Clocks for airborne systems

The potential performance of compact oscillators, needed for the development of accurate clocks for future airborne systems (such as Identification Friend or Foe schemes), is addressed. In particular, extensive testing of rubidium oscillators manufactured by Efratom is discussed. The results indicate that an accuracy of better than 10 microseconds should be achievable in tactical aircraft provided that appropriate measures are adopted to counter the many environmental factors. In a favorable environment a stability of better than 5 x 10 to the -13th power for one day is achievable with present commercial units, but improvements are required to suit operation in an aircraft. With further development of rubidium controlled clocks the ultimate limitation on time accuracy in aircraft will probably be associated with time dissemination, maintenance difficulties and doctrinal hurdles

Confidence and Attitudes Toward Osteoarthritis Care Among the Current and Emerging Health Workforce: A Multinational Interprofessional Study.

Objective: To measure confidence and attitudes of the current and emerging interprofessional workforce concerning osteoarthritis (OA) care. Methods: Study design is a multinational (Australia, New Zealand, Canada) cross-sectional survey of clinicians (general practitioners [GPs], GP registrars, primary care nurses, and physiotherapists) and final-year medical and physiotherapy students. GPs and GP registrars were only sampled in Australia/New Zealand and Australia, respectively. The study outcomes are as follows: confidence in OA knowledge and skills (customized instrument), biomedical attitudes to care (Pain Attitudes Beliefs Scale [PABS]), attitudes toward high- and low-value care (customized items), attitudes toward exercise/physical activity (free-text responses). Results: A total of 1886 clinicians and 1161 students responded. Although a number of interprofessional differences were identified, confidence in OA knowledge and skills was consistently greatest among physiotherapists and lowest among nurses (eg, the mean difference [95% confidence interval (CI)] for physiotherapist-nurse analyses were 9.3 [7.7-10.9] for knowledge [scale: 11-55] and 14.6 [12.3-17.0] for skills [scale: 16-80]). Similarly, biomedical attitudes were stronger in nurses compared with physiotherapists (6.9 [5.3-8.4]; scale 10-60) and in medical students compared with physiotherapy students (2.0 [1.3-2.7]). Some clinicians and students agreed that people with OA will ultimately require total joint replacement (7%-19% and 19%-22%, respectively), that arthroscopy is an appropriate intervention for knee OA (18%-36% and 35%-44%), and that magnetic resonance imaging is informative for diagnosis and clinical management of hip/knee OA (8%-61% and 21%-52%). Most agreed (90%-98% and 92%-97%) that exercise is indicated and strongly supported by qualitative data. Conclusion: Workforce capacity building that de-emphasizes biomedical management and promotes high-value first-line care options is needed. Knowledge and skills among physiotherapists support leadership roles in OA care for this discipline

The feasibility of adapting UK maternity clinical information systems for observational research: recent experiences of the POOL study

Background: Using routinely collected clinical data for observational research is becoming a popular method for data collection, especially for outcomes that are rare events. The POOL study was commissioned to evaluate the safety of waterbirth in the UK using routine maternity and neonate clinical data. This paper sets out the design rationale, set-up and data collection pilot for this bespoke data linkage study. Methods: Wellbeing Software®, provider of the Euroking® information system was selected to add new variables to their information system, extract study data from participating NHS sites and transfer data for matching with the National Neonatal Research Database (NNRD). The data extraction, linkage and cleaning was piloted with the first NHS site set-up to confirm data could be linked to the NNRD, identify steps for data management and cleaning, assess data completeness for new and key data fields and develop a plan for a risk classification algorithm. Results: Twenty six sites were set-up over a # months. Twenty-four thousand records were extracted from the pilot NHS site, pertaining to the period from January 2015 to March 2019. Data field completeness for maternal and neonatal primary outcomes were assessable, although some data fields’ completion had been identified as less than adequate. Data flowed to the NNRD enabling matching and linkage between maternal and neonate data. Discussion: Piloting the data extraction and linkage has been a useful exercise which highlighted the need for additional documentation, training and processes to ensure data quality and confidentiality are upheld for the remainder of the study. Accessing such data on scale, is possible, but continues to be a time consuming and a technically challenging exercise