159 research outputs found

    Processing of soot in an urban environment: case study from the Mexico City Metropolitan Area

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    Chemical composition, size, and mixing state of atmospheric particles are critical in determining their effects on the environment. There is growing evidence that soot aerosols play a particularly important role in both climate and human health, but still relatively little is known of their physical and chemical nature. In addition, the atmospheric residence times and removal mechanisms for soot are neither well understood nor adequately represented in regional and global climate models. To investigate the effect of locality and residence time on properties of soot and mixing state in a polluted urban environment, particles of diameter 0.2–2.0 μm were collected in the Mexico City Metropolitan Area (MCMA) during the MCMA-2003 Field Campaign from various sites within the city. Individual particle analysis by different electron microscopy methods coupled with energy dispersed x-ray spectroscopy, and secondary ionization mass spectrometry show that freshly-emitted soot particles become rapidly processed in the MCMA. Whereas fresh particulate emissions from mixed-traffic are almost entirely carbonaceous, consisting of soot aggregates with liquid coatings suggestive of unburned lubricating oil and water, ambient soot particles which have been processed for less than a few hours are heavily internally mixed, primarily with ammonium sulfate. Single particle analysis suggests that this mixing occurs through several mechanisms that require further investigation. In light of previously published results, the internally-mixed nature of processed soot particles is expected to affect heterogeneous chemistry on the soot surface, including interaction with water during wet-removal

    The role of informal dimensions of safety in high-volume organisational routines:an ethnographic study of test results handling in UK general practice

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    Abstract Background The handling of laboratory, imaging and other test results in UK general practice is a high-volume organisational routine that is both complex and high risk. Previous research in this area has focused on errors and harm, but a complementary approach is to better understand how safety is achieved in everyday practice. This paper ethnographically examines the role of informal dimensions of test results handling routines in the achievement of safety in UK general practice and how these findings can best be developed for wider application by policymakers and practitioners. Methods Non-participant observation was conducted of high-volume organisational routines across eight UK general practices with diverse organisational characteristics. Sixty-two semi-structured interviews were also conducted with the key practice staff alongside the analysis of relevant documents. Results While formal results handling routines were described similarly across the eight study practices, the everyday structure of how the routine should be enacted in practice was informally understood. Results handling safety took a range of local forms depending on how different aspects of safety were prioritised, with practices varying in terms of how they balanced thoroughness (i.e. ensuring the high-quality management of results by the most appropriate clinician) and efficiency (i.e. timely management of results) depending on a range of factors (e.g. practice history, team composition). Each approach adopted created its own potential risks, with demands for thoroughness reducing productivity and demands for efficiency reducing handling quality. Irrespective of the practice-level approach adopted, staff also regularly varied what they did for individual patients depending on the specific context (e.g. type of result, patient circumstances). Conclusions General practices variably prioritised a legitimate range of results handling safety processes and outcomes, each with differing strengths and trade-offs. Future safety improvement interventions should focus on how to maximise practice-level knowledge and understanding of the range of context-specific approaches available and the safeties and risks inherent in each within the context of wider complex system conditions and interactions. This in turn has the potential to inform new kinds of proactive, contextually appropriate approaches to intervention development and implementation focusing on the enhanced deliberation of the safety of existing high-volume routines

    Unlearning and patient safety

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    This chapter adds to the growing body of literature on unlearning by contributing a model applicable to the context of professional organisations, and more specifically to healthcare and patient safety. An overview of the global patient safety agenda is described and a gap in implementing sustained safety improvement identified. The UK’s efforts to bridge this gap in patient safety by transforming their NHS into a ‘learning organisation’ are discussed. The unlearning literature is reviewed and an updated model of unlearning conceptualized that contains three dimensions relevant to the study of professionals: cognitive, cultural and political. As a research agenda, this chapter provides a starting point for thinking about how unlearning can be studied in organisations; establishing a theoretical foundation for future study

    "Poof! a'm heppily saving the Lord...": multimodality and evaluative discourses in male toilet graffiti at the University of the Western Cape

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    This paper explores the use of punctuation, capitalisation, linguistic forms and images in the construction of evaluative discourses in male toilet graffiti at the University of the Western Cape. Of particular interest is how male students use these devises in the discursive construction of the appraisal resource of Attitude, Graduation and Evaluation. Using over 150 tokens of graffiti, the paper uses a multimodal approach employing notions of resemiotisation and remediation to show how taboo language, font size, images and sketches are repurposed to aid the evaluation of the 'self' and the 'other' in toilet graffiti. The paper shows that through utilising multimodal texts, graffiti writers are able to reformulate and situate novel meanings in contexts; and in terms of appraisal, the verbal and non-verbal semiotic material are strategically combined to engender novel evaluations

    Re-storying and visualizing the changing entrepreneurial identities of Bill Gates and Richard Branson.

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    The storytelling in textual and visual re-constructions of Bill Gates and Richard Branson by their organizations produces entrepreneurial identities bound into particular social power-knowledge relations. Our purpose is to examine how these organizations, and their critics, mobilize storytelling in acts of re-storying (enlivening) or re-narrating (branding a monologic) practices using Internet technologies to invite viewers to frame the world of entrepreneurship. We use visual discourse and storytelling methods to analyze how Microsoft and Virgin Group use various kinds of entrepreneurial images and textual narratives to re-narrate and produce particular brands of capitalism. These organizations' scoptic regimes of representation are contested in counter-visualizing and counterstory practices of external stakeholders. We suggest that the image and textual practices of storytelling have changed as both entrepreneurs court philanthropic and social entrepreneur identity markers. Our contribution to entrepreneurial identity is to apply double and multiple narrations, the appropriation of another's narrative words (or images) into another's narrative, and relate such storytelling moves to visuality

    Conceptual and practical challenges for implementing the communities of practice model on a national scale - a Canadian cancer control initiative

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    <p>Abstract</p> <p>Background</p> <p>Cancer program delivery, like the rest of health care in Canada, faces two ongoing challenges: to coordinate a pan-Canadian approach across complex provincial jurisdictions, and to facilitate the rapid translation of knowledge into clinical practice. Communities of practice, or CoPs, which have been described by Etienne Wenger as a collaborative learning platform, represent a promising solution to these challenges because they rely on bottom-up rather than top-down social structures for integrating knowledge and practice across regions and agencies. The communities of practice model has been realized in the corporate (e.g., Royal Dutch Shell, Xerox, IBM, etc) and development (e.g., World Bank) sectors, but its application to health care is relatively new. The Canadian Partnership Against Cancer (CPAC) is exploring the potential of Wenger's concept in the Canadian health care context. This paper provides an in-depth analysis of Wenger's concept with a focus on its applicability to the health care sector.</p> <p>Discussion</p> <p>Empirical studies and social science theory are used to examine the utility of Wenger's concept. Its value lies in emphasizing learning from peers and through practice in settings where innovation is valued. Yet the communities of practice concept lacks conceptual clarity because Wenger defines it so broadly and sidelines issues of decision making within CoPs. We consider the implications of his broad definition to establishing an informed nomenclature around this specific type of collaborative group. The CoP Project under CPAC and communities of practice in Canadian health care are discussed.</p> <p>Summary</p> <p>The use of communities of practice in Canadian health care has been shown in some instances to facilitate quality improvements, encourage buy in among participants, and generate high levels of satisfaction with clinical leadership and knowledge translation among participating physicians. Despite these individual success stories, more information is required on how group decisions are made and applied to the practice world in order to leverage the potential of Wenger's concept more fully, and advance the science of knowledge translation within an accountability framework.</p
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