Caring for the patient, caring for the record: an ethnographic study of 'back office' work in upholding quality of care in general practice

© 2015 Swinglehurst and Greenhalgh; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Additional file 1: Box 1. Field notes on summarising (Clover Surgery). Box 2. Extract of document prepared for GPs by summarisers at Clover Surgery. Box 3. Fieldnotes on coding incoming post, Clover (original notes edited for brevity).This work was funded by a research grant from the UK Medical Research Council (Healthcare Electronic Records in Organisations 07/133) and a National Institute of Health Research doctoral fellowship award for DS (RDA/03/07/076). The funders were not involved in the selection or analysis of data nor did they make any contribution to the content of the final manuscript

An examination of business occupier relocation decision making : distinguishing small and large firm behaviour

This paper explores how business occupiers decide whether and where to relocate. It captures the experience and behaviour of a range of sizes and types of business occupier and subjects their decision-making processes to detailed scrutiny. A linear three-stage decision model is used to sequence and structure interviews with individuals who have intimate involvement with the relocation of 28 firms and organizations in Tyne and Wear, in the north-east of England. The 'constant comparative' method is used to analyse the interview data, from which emerges 18 key concepts, comprising 51 characteristic components. Using an axial approach, these are organized into 10 cross-cutting themes that represent the main areas of consideration or influence on the thinking of the people involved in determining whether a firm or organization should relocate and, if so, where to. The resulting analysis finds that organizations adopt varying degrees of sophistication when making relocation decisions; small firms are more inclined to make decisions based on constrained information; larger organizations adopt a more complex approach. Regardless of firm size, key individuals exert considerable influence over the decision-making process and its outcome

Isothiourea-catalysed sequential kinetic resolution of acyclic (±)-1,2-diols

Authors thank the EPSRC Centre for Doctoral Training in Critical Resource Catalysis (CRITICAT, grant code EP/L016419/1, R.M.N.) for funding. We thank the European Research Council under the European Union’s Seventh Framework Programme (FP7/2007–2013) ERC grant agreement no. 279850 (A.D.S.). A.D.S. thanks the Royal Society for a Wolfson Research Merit Award.The isothiourea-catalysed acylative kinetic resolution of a range of acyclic (±)-1,2-diols using 1 mol% of catalyst under operationally simple conditions is reported. Significantly, the bifunctional nature of (±)-1,2-diols was exploited in a sequential double kinetic resolution, in which both kinetic resolutions operate synergistically to provide access to highly enantioenriched products. The principles that underpin this process are discussed, and selectivity factors for the individual kinetic resolution steps are reported in a model system.PostprintPeer reviewe

What’s in a mechanism? Development of a key concept in realist evaluation

Background: The idea that underlying, generative mechanisms give rise to causal regularities has become a guiding principle across many social and natural science disciplines. A specific form of this enquiry, realist evaluation is gaining momentum in the evaluation of complex social interventions. It focuses on ‘what works, how, in which conditions and for whom’ using context, mechanism and outcome configurations as opposed to asking whether an intervention ‘works’. Realist evaluation can be difficult to codify and requires considerable researcher reflection and creativity. As such there is often confusion when operationalising the method in practice. This article aims to clarify and further develop the concept of mechanism in realist evaluation and in doing so aid the learning of those operationalising the methodology. Discussion: Using a social science illustration, we argue that disaggregating the concept of mechanism into its constituent parts helps to understand the difference between the resources offered by the intervention and the ways in which this changes the reasoning of participants. This in turn helps to distinguish between a context and mechanism. The notion of mechanisms ‘firing’ in social science research is explored, with discussions surrounding how this may stifle researchers’ realist thinking. We underline the importance of conceptualising mechanisms as operating on a continuum, rather than as an ‘on/off’ switch. Summary: The discussions in this article will hopefully progress and operationalise realist methods. This development is likely to occur due to the infancy of the methodology and its recent increased profile and use in social science research. The arguments we present have been tested and are explained throughout the article using a social science illustration, evidencing their usability and value

Shared visiting in Equator city

In this paper we describe an infrastructure and prototype system for sharing of visiting experiences across multiple media. The prototype supports synchronous co-visiting by physical and digital visitors, with digital access via either the World Wide Web or 3-dimensional graphics

Three-centre cluster structure in 11C and 11B

Studies of the 16O(9Be,alpha 7Be)14C, 7Li(9Be,alpha 7Li)5He and 7Li(9Be,alpha alpha t)5He reactions at E(beam)=70 and 55 MeV have been performed using resonant particle spectroscopy techniques. The 11C excited states decaying into alpha+7Be(gs) are observed between 8.5 and 13.5 MeV. The alpha+7Li(gs), alpha+7Li*(4.652 MeV) and t+8Be(gs) decays of 11B excited states between 9 and 19 MeV are observed. The decay processes are used to indicate the possible three-centre 2alpha+3He (2alpha+3H) cluster structure of observed states. This cluster structure is more prominent in the positive-parity states, where two rotational bands with large deformations are suggested. Excitations of some of the observed T=1/2 resonances coincide with the energies of previously measured T=3/2 isobaric analogs of the 11Be states,indicating that these states may have mixed isospin.Comment: Contribution for the proceedings of the NUSTAR'05: NUclear STructure, Astrophysics and Reactions, University of Surrey, Guildford, UK; accepted for publication in Journal of Physics

Inter-social-networking: Accounting for multiple identities

We argue that the current approaches to online social networking give rise to numerous challenges regarding the management of the multiple facets of people’s digital identities within and around social networking sites (SNS). We propose an architecture for enabling people to better manage their SNS identities that is informed by the way the core Internet protocols developed to support interoperation of proprietary network protocols, and based on the idea of Separation of Concerns [1]. This does not require modification of existing services but is predicated on providing a connecting layer over them, both as a mechanism to address problems of privacy and identity, and to create opportunities to open up online social networking to a much richer set of possible interactions and applications.This work is supported by Horizon Digital Economy Research, RCUK grant EP/G065802/1; and by CREATe, the Centre for Copyright and New Business Models, RCUK grant AH/K000179/1. Packages and source are available under open source licenses at github.com/CREATe-centre/.This is the author accepted manuscript. The final version is available from Springer via http://dx.doi.org/10.1007/978-3-319-20367-6_2

Piezoresistive structural composites reinforced by carbon nanotube-grafted quartz fibres

Nano-engineered fibre/matrix interfaces can improve state-of-the-art fibre-reinforced composites. Grafting carbon nanotubes (CNTs) to high temperature quartz glass fibres produces “hairy” or “fuzzy” fibres, which combine reinforcements at micrometre and nanometre length scales. Fuzzy quartz fibres were produced continuously, reel-to-reel, on whole tows, in an open chemical vapour deposition reactor. The resulting uniform coverage of 200 nm long CNTs increased the interfacial shear strength with epoxy (90.3 ± 2.1 MPa) by 12% compared to the commercially-sized counterpart, as measured by single fibre pull-out tests. The improved interfacial properties were confirmed at the macroscale using unidirectional hierarchical bundle composites, which exhibited a delayed onset of fibre/matrix debonding. Although the quartz fibres are electrically insulating, the grafted CNT create a conductive path, predominantly parallel to the fibres. To explore the applicability for structural health monitoring, the resistivity was recorded in situ during mechanical testing, and correlated with simultaneous acoustic emission data. The baseline resistivity parallel to the fibres (ρ0 = 3.9 ± 0.4 × 10−1 Ω m) displayed a linear piezoresistive response (K = 3.64) until failure at ca. 2.1% strain, also referred to as "gauge factor”, a two-fold improvement over traditional resistance strain gauges (e.g. constantan). Hierarchical, fuzzy quartz fibres, therefore, simultaneously enhance both structural and sensing performance, offering multifunctional opportunities in large composite parts

NHC-catalyzed enantioselective synthesis of β-trifluoromethyl-β-hydroxyamides

Authors acknowlege the European Research Council under the European Union’s Seventh Framework Programme (FP7/2007-2013) ERC grant agreement no. 279850 (A.T.D.). We also thank the EPSRC UK National Mass Spectrometry Facility at Swansea University.The N-heterocyclic carbene (NHC) catalyzed formal [2+2] cycloaddition between α-aroyloxyaldehydes and trifluoroacetophenones, followed by ring-opening with an amine or reducing agent is described. The resulting β-hydroxy-β-trifluoromethyl amide and alcohol products are produced with reasonable diastereocontrol (typically ~70:30 dr) and excellent enantioselectivity, and can be isolated in moderate to good yield as a single diastereoisomer.Publisher PDFPeer reviewe