Excellent patient environments within acute NHS trusts: external influences and trust characteristics

Purpose – The purpose of this paper is to investigate the possible common factors in 15 Acute Hospital Trusts in the UK that achieved excellent scores at all their sites in four years of national Patient Environment audits. Design/methodology/approach – A desk-based study tested for external factors, organisational commonalities or particular contractual arrangements which the sample might have in common. A second piece of work was then undertaken; an ethnographic study that examined the behaviours exhibited by 22 managers in six of the trusts. The second phase of research will be described in a separate paper. Findings – The research found that no external, organisational or contractual commonalities could be identified as shared by the trusts that formed the Research Group. This led the researchers to ask further questions as to the management/leadership of the FM Managers who had achieved consistantly high standards of Patient Environment over the four year period. Practical implications – The research reveals that the trusts which achieved high standards of Patient Environment had no shared advantage in terms of external, organisational or contract characteristics. Thus, it should be possible for all trusts to achieve consistently high standards. Originality/value – This is believed to be the only study looking at influences and characteristics that are outside the FM Managers’ control and impact on the FMs’ ability to deliver consistantly high standards.</p

Making A Difference

Volunteering at the ANA meant helping new Americans feel welcome in a new place. It meant helping people feel capable at new things, make connections, and feel like they belong. We assisted them to become leaders of tomorrow. By lending a helping hand to a family, we were embraced by the sharing of two totally different yet very similar cultures. They taught us, we taught the

Basaltic Lava Domes, Lava Lakes, and Volcanic Segmentation on the Southern East Pacific Rise

Meter-scale DSL-120 sonar mapping and coregistered Argo II photographic observations reveal changes in eruptive style that closely follow the third-order structural segmentation of the ridge axis on the southern East Pacific Rise, 17o11\u27-18o37\u27S. Near segment ends we observe abundant basaltic lava domes which average 20 rn in height and 200 rn in basal diameter and have pillow lava as the dominant lava morphology. The ubiquity of pillow lava suggests low effusion rate eruptions. The abundance of lava domes suggests that the fissure eruptions were of sufficient duration to focus and produce a line of volcanic edifices. Near segment centers we observe fewer but larger lava domes, voluminous drained and collapsed lava lakes, and smooth lobate and sheet lava flows with very little pillow lava. The abundance of sheet flows suggests that high effusion rate eruptions are common. Fewer lava domes and large lava lakes suggest that fissure eruptions do not focus to point sources. This pattern was observed on eight third-order ridge segments suggesting that a fundamental volcanic segmentation of the ridge occurs on this scale. The third-order segment boundaries also correlate with local maxima in the seismicaxial magmac hamber reflector depth throughout the study area and decreased across-axis width of the region of seismic layer 2A thickening along the one segment where sufficient cross-axis seismic lines exist. The geochemically defined magmatic segment boundaries in the study area match the locations of our volcanic segment boundaries, although rocks ampling density is not adequate to constrain the variation across all the third-order volcanic segments that we identify. These observations suggest that variation in the processes of crustal accretion along axis occurs at a length scale of tens of kilometers on superfast spreading (\u3e 140 km/Myr full rate) mid-ocean ridges

Probing the National Geoscience Faculty Survey for Reported Use of Practices that Support Inclusive Learning Environments in Undergraduate Courses

What is the extent to which college and university geoscience faculty report using education practices that contribute to more inclusive learning environments and engage a diverse population of students? In the 2016 National Geoscience Faculty Survey, faculty answered questions about their practices in a specific introductory or major course they had taught in the previous two years, and about how they share and learn about the content and methods used in their teaching. Based on factor analysis, 22 of the survey questions divided into four categories associated with inclusive teaching practices: geoscientist representations, curricular choices, learning strategies, and career pathways. The self-reported use of practices across these four categories varies greatly, with some used by as many as 71% of faculty respondents whereas others by only 8%. These data provide new information on the current state of teaching practices in the geosciences with regard to inclusive practices, and establish a baseline to which responses from future surveys may be compared. Univariate general modeling combined with ANOVA tests on the responses to the questions shows that education practices differ based on variables such as teaching style, communication with colleagues, years of teaching experience, faculty type, institution type, class size, and course type (introductory or major). These differences suggest opportunities for focused geoscience faculty development around education practices that support the success of a diverse population of undergraduate students and the enhancement of inclusive learning environments in the geosciences

Burning pain secondary to clozapine use: a case report.

BACKGROUND: The first of the atypical antipsychotics introduced in the 1970s, clozapine remains the most efficacious neuroleptic to this day. However, serious and potentially fatal side effects have necessitated careful regular monitoring among prescribing clinicians. Some adverse effects (e.g. ischaemic bowel) remain under recognized, while newly identified adverse effects continue to be described in the literature. CASE PRESENTATION: In this report, we describe a healthy 43-year old Caucasian male who experienced onset of a full body deep burning pain several months after the onset of treatment with clozapine. The pain worsened over time, ceased with cessation of treatment, and returned soon after the patient was rechallenged. CONCLUSION: We describe an unusual adverse effect from clozapine treatment that has not been described elsewhere to our knowledge. We present the time course of the pain symptom, relationship to dose, associated laboratory results, and ultimately how it was dealt with and how it improved for the benefit of clinicians who may encounter it in the future

Excellent patient environments within acute NHS trusts: The leaders who enable them.

No abstract provided