The mental health safety improvement programme: a national quality improvement collaborative to reduce restrictive practice in England

In 2018, 38 mental health inpatient wards belonging to NHS trusts across England took part in the national reducing restrictive practice collaborative project, which aimed to reduce the use of rapid tranquillisation, restraint and seclusion of patients by 33%. Teams were supported to use quality improvement tools by skilled coaches as part of a national collaborative learning system. At the end of the programme, the overall use of restrictive practice had reduced by 15%. Of the teams that achieved improvements, the average reduction in restrictive practice was 61%. Across the collaborative there were improvements in the mean monthly use of restraints and rapid tranquillisation, and in the total use of all three measures of restrictive practice combined. Support from quality improvement coaches allowed ideas to be tested across the collaborative, enabling the creation of a theory of change for reducing restrictive practice based on areas with a high degree of belief to inform future improvement work in this area

The Dwarf Galaxy Population of the Dorado group down to Mv=-11

We present V and I CCD photometry of suspected low-surface brightness dwarf galaxies detected in a survey covering ~2.4 deg^2 around the central region of the Dorado group of galaxies. The low-surface brightness galaxies were chosen based on their sizes and magnitudes at the limiting isophote of 26.0V\mu. The selected galaxies have magnitudes brighter than V=20 (Mv=-11 for an assumed distance to the group of 17.2 Mpc), with central surface brightnesses \mu0>22.5 V mag/arcsec^2, scale lengths h>2'', and diameters > 14'' at the limiting isophote. Using these criteria, we identified 69 dwarf galaxy candidates. Four of them are large very low-surface brightness galaxies that were detected on a smoothed image, after masking high surface brightness objects. Monte Carlo simulations performed to estimate completeness, photometric uncertainties and to evaluate our ability to detect extended low-surface brightness galaxies show that the completeness fraction is, on average, > 80% for dwarf galaxies with $-17<M_{V}<-10.5$ and 22.5<\mu0<25.5 V mag/arcsec^2, for the range of sizes considered by us (D>14''). The V-I colors of the dwarf candidates vary from -0.3 to 2.3 with a peak on V-I=0.98, suggesting a range of different stellar populations in these galaxies. The projected surface density of the dwarf galaxies shows a concentration towards the group center similar in extent to that found around five X-ray groups and the elliptical galaxy NGC1132 studied by Mulchaey and Zabludoff (1999), suggesting that the dwarf galaxies in Dorado are probably physically associated with the overall potential well of the group.Comment: 32 pages, 16 postscript figures and 3 figures in GIF format, aastex v5.0. To appear in The Astronomical Journal, January 200

Selling Ethics: Discourses of Responsibility in Tourism

10.1080/24694452.2016.1218266Annals of the American Association of Geographers1071218-23