calibration uncertainties in this analysis, previous low-$z$ samples may have correlated calibration uncertainties that were neglected in past studies. The full Foundation sample will observe up to 800 SNe to anchor the LSST and WFIRST Hubble diagrams.Comment: 30 pages, 17 figures, accepted by Ap

Do Interventions Designed to Support Shared Decision-Making Reduce Health Inequalities? : A Systematic Review and Meta-Analysis

Copyright: © 2014 Durand et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Background: Increasing patient engagement in healthcare has become a health policy priority. However, there has been concern that promoting supported shared decision-making could increase health inequalities. Objective: To evaluate the impact of SDM interventions on disadvantaged groups and health inequalities. Design: Systematic review and meta-analysis of randomised controlled trials and observational studies.Peer reviewe

Adjuncts or adversaries to shared decision-making? Applying the Integrative Model of behavior to the role and design of decision support interventions in healthcare interactions

Background A growing body of literature documents the efficacy of decision support interventions (DESI) in helping patients make informed clinical decisions. DESIs are frequently described as an adjunct to shared decision-making between a patient and healthcare provider, however little is known about the effects of DESIs on patients' interactional behaviors-whether or not they promote the involvement of patients in decisions. Discussion Shared decision-making requires not only a cognitive understanding of the medical problem and deliberation about the potential options to address it, but also a number of communicative behaviors that the patient and physician need to engage in to reach the goal of making a shared decision. Theoretical models of behavior can guide both the identification of constructs that will predict the performance or non-performance of specific behaviors relevant to shared decision-making, as well as inform the development of interventions to promote these specific behaviors. We describe how Fishbein's Integrative Model (IM) of behavior can be applied to the development and evaluation of DESIs. There are several ways in which the IM could be used in research on the behavioral effects of DESIs. An investigator could measure the effects of an intervention on the central constructs of the IM - attitudes, normative pressure, self-efficacy, and intentions related to communication behaviors relevant to shared decision-making. However, if one were interested in the determinants of these domains, formative qualitative research would be necessary to elicit the salient beliefs underlying each of the central constructs. Formative research can help identify potential targets for a theory-based intervention to maximize the likelihood that it will influence the behavior of interest or to develop a more fine-grained understanding of intervention effects. Summary Behavioral theory can guide the development and evaluation of DESIs to increase the likelihood that these will prepare patients to play a more active role in the decision-making process. Self-reported behavioral measures can reduce the measurement burden for investigators and create a standardized method for examining and reporting the determinants of communication behaviors necessary for shared decision-making

Intradermal Anti-Loxosceles Fab Fragments Attenuate Dermonecrotic Arachnidism

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73371/1/j.1553-2712.1999.tb00133.x.pd

Shared decision-making – Rhetoric and reality: Women’s experiences and perceptions of adjuvant treatment decision-making for breast cancer

This interview-based study uses phenomenology as a theoretical framework and thematic analysis to challenge existing explanatory frameworks of shared decision-making, in an exploration of women’s experiences and perceptions of shared decision-making for adjuvant treatment in breast cancer. Three themes emerged are as follows: (1) women’s desire to participate in shared decision-making, (2) the degree to which shared decision-making is perceived to be shared and (3) to what extent are women empowered within shared decision-making. Studying breast cancer patients’ subjective experiences of adjuvant treatment decision-making provides a broader perspective on patient participatory role preferences and doctor–patient power dynamics within shared decision-making for breast cancer

Identification of the Changbaishan ‘Millennium’ (B-Tm) eruption deposit in the Lake Suigetsu (SG06) sedimentary archive, Japan: Synchronisation of hemispheric-wide palaeoclimate archives

The B-Tm tephra, dispersed during the highly explosive Changbaishan ‘Millennium’ eruption (ca. 940–950 CE) and a key marker layer within the Greenland ice cores, has now been identified in the Lake Suigetsu (SG06) sedimentary sequence, central Japan. The major element geochemistry of the volcanic glasses within this tephra layer are compared to a new glass dataset from the distal type-locality (Tomakomai Port, Hokkaido) and other published ‘Millennium’ eruption/B-Tm deposits, to verify this correlation. The discovery of the B-Tm tephra in the Lake Suigetsu record provides, to date, the most southerly identification of this ash and, crucially, the first direct tie-point between this high-resolution, mid-latitude palaeoclimate archive and the Greenland ice cores. These findings present significant encouragement for on-going research into the tephrostratigraphy of East Asia, focusing on the identification of widely-dispersed tephra layers which can facilitate the synchronisation of disparate palaeoclimate archives and thus enable the assessment of spatio-temporal variations in past climatic change

Precision Determination of the Neutron Spin Structure Function g1n

We report on a precision measurement of the neutron spin structure function $g^n_1$ using deep inelastic scattering of polarized electrons by polarized ^3He. For the kinematic range 0.014<x<0.7 and 1 (GeV/c)^2< Q^2< 17 (GeV/c)^2, we obtain $\int^{0.7}_{0.014} g^n_1(x)dx = -0.036 \pm 0.004 (stat) \pm 0.005 (syst)$ at an average $Q^2=5 (GeV/c)^2$. We find relatively large negative values for $g^n_1$ at low $x$. The results call into question the usual Regge theory method for extrapolating to x=0 to find the full neutron integral $\int^1_0 g^n_1(x)dx$, needed for testing quark-parton model and QCD sum rules.Comment: 5 pages, 3 figures To be published in Phys. Rev. Let

Measurement of the Proton and Deuteron Spin Structure Function g_1 in the Resonance Region

We have measured the proton and deuteron spin structure functions g_1^p and g_1^d in the region of the nucleon resonances for W^2 < 5 GeV^2 and $Q^2\simeq 0.5$ and $Q^2\simeq 1.2$ GeV^2 by inelastically scattering 9.7 GeV polarized electrons off polarized $^{15}NH_3$ and $^{15}ND_3$ targets. We observe significant structure in g_1^p in the resonance region. We have used the present results, together with the deep-inelastic data at higher W^2, to extract $\Gamma(Q^2)\equiv\int_0^1 g_1(x,Q^2) dx$. This is the first information on the low-Q^2 evolution of Gamma toward the Gerasimov-Drell-Hearn limit at Q^2 = 0.Comment: 7 pages, 2 figure

Why do some women choose to freebirth in the UK? An interpretative phenomenological study

Background Freebirthing or unassisted birth is the active choice made by a woman to birth without a trained professional present, even where there is access to maternity provision. This is a radical childbirth choice, which has potential morbidity and mortality risks for mother and baby. While a number of studies have explored women’s freebirth experiences, there has been no research undertaken in the UK. The aim of this study was to explore and identify what influenced women’s decision to freebirth in a UK context. Methods An interpretive phenomenological approach was adopted. Advertisements were posted on freebirth websites, and ten women participated in the study by completing a narrative (n = 9) and/or taking part in an in-depth interview (n = 10). Data analysis was carried out using interpretative methods informed by Heidegger and Gadamer’s hermeneutic-phenomenological concepts. Results Three main themes emerged from the data. Contextualising herstory describes how the participants’ backgrounds (personal and/or childbirth related) influenced their decision making. Diverging paths of decision making provides more detailed insights into how and why women’s different backgrounds and experiences of childbirth and maternity care influenced their decision to freebirth. Converging path of decision making, outlines the commonalities in women’s narratives in terms of how they sought to validate their decision to freebirth, such as through self-directed research, enlisting the support of others and conceptualising risk. Conclusion The UK based midwifery philosophy of woman-centred care that tailors care to individual needs is not always carried out, leaving women to feel disillusioned, unsafe and opting out of any form of professionalised care for their births. Maternity services need to provide support for women who have experienced a previous traumatic birth. Midwives also need to help restore relationships with women, and co-create birth plans that enable women to be active agents in their birthing decisions even if they challenge normative practices. The fact that women choose to freebirth in order to create a calm, quiet birthing space that is free from clinical interruptions and that enhances the physiology of labour, should be a key consideration