A multilevel neo-institutional analysis of infection prevention and control in English hospitals: coerced safety culture change?

Despite committed policy, regulative and professional efforts on healthcare safety, little is known about how such macro-interventions permeate organisations and shape culture over time. Informed by neo-institutional theory, we examined how inter-organisational influences shaped safety practices and inter-subjective meanings following efforts for coerced culture change. We traced macro-influences from 2000 to 2015 in infection prevention and control (IPC). Safety perceptions and meanings were inductively analysed from 130 in-depth qualitative interviews with senior- and middle-level managers from 30 English hospitals. A total of 869 institutional interventions were identified; 69% had a regulative component. In this context of forced implementation of safety practices, staff experienced inherent tensions concerning the scope of safety, their ability to be open and prioritisation of external mandates over local need. These tensions stemmed from conflicts among three co-existing institutional logics prevalent in the NHS. In response to requests for change, staff flexibly drew from a repertoire of cognitive, material and symbolic resources within and outside their organisations. They crafted 'strategies of action', guided by a situated assessment of first-hand practice experiences complementing collective evaluations of interventions such as 'pragmatic', 'sensible' and also 'legitimate'. Macro-institutional forces exerted influence either directly on individuals or indirectly by enriching the organisational cultural repertoire

Cold Gas in Cluster Cores

I review the literature's census of the cold gas in clusters of galaxies. Cold gas here is defined as the gas that is cooler than X-ray emitting temperatures (~10^7 K) and is not in stars. I present new Spitzer IRAC and MIPS observations of Abell 2597 (PI: Sparks) that reveal significant amounts of warm dust and star formation at the level of 5 solar masses per year. This rate is inconsistent with the mass cooling rate of 20 +/- 5 solar masses per year inferred from a FUSE [OVI] detection.Comment: 10 pages, conference proceeding

Intoxicação por monofluoroacetato em animais

O monofluoroacetato (MF) ou ácido monofluoroacético é utilizado na Austrália e Nova Zelândia no controle populacional de mamíferos nativos ou exóticos. O uso desse composto é proibido no Brasil, devido ao risco de intoxicação de seres humanos e de animais, uma vez que a substância permanece estável por décadas. No Brasil casos recentes de intoxicação criminosa ou acidental têm sido registrados. MF foi identificado em diversas plantas tóxicas, cuja ingestão determina "morte súbita"; de bovinos na África do Sul, Austrália e no Brasil. O modo de ação dessa substância baseia-se na formação do fluorocitrato, seu metabólito ativo, que bloqueia competitivamente a aconitase e o ciclo de Krebs, o que reduz produção de ATP. As espécies animais têm sido classificadas nas quatro Categorias em função do efeito provocado por MF: (I) no coração, (II) no sistema nervoso central (III) sobre o coração e sistema nervoso central ou (IV) com sintomatologia atípica. Neste trabalho, apresenta-se uma revisão crítica atualizada sobre essa substância. O diagnóstico da intoxicação por MF é realizado pelo histórico de ingestão do tóxico, pelos achados clínicos e confirmado por exame toxicológico. Uma forma peculiar de degeneração hidrópico-vacuolar das células epiteliais dos túbulos uriníferos contorcidos distais tem sido considerada como característica dessa intoxicação em algumas espécies. O tratamento da intoxicação por MF é um desafio, pois ainda não se conhece um agente capaz de reverte-la de maneira eficaz; o desfecho geralmente é fata

DESIGN CURRENT DENSITY IMPACT ON COST AND RELIABILITY OF SUPERCONDUCTING MAGNET SYSTEMS FOR EARLY COMMERCIAL MHD POWER PLANTS

Ce rapport étudie les conséquences du choix de la densité de courant sur le coût de grands systèmes d'aimants supraconducteurs MHD, en utilisant les indices d'estimation de coût fournis par ordinateur. Il y est démontré que la densité de courant choisie affecte de façon significative le coût du système, en particulier les systèmes à plus faible puissance pris en considération, ce qui indique que les densités de courant moyennes sélectionnées pour les aimants MHD doivent être choisies sur la base des effets affectant aussi bien le coût que la fiabilité des systèmes.The impact of design current density on the cost of large superconducting MHD magnet systems was studied using cost estimating computer codes. Design current density was shown to affect system cost significantly, particularly for the lower-power systems considered, indicating that average current densities selected for final MHD magnet designs should be chosen based on effects on both cost and system reliability