Change of managerial roles of doctors in hospitals: what can we learn from the British?

Niniejszy artykuł przedstawia role medical managers i nastawienie do nich prezentowane przez brytyjskich i polskich lekarzy oraz ewolucję tego nastawienia w ostatnich dekadach. Artykuł powstał na podstawie analizy literatury, dokumentów systemowych, statystyk dotyczących ochrony zdrowia oraz wywiadów półustrukturyzowanych.W wyniku badania stwierdzono, że w przeszłości lekarze niechętnie podejmowali role zarządcze w brytyjskim systemie ochrony zdrowia, natomiast w polskim – byli nimi zainteresowani. Zmiany w obu krajach (większa orientacja rynkowa, polityka prowadzona w Wielkiej Brytanii) zmieniły omawiane nastawienie lekarzy. Obecnie w Wielkiej Brytanii lekarze wykazują chęć podejmowania ról zarządczych, a w Polsce w publicznych szpitalach lekarze są mniej zainteresowani takimi stanowiskami, w związku z pojawianiem się większych korzyści finansowych za wykonywanie zadań klinicznych. W szpitalach prywatnych natomiast lekarze lepiej rozumieją potrzebę współpracy z menedżerami i z innymi grupami zawodowymi.This paper surveys the attitudes to managerial roles shown by Polish and British doctors and their evolution over the past decades. The paper is based on a review and analysis of literature, policy documents, healthcare statistic sand semi-structured interviews. Results of this research show that in the past doctors were reluctant to assume managerial roles in the UK system, whereas they were actually keen to do so in the Polish one. Changes in both countries (more market orientation in both countries, UK state policy) changed the doctors’ attitude to management. In the UK, doctors are at the moment more interested in taking on managerial responsibilities, while in Poland they are less interested in doing so in public hospitals due to the financial incentives attached to clinical work. In private hospitals, however, doctors understand the need for collaboration with general managers and other professional groups

Photogrammetry and ballistic analysis of a high-flying projectile in the STS-124 space shuttle launch

A method combining photogrammetry with ballistic analysis is demonstrated to identify flying debris in a rocket launch environment. Debris traveling near the STS-124 Space Shuttle was captured on cameras viewing the launch pad within the first few seconds after launch. One particular piece of debris caught the attention of investigators studying the release of flame trench fire bricks because its high trajectory could indicate a flight risk to the Space Shuttle. Digitized images from two pad perimeter high-speed 16-mm film cameras were processed using photogrammetry software based on a multi-parameter optimization technique. Reference points in the image were found from 3D CAD models of the launch pad and from surveyed points on the pad. The three-dimensional reference points were matched to the equivalent two-dimensional camera projections by optimizing the camera model parameters using a gradient search optimization technique. Using this method of solving the triangulation problem, the xyz position of the object's path relative to the reference point coordinate system was found for every set of synchronized images. This trajectory was then compared to a predicted trajectory while performing regression analysis on the ballistic coefficient and other parameters. This identified, with a high degree of confidence, the object's material density and thus its probable origin within the launch pad environment. Future extensions of this methodology may make it possible to diagnose the underlying causes of debris-releasing events in near-real time, thus improving flight safety.Comment: 26 pages, 11 figures, 3 table

Polish and UK doctors' engagement with hospital management

Purpose – The purpose of this paper is to present the findings of a short research project, conducted in 2010 as part of a larger EU funded action investigating the participation and impact of doctors in management. The authors sought to compare the ways in which hospital doctors in the UK and Poland – countries with distinct histories – participate in management; whether they are converging and whether the type of participation found results from changes in the governance and management of these systems. Design/methodology/approach – First, a review of existing evidence and an analysis of policy documents and healthcare statistics were conducted. Identifying a lack of empirical data in the Polish context, and a potentially changing situation in the UK, the authors proceeded to collect some exploratory data in Poland, via interviews with expert informants, and to draw on data collected alongside this study in the UK from qualified doctors participating in research on management and leadership development. Findings – Hospital doctors currently hold similar types of management role in both systems, but there are signs that change is underway. In Poland, different types of medical manager and role are now emerging, whereas in the UK younger doctors appear to be expecting greater management responsibility in the future, and are starting to take up the management training now on offer. Research limitations/implications – The potential implications of these changes for the profession and policymakers in both Poland and the UK are discussed, with opportunities for further research highlighted. Originality/value – The paper provides a comparison of how medical engagement within two systems with different histories is occurring, and also of the changes underway. It provides some much needed initial insight via interviews with expert informants within the polish system, which has been under-researched in relation to the involvement of medicine in management

The XMM Cluster Survey: The interplay between the brightest cluster galaxy and the intra-cluster medium via AGN feedback

Using a sample of 123 X-ray clusters and groups drawn from the XMM-Cluster Survey first data release, we investigate the interplay between the brightest cluster galaxy (BCG), its black hole, and the intra-cluster/group medium (ICM). It appears that for groups and clusters with a BCG likely to host significant AGN feedback, gas cooling dominates in those with Tx > 2 keV while AGN feedback dominates below. This may be understood through the sub-unity exponent found in the scaling relation we derive between the BCG mass and cluster mass over the halo mass range 10^13 < M500 < 10^15Msol and the lack of correlation between radio luminosity and cluster mass, such that BCG AGN in groups can have relatively more energetic influence on the ICM. The Lx - Tx relation for systems with the most massive BCGs, or those with BCGs co-located with the peak of the ICM emission, is steeper than that for those with the least massive and most offset, which instead follows self-similarity. This is evidence that a combination of central gas cooling and powerful, well fuelled AGN causes the departure of the ICM from pure gravitational heating, with the steepened relation crossing self-similarity at Tx = 2 keV. Importantly, regardless of their black hole mass, BCGs are more likely to host radio-loud AGN if they are in a massive cluster (Tx > 2 keV) and again co-located with an effective fuel supply of dense, cooling gas. This demonstrates that the most massive black holes appear to know more about their host cluster than they do about their host galaxy. The results lead us to propose a physically motivated, empirical definition of 'cluster' and 'group', delineated at 2 keV.Comment: Accepted for publication in MNRAS - replaced to match corrected proo

Extensive and intensive globalizations: explicating the low connectivity puzzle of U.S. cities using a city-dyad analysis

This article reports an experiment in world city network analysis focusing on city-dyads. Results are derived from an unusual principal components analysis of 27,966 city-dyads across 5 advanced producer service sectors. A 2-component solution is found that identifies different forms of globalization: extensive and intensive. The latter is characterized by very high component scores and describes the more important city-dyads focused upon London-New York (NYLON). The extensive globalization component heavily features London and New York but with each linked to less important cities. U.S. cities score relatively high on the intensive globalization component and we use this finding to explain the low connectivities of U.S. cities in previous studies of the world city network. The two components are tentatively interpreted in world-systems terms: intensive globalization is the process of core-making through city-dyads; extensive globalization is the process of linking core with non-core through city-dyads

Versatile Aggressive Mimicry of Cicadas by an Australian Predatory Katydid

Background: In aggressive mimicry, a predator or parasite imitates a signal of another species in order to exploit the recipient of the signal. Some of the most remarkable examples of aggressive mimicry involve exploitation of a complex signal-response system by an unrelated predator species. Methodology/Principal Findings: We have found that predatory Chlorobalius leucoviridis katydids (Orthoptera: Tettigoniidae) can attract male cicadas (Hemiptera: Cicadidae) by imitating the species-specific wing-flick replies of sexually receptive female cicadas. This aggressive mimicry is accomplished both acoustically, with tegminal clicks, and visually, with synchronized body jerks. Remarkably, the katydids respond effectively to a variety of complex, species-specific Cicadettini songs, including songs of many cicada species that the predator has never encountered. Conclusions/Significance: We propose that the versatility of aggressive mimicry in C. leucoviridis is accomplished by exploiting general design elements common to the songs of many acoustically signaling insects that use duets in pairformation. Consideration of the mechanism of versatile mimicry in C. leucoviridis may illuminate processes driving the evolution of insect acoustic signals, which play a central role in reproductive isolation of populations and the formation of species

A catalogue of structural and morphological measurements for DES Y1

We present a structural and morphological catalogue for 45 million objects selected from the first year data of the Dark Energy Survey (DES). Single Sersic fits and non-parametric ´ measurements are produced for g, r, and i filters. The parameters from the best-fitting Sersic ´ model (total magnitude, half-light radius, Sersic index, axis ratio, and position angle) are mea- ´ sured with GALFIT; the non-parametric coefficients (concentration, asymmetry, clumpiness, Gini, M20) are provided using the Zurich Estimator of Structural Types (ZEST+). To study the statistical uncertainties, we consider a sample of state-of-the-art image simulations with a realistic distribution in the input parameter space and then process and analyse them as we do with real data: this enables us to quantify the observational biases due to PSF blurring and magnitude effects and correct the measurements as a function of magnitude, galaxy size, Sersic ´ index (concentration for the analysis of the non-parametric measurements) and ellipticity. We present the largest structural catalogue to date: we find that accurate and complete measurements for all the structural parameters are typically obtained for galaxies with SEXTRACTOR MAG AUTO I ≤ 21. Indeed, the parameters in the filters i and r can be overall well recovered up to MAG AUTO ≤ 21.5, corresponding to a fitting completeness of ∼90 per cent below this threshold, for a total of 25 million galaxies. The combination of parametric and non-parametric structural measurements makes this catalogue an important instrument to explore and understand how galaxies form and evolve. The catalogue described in this paper will be publicly released alongside the DES collaboration Y1 cosmology data products at the following URL: https://des.ncsa.illinois.edu/releases

Trivial and normative? Online fieldwork within YouTube’s beauty community

In this article, I discuss methodological understandings around qualitative research and online ethnographic practice to bring forward a reflexive account on the particularities of doing fieldwork on YouTube. I draw from a multiyear ethnographic examination of YouTube’s beauty community that sought to understand online popularity framed by local norms and practices and shed light into the local significance of knowledge, expertise, and self-development. I argue for an epistemological perspective that acknowledges the diversity of viable, conceivable fieldwork experiences while distancing from prescriptive modes of argumentation. I propose seeing fieldwork in and through its richness and predicaments, persistently naturalistic while interpretive. I approach online popularity, fandom, and even YouTube itself from a perspective that tolerates ambivalence, contradictions, and embraces the complexity of social worlds and human interaction

Untangling approaches to management and leadership across systems of medical education

Aims: How future doctors might be educated and trained in order to meet the population and system needs of countries is currently being debated. Incorporation of a broad range of capabilities, encompassed within categories of management and, increasingly, leadership, form part of this discussion. The purpose of this paper is to outline a framework by which countries’ progress in this area might be assessed and compared. Methods: Key databases and journals related to this area were reviewed. From relevant articles potential factors impacting on the incorporation of aspects of management and leadership within medical education and training were identified. These factors were tested via an online survey during 2013 with six members of a European Association of doctors who promote medical involvement in hospital management, including members from countries less represented in the health management literature. Results: A framework for analysing how management and leadership education is being approached within different systems of healthcare is developed and presented. Conclusions: More systematic work across a wider range of countries is needed if we are to have a better understanding of how countries within and beyond Europe are approaching and progressing the education of doctors in management and leadership. Keywords: Medical education, Management, Leadership, Competency framework